Wednesday, April 7, 2021

The Big Tech of Health Care - The American Prospect

The Big Tech of Health Care - The American Prospect Comment by Don McCanne UnitedHealth/Optum is BIG - the largest health care entity in the U.S. - representing that medical-industrial complex that Arnold Relman warned us about so many years ago. Well, it's here. And it is structured to make money - a lot of it - and patients just happen to be an essential element in their equation, but patient care is an expense. So much of what they do is to create administrative functions that are designed to reduce spending on patients, and, further, to increase revenues by selling those administrative services. By gaining control of much of the industry - hospitals, doctors, pharmacies, insurance functions - they are in a position to dictate the business terms for health care. So what will happen should we ever be able to enact and implement a single payer Medicare for All program? The model calls for negotiating rates with physicians, global budgets for hospitals and bulk purchasing of pharmaceuticals. How do you do that with a mega-corporation like UnitedHealth/Optum? Do you really think that they will accept government negotiations for payment rates for health care entities such as doctors, hospitals and pharmacies while not being paid for their large infrastructure that has been designed to increase revenues? Change Healthcare is a data analytics firm that is used to leverage higher revenues (profits, executive salaries, stock dividends and buybacks); it is not for the purpose of providing quality and value in patient care. Again, the entire corporation is structured to make money with patient services being a necessary expense that is to be minimized as much as possible. Will Medicare for All legislation be written in a way that we can remove passive corporate investors and excess executive salaries from the equation, thus essentially destroying the for-profit corporate structure? Would our conservative courts even uphold such limitations? Health care should be guided by a patient service ethic rather than a business ethic. Can we rein in the medical-industrial complex, or is it too late? The transition to Medicare for all will certainly cross paths with this corporate monster, and something will have to give.

Tuesday, April 6, 2021

The Age of Care | The Nation

The Age of Care | The Nation "... only a radical reconfiguration of the way that health care and other services are delivered to the American people can enhance the dignity and well-being of workers in the caregiving economy. American hospitals and their satellite enterprises must be stripped of their profit-making, empire-building propensities. And for that to happen, we will need to embrace the inherent socialization that must govern health care in our time."

Saturday, April 3, 2021

In U.S., An Estimated 46 Million Cannot Afford Needed Care

In U.S., An Estimated 46 Million Cannot Afford Needed Care Comment by Don McCanne We are spending almost $4 trillion per year on health care, the highest per capita spending of all nations, and yet, because of our dysfunctional health care financing system, far too many U.S. residents are facing potential financial hardship due to these costs. Although the COVID-19 relief bill will provide partial temporary relief for a portion of those affected, it is quite clear that, with the amount we are already spending, the health care financing system still needs major structural reform if we expect to provide affordable access to health care for everyone. Perhaps the most significant finding in this survey is that the majority now supports government action to make health care more affordable. But only 19% of Republicans favor making Medicare available to everyone, and even less, only 15%, support expanding and strengthening the Affordable Care Act. And yet over 70% of Republicans favor setting caps on out-of-pocket costs for Medicare. So do they want the government involved or don't they? Since they have come up with no reasonable alternative (medical savings accounts won't do it), we should move ahead anyway. U.S.-style private insurance is too expensive and inefficient, and they don't really want that anyway based on their opposition to the Affordable Care Act. Although other models exist, the most affordable, comprehensive and effective model is single payer improved Medicare for All. The Republicans can either join us or watch, but their inaction can no longer be tolerated.

Wednesday, March 31, 2021

The Importance of the ‘VA Advantage’ - The American Prospect

The Importance of the ‘VA Advantage’ - The American Prospect Comment by Don McCanne Opponents of single payer Medicare for All tell us, "The government can't do anything right; just look at the VA system." Yes, just look at that system - better outcomes at a lower cost. Of course, providing VA care to everyone would be more like socialized medicine through a national health service, whereas single payer Medicare for All would be a social insurance program with a private health care delivery system. Also Medicare for All would be an improved version of Medicare over what we have right now. The point is that our government can do it better, in this case through Medicare rather than through the private insurance industry, so let's let them do it. After all, it is our government, so it should work for us, not the private insurers.