45 Comments
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Leigh Horne's avatar

Just a personal vignette. When I was newly licensed as a clinical mental health social worker my first job was to help poor and substance abusing pregnant mothers enter recovery, thereby offering their babies a better start in life. It was good and inspiring, if difficult work. And it paid badly. As I was paying off student loans and trying to keep my ancient car on the road via frequent repair efforts, after a couple of years I quit and got a job with a major insurance company. In that job I communicated with hospital representatives whose job it was to secure approval for continuing treatment for those psychiatric inpatients who needed extended care. To make a long story short, when one of 'our' psychiatrists denied approval of extended care for a patient who had just the day before grabbed a coffee carafe, smashed it, and threatened to slash herself with the shards, insisting she was faking her distress, it was so obviously a scam to save money that I quit, and have never looked at insurance companies as anything but self-serving bastards ever since.

VALERIE MELUSKEY's avatar

I hope that your voice with your important knowledge through experience reaches a much larger audience. Is there an office you could run for that would give you this kind of opportunity?

Leigh Horne's avatar

How lovely to hear your kind words. Unfortunately, I will turn 78 next month, and believe that, although I have indeed accrued a lifetime of experience, younger people ought to be the ones carrying the banner from here on out. It would be nice to consult with one or more of them, though, and I will be looking for those kinds of opportunities as well as continuing to post here and in my own substack. So I will be heard, if only in a small way.

Sam Myovich's avatar

This is the prime moment for leaders with courage and vision for a new nation. Hakeem Jeffries, Corey Booker, and Chuck Schumer are NOT those leaders.

Jeffrey Hobbs's avatar

I think we may be on the verge of a renaissance similar to the first one, but instead of overcoming the restrictions of the Church of Rome, we must overcome the impositions of corporate power. When the people finally get what they desperately need, it's like the sun coming out after the deluge.

Robert B. Elliott's avatar

This story, new to me and probably to just about everyone else, illustrates a couple of things. One is that nothing will happen without a knock-down, drag-out fight, which will be protracted and very ugly and will have serious casualties. Secondly, there has to be public support, which requires a media that addresses the issues fairly and honestly and a public that is not too thoroughly conditioned or brainwashed and anesthetized against logic and science to buy into right-wing and billionaire lies. I hope I didn't just say that the task is impossible in the US.

G.P. Baltimore's avatar

I’m afraid you’re correct about the fight. This is one of the main pots of gold that billionaire investors get rich from, and I don’t believe they’re going to let it go without pouring more and more cash into negative publicity and attacks.

I also think you’re correct that this, like so many other issues, depends upon how much we all want this as a people.

But there’s also a third thing. The average person needs to be clear in the fact that healthcare IS a right for all citizens and therefore our system needs to reflect this for us.

The system is here to serve us, not the other way around.

Our citizens have been trained to believe they need to hoard and protect themselves from an enemy—the other average citizen. This has to be shown up for what it is. We have to unite not separate from each other. This is the biggest fear that the billionaires have, by the way.

William Farrar's avatar

Water, air, healthcare and food. Control any of those and you control the world.

In the 1980's Dick Cheney, then of Halliburton, said "water is liquid gold"

Is it really about money. How many yachts does one need? or is it about control.

Money to obtain power, power to exercise control. money to keep power.

What are the real goals of Musk, Zuckerberg, the Ellison's, Sacks, Huang's, the Jamie Dimonds, etc? Is it money? I think not, they have more than they can spend. it is about power and power is needed to control.

imhumanru's avatar

Add energy to that list.

William Farrar's avatar

Again,, we are in total agreement Robert

Dani Smart's avatar

Thank you for the Canadian history. I've written about this repeatedly over the past few years, and I hope the public is finally catching on. We pay more than any peer nation and get worse outcomes for it. I find that moving the argument away from the moral statement that everyone 'deserves' access to healthcare and towards the economic basis for it has been more productive in the conversation.

The piece of this that doesn't get enough attention is that health insurance costs suppress wages. They eat into purchasing power. They choke off innovation. And I'd argue they're a direct threat to the middle class's ability to survive, let alone thrive. Moving to a Medicare for All system, in whatever form it takes, would be an economic boon, not just a health one.

I own a small business. I know firsthand what it costs to keep health insurance and health care afloat for a team. Those are two different expenses. It's the single biggest obstacle to growth in my industry.

And for those who point out that our median tax burden is lower than peer nations with universal healthcare: that comparison is incomplete. U.S. taxes run around 27-28% of GDP. France and Denmark, near the top of the OECD, run closer to 46-48%. But those countries fund healthcare, and often childcare and eldercare, through that tax base. We fund ours separately, through premiums, deductibles, and out-of-pocket costs, and that private spending adds another 17-18% of GDP on top of our taxes. Do the math, and our real household burden lands close to theirs. We're not paying less. We're paying the same or more, just through a tollbooth instead of a ledger.

William Farrar's avatar

In Denmark, half of all income is taxed, however no one dies of cold, starvation, for lack of medical care, and even elective surgery is available at minimal cost.and everyone has the ability to obtain as much education as they want, without going into lifetime debt.

Jacob Kaarsbo, a former Danish intelligence expert,https://jacobkaarsbo.substack.com/ has a vacation home in Jutland, on the north sea, on a civil servants salary.

Denmark consistently ranks near the top of the global World Happiness Report, while the United States typically ranks significantly lower, often outside the top 20.

Dani Smart's avatar

Ironically, I wrote about Denmark’s status as the happiest country in January of this year.

https://danismart.substack.com/p/the-great-sleight-of-hand-why-americans?r=1c5095&utm_medium=ios

US Taxpayer's avatar

The insurance is the toll booth of life: 1. Life 2. Health 3. Mortgage 4. Vehicle. I’m sure there are more….retail products.

William Farrar's avatar

Renters Insurance, Pet Insurance. Where the real profit is, in mandatory insurance.

That is why the Association of Health Insurance Providers (AHIP) lobbied for and bless "Obama care" because it was a gift to them, it forced everyone to buy health insurance, or pay a fine in the form of taxes.

Bela's avatar

Can't buy that those arguments.

William Farrar's avatar

Not trying to sell an argument. Fact is that during the debate in congress and W.H.

Single payer advocates were not allowed into the White House, but there was a constant parade of insurance execs and lobbyists, and Nancy kept single payer from coming to the floor.

Those are facts, whether or not you buy them is immaterial.

Bela's avatar

5. crop insurance

William Farrar's avatar

Crop insurance is a federally subsidized risk management tool that helps agricultural producers protect against crop yield losses and revenue declines.

Farmers also hedge by playing the futures market (legalized gambling)

Bela's avatar

I know what it is. But it uses private insurers. That's my point.

It feeds aa the public taxpayer trough.

I take your second point.

alis's avatar

Perhaps break it down to medicine and care for all. No need to reinvent the wheel on paying for health care, every developed nation in the world has already figured out the mechanics of it. We should be pointing out that they are not richer or smarter than we are.

This is issue number one. Democrats have won this argument and now we need the Congress and Presidency to get rid of the tollbooth. Thanks for the history, Thom. See you in the streets.

Tomonthebeach's avatar

We pay out of pocket for any procedure Insurance companies consider to be cosmetic or unnecessary like glasses or hearing aids. Even though I have DOD Tricare for life, which is supposed to pay any bills Medicare will not, I will have to cough up $3,000 for eye surgery to remove glaucoma and cataracts (which is covered) because one eye has a stigmatism and the "special" lens for that eye costs an extra 3 big ones. That is because glasses are not covered. I can afford that easily, so here's lookin' at you next month. But what if $3,000 was your entire monthly income?

Another thing Thom did not touch on is the law profession. Insurers are in court all the time over overcharges, insurers refusing to pay, and HIPAA laws that protect confidentiality. I had to sign 12 forms for my eye surgery that were merely legal cover-their-ass forms in case of insurance squabbles. Ergo, the legal profession is also getting rich off healthcare.

William Farrar's avatar

I had cataract surgery in 2024, both eyes, Medicare would pay for one set of glasses, but only medicare approved glasses, and the frames broke within one year. As you have done, I paid for my own glasses

Surgery was a success, prior to surgery I wore trifocals, after surgery none, but a year later is when I needed reading glasses,still do, old age catches up with us like death and taxes.

Idon't worry about Dental as my teeth are plastic, but there is a Benefeds program for Tricarefor life recipients, but it is a rip off, outrageous monly premium, and still have to pay over the allowed. Cancelled my visual plan, I would pay more for premium than in glasses, kept my dental plan, as my wife has her teeth cleaned twice a year, and recently had a cap recemented, no cost.

William Farrar's avatar

With Jeffries, Schumer , Fetterman and their ilk, who needs Republicans. Check opensecrets.org for Jeffries biggest contributor. What good is it to elect Democrats when they are cowardly, corrupt and complicit

Seven Democratic senators voted to confirm Kristi Noem

John Fetterman (Pennsylvania)Maggie Hassan (New Hampshire)Tim Kaine (Virginia)Andy Kim (New Jersey)Gary Peters (Michigan)Jeanne Shaheen (New Hampshire)Elissa Slotkin (Michigan)

: Three Democrrats voted in favor of the SAVE America Act during the House floor votes Henry Cyellar, TX, .Jared Golden (D-ME): Voted in favor of the original SAVE Act package in the House.Marie Gluesenkamp Perez (D-WA): Supported initial iterations of citizenship-verification voting legislation in the House, though she and most Democrats opposed later modified versions.

Bo Baggs's avatar

Thanks Thom! Love your essays. This one is brilliant.

Gloria J. Maloney's avatar

I need my eyesight, but even though I am covered by Medicare and a United Healthcare Gap plan, $665 for assessment of retinal and cataracts has been denied. So here I go on another fight for essential care. It's exhausting.

Thanks Thom for explaining this and other issues that directly affect our lives.

William Farrar's avatar

I don't know your situation, But I made an appointment with Cascadia Eye, my PCP whom I see for diabetes, referrred me. They examined me, found I had cataracts, and performed the surgery including implanting a new lens. I haven't paid a cent. But I have Medicare and Tricare for life, which takes up the 20% Medicare doesn't cover.

I've noticed that since Trump and Musk took over, that Medicare is acting more like a private insurer, and I saw something about some procedues needing pre authorization, admittedly they is a buse.

I was billed for equipment i never used, including COVID tests and a catheter.

Gloria J. Maloney's avatar

A catheter?!

I am diabetic and have a collagen deficiency disorder, so I’m not supposed to have to pay with Medicare, but United Healthcare's gap policy is probably automatically denying it, just because that’s their thing. What a pain.

Dian Allison's avatar

Thank you for the background on Canada's health care system's development! I had not known any of this. Sadly, I doubt that the gazillionaire owners of our U.S. health insurance companies will ever allow it here

Protect the Vote's avatar

Where Is America’s Outrage For Fascist Republican Lawlessness With No Due Process?

Protesters are showing up all over the country from Minnesota to Texas, from Vermont to California, voicing dissent over many issues. A recent ICE shooting in Austin of a DoorDash driver occurred last night, alive but having an obvious bullet wound to the right upper back without immediate medical attention. Of course there is no due process for any immigrants or US citizens. But there are many other reasons to protest and Americans are showing up to this immoral lawless fascist regime.

Institutions such as MSM compared to protesters have wimped out in the first 18 months. But that’s about to change since Cheeto went after CNN, MSNOW, and Politico, banning them from the BH(Black House) without due process. These media rivals have signed onto a lawsuit to protect their first amendment rights and have now been joined by NYT, AP, Reuters, NPR, and Getty to boycott covering BH events. This is with now Cheeto having his new all time low of 32%(reminder that at 30% or lower a president never recovers) and even Melania is asking that one of the banned CNN lady reporters cover her event planned for the UN General Assembly on the topic of global child advocacy.

WE the People are furious and expect our elected Democratic officials to go after fascist Republicans and their lying executive branch cabinet members. WE will protest, WE will vote, WE will demand a return to morality, WE will demand billionaires to get out of politicsa and government. This autocratic coup d’etat is being met with an evolving angrier and angrier electorate. French revolution 2.0 American nonviolent style.

Tom Halstead's avatar

Repugnican defeat will be for naught in virtually all respects if current Democratic “leadership” is allowed to remain in place.

Barry's avatar

The Canadian system is not perfect. There are waits for some procedures, BUT if you show up, at a hospital with symptoms that appear potentially fatal, you will be looked after, quickly. The system needs more money, but with Trade wars & depleting resources & a need for more doctors & nurses the system faces challenges. I did watch John Oliver & am glad you mentioned him. He is brilliant, illustrating system problems & his humor helps swallow the horror of privatized medicine.

Bela's avatar

No system is perfect, at least ones involving humans.

Add: we CAN improve them.

William Farrar's avatar

The grandson of Tommie Douglas is Donald Sutherland, Kiefer is his great grandson. Of course the Canadian and English system aren't perfect, overloaded with people because health care is free, and mom's bring the kid to the doctor when they sniffle.

In 1983, I had been retired a year, and found myself in a propane fire, 2nd and 3rd degree burns of the face and hands. I was driven to the nearest military hospital, and still had to wait, beause I wasn't bleeding out, however once they saw me I got first rate medical attention, morphine, a bed, debreeding, silver ointment, and the scars barely noticeable/

And no medical bills, yes socialized medicine, which is what you get in the armed forces, has it's problems, but damn it is even better than civilian medicine, and that was my second experience. I had a A posterior cervical discectomy , because of a parachuting incident, official business for Uncle Sam, Years later there was a recurrence of pain, and a trip to the VA fixed me up.

As a child I wound up twice in the local Naval clinic, I was a Marines brat, mom and dad were separated. Mom didn't have to pay a cent, and I got treatment.

Sis was hit by a car, thrown a hundred feet, they took care of her also.

Vuva socialized medicine, warts and all.

Barry J Kaufman DO's avatar

How soon we forget that it was you Thom Hartmann who hung up on me a physician when I called to tell you that The Affordable Care Act was not going as planned. Anyone who called with a genuine concern regarding Obama's lies about the ACA ("You can keep your doctor...your premiums will not go up...etc) was dismissed as a Republican plant. It was Obama and the Democrats who privatized our health care system, expanded Medicare Advantage and sold us to the health care conglomerates. And please Thom and his minions, while the Republicans are a menace and did weaken the ACA, it is not their fault such an albatross of a legislation (2000 pages in all) was passed in the first place. It was destined to fail as it was largely written by the health care lobby. https://barryjkaufmando.substack.com/p/no-democrats-its-not-republicans

Robert B. Elliott's avatar

I have no idea where you are coming from or what you had offered as an alternative. But I would suggest that for decades before Obama, and with little backing of Democrats, medical care had been turned into a business and the insurance industry was clamoring to get their hands on the money that would potentially be available because of technical and scientific advances. The ACA was a compromise that opened the door to the possibility of ultimately developing a more equitable system. I'm going to hang up on you now.

William Farrar's avatar

You really have a hard on for Thom, don't you Boris, because he is not a hard core, retread,old time Marxist like you, also because, unlike you, he will not fellate Valdimir.

And I doubt that your phone call was of that nature, because I was listening and watching his show when he had Brunch with Bernie, who was an advocate for single payer

You dear friend, have zero credibility except with some like minded Putinski and Marxist trolls.

Larry Mark's avatar

Thom had Brunch with Bernie for maybe 10 years. Then when Bernie was running for president for 2016 Thom supported Hillary. Can you explain why?

Exit polls for the 2016 general election showed people who voted for Trump would have voted for Bernie if he was on the ballot. Thom, Bill, and Hillary did everything they could to keep Bernie from having a fair shake in the primaries, If Thom had supported his supposed friend Bernie maybe Trump would just be a side note in history. Can you explain why Thom supported Hillary instead of Bernie? And I'm not a Marxist who wants to b**w Putin.

William Farrar's avatar

Thom backed Hillary after the primaries went for Hillary, What is so difficult to understand about that.

Who the fuck are you? A Putin assett or agent trying to create trouble with lies?