Thank you! My cost for healthcare (insurance, absurdly high deductibles, et al.) is close to $9K annually. That does NOT include dental costs for which Medicare offers zero help, so these costs are directly out-of-pocket. I am 78-years-old, live on social security, have no portfolios to dip into for unexpected medical issues or any other surprises. I am vibrant, stay active with my writing and art, am a political activist, and love life. I receive help from SNAP (food stamps), which will run out if they haven't already. Normally, I receive $20/month in total. Because of the pandemic, I've received the maximum amount of $250/month. What a difference that has made. It allowed some of us to live a tiny bit better. But why only $20 a month normally? Because my gross social security ($21K) is NOT considered poverty level in New York State. What??? They use an arcane, out-of-date formula to determine how much is allocated to an individual. And, it is not relevant to today's increased food and medical costs.
I've worked since I was seven years old as a performance artist, then marketing consultant, and am finally devoting full time to my writing and photography. I cannot express how important your voice will be in Congress today. Ageism is severe in our country, which few give any focus. It is harsh, judgemental, humiliating. There are inequities, mistreatment and disrespect from the government, from our state representatives, from BIG Pharma, from the young woman who manages our subsidized housing. I know you fight for people of all ages. But I argue for those who can no longer advocate for themselves. I had to sell my car this year. Not because I can no longer drive but to pay off dental expenses. I was doing volunteer work delivering food to the homebound among other efforts. Now, I am one who is homebound.
None of this is right for any age group, every family, unfed children, working moms, single dads--all who have their issues. It is heartbreaking to watch our Congress play the games they choose to play. It is gut-wrenching to watch the powers-that-be get rich on the working poor and the elderly. Shame on us and shame on our healthcare system. What can I do to help?
Lee Anne, Thanks for your important thoughts. How can you help? You can begin by writing your members of Congress (in long hand -- they pay more attention) that you want Medicare for All.
Lee Anne, With a few differences and details, you have written MY LETTER to Robert. Down to going carless, being fairly lively, living on SSA alone, having a fast-dwindling pension and no other resources, still trying to be a part of things, dealing with dental bills, and, oh, also doing a ton of writing and some publishing. (I was an academic wannabe and spent a lot of time writing stuff no one but an academic would read but, between covid-19 and retiring, I am now writing stuff that general readers might want to check out and that is even appealing to me, I think.) The biggest issue I have going is the fact that I have to fund a supplemental insurance policy and that, well, my pension from Macy*s is nearly exhausted and I live in fear for when it's gone. I might add that I am increasingly irritated by word that a 4th stimulus for seniors might show up but never seems to. It would help with the bills since my SSA COLA increase was consumed by inflation as, I guess, yours was.) THe deal with me is that I have pared life down to one specific discretionary expense that I will NOT surrender and writing to this and other sites (and my COngressperson (Zoe Lofgren of the Select Committee and Impeachment trials) in the hopes of supporting those who may be interested in helping. I believe it goes without saying that most of our elected officials are in a higher income bracket and receive more benefits and perks than their own constituents. While I take their duties more seriously than they do (at times), I think that they tend to live in a bubble. However, there are many of us---older, retired/disabled, homeless, working people, families and kids--who will never live in that bubble. I think we still should lay a claim to a decent and secure life--however long or short it may be--and a chance to enjoy, explore, and experience what all too many of our elected representatives take for granted. (Some of them would running screaming from the chambers of government if they were forced to live with the conditions you and I share on a daily basis!) Bravo to you and continue to share your thoughts as I will too. The government needs to respond, to learn what has happened to individuals during the pandemic era and decide to take action (not just talk about it, argue, and decide to throw a tantrum over the opposition). Every single elected official on the city, state, national level should be asking: "What can I do to help my constituents?" This is not a matter of scoring points with the party leaders or avoiding flak from those leaders but of honoring a commitment made to serve and honor the rule of law. Wasn't there an oath of office that they took and that made the same sort of statement?
There is much work to be done and we must not give up. Your story, my story, are like too many others. We will move through this only if we stay the course and make our voices heard with the handwritten letters (see Robert's comment to me above) to our Congress women and men. Local assembly people, too. I know nothing about a fourth stimulus check and with inflation rising so rapidly I doubt that would be on the table. I've received so many wonderful comments and am overwhelmed with the kindred spirits on this forum. A huge THANK YOU, ROBERT, for making it possible for people to exchange ideas and share deep concerns with one another. I end with this quote from Margaret Mead: "Never underestimate the power of a small group of committed people to change the world. In fact, it is the only thing that ever has." 😊💜
Lee Anne, Thanks so much for your immediate response to my comments on your note to Robrt...And thanks for your reference to the quote from Margaret Mead. When I first started on Robert's website, I thought I would most likely be sort of an "odd-duck" and that no one could relate to my experiences and my background. I was very, very wrong as I am finding good friends who either share where I have been and am coming from or have enough compassion and empathy to realize that "there but for the grace of God go I." I frankly do not know how I manage but, at the same time, I can easily envision folks with far less who are struggling even harder than I do. It is discouraging to realize that I am either "preaching to the choir" (folks such as yourself) or "shouting at the top of my lungs" to people who have willfully chosen not to listen and prefer to feather their own nests. I for one am more than weary of the lies and deceit and carrying on that seem part of the system of government and of the adverse effects of 2-1/2 years of isolation and distancing, 5+ years of treachery and deceit. However, there is no way out but through. I think we have to keep trying and demanding change and action, especially from those who have decided to ignore their oath of office and focus on defending the indefensible. Our lives are essentially at stake and we do well to fight for them. Your words of encouragement help me carry on and endeavor to keep it together, write (Handwritten) letters, and hope for better days....so THANK YOU.
Oh, by the way. I occasionally check out "news items" on MSN.com or yahoo.com to the effect that there is some sort of a BIden proposal to fund a 4th stimulus check for seniors, seeing as how inflation quickly dispensed with the COLA we were supposed to get. I have even seen photos of Joe Biden sitting at his desk and signing the executive order that will authorize distribution of the checks in a few days. This is extremely irritating and deceptive (almost as bad as some of the lies and deception by the red team!) but, well, I guess they all assume we're too old to car/won't notice/don't understand, etc. etc. I have also checked the irs.gov site for this and there is mention of the 4th check for seniors but, well, that may just be a tease. I for one am in no mood whatsoever for teaching of any kind.
Be a Hero is an excellent Medicare for All advocacy group, Lee Anne. Their founder, Ady Barkan, is an activist in his thirties who was diagnosed with ALS a few years ago. He can no longer talk but he’s still very active. Please give them a look.
Thank you, Paula. "Be A Hero" is on my list today/tomorrow. On top of what I wrote, I just learned that my electric went from $5 cents/KW hour TO .$22 cents/KW hour!!! I live with very elderly people and they will not be able to afford this. Yes, we receive help from the state, but this is more than they provide and it is a serious matter when not-so-healthy seniors have stopped using their heat. I am not there yet. I hope not to be. But my heart breaks over this, so I must turn that sadness and anger towards constructive things like 'Be A Hero.'
My life long (since 5 years old) and best friend lost her husband to throat cancer. He was a carpet layer and had no health insurance. He developed a throat problem (swallowing, irritation) and waited the year or so till he would turn 65 to go to a doctor. By that time it was stage 4 cancer and had spread and there was nothing the doctors could do. He died within a year. The doctors told him that if he had come to them sooner they could have saved him. This should never happen in this country.
I am a retired emergency physician who has worked all over the USA.
The medical system has so much money in it that it has been taken over by capitalist business. Most doctors now work for a private company and are paid for productivity and increased billing. They spend 1/3 of their time on computers documenting the high possible charges and defense against malpractice. (In most countries contingency fees are unethical and illegal).
Most Western countries have a system like universal Obama care, only with complete coverage, low overhead like Medicare, and no maximum care and billing.
The top medical students at Harvard go into Dermatology because it has the best life style and pay., instead of increasing the length and quality of life.. The average American medical student graduates $300,000 in debt, but in Europe most medical school is free.
Most welfare patients get their medical care from the ER and clinics because Medicaid pays doctors too little. All the drug abuse, violence, and poverty also increases medical costs. Most Republicans think medical care (and welfare) is a privilege and not a right.
I'm on Medicare and am not strapped financially. But preventive health care? Good luck. Unavailable at any price. My "healthcare provider" primary physician sees me for 15 minutes, recommends tests and just hopes some sign of disease shows up that she can recommend meds or surgery for. So far I am healthy, but I know sooner or later I'm going to need care. What then?
Get out of mainstream medicine, and do like Robert did- clean up your diet now, walk daily, take a few pounds off- you may stay healthy and never need high tech care
Whatever our health insurance system is (private or public) it must reimburse doctors for providing lifestyle medicine treatment, consultation, and education. We don’t just want an efficient system, we also want a healthcare system that focuses on promoting wellness. There are many organizations trying to promote lifestyle medicine but they need a radical change in the way doctors are paid. Checkout the American College of Lifestyle Medicine (ACLM) and Physician for Responsible Medicine. Checkout the Rochester Lifestyle Medicine Institute (RLMI) and sign up for the virtual Jumpstart course that will help get you on a Whole Food Plant-Based (WFPB) lifestyle to prevent and reverse cardiovascular disease, Type 2 diabetes, obesity, and debilitating inflammation. There’s so much we can do to be healthier and paying doctors for lifestyle medicine - no matter what our healthcare system is - is essential!
I love this positive approach! I'm curious about your background. Would you care to share? Are you by any chance a neurosurgeon somewhat paradoxically? No pressure to "blow your cover".
Thank you for this important essay and your willingness to further the cause of Medicare for All.
However, I think the greater problem is American capitalism and its relentless urge to privatize; profit at any cost; scam and lack of accountability for profiteers; especially against the non-wealthy in this country.
Just look at the scandal surrounding the approval by the FDA of the unproven and dangerous Altzheimers' drug, Aduhelm.
As a result of collusion between some FDA members and Biogen ( the maker of Aduhelm), and the outrageous price (originally over $58.000, now $28.000 after pushback), Medicare recipients will see the greatest cost increase in Medicare history, in anticipation of the drug's cost.
And while CMS has proposed limiting the availability of Aduhelm, Biogen has been flooding the CMS comments period lobbying for widespread use of this dangerous and unproven medication; this despite the fact that many medical institutions and doctors have stated that the'll refuse to prescibe the medication to their patients.
The scandal surrounding Aduhelm is just another reminder that Medicare for All is desperately needed in this country.
I definitely agree that the problem is profit at any cost and that the price of Aduhelm is absurd. Having followed the development of Aduhelm, I, like a number of medical professionals, disagree about its "danger." It's not more dangerous than Alzheimers. It's certainly a small, imperfect step in efforts to address an horrific, fatal disease. Big Pharma greed already destroys lives. It shouldn't also be allowed to halt even small first steps. If potential help exists, it should be up to doctors and patients whether to use it. Judgment shouldn't be made based on greed and price. To allow that is to enable Big Pharma greed. If the price of Aduhelm were $2/year, how many would complain about having a choice that could slow impending horror? Better to fight Big Pharma greed and a broken healthcare system than to punish patients by thwarting small steps and options.
But no question, the U.S. Healthcare system is terrible. No doubt the money spent on drug ads alone could save many lives. Greedy drug companies market drugs as if they're candy, leaving doctors to waste time "unselling" patients on drugs that aren't right for them. The capitalism of greed doesn't belong in healthcare.
I'm replying to the original post. A common theme for me is that "the" fundamental problem may be lack of will by our voting majorities for solutions which often benefit us better as individuals as well as collectively. This begs the question of what is the root of that problem.
Good idea. Take a look across the “Pond” to Australia. Medicare for all, plus the option of purchasing private health insurance. Also, if your income is very high you are hit with an extra tax….the Medicare Levy if you do not have the add on insurance. This way everybody gets a “fair go”
Let's get real. Specialists are not the problem. Corporate medical care especially hospitals and specialty group practices SUPPORTED BY PRICE GOUGING CORPORATE INSURANCE companies are. For those of us on Medicare--RR?--read your periodic statements. See what the system charges, and how small a portion Medicare pays! Read the documents.
With the unusual advice of a university human resources officer and our excellent certified socially responsible financial advisor, we kept our BlueCross/BlueShield of TX insurance even as I moved to a much better academic position in another state. Few have this advantage,
But the US needs to learn, and be shamed by international comparisons. As in most social issues, we are a tragic outlier. Death rates--far more than ankles--underscore this. All "developed" nations and many "undeveloped" nations have forms of universal health care. Not US. American exceptionalism. DR (haha) Rand Paul certainly wouldn't know this :) But his "friend" Tony Fauci does!
When my future wife and I moved to Canada in 1970 for graduate school (and for her to complete her BA and BEd) and take preemptive measures in face of the draft for the Vietnam invasion, we became "landed immigrants" not "resident aliens". And we immediately received free health care in Ontario, passed by the Progressive Conservative Party. We didn't spend a penny on health care, other than prescriptions for five years.
Then we returned to the US in 1975. As they say (both not in this blog), "the rest is history." It's now 2022 ....
Hi Harvey. I'm about to comment on the original post. It is useful but of course limited to conceptualize "The Problem" but here's my attempt: With physician being one of my many hats ", I see THE fundamental problem as our society having excessive trouble achieving "the greatest good for the greatest number" in far too many aspects of our life with healthcare being only one of the most notable ones. We as a society cannot seem to wrap ourselves in thought and action including voting around the idea that giving up some options, including some which we consider as "rights", such as specific health care services is often worthwhile in order to gain better ones overall such as better healthcare, for ourselves as individuals and society. More above. I always enjoy your thoughts.
Universal health care was studied by the OMB as well as conservative groups like Forbes and even Koch- associated. All three huge deep dives into policy concluded over the first decade covering us all with a Single Payer Plan would save billions. All the other studies regarding lack of coverage effects show huge benefits and lives saved if we were all covered from birth. A simple way to see why Medicare for All would save so much money while making us all better off is:
As Reich and others point out, there is so much administrative cost (overhead, marketing, profit, determining who is covered for what and tests authorized at every point in the patient-system encounter, roughly 33% or more, when Medicare has on overhead of about 2%---Canada and other developed countries have overhead of about 12%. Now 20% difference between US and Canada overhead of 4 trillion dollars is a huge saving. With that we could cover everyone and have plenty to transition insurance industry workers into healthcare workers, dental, mental health, and so much more. Just by allowing a Single Payer system to negotiate a volume discount like the VA and Canada do would save billions. (Congress, assaulted by more lobbyists than Congressmen, outlawed volume discounts).
So just by providing a nonprofit system and slashing the nearly trillion dollars in administrative waste, we could cover everyone at birth with a "Cadillac" comprehensive plan far better than any of us have now and save money in the process.
First we may need to agree as a nation that healthcare for All is a right.
Medicare for All won't save anybody any money and will make health care worse if it were implemented like the stealth "pilot Program" being implemented by the Innovation Center at CMS. The Direct Contracting Entity program is Medicare Advantage plans fraud on steroids and needs to be stopped immediately. You must emphasize that you are talking about Single Payer traditional Medicare, and no for profit middle men managing billing and payments as the pilot program is doing. Be sure to mention that in your presentation.
For those among us who are incapable of resolving ambiguous acronyms from memory, "CMS" refers to a U.S. government agency named "Centers for Medicare & Medicaid Services". Or at least that seemed to be the best match from the hundreds of possibilities.
Jane, I was so angry when I read that CMS was going to force Medicare recipients into HMOs in ~ 10 metro areas. Are they doing this? I can't find out for sure. They can take their Disadvantage plans and shove them.
Time to start writing letters. Unfortunately the last time I wrote to Biden I got a response that was so content-free I couldn’t even tell what the issue was. I was extremely disappointed. We have to stop this.
I suspect Medicare for All is a shortcut way of explaining what they’re promoting, not necessarily a description of exactly how it will work. I get the impression that people have a negative view of the term “single payer,” or they don’t understand it. Just a guess.
A conversation with a student from Germany years ago that still lingers makes me wonder what role our current healthcare system is playing in preventing us from being our most fit and health-conscious. This student said that BECAUSE of the national health care system in Germany, people have the attitude that it is the citizen's responsibility to remain as fit and healthy as possible - for the good of all.
Neither of my twins could afford insurance under the 'Affordable' care act. The deductibles were so high, it just did not make sense. They were uninsured until my daughter's husband joined the Navy and my son got a job paying $30/hour, which included health insurance for himself and his wife that cost $300/month.
We keep having example after example of the failure of the American state capitalist system to effectuate any of these reforms because the battle between laissez-faire capitalism and state capitalism is increasingly one in which the latter triumphs. Corporations have consolidated their control over Congress and the regulatory apparatus and the courts. Soon the state will be deprived of any right to tell private enterprise what to do about preserving the health of the population if it interferes with commerce, not that institutions like the CDC will do so. It might take a few more years before they do away with Medicare via the HMO route but they will.
So when I see all of those members of the progressive caucus, you know the ones who voted to delink infrastructure and BBB bills, I wonder what planet they are on. Is it Planet Fantasy where they sing “would in it be wonderful” from My Fair Lady?
Wasn't the infrastructure bill originally broken out from the BBB bill in the Senate? And then sent back to the House? I thought the progressives were against breaking out the infrastructure bill, and then once it was broken out and sent back to the House, against delinking them.
No what happened was that the House progressive caucus held out from signing off on the infrastructure bill until the Senate passed the BBB bill so that one couldn’t be approved without the other. They demanded this because delinking meant BBB would flounder. They were persuaded by Biden to abandon their opposition on his promises that he could get BBB through the Senate. the infrastructure bill was then passed by the House. Once this lever was lost Manchin did his thing and BBB floundered in the Senate. So this has been a problem with the progressive caucus lacking political nerve and strategy and depending upon the President’s leadership to no avail. It is why Biden’s poll numbers are so low and why the Democrats are about to commit political suicide this Fall and put the Trumpers in control of Congress.
As Michael Moore pointed out, Medicare for All was a huge giveaway to the insurance industry, and the name 'Affordable Care Act' is a misnomer; it is neither affordable nor is it 'caring'.
@Laurie. I am so glad you brought this up - in this country nothing gets through Congress without a big paycheck attached for one or the other interest group. The "cost of doing business" to get Medicare for All past our nominal representatives and particularly past the so-called deliberative body is to have a bill that preserves at least some of the "rents" that go to the medical insurance companies. This insurance industry employs thousands of people too, so if they were suddenly cut off completely there would result job losses and a certain amount of economic dislocation. I'm not trying to put words in anybody's mouth, but it seems that support for the current legislative efforts is the pragmatic approach, to not let perfection be the enemy of progress.
Every time they privatize something they build up a huge infrastructure and then when people propose doing away with that Republicans cry “job losses.” It’s happened over and over and it’s intentional. Of course doing away with government jobs doesn’t bother them one bit. We can’t let this manipulation derail us.
There is nothing in the American health care system that can be considered progress on any level. We are an outlier, this system is awful, lowest mortality rates, Americans are the sickest among rich nations, it is a wholly owned subsidiary of the corporate elite. No other comparable nation lives like this. Oh, and those jobs? People won't lose jobs they'll be plugged into the new system that also will require administrative work, etc.
@Claire. I hope nothing in what I wrote can be construed as a defense of the current situation? I was talking about the role of money, lobbyists and industry influence in what happens to legislation in our Congress.
Unfortunately, "the cost of doing business" is what keeps us from getting anything meaningful or worthwhile ever done or done right, which is then always followed by our representatives telling us how wonderful it is, but people know it's BS and just despair of Congress ever getting anything right. Why do we keep doing stupid and stupider? When do we ever learn? Because government doesn't work for the majority, as most of us here would probably agree. And those who support the other guy, they just want to do away with all of government for probably many of the same reasons.
@Jim. This can be a very valuable conversation! For example, is it really a majority of Americans that get nothing (or too little) from government? Or is it really the media circus pushing misinformation that makes a lot of people think that a lot of other people are unhappy? I think Reich has shown in this column that there is a gap between way people say about themselves (doing ok, feeling pretty good) versus what people in the same poll say about the state of the country (going to hell, people very unhappy). As you can easily see the "majority unhappy" is a perception, a big lie and a piece of leverage to influence votes. In our country a clear majority vote Democratic; it is the operation of the Electoral College, the design of only 2 senators per state regardless of population, the role of money in Congressional influence and the malicious, cynical manipulation of the media by corporations, the super rich and international oligarchs that reduces the Democratic majority enough to keep Republicans in government.
The only way to efficiently, cost effectively and reduce worsening of death rates and chronic illness is the Medicare for All Act. The continued move to privatize (DCE) Medicare and for profit middle men will only continue to raise the costs, while making a few for profit entities richer. Decisions need to be between the provider and patient period. The Medicare for all Act is the best solution as far as I can see
The fundamental problem is not that there are a lot of specialists and not enough generalists. That is somewhat symptomatic. The fundamental problem is that almost all of the medical profession adheres to the mistaken ideology of allopathic medicine....that only man made chemicals can cure disease. It is a cult belief (with no scientific basis) which has prematurely killed millions, injured millions more and rarely cures anything. But it does massively enriches drug companies, insurers, hospitals, government gatekeeper "regulators", practitioners, their instructors and a whole plethora of associated professions. The belief in our allopathic medical practices sustains the pill illusion because pills may "cure" some bacterial diseases, and some inoculations may prevent some fatal childhood scourges. They have no curative effect on the vast majority of chronic diseases that plague modern life (heart disease, cancer, diabetes etc.) The patient is grateful for the symptom relief of "modern medical practice". The symptoms have been suppressed but the disease is still raging and will likely prematurely kill them. In short, not only is modern U.S. medical practice outrageous expensive, the practice is a fraudulent unscientific deception.
@Kendrick. The science is clear on the other side - homeopathic attempts at treatment are ineffective across the board. This is proven fact. Also, many formulations are toxic and/or dangerous by enticing people to avoid modern medical treatments. So far as I have been able to find, there are no exceptions. Meaning there are no homeopathic, traditional or shamanic treatments that are better than modern medical practices.
Thank you! My cost for healthcare (insurance, absurdly high deductibles, et al.) is close to $9K annually. That does NOT include dental costs for which Medicare offers zero help, so these costs are directly out-of-pocket. I am 78-years-old, live on social security, have no portfolios to dip into for unexpected medical issues or any other surprises. I am vibrant, stay active with my writing and art, am a political activist, and love life. I receive help from SNAP (food stamps), which will run out if they haven't already. Normally, I receive $20/month in total. Because of the pandemic, I've received the maximum amount of $250/month. What a difference that has made. It allowed some of us to live a tiny bit better. But why only $20 a month normally? Because my gross social security ($21K) is NOT considered poverty level in New York State. What??? They use an arcane, out-of-date formula to determine how much is allocated to an individual. And, it is not relevant to today's increased food and medical costs.
I've worked since I was seven years old as a performance artist, then marketing consultant, and am finally devoting full time to my writing and photography. I cannot express how important your voice will be in Congress today. Ageism is severe in our country, which few give any focus. It is harsh, judgemental, humiliating. There are inequities, mistreatment and disrespect from the government, from our state representatives, from BIG Pharma, from the young woman who manages our subsidized housing. I know you fight for people of all ages. But I argue for those who can no longer advocate for themselves. I had to sell my car this year. Not because I can no longer drive but to pay off dental expenses. I was doing volunteer work delivering food to the homebound among other efforts. Now, I am one who is homebound.
None of this is right for any age group, every family, unfed children, working moms, single dads--all who have their issues. It is heartbreaking to watch our Congress play the games they choose to play. It is gut-wrenching to watch the powers-that-be get rich on the working poor and the elderly. Shame on us and shame on our healthcare system. What can I do to help?
Lee Anne, Thanks for your important thoughts. How can you help? You can begin by writing your members of Congress (in long hand -- they pay more attention) that you want Medicare for All.
Thank you. Consider it done. And thanks for the heads-up on writing in longhand.
Lee Anne, With a few differences and details, you have written MY LETTER to Robert. Down to going carless, being fairly lively, living on SSA alone, having a fast-dwindling pension and no other resources, still trying to be a part of things, dealing with dental bills, and, oh, also doing a ton of writing and some publishing. (I was an academic wannabe and spent a lot of time writing stuff no one but an academic would read but, between covid-19 and retiring, I am now writing stuff that general readers might want to check out and that is even appealing to me, I think.) The biggest issue I have going is the fact that I have to fund a supplemental insurance policy and that, well, my pension from Macy*s is nearly exhausted and I live in fear for when it's gone. I might add that I am increasingly irritated by word that a 4th stimulus for seniors might show up but never seems to. It would help with the bills since my SSA COLA increase was consumed by inflation as, I guess, yours was.) THe deal with me is that I have pared life down to one specific discretionary expense that I will NOT surrender and writing to this and other sites (and my COngressperson (Zoe Lofgren of the Select Committee and Impeachment trials) in the hopes of supporting those who may be interested in helping. I believe it goes without saying that most of our elected officials are in a higher income bracket and receive more benefits and perks than their own constituents. While I take their duties more seriously than they do (at times), I think that they tend to live in a bubble. However, there are many of us---older, retired/disabled, homeless, working people, families and kids--who will never live in that bubble. I think we still should lay a claim to a decent and secure life--however long or short it may be--and a chance to enjoy, explore, and experience what all too many of our elected representatives take for granted. (Some of them would running screaming from the chambers of government if they were forced to live with the conditions you and I share on a daily basis!) Bravo to you and continue to share your thoughts as I will too. The government needs to respond, to learn what has happened to individuals during the pandemic era and decide to take action (not just talk about it, argue, and decide to throw a tantrum over the opposition). Every single elected official on the city, state, national level should be asking: "What can I do to help my constituents?" This is not a matter of scoring points with the party leaders or avoiding flak from those leaders but of honoring a commitment made to serve and honor the rule of law. Wasn't there an oath of office that they took and that made the same sort of statement?
There is much work to be done and we must not give up. Your story, my story, are like too many others. We will move through this only if we stay the course and make our voices heard with the handwritten letters (see Robert's comment to me above) to our Congress women and men. Local assembly people, too. I know nothing about a fourth stimulus check and with inflation rising so rapidly I doubt that would be on the table. I've received so many wonderful comments and am overwhelmed with the kindred spirits on this forum. A huge THANK YOU, ROBERT, for making it possible for people to exchange ideas and share deep concerns with one another. I end with this quote from Margaret Mead: "Never underestimate the power of a small group of committed people to change the world. In fact, it is the only thing that ever has." 😊💜
Lee Anne, Thanks so much for your immediate response to my comments on your note to Robrt...And thanks for your reference to the quote from Margaret Mead. When I first started on Robert's website, I thought I would most likely be sort of an "odd-duck" and that no one could relate to my experiences and my background. I was very, very wrong as I am finding good friends who either share where I have been and am coming from or have enough compassion and empathy to realize that "there but for the grace of God go I." I frankly do not know how I manage but, at the same time, I can easily envision folks with far less who are struggling even harder than I do. It is discouraging to realize that I am either "preaching to the choir" (folks such as yourself) or "shouting at the top of my lungs" to people who have willfully chosen not to listen and prefer to feather their own nests. I for one am more than weary of the lies and deceit and carrying on that seem part of the system of government and of the adverse effects of 2-1/2 years of isolation and distancing, 5+ years of treachery and deceit. However, there is no way out but through. I think we have to keep trying and demanding change and action, especially from those who have decided to ignore their oath of office and focus on defending the indefensible. Our lives are essentially at stake and we do well to fight for them. Your words of encouragement help me carry on and endeavor to keep it together, write (Handwritten) letters, and hope for better days....so THANK YOU.
Oh, by the way. I occasionally check out "news items" on MSN.com or yahoo.com to the effect that there is some sort of a BIden proposal to fund a 4th stimulus check for seniors, seeing as how inflation quickly dispensed with the COLA we were supposed to get. I have even seen photos of Joe Biden sitting at his desk and signing the executive order that will authorize distribution of the checks in a few days. This is extremely irritating and deceptive (almost as bad as some of the lies and deception by the red team!) but, well, I guess they all assume we're too old to car/won't notice/don't understand, etc. etc. I have also checked the irs.gov site for this and there is mention of the 4th check for seniors but, well, that may just be a tease. I for one am in no mood whatsoever for teaching of any kind.
Leynia, see my reply to Lee Anne about Be a Hero, above. Hope it helps!
Thank you, Leynia. that sounds like a plan! ✨
Thank you so much. I would very much like to know more about the advocacy group you joined. I hope this response enables you to get my email. 💜
Be a Hero is an excellent Medicare for All advocacy group, Lee Anne. Their founder, Ady Barkan, is an activist in his thirties who was diagnosed with ALS a few years ago. He can no longer talk but he’s still very active. Please give them a look.
Thank you, Paula. "Be A Hero" is on my list today/tomorrow. On top of what I wrote, I just learned that my electric went from $5 cents/KW hour TO .$22 cents/KW hour!!! I live with very elderly people and they will not be able to afford this. Yes, we receive help from the state, but this is more than they provide and it is a serious matter when not-so-healthy seniors have stopped using their heat. I am not there yet. I hope not to be. But my heart breaks over this, so I must turn that sadness and anger towards constructive things like 'Be A Hero.'
Ack! That’s terrible! How can they raise the rate so much? Did they give an explanation?
My life long (since 5 years old) and best friend lost her husband to throat cancer. He was a carpet layer and had no health insurance. He developed a throat problem (swallowing, irritation) and waited the year or so till he would turn 65 to go to a doctor. By that time it was stage 4 cancer and had spread and there was nothing the doctors could do. He died within a year. The doctors told him that if he had come to them sooner they could have saved him. This should never happen in this country.
I am a retired emergency physician who has worked all over the USA.
The medical system has so much money in it that it has been taken over by capitalist business. Most doctors now work for a private company and are paid for productivity and increased billing. They spend 1/3 of their time on computers documenting the high possible charges and defense against malpractice. (In most countries contingency fees are unethical and illegal).
Most Western countries have a system like universal Obama care, only with complete coverage, low overhead like Medicare, and no maximum care and billing.
The top medical students at Harvard go into Dermatology because it has the best life style and pay., instead of increasing the length and quality of life.. The average American medical student graduates $300,000 in debt, but in Europe most medical school is free.
Most welfare patients get their medical care from the ER and clinics because Medicaid pays doctors too little. All the drug abuse, violence, and poverty also increases medical costs. Most Republicans think medical care (and welfare) is a privilege and not a right.
I'm on Medicare and am not strapped financially. But preventive health care? Good luck. Unavailable at any price. My "healthcare provider" primary physician sees me for 15 minutes, recommends tests and just hopes some sign of disease shows up that she can recommend meds or surgery for. So far I am healthy, but I know sooner or later I'm going to need care. What then?
Get out of mainstream medicine, and do like Robert did- clean up your diet now, walk daily, take a few pounds off- you may stay healthy and never need high tech care
Whatever our health insurance system is (private or public) it must reimburse doctors for providing lifestyle medicine treatment, consultation, and education. We don’t just want an efficient system, we also want a healthcare system that focuses on promoting wellness. There are many organizations trying to promote lifestyle medicine but they need a radical change in the way doctors are paid. Checkout the American College of Lifestyle Medicine (ACLM) and Physician for Responsible Medicine. Checkout the Rochester Lifestyle Medicine Institute (RLMI) and sign up for the virtual Jumpstart course that will help get you on a Whole Food Plant-Based (WFPB) lifestyle to prevent and reverse cardiovascular disease, Type 2 diabetes, obesity, and debilitating inflammation. There’s so much we can do to be healthier and paying doctors for lifestyle medicine - no matter what our healthcare system is - is essential!
I love this positive approach! I'm curious about your background. Would you care to share? Are you by any chance a neurosurgeon somewhat paradoxically? No pressure to "blow your cover".
Thank you for this important essay and your willingness to further the cause of Medicare for All.
However, I think the greater problem is American capitalism and its relentless urge to privatize; profit at any cost; scam and lack of accountability for profiteers; especially against the non-wealthy in this country.
Just look at the scandal surrounding the approval by the FDA of the unproven and dangerous Altzheimers' drug, Aduhelm.
As a result of collusion between some FDA members and Biogen ( the maker of Aduhelm), and the outrageous price (originally over $58.000, now $28.000 after pushback), Medicare recipients will see the greatest cost increase in Medicare history, in anticipation of the drug's cost.
And while CMS has proposed limiting the availability of Aduhelm, Biogen has been flooding the CMS comments period lobbying for widespread use of this dangerous and unproven medication; this despite the fact that many medical institutions and doctors have stated that the'll refuse to prescibe the medication to their patients.
The scandal surrounding Aduhelm is just another reminder that Medicare for All is desperately needed in this country.
I definitely agree that the problem is profit at any cost and that the price of Aduhelm is absurd. Having followed the development of Aduhelm, I, like a number of medical professionals, disagree about its "danger." It's not more dangerous than Alzheimers. It's certainly a small, imperfect step in efforts to address an horrific, fatal disease. Big Pharma greed already destroys lives. It shouldn't also be allowed to halt even small first steps. If potential help exists, it should be up to doctors and patients whether to use it. Judgment shouldn't be made based on greed and price. To allow that is to enable Big Pharma greed. If the price of Aduhelm were $2/year, how many would complain about having a choice that could slow impending horror? Better to fight Big Pharma greed and a broken healthcare system than to punish patients by thwarting small steps and options.
But no question, the U.S. Healthcare system is terrible. No doubt the money spent on drug ads alone could save many lives. Greedy drug companies market drugs as if they're candy, leaving doctors to waste time "unselling" patients on drugs that aren't right for them. The capitalism of greed doesn't belong in healthcare.
I'm replying to the original post. A common theme for me is that "the" fundamental problem may be lack of will by our voting majorities for solutions which often benefit us better as individuals as well as collectively. This begs the question of what is the root of that problem.
Good idea. Take a look across the “Pond” to Australia. Medicare for all, plus the option of purchasing private health insurance. Also, if your income is very high you are hit with an extra tax….the Medicare Levy if you do not have the add on insurance. This way everybody gets a “fair go”
Let's get real. Specialists are not the problem. Corporate medical care especially hospitals and specialty group practices SUPPORTED BY PRICE GOUGING CORPORATE INSURANCE companies are. For those of us on Medicare--RR?--read your periodic statements. See what the system charges, and how small a portion Medicare pays! Read the documents.
With the unusual advice of a university human resources officer and our excellent certified socially responsible financial advisor, we kept our BlueCross/BlueShield of TX insurance even as I moved to a much better academic position in another state. Few have this advantage,
But the US needs to learn, and be shamed by international comparisons. As in most social issues, we are a tragic outlier. Death rates--far more than ankles--underscore this. All "developed" nations and many "undeveloped" nations have forms of universal health care. Not US. American exceptionalism. DR (haha) Rand Paul certainly wouldn't know this :) But his "friend" Tony Fauci does!
When my future wife and I moved to Canada in 1970 for graduate school (and for her to complete her BA and BEd) and take preemptive measures in face of the draft for the Vietnam invasion, we became "landed immigrants" not "resident aliens". And we immediately received free health care in Ontario, passed by the Progressive Conservative Party. We didn't spend a penny on health care, other than prescriptions for five years.
Then we returned to the US in 1975. As they say (both not in this blog), "the rest is history." It's now 2022 ....
Hi Harvey. I'm about to comment on the original post. It is useful but of course limited to conceptualize "The Problem" but here's my attempt: With physician being one of my many hats ", I see THE fundamental problem as our society having excessive trouble achieving "the greatest good for the greatest number" in far too many aspects of our life with healthcare being only one of the most notable ones. We as a society cannot seem to wrap ourselves in thought and action including voting around the idea that giving up some options, including some which we consider as "rights", such as specific health care services is often worthwhile in order to gain better ones overall such as better healthcare, for ourselves as individuals and society. More above. I always enjoy your thoughts.
Universal health care was studied by the OMB as well as conservative groups like Forbes and even Koch- associated. All three huge deep dives into policy concluded over the first decade covering us all with a Single Payer Plan would save billions. All the other studies regarding lack of coverage effects show huge benefits and lives saved if we were all covered from birth. A simple way to see why Medicare for All would save so much money while making us all better off is:
As Reich and others point out, there is so much administrative cost (overhead, marketing, profit, determining who is covered for what and tests authorized at every point in the patient-system encounter, roughly 33% or more, when Medicare has on overhead of about 2%---Canada and other developed countries have overhead of about 12%. Now 20% difference between US and Canada overhead of 4 trillion dollars is a huge saving. With that we could cover everyone and have plenty to transition insurance industry workers into healthcare workers, dental, mental health, and so much more. Just by allowing a Single Payer system to negotiate a volume discount like the VA and Canada do would save billions. (Congress, assaulted by more lobbyists than Congressmen, outlawed volume discounts).
So just by providing a nonprofit system and slashing the nearly trillion dollars in administrative waste, we could cover everyone at birth with a "Cadillac" comprehensive plan far better than any of us have now and save money in the process.
First we may need to agree as a nation that healthcare for All is a right.
Ray Bellamy MD Retired
Medicare for All won't save anybody any money and will make health care worse if it were implemented like the stealth "pilot Program" being implemented by the Innovation Center at CMS. The Direct Contracting Entity program is Medicare Advantage plans fraud on steroids and needs to be stopped immediately. You must emphasize that you are talking about Single Payer traditional Medicare, and no for profit middle men managing billing and payments as the pilot program is doing. Be sure to mention that in your presentation.
For those among us who are incapable of resolving ambiguous acronyms from memory, "CMS" refers to a U.S. government agency named "Centers for Medicare & Medicaid Services". Or at least that seemed to be the best match from the hundreds of possibilities.
Jane, I was so angry when I read that CMS was going to force Medicare recipients into HMOs in ~ 10 metro areas. Are they doing this? I can't find out for sure. They can take their Disadvantage plans and shove them.
I haven’t heard anything about this. It had better not be true.
I found it in this article in the WAPost: https://www.washingtonpost.com/opinions/2021/12/13/medicare-direct-contracting-privatization-health-care/
Time to start writing letters. Unfortunately the last time I wrote to Biden I got a response that was so content-free I couldn’t even tell what the issue was. I was extremely disappointed. We have to stop this.
I suspect Medicare for All is a shortcut way of explaining what they’re promoting, not necessarily a description of exactly how it will work. I get the impression that people have a negative view of the term “single payer,” or they don’t understand it. Just a guess.
A conversation with a student from Germany years ago that still lingers makes me wonder what role our current healthcare system is playing in preventing us from being our most fit and health-conscious. This student said that BECAUSE of the national health care system in Germany, people have the attitude that it is the citizen's responsibility to remain as fit and healthy as possible - for the good of all.
Neither of my twins could afford insurance under the 'Affordable' care act. The deductibles were so high, it just did not make sense. They were uninsured until my daughter's husband joined the Navy and my son got a job paying $30/hour, which included health insurance for himself and his wife that cost $300/month.
Ugh.
We keep having example after example of the failure of the American state capitalist system to effectuate any of these reforms because the battle between laissez-faire capitalism and state capitalism is increasingly one in which the latter triumphs. Corporations have consolidated their control over Congress and the regulatory apparatus and the courts. Soon the state will be deprived of any right to tell private enterprise what to do about preserving the health of the population if it interferes with commerce, not that institutions like the CDC will do so. It might take a few more years before they do away with Medicare via the HMO route but they will.
So when I see all of those members of the progressive caucus, you know the ones who voted to delink infrastructure and BBB bills, I wonder what planet they are on. Is it Planet Fantasy where they sing “would in it be wonderful” from My Fair Lady?
Wasn't the infrastructure bill originally broken out from the BBB bill in the Senate? And then sent back to the House? I thought the progressives were against breaking out the infrastructure bill, and then once it was broken out and sent back to the House, against delinking them.
No what happened was that the House progressive caucus held out from signing off on the infrastructure bill until the Senate passed the BBB bill so that one couldn’t be approved without the other. They demanded this because delinking meant BBB would flounder. They were persuaded by Biden to abandon their opposition on his promises that he could get BBB through the Senate. the infrastructure bill was then passed by the House. Once this lever was lost Manchin did his thing and BBB floundered in the Senate. So this has been a problem with the progressive caucus lacking political nerve and strategy and depending upon the President’s leadership to no avail. It is why Biden’s poll numbers are so low and why the Democrats are about to commit political suicide this Fall and put the Trumpers in control of Congress.
I meant to say in the battle between state capitalism and laissez faire capitalism in the US it is laissez faire capitalism that triumphs.
As Michael Moore pointed out, Medicare for All was a huge giveaway to the insurance industry, and the name 'Affordable Care Act' is a misnomer; it is neither affordable nor is it 'caring'.
@Laurie. I am so glad you brought this up - in this country nothing gets through Congress without a big paycheck attached for one or the other interest group. The "cost of doing business" to get Medicare for All past our nominal representatives and particularly past the so-called deliberative body is to have a bill that preserves at least some of the "rents" that go to the medical insurance companies. This insurance industry employs thousands of people too, so if they were suddenly cut off completely there would result job losses and a certain amount of economic dislocation. I'm not trying to put words in anybody's mouth, but it seems that support for the current legislative efforts is the pragmatic approach, to not let perfection be the enemy of progress.
Every time they privatize something they build up a huge infrastructure and then when people propose doing away with that Republicans cry “job losses.” It’s happened over and over and it’s intentional. Of course doing away with government jobs doesn’t bother them one bit. We can’t let this manipulation derail us.
Agreed.
There is nothing in the American health care system that can be considered progress on any level. We are an outlier, this system is awful, lowest mortality rates, Americans are the sickest among rich nations, it is a wholly owned subsidiary of the corporate elite. No other comparable nation lives like this. Oh, and those jobs? People won't lose jobs they'll be plugged into the new system that also will require administrative work, etc.
@Claire. I hope nothing in what I wrote can be construed as a defense of the current situation? I was talking about the role of money, lobbyists and industry influence in what happens to legislation in our Congress.
By t he way, 58 countries have some form of universal health care. 58! No, this is not acceptable.
Sounds like an argument to continue the sell out. Jobs! Maybe we support 'clean coal' ? Just sayin'!
@Laurie. You keep a clear and consistent view!
Unfortunately, "the cost of doing business" is what keeps us from getting anything meaningful or worthwhile ever done or done right, which is then always followed by our representatives telling us how wonderful it is, but people know it's BS and just despair of Congress ever getting anything right. Why do we keep doing stupid and stupider? When do we ever learn? Because government doesn't work for the majority, as most of us here would probably agree. And those who support the other guy, they just want to do away with all of government for probably many of the same reasons.
@Jim. This can be a very valuable conversation! For example, is it really a majority of Americans that get nothing (or too little) from government? Or is it really the media circus pushing misinformation that makes a lot of people think that a lot of other people are unhappy? I think Reich has shown in this column that there is a gap between way people say about themselves (doing ok, feeling pretty good) versus what people in the same poll say about the state of the country (going to hell, people very unhappy). As you can easily see the "majority unhappy" is a perception, a big lie and a piece of leverage to influence votes. In our country a clear majority vote Democratic; it is the operation of the Electoral College, the design of only 2 senators per state regardless of population, the role of money in Congressional influence and the malicious, cynical manipulation of the media by corporations, the super rich and international oligarchs that reduces the Democratic majority enough to keep Republicans in government.
The only way to efficiently, cost effectively and reduce worsening of death rates and chronic illness is the Medicare for All Act. The continued move to privatize (DCE) Medicare and for profit middle men will only continue to raise the costs, while making a few for profit entities richer. Decisions need to be between the provider and patient period. The Medicare for all Act is the best solution as far as I can see
The fundamental problem is not that there are a lot of specialists and not enough generalists. That is somewhat symptomatic. The fundamental problem is that almost all of the medical profession adheres to the mistaken ideology of allopathic medicine....that only man made chemicals can cure disease. It is a cult belief (with no scientific basis) which has prematurely killed millions, injured millions more and rarely cures anything. But it does massively enriches drug companies, insurers, hospitals, government gatekeeper "regulators", practitioners, their instructors and a whole plethora of associated professions. The belief in our allopathic medical practices sustains the pill illusion because pills may "cure" some bacterial diseases, and some inoculations may prevent some fatal childhood scourges. They have no curative effect on the vast majority of chronic diseases that plague modern life (heart disease, cancer, diabetes etc.) The patient is grateful for the symptom relief of "modern medical practice". The symptoms have been suppressed but the disease is still raging and will likely prematurely kill them. In short, not only is modern U.S. medical practice outrageous expensive, the practice is a fraudulent unscientific deception.
@Kendrick. The science is clear on the other side - homeopathic attempts at treatment are ineffective across the board. This is proven fact. Also, many formulations are toxic and/or dangerous by enticing people to avoid modern medical treatments. So far as I have been able to find, there are no exceptions. Meaning there are no homeopathic, traditional or shamanic treatments that are better than modern medical practices.
I agree that homeopathic or shamanic practices are just as unscientific cults as allopathic medicine.