Medicare for All

At Healthcare NOW, we’re used to getting push-back from folks who don’t believe in Medicare for All, and we always expect to hear from those folks – but this episode is about something different. When we announced our annual national  Medicare for All Strategy Conference is happening this November, we got some push-back – not about our fight for healthcare justice, but about our choice of venue. Some of our supporters were upset that we’re going to be gathering in a Red State – ok, arguably the king of the Red States: Florida. We’ve gotten emails from folks who won’t attend on principle because they refuse to go to (and this is a quote) the “Evil DeSantis State.” So today we’re joined by one of the leaders of Medicare for All Florida to dig into what’s happening in Florida, why we’re heading to the Sunshine State for our conference, and – most importantly – how you can join us this November 22&23rd to bring the fight to Red America. https://www.youtube.com/live/2PU2kuMoaJw?si=Sd1duyLhAXUoeqHG Consider this your official invite to our National Medicare for All Strategy Conference: Find out more and register here! Want to learn more about how Medicare for All activists are fighting to move forward toward healthcare justice amid constant assaults on public healthcare from their state government? Check out the Medicare for All Florida website! Follow & Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts, Google Podcasts, or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! This show is a project of the Healthcare-NOW Education Fund! If you want to support our work, you can donate at here!

Anyone who’s been on the internet and wants to preserve their sanity knows one, eternal truth: Don’t read the comments section. The comments, as we all know, are where our better angels go to die – where we forget our humanity and type out the ugliest, scariest stuff we were apparently thinking all along? Well, today, against our better judgement, we are going to disregard best practice and dig in to what people are saying in the comments about healthcare. Because how are we ever going to win over the people if we don’t know what the people have to say? We tasked our researcher, Ashley Schultz -- the most chronically online of our followers, with digging through the dregs of the internet, and she’s here to talk about what she found. https://www.youtube.com/live/qsWogMDDbWw?si=exWiYo0B5L5BTVgC Follow & Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts, Google Podcasts, or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! This show is a project of the Healthcare-NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org.

:::CONTENT WARNING::: This episode contains graphic discussions of genocide. Here at the Medicare for All Podcast, we are usually focused on the US, but the fight for universal access to healthcare is one that stretches way beyond our borders. Today we take a global perspective and check in with a group of doctors who are putting their lives on the line to address the serious devastation happening right now in Gaza and its impact on the health of Palestinians living through that devastation. We’re joined by the founders of Doctors Against Genocide to talk about how a political conflict turns into a public health crisis, and what kind of action we can take to stop it. Our guests are Dr. Karameh Hawash-Kuemmerle, a pediatric neurologist in Boston, Massachusetts, and Dr. Nidal Jboor, an internist in Dearborn, Michigan, who together co-founded of Doctors Against Genocide (DAG), “a global coalition of healthcare workers dedicated to succeeding where global governments have failed in confronting Genocide.” https://www.youtube.com/live/sTCSO2kFeA8?si=tCuiVlE3I7Co3HoC Want to support the incredible work of Doctors Against Genocide? Whether or not you're a doctor, you can join DAG and/or donate here! Follow & Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts, Google Podcasts, or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! This show is a project of the Healthcare-NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org.

We’re talking about Medicaid folks, the public healthcare system meant to be our social safety net for anyone who can’t afford private insurance and doesn’t have access to healthcare from an employer. I’m sure most of you are aware of Medicaid — but what you might not know is just how many of our friends and neighbors land in that safety net every year. Over 70 Million people in this country rely on the Medicaid program for basic healthcare. That’s 20% of Americans, or one out of every five people you meet. That means that even if you are not on Medicaid, the $880 Billion in cuts to the program proposed by congress will affect you or someone you love, and not in a good way. In fact, just today, researchers at Yale and UPenn released new research stating that the Trump cuts would cause over 51,000 additional Americans to die each year. For this episode, I’m joined by Jaron Benjamin, Deputy Chief of Campaigns from Popular Democracy to break down why we all need to care about stopping the cuts and act NOW, before it’s too late! https://www.youtube.com/live/I4xu6zglswc?si=OmFDD5gezpbwppNq We need YOU to join the fight to save Medicaid! Find out more about what you can do here! You can learn more about the great work happening at Popular Democracy here! Follow & Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts, Google Podcasts, or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! This show is a project of the Healthcare-NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org.

Whether you are a party planner or a community organizer, you know that since the pandemic, it has been REALLY hard to get folks out of the house. It makes sense: the news is depressing, our screen-based scrolling culture is alienating, and our politics are polarizing to the point where a casual conversation can easily escalate to throwing hands. That being said, this month has been different! In response to Trump 2.0, we’re seeing an uprising of activism in the streets, with millions of Americans participating in Hands Off protests and other actions to fight back against Trump’s attacks on everything from migrant rights to Medicaid. What’s behind this second wave of Trump resistance? As per usual, it’s a lot of ordinary people deciding they can’t wait any longer for change. On today’s episode, I’m talking to the leaders taking action in my local Texas community to get some perspective on Resistance 2.0 and why it’s all kicking off right now! https://www.youtube.com/live/7OedeuSqD40?si=eXb6DqbW-5vz0LeS In this episode, Gillian talks with her favorite new activists from Indivisible Coastal Bend, the local Indivisible chapter in Corpus Christi, Texas. Ashley, Misty, and Stacie have always been concerned with politics, but the latest developments of the 2nd Trump Administration prompted them to take their concern to the streets and start organizing! Now these women are local leaders in the national uprising happening right now across the US, fighting against cuts to Medicaid and social security, the elimination of DEI, and the overall assault on Democracy. You can read more about the incredible work they've been doing here and here! This is an important moment for all of us in the healthcare justice movement to get together with our allies in the streets to stand up for our public healthcare and demand that we move forward toward universal healthcare, not backward, leaving even more folks out in the cold. So make sure to sign up for our Healthcare Now HEAT (Health Emergency Action Team) to get alerts about rapid response actions you can take to defend Medicaid, Medicare, the VA, reproductive healthcare, gender-affirming care, vaccines, the rights of healthcare workers, and more! Join the team here! Follow & Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts, Google Podcasts, or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! This show is a project of the Healthcare-NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org.

For this episode, we’re going back to a familiar villain from podcast-past because  unfortunately, healthcare villains have a habit of staying relevant. This is a guy who made his fame by cozying up to Oprah while schilling diet pills, supplements, and medical conspiracy theories – it’s Doctor Oz, who is now Trump’s nominee for Director of the Center for Medicare and Medicaid Services. That’s right, the man who has previously claimed that there are deadly levels of arsenic in apple juice, that most olive oil is fake, that “Reparative Therapy” can cure homosexuality, and that hydroxychloroquine cures COVID, is pretty close to running our largest public health systems. Today I’m talking with Dr. Diljeet Singh of Physicians for a National Health program about what that means for you and the country at large, and how we can do something about it!  NOTE: At the Medicare for All Podcast, we’ve had a brief, unplanned hiatus due to pesky technical issues – and the fact that Trump is keeping us busy in our organizing work – but we are very excited to be back! I’m flying solo right now while my regular cohost Ben is saving the environment at his 9 to 5 organizing job, but that feels like important work as well, so we’re going to give him a pass and send him our love! https://www.youtube.com/live/3ZUE4sOTI_g?si=WGg97KnP-UxktIsu Our guest for this episode was the brilliant Dr. Diljeet Singh! She's a women’s health advocate, an integrative gynecologic oncologist, and the President of Physicians for a National Health Program. Dr. Singh received her medical degree from Northwestern University and her master’s degree from the Harvard School of Public Health. She completed an obstetrics and gynecology residency at Johns Hopkins and a gynecologic oncology fellowship at the MD Anderson Cancer Center. She completed her doctoral degree in public health on cost analysis at the University of Texas School of Public Health and an associate fellowship in integrative medicine at the University of Arizona. Dr. Singh and our friends at Physicians for a National Health Program are going all out to let folks know about the serious danger Dr. Oz poses to our national health! Check out the videos from their Dr. Oz Shadow Hearing below: https://youtube.com/playlist?list=PLO8yDO3B42TdHs6GC-PcLez2ZHfZ4CfTN&si=Q3YMJR1IEvr9uHX1 Even though it is likely that the Senate will make it official later this month, as of April 1st, Dr. Oz still hasn't been confirmed, so if you're listening to this in the next couple weeks, you may still be able to call your Senators to ask them to come to their senses! Reach their offices through the Capitol Hill switchboard: (202) 224-3121. Follow & Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts, Google Podcasts, or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! This show is a project of the Healthcare-NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org.

Listeners, what were you doing in 2004? Perhaps you were strolling down the street in low rise jeans, Uggs, and a Livestrong bracelet listening to Outkast’s “Hey Ya!” Or maybe you were sitting in a movie theater ready to have your mind blown by Ashton Kutcher’s tour de force performance in The Butterfly Effect. Well, the folks joining us on this week’s episode of our podcast may have missed some of that stuff because they were too busy building a movement for healthcare justice! 2024 marks the 20th anniversary of Healthcare NOW, the national organization fighting for Medicare for All that brings you your favorite podcast! If you’re a regular listener, you probably know that I was the Executive Director of Healthcare NOW for 11 years, and Gillian is the current Executive Director, but today we’re taking it back to 2004 and talking with some of the OGs who started it all! https://www.youtube.com/live/jSkKQLVHkTU?si=JS1PCFWWgEU6SEP2 This episode features some of our very favorite people -- the leaders in the healthcare justice movement who have made Healthcare NOW what it is today (the creator of your favorite podcast content!): Mark Dudzic is a longtime union organizer and activist.  He served as national organizer of the Labor Party from 2003 to 2007 and was a cofounder of the Labor Campaign for Single Payer in 2009.  He has been a member of the Healthcare Now board since its founding in 2004. Lindy Hern is the Chair of the Sociology Department at the University of Hawaii at Hilo and President of the Association for Applied and Clinical Sociology. She has been on the Healthcare NOW board since 2009 and is the author of “Single Payer Healthcare Reform: Grassroots Mobilization and the Turn Against Establishment Politics in the Medicare for All Movement."  Donna Smith is an advocate for single payer, improved and expanded Medicare for all. Her journalism career included work as a stringer for NEWSWEEK magazine, editing and reporting for the Black Hills Pioneer in South Dakota, as well as appearances on CNN and Bill Moyers Journal, and as one of the subjects in Michael Moore's 2007 film, SiCKO. She worked for National Nurses United and traveled more than 250,000 miles advocating for health justice. She now serves as the National Advisory Board chair for Progressive Democrats of America. Walter Tsou is a Board Advisor to Physicians for a National Health Program and on the Board of HCN.  He has been a long time single payer healthcare activist.  Walter is a former Health Commissioner of Philadelphia and Past President of the American Public Health Association. Cindy Young has been a healthcare activist for over 40 years. She has served on the Health Care Now board since 2012. In her retirement, she serves as a Vice President for the California Alliance for Retired Americans (CARA), whose principle goal is to establish a single payer system in California. If this episode doesn't give you your fill of Healthcare NOW history, you can always check out Lindy's book or this sweet tribute to our founder Marilyn Clement. And of course, if you want to keep up the good work of all these amazing folks, you can make a donation to support our work!

Well, the voters have spoken, and despite all of our recommendations to the contrary, they seem to have voted for Trump. Yeah, we’re pretty sad/scared/pissed off/trying to cope by dissociating and stress eating as well. Regardless, once again, it’s Trump’s America and we’re just living (or dying) in it. We know from experience that a Trump presidency is bad for our health, but now he has a surprising new ally in making our lives shorter and more dangerous: Robert F. Kennedy Jr.  https://www.youtube.com/watch?v=ZhwR1W_x-TA Show Notes RFK is a former presidential candidate and critic of Trump, an expert falconer, an eater of roadkill, a source of shame for the entire Kennedy family, and a “superspreader” of false information about vaccines. And now he’s about to bring his mission to Make America Healthy Again to the masses as the Secretary of Health and Human Services for the entire USA. In this episode, we’re going to try to figure out what the hell that means. RFK Jr has some wild ideas about medicine and public health, making some strange connections between cause and effect in our health. Let’s play a game! We’ll give you some health outcomes, and you guess what RFK has said is the cause of the problem (or “problem” in several cases). (Sources: BBC, HuffPo, Daily Beast)  Problem: Autism, cancer, autoimmune disorders, and ADHDCause: Vaccines!   This assertion is primarily based on the fact that SOME earlier vaccines included a preservative thimerosal, a compound that contains mercury, even though it’s been debunked AND hasn’t been included in children’s vaccines since 2001. Problem: Arthritis, bone fractures, bone cancer, IQ loss, neurodevelopmental disorders, and thyroid diseaseCause: Fluoride in drinking water! Problem: Fatness, depression, and cancerCause: Ultra Processed Foods Solution: Raw milk! Problem: AIDSCause: Not HIV! (See his book about Anthony Faucci) Problem: Increasing concentrations of bioavailable aluminum in the environmentCause: Chemtrails This one’s a trick question because in a 2016, a survey of scientists showed that most of them didn’t even believe that aluminum levels were increasing, let alone that chemtrails exist. Problem: Gay and Trans KidsCause: Pesticides (atrazine) in tap water. Amazing logic here: “[atrazine can] chemically castrate and forcibly feminize [frogs]... If it’s doing that to frogs, there’s a lot of other evidence that it’s doing it to human beings as well.”   Problem: COVID 19Cause: Chinese bioweapon. His logic (from a campaign video leaked to the NY Post): “COVID-19 is targeted to attack Caucasians and Black people. The people who are most immune are Ashkenazi Jews and Chinese. We don’t know if it was deliberately targeted or not, but there are papers out there that show the racial and ethnic differential and the impact of that. We do know that the Chinese are spending hundreds of millions of dollars developing ethnic bioweapons and we are developing ethnic bioweapons.” A heaping helping of anti-Asian racism with a side of antisemitism! Problem: RFK Jr’s own problems with memory loss and cognitionCause: He said in a 2012 divorce deposition, “a worm that got into my brain and ate a portion of it and then died.” Also, tuna fish. He hasn’t ever provided medical records to document this, but doctors say it might have happened? Despite the fact that he’s about to be nominated to lead the Department of Health and Human Services, RFK Jr. isn’t a doctor or a medical researcher. The brain worm explains a lot about RFK Jr’s thinking, but neural parasites aside, how did this guy get to be a “public health expert” to begin with? He started as a well-respected environmental lawyer. In 1984, he began volunteering with The Hudson River Fisherman's Association, later renamed “Riverkeeper,” which inspired the global “Waterkeeper” movement. He sued big polluters, helped formulate a model for sustainable development,

We spend a lot of time griping about the insidious power of corporate health insurance in our healthcare system here. But you would expect that taxpayer funded public programs for our most vulnerable friends and neighbors are free from profiteering right?  Sadly, no. Medicaid - the public program that serves the lowest income Americans, plus some people with disabilities, and a lot of the country’s long-term care - has been extensively privatized in most states. Hoping to trim budgets, most states have outsourced Medicaid recipients to “Medicaid Managed Care Organizations,” which are actually private insurance companies. And with private insurance comes the barriers to care we know all too well, like prior authorizations, denial of claims, and narrow networks. These are all part of the private insurance/public programs business model: the more care they avoid paying for, the more money from those capitated payments they get to keep. But today we have a rare ray of sunshine: a state showing there’s another way to provide care, not just coverage, to some of their most vulnerable residents. In 2012 Connecticut kicked the private insurance-run Managed Care Organizations out of their Medicaid program. They took on Big Insurance and won. Our guest today will walk us through how it went down. Sheldon Toubman has been a litigation attorney for Disability Rights Connecticut since 2021, and a leader of the efforts to remove Managed Care Organizations from the state’s Medicaid program. Before that, he was a staff attorney with New Haven Legal Assistance Association (NHLAA), where he spent 30 years representing and working on behalf of Medicaid enrollees. He engages in a variety of strategies on behalf of people with disabilities, from litigation to legislative advocacy and public education through media, webinars and other means. https://www.youtube.com/watch?v=zM7dRzHkVu0&t=1804s Show Notes Sheldon tells us that before 2012, Connecticut’s Medicaid program was bifurcarted: eligible kids, pregnant people, and families were in a capitated Managed Care Organization (MCO) model and people with disabilities were in a fee-for-service program. (Medicaid is funded with federal dollars, but unlike Medicare, states design the programs and make all the decisions about plans.) With a fee-for-service model, the state takes on the risk. With the MCO model, the MCO receives a per-person/per-month fee (a "capitated payment") from the state, and they have to provide the care; if the patient requires less care, the MCO keeps the money, but if the patient requires more care, the MCO has to pay for the amount above the per-person/per-month fee. MCOs had a financial incentive to deny care so they could recoup more money. Beginning in the late 1990s, Medicaid advocates began a campaign of lawsuits and lobbying to remove Managed Care from their Medicaid program. Hartford, Connecticut is known as the insurace capital of the US, so this was a tough fight. Insurance companies fought this campaign because public programs are a major profit center for insurers, often more profitable than private employer-sponsored insurance. The insurance industry claimed they provided excellent care for less money, and coordinated care in a way that's not possible with the fee-for-service model. The insurance industry also ran ads about all the jobs they provide, and legislators were afraid to tangle with them. When the state asked for data about how the MCOs spent public dollars, they refused to provide it. So advocates only had anecdotal information, and it was hard to refute the claims the MCOs made about how well they served patients. One of the anecdotal complaints they heard the most was the lack of access to providers. Advocates convinced the state to check the insurance company provider network lists, so the state instituted a Secret Shopper survey to analyze them. They found that patients could get an appointment with supposed in-netw...

In case you’ve been asleep or under a rock for the past six months, we need to let you know two things: First, Kendrick won his beef with Drake, and second, there is a presidential election coming up. Like any presidential election year, everyone’s so focused on the big showdown at the top of the ticket, but that means that a lot of the local and state races, congressional races, and referenda that will make up most of your ballot are getting ignored. Just because Anderson Cooper isn’t covering your city’s mayoral contest or your state’s Railroad Commissioner race doesn’t mean those elections aren’t critically important in determining the immediate future of your community and getting important issues like healthcare on the table! So for this episode, we’re going to leave the speculation about Donald and Kamala to Anderson and take our own 360 view of why we all need to get in on the down-ballot action and how we bring healthcare justice to the forefront of our election conversations.  https://www.youtube.com/watch?v=eY6SAa8LU9c Show Notes We have two guests who know their way around a Get Out the Vote Drive! Jasmine Ruddy is the Assistant Director of Campaigns for National Nurses United. She helps lead NNU's political campaigns from Medicare for All to electoral work and more! Her background is in the climate justice movement and campus/student organizing in her home state of North Carolina  Jonathan Cohn is the Policy Director at Progressive Massachusetts, which does multi-issue advocacy work. Jonathan wears many hats in the political space in Massachusetts and has been active in many progressive issue and electoral campaigns over the past little over a decade. Jasmine describes the local campaign that got her hooked: as a campus organizer for climate justice she helped win ballot measures to pass a regional transit tax. It was a concrete and tangible way to make an impact on the climate justice movement. Jonathan cut his political teeth on the Obama 2012 campaign, and got the local politics bug when Boston Mayor Tom Menino retired. Twelve candidates came forward for the first open mayoral race in 20 years. He was especially interested in public school policies and funding. He volunteered for mayoral candidate and City Council Member Felix Arroyo Jr. Ben confesses that while he loves democracy, he hates elections (#relatable). But he does find more hopefulness at the local level. He also got started in a mayoral election in Boston, but the most exciting campaign he worked on was for state house. He lived in one of the most progressive districts in the state but their state representative was a powerful, well-funded right-leaning Democrat. Ben's candidate, Nika Elugardo, a true progressive beat him despite all those advantages. Picture it: New Jersey, 1990s, tween Gillian lives in a suburb (North Plainfield) seeking to change its name to distance itself from the majority Black and Brown city of Plainfield. During a town-wide debate on the ballot measure, young Gillian spoke against renaming the city. She was quoted on the front page of the local paper: "North Plainfield shouldn't change its name. Stonybrook is just a dirty brook that divides our town, just like this issue is doing right now." The anti-name change side won and our star was born. We discuss the additional influence a voter can have when working on a local election. When races can be won or lost by a few dozen votes, the candidates care a lot more about each individual. They may knock on your door or call you seeking support, which is a great opportunity to insert the issues you care about into the election. Once your candidate gets elected, they'll remember the folks who helped them get there and you'll have more influence when lobbying them on the issues you care about. (You may even end up with a job.) Jonathan's personal philosophy is "Boo and Vote." He never liked Obama's catchphrase "don't boo; v...

The United States is unique among industrialized nations. Lucky for us, we can accumulate medical debt! Most industrialized and some developing nations have national healthcare programs that guarantee care to their residents. But we in the richest nation in the world have the freedom to get insurance through the free market, and go into debt when it doesn’t cover the care we need! USA USA USA! According to the Kaiser Family Foundation (KFF), while over 90% of Americans have health insurance, we owe at least $220 billion in medical debt. Approximately 14 million people owe more than $1,000, and about 3 million owe more than $10,000. When the debt is cast more widely to those who have put medical bills on their credit cards or borrowed money to pay them, KFF found that 41% of adults have healthcare debt. According to the US Census Bureau in 2021, Black and Latinx households are disproportionately affected by medical debt.   Today we’ll dive into the topic of medical debt: who has it, who profits off it, and what can we do about it?  https://www.youtube.com/watch?v=dZPd1kFbEuE Show Notes What causes medical debt? Believe it or not, our freewheeling use of the healthcare system is not to blame. In the US medical debt is caused by the high prices charged by hospitals, pharmaceutical companies, and insurance companies. While most industrialized nations have some means of controlling prices, in the United States the healthcare industry sets prices more or less however they want. As a result, according to a nationwide poll in 2022, over a five year period more than half of US adults report going into debt because of medical bills.  Debt is preventing Americans from saving for retirement, paying for college, or buying a home.  The 2022 poll found that 1 in 7 people reported being denied care due to unpaid bills. Two-thirds of those polled reported putting off necessary care due to cost.  This is all despite the Affordable Care Act expanding insurance coverage to more Americans than ever before. Insurance companies increasingly shift costs onto patients, with higher deductibles and more claim denials. According to the 2022 KFF poll, 61% of insured Americans had medical debt in the previous five years.  What makes medical debt so dangerous? We know health systems are denying care to patients who have unpaid bills. And we know people put off care so they don’t incur more debt. Those barriers to care make us sicker, and they disproportionately impact people with higher rates of chronic conditions. The Commonwealth Fund found that 54% of people with employer coverage who skipped or delayed care reported getting sicker; 61% in individual market plans and 63% with Medicare reported the same. A 2024 study published in the Journal of American Medical Association found that medical debt is associated with higher mortality and premature death. What happens when you can’t pay your medical debt? When you think about all the real people on the end of those medical debts, that makes it all the harder to swallow a fact that gets relatively little attention in the broader conversation. Medical debt collection is a for-profit business. In many cases, non-profit hospitals sell debts to for-profit medical debt collections agencies. Some health systems even operate their own for-profit debt collection arms. Think of it: They set the prices for their services as high as they want, and on the other end of the equation, they’re making money off debt collection.  Dr. Luke Messac of Brigham and Women’s Hospital testified at a July hearing of the Senate Health, Education, Labor and Pensions Committee that he learned that his and many other hospitals as well as collection agencies report sick, vulnerable patients to credit bureaus, garnish wages, seize bank accounts, and seek warrants for their arrest. And again, we have to highlight the evil practice of hospital systems that restrict patients from getting n...

Usually on the Medicare for All Podcast, we talk about people who want healthcare but can’t get it, but today we’re talking about people getting healthcare they have specifically refused: folks who have been involuntarily committed. For plenty of our listeners, the idea of being held against your will at a psychiatric institution feels like a nightmare from another time – something out of gothic fiction or horror movies set far in the past. But for folks struggling with mental illness in 21st century America, the terrifying prospect of psychiatric commitment is alive and well. In fact, a 2020 UCLA study found that in the 25 states where they actually keep data on this, the numbers of involuntary psych detentions have been sharply rising in recent years. Today, we’re joined by two experts in this dark corner of our healthcare system to talk about why so many people are getting committed and who is reaping the benefits. https://www.youtube.com/watch?v=qjXjCSIM_2E Show Notes Originally from Massachusetts Jesse Mangan has experienced a few different psychiatric hospitalizations and has spent over two decades struggling with the impacts of those experiences, so now he produces a podcast about mental health laws called Committable. Rob Wipond is a freelance journalist who writes frequently on the interfaces between psychiatry, civil rights, policing, surveillance and privacy, and social change. His articles have been nominated for seventeen magazine and journalism awards. He is also the author of the 2023 book Your Consent Is Not Required: The Rise in Psychiatric Detentions, Forced Treatment, and Abusive Guardianships. Jesse shares how he came to have so much (unwanted) expertise in psychiatric commitments, and how he turned that experience into a podcast, Committable. He was involuntarily committed and held longer than the standard of care dictated, past the date his insurance ran out. He was finally discharged with no real discharge plan and a big bill. Rob tells us he's been writing about mental health for a couple of decades. He says that the media typically portrays people who have been committed as really out of touch with reality, but he's found that they're far more like the rest of us. He watched his dad - who had no history of mental illness - go through a catastrophic health crisis that led to a depressive episode. Rob tells us that his dad was held and treated against his will for months. This happened in Canada where healthcare is guaranteed, so it's a more complex problem than just enacting the right financing system. A lot of people tend to think of psychiatric commitment as a barbaric tactic from the bad old days – like Nurse Ratchet in One Flew Over the Cuckoo’s Nest – but this is obviously a practice that continues to this day. It's more common now for people to be held for a few days, rather than months or years on end. We only have data on these commitments from 25 states, but they show that these kind of commitments are rising dramatically. Jesse explains that due to disability rights activism and investigative journalism, a number of federal cases in the 1970s established some basic due process standards for patients. At the same time the mental health system became increasingly privatized and our understanding of mental health changed dramatically. The expense of due process became a factor - as soon as a case reaches a court hearing, private providers become more likely to release the patient because of cost. State mental health laws have given a lot of authority to law enforcement and providers to detain patients on an emergency basis without a due process check until the point the facility wants to hold the patient beyond the emergency period (in many states 72 hours). The justification for holding these patients are often very vague and broad, posing a risk to many Americans. Mental healthcare in this country isn't a clearly defined system.

If there’s one thing everyone is talking about these days, it’s JD Vance’s affinity for couches. But if there are two things everyone is talking about, it’s Vance’s couches and Project 2025. You may be wondering, what is this mysterious project, and what does it have to do with me? Well, it turns out, a lot! Project 2025 is the right-wing map to a terrifying future, and if its proponents have their way, the future of healthcare is especially grim. Today, we’re doing a deep dive into what this thing is and how it could change healthcare as we know it. https://www.youtube.com/watch?v=a4kYQ-Hh5pY Show Notes Gillian Mason, Healthcare-NOW's Executive Director, has read Project 2025 so you don't have to. P25 is the brainchild of the Heritage Foundation, the think tank founded in 1973 because conservative businessmen thought Richard Nixon was too liberal (remember that Nixon created the EPA and advocated for a better national health plan than Obamacare, so they weren’t all wrong). They really hit their stride during the Reagan administration when they wrote his policy playbook, which they called the “Mandate for Leadership” — Reagan implemented or initiated about 60 percent of the 2,000 policy changes they recommended. They do this Mandate for Leadership report now every presidential cycle, and it’s been pretty influential whenever a Republican wins. These people are unabashed fascists. We use that term a lot kind of casually but these guys literally fit the Merriam-Webster Webster dictionary definition: “a political philosophy, movement, or regime that exalts nation and often race above the individual and that stands for a centralized autocratic government headed by a dictatorial leader, severe economic and social regimentation, and forcible suppression of opposition.” The Heritage Foundation’s whole deal is consolidating all authority in the office of the president so he can implement severe economic and social regimentation based on nationalism and barely-veiled-when-it’s-not-just-blatant racism. Project 2025 It’s the “Mandate for Leadership” for this election season, so it’s supposed to be a template for Trump’s next four years. Although reading Project 2025 would make you think it was a room full of monkeys at typewriters type situation, it was actually written by a room full of Trump’s cronies. Hundreds of people contributed to writing and researching this thing, and a hefty percentage were former Trump appointees and employees of the administration. Also, VP pick JD Vance just wrote the foreword for an upcoming book by Kevin Roberts, the head of the P25 team. Vance has also been a mouthpiece for some of the wilder shit in P25. Trump claims he really doesn’t know much about P25. But it’s still worth talking about because COINCIDENTALLY it turns out that a lot of his policies are the same as the ones in P25. The Premise: The liberals in Washington, in cahoots with Chinese Communists and the  “totalitarian cult known today as ‘The Great Awokening’” have put “the very moral foundations of our society are in peril.” (This is not an exaggeration— it’s literally all on the first page) P25 has 4 main goals: Restore the family as the centerpiece of American life and protect our children. Dismantle the administrative state and return self-governance to the American people. Defend our nation’s sovereignty, borders, and bounty against global threats. Secure our God-given individual rights to live freely—what our Constitution calls ‘the Blessings of Liberty.’” All the recommendations are laid out systematically according to the different areas of the federal government they want to control (The Executive Office, Department of Homeland Security, Intelligence Services, Media Agencies, etc.) We’ll mainly be focusing on healthcare today but context is important so here are a few highlights of what they’re planning to give you some flavor: Reclassify most federal employees as appointees

It’s our 100th episode folks, and we are celebrating the only way we know how – by sharing our predictions of the grim, apocalyptic future that surely awaits us if we fail to get our healthcare system together! That’s right, we’re talking about the next pandemic, and if experts are right, it’s coming sooner than we think. In addition to several somewhat less familiar pathogens on the rise this summer, COVID is back, and this time it’s FLiRTy. Today we’ll go into some of the outbreaks currently threatening to explode into our next global disaster and explore how prepared our for-profit healthcare system is to keep us safe. Spoiler: It isn’t. https://www.youtube.com/watch?v=ErXbxe4U-QQ Show Notes This emerging new pandemic situation is pretty serious, and more people should be taking it seriously. Forbes healthcare reporter Alex Knapp called this: “Hot Virus Summer.” First, COVID is up! Again! It’s important to point out that COVID never really left – in 2023 75,000 people died from COVID 19, nearly 1 million were hospitalized, and plenty of people are still suffering from Long COVID. Now we have the new FLiRT variants — sexy! There are almost 34,000 new cases per week globally.  Next up: Bird Flu, which has historically tended to infect birds, is evolving and has begun to infect mammals. For now, that mostly means livestock – so far 129 dairy herds in 12 US states. As far as animals are concerned this is already a pandemic – it’s impacting industries all over the world and could cause shortages of meat and dairy. You may be panicking: IS OUR CHEESE SAFE? Don’t worry, most commercially available dairy products are pasteurized, which kills the virus.  There have, however, been three cases of the virus in humans reported in the US. Around the world, more than 50% of people infected with Bird Flu die from the virus. All three of those people in the US worked on farms in direct contact with birds and livestock, and right now the CDC is just limiting their warnings about Bird Flu to folks who also work in close contact with animals. BUT, scientists are warning that at any time the virus could mutate and become transmissible between humans, at which point, we would be facing epic disaster.  How likely is that to happen? In August 2023, Dr. Michael Greger said of Bird Flu, "The question is not if, but when.”  In addition to COVID and Bird Flu, Mpox (fka Monkey Pox) is having another moment, as is West Nile Virus, so there are a lot of ingredients in the virus stew we’re cooking. So the best indicator of future outcomes is to look at how we’ve fared in similar situations in the past. Luckily (or not), the 2020 COVID outbreak is still fresh in some of our minds. You may remember that we, as a country, were not particularly well-prepared. For one, our profit-driven healthcare system creates disparities of access and care, which were exacerbated by the pandemic. Also, we don’t have a truly cohesive public health program in this country. Health departments in various counties, municipalities, and states work largely independently of each other, so there was little to no coordination on surveillance and testing. We had to rely on private companies for important preventative measures like PPE and, most notably, vaccines (the research and development for which were PUBLICLY FUNDED with our tax dollars.) During pandemics, a lot of people stopped going to healthcare facilities for elective procedures and surgeries - the real moneymakers for the for-profit healthcare system. That led to layoffs of staff at the same time that patients who desperately needed care struggled to get it. In countries with a national health system, hospitals don’t lose money if people stop going; they have a fixed amount to cover the operating expenses based on past history. So you don’t see mass layoffs and shrinking of the healthcare workforce when they are most needed.     So if we were to do the whole pandemic over again...

It's the most wonderful time of the year! For activists in the movement to make Medicare for All a reality, this is the week when we gather to plot, scheme, and kvetch. Welcome to the 2024 Annual Medicare for All Strategy Conference, “Healthcare Beyond the Ballot Box,” organized by Healthcare NOW! For those of you who are attending the conference right now, you are getting a sneak preview of our Very Special Conference Episode! Since our theme this year is about what happens to Medicare for All in an election year — and beyond — we wanted to invite some of our favorite policy people with their fingers on the pulse of what’s happening in DC to help us sort out what’s happening with healthcare on Capitol Hill and what role we can play to get some justice out of DC in the coming year! https://www.youtube.com/watch?v=n36v0eTV1a8&t=1167s powerpress Our guests are Eagan Kemp and Alex Lawson. Eagan Kemp is the health care policy advocate for Public Citizen’s Congress Watch division. He is an expert in health care policy and served as a senior analyst at the U.S. Government Accountability Office prior to coming to Public Citizen. Alex Lawson is the Executive Director of Social Security Works, the convening member of the Strengthen Social Security Coalition— a coalition made up of over 340 national and state organizations representing over 50 million Americans.  Show Notes With one of our major candidates being a guy who is solidly against Medicare for All and the other being Trump, is 2024 a bad federal election cycle, or the worst federal election of our lifetime, and why? Alex puts a positive spin on it: we are closer to M4A with a Biden presidency than any other Democratic presidency. He's definitely not a M4A guy, but all his other economic policies are based on Sanders-esque populism, rather than Obama-esque neo-liberalism. We've seen Biden enact serious corporate reform in several sectors, and in a second Biden administration, taking on corporate greed and sociopathy in health insurance is on the agenda. On the other hand, we know exactly what's at stake with another Trump presidency, driven entirely by profit for his billionaire friends. Eagan notes that there has been movement on Medicare in recent years, including die-hard GOPs shying away from talking about cuts to Medicare until after the election. At the same time, we're seeing Biden moving more toward the M4A movement and the folks trying to expand and improve traditional Medicare. We're seeing insurance companies running scared, feeling the pressure from our movement in a way they haven't before. Alex notes that Biden's economic vision contains a lot that Medicare for All folks can work with. Our movement worked hard to expand Medicare to include vision, hearing, and dental, which was ultimately included in Biden's Build Back Better plan. We didn't get that, but we did get prescription drug negotiations, which is a huge part of improving Medicare before we expand it to everyone. (Go back and listen to another episode where we were joined by Alex to discuss prescription drug negotiations for more details.) We've also seen a lot of good work against Medicare privatization, via Medicare Advantage, and that solidarity has moved the ball a lot - more than ever before to restrain private insurance companies. We didn't just give up when we knew Biden wouldn't sign M4A; we pivoted to expanding benefits and reversing the privatization with a lot of success. Eagan found a silver lining in - of all places - the subject of private equity in healthcare. He thinks we've passed the peak of PE ravaging healthcare, and they are now backing off the healthcare sector in part because of increased pressure from the DOJ, FTC and HHS. That's due to pressure from doctors, patients, and whistleblowers. Eagan also notes that the Trump administration pilot of throwing seniors in traditional Medicare into private relationships with providers.

We are in the middle of a resurgence of organized labor in the US. From Amazon workers to auto workers and grad students to baristas at Starbucks, everyone is getting in on the action! One of the big reasons workers are so hot to get that union card is because of… you guessed it, healthcare! Today we’re going to be talking union healthcare plans – how they work and how workers have managed to use collective bargaining to resist the national erosion of healthcare access. Most importantly, we’re going to take a deep dive into why, even with better healthcare, unions have been leaders in the fight for Medicare for All, and how they might save the rest of us from corporate healthcare hell. Our guest Jim McGee has spent his entire career working in union health benefits, starting with the Plumbers and Pipefitters local he belonged to in Harrisburg Pennsylvania. For the past 20 years, he has been the administrator of the health benefits plan for Amalgamated Transit Union Local 689. He’s on the steering committee for the labor campaign for single payer healthcare, and he’s joining us today from Bethesda, MD. https://www.youtube.com/watch?v=cNFBkHBrpUY Show Notes Jim educates us on the two types of union health plans: Unionized workers with a single employer (think nurses or teachers) earn employer-sponsored health benefits much like unorganized workplaces, but the cost and benefit sets of those plans can be negotiated if the workforce is unionized. Taft-Hartley plans are multiemployer plans that are jointly managed by multiple companies and the union within the same industry. The workers pay while they're working to have health insurance when they're not. Taft Hartleys exist in industries where there's a lot of turnover, like the building trades. A worker may have many different employers and many periods of unemployment over their careers. Typically both those options sound a lot better than what your average non-union worker is getting from their employer, though they are still subject to same rising costs and economic pressures as every other health insurance plan. Given that union members are more likely to have health coverage than non-union workers, it’s interesting that unions have been at the forefront of the movement for Medicare for all. Many unions come from a rich progressive tradition that looks past the short term to the long term value of guaranteed healthcare for all workers. Jim also shares that the unions that are more exposed to competitive pressure in their environment are more likely to be supportive of Medicare for All. This is especially evident in less urban areas where locals are facing more non-union competition. Jim notes that throughout his career, healthcare has been #1 cause of strikes. Taking it off the table would not only benefit the workers, it would benefit their entire community. Small businesses and non-union employers that offer poorer or no healthcare benefits to their employees often stay afloat on the backs of the unionized employers in their community that do offer good health benefits; this is an inquitable and unsustainable system. Speaking of strikes, graduate student workers at Boston University are on strike right now over healthcare benefits among other things. Not only would Medicare for All take health insurance off the negotiating table (making more room for workers to bargain for pay, safety and other benefits), it would take away a the ability of employers to weaponize health insurance to break strikes; solidarity can crumble quickly when the employer stops paying those premiums at the first of the month. Follow and Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on  Apple Podcasts, Google Podcasts, or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org.

The U.S. is wrestling with a massive mental health crisis - impacting young people in particular. Half of young adults and one-third of all adults report that they always feel anxious or have often felt anxiety in the past year. One-third of respondents could not get the mental health services they needed. Why? 80% say they couldn’t afford the cost and more than 60% said that shame and stigma kept them away. The shortage of mental health providers also means that care can be very hard to find, even when we try hard to find it. Usually on the Medicare for All Podcast, we focus on the stories we think you need to know about. Today we decided to scrap the show and come up with a plan to get an hour of free therapy!* (*Not really. None of this information is intended as medical advice.) Our guests today are Dr. Pamela Fullerton and Lindsay Baish.  Lindsay is a therapist and an Licensed Professional Counselor (LPC) in Illinois and a certified trauma professional – and former volunteer for the podcast. Dr. Pamela Fullerton, Ph.D., is the founder and clinical director of Advocacy & Education Consulting, a counseling and consulting organization dedicated to ensuring social justice and advocacy through equitable access to mental health and well-being services. She is a Latina bilingual Certified Clinical Trauma Professional (CCTP), a Certified Dialectical Behavior Therapy professional (C-DBT), a Certified Clinical Anxiety Treatment Professional (CCATP), a Certified Grief Informed Professional (CGP), and a clinical supervisor and consultant specializing in working with BIPOC communities, undocumented communities, immigration and acculturation, trauma, anxiety, life transitions, and career counseling. In addition to being a professional writer and speaker, Dr. Fullerton is an adjunct instructor in the Counselor Education department at Northeastern Illinois University. She is also a volunteer contributing writer for three publications and runs a nonprofit to support Latinx youth in the Chicagoland area. Dr. Fullerton consults for two behavioral health advisory boards, Sinai Urban Health Institute (SUHI) and Illinois Unidos/Latino Policy Forum, providing advice and input to assist in promoting health equity and justice initiatives for underserved communities in Illinois.   https://www.youtube.com/watch?v=GGql7_NXhts Show Notes Pam tells us that counselling is a subset of psychiatry and psychology that started as a movement for career development for veterans returning from war. The profession started helping people through life transitions puts people and their lives and livelihoods at the center. Lindsay notes that a lot of the language of mental healthcare is used interchangeably, but there are distinctions: psychologists have PhDs and can provide therapists; psychiatrists have MDs and can prescribe medications. Counselors and therapists can diagnose but not prescribe. Congress passed the Mental Health Parity and Addiction Equity Act in 2008 to prevent insurers from providing worse coverage for mental health than they do for medical or surgical treatment. However, mental health providers are not usually treated the same as medical doctors when it comes to insurance coverage and payments. Historically, counselors are the newest mental health clinicians on the scene and are more limited by insurers than more established clinicians like social workers or psychologists. Insurers often only reimburse for certain therapeutic models of care (Cognitive Behavioral Therapy, for example) leaving other kinds of counseling uncovered in the midst of a crisis in mental healthcare. Pam tells us that a big part of her job is the extra work to navigate her patients' insurance plans, Medicare and Medicaid in order to get coverage for their care. Most Americans can't afford to pay out of pocket for mental healthcare. Counselors just got approved for Medicare reimbursement on January 1, 2024,

We hear it over and over again – the private sector just does it better. Whether we’re talking education or healthcare or our criminal justice system, the default Republican (and sometimes Democratic) talking point is that competition in the marketplace allows the best ideas and best people (Elon Musk, lookin at you) to rise to the top and lead us to a utopian future (sponsored by Meta). But then something wild happens like the cyberattack on UnitedHealthcare, which is causing massive fallout throughout our healthcare system over the past two weeks – so much so, that the company appears to have paid a 22 million dollar ransom to the hackers who breached their system and now the federal department of Health and Human Services has had to bail them out. That kind of thing really makes you question how anyone is still making the argument that the private sector has this shit handled. This episode, we’re bringing in special guest and political messaging expert Jordan Berg Powers to talk about how we talk about all of this stuff: public healthcare, private corporations, and how to message our way out of the corporate hellscape in which we currently find ourselves! Jordan Berg Powers is a consultant and the former director of Mass Alliance. Most importantly, he is coming up on 30 YEARS of experience in campaigning and organizing for progressive causes and candidates. Jordan is a return guest to the podcast, first appearing in our My Big Fat American Healthcare episode. https://www.youtube.com/watch?v=Z6QvGQja1N8 Show Notes UnitedHealthcare debacle is a little bit fun for us because we get to talk about the failures of a really shitty company, but like any healthcare debacle, there are some serious consequences. What happened here, and what does the UnitedHealth scandal look like for folks on the ground? Starting on February 21, a group of hackers breached “Change Healthcare,” which is the largest electronic medical records and medical claims processing platform in the country. About half of all Americans’ health insurance claims pass through Change Healthcare, which was bought two years ago by UnitedHealthcare, the largest health insurer in the country. Following the hack, Change Healthcare shut down its entire network, leading to complete mayhem in the healthcare system, which is still ongoing: “Hospitals have been unable to check insurance benefits of in-patient stays, handle the prior authorizations needed for patient procedures and surgeries or process billing that pays for medical services. Pharmacies have struggled to determine how much to charge patients for prescriptions without access to their health insurance records, forcing some to pay for costly medications out of pocket with cash, with others unable to afford the costs.” (source) This has led to a financial crisis for many hospitals, health clinics, physicians, and pharmacies, none of whom can be reimbursed for the care they’re providing, since they can’t submit medical claims. Provider associations are losing their shit, and the federal government has had to intervene to try to bail providers out in the meantime.  The story keeps getting crazier and juicier: apparently UnitedHealthcare made a ransom payment of $22 million to the hackers who breached their system using BitCoin (source) - p.s. those are our healthcare premium dollars hard at work Russian hackers may now have access to almost half the country’s medical records. I’m sure that won’t come back to haunt anyone in the years to come! As much as we’d love to dwell on the UnitedHealthcare scandal that is unfolding, this incident really got us thinking about the broader debate over distrust of government, hatred of taxes, and bipartisan worship of market-based solutions. Jordan explains the false dichotomy of government vs marketplace, public vs private; there is no marketplace without government. The question is,

Occasional fistfights aside, most of our legislators make the choice to use their words when they’re angry, and a lot of those words go into public letters they write to presidents, officials, and even each other. Despite the fact that no one else in this country has written or read a letter in decades, the public comment letter is still popular with politicians, who have elevated this obscure literary genre to a competitive sport, using these letters to demonstrate their power, build alliances, and shape policy. Today we’re going to focus on one ongoing battle of letters over one of our favorite topics: the privatization of Medicare through a program known as Medicare Advantage. We’ll talk about how all the players in the debate about Medicare Advantage are engaging in that battle, and how it could impact our access to healthcare! https://www.youtube.com/watch?v=MmM6HrIiS8o Show Notes We've recorded a bunch of episodes about Medicare Advantage! Medicare Advantage was created as a private, for-profit alternative to traditional (or public) Medicare, was the promise of lower costs… which never happened. Surprise: Medicare Advantage plans are FAR more expensive to taxpayers than traditional Medicare for covering the same person, costing taxpayers $7 billion more per year than if everyone were just covered by traditional Medicare. (source) It’s the healthcare Joe Namath, Jimmy JJ Walker, and Big Papi are selling to seniors with big promises of coverage for vision and dental care, transportation, groceries, and more – for $0 premiums. Free shit! Private companies drain public money to provide generally substandard insurance. These companies are exploiting a legit problem in Medicare, where many seniors are forced to pay premiums for medigap plans to cover stuff like chewing and seeing. If you can’t afford the premiums for Medigap coverage, but you need to chew or see, you might be forced into an Medicare Advantage plan just because that’s what you can afford month-to-month. And that could be fine… until you need care and find out that the copays and deductibles are too high, there are super limited networks, or the insurance company refuses to pre-authorize your treatment. But many of these MA plans don’t come through on their wild promises, and in fact, seniors end up being pushed out of MA and back into original Medicare when they are sick and actually need care. Private insurance companies love collecting money,but they hate paying money for the service they’re supposed to provide. Go figure!  We put out a report about this! Taking Advantage Who's Who? AHIP: “America’s Health Insurance Providers” is the trade organization for the health insurance industry. Unsurprisingly, they are big proponents of Medicare Advantage. AHIP has written their own comment letters to CMS (the Center for Medicare and Medicaid Services) advocating for expansions to the MA program since at least 2015. Lately they also began coordinating their besties in the House and the Senate to write letters on their behalf. They claim that Medicare Advantage will expand the program to more seniors, and present some of their own research: MA will bring more money into the Medicare system… because MA plan holders use less care. (nothing to brag about!) MA is serving a diverse populatio “As of 2021, approximately 59% of Hispanic or Latino/a individuals and 57% of Black individuals eligible for Medicare choose Medicare Advantage plans. Overall, 54% of Medicare beneficiaries who belong to diverse populations choose Medicare Advantage.” Turns out if you set out to exploit a diverse demographic of people, you can! In 2021, 70 members of congress signed "dear colleague" letter, initated by initiated by Reps. Val Demings (D-FL), Mike Gallagher (R-WI), Marc Veasey (D-TX), and Gus Bilirakis (R-FL).  In 2023 – 60 Senate signers – a good example of how this is insidiously bipartisan,

Here at the Medicare for All Podcast, we love calling out all the bad actors in our healthcare system – greedy insurance companies, soul-less CEOs in Big Pharma,profit-hungry “non-profit hospitals”, and all our favorite villains. Mostly, we look at the ways those predators target sick people and poor people for exploitation, but today we’re looking at what happens when they start fighting each other for a bigger piece of the pie? Specifically, we’re going to explore the world of hospital consolidation – that’s when smaller hospitals merge to form bigger corporate entities who can battle it out with insurance companies to secure more of patients’ healthcare dollars! What does hospital consolidation mean for regular people? No spoilers, but it turns out that when giant healthcare monsters go at each other, much like when Godzilla took on Mothra, it’s the rest of us tiny humans who suffer! https://www.youtube.com/live/LXBGMk8HEE8?si=9cIQ6G9wkwMSYLrZ Show Notes Like every major industry in this country, healthcare is full of big corporations that will stop at nothing to get bigger, using the time-honored capitalist techniques of mergers and acquisitions to become HUGE corporations. But, of course, we live in America, where bigger is always better – what could possibly be wrong with bigger, better healthcare companies? We start out this episode with a cautionary tale from Massachusetts that began in 1994, when two of Boston’s biggest hospitals merge to create a mega-corporation called “Partners Health,” which over the next two decades bought up… everything. This was a response to a national wave of insurance company mergers and consolidations, which allowed insurers to squeeze both patients and providers under “managed care.” Hospitals, not wanting to be out-squeezed, fought back with their own mergers, ostensibly so they could negotiate with insurance companies. Of course, what actually happened was something much more nefarious – and secretive. In fact, we only know any of this happened thanks to the Boston Globe’s illustrious Spotlight reporting team, who dug up the truth in a 2008 article. Basically, in 2000, Dr. Samuel O. Thier, chief executive of Partners HealthCare, and William C. Van Faasen, chief executive of Blue Cross Blue Shield of Massachusetts engaged in an unwritten agreement between the two entities without putting it in writing to avoid legal implications. The agreement involved Blue Cross Blue Shield giving significant payment increases to Partners' doctors and hospitals, and in return, Partners would protect Blue Cross from allowing other insurers to pay less, effectively raising insurance prices statewide. This "market covenant" marked the beginning of a period of rapid escalation in Massachusetts insurance prices, leading to a significant annual rise in individual insurance premiums. Partners used its clout to negotiate rate increases, pressuring other insurers to match or exceed the payment increases given by Blue Cross, leading to cost increases for consumers. In turn, Partners' significant growth and influence in the healthcare industry compounded the impact of this backroom deal, leading to a substantial rise in medical costs in Massachusetts. Partners employed aggressive tactics, resulting in major payment increases benefiting a few powerful hospital companies while leaving others behind. This led to significant payment disparities, with Partners' flagship hospitals earning substantially more than other academic medical centers. Partners is an outstanding example of the evils of hospital consolidation, but it’s not an anomaly. This episode was originally inspired by our friends at the Minnesota Nurses Association (shout out to Geri Katz), who last year were fighting a proposed merger of Fairview Health with Sanford Health, two giant corporations with dozens of hospitals and clinics. Fortunately, the nurses and MN patients won this fight - merger talks were abandon...