Friday, September 22, 2023

"Cha-Ching!" Lina Khan Attacks Private Equity in Health Care

FTC Chair Lina Khan is getting more aggressive, targeting individual Amazon executives, and seeking to stop a brazen scheme to monopolize health care in Texas. Private equity is big mad. MATT STOLLER SEP 22, 2023 -- article link

Wednesday, September 20, 2023

Understanding & Fighting Investor Ownership of Health Care Summary: Private for-profit ownership of health care is undermining the health care mission, diverting care resources to shareholder bank accounts. Single payer financing is not enough … we need to resist the corporate takeover. Two important webinars are coming up NEXT WEEK. Listen in, and get involved. Medicare for All Is Not Enough The Nation March 31, 2022 By David U. Himmelstein, Steffie Woolhandler, Adam Gaffney, Don McCanne, John Geyman covered in HJM here Dr. Glaucomflecken videos (2 min each) 30 Days of US Healthcare: United Healthcare For All September 20, 2023 30 Days of US Healthcare: Private Equity Visits Rural Medicine September 19, 2023 30 Days of US Healthcare: Physician Owned Hospitals September 9, 2023 Comment by: Don McCanne Single payer financing meets the goal of insuring everyone, funded equitably through progressive taxation. However, it is incapable of controlling the dictates of private ownership with a primary mission of increasing private wealth as opposed to providing the public service of health care for all. Private equity is acquiring not only facilities but also the health care professional groups staffing these facilities. Our article in The Nation summarizes these terrible trends, and Dr. Glaucomflecken distills the problems with his astringent humor. The public service model of single payer cannot work in a system designed to pump up the coffers of billionaires. Two zoom webinars NEXT WEEK address the hazards of private ownership in health care: 1) The Lancet Webinars: Public policy and health in the USA miniseries: should investors own healthcare? Tuesday September 26, 2023 2 pm EDT / 11 am PDT Register here Four US experts will examine the implications of growing investor ownership of physicians' practices, hospitals, and other health services in the US, and their consolidation into giant corporate enterprises that dominate insurance and care delivery in many regions of the US. Panelists are luminaries Don Berwick, Rosemary Batt, Steffie Woolhandler, and Claudia Fegan. 2) Health Affairs: Briefing: How the Ownership and Structure of Health Care Entities Affect Clinicians & Patients Wednesday September 27, 2023 2 pm EDT / 11 am PDT Register here WATCH THE ZOOM MEETINGS AND THEN WORK TOGETHER TO FIGHT THIS PROCESS. WE HAVE TO DO IT. SINGLE PAYER WILL GO NOWHERE IF WE DO NOT ADDRESS THE OWNERSHIP HARM CAUSED BY THE BILLIONAIRES. WE HAVE TO REBUILD THE SYSTEM! In solidarity and with love, Don

Sunday, August 13, 2023

Basic library of universal health care

Basic library of universal health care What is “Single Payer” and What is it Not? By KIP SULLIVAN and JOEL CLEMMER. As the single-payer solution has become more popular, the phrase “single-payer” has been misinterpreted by both proponents and opponents of universal coverage. It is extremely important that the public understand what the phrase means. Link to copy with the links to articles Healing Health Care: The Case For A Comprehensive Universal Health System By JOHN MARTY. Roseville, MN, Birch Grove Publishing, 2016. The lead author of The Minnesota Health Plan and well-known state Senator brings it home with a specific proposal for our state. The fundamental arguments for universal care are here, as are extensive footnotes to peer-reviewed science. A free download is available. The Healing of America: A Global Quest For Better, Cheaper, And Fairer Health Care By T. R. REID. New York, Penquin, 2009. A very accessible 30,000 foot view of national health care systems. This comparative approach puts our non-system into perspective. Available through libraries and stores. FIX IT – Healthcare At The Tipping Point Unfinished Business Foundation This docuseries addresses many issues within our healthcare system in the United States. It is eye-opening and very informative. CLICK HERE to visit their website. Rethinking Consumerism in Healthcare Benefit Design CONSUMERS UNION, Research Brief No. 11, April 2016 Isn’t it all about high deductibles driving health care “consumers” with “skin in the game” to shop wisely in the health marketplace? Doesn’t “market magic” ensue? The organization behind Consumers Reports says – usually not. . . Continue reading It’s The Prices, Stupid: Why The United States Is So Different From Other Countries By GERARD F. ANDERSON, UWE E. REINHARDT, PETER S. HUSSEY and VARDUI PETROSYAN Health Affairs, 22, no.3 (2003): 89-105 Everyone now admits that health care costs are high in the U.S. But that is because greedy American doctors looking for extra fees and overly demanding patients utilize too much medicine, right? The facts say otherwise. . . Continue reading Medicare at 50: Why Medicare-for-all Did Not Take Place By THEODORE R. MARMOR and KIP SULLIVAN Yale Journal of Health Policy, Law, and Ethics, Volume 15, Issue 1, Article 9, 2015 Universal health care has been a popular goal in the U.S. and the Medicare system would appear to offer a way forward. Why did it never happen? The rise of managed care and the myth of competitive markets in health coverage offer and explanation and say a lot about where we are now. . . . Continue reading or download from Yale’s digital commons site.

Friday, July 21, 2023

Health Care Financing Issues

NY Times Tantalizingly Close On Health Care Financing Issues Post author By Admin2 Post date July 20, 2023 No Commentson NY Times Tantalizingly Close On Health Care Financing Issues Summary: This week, a profile of challenges facing the UK NHS and an op-ed proposing universal coverage in the US got so many issues right. But they critically missed on pivotal pillars of successful health care financing: adequate funding and comprehensiveness of coverage. A National Treasure, Tarnished: Can Britain Fix Its Health Service? New York Times July 16, 2023 By Mark Landler As it turns 75 this month, the N.H.S., a proud symbol of Britain’s welfare state, is in the deepest crisis of its history: flooded by aging, enfeebled patients; starved of investment in equipment and facilities; and understaffed by doctors and nurses, many of whom are so burned out that they are either joining strikes or leaving for jobs abroad. … Health care spending rose by an average of less than 2 percent a year from 2010 to 2019, compared with 5.1 percent from 1998 to 2008. Britain spent less a year per person on health care than the wealthiest European Union countries during the decade of austerity, and now has fewer doctors and hospital beds per capita than its European neighbors. Its capital investment lagged the bloc’s average by $41 billion, according to the Health Foundation, which tracks the industry. We’re Already Paying for Universal Health Care. Why Don’t We Have It? New York Times July 18, 2023 By Liran Einav and Amy Finkelstein There is no shortage of proposals for health insurance reform, and they all miss the point. They invariably focus on the nearly 30 million Americans who lack insurance at any given time. But the coverage for the many more Americans who are fortunate enough to have insurance is deeply flawed. Health insurance is supposed to provide financial protection against the medical costs of poor health. Yet many insured people still face the risk of enormous medical bills for their “covered” care. A team of researchers estimated that as of mid-2020, collections agencies held $140 billion in unpaid medical bills, reflecting care delivered before the Covid-19 pandemic. To put that number in perspective, that’s more than the amount held by collection agencies for all other consumer debt from nonmedical sources combined. As economists who study health insurance, what we found really shocking was our calculation that three-fifths of that debt was incurred by households with health insurance. What’s more, in any given month, about 11 percent of Americans younger than 65 are uninsured. But more than twice that number — one in four — will be uninsured for at least some time over a two-year period. Many more face the constant danger of losing their coverage. Perversely, health insurance — the very purpose of which is to provide a measure of stability in an uncertain world — is itself highly uncertain. And while the Affordable Care Act substantially reduced the share of Americans who are uninsured at a given time, we found that it did little to reduce the risk of insurance loss among the currently insured. It’s tempting to think that incremental reforms could address these problems. For example, extend coverage to those who lack formal insurance. Make sure all insurance plans meet some minimum standards. Change the laws so that people don’t face the risk of losing their health insurance coverage when they get sick, when they get well (yes, that can happen) or when they change jobs, give birth or move. But those incremental reforms won’t work. Over a half-century of such well-intentioned, piecemeal policies has made clear that continuing this approach represents the triumph of hope over experience, to borrow a description of second marriages commonly attributed to Oscar Wilde. … Coverage needs to be free at the point of care — no co-pays or deductibles — because leaving patients on the hook for large medical costs is contrary to the purpose of insurance. A natural rejoinder is to go for small co-pays — a $5 co-pay for prescription drugs or $20 for a doctor visit — so that patients make more judicious choices about when to see a health care professional. Economists have preached the virtues of this approach for generations. But it turns out there’s an important practical wrinkle with asking patients to pay even a very small amount for some of their universally covered care: There will always be people who can’t manage even modest co-pays. … Finally, coverage must be basic because we are bound by the social contract to provide essential medical care, not a high-end experience. Those who can afford and want to can purchase supplemental coverage in a well-functioning market. Keeping universal coverage basic will keep the cost to the taxpayer down as well. It’s true that as a share of its economy, the United States spends about twice as much on health care as other high-income countries. But in most other wealthy countries, this care is primarily financed by taxes, whereas only about half of U.S. health care spending is financed by taxes. For those of you following the math, half of twice as much is … well, the same amount of taxpayer-financed spending on health care as a share of the economy. In other words, U.S. taxes are already paying for the cost of universal basic coverage. Americans are just not getting it. They could be. We … were struck — and humbled — to realize that at a high level, the key elements of our proposal are ones that every high-income country (and all but a few Canadian provinces) has embraced: guaranteed basic coverage and the option for people to purchase upgrades. Comment by: Jim Kahn & Don McCanne The profile of UK NHS challenges is vivid and compelling in portraying the financial and associated operational and clinical problems plaguing that system. And, buried deep into the article, they do mention, in passing, the reason: “Health care spending rose by an average of less than 2 percent a year from 2010 to 2019, compared with 5.1 percent from 1998 to 2008.” Let’s be appropriately blunt about this: The Conservative Party (the Tories) are intentionally bleeding the system, since 2010 putting the NHS on austerity footing. See HJM discussion here. Privatization is driving up family financial burdens and increasing mortality. Thus, the crisis is intentional, policy- and politics-driven. The good news is that there is a good chance that the Tories will pay a steep political price for this evisceration of the popular NHS. Turning to the US: Wow, Einav and Finkelstein got so much right. The health insurance system is fundamentally broken, unfixable. We need free, universal coverage. Just what we in the single payer movement have been saying for decades. Just what all other wealthy nations do. But wait, “basic”? What does that mean? The article doesn’t elaborate (their book, to be released later this month, lays out some principles if not a definitive definition …). We don’t like the sound of it. If “basic” means “access to under-funded and over-stretched providers,” that’s a recipe for a two-tiered system with divergent political interests, like we have for schools. If basic means excluding a subset of medical services, what would we comfortably omit? Not a good solution. On the other hand, if “basic” means “everything necessary for quality medical care, and no fluff” that could be fine. As long as “medical care” includes inpatient, outpatient, drugs, mental health, dental, vision, medical equipment … everything medically indicated. That’s what other countries do: supplemental insurance is typically just a few percent of total health spending, for example providing access to private hospitals or specialists in a system with excellent public care. Long-term care should be in the “basic” category too. We think it will be impossible to define “basic” narrowly in a way that is medically sound and doesn’t lead to operational and political fractures. The good news is, we don’t need to be stingy. Analyses of single payer demonstrate that we can provide standardized, comprehensive coverage and still save money for the system and for households. Our colleague Ed Weisbart put it very well: “Two-tiered systems become as underfunded as the UK’s National Health Service, and outcomes degrade. We’re either all in this together, as a society that looks out for each other, or it’s Game of Thrones for us all.”

Thursday, July 13, 2023

Rose Roach talks about nurses, unions, single-payer. July 11, 2023 at OPS Office Hours

Joel Clemmer via Jul 12, 2023, 7:32 PM (12 hours ago) to GreatNorthernHealth Minnesota had a great legislative system and that goes for healthcare reform, too. Rose Roach is former head of MN Nurses Union and current head of Healthcare for Minnesota NOW and she is the perfect person to summarize. She just did so in a presentation to One Payer States. See the announcement below. Typical for Rose, it is high-energy and very pertinent. I especially liked her spontaneous editorial on MN Attorney General Ellison. The direct URL is . Joel Clemmer Rose gave an excellent presentation last night at the Tuesday, July 11, 2023, OPS Office Hours. Topic: Unions, Nurses, State-based Universal Healthcare Click HERE view her slides and text. Click HERE to view. the video Speaker: Rose Roach, Volunteer director of Unions for Single Payer Rose discussed foundational legislation passed in the recent Minnesota state session that will play a role in Minnesota's overall strategy to make single-payer possible. She addressed specific lessons learned related to the nurses but applicable to all of us effectively fighting the medical-industrial complex. She also described Health Care for All MN multi-year statewide campaign to pass the state single-payer bill, the MN Health Plan. Please donate to One Payer States. Your contributions keep these crucial conversations coming to help you educate, agitate, and activate. Mike Huntington 541-829-1182 Secretary, One Payer States

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[GrNoHealth] Private equity is having a moment Full Message with Links Joel Clemmer via Jul 12, 2023, 4:24 PM (15 hours ago) to GreatNorthernHealth This long-ish and optional post has to do with the invasion of healthcare by private equity firms. It recommends three sources of information and perspective: a podcast by Dr. Abdul El-Sayed, an article in the New York Times' Upshot series, and a book by an author with Saint Paul roots. The podcast is an episode of El-Sayed's America Dissected series, among those mounted by Jon Favreau's Crooked Media. Favreau was Barack Obama's Wunderkind head speechwriter. (Check out the excellent Pod Save America when you visit Crooked). Abdul El-Sayed has one of those biographies that makes me think I've wasted my life: Dr. Abdul El-Sayed is a physician, epidemiologist, educator, and public communicator. He is a commentator at CNN and a Contributing Editor at the New Republic, and his newsletter, The Incision, cuts into the trends shaping our moment. His three books include Healing Politics: A Doctor’s Journey into the Heart of Our Political Epidemic (Abrams Press, 2020), which diagnoses our country’s epidemic of insecurity and the empathy politics we will need to treat it; and Medicare for All: A Citizen’s Guide(Oxford University Press, 2021), co-authored with Dr. Micah Johnson, which offers a no nonsense guide to the policy. He is the host of “America Dissected,” a podcast by Crooked Media, which goes beyond the headlines to explore what really matters for our health. He is a Towsley Foundation Policymaker in Residence at the University of Michigan Gerald R. Ford School of Public Policy, and a Senior Fellow at the FXB Center for Health & Human Rights at the Harvard T.H. Chan School of Public Health, teaching at the intersection of public health, public policy, and politics. In addition, he is a Scholar-in-Residence at Wayne State University and American University. Note that he more than gets it about single-payer. El-Sayed discusses the effects of private equity on healthcare with Eileen O'Grady of the Private Equity Stakeholder Project at Highly recommended. peq6.png The second source only just appeared. The Upshot feature of the Times published a frank, evidence-based assessment of private equity in healthcare. The "upshot" of this review is not good. See peq1.png peq2.png peq3.png . . . And this is the study to which this article refers (which I have not read yet). My impression is that it could be a supplemental chapter for Paul Starr's The Social Transformation of American Medicine. peq8.png See Finally, we have Brendon Ballou, who was born in Saint Paul and whose mother some of us know. Both have since moved on, Brendon to Stanford Law. After that, he was Special Counsel for Private Equity in the Justice Department's Antitrust Division.He is ideally suited to write this book, which just appeared to rave reviews. It deals with private equity across all sectors, not just the medical-industrial complex. peq4.png Here is a snippet from the Times' review, which included another book, as well: . . . peq5.png . . . Consider all this as summertime beach reading for nerds. Enjoy! Joel Clemmer