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I watched a video on YouTube this morning about a law student who did a deep dive into employer-based health insurance to appeal claim denials for the care his wife needs due to a genetic illness. His paper was in a law review. His name was only mentioned once, and the closed captions spelled it Frank Beyfus, but closed captions are often hilariously wrong.

What caught my attention was that he said that, as numerous cases go before the SCOTUS, the court nearly always rules in favor of insurance. But one thing that speaks the loudest to me is that doctors who treat patients are held to "the standard of care" and can be sued for malpractice, but doctors who work for health insurers and deny claims are not held to that standard and can't be sued for malpractice. Wow. They can pronounce death sentences willy-nilly by denying claims without civil consequences.

The major weakness in our patchwork health system is for-profit corporate control, which is maintained through money in politics. Racism made universal health care a hard sell 100 years ago, but money in politics, Citizens United, is the obstacle to be overcome now. What will it take to overcome Citizens United?

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I don't know what the batting average is for Medicare appeals, but I bet it's high. In private insurance, patients don't have the same rights. ERISA rules definately favor the carriers. At DOL we had overall review of ERISA.

When Trump was president he tried to undercut Obamacare using "Association Health Plan (AHP) reform" but the Biden administration rescinded it. "....the 2018 AHP Rule was a significant departure from the DOL’s longstanding pre-rule guidance on the definition of “employer” under ERISA and substantially weakened the DOL’s traditional criteria in a manner that would have enabled the creation of commercial AHPs functioning effectively as health insurance issuers. The 2018 AHP Rule set forth alternative criteria under ERISA for determining when employers and associations may join together to sponsor a single group health plan under ERISA. For example, the 2018 AHP Rule required that the group or association have “at least one substantial business purpose unrelated to offering and providing health coverage or other employee benefits to its employer members and their employees.”[ii] Previous guidance required that such group or association “must exist for purposes other than providing health benefits.”[iii] The intent behind the 2018 AHP Rule was to encourage the creation of AHPs as alternatives for affordable health coverage for small employers and self-employed individuals."

Medicare for all would eliminate a need for all these regulations.....

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There is not one industry in the USA that isn't sucking the life out of ordinary people. And cover is being provided by main stream media. If we don't get money out of politics we will suffer the consequences.

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We are and have been suffering the consequences NOW

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Currently reading your book on the Hidden History of the American Dream. It is an amazing work and I encourage everyone to read it. I plan to read all of the series.

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Thank you, Mary!

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Thank you for this. It really does feel that we're at a tipping point where Americans are realizing how dysfunctional and parasitic our "healthcare" system is and how much we are dying (literally) for a change. I wrote a piece about this a few weeks ago in hopes that we can keep the conversation going...

"Close to 250,000 GoFundMe campaigns are established each year to cover medical costs. In 2021, approximately $650 million (one-third of all GoFundMe funds) went to medical campaigns. 22% of American adults have contributed to these funds and the number of medically-focused campaigns continues to rise each year. Crowd sourcing among our friends and family to pay for critical care should not be normal. Share a casserole, provide a shoulder to cry on, heck, send “thoughts and prayers” but raising money because the medical event will most likely bankrupt our friends and family is simply wrong.

Why are we flailing to raise donations through our social networks? Simply put, the for-profit health care industry is not in the business of paying for our care. Their fiduciary responsibility is to shareholders, not to the people paying premiums in exchange for coverage. Profit and care do not – and cannot – coexist."

https://open.substack.com/pub/danismart/p/healthcare-in-america-analysis-paralysis?r=1c5095&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true

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IMHO we could use charitable deductions to endow the trust funds...SS and Medicare.

People who are in SSI, automatically are eligible for Medicaid which usually pays 100%. Depends on state system. .

When I lived in Pennsyltucky, some people rented apartments in Toronto, to take advantage of the Ontario system. Lots of people here in Baghdad By the Sea have dual citizenship.

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There is litte difference between the fossil fuel industry and the Iong time IndustriaI complexity health care industry. It is a no wonder the latest big news shooting occured. I'm not condoning violence however. Let's call a spade a spade. How many uncalled for deaths have been attributed to heath care industry denials, these are denials directly attributed to PEOPLE the creators of the policies that are denying people services, testing, and treatment for very possibly curable illnesses. CEOS are at the top of the murderer lists and

lets not forget this

i

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If you are a CEO and you murder thousands you get a bonus and a pay raise. The media praises you and you are exalted

If you kill a Health Care CEO you are called a Murder, a Vigilante and the media condemns you, and you are imprisoned or executed.

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That's a moronic argument.

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You have to do better than that. Explain yourself Or are you a narcissist that he believes he is a god?.

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What you are arguing is that it's ok to kill a CEO. No, that is murder. It's an evil act, and it should be condemned by the media and every human being with a sense of decency and empathy. The alternative is social chaos. Luigi Mangione should face the death penalty for his action, premeditated murder. To call me a narcissist who believes he is a god is nonsensical and borders on idiotic.

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Nope Eric, I am not arguing that it is OK to kill a CEO or anyone, just pointing out the utter hypocrisy of how when a CEO kills thousands, tens of thousands he is rewareded with bonuses and lionized, Yet then one kills a CEO they are,per your feelings, should face the death penalty.

Now the question of the efficacy of the death penalty and it's morality are a different subject.

By your own logic, gthe CEO's of Corporations that cause the death of even one, much less hundreds of thousands should also face the death penalty

And on you are a narcissist who believes he is a god, because only a god would would have the authority and ability to determine whether one lives or dies.

Back on subject: Union Carbide of India, killed thousands with a chemical leak, because the CEO didn't want to spend the money on preventive maintenance, and all that happened, after years of law suits, was from them to pay damages, and they didn't even do that. They declared bankrptcy, was taken over by DOW, and a corrupt Indian Supreme Court let them off the hook for damagage.

That CEO, as well as Brian L. Thompson should have faced the death penalty for murder.

But I guess murder for corporate and investor profits is quite OK is it not?

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William, you are going in two different directions. Luigi assassinates a 50 yr. old man who is the father of two kids. They will grow up without a father. Because you 'see' a larger picture, the evil of the health insurance industry, the 'act' is acceptable to you. It's not to me.

Second, the only people who have done anything to try and make health insurance better are the Democrats. Republicans have fought them every step of the way. With Trump in power, do you think it will get better? Should we go and shoot Republicans without any consequences? They are the primary reason healthcare has the problems it has. I hold Republicans completely responsible for the state of the healthcare industry. Not the CEO of United Healthcare. This husband, father of two, was doing what the capitalist system demands. A snoot-noised kid blows him away.

One last thing: I've been in the health insurance business for 40 years. I've put numerous clients, both under 65 and over 65, on health plans with United Healthcare. I've never had a problem—just the opposite. I get calls thanking me all the time. I educate every single one of my clients so they understand how to use the system. Today, most problems are caused by ignorance of the plan someone is on. 80% or more of my health insurance clients are all low-income, and I mean low-income; most earn less than 25,000 a year even closer to $20,000. I have many clients that make barely $16,000 a year. If lower, they should be on Medicaid, except Red states make Medicaid almost out of reach. We have to thank FDR for Medicare, Obama for Obamacare, Johnson for Medicaid, and Advantage plans that have allowed me to put low-income folks on plans they would never have been able to afford. United Healthcare has been exceptional in this area. Do you want to fantasize about a perfect system or, like me, with boots on the ground, do you want to help people right now? The election of Donald Trump is the worst event to happen to the health insurance industry. We are heading in absolutely the wrong direction. I guarantee you that if you shoot enough CEOs, nothing will change. But some idiots will 'feel' better.

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I wrote a response, but it disappeared when I pressed share. I'm not going to do it again. Just understand I profoundly disagree with you.

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Cliff makes a point and thanks for the reference from Mary. My perspective as well-worn physician is that our profit system creates a gap between labor earnings/taxation compared to corporate returns. The tobacco companies in addition to Big Oil invest in Hospital systems, tear them down and sell for scrap, then buy up at bargain prices to start the cycle again. It sucks $ tax breaks from the Government. So Hospitals are again in the bankruptcy phase of vulture capitalism, an aggregation/disaggregation cycles that pumps out profit to the top.

I ran for Congress this year to offer a Single Payer State Sales Tax approach that the Nurses have been working on (essentially eliminates the Health Insurance Industry - https://www.casinglepayerinfo.com/ ). National Medicare For All has been a distraction to note.

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Futile wishful thinking on my part, but I would like to see a return to the post Charter war days, and then all tobacco companies given the corporate death penalty, as wll as other corporations that injure the public health.

Thom has covered the Charter Wars. In the late 19th Century, The charter laws of the states, uniformly had an expiration date, usually about 50 years, to renew the charter the corporation had to prove that it acted in the public interest.

John Davidson Rockefeller felt that this was an imposition, besides believing that competition was a sin, he believed that anything that hampered his acquisition of wealth and power was a sin.

He therefore advertised that the state that came up with the most favorable charter law, would be where he moved his corporation. New Jersey won the bid and Standard Oil New Jersey came into being.

Other states saw that, and rushed to amend their Charter Laws, Ohio wound up with SOHIO. Delaware, did NJ even better, and as a result over 600 corporations, mostly financial and insurance incorporated in Delsware, and they have their own senators.

The Judiciary stepped in 1919 in Dodge v Ford Motor Company and declared that the only purpose of a corporation was to make a profit for the investors, meaning that corporations had no social responsbility other than producing a postive rate of return for investors.

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That case is state law. I've been arguing that Congress could fix it....federalize it, but it doesn't look like we'll ever have that opportunity again.

It wasn't long ago that Montana had an anti lobbying law but SCOTUS reversed a decision of the Montana Supreme Court that had upheld a Montana state law prohibiting corporations from making expenditures supporting or opposing candidates or political parties. The Court held that the Montana decision was inconsistent with Citizens United. https://www.npr.org/sections/itsallpolitics/2012/06/25/155707295/supreme-court-says-montana-cannot-ignore-citizens-united-ruling

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You are correct Daniel, it applies only to Michigan, but it was and is sufficient for corporations to have universities tout it in econ and management courses as prevailing law

Money talks, professors walk.

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Looks like you put a lot of thought into it.

A cursory look at the plan does not mention elimination of the collateral source rule, which would make health insuance rates drop like rocks.

Employers have mandatory workers' comp and many actors stand liable for pain and suffering, which is usually based on the cost of future medical care. Medicare is basically a high risk category because it covers people who are not insurable or are highly risky like people entitled to SS disability. Most medical risk occurs at the end of life.

How would your plan react?

Also the Ontario plan is more efficient than the "Canadian" plan you mention.

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Thanks for exposing this sick cycle ...venture capitalism is destroying the humanity in this country and killing our residents. Now we have to wait, as we watch it get worse and worse

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Healthcare, education and confinement (prisons) spring to mind as areas where the profit motive ought never be permitted, let alone encouraged.

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You may see this comment as rather abstract or not. I have over twenty years of experience in shamanic healing. The most basic foundation of this type of healing modality is that you NEVER charge for healing. You are performing a human-to-human service and to charge money for this type of healing approach is simply not tolerated...not in this world or in the other worlds. Spiritual healing is obviously something that most people do not understand nor have any interest in discovering. It has been filed under "quack" methodology. However, the lead person for the healing paradigm that I worked with was a doctor who had developed cancer and was written off until she agreed to a shamanic healing. She was cured and her doctors in Canada were all blown away. She packed up and headed to a place where she believed that she belonged based on this experience. We have a long way to go in the world before we can come to terms with "not everything is about money" ideology and I am not just commenting on emotional entanglements. Until we can come to terms with both our physical and spiritual qualities, these profiteers will continue to scam us on all levels.

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Mr Stronghorse, I think what you are describing, and the basis of Shamanic healing, absent the application of herbal remedies is the mind body connection, or as you thinketh, so you be.

I subscribe, I have been living with pain since 1975, and do not take any medication, the strongest I have taken is tylenol, and only once or twice.

Some years ago, a researcher came back from the Amazon with a concoction that cured diabetes. PhRMA was interested, but couldn't synthesize a drug, because they looked for a specific chemical.

The natives that produced the concoction said that it wasn't one drug but all working in concert

It is like Ayahuasca. It is made from a vine and a plant by a shaman who knows what he is doing.

It was found that the vine was the source of a chemical I think is called DMT, but DMT passes through the digestive system without being absorbed, the plant produces a chemical that enables the DMT to be absorbed.

PhRMA gets it wrong every time, but they aren't interested in natural remedies because they can't patent them and their is no profit in them.

My wife has fibromyalgia, and some joint issues, she relieve them via marijuana, it works for her.

I don't partake, tried a gummy once, and got dizzy and fell asleep for 4 hours, that was it for me. I don't do any drugs, nlegal or illegal.

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Mr. Farrar: Well...yes and no. The mind certainly has a big part to play in our conscious existence, but my healing techniques are more geared toward the participation of the spirit world. This unique approach actually originated, I believe, from the shamans who could communicate with the plant world and learned their secrets for healing. They didn't actually have a CVS down the street. This level of communication is necessary for the quality of spiritual healing paradigms to retain their integrity. Developing this level of communication is an art and a science beyond western / industrial commercial health community standards.

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When I heard disability cases, I sometimes had claimants call their babalus and or shamans as witnesses. A couple of them actually had medical training, there used to be a "Shaman Mental Health Clinic" in Hialeah, Florida. Here in Baghdad By the Sea, we have many "botanicas." https://florida.pbslearningmedia.org/resource/awr09.socst.global.first.eur.botanicas/botanicas-markets-of-the-divine/

A SCOTUS opinion protected the religious aspect. https://en.wikipedia.org/wiki/Church_of_the_Lukumi_Babalu_Aye_v._City_of_Hialeah

There nused to be a babalu on call at the emergency room at our public hospital.

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Healing any illness requires deep inner work. Often this work is shared in societies that respect shamanic approaches and S-guides are capable of navigating the person and illness in ways that drugs and pills can only work for short periods and often in cases of some illnesses like cancer, do not work at all because the foundation of the illness is emotional/mental, spiritual and no pill or western therapy can cure.

Thanks Frank!

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We came close to a single payor system when Obama was president, and had it not been for Nancy Pelosi and Rahm Emanuel we would have had one. All that is needed is to change one sentence inTitle 42 of the United States Code, subchapter XVIII of chapter 7, in the sections 1395–1395lll, simply change the eligibility date from 65 to at birth. But that would have pissed off AHIP there would still be room for private insurance as there is in Europe.. There is co insurance and elective procedures.

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TR Reid - The Healing of America

Excellent direct comparison of US vs most of the world, especially developed countries’ medical systems.

“Do people have a right to health care?” In most countries, except the US, the answer is “YES”

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https://youtu.be/apAUfd0Vg1s?si=U_J5mpVbtKbbAa4y

Thom - Great report on America’s health “care” system. In NC getting Medicare through has been a boon for at least 600k people and, by extension, I would imagine, the people who love them.

500k medically-induced bankruptcies a year is insane. And the terror of it looms large.

Marianne Williamson has been out there talking to people in the hinterlands for years and speaks of WellCare reform and many of the same ideas and policies you write and speak about.

Would be great to hear the two of you in conversation. Have you ever interviewed her before? I’ll look it up.

Either way, would love to see independent journalism NOT take the path of mainstream media in the past as labeling Marianne as “woo-woo” and as not being a serious choice for the offices for which she has run.

The Democratic Party sold out Bernie and we’ve paid for it.

Having a DNC team comprising Marianne Williamson, David Hogg, Stacey Abrams, Robert Reich, some good people from the Harris-Walz campaign, perhaps, would be amazing. Democrats using government to lift up all people by doing right by poor and working class people would lift up the entire country.

Would love to hear you talk with Marianne Williamson about this job she is seeking.

Thank you for considering. ✌🏽🐝✌🏽

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Terrific condensed history! A casual remark … “It became a major best-seller across America when it was first published for the American Economic Association by the Macmillan Company in 1896, … “

Everyone should know that from the get go the American Economic Association & the brand of economics they support was wholly wedded to virulent racism & misogyny. The AEA provided “experts” for all the Southern states when they were passing Jim Crow laws. The AEA kicked women out of economics & relegated them to the new fields “home economics” and social work.

The AEA only in the past 10 years has an ethics code — that they don’t enforce — these jerks actually argued “economists don’t need to disclose that their research showing complete bank deregulation is great is funded by banks, or that private health insurance is optimal is funded by insurers, or food additives … etc.

So when economists weigh in on public policy … they are probably arguing for more power for oligopoly

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Economics is not a science. Economists use mathematics to calculate formula's like Economic Order Quantity, but business who rely on EOQ wind up either selling inventory to Overstock.com, Marshals, T J Max or dumpiing it.

Human behavior, needs, attitudes, opinions cannot be quantified.

In the same vein there is no such thing as Social Science,or Political Science.

There are opinions, feelings, tastes, and thus are conditional, subjective and ever changing.

For instance the low income and low information voters who voted for Trump, are now, even before he has been sworn in, learning and regretting their choice.

No mathematical formula could have predicted their choice or their regrets.

Milton Friedman, of the Chicago School of Economics, created the idea of comparative advantage, and his disciples, the Chicago Boys, helped overthrow the Allende government of Chile and install the fascist Pinochet, and what ensued was a reign of terror, torture and murder. (Note to self: Will we be seeing the same in America?)

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Milton Friedman did not invent Comparative Advantage…that was David Ricardo, a classical British economist who thought he was “completing” Adam Smith’s work.

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Thanks Susan. Isn't google wonderful?

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As my ol' pappy used to say, social science is to science as masturbation is to fornication.

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Laughs. I like your pappy, my kind of guy. Like father like son.

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Thom, Medicare consists of Parts A and B. Part B pays 80% of outpatient costs, and the patient is responsible for 20% uncapped. How is this going to be covered? It's easy to say Medicare for all, but how do you pay for the uncapped 20%?

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T-H-E message should be that Americans are getting screwed. The Republican's policies move money to the top and people doing all the work are being pushed farther and farther down the economic ladder. Health insurance rip-offs are a good example to use to explain it.

Statistics do NOT speak for themselves. Presidents and members of Congress need to speak about them. That's exactly what Bernie and Elizabeth do. Time to keep the message simple, loud and clear.

Thanks Thom. Always happy that you give them a platform. The smart ones USE it!

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Tom, you are correct in your assessment of need. The problem seems to be that even though partisan stooges are under orders to scream "False Equivalence!!!" to every citizen who notes that operatives of the Democratic and Republican parties organize their parties to march in lock step to play KEEPAWAY BALL of national health care from citizens, if either cartel party was actually willing to run seriously to enact it, we would have had national health care decades ago like real functional democracies do. Meanwhile, under the vice grip of two cartel parties and their oligarchy, we slipped 10 places this year in international rankings of press freedom to #55.

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Totally agree. The supporters and recipients of profit from our present healthcare system supports both parties almost equally, just to hedge their bets. Doesn’t matter which side wins cause both are beholden to the same payperplay corporations controlling health management, insurance companies and their toady lobbyists.

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This is why the Repubs are focused on getting rid of medicare because all that needs to be done is to lower the age requirements of this long standing law. But that is not going to happen until the right to vote is accepted. Biden had a bill but the Senate Dems failed to pass it due to two traitors. It is not going to matter much as authority is only given to the consented. Authority comes from the desire and will of the people despite what the political structure is. When the Galactic Federation Council decides who represents the will of the people it will transfer its connections to the lightworkers to whom are deemed worthy and those in office will lose all spiritual authority and this authority is felt. Those that lose their authority will walk out because the nakedness is real. This will happen in 2025 when the Chosen One comes out.

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