2018 Single Payer News

Posted Dec 30, 2018

Jon Walker, “Best option for funding Medicare for All may be employer mandate,” Shadowproof, Dec. 10, 2018

Walker is a thoughtful critic who campaigns against the transformative (“disruptive”) approach of single-payer. Here, he argues for allowing the employer-sponsored option to remain as a political feasible, step-by-step approach. However, note that it keeps multiple payers in the game and protects insurance companies’ role (“Medicare or equivalent coverage”). Also, he continues to argue that single-payer must be “paid for,” which is a GOP talking point, taken up by Pelosi and the corporate Dem wing. Wars and tax cuts are never “paid for” as their backers (correctly) realize that the federal government can issue fiat currency at will. (The New York Health Act is a different animal because NY State does not issue a currency but must obtain dollars.)

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"Single Payer Myths: Removing People From Employer Plans Matt Bruenig," People’s Policy Project, Oct. 24, 2018

Answers to Walker’s arguments.

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Adam Gaffney, “Universal healthcare could save America trillions: what’s holding us back?” Guardian, Dec. 11, 2018

“If you can’t undercut a popular proposal as undesirable, make it sound impossible.” A good antidote, but Gaffney also falls into the “how to pay for it” trap with a long discussion of new taxes.

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Peter Sullivan, “2020 Dems go on offense over drug prices," The Hill, Dec. 25, 2018

Everyone loves to hate Pharma, but watch closely to see which contenders in the presidential sweepstakes will desperately sidestep any links to single-payer. (Prediction: almost all)

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Charles Ornstein,  & Katie Thomas, New York Times, “Prominent doctors aren’t disclosing their industry ties in medical journal studies, and journals are doing little to enforce their rules,” ProPublica & NYT, Dec. 8, 2018

Part of the spinning profit wheel that makes U.S. healthcare so expensive. The journals are so lucrative that it would be quite easy for them to do more thorough checks.

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David Siders, “‘You don’t just get to say that you’re progressive’: The left moves to defend its brand,” Politico, Dec. 9, 2018

Why is it surprising that people with progressive political beliefs want candidates for office to be precise about what they stand for? This article weirdly casts the process as “defending the brand,” which could only be written by a reporter who views elections as product placement campaigns.

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Donald Shaw, “Dems who rejected corporate PACs took money from corporate-funded NewDemPAC,” Sludge, Dec. 7, 2018 https://bit.ly/2BMKVL5

How to be a progressive champion and still remain on the corporate gravy train. See above.

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Christopher Rowland, “Investigation of generic ‘cartel’ expands to 300 drugs,” Washington Post, Dec. 9, 2018

Price-fixing (“sudden, coordinated price hikes”) in generic drugs, a $104 billion industry.

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Rachana Pradhan, “Conservative health care experiment leads to thousands losing coverage,” Politico, Dec. 30, 2018

Cruelty on skates in Arkansas. And recall that forcing people to navigate complex, dysfunctional online systems is a tax on time at the very least, even when people are successful. And low-income people have less free time to spare.

Posted Dec 14, 2018

Mattie Quinn, “Trump Administration gives states new ways to rewrite Obamacare,” Governing, Nov. 30, 2018

Possibly overtaken by the federal judge’s ruling that Obamacare is unconstitutional, this describes White House use of administrative measures to undermine the ACA. Note the strong endorsement of state-led policy changes—although unlikely to apply if NY passes single-payer.

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Ross Barkan, “Powerful NY unions could complicated push for single payer health care,” Gothamist, Dec. 11, 2018

A new wrinkle: questions about how to prevent harm to unions who cover out-of-state workers.

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Alex Press, “Case Study of 1,” Alex Press, Dec. 7 2018

A tale: psychiatric care for the working poor.

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Emmarie Harrington, “Democrats taking key leadership jobs have pocketed millions from pharma, Kaiser Health News, Nov 29, 2018

Pelosi, Hoyer and Clyburn rake in the pharma dough.

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Adam Cancryn, “Establishment looks to crush liberals on Medicare for All,” Politico, Dec. 10, 2018

Discusses the The Partnership for America’s Health Care Future, see list of the ususal suspects below. Note the similarity between these “centrist” Democrats’ talking points and traditional GOP discourse. Avalere, the consulting firm mentioned, boasts that it can help clients “optimize your provider network for growth and profitability.” Just in case anyone thought the two wings of the Democrat Party are pursuing similar ends.

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Partnership for American’s Health Care Future

Check out the membership roster.

Posted Nov 26, 2018

Lisa Hagen, “Dem gains put Sunbelt in play for 2020,” The Hill, Nov. 18, 2018

How Democrat candidates in the Southwest neutralized the GOP’s historical advantages. “Both [victorious Senate candidates] relentlessly focused their messaging on health care and protections for pre-existing conditions coverage.” However, Sinema (AZ) is a Blue Dog who is unlikely to support single-payer.

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Mike Ludwig, “Parents deliver ashes of diabetic children to price-gouging insulin manufacturer,” Truthout, Nov. 16, 2018

More obscenity. Insulin was discovered 100 years ago, so you’d think the cartel would be illegal by now.

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Dylan Scott, “This drug saves Americans from opioid overdoses. Its price has been hiked 600 percent,” Vox, Nov. 19, 2018

Naloxone for overdose reversal.

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Dan Glaun, “Question 1: Massachusetts' nurse-patient ratio ballot measure is defeated,” MassLive, Nov. 6, 2018

This attempt to boost nurse staffing in hospitals went down to a crushing (70-30) defeat, which is an interesting lesson in how this approach can be spun negatively.

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Lee Fang & Nick Surgey, “Lobbyist documents reveal health care industry battle plan against ‘Medicare for All,’” The Intercept, Nov. 20, 2018

Great detail on the oppo plans to beat back single payer. Industry groups manifest “growing concern.”

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Lambert Strether, “Hedda Martin’s GoFundMe, Spectrum Health, and putting a Band-Aid on the cancer of American’s health care system,” Naked Capitalism, Nov. 27, 2018

This is a great dive into the outrageous proliferation of crowdfunding charity campaigns by people forced into GoFundMe to pay for their health care. Note the role of the DeVos family in the example cited.

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Abby Goodnough, “This city’s overdose deaths have plunged: Can others learn from it?” New York Times, Nov. 25, 2018

(Dayton, Ohio). Medicaid expansion (i.e. single-payer for the low-income) was the first step, along with an enlightened police chief.

Posted Nov 13, 2018

“What does the outcome of the midtern elections mean for Medicaid expansion?” Kaiser Health News, Nov. 7, 2018

State-by-state summary.

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Michael Hiltzik, “Dialysis companies' anti-Proposition 8 fight has gone over the top — in self-interested campaign spending,” Los Angeles Times, Oct. 29, 2018

The dialysis industry successfully buried this cost-cutting California referendum as the perverse system permits monopoly pricing, which then gives the corporations plenty of cash to crush attempts to rein them in.

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Crystal Hayes, “Medicare head tweets ‘scariest Halloween costume' would be Medicare for all,” USA Today, Oct. 31, 2018

Trump’s troll at Medicare displayed now familiar Trumpian class in dissing single-payer as unaffordable and destructive of patient “choice.” Yawn.

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Nicole Gaudiano and Maureen Groppe, “Democrats back Medicare for All in about half of House races they're contesting, USA Today, Oct. 23, 2018

Many more Democrat candidates are on board with single-payer, and attacks on them over it don’t seem to have connected with the voting population. Health remains the #1 concern for voters in all the polls. Note that Pelosi immediately muddied the waters by calling it a “public option”—this is straight out of the ACA playbook.

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Thom Hartmann, “Here's the real reason why Republicans fear ‘Medicare for All',” Independent Media Institute, Nov. 5, 2018

An interesting theory: that single-payer would make voting by low-income people too easy! A standard health insurance card, which everyone would want, could undermine GOP voter suppression tactics by providing a universal voter ID.

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Zaid Jilani, “Michigan’s Democratic governor-elect puts Blue Cross/Blue Shield executive on transition team—after the cmpany funded her campaign,” The Intercept, No.v 9, 2018

Good corrective to excessive enthusiasm over Democrat successes: Whitmer, whose father was the head of Blue Cross, beat a single-payer advocate in the primary. Her industry-heavy staff now can make sure Michigan is no threat to that business.

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Susan Jaffe, “Trumpeted new Medicare Advantage benefits will be hard for seniors to find,” Kaiser Health News, Nov. 9, 2018

This is an underappreciated negative factor in our crazed health care non-system: how we have to dig and search for the right “product,” as consumers of medical attention. The article even refers to Medicare recipients as “shoppers.” Complexity and inconsistency then create the need for system “navigators,” who in turn then have a stake in not simplifying things.

Posted Oct 26, 2018

Bryan Rinker, “Gavin Newsom is bullish on single-payer — except when he’s not,” Kaiser Health News, Oct. 23, 2018   

Newsom took credit for the San Francisco version but didn’t do much to back it. So as governor expect him to lead from behind.

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Sarah Kliff, “White House anti-socialism report inadvertently makes a case for single-payer,” Vox, Oct. 23, 2018

This widely-scorned hatchet job also made the case for single-payer while trying to trash it. More attacks like this!

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Jake Johnson, “Buried in "Hilariously Stupid" White House attack on socialism, an accidentally strong argument for Medicare for All,” Common Dreams, Oct. 23, 2018

Another take on it: White House document brags about low wait times for seniors in the U.S. without realizing that Medicare is a single-payer system.

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Dave Colon, “Democrats in swing districts run on, not from, single-payer health care,” Gotham Gazette, Oct. 16, 2018

New York focus. Note the original title in the URL: “Despite lack of support from Cuomo.” Plenty of panic-mongering from Republicans, but there is no evidence in this article that candidate support for single-payer is alienating the swing voters who can decide these close races—quite the contrary.

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Julia Manchester, “Majority of Republicans supports ‘Medicare for All,” poll finds,” The Hill, Oct. 22, 2018

If the GOP were ever to reverse course and push for single-payer, they would be in power for the next 20 years. And finally, just to keep everyone motivated . . .

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Robbie Gonzalez, “Your poop is probably full of plastic," Wired, Oct. 22, 2018

Don’t ask how the researchers found this out. But it means we’re consuming microparticles constantly.

Posted Oct 19, 2018

Naomi LaChance, “Maine’s radical universal home health care proposition,” Truthdig, Oct. 14, 2018

Another state-level single-payer-ish initiative. Curious (and unusual) that the pro groups seem to have a lot more money than the antis—at least from this report. The context is that Mainers voted to expand Medicaid despite opposition from the (nutcase) governor, but it is still being fought out in court. So perhaps it makes sense that people would go back to the ballot initiative route.

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Judith Graham, “Will Maine voters decide to make aging in place affordable?” Kaiser Health News, Oct. 11, 2018

“Maine ranked last in the nation on affordability of home care.” Points out some administrative specifics in the proposal that are unusual.

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Margot Sanger-Katz, “1495 Americans describes the financial reality of being really sick,” New York Times, Oct. 17, 2018

Good response to the affordability objection to single-payer: the current system does not fulfill its basic function of protecting people from catastrophic illness or injury. “[T]he financial stress of unpaid medical bills should be seen as another kind of side effect of certain treatments.”

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Chad Terhune, “As billions in tax dollars flow to private Medicaid plans, who’s minding the store?” Kaiser Health News, Oct. 19, 2018

Not rocket science: when monetary incentives exist to defraud the system and/or provide less care, lo and behold, that’s what happens! “The company’s chief executive took in $25 million last year, the highest pay for any CEO in the health insurance industry.”

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Rachel M. Cohen, “Democratic consulting firm teams up with hospital industry to battle nurses union,” The Intercept, Oct. 19, 2018

Another ballot initiative with the Democrat mainstream split. As usual, the opposition couches the profit motive in “patient safety.”

Posted Oct 11, 2018

Donald J. Trump, “Democrats ‘Medicare for All’ plan will demolish promises to seniors,” USA Today, Oct. 10, 2018

“If Democrats win control of Congress this November, we will come dangerously closer to socialism in America.” If only!

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Bernie Sanders, “Trump lies about ‘Medicare for All’ and he’s made health care worse,” USA Today, Oct. 11, 2018

Bernie’s rebuttal. “Nonsense.” Also, “President Trump lies about everything.” Including, unfortunately, the imminent triumph of socialism.

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Glenn Kessler, “Fact-checking President Trump’s USA Today op-ed on ‘Medicare-for-All,’” The Washington Post, Oct. 10, 2018

“Almost every sentence contained a misleading statement or a falsehood.” Great reminder of the Reagan rhetoric against Medicare from 1961, almost exactly echoed in the Trump screed.

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Beth Mole, “DOJ approves $69B CVS-Aetna merger as healthcare industry restructures,Ars Tecnica, Oct. 11, 2018

More monopolistic gigantism in the healthcare industry to go with the Cigna/Express Scripts combo. And don’t we all look forward to getting medical attention at a drugstore?

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Amanda Dunker, “Testimony on CVS Health’s Acquisition of Aetna Inc.,” Health Care for All New York, June 13, 2018

Why this merger is a bad idea. From June but timely.

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Susan Morse, “Aetna whistleblower accuses CVS Health’s Caremark of fraud in Medicare Part D drug prices in commercial contracts,” Healthcare Finance, Apr. 10, 2108

CVS Health’s priors in Medicare fraud.

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Emily Stewart, “What the CVS-Aetna merger could mean for health care deals, drug prices, and Amazon,” Vox, Dec. 4, 2017

From last year. One commentator: “This is a watershed event. The entire health care system is about to converge.” So then why not converge it all into single-payer? The ongoing consolidation would make the administrative transition that much easier.

Posted Oct 5, 2018

Ranit Mishori, “The social determinants of health? What about the political determinants of health?” Medical Care Blog, Oct. 4, 2018

“Political epidemiology”—long overdue.

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Gregory S. Schneider, “Virginia’s Medicaid work requirement won’t hit until long after program expands next year,” Washington Post, Sept. 22, 2018

Heaven forfend that we “give” people health care just for existing in generous Virginia—“Childless adults will be eligible for the first time if they make less than $16,750 per year.” Don’t want them to get too comfortable!

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Michelle Chen, “Pharmaceutical giants have avoided paying about $2.3 billion in taxes in the US alone,” The Nation, Oct. 2, 2018

How pharmaceutical loot quickly “vanishes” into offshore accounts instead of being taxed. Unfortunately, the author slips into the fallacy that taxes pay for government services.

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Dave Lindorff, “Letter from Oxford and Philadelphia: Britain’s NHS offers surprisingly good and affordable care to a visiting Yank with a sudden heart problem,” Tarbell, Sept. 27, 2018

NHS=National Health Service, Britain’s state-run, universal healthcare system. A great episode illustrating the difference between humanely organized health care and the cash-cow system we currently enjoy.

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James Meek, “NHS SOS,” London Review of Books, April 5, 2018

And here’s the alternative view of how the Tory regime is systematically undermining the NHS to pave the way for re-privatization. Very long & detailed, but worth skimming for the telling anecdotes.

Posted Sep 26, 2018

Marsha Mercer, “Take two carrots and call me in the morning,” Pew Health, Sept. 7, 2018

“The idea behind ‘food is medicine’ is that if chronically ill people eat a nutritious diet, they’ll need fewer medications, emergency room visits and hospital readmissions.” I like the “Farmacy” concept of a doctor’s prescription for green peppers and kale. However, the slogan reinforces the idea that poor nutrition and obesity are exclusively the fault of individuals and an individual problem.

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Jessica Glenza, “World's biggest tobacco companies aim to kill Montana healthcare initiative,” Guardian, Sept. 14, 2018

Nothing wrong with cigarette taxes, but it’s rather pathetic to see that a state has to come up with new taxes to fund its 10% share of Medicaid expansion. Also, note the astroturf phenomena (big business creating phony citizens’ organizations), which we will see more of in the single-payer fight.

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Tony Leys, “Iowa Medicaid’s per-member cost increases nearly triple since privatization,” Des Moines Register, Sept. 19, 2017

Average of 4.4 % annually v/s 1.5% over the previous six years. Creeping privatization followed by cries of “Look! Medicaid is bankrupt!” Also, note where the head of Iowa Medicaid admits he doesn’t know what his own chart means. “The Medicaid cost increases for this fiscal year are partly driven by an 8.4 percent ($344 million) raise the Iowa Department of Human Services agreed last month to give the two managed-care companies running the program.”

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Jenny Gold, “Workers overdose on the job, and employers struggle to respond,” Kaiser Health News, Sept. 25, 2018

Appalling as far as it goes, but the article does not touch upon the possibility that the workplace has become so much more grueling that workers turn to painkillers and other chemical strategies to keep up.

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Ed Cara, “The current U.S. drug overdose crisis began in the late 1970s, study finds,” Gizmodo, Sept. 20, 2018

Very interesting analysis suggesting that the overdose crisis started way earlier and is driven by more complex factors.

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Jessica Glenza, “Ex-UN chief Ban Ki-moon says US healthcare system is ‘morally wrong,’” The Guardian, Sep. 25, 2018

“Ban said he hopes states, including California and New York, will pass universal health coverage and spark a national call for public financing of health.” Thanks for that!

Posted Sep 11, 2018

Peter Sullivan, “Fearing ‘blue wave,’ drug, insurance companies build single-payer defense,” The Hill, Aug. 10, 2018

The industry is “alarmed”—best news ever. Tsunami of money to “centrist Democrats” to follow.

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Jeffrey Sachs, “Medicare for All makes a lot of sense,” CNN, Aug. 4, 2018

Solid arguments from a well-known economist on a very mainstream platform.

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Dean Baker, “Medicare for All battles,” Beat the Press, Sept. 4, 2018

A provocative idea on how to push healthcare costs down: allow patients to seek cheaper treatment (and drugs) overseas, even under single-payer. You get a good deal, the government saves, and there is great educational value of seeing how inflated our own system is.

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John Siman, “If you read this book, it’ll make you a radical: a conversation with Thomas Frank,” Naked Capitalism, Sept. 11, 2018

A little off-topic but worth a read, I think, for the insight into mainstream Democratic Party politics and its ferocious resistance to single-payer and other worker-friendly reforms.

Posted Aug 31, 2018

Jon Walker, “Two challenges the single-payer movement must address,” Shadowproof, Aug. 22, 2018

His two issues are taxes & provider pay. “Bills aren’t judged by their most popular provisions but by their least.”

“There is no time for ‘dealing with the details later,’ since the opposition is already taking action to exploit them. That time is now.” Some interesting tactical suggestions on how to push single-payer through.

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Matt Breunig, “The fact-checkers are clueless,” Jacobin, Aug. 2018

More on the Mercatus study that boomeranged. “I think it is safe to say that one of the main impediments to the success of Medicare for All is that liberal and centrist media is mostly too stupid or dishonest to accurately describe the proposal to their audience.” This implies that they want to get it right, a presumption not supported by evidence.

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Carolyn Y. Johnson, “Chemists beware: Amazon’s attack on pharmacies has just begun,Sydney Morning Herald, Jun 29, 2018

"Chemists" meaning pharmacists in Brit-speak. Interesting question: what effect would an Amazon pharmacy monopoly have on public attitudes toward drug prices?

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Beth Mole, “Doctors fear urgent care centers are wildly overusing antibiotics—for profit,” Ars Technica, July 17, 2018

“Doctors at urgent care centers may not have the necessary relationships with patients to talk them out of wanting an antibiotic. But they do have a financial incentive to keep them happy and returning.” If healthcare is a business, profits will rule.

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Sarah Jones, “Red state voters take Medicaid expansion into their own hands,” The New Republic, Aug. 27, 2018 Interesting grassroots referenda in Nebraska, Idaho, Utah and Montana in the face of GOP opposition.

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Rachel Bluth, “Over past 20 years, the percentage of children with ADHD nearly doubles,” Kaiser Health News, Aug. 31, 2018

So are kids twice as nuts today, or are providers diagnosing this with a little nudge from Pharma? Or is it something in the water?

Posted Aug 15, 2018

Megan Molten, “23AndMe’s pharma deals have been the plan all along,” Wired, Aug. 3, 2018

Tempted to send in your DNA to those genealogy sites? You are signing away your rights to pharmaceutical companies.

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Michael Corcoran, “Why the latest attack on single-payer backfired,” Truthout, Aug. 8, 2018

As the author points out, pre-Bernie this attack would have worked.

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Glenn Kessler, “Democrats seize on cherry-picked claim that ‘Medicare-for-all’ would save $2 trillion,Washington Post, Aug. 7, 2018

Backlash to the backlash. The organ of liberal Washington comes to the rescue of the discredited Koch-funded attack on single-payer.

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Dean Baker, “Fact checking the fact checker on Medicare for all,” Beat the Press, Aug. 11, 2018

And finally backlash to the backlash to the backlash. Baker demolishes the liberal defense of the conservatives.

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Lev Facher, “Drug pricing could be a slam-dunk campaign issue for Democrats — if only they had a plan,” Stat, Aug. 8, 2018

This article presumes, in the absence of any evidence, that Democrats want to confront their pharmaceutical backers.

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Michael Corcoran, “Top Democrats are taking health care industry cash then opposing candidates who support ‘Medicare for all,’” Tarbell, Aug. 15, 2018

Follow the money, it’s clarifying. “If the [industry] strategy succeeds, a Democrat elected in 2020 who supports single-payer may find an uncooperative Democratic House caucus.”

Posted Aug 8, 2018

The RAND Corporation, “Single-payer health plan in New York State could cover all without increasing total health spending if cost growth slows,” Aug. 1, 2018

This the RAND announcement with links to the full report as well as an executive summary.

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Addy Baird, “Koch-backed study finds “Medicare for All” would save U.S. trillions,” Think Progress, July 31, 2018

Boomerang. And even these savings are low estimates based on questionable assumptions in the modeling exercise. Note how corporate Democrats piled on the Koch bandwagon.

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Dylan Scott, “Bernie Sanders’s $32 trillion Medicare-for-all plan is actually kind of a bargain,” Vox, July 30, 2018

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Single dollar figures out of context are meaningless.

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Jordan Weissmann, "Conservative think-tanker accidentally argues that single payer could save Americans $2 trillion,” Slate, July 30, 2018

Bernie Sanders’ plan for a national single-payer health care system could, in theory, reduce American health care spending by as much as $1.4 trillion. According to the GOP's favorite think tank.

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Jonathan LaMantia, “Single-payer bill would save most New Yorkers money but cost the rich, study says,” Crain’s, Aug. 1, 2018

This one has a lot of quotes from opponents.

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Cathalijne Adams, “China is quietly becoming the world’s pharmacy — and there are big risks,” Alliance for American Manufacturing, July 20, 2018

Curious how Pharma relentlessly blocks drugs from coming in from Canada to protect their price-gouging (but always using the safety argument) but has no problem whatsoever in outsourcing the physical production of the drugs to China where the process cannot be properly monitored. The offshoring undercuts U.S. workers, so that’s fine. Note: AAM is a joint entity comprised of domestic steel manufacturers and the United Steelworkers Union.

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Sarah Karlin-Smith, Sarah Owermohle & Andrew Restuccia, “How drug companies are beating Trump at his own game," Politico, Aug. 3, 2018

How the Trump tongue-lashing doesn’t add up to much. “Of the few companies that actually cut prices, for instance, most targeted old products that no longer produce much revenue.” Nonetheless, the rhetoric could have an impact eventually.

Posted July 31, 2018

Simon G. Talbot & Wendy Dean, “Physicians aren’t ‘burning out.’ They’re suffering from moral injury.” Stat, July 26, 2018

The concept of moral injury implies that our profit-driven rather than person-centered health service undermines providers’ capacity to perform their duties and retain a sense of integrity, similar to how soldiers become alienated from themselves by being forced to witness, collude in, or commit immoral acts. (Note that physician suicide is double the rate of active-duty military.)

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Deane Waldman, MD MBA, “Medicare for all is a socialist’s dream — and an American nightmare,” The Hill, July 28, 2018

Here’s a fun exercise for advocates: pick apart this sophistic exercise in high-blown obfuscation. Bonus fun fact: the author hails from the nonprofit Texas Public Policy Foundation. TPPF Chairman of the Board, Wendy Lee Graham, was once termed “my favorite economist” by Ronald Reagan. She was on the board of Enron when it was sued for insider trading and had to pony up part of the $13 million settlement. Her spouse is Phil Gramm of bank deregulation infamy. These are the folks telling us what we can and cannot “afford.”

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Marshall Allen, “Health insurers are vacuuming up details about you — and it could raise your rates,” Pro Publica & NPR, July 17, 2018

Amazing new opportunities offered by data mining to scientifically deny care and/or charge more for it.

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Roy M. Poses, “Spin it again—four more go through the revolving door from the world of corporate health care to top US government leadership positions,” Health Care Renewal, July 27, 2018 https://bit.ly/2NZDKnt

This site monitors the smooth and lucrative flow of personnel between government and the corporate health sector.

Posted July 27, 2018

John Tozzi & Zachary Tracer, “Sky-high deductibles broke the U.S. health insurance system,” Bloomberg June 26, 3018

Medical bankruptcy among the insured. As prices rise inexorably, plans either have to have insanely high premiums or ridiculous deductibles.

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Marshall Allen, “Why your health insurer doesn’t care about your big bills,” ProPublica, May 25, 2018

An investigation of “the bewildering, sometimes enraging ways the health insurance industry works by taking an inside look at the games, deals and incentives that often result in higher costs, delays in care, or denials of treatment.” Conclusion: while awaiting single-payer, use the Healthcare Bluebook and get a written estimate before a big procedure.

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James Meek, “NHS SOS,” London Review of Books, Apr. 5, 2018

This is long: how the Tories are dismantling the jewel of Britain’s post-war social democracy, the National Health Service.

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Randy Barrett, “Rigged drug prices at pharmacies and hospitals,” Tarbell, May 29, 2018

Many medicines are cheaper if you buy them outside your insurance for the cash price.

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Wendell Potter, “Health insurers writing big checks to Democrats as single payer support grows,” Tarbell, Jun 25, 2018

Follow the money!

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The Healthcare Bluebook

Worth knowing about!

Posted June 12, 2018

Alice Ollstein, “Arkansas pulls the trigger on nation’s first-ever Medicaid work requirement,” Talking Points Memo, June 5, 2018

Not just a work requirement but a navigate-this-website requirement. If you can’t document your hours, you lose. Those booted cannot reapply until a year later. Of course, this is moving directly AWAY from single-payer in which no one would have to “qualify” for medical care in the first place.

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Emma Court, “Doctor’s offices are a hot investment — what does that mean for profit vs. patient care?” MarketWatch, June 12, 2018

Big businesses, like private equity and venture capital, are vacuuming up doctors’ practices with promises of “efficiency”—what could go wrong?

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Nicholas Bagley, “Texas Fold ‘Em,” The Incidental Economist, June 7, 2018

The Trump DoJ’s refusal to defend the ACA (Obamacare) in court is a highly unusual and authoritarian move, says this commentator. If the executive can decide which laws to enforce and which to ignore, the role of Congress is sharply reduced.

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Drew Altman, “Trump gives Democrats a big health care opening for the midterms,” Kaiser Health News, June 11, 2018

Trump is taking away protections for people with pre-existing conditions. Will Democrats channel the ensuing outrage? Where to?

Posted May 29, 2018

Lambert Strether, “Neoliberalism’s assault on the Veterans Administration continues,” Naked Capitalism, May 27, 2018

Great description and example of the “neoliberal playbook,” i.e., take a working government program, starve (or sabotage) it, point to its failures as an inherent failing of public-sector programs, demand privatization, and sell it to your friends (at a big discount). Shows how the Trump camp (with Democrat collusion) is pushing in the opposite direction, and is an excellent point to raise to the faux-single-payer advocates urging “gradual” steps: are they fighting this VA debacle tooth and nail?

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Marilyn Serafini & Randy Barrett, “Secret deals drive higher prescription drug costs,” Tarbell, May 24, 2018

“When you step up to the pharmacy counter to get your prescription, a deal has already been struck behind the scenes between two major players in the supply chain: drug makers and pharmacy benefit managers, like CVS Caremark.” A bit dense but an essential piece of the big picture.

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Michael Lighty, “10 questions about healthcare, answered,” The Sanders Institute, May, 2018

A condensed response to the most common objections to single-payer from Bernie’s think tank. What I learned:

Q2. “Hospitals and insurance companies ironically benefit from higher drug prices because those prices ‘justify’ higher rates, and generate more profit as a percentage of those higher rates.”

Q3. “The cost of premiums has been subsidized by the federal government for individuals but not for family coverage.”

Q4. “It is not the mandate that has motivated people to buy coverage, it is the availability of subsidies for purchasing coverage.”

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Ray M. Poses, “The march of legal settlements made by pharmaceutical companies is diminishing - presaging even less accountability for top health care organizational leaders?” Health Care Renewal, May 25, 2018

The paltry enforcement that reigned under Obama has withered to such levels that pharma and device makers are now encouraged to inflict harm for profit.

Posted May 18, 2018

Lambert Strether, “What’s the matter with Kansas Medicaid?” Naked Capitalism, May 13, 2018

An excellent case study in everything wrong with creeping privatization of Medicare/Medicaid. Also highlights how single-payer will put corrupt and/or useless intermediaries out of business, so they will fight to the death.

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Eliza Griswold, “The hard-left candidate taking on the Democratic establishment in southwestern Pennsylvania," New Yorker, May 11, 2018,

“Hard-left” is a tendentious term, but at least they manage to distinguish people running on New Deal-style platforms from corporate Democrats. The woman featured here won on Tuesday by a landslide against the incumbent. Also note the rise in Pittsburgh DSA membership in one year: from a dozen to 500.

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Anna Edney, Erik Wasson, and Robert Langreth, “Drug industry dodges its worst fears in Trump’s plan to lower prices,” Bloomberg, May 11, 2018

Classic Trump: After the bombastic announcement, Wall Street pharmaceutical stocks promptly shoot up.

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Rena Xu, “The burnout crisis in American medicine,” The Atlantic, May 11, 2018

Fascinating. We always argue that single-payer will simplify medical care by removing wasted clinician hours hassling with insurance companies. But this suggests the problem goes further than that to the insistence on “modernizing” care with EMRs. On the positive side, it shows how much new work would be generated by rationalizing our entire approach as more demand for services and a simple reimbursement system would create thousands of new, well-paying jobs in the sector.

*

The Washington Post (editorial), “A near-universal health-care plan that wouldn’t break the bank,” May 13, 2018

A reminder of how the pro-insurance mainstream Democrats will pitch their opposition to single-payer. Key terms: “near-universal”, “compassionate and realistic” (as opposed to “sweeping” and “radical”). These proposed tweaks to Obamacare will get lots of air right up to the moment single-payer loses traction, then will fade away, having done their job.

Posted May 8, 2018

John Nichols, “Nurses have a prescription for the Democratic Party: Back single payer,” The Nation, May 3, 2018

Nurses backing Kucinich for Ohio governorship based on single-payer support.

*

Jilian Mincer, “Hospital operator HCA spends big to keep nurses on board,” Reuters, May 4, 2018

Labor market for nurses is now “fiercely competitive” while Wall Street analysts worry about the for-profit companies’ “margins.” But the article doesn’t mention that nurses’ unions have been effective in obtaining these concessions, making them sound like ideas from management or the workings of impersonal markets.

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Dylan Scott, “How Medicaid work requirements can exempt rural whites but not urban blacks,” Vox, May 3, 2018

GOP already drawing up exemptions to work requirements to benefit whiter areas.

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Ana Maria Berry-Jester, “Does Medicaid expansion have a shot in a state as red as Idaho?” FiveThirtyEight, May 2, 2018

For or against? Depends on how the questions are phrased. If healthcare is “free for the able-bodied,” support drops off.

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Eugene Kim, “Amazon has shelved a plan to sell drugs to hospitals, and insiders say there are two reasons why,” CNBC, Apr. 16, 2018

Logistics of supplying pharmaceuticals and medical devices is more complicated than mailing pet food and notebooks. Duh.

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Ovetta Wiggins, “Fourth Circuit appeals court strikes down Maryland’s drug price-gouging law,” Washington Post, Apr. 13, 2018

An example of how hard it is for states to act on their own in these complex areas, but new approaches might pass constitutional scrutiny.

*

Posted Apr. 29, 2018

Alma Almendrala, “Las Vegas shooting victims are turning to GoFundMe for help with medical bills,” Huffington Post, Oct. 27, 2017

Surely one of the most perverse aspects of our for-profit health system: forcing people to compete in the “charity market” for the most compelling sob story and thus avert bankruptcy. “The most successful campaigns usually have a combination of an inspirational story, high-quality photos and videos, and the leverage of additional media coverage to help raise awareness about the need.” So here, too, the better-educated and savviest will triumph.

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Carl Gibson, “Health insurerers spend $158K to make sure ‘blue wave’ is against Medical for All,” GritPost, Mar. 26, 2018

The 11 Senate Democrats up for re-election this year who have not [endorsed the Sanders bill are all major insurance industry takers—big shock. Note the prominent place of CT senator Chris Murphy, co-author of an insidious faux-reform bill designed to head off single-payer; thus CT-headquartered insurance companies are ponying up big time. Another big insurance company fav: Tim Kaine (D-VA).

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Jeff Stein, Jan. 12, 2018 “Smoking penalties, ER fees, premiums on the poor: How states want to shrink Medicaid,” Washington Post, Jan. 12, 2018  [paywalled]

The usual privatization playbook: disrupt and undermine a successful benefit program, then trumpet its failure and push to privatize/eliminate it.

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Julie Rovner, “5 outside-the box ideas for fixing the individual insurance market,” Kaiser Health News, Aug. 20, 2017

We will hear more about halfway measures like lowering the Medicare eligibility age to 55 or permitting buy-ins (Tim Kaine’s favorite idea). Insurance company domination of healthcare would thus be preserved.

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Eric Levitz, “Would 'Medicaid for All' cure what ails our health care system?" New York Magazine, Oct. 25, 2017

More tinkering: resuscitate the “public option” now that single-payer threatens to win the policy debate. Schatz’s plan would permit buying into Medicaid and “compete with the private market”, thus preserving the insurance company role in healthcare and sacrificing the administrative savings from single-payer. Curiously, Sanders is a co-sponsor.

Posted Apr. 14, 2018

Phil Willon, “How single-payer healthcare became the biggest policy flashpoint in California's race for governor,” Los Angeles Times, Apr. 11, 2018 

California tax law is particularly problematic, so this debate is complex. However, the fact that single-payer is the “biggest policy flashpoint in the campaign” is significant.  

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Jeffrey Epstein, “The true, accurate and only answer to ‘How *EXACTLY* will we pay for Medicare for All?’” Citizen’s Media TV, Apr. 12, 2018 

A concise summary of the bogus debate about where the federal funds would come from to finance single-payer. This is a different matter, however, at the state level since states do not create their own money supply. (The U.S. Government does by issuing dollars.)

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Barbara Ehrenreich, “Why I’m giving up on preventative care,” Literary Hub, Apr. 9, 2018  

A dissent from over-testing and dubious treatment regimes from her new book Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer. “As for medical care: I will seek help for an urgent problem, but I am no longer interested in looking for problems that remain undetectable to me.”

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Roy M. Poses, “Don’t know much about health care and public health. . . but appointed to leadership positions in U.S. government health care agencies,” Health Care Renewal , Apr. 4, 2018 

None of the details are surprising, but the description of the relentless accumulation of incompetent toadies is impressive.  

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Logan Espinoza, “Goldman Sachs: Curing patients’ illnesses is bad for business,” Gritpost, Apr. 13, 2018 

The statement is accurate, of course, because people with chronic conditions that are never cured are cash cows for pharma. But it’s unusual to see them imprudently discuss this fact of for-profit healthcare. 

Posted Apr. 9, 2018

Topher Spiro, “Donald Trump and Republicans are botching health care. We need Medicare for anyone,” USA Today (op ed), Apr. 3, 2018

We need to build on the gains of the Affordable Care Act, not go backward.” More kidnapping of single-payer language to push a new “centrist” compromise.

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Andy Slavitt & Jonathan Schleifer, “As state voters lead on Medicaid, could health care be the next gay marriage?” USA Today (op ed), March 26, 2018

More of the same from United States of Care: “Trump & GOP] policies are so out of line with public thinking that the more they push them, the higher the likelihood that they put the country on an inevitable path to Medicaid, Medicare or some other health care plan that is ubiquitous and available to all.” But the article includes an interesting rundown of all the pressure nationwide to solve the healthcare crisis—no wonder the corporate Democrats are worried.

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Emily Kopp, Sydney Lupkin, & Elizabeth Lucas, “Patient advocacy groups take in millions from drugmakers. Is there a payback?” Kaiser Health News, Apr. 8, 2018

This is a very sticky topic for those of us who have been involved in advocacy around specific diseases. The database is long overdue.

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Jerry Ianelli, “Donna Shalala won't discuss working for Lennar during housing bust, profiting off health-care work,” Miami Times, Mar. 9, 2018 https://bit.ly/2EjFG50

Shalala, a cabinet officer under Clinton, is running for an open House seat in Florida, and Lennar was a contributor to the subprime meltdown and subsequent mega-recession. Textbook example of how the Dems can completely the anti-Trump wave with a passle of corporate millionaires from the same category who created Trump in the first place. Shalala also raked in $5 million from UnitedHealth.

Posted Apr. 2, 2018

John Tozzi, “Why some Americans are risking it and skipping health insurance,” Bloomberg, Mar. 26, 2018

The Obamacare death spiral in a prosperous family.

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Michael Corkery, David Gelles & Margot Sanger-Katzmarch, “Walmart in talks to strengthen ties with health insurer Humana,” New York Times, Mar. 30, 2018

“Walmart could open urgent care clinics inside its stores or hold community events, like bingo nights, that cater to enrollees in Humana’s insurance plans. ‘Seniors will come into their stores, visit the pharmacy, see a doctor and do some shopping while they are there,’ said Ana Gupte, a senior analyst."

Bingo night & doctors, can’t wait!

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Melissa Bailey, “As Trump targets immigrants, elderly brace to lose caregivers,” Kaiser Health News, Mar. 28, 2018

Immigrants with temporary status and permission to work are the “backbone” of the long-term care business.

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Evan V. Symon, “Millions of Americans go to Mexico when they need healthcare,” Cracked, Mar. 29, 2018

I’m not sure which part of this story is more “cracked”—the fact that people have to do this or the reactions of the crazy American medical tourists taking advantage of the services.

Posted Mar. 28, 2018

Dr. Thomas W. Lagrelius, “Computers are amazing, but electronic health records are not,” The Hill, Mar. 26, 2018

Another part of ACA that falls way short of its promises.

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Brigid Bergin, “Whistleblowers sue city’s top health insurance providers,” WNYC News, Mar. 16, 2018

“One of the plaintiffs is Ariella 'Kami' Barker, who has spinal muscular atrophy and has used a wheelchair since she was a kid. . . . Barker spent time in six different hospitals in four different states, including emergency room visits. Barker made a habit of calling hospitals before going in for treatments to confirm they were ‘in-network,’ only to later learn that the individuals providing the care at those hospitals were ‘out-of-network.’ She incurred $1.5 million in medical bills.”

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The Editors, “Health insurance company makes big profits by playing hardball,” St Louis Post-Dispatch, Mar. 15, 2018

The inevitable result of basing health access (not care) on profit-driven entities: every denial of care means larger profits. This is not hard. Anthem saved an extra $1.1 billion from the GOP tax giveaway, paying an effective tax rate of 3.1 percent in 2017.

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Rebecca Robbins, “A billionaire couple is pumping money into the drug pricing debate. Can they loosen pharma’s grip?” STAT, Mar. 26, 2018

The Arnolds are following the playbook of the Koch brothers by funding think tanks and political action groups to tackle pharma dominance. Too bad our politics has to be dependent on the rich, but how ironic is it that their industry critics denounce the outsized influence of billionaires?

Posted Mar. 21, 2018

Michael Lighty, “A labor-based movement for Medicare for All,” Sanders Institute, Mar. 15, 2018

A call for unions to get behind single-payer: “A defensive posture and incremental demands have not worked. Let’s play offense instead. In the face of existential threats to unions’ ability to fund their operations and the continuing assault on health benefits, let’s unite with the growing public demand for Medicare for All. We don’t need insurance, we need healthcare.”

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Shefali Luthra, “Bill of the month: For toenail fungus, a $1,500 prescription,” Kaiser Health News, Mar. 16, 2018

This is a regular feature of KHN.

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Harris Meyer, “Azar demands price transparency, but how will he achieve it?” Modern Healthcare, Mar. 19, 2018

Here is a contradiction in the usual argument about how well markets work to provide healthcare: why is it that this terrific, market-driven system does NOT allow us to know what things cost before we buy them? Though the aim of this “reform” proposed by Trump’s new HHS secretary is to strengthen commercial medicine, will the free-marketeers actually take steps against the industry? Or will it be another case of all hat, no cattle? Note that the impetus for this move came from Azar’s personal experience while trying to comparison shop.

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Derek Kravitz, Al Shaw & Isaac Arnsdorf, “What we found in Trump’s drained swamp: Hundreds of ex-lobbyists and D.C. insiders,” ProPublica, Mar. 7, 2018

No big surprise, but the detail is brutal. My favorite quote: “There was absolutely no overlap. He took one hat off and put another one on.”

Posted Mar. 13, 2018

Janine Jackson, “Our healthcare crisis won’t be solved until we get private insurance out,” (interview with Margaret Flowers) Fairness and Accuracy in Reporting, Mar. 8, 2018

Discusses the sleight-of-hand involved in the “Medicare Extra for All” being pushed by the insurance industry and its acolytes. Good questions from the interviewer who calls out defeatist (“never, ever”) coverage and the inevitable objections based on what is “politically feasible.”

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Dean Baker, “When US drug companies insist on stronger patent related protections, are they really trying to counter China's growing economic might in Asia?" Beat the Press, Mar. 8, 2018

Given that an important part of the TPP was to protect pharmaceutical patents/profits, this framing from the mainstream media that it is all about “free trade” is a major distortion.

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Diana Fine Maron, “Maternal health care is disappearing in rural America,” Scientific American, Feb. 15, 2018

“In 1980, 45 of Alabama’s 54 rural counties had hospitals providing obstetrical services. Today only 16 of them offer such care.” In a sane world, obstetric care would be made available anywhere women residen. Or am I missing something?

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Lambert Strether, “Notes on the West Virginia teachers strike of 2018,” Naked Capitalism, Mar. 4, 2018

Good background on the misnomer of “teachers strike” (which also included service workers, bus drivers, etc.) but also poor coverage of their core demand to fix crippling health insurance costs. “They’ve been cutting our health insurance over and over, making it really expensive to survive.”

Also note the relentless (bipartisan!) tax cutting that was supposed to lure business to the state, but which left the state penniless. Of course, Medicare for All would eliminate the problem, but top WV Democrats don’t support it.

Posted Mar. 6, 2018

Matt Pearce, “Soaring health care costs drove West Virginia teachers to go on their (possibly illegal) statewide strike,” Los Angeles Times, Mar. 2, 2018

Headline says it all. How often do strikes emerge (1) from the bottom up and (2) over healthcare? Note that the slowly increasing coverage of this strike almost exclusively focuses on pay issues and ignores the healthcare angle. This LAT piece is an early exception.

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Sally C. Pipes, “Bernie Sanders’ single-payer message won’t fly,” Real Clear Politics, Mar. 2, 2018

A handy summary of all the terrible things single-payer will do if we get our way. There’s a lot to be learned from a careful look at the arguments from this conservative think tank while watching for similarities in discourse from mainstream Democrats.

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Yves Smith, “So bad the DoJ woke up: Saline bag makers look to have endangered patients via illegal ‘tying’ and price gouging,” Naked Capitalism, Mar. 6, 2018

A bit dense, but important to start seeing how for-profit monopoly and oligopoly are further distorting the health sector. And everyone can relate to saline-drip bags, so it’s a good example.

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Ben Hirschler, “Big pharma, big data: Why drugmakers want your health records,” Reuters, Mar. 1, 2018

Digitization can lead to the creation of massive databases. Who will control them and to what ends?

Posted Mar. 1, 2018

Margaret Flowers, “New proposal designed to confuse public and prevent Medicare for All,” Health Over Profit, Feb. 23, 2018

“The fact that [the Wall Street-funded Center for American Progress] is using Medicare for All language is both a blessing and a curse. It means Medicare for All is so popular that they feel a need to co-opt it, and it means that they are trying to co-opt it, which will give Democrats an opportunity to use it to confuse people. . . .We must be aware of what is happening so that we are not fooled into another ‘public option’ dead end.”

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Kevin Zeese & Margaret Flowers, “Obamacare: The Biggest Insurance Scam in History,” Truthout, Oct. 30, 2013

This archive piece uses harsher rhetoric than that usually deployed by single-payer advocates. But its take-down of the ACA’s limitations is epic.

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Ran Dragoni, “Outrage as Teva charges $18,275 for generic drug in US,” Globes, Feb. 25, 2018

Valeant started this innovation by buying up patents on obscure drugs and jacking up the prices (Martin Shkreli being the most notorious practitioner). This Israeli company then got into the act by producing an “economy” version at slightly less. The original cost of this medication was $652.

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Susannah Luthi & Virgil Dickson, “2018 Outlook on Politics and Policy: Insurers will come out ahead,” Modern Healthcare, Dec. 30, 2017

“Who's going to do well in this environment? . . . Centene Corp., UnitedHealthcare, CVS Health and Aetna . . . the payer community is poised to fare well in the new Wild West of policy.” Who loses? "hospitals and providers who have watched helplessly as key programs lapsed without Congress mobilizing to fund them.”

Posted Feb. 20, 2018

Fred Schulte, “How a urine test after back surgery triggered a $17,800 bill,” Kaiser Health News, Feb. 16, 2018

So we have to insist always that tests be sent to in-network labs. Insane that we have to think about this crap at all.

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Justin Anderson, “Media embrace new ‘reform’ group as bulwark against guaranteed healthcare,” Fairness & Accuracy in Reporting (FAIR), Feb. 16, 2018

Follow-up to our alert last week on this bogus outfit (US of Care). The amount of non-committal doublespeak emitted by these folks is exhausting, but they will get a lot of airtime from the mainstream. Possible topic for one of our quarterly study sessions?

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Katie Keith, “Blue Cross of Idaho takes the plunge to sell non-ACA-compliant plans,” Health Affairs, Feb. 15, 2018

Undermining the ACA and restoring insurers’ power to deny coverage based on pre-existing conditions. But then again, the insane premium increases in the ACA exchanges are unsustainable, drive people into penury or dropped coverage, and open the floodgates for the red states to take advantage.

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SINGLE-PAYER AROUND THE WORLD—INDIA

Soutik Biswas, “India healthcare: Will the ‘world’s largest’ public scheme work?” BBC Feb. 4, 2018

Single-payer is a step in the right direction, but not enough: there also has to be sufficient funding and a competent regulatory regime.

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Milton Packer, MD, “Who actually is reviewing all those preauthorization requests?” MedPage Today, Nov. 8, 2018

From last fall but devastating.

Posted Feb. 13, 2018

Aaron Carroll, “JAMA Forum: The problem with work requirements for Medicaid,” Journal of the AMA, Jan. 11, 2018

Adding a work requirement to Medicaid eligibility costs money and administrative staff time, even for those who do work and have to prove it. (Not to mention those who could work but can’t find a job—how does the system monitor that?) The extra layer of bureaucracy will mean real expenditures burdening an already cost-conscious system. The Trump/GOP plan is especially punitive, but the ACA also required an “extra” administrative burden because it ditched the idea that everyone should be eligible automatically based on residence.

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Wayne Drash, “California launches investigation following stunning admission by Aetna medical director,” CNN, Feb. 11, 2018

Aetna’s PR department should have coached the witness better! Could generate other statewide investigations, including in NY.

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Michael Hochmann, “Electronic Health Records: A ‘quadruple win,’ a ‘quadruple failure,’ or simply time for a reboot?” Journal of General Internal Medicine, Feb. 5, 2018

EMRs were supposed to improve quality, patient experience, efficiency, and clinician satisfaction. Evidence suggests it is doing none of these.

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Megan Thielking, “NIH funding contributed to 210 approved drugs in recent years, study says,” STAT, Feb. 12, 2018

In case anyone is still swallowing the pharmaceutical industry’s propaganda about how they need all that cash to fund research.Feb. 9, 2018

Tony Pugh, “After approving Medicaid work requirements, Trump’s HHS aims for lifetime coverage limits,” McClatchy, Feb. 5, 2018

More on the destruction of the 1960s safety net. Means testing, age restrictions, coverage limits, work requirements, etc., all reinforce the view of health care as a market commodity rather than a universal right. (P.S. The ACA did, too.)

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Andy Slavitt, “Our broken health care politics are hurting instead of helping Americans,” USA Today, Feb. 6, 2018

Oh, an expert initiative that will “put the health of our nation over politics”! And save us from bitter, partisan divisions, no doubt. (That worked out so well in the run-up to the ACA.) Slavitt is a Wharton School of Economics grad, has a Harvard MBA, and came to the health industry after a stint as a Goldman Sachs investment banker. How is this sounding so far?

Here’s the full Board of Directors (www.unitedstatesofcare.org/about-us), including at least five people deeply involved in (and profiting from) the current system. What is the likelihood that they will advocate for the elimination of their sources of income? Note that there are NO single-payer advocates, so barring evidence to the contrary, this can be seen as an early attempt to head off single-payer once the Democrats regain control of one or both houses of Congress.

Just for the record, here is a note from board member and former U.S. senator Bill Frist’s early years: “Frist disclosed that he went to animal shelters and pretended to adopt the cats, telling shelter personnel he intended to keep them as pets. Instead he used them to sharpen his surgical skills, killing them in the process.”  Sounds like how he treated us while in Congress.

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Zachary Tracer, “Strange bedfellows? Group unites old foes in hunt for health fix,” Bloomberg, Feb. 6, 2018

“Bipartisan policymaking”—what’s not to like? Then again, who promises to solve the healthcare madness without confronting entrenched special interests? Perhaps those who represent them?

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Paul Demko & Renuka Rayasam, “Why desperate families are getting religion on health care,” Politico, Feb. 4, 2018

On the “sharing ministries” healthcare plans exempted from the ACA that offer cheaper alternatives to the ACA exchanges and escape most regulation. What could go wrong?

Posted Feb. 4, 2018

John Naughton, “Healthcare is a huge industry – no wonder Amazon is muscling in,” The Guardian, Feb. 4, 2018

This odd development—the announcement by Amazon, JPMorganChase & Buffett’s Berkshire Hathaway that they will do healthcare in-house—has the potential to shake up the entire industry in ways we can only imagine.

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Nate Raymond, “New York accuses Insys of deceptively marketing opioid,” Reuters, Feb. 1, 2018

Given the conduct alleged by a slew of state A-Gs, you’d think someone would hit the individuals in charge with an indictment, not just the corporate entity. Otherwise, it’s a cost-of-doing-business fine.

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Molly Rutherford, M.D., “This is how not to do healthcare,” Medical Economics, Jan. 25, 2018

And speaking of opioids, here is a case that Amazon’s big data will not only not solve, but make worse.

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Deidre McDonald, “I spent three days on a prison bus to see a doctor,” Vice, Jan. 26, 2018

Health from the prisoner perspective—and a reminder of our excessively punitive response to addiction.

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Susan Perry, “Erica Garner and Serena Williams’ stories underscore health inequalities facing black women,” MinnPost, Jan. 26, 2018

Black women have worse outcomes in childbirth even after controlling for all other factors.

Posted Jan. 30, 2018

Nick Wingfield & Katie Thomas, "Amazon, Berkshire Hathaway and JPMorgan team up to disrupt health care,” New York Times, Jan. 30, 2018

Potentially a game-changer. Buffett’s quote could be taken from one of our mailers: “The ballooning costs of health care act as a hungry tapeworm on the American economy.” The announcement tanked shares of health-related companies on Wall Street, from insurers to pharmacy benefit managers.

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Sydney Lupkin, “Big pharma greets hundreds of ex-federal workers at the ‘Revolving Door,’” Kaiser Health News, Jan. 25, 2018

The depressing litany of government-to-industry hustlers. How many Democrats voted to approve all or most of them?

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Hooman Norchashm, “'' 'Evidence-based medicine' ”: Corporate medicine’s corrupted instrument," Medium, Oct. 6, 2017

In our science-hostile world, who could object to “evidence-based” anything? But the author points out that scientific evidence is based on average outcomes, which means that the standard treatment will not be good for everyone. Treatment by algorithm is quite different from studying each patient carefully before ordering drugs or procedures. Not impressed with the author’s proposed solution though—more, better malpractice litigation.

Posted Jan. 17, 2018

Michael Schlosser, Ravi Chari & Jonathan Perlin, “The case for confronting long-term opioid use as a hospital-acquired condition,” Health Affairs, Sept. 8, 2017

Cautious, academic language laying out the case amply covered in many recent general articles. So the diagnosis and programmatic responses are all set. However, see below.

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Robert O’Harrow, Jr., “Meet the 24-year-old Trump campaign worker appointed to help lead the government’s drug policy office,” The Washington Post, Jan. 14, 2018

Underfunding and placing unqualified figureheads in charge demonstrate official indifference to supposed policy goals, i.e., Opioid epidemic talk is just that.

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Posted MEDICAID WORK REQUIREMENTS

Jeff Spross, “Don’t make the poor work for health care,” The Week, Jan. 9, 2018

How about “Don’t make ANYONE work for health care”?

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Rachel Garfield & Robin Rudowitz, “Understanding the intersection of Medicaid and work,” Kaiser Health News, Dec. 7, 2017

Good summary of the main points in the second half.

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Katherine Gallagher Roberts & Rachel West, “Trump’s Medicaid work requirements could put at least 6.3 million Americans at risk of losing health care,” Center for American Progress, Jan. 12, 2018

The requirements are cruel and counterproductive, okay, but why should ANYONE have to qualify to access health care at any time for any set of reasons? The response arguments almost legitimize the idea that people should earn the right to be cared for when sick!

Posted Jan. 9, 2018

Dean Baker, “We upset workers in the auto industry, why does the NYT think we should be worried about upsetting people in the health care industry?” Beat the Press, Jan. 3, 2018

Points out the anomalous attitude of mainstream commentators who champion “free trade” when it affects traditional industrial jobs but suddenly become concerned about job loss when discussing single-payer and the end of for-profit health insurance.

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Julie Appleby, “Trump Administration rule paves way for association health plans,” Kaiser Health News, Jan. 4 2018,

Another move to sabotage the ACA with benign-sounding adjustments.

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Lambert Strethner, “Trump Adminstration doubles down on efforts to crapify the entire health care system (unless you’re rich, of course),” Naked Capitalism, Oct. 8, 2017

Here is a good (and prescient) backgrounder on the three-pronged strategy by Trump et al. to destroy Obamacare with multiple dagger thrusts once outright repeal was defeated. Also has astute political observations in the footnotes.

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Michael Hiltzik, “Pfizer, pocketing a big tax cut from Trump, will end investment in Alzheimer's and Parkinson's research,” Los Angeles Times, Jan. 8, 2018

So much for that phony argument.

Posted Jan. 6, 2018

Margaret Flowers, MD, “National improved Medicare for all making progress,” Truthdig, Jan. 5, 2018 - 1059 words

Extremely timely commentary alerting us to the new tactics by single-payer opponents: steal the language and insist on returning to failed non-solutions in the name of what is “realistic.”

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Jay Hancock, Rachel Bluth & Daniel Trielli, “Hospitals find asthma hot spots more profitable to neglect than fix,” Kaiser Health News, Dec. 6, 2017 -  2384 words

How reimbursement practices incentivize chronic treatment rather than community-based preventive medicine. Could we examine NY Presbyterian’s record on this issue given its nonprofit tax benefits?

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Benjamin F. Miller & Larissa Estes, “To address opioids and diseases of despair, communities must build resilience,” Health Affairs, Jan. 4, 2018 - 1053 words

An excellent diagnosis although the emphasis on small, community-based mental health projects strikes me as missing the main point: how to reverse the economic devastation wrought by the massive relocation of U.S. industry to sweatshops in the union-free global South that has left millions with no chance for a decent job. Or to put it another way: rather than a drug-use epidemic, this is a neoliberal epidemic.

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Dr Oxiris Barbot, “Puerto Rico’s mental heatlh crisis,” NY Daily News, Jan. 6, 2018 - 702 words

Accumulating PTSD and child trauma while half the island remains without steady electricity.

Posted Dec. 31, 2017

Aaron E. Carroll & Austin Frakt, “The Leap to Single-Payer: What Taiwan Can Teach,” New York Times, Dec 26, 2017

A short article relevant to our recent discussion about gradual v/s all-at-once systemtic change. “Taiwan is proof that a country can make a swift and huge change to its health care system, even in the modern day.”

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Natalie Shure, “The feminist case for single payer,” Jacobin, Dec. 8, 2017

How single payer would free women from dependence on spouses and alleviate the burdens of home care now mostly performed by (unpaid) women.