Single Payer Healthcare Financing Series -Part 1
I ran across this three-part series while reading one of Kip Sullivan’s articles “Kip Sullivan on the Creeping Privatization of Medicare, ” Corporate Crime Reporter
PNHP Single Payer Healthcare Financing Series, Kip Sullivan JD
If you wish to understand the evolution of healthcare, like All On 4, and how we got to this point the US, the detail is here on YouTube. Kip’s discussion starts in the seventies detailing HMOs (HMO Act 1973) during the Nixon era. He goes on to explain how it was an attempt to decrease the overuse of healthcare in the US and the resulting costs.
“Now there are a slew of these insurance companies like managed care organizations – accountable care organizations (ACO), medical homes, hospital readmission reduction programs, merit based incentive payment systems. And they are eating Medicare from the inside out.
Most troubling now is the direct contracting entity (DCE) which was conceived in the Trump administration but is being pushed by President Biden and Elizabeth Fowler who heads the Center for Medicare and Medicaid Innovation.
‘The proposal calls for a pilot test in ten cities where traditional Medicare beneficiaries will be assigned to a DCE and they will have no choice to get out,” Sullivan said. “In this case, the DCE may not be able to tell patients where they can go. But now they are being paid like HMOs, they will have tremendous incentive to keep people from going outside of network. And to deny services.
That is the problem with creeping privatization in traditional Medicare.'”
I am very concerned with being locked into a MA plan which has been over coding and over charging CMS for the care provided, if provided. As a result, MA Advantage plans owe $billions to CMS. It appears the effort to “force” people on to MA plans is off the table for 2022.
MA plans are more costly than Traditional Medicare and provide a lesser standard of care. I will follow up with the other two parts also.
This is also A YouTube Presentation
troubles me that Biden and Warren, not to mention Bernie, are not on top of this.
the creeping privatization began, in my opinion, when Medicare stopped being worker funded, and “the rich” were “made to pay their fair share.” so of course they would find a way to privatize it.
if you want single payer, the way to get it is to make it worker-paid. yes it’s a significant “tax” increase. but you’d save a lot of money in the long run.
Social Security had the advantage of being able to be phased in from the start (also had Roosevelt and recent memory of the Depression). but now even SS is under attack from “liberals” who want to turn it into welfare… because increasing the payroll tax a dollar per week per year is an intolerable burden on “the poor”…those with incomes of 50k per year.
stupidity and greed.
Worker paid Medicare does not resolve the rising cost of commercial healthcare. All the times I have written on this issue, and you still have not picked up on it. Did you watch the presentation?
okay, i found the presentation.
help me out here, i read a lot faster than i listen. most of this stuff i already know, and a lot of it is just advertising for itself..nothing wrong with that, i just don’t have time to listen to it. can you tell me how “single payer” (i believe in single payer) is different from “worker paid” and why “worker paid won’t control costs?”
not ar once, but it is the ONLY thing that will resolve it in the end.
i probably did not watch “the” presentation. because I didn’t see it.
as for “all the times”…as many times as i have tried to tell people the best (only) way to save Social Security is to pay for it themselves?
I agree with Run. The rising costs of our health care will not be solved by workers only paying for the single payer system. When you think it through, the entire purpose of having a single payer system is so that everyone is covered simply as being a citizen of the US.
The problem of our system is that we are treating the delivery of health care as any other commodity. That we assume profit motivation and competition will strip out the waste is just selfishness incarnate. There is no competition in the actual delivery of health care. Science and date dictate how a given health problem shall be treated in general. The only competition is the artificial created market for products and the middle man.
This artificial, surreal structure we put in place leaves no option for the “art” of the practice of medicine. The art being the thinking part of the job of delivering health and healing.
Then again, we have rather down played “art” and “creativity” in our society. It’s all about STEM which is all about Wall Street.
We can’t fix our health care system until we fix our overall economic structure and put the economy in service of us.
For now, I get to carry 4 cards for my insurance. Medicare, Supplemental, Drug and Dental. How stupid is this?
Ditto on the Four Cards. I was fortunate to strike up a conversation with Kip Sullivan about Single Payer. I still have a third post to comple on why Vale Added Plans do not work This comes in addition to the 3rd part of this series.
I hate phrases like “if you think about it…” as if I didn’t think about it.
meanwhile we don’t deliver health care as if it were any other commodity. at least, we don’t generally buy our groceries or cars by buying insurance so we can pay for them if we need them in the future. (actually, we do, in the case of Social Security though we don’t usually think of it that way.)
Worker-paid is not “if you don’t pay for it you don’t get it.” it’s that it needs to be paid for, but no one else can be counted on paying for yours. so you buy insurance. but the government is the only entity that i know of that can guarantee your insurance will be there at a price you can afford when you need it.
the beauty of Medicare is that you can pay for it at a reasonable rate while you are young and not sick and working and have money. insurance companies typically charge young people less because they probably won’t need it…this month or this year. then they charge a lot more when you are old, probably will need it but may not be working or have the money to pay for it.
worker-paid is the only way you can keep “damn politicians from taking it away from you”…and then only if you are smart enough to not let them fool you by turning it into welfare and then gradually privatizing it so they can go back to charging what the traffic will bear: pay or die.
i can hardy wait for you to “fix our overall economic structure and put the economy in service of us.” but meanwhile we could fix it today by taking a small amount out of our own paycheck and paying for our healthcare (insurance) ourselves. not so small, of course, but less than buying private insurance, and more politically stable than begging the rich to pay for your health care. after that, working on controlling costs has a better than fair chance of working…though not if the people don’t keep an eye on it.
i can’t see that “thinking that the profit motive and competition will strip out the waste” is selfish. It might be stupid. but selfish?
or have you decided that when i say “worker paid” you think I mean “every man for himself”?
nor can i see what’s stupid about carrying four cards. what’s stupid is thinking you can get the rich to pay for it.
Yes Coberly, that is what I’ve been saying since I started blogging here, that the rich should pay for me, you and everyone. Every man for themself. Really?
4 cards represents 4 different insurances. It is stupid because it is duplication of admin costs and profit taking.
Insurance is just the middleman. So yes, we treat the purchase and now delivery of health care just like any other commodity or goods.
To use one of your comparisons, cars. Imagine if the bank said you can only buy a GM car. If you buy a Ford you are paying a higher rate. If you buy a foreign car, well that is out of country (network) so…no coverage. Then imagine getting your car fixed. Or imagine being told you can only shop at Z store and not at Y or B. Imagine the pricing for all of it being set by contracts the vendors have with the bank. Not by you the actual consumer, the end user of the item.
It is not much different than the big box stores selling shelf space. They are in the middle of the transaction and getting money from both hands.
Of course, you can choose a different bank and you get to have that choice every year.
Isn’t it fun having options?
The problem with this retail/wholesale model applied to the delivery of health care is there is no actual competition as to what the product is. That is because there is only 1 product: the application of the knowledge of health and healing. So, we’re created competition that has little to do with the actual product and everything to do with making money.
There is no virtue in taking profit. Profit requires self restraint. We don’t have that. Earning a living is not profit.
I have been told my comments will be deleted because I disagree with people and hurt their feelings. This is mostly to let you know, if not deleted, that I read your reply to me. It does not appear to me that you understood what i was saying.
Gee, only 167 views of the video. Sad!
Part 2 is up. there is a Part 3 also. I have to listen to it first before I post it. It is an education in itself if someone whated to know what Single Payer is about.
When I enrolled in Medicare, just ten years ago, I attended a session provided by our local Council on Aging (which are common in many if not all MA/NE towns), which had a medical-care-for-seniors advisor on call. Medicare choices seemed daunting. The advisor advised that Medicare Advantage plans, while generally rip-offs in most states, were quite effective in MA. In addition, Mrs Fred had spent about ten years dealing with her aging mother’s trials and tribulations with ‘regular’ Medicare. Then I went to a session put on by MA Blue Cross (MA BC/BS) about their Advantage plan. The decision was an easy one. However, they are technically NOT non-profit; instead they are ‘not-for-profit’ (which is not uncommon in Big Healthcare). They have a lot of revenue, and they pay taxes. And some of their offerings are questionable: dental care benefits are not great, nor are hearing or vision benefits. So be it. They have been easier for Mrs Fred to deal with than ‘ordinary’ Medicare was.
However, it appears from what I see on TV, that Big Insurance (Aetna, Cigna, United Healthcare) are getting into providing Medicare Advantage big time, and they are seriously NOT non-profit and NOT not-for-profit either.
So, as the advisor said, Medicare Advantage seems ‘decent’ in MA, it may not be such elsewhere in the USA.
About Blue Cross/Blue Shield…
Blue Cross profits
Anthem Blue Cross Profits Fall As Pandemic Medical Costs Rise