Medicare for All

Written by: Benjamin Day and Gillian Mason - Healthcare-NOW
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  • Summary

  • Benjamin Day and Gillian Mason of Healthcare-NOW break down everything you need to know about the social movement to make healthcare a right in the United States. Medicare for All!
    ©2023 Healthcare-NOW Education Fund, Inc.
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Hygiene & Healthy Living Political Science
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Episodes
  • Medicaid Privatization Smackdown in Connecticut!

    Medicaid Privatization Smackdown in Connecticut!
    Nov 13 2024
    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...
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    56 mins
  • Boo and Vote Local!

    Boo and Vote Local!
    Oct 21 2024
    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...
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    50 mins
  • Medical Debt in the I.O.U.SA

    Medical Debt in the I.O.U.SA
    Sep 30 2024
    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...
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    7 mins

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