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Paul Cohen's avatar

Our current health-care system is built around guaranteeing massive profits for the insurance industry; that system is wasteful and it costs too much. And our tax system is now built around avoiding taxes for corporations and the very wealthy. Hmmm. how could we possibly do better?

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Wayne Caswell's avatar

It’s not just insurance but the entire for-profit medical industrial complex, which also includes hospitals, drug companies, testing companies, and medical equipment suppliers. This group functions like a cartel, and as Trent says, they work to maximize profits.

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Paul Cohen's avatar

I agree, though I'm not sure the hospitals are making out like bandits (though I'm sure some are). But I do think the insurance companies are at the core of the problem.

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Edward Bryant's avatar

Let’s see; how about confiscatory and punitive taxation of the obscenity wealthy and corporations, coupled with a death tax which allows only a modest inheritance to the scions of great fortunes so they have to work for a living like the rest of us?

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Paul Cohen's avatar

That worked pretty well in the 1940's until the Reagan administration. The French economist Thomas Piketty documented that a 50% tax or higher on the top incomes is needed for maintaining a healthy economy. In this country they are taxed at somewhere around 3%. You likely pay a higher rate.

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Edward Bryant's avatar

I completely agree and think the power of government can also be used to encourage healthy citizens. If we regulated food and food manufacturers the way the EU does and changed building codes to require walkable cities and towns, the present burden on the healthcare system would be reduced and the average person would suffer less from “lifestyle” diseases.

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Robin Liberte’'s avatar

If I were running for office, I'd give my constituents a clear, unabashed, left-wing populist alternative to MAGA. It would consist of three, simply communicated focus areas: 1) Medicare for all, 2) Universal Basic Income (UBI), and 3) Universal Higher Education (including technical school). How would I pay for it? I'd tax the rich, of course!

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debra's avatar

Brilliant, yet so common sense! Get the “for profit” out of it, and the solutions flow. Also, get the sugar and unnecessary additives out of everything. Encourage people to eat healthier and get more exercise. We don’t need personal trainers and high-tech gyms. We just need to WALK! Try alternative therapies like acupuncture and yoga. You’ll be amazed what they do (inexpensively) for the body, mind and spirit!

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Chris G's avatar

Excellent diagnosis of our failing system, failing at its most basic level of keeping people healthy. Shameful that the wealthiest country on the planet has turned its healthcare system into just another private equity scam heading for bankruptcy. What is perhaps most shameful is that neither political party is interested in fixing it, because they too, are profiting off of this racket. Bernie Sanders being one of the biggest recipients of big Pharma donations. It will likely take a recession along with another pandemic before we ever see a significant effort to demand M4A.

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Corbin Trent's avatar

I think there is also a sense of hopelessness among the folks leading the parties. I think they've decided our decline is inevitable. That's why I think so many of them need to be replaced with excited, engaged people ready to do the hard work or repairing the systems.

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toolate's avatar

More like a sense of "I've got mine"....take a look at net worth of AOC for example

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Matthew Knight's avatar

Bernie’s donations aren’t from big Pharma companies, but from people who work in the pharmaceutical industry. It’s a vast difference. It’s not large sums of money from corporations backing the guy who wants the government to break up their monopolies and have the ability to negotiate, who took a bus load of people to Canada to buy medications at 10% of their American price.

Don’t allow the cynics to destroy your faith in the very few that we have that are actually fighting the fight.

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Thomas Pinzone's avatar

A greater willingness to frame federal spending around MMT would be helpful getting beyond "how will you pay for it?" issue

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Corbin Trent's avatar

I think it's an issue of out-of-control costs, too, though.

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Thomas Pinzone's avatar

Oh absolutely 100%, it's just the initial hurdle for any legislation that might benefit the wider public is the pay for issue that Democrats boxed themselves into. Republicans run up the "deficit" with glee with their hopeless legislation on taxes and military spending

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dana klein's avatar

Yes and a very large percentage of that is cost is doing business. CEO salaries are way up there on the list of required financial items at a for profit healthcare operation. Compare the annual costs for any national or non-profit healthcare system to any for profit health care company. Several years ago someone published a study of Massachusetts vs Canada’s healthcare systems I don’t remember the exact numbers but it was about 40% to 4% for just that one state.

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Bill Semple's avatar

Scarcity is baked into our current profit/market oriented health care. The need for health care doesn’t go away if not met. So, limit the supply, demand is constant, prices go up. Indeed our US health care functions as a cartel to keep availability of care scarce. The “success” of this is demonstrated by our paying twice as much per person for health care as other countries that have universal systems as well as better outcomes/health.

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Wayne Caswell's avatar

With a focus on public health, rather than corporate profits, America could save well over $2 trillion PER YEAR by just becoming “average.” Compared to other rich nations, we spend twice as much on health care but still live sicker and die younger. The potential benefits of health reform, however, go way beyond my rough yearly estimate, or Corbin Trent’s 10-year estimate.

Universal healthcare, uncoupling insurance from employment, would allow good workers to seek better job opportunities elsewhere, forcing [and allowing] employers to pay higher wages to keep them.

And in general, the entire economy, measured by GDP, would benefit from strategic public investments in a healthy, skilled, and more productive workforce paid well enough to actually buy the goods and services they create. But that takes political will. And as I’ve said for years, “To fix our broken health care system, we must fix our broken politics, and to do that, we must get the corrupting influence of big money out.”

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Susananda's avatar

Yes there is enough money, although republicans prefer trickle down economics.

The current Republican leader of house will only support those that believe his policies of Christian nationalism.

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Giampiero Campa's avatar

Yeah the public option is how things work in Italy, for example. If you don’t want to wait too long and you can afford it you go to a private clinic.

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Giampiero Campa's avatar

But public hospitals work well overall. Once you are able to get treatment.

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The Sand Pit's avatar

"Medicare for All" has been a primary focus for me for the past 8 years. During the Bernie 2020 campaign I was a low level policy advisory, with an expertise in Medicare for All. You are certainly hitting the right notes. The metrics tell the story of a failed healthcare system that often forces people to chose between financial hardship or life saving procedures to cover deductibles, algorithmic produced "holes" in coverage, or insurance denials (again algorithmic produced.). The weight in our healthcare is profit, not service.

A government sponsored alternative healthcare, competitive with insurance, could be a necessary step needed to advance our healthcare system. But it would still leave some people out in the cold. And it would still be more expensive.

Economy of scale in a single payer system that covers everyone and paid for via taxes is the most efficient way to ensure that everyone has healthcare in the least expensive way. And a system that offers full healthcare for everyone produces a much healthier society. All the B.S about long lines, poor medical staff etc, is exactly that: B.S. The American people have been sold a shitload of goods for too long.

Thanks for pushing this

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jeanne's avatar

I enjoyed reading your post and agree with much of it. Until our politicians become principled and the healthcare system is nonprofit, we will get more of the same. Changing our healthcare system includes the herculean task of removing corruption from our government, as well as cutting out other profiteering middlemen in the insurance and bankster industries. I see no difference between the Democratic and Republican parties anymore. They've been equally destructive to the middle class for decades.

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Manqueman's avatar

All completely correct here.

But how do you get a corporate party to push healthcare reform with any credibility, with anything beyond empty promises not intended to be kept? Or, if kept, then with a public/private partnership with a decency of states having the last word on whether their people benefit?

Oh, wait, I just described what we have: The ACA.

So, again, how do we get to M4A (the proper solution) with the corporate Party of Clinton.

Or maybe today’s post requires a caveat that none of this happens with electing a dominating group of progressives. Without that happening in the first instance…

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GS-z-14-1's avatar

Corbin:

The Democratic Party cannot offer a credible response to fascism because from its beginning, it served NOT as an engine of social struggle, but a contrivance to mollify Capitalism’s worst abuses, thereby reinforcing that system and buttressing it from removal through collective proletarian action.

The collapse of social democracy in the Weimar Republic, the New Deal [a bribe to dissuade US workers NOT to repeat 1917 in the US], the rise of a distinctively US form of fascism — under Biden’s nose …

The GOP functioned as an incubator of fascism, and the Biden admin refused all effective action.

How is that responsible action Responsible citizens won’t affirm that behavior.

The second issue you face is that there is no Republic to repair.

That the Constitution has no influence of restraint or requirement over the several branches of government means that the United States Republic has fallen.

‘America’ doesn’t exist.

If you can’t come to terms with such matters, you cannot be part of the solution.

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Kim's avatar

FYI, while the most recent Medicare for All bills don't create public "ownership" of health care infrastructure and providers per se, they do create a considerable amount of public control over the health care system, mainly via global budgeting for operating expenses of institutional providers,

https://www.congress.gov/bill/118th-congress/house-bill/3421/text#toc-H4FEA63A7A89649E5B0057DCDA109A434

and through capital expenditures and a special projects budget.

https://www.congress.gov/bill/118th-congress/house-bill/3421/text#toc-H253D392978D94ECEA9CD4B6B1A2B1D2E

Basically, the Medicare for All system would be able to control the allocation of health care resources by negotiating with all of the institutional providers. And none of the payments from the Medicare for All system would be allowed to be used for "the profit or net revenue of the provider, or increasing the profit or net revenue of the provider." So essentially, it takes out much of the profiteering from the health care system.

There are also some provisions in the bill related to the recruitment and education/training of more health care professionals.

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Kim's avatar
May 9Edited

National Nurses United also has a good FAQ that addresses the "provider shortages."

https://medicare4all.org/about/#1579909958338-6106ef8c-dc30

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Jane Penne-Morse's avatar

Very constructive. We really do need a change as we are definitely in a healthcare crisis in this country. Healthcare has become a profit making business where not only we as patients but nurses, aids and in some cases Dr’s are shot changed Hospitals have been closing in all small towns in America.

Have you tried to get an appointment lately. Right what a joke. Bottom line we need a change. Unfortunately it won’t come in my lifetime.

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