Posts Tagged ‘Medicare For All’

Progressive Medicare For All, Or How And Why To Morph US Healthcare Into French Healthcare

April 22, 2019

European universal health care systems vary, from fully socialized (UK, Sweden) to mixed (France) to rather peculiar (Germany, universal health care from Bismarck, before 1880). The best and most expensive systems (Germany, Italy, France) amount to 12% of GDP, UK only 8%.

As the achievements of the US are objectively inferior (say relative to the UK NHS, and all other European systems), one can deduce that more than half of the US healthcare system is profits.

The European health care systems all have this in common: they are not profit centers. instead, they center around care. In the USA, in 48 states out of 50, the wealthiest profession is Medical Doctors. The naive will think that brings the best. In truth, it tempts those who are the greediest to become MDs.

 

Life Expectancy peaked in the USA in 2015 (above). Since then, it has been going down, demonstrating Obama’s Affordable Care Act didn’t work.[1]

The US system as it exists, with HMOs, was organized by president Nixon, under the guidance of his good friend, plutocrat Kaiser. (who founded the eponymous HMO, thanks to Dick’s help: dicks help dicks). Some US contemporary tycoons, such as Warren Buffet, one of the world’s wealthiest men, have made billions, personally, by investing in US healthcare. Buffet is revered in Democratic circles, but his advice may not be beyond any suspicion, as he and his ilk can only be grateful of the rewards US “care” brought them.

The French system provides a universal coverage of basic healthcare. The US equivalent would be Medicare For All, completed by private insurance for elective services and procedures. Average French doctors attached to public hospitals have often a private practice attached to a private clinic (say for a surgeon). When publicly serving. Fees are limited by law. In private practice, payments can be much higher (and are then paid with a mix of public reimbursement and private insurance, or more often, “mutual” insurance… The French are always comparing those “mutuelles”).

A progressive instauration of Medicare For All (as an elective in the beginning) would allow to morph the US healthcare system into the French one… without the dramatic, hence impossible, change that going to a socialist system like the Canadian, British or Swedish system would force.  

All this is current and hot. Nancy Pelosi, the quasi-Prime Minister of the USA (she decides the US budget, Trump proposes it) recently was claiming that Obama’s ACA was much better than Medicare For All. Sure. For her and her class of the .01%.

Medicare For All is the only reasonable solution for the USA. The beauty is that it can be introduced progressively, without economic disruption, a bit like better mileage for cars…

Patrice Ayme

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The preceding was a comment sent to NYT which had compared US healthcare with Singapore’s. Singapore’s population is mentally enslaved, obedient, and 1.7% of the size of the USA. It’s a mix of disciplined Han Chinese, grateful to exist thanks to their government, considering the enormous alien countries around, and foreigners also grateful to have been allowed in to enrich themselves… Plus 1.7 million quasi slaves for underclass work…

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[1] Obama’s ACA was supposed to have a Public Option offered, the prospect of which handily enabled to dodge the threat to the plutocracy presented by Medicare For All. Once socialist Medicare For All was safely taken care of, profits for professional politicians, lobbyists and plutocrats turned out to be more important than the health of citizens. Overall, ACA is disastrous: a member of my family died from it, he was 45. What the pseudo-“Democrats” will not tell you, is that doctors, or their groups, or organizations, will refuse to see you, when on the local version of ACA, like “Covered California”. So Obama covers you with words, while he drinks martinis on a yacht, watching the sun set among the paradise tax haven islands he loves. My brother-in-law, a proud, but somewhat destitute artist, who refused my personal financial assistance got a complication of heart disease, and got minor treatment after a second major heart attack, then was sent back home. When he started to die, the hospital rejected him, because he was no juicy profit center, but a drain, after a few more stents. He died at 2 am, in a parking lot, in his car, close to another hospital he tried to drive himself to.

Mention any of this to pseudo-Democrats, and they will bleat, as the good Sheeple they are. None of them is on Obama’s ACA. Their leaders, the great pseudo-Democrats, is immensely wealthy (more than 60 million dollars admitted), while her colleague great pseudo-“Democrat” Feinstein is outright a billionaire (she made it so that her husband was a go-between with China, while she oversaw business with the PRC, from the Senate…)

ObamaCare Crazed?

October 1, 2013

So Obama wanted to be president. He was elected, and pursued the works of Bush: throwing all the money in the world to save his friends the bankers, and other financiers.

We were far from Roosevelt’s “I welcome their hatred!” (speaking of bankers).

To make his sense of friendship official, Obama, while president, called Jamie Dimon, the CEO of the giant bank JP Morgan, many times,“my friend”. 

Yet, it ought to have been then completely obvious that Dimon was a crook, in bed with the Bush administration (who offered him the bank Bear-Sterns in the infamous “Jamie Deal”).

Right now Dimon is negotiating a 11 billion dollar fine with Att. Gen Holder (probably proposing him in exchange a mansion on Grand Cayman, or something a bit less obvious: Holder himself is an expensive boy, with a fortune esteemed to more than 12 million dollars).

Of course, it was not all Obama’s fault: he had been selected precisely because he claimed to read the Financial Times, a perfect tool for the plutocratic system. Thousands of experts of said system were ready to steer Obama the right way.

Obama was told by one of the principals of Clinton, Mr. Bowles, himself a plutocrat, scion of an investment banker, in charge of setting up Obama’s cabinet, to “leave his friends behind, they only cause problems”.

Hence Obama’s friendship with well to do characters, such as the Gates, Buffets, Dimons… or even Wolf the more or less criminal ex-boss of UBS USA.

Looking back at the Obama presidency, we see nothing, but Bushes to the horizon. Ah, except Obamacare, a giant mountain that gave birth to a mouse. Obamacare’s official aim was to cover all Americans with a health plan, thanks to public subsidies to… private companies.

It’s esteemed that 45 million Americans have no health care coverage. Obamacare officials claim that, in ten years, in 2023, they will have reduced that number to…  a slightly less horrific 31 millions.

In any case, his lack of overall achievement, or even definition, is why Obama is obsessed by Obamacare. Remove Obamacare, and eight years of Obama would have achieved less than Bush (who passed the financing of drugs for seniors).

And the truth is… That Obamacare should perhaps be called Obamacraze. Indeed, it seems to be the most complicated medical system ever devised, a thorough entanglement of government administration and private profit.

Complexity is a major defect, in all systems. A few years back, a tree touched a transmission line in Switzerland. All over Europe, lights went out. Rome stayed dark for hours, creating a giant mess. This was the result of too much, uncontrolled, fragile complexity.

Complexity ought to be engaged, as required, but not a step more.

In a country such as France, the “Assurance Maladie” (basically, “Medicare For All”) covers everybody, up to fluff. Fluff is covered by private insurance.

If one needs a liver transplant, Assurance Maladie pays everything. But, if one wants to recover in a private clinic, instead of a public hospital, then private insurance (typically connected to an employer) kicks in. If one wants a fancy fake tooth, private insurance will have to pay the difference with the reimbursement provided by Assurance Maladie for a basic fake tooth. and so on…

Such as national health care system has reduced complexity: basic health care is handled by a governmental system, and non basic care by a profit based system. The lines are clearly defined.

Thus the worst is… That Obamacare may not even be worth fighting for! Obamacare is very far from the basically free universal health coverage that exists in dozens of countries.

Instead Obamacare is a weird system with the cheapest coverage for the lower classes being called “bronze” (like in… colored), whereas the better stuff is associated to whitish hues. In other words Obamacare, symbolically, but also very practically, perpetuates the class scheme based on color.

If you are “Bronze”, you will find yourself with ruinous health care, once sick. 

Obamacare was written down by a private health insurance executive who worked “under” Sen. Baucus, himself a plutocrat, for the occasion. Meanwhile, Obama was going around calling Warren Buffet his friend. Buffet made billions, personally by investing in private health care.

Despite the belief of much of their electorate in single payer, the professional Democrats took the strange step of offering a conservative, market-based solution instead. In other words, they went Republican. Now true blood republican make them eat crow.

The most hilarious detail was the last bill of the Republican controlled Congress, which proposed, among other things, that all the top politicos, including those in Congress and staff at the White House, led by President and VP, would have no more subsidies for health care. Instead the bill wanted to force them to buy their health coverage from the Affordable Care Act, Obamacare.

The “Democratic” leadership replied that it was impossible to force them to buy into Obamacare, because… junior employees could not afford it”.

Unreal.

***

Patrice Ayme

MEDICARE FOR MORE.

September 19, 2009

Abstract: If my "Medicare For All" cannot be had now, because of greedy critters in the way, "Medicare For More" will nevertheless put the USA on the same road to the (French) heaven of the best health care in the world, in the fullness of time. There is no reason whatsoever to obstruct and deny this more modest reform, except from debasing and outrageous respect for the religion of greed of the few as ultimate good for all, forever and ever, Amen.

Even Obama cannot bipartisan his way out of that one, which is to put Medicare on the road of becoming a universal public insurance plan. As proposed below, it’s self financing, and autonomous. In particular, as explained below, it would be public, but independent of the executive branch and elected officials’ direct interference.

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The democrats are controlling Congress, the Senate and the Presidency. Thus, they are under big pressure to show that they can make the country progress towards better outcomes by taking some significant positive action somewhat, somewhere, somehow, that can seem to benefit the People, and not just their beloved hyper wealthy bankers.

Killing Afghans more efficiently may not be good enough, so those crafty dems are trying to tinker with the health care system, since, after all, they campaigned on making it much better. At the same time, those professional politicians and would be higher elements of society have to satisfy the BIPARTISAN PARTY, the party of the plutocrats, the only way they seem to know to elevate themselves.

The Swiss system is often touted as a template of what leftist American politicians want to do. But, as we will show, they can’t use it as a template. Nor do they want to, come to think of it.

In Switzerland, those who can afford to buy insurance are required to do so by law (as individuals, this has nothing to do with employment). For those who can’t, the government provides subsidies. About a third of the population receives subsidies (40% of households).

Nevertheless, the core reason that Switzerland has universal coverage, and good private health insurance, is that the Swiss people demanded that the Swiss government heavily regulate the health insurance industry and the Swiss people decided to pay more taxes so that the government would provide subsidies. In Switzerland, basic coverage components, very good by American standards, must be included in all plans. Basic health insurance is provided by nonprofit insurers — though some are affiliated with for-profit companies that offer supplemental policies (private rooms, super teeth, etc., similar to Medigap in the United States). The basic benefit package is defined by law and is quite generous. Maximum drug prices are regulated.

Still, Switzerland is trying to push its health care system in the French direction. The reason is that the Swiss system underperforms the French one, it costs more, and ever more so. In frontier areas, the French and Swiss systems are imbricated for practical reasons

It is not easy to go from Swiss to French health cares, although the basic structures are both non-profit: there are fierce debates on how to get the Swiss system more like the French (which is itself a work in progress, with major changes on how to make foreigners pay, and also a new, extremely expensive cardiac care system, to save more lives). That is why it’s important that US health care reform takes the right road, even if it cannot get to its destination now.

The French insurance system looks complicated, to the foreign observer. In truth it is simple in its value system, the dominant value being that LIFE IS A RIGHT. In contrast, Obama recently explained to us that Greed Is Good. Or that a person is never bad as long as profit is the motive.

At this point it’s important to keep in mind the liberal president Obama’s famous quote: "Insurance executives don’t do this [kill people] because they are bad people. They do it because it’s profitable." That’s where Liberal America is at: way out in the twilight zone of smoldering fundamental values, set on fire by bankers and greedsters. Very far from Europe.

Thus, in France, as in Switzerland, basic health insurance is non profit. Just it does not masquerade in France as a herd of private outfits. The main French public insurer is gigantic: the giant public French BASIC HEALTH CARE insurer is ‘Assurance Maladie’. Per its bulk, ‘Assurance Maladie’ has enormous negotiating power, and medical drugs from the USA, purchased as is, without any insurance, cost less in France than the co-pays in the USA with an excellent private insurance plan.

Superb care is given by the French health professional themselves, who are completely detached, physically separated, from the compensation system. Although some doctors, mostly the surgeons and professors in the hospitals are partly paid by the public system, paradoxically, most French doctors are in private practice (but paid by the public insurer(s) and complementary private insurance(s) if need be, for non essential care such as age spots).

Economies are made by endowing personnel with examining and curative powers. For example, midwives run in minutes exams that take many visits to many different specialists in the USA. The French midwives, in their offices (thrice bigger than a doctor office in the USA) have all the machinery, and know how to use it. Results come in seconds. There are also private labs for sophisticated ultrasounds (completely for profits, owned by the local doctors operating them), but the fees are much less than in the USA, although the electronics is much more advanced (straight from Japan, with lower prices negotiated in bulk). The system saves by making no mistakes (decisions are taken collegially, and from protocols), so there are no lawsuits: there is nothing to sue about.

The one and essential part of health care reform as proposed in Obama’s electoral platform is a PUBLIC OPTION.

If the Public Option does not happen, as Obama himself more or less admits, there is no reform in the direction of progress, and forcing everybody to pay private insurers would be making the later in a functional equivalent of the French Fermiers Generaux under the Ancient Regime. Those were private individuals in charge of gathering taxes (they paid themselves in passing).

The Fermiers Generaux’ motto was: ‘your money, or your freedom’. By law, everybody had to pay them. In turn, they paid the king. Many Fermiers Generaux were judged and executed during the revolution. Modern American life insurers have assuredly a similar motto: ‘your money, or your life’. If Obama makes paying them mandatory by law, and they, in turn, as they already do, pay the king, the USA would have gone back full circle to the France of the Ancient Regime. (After that maybe we can organize a revolution too? Just an idea.)

Indeed when your private insurer refuses to treat your cancer, that is what he does; take your life (that was a precise example used by Obama). In theory, people could divorce, give up all their belongings, then apply for Medicaid, but, by the time they get to that, they will be dead. Anyway, what is the difference between giving all you have to save your life, while getting half dead in the process, and the worst abuses of slavery?

There is only one way to save the public option: free Medicare from its constraints. Allow people to pay for it before the age of 65, on a sustainable basis (namely allow Medicare to charge as much as it wants: it will always be less than the Wall Street health care insurance plans, because Medicare does not have the necessity to make a profit to stay interested, whereas Wall Street does). The important point is to accept that Medicare (or the somewhat related Medicaid) will grow.

After launching the "Medicare For All" slogan, I propose that the best that can be hoped for now is "MEDICARE FOR MORE". As Medicare grows, it will be able to squeeze out the profiteers, if it is given full authority to negotiate costs with providers. Then, in the fullness of time, it will become "Medicare For All".

Patrice Ayme

https://patriceayme.wordpress.com/


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in truth, only atoms and the void

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Omnes vulnerant, ultima necat

GrrrGraphics on WordPress

www.grrrgraphics.com

Skulls in the Stars

The intersection of physics, optics, history and pulp fiction

Footnotes to Plato

because all (Western) philosophy consists of a series of footnotes to Plato

Patrice Ayme's Thoughts

Striving For Ever Better Thinking. Humanism Is Intelligence Unleashed. From Intelligence All Ways, Instincts & Values Flow, Even Happiness. History and Science Teach Us Not Just Humility, But Power, Smarts, And The Ways We Should Embrace. Naturam Primum Cognoscere Rerum

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Dogs are animals of integrity. We have much to learn from them.

ianmillerblog

Smile! You’re at the best WordPress.com site ever

Defense Issues

Military and general security

RobertLovesPi.net

Polyhedra, tessellations, and more.

How to Be a Stoic

an evolving guide to practical Stoicism for the 21st century

Donna Swarthout

Writer, Editor, Berliner

coelsblog

Defending Scientism

SoundEagle 🦅ೋღஜஇ

Where The Eagles Fly . . . . Art Science Poetry Music & Ideas

Artificial Turf At French Bilingual School Berkeley

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Patterns of Meaning

Exploring the patterns of meaning that shape our world

Sean Carroll

in truth, only atoms and the void

West Hunter

Omnes vulnerant, ultima necat

GrrrGraphics on WordPress

www.grrrgraphics.com

Skulls in the Stars

The intersection of physics, optics, history and pulp fiction

Footnotes to Plato

because all (Western) philosophy consists of a series of footnotes to Plato

Patrice Ayme's Thoughts

Striving For Ever Better Thinking. Humanism Is Intelligence Unleashed. From Intelligence All Ways, Instincts & Values Flow, Even Happiness. History and Science Teach Us Not Just Humility, But Power, Smarts, And The Ways We Should Embrace. Naturam Primum Cognoscere Rerum

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ianmillerblog

Smile! You’re at the best WordPress.com site ever

Defense Issues

Military and general security

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Polyhedra, tessellations, and more.

How to Be a Stoic

an evolving guide to practical Stoicism for the 21st century

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Writer, Editor, Berliner

coelsblog

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