13 Comments

Over and Over again, decade after decades we've had this discussion and nothing get done when dems are in control or republicans are in control. Except, republican fight for privatization year after year, decade after decade. And after all these decades Bernie fights the good fight for Medicare For All.

Expand full comment

It is remarkably obscene that the smartest people of the greatest country in the world have been suckered for so long, and have allowed generation after generation to be used in the manner our US Sick-Care-Industry-for-Profit has herded all of us for the last 100 years. https://www.beautips.info/prenatal-care-system-of-different-countries/

This is a perfect storm waiting for enough rational young voters to finally make a generational change to: 1. Stop voting for any incumbent politician https://www.opensecrets.org/elections-overview/reelection-rates 2. Register everyone over 18 to vote and take the time to be informed and vote, and 3. Cut the Military Industrial-Pentagon budget that President Eisenhower warned us against.https://www.opensecrets.org/elections-overview/reelection-rates

The current GOP has vowed to gut Social Security and Medicare in 2023, at a time when most of Americans have no pension other than Social Security, and only SickCare during their working years, with little to look forward to as they retire or go broke https://protectpensions.org/2018/09/25/americans-no-retirement-savings/. With Medical bankruptcies hitting historical highs, it is a timely opportunity to stop all this madness. https://www.commondreams.org/news/gop-pentagon-social-security-medicare

Mr. Hartman citations:

Yet the United States spends more on “healthcare” than any other country in the world: about 17% of GDP.

Switzerland, Germany, France, Sweden and Japan all average around 11%, and Canada, Denmark, Belgium, Austria, Norway, Netherlands, United Kingdom, New Zealand and Australia all come in between 9.3% and 10.5%.

Health insurance premiums right now make up about 22% of all taxable payroll (and don’t even cover all working people), whereas Medicare For All would run an estimated 10% and would cover every man, woman, and child in America.

How and why are Americans being played for such suckers?

We are literally the only developed country in the world with an entire multi-billion-dollar for-profit industry devoted to parasitically extracting money from us to then turn over to healthcare providers on our behalf. The for-profit health insurance industry has attached itself to us like a giant, bloodsucking tick.

Expand full comment

I had a temp job in 1983 in Australia processing the enrollments for every person to have Medicare. The Australian government has a standardized fee that all providers must abide by and if they want to charge more the patient signs to agree or they get hit with hefty fines then jail. That’s 40 years ago! We are so backwards here, no wonder we have a labor shortage. People around the world know what a crappy standard of living we have so they’re staying away but they’re luring our Millennials overseas.

My Australian family are shocked by the cost of living here and feel sorry for me. If it wasn’t for my adult daughter living here I’d be sorely tempted to move back.

I sometimes lose hope, then I go to work and chat with the University students there, and I believe in the GenZs to turn it around.

Expand full comment

There are rural hospitals in the US closing all the time, which is tragic, but it’s a great opportunity to win these rural people over to sensible thinking.

The Federal Govt needs to buy up all these hospitals and they become Medicare hospitals and also offer care to low income people for free.

The government in Australia owns hundreds of thousands of hospitals throughout the nation and people can go on a waitlist for operations, such as knee replacements, or they can pay private insurance premiums and within the private hospital system they get their choice of Doctor and no waiting list. If they opt for that system and there is a financial gap between coverage the patient can claim a portion of that from Medicare. This relieves the burden on the public system so if you can afford it you get no waiting lists. The private insurance companies pay healthcare providers a government set standard rate for any procedure so this keeps premium prices down.

My mother decided not to wait for the public hospital to provide her colonoscopy and paid the $500 out of pocket cost to the private hospital and stayed on top of her urgent needs. So there are options but it will cost a little extra to not use the waitlist with public hospitals.

Can you imagine how rural people would be relieved to have their hospital back and healthcare available to them. Why isn’t there a Bill to bring something like this about? What course would the current administration take to make this happen?

Expand full comment
Jan 11, 2023·edited Jan 11, 2023

This one factor has changed the trajectory of so many American lives; we will never know the whole picture of the damage. We do have a good idea of how many people it has killed.

The insurance coverage through work idea should go down in history as one of the worst. It worked for some and left others outside looking-in, and as stated, it cost us all a fortune. The American work-force deserves something fairer, more practical, and all of us (working or not) deserve something humane.

The answer to our ridiculous situation is teaching everyone, especially the youth of this nation, that we all deserve better. I thank Thom and Bernie for their monumental efforts to do just that. The history of the repression of the right is part of that lesson we must pass on. I plan to let my new Representative know what I expect of her regarding national health care legislation. I hope everyone does the same. My Senators are already great advocates, and I will thank them.

Expand full comment

If we want improvement, we need to participate in the political process. Perhaps Hartman could address this in a full length report or three. For me, this would involve participation in the nuts and bolts of elections and involvement in communication with voters in our local precincts.

Expand full comment

The lead-in to this story lists Social Security and Medicare as entitlements. They are not. We paid into those programs like a retirement account. In fact, we pay a monthly premium for Medicare. Nobody would call a retirement account an entitlement. Thom, I generally think that your programs and historical perspectives are right. I’m surprised that you have adopted the corporate media nomenclature.

Expand full comment

As a family doc with 40 years experience caring for sick people you made a good diagnosis. I can attest our horribly dysfunctional, pain causing system is built on the 2 policy pillars of racism and profit (both made real by the Republican Party). Caring, compassion, treatment and support for the sick comes later. Now, with Medicare Advantage and the REACH program growing (with huge government subsidy), Medicare - our only universalist program - is atrophying and may disappear. The sick will suffer first, then all the rest of us.

Expand full comment

Well done. Maybe we need a TV sitcom that shows insurance actuarials laughing off claims denials as schools hold bake sales to help pay medical expenses for families in need. Maybe one of the actuarials has a teenage daughter who’s in love with the basketball star who has some undetected — until just before the big game — heart issue. Hilarity ensues as the family fights for great healthcare for the youth. The bills are undgodly and these people learn that asking for help is necessary.

Expand full comment

One personal example, on Christmas Eve I developed, rapidly, a very painful tooth infection, no dentists open, I got there too late for Urgent Care, so ER. The triage nurse saw me in about 10 minutes, looked it over, said the doctor would be in soon and they would prescribe antibiotics and pain meds, then see a dentist asap. I knew all that before going in, could have told her exactly what she was going to tell me. Then she said the doc would be in soon. That took 5 or 10 minutes of nurse time.

5 hours later the doctor showed up, and it was NOT a busy night, it took her 5 minutes to look at my teeth and repeat exactly what the nurse told me fiver hours before. 30 minutes after that I went out to the nurses station and asked when the doc was going to come back with my prescription. The nurse there got a bit huffy and told me to go back and wait, doctor would be there soon. 20 minutes later nurse came in with the prescription and a few pills to get me started.

I wanted to fill the Rx there then at the hospital pharmacy, but nurse told me they don't do that (that's pretty dumb, from a business perspective) so I had to drive 20 miles each way to the nearest pharmacy open all night on Christmas Eve . . . this is in Sacramento, the capital city of California . . . and at one of the largest regional hospitals.

As I was waiting 5.5 hours to get meds for a simple tooth infection, and the ER was definitely not busy, maybe 5% seating capacity, I was thinking, This is a great example of grossly incompetent business management! Simple cases like me should have been triaged in and out in 10 minutes!

I have good private sector insurance, so of course the copay was only $150 for 10 minutes of nurse time + 5 minutes of doctor time, that averages $10 a minute, $600 an hour, which is obviously one reason American healthcare is more expensive than anywhere else,

__________________________________________________________

The insurance pay was I'm guessing maybe another $1,000, I haven't got the statement yet, so the corporation was getting maybe $75 A MINUTE for doc + nurse time.

____________________________________________________________________________________

American prescription med prices are wildly inflated too, Viagra at major US pharmacies including Walmart is about $30 per pill, over the center in the UK about $2 a pill for an 8 pack, buy 100 or more at a time it comes down to about 80 cents.

For profit healthcare in America is a crazy money factory for the medical industrial complex. If Congress was doing its job it would do a big "investigation," asking, WHY DOES HEALTHCARE IN AMERICA COST TWICE AS MUCH AS THE AVERAGE OF THE REST OF THE G20?

Bringing the cost of medical care down consistent with Canada and the EU could bring the cost of Medicare / Medicaid down 30%, 40%.

Expand full comment

Could someone please help me understand this?

Racists defeated attempts to pass legislation to implement a single-payer or other national healthcare system such as Medicare-for-all solely because they were adamantly opposed to taxpayer funds paid by Whites covering the costs of healthcare for Black people. This is documented history. Racism remains as a major factor today behind the right-wing resistance to dismantling the corrupted and exploitative private insurance-based system.

And, the healthcare industry is just one more example of corporate interests and wealthy scions having the ability to rake off huge profits at the expense of ordinary taxpayers, including most Black people. This is enabled by legalized bribery and corporate personhood, which are all part of the strategic efforts by those same wealthy people to undermine democracy. They favor a plutocracy or oligarchy, believing they are superior, and race once again is central in many respects to the whole picture.

White supremacy and racism in all its forms represents, more than anything else, ignorance. Likewise, the anti-democratic beliefs of the people who think that autocracy and authoritarianism are necessary for good governance represent ignorance. They lack a fundamental understanding of what constitutes competence, knowledge, wisdom, discretion, or quality of character and of where those things come from or who possesses them. They imagine that people will want their gracious benevolent guidance. They have wrongly believed that the people who work and who are not exceptional by virtue of wealth and property ownership are inferior and cannot make good decisions about the laws and the nation.

At the same time, “We have the best schools in the world”, and “We put men on the moon”. We require all citizens to attend school for over a decade. We have had those laws in place and those extraordinary public schools for many generations.

So, what am I missing? Why are so many graduates of the schools so woefully ignorant about race and racial matters? Why do so many “educated” people gravitate toward anti-democratic ideas and ideals? Why do people vote against their own best interests and in favor of bad policies and reactionary politicians and legislation? Whatever happened to the concept of progress?

The schools have been attacked by those on the right. If we on the left defend the schools, and pretend that they are going to magically change and stop contributing to the problems of racism, ignorance, and authoritarianism after more than a century, are we not defending the racism and authoritarianism? Will the schools ever get it right if we do not accept the reality of gross failure?

Hey, I know. I just had a novel idea! Why not just eliminate the authoritarianism from the schools by eliminating the arbitrary authority granted inappropriately to officials, bureaucrats, and supposed experts -- who actually know zip about human behavior or education -- by getting rid of the compulsory attendance laws! School would be voluntary, students would have to perceive a purpose and benefit and participate for their own reasons, and the negative, insulting, and punitive factors would be removed. Everything else would stay, including public funding and limited government oversight.

Utopia is not for the real world. Education of the masses through coercion is a pipe dream. Autonomy and a sense of agency and security for children, however, are realistic goals. Indeed, they are essential. If education is a cultural value and if it is supported by government as such, it will be appealing and popular. Force can never be a part of the mission. Putting an end to these bad laws will not be easy. But there is simply no alternative coming to save democracy.

Unfortunately, I am almost totally alone in my observations. Is there no one who can explain where my logic or information are inaccurate? Will everyone sit back and complain bitterly until the inevitable happens, instead of at least trying to cut the cancer out of our society?

Maybe I’m wrong about how many people are ignorant or about the levels of ignorance and semi-literacy. Maybe a high level of ignorance isn’t the dangerous thing I believe it to be. Maybe the shift to STEM subjects away from liberal arts or civics classes is the real issue (I sincerely hope no one believes that). Over seventy million voted for Trump TWICE and a similar number did not vote at all or voted with their eyes closed. Lots of other stats tell a similar story.

Is this not the proper forum for a discussion about education or miseducation with respect to our form of government and way of life? Can one be educated and not have any knowledge about politics, or vice versa? I’m waiting for some clarification from somewhere. Things are not adding up.

Expand full comment

Yes! We've all got U.S. healthcare horror stories directly related to the lack of universal health care. JFK could have been speaking today. I just don't see a path, though. Pray, perhaps?

Expand full comment