The High Cost of Collusion: Why Health Care is So Expensive in the US

January 10,2021

“Why didn’t we know? To start with, unlike any other business in America, almost all of the financial transactions in healthcare are hidden from the providers as well as the patients. We order tests, procedures and medications to manage our patients, but very few doctors, or other healthcare providers, have any idea how much any of those things cost. Patients only rarely pay directly for these services and payment for any service varies substantially from different payers. Hospitals have separate billing departments that are far removed from anyone ordering or performing tests or procedures. No one directly involved with patient care has any notion of the charge or reimbursement for their service. Even most private doctor’s offices contract billing companies, who just send them a check each month from the total amount collected, leaving them no notion of the actual charge or reimbursement for an individual service they provided.”




January 5th 2021

How California Can Lead The Way For Medicare-For-All with Sonali Kolhatkar & BETTY DOUMAS ON KPFK RADIO



Published on

Friday December 11, 2020 by Common Dreams

‘Seems Like a Good Policy!’ CBO Shows Medicare for All Could Cover Everyone for $650 Billion Less Per Year’

‘Seems Like a Good Policy!’ CBO Shows Medicare for All Could Cover Everyone for $650 Billion Less Per Year.

The Congressional Budget Office on Thursday released a report examining the costs associated with universal healthcare proposals that are based on Medicare’s fee-for-service program and found that implementing a single-payer health insurance program in the United States would not only guarantee coverage for every person in the country but would also reduce overall healthcare spending nationwide. In the words of researcher Matt Bruenig—founder and president of the progressive think tank People’s Policy Project who called the CBO’s working paper (pdf) on the topic “more exhaustive than any other recent study on the subject”—the new analysis shows that administrative costs under a single-payer healthcare system “will be lower than what even the most rabid Medicare for All supporters have traditionally claimed. According to Bruenig, “Modeling the cost of a single-payer program is relatively straightforward. You begin with the status quo healthcare system and then make educated guesses about the following questions:
  1. How many more units of healthcare services will be demanded and supplied when price barriers are removed?
  2. How much more efficient will health insurance administration be after the enrollment and payment systems are radically simplified?
  3. How much money will be saved by reducing the payment rates for healthcare providers and drug companies?”
In its analysis, the CBO looked at several distinct single-payer designs and determined that four such systems—fully implemented by 2030—would save anywhere from $42 billion to $743 billion that year alone. “Never let a politician ask: ‘How will we pay for it?'” tweeted Democratic Socialists of America for Medicare for All. READ MORE


There is a lot of nonsense and confusion on the subject of healthcare in the United States. During the Democratic primary, Bernie Sanders was criticized by fellow Democrats for wanting to raise middle-class taxes and abolish the private insurance industry. Many Democrats have defended the system of private, for-profit health insurance, suggesting that a “Medicare For All” plan would be a radical proposal that would upend healthcare. The last Democratic president, Barack Obama, explicitly rejected a “single-payer” healthcare system and said it is not right for America.

I think it is very important for every single adult in this country to understand the left critique of the current system and why the defenses of this system make no sense. Everyone has health, everyone needs healthcare. It is in all of our interest to have as good of healthcare as possible, delivered as inexpensively as feasible. We should all want it to be easy to get the care we need, and for nobody to fret about money when they go to the doctor.

I want to explain as clearly and simply as possible, then, why having for-profit private health insurance companies is fundamentally irrational and harmful.

Let’s start with: what is it that a health insurance company actually does? Its job is to move money. You pay them, so that when you need to visit the doctor, they will pay the doctor. If you need something exorbitantly expensive, and all of us risk having some medical problem that needs very expensive treatment, the insurance company will pay, and you won’t go broke. From your perspective, it’s necessary to have someone who will cover the cost if this happens, so there’s reason for you to pay your insurance premiums. The insurance company also gets better rates from healthcare providers than you would if you were approaching them alone, and even though there are deductibles and co-pays in addition to your premiums (and your premiums and deductibles both might be very high) on the whole, from your perspective, health insurance is supposed to be worth it.





Gavin Newsom talks about how good Single-Payer Healthcare could be good for California.  In this pandemic every industrialized nation has been able to lower the curve of infections.  All those nations use Single-Payer healthcare as a weapon against Covid-19. In a Single-Payer environment nobody would fear financial destitute Let us hold Gavin Newsom to his comments.v

IDEAS: Essays

Hawaii Was Creating A Plan For Universal Health Care. It’s Time To Return To It

“Even before the pandemic arrived on our shores, our health care system was in crisis.”


Civil Beat is a high quality online newspaper in Hawaii with a reputation for excellent investigative journalism and commentary. They published my article this morning.

In 2009 Hawaii passed a law to create the Hawaii Health Authority, or HHA, and charged the group with designing a universal health care system that would cover all residents of the islands.

The HHA evoked the fundamental questions at the core of health care in the United States today. Should health care be a commodity, sold by corporations to those with the ability to pay? Or should it be a public good that is assured for all, similar to roads, schools, national parks and national security?


I was an original member of the HHA, appointed by Gov. Neil Abercrombie. The HHA met regularly from 2011 until April 2013 but at that point the Abercrombie administration pivoted away from the HHA and toward the federal government’s Affordable Care Act.

The ACA was largely written by the insurance industry in order to cement the industry’s central role in health care. At the heart of the ACA was a move to expand coverage by getting greater numbers of people on competing private healthcare plans.


So, what has happened to health care in Hawaii under the ACA?





“In Canada or the U.K., there are no cracks of this sort: billing the patient like this is simply not allowed,” said Dr. Adam Gaffney, president of Physicians for a National Health Program.

In March, Congress passed legislation aimed at requiring for-profit health insurance companies to cover all FDA-approved coronavirus tests with no cost-sharing—but federal laws have not stopped insurers from hitting vulnerable Americans with large surprise bills during an ongoing pandemic and economic crisis that pushed millions to the brink of financial ruin.


“If I had to pay it off, it would clear out my savings,” New York City resident Kelly Daisley told the New York Times after Anthem charged her $2,718 for a Covid-19 test that was advertised as free.


Under the Families First Coronavirus Response Act and the CARES Act, private insurers are supposed to shoulder the all of the costs of coronavirus tests, including those offered by out-of-network providers. But the laws—and the Trump administration’s narrow interpretations of them—are rife with loopholes that insurance giants have not hesitated to exploit, potentially leaving hundreds of thousands of Americans with unanticipated charges.






“My preference is that we … have one single payer either at the national level or through the 50 states,” Brown said in 1992.


CALIFORNIA’S SENATE PASSED legislation to create a first-in-the-nation single-payer universal health care system earlier this month, but it faces tough odds against a skeptical Assembly.


It also faces opposition from California’s Democratic Gov. Jerry Brown. “We’re hearing the governor is doing everything he can to make sure this never gets on his desk,” Paul Song, co-chair of single-payer advocacy group Campaign for a Healthy California, told the Sacramento Bee in early June.


Brown has complained that such a system would be too expensive in the recent past. “Where do you get the extra money?” Brown asked in a chat with reporters that took place in March. “This is the whole question. I don’t even get … how do you do that?”


As some have pointed out, the California single-payer legislation is actually a pretty good bargain.  The efficiencies created from having one public insurer save a lot of money. The state would spend about 15 percent of its gross domestic product to achieve universal health care, which is 3 percentage points less than the United States as a whole currently spends for less-than-universal health care.


Brown himself once forcefully argued exactly that — that moving to a single-payer system would save money and cover everybody. It was a cornerstone of his unsuccessful 1992 bid for the Democratic presidential nomination.


In April of 1992, Brown passionately argued for this system in a debate with then-Arkansas Democratic Gov. Bill Clinton on the nationally-syndicated Phil Donahue Show.


“My preference is that we create a single system, put everyone under a universal health care system. We treat health care not as a commodity to be played with for profit but rather the right of every American citizen when they’re born,” he explained.


He then went on to explain how this system would save money:


“You cut out all the private health insurance. You have one single payer either at the national level or through the 50 states. And that one single payer will be the one that negotiates with the doctors, the hospitals, and the other providers. And since you have only one source of income in the whole medical establishment, you can drive down the cost. With the holding down of the cost, you can eliminate the intermediary, the middle man, the bureaucracy. In some of these hospitals there’s more people doing the billing then there are in direct patient care on an eight-hour shift. It doesn’t make any sense. But through a single payer, as we’ve seen in Canada, you can eliminate tremendous amounts of paperwork both for the doctors, the hospitals, and the part of the insurance companies.”




Listen to Montara Davis RN tell us why she supports Single Payer Universal healthcare for all. She witnesses and experiences the injustices and discrimination of the current healthcare system firsthand. 


Having great compassion for her patients and concerns for nurses’ safety, Montara wants to create a new Single Payer system that offers all people the care that we need when we need it. Every body in. No body out. People not Profit!


Wonderful publicity for our cause.  Please go online to the website to respond and comment about MediCare for All/Single Payer.The comment section is a great opportunity to educate the public. You can join MEDPAGE TODAY for free and unsubscribe after you comment if you choose.


Please thank the journalists Joyce Frieden and Shannon Firth who wrote these pieces.  POST ON SOCIAL MEDIA and WEBSITES! 

Small Steps Not Enough to Get to Universal Healthcare

— Many, including Bernie Sanders’ supporters, hope California will pass a “Medicare for All” bill

Imagine having to sneak out of the doctor’s office because you couldn’t afford to pay the bill, or having perfect strangers tearfully confide in you that they can no longer afford their mental health treatment.

These are just two of the reasons people gave for supporting single-payer, government-financed health insurance during a pre-Democratic National Convention webinar Saturday on “Why and How to Win Single-Payer in California.” The event was part of a “weekend of action” event known as the “People’s Assembly: Building Beyond Bernie.” Many of the webinar participants were supporters of or delegates for Sen. Bernie Sanders (I-Vt.), who pulled out of the presidential race in April and endorsed former Vice President Joe Biden, the likely Democratic nominee.

“No People Matter”

“My daughter broke her leg at school; I didn’t have healthcare coverage,” said Greg “Baba” Akili, director of the Fannie Lou Hamer Institute, an organization aimed at empowering young Black women. “We went to the doctor and they put her leg in the cast. But when we went back to get it off, I couldn’t pay and we literally had to sneak out. It was embarrassing and it was hurtful; I thought there had to be a better way.”


Maureen Cruise, RN, a director of the Los Angeles chapter of Health Care for All, a pro-single-payer group, explained that during the 1970s, when she was a graduate student working in research at the University of California Los Angeles (UCLA), “I was interviewing people who had been patients in a variety of UCLA-sponsored research done by psychiatry residents and fellows … I encountered people weeping on the phone because they were no longer needed for research and could no longer access mental healthcare. That to me was a real shock.”

Her shock continued after she left graduate school and became an RN. “Dying seniors were getting treatment they didn’t need because it made money for the hospital, and young people with families and futures were denied care,” she said. “The message was that poor people don’t matter — and over time, that has devolved into ‘no people matter.'”





Frequently asked questions on Medicare for All



Bernie’s payment plan fpr Single Payer


Our two single payer health care panels at the People’s Assembly were covered by MEDPAGE TODAY!   CONGRATULATIONS CHENG SIM LIM for getting this great publicity!!!!…and RON BIRNBAUM MD for his access and to Dr. Ron and Jeannna Harris RN for their comments in a first article prefacing the topic.  Thanks to Denis Recendez for hosting the zoom with Cheng Sim.

Wonderful publicity for our cause.  Please go online to the website to respond and comment about MediCare for All/Single Payer.The comment section is a great opportunity to educate the public. You can join MEDPAGE TODAY for free and unsubscribe after you comment if you choose.

Please thank the journalists Joyce Frieden and Shannon Firth who wrote these pieces.  POST ON SOCIAL MEDIA and WEBSITES! 

A Message From the Future With Alexandria Ocasio-Cortez


What if we actually pulled off a Green New Deal? What would the future look like? The Intercept presents a film narrated by Alexandria Ocasio-Cortez.

Video by

Today, The Intercept launches “A Message From the Future With Alexandria Ocasio-Cortez,” a seven-minute film narrated by the congresswoman and illustrated by Molly Crabapple. Set a couple of decades from now, it’s a flat-out rejection of the idea that a dystopian future is a forgone conclusion. Instead, it offers a thought experiment: What if we decided not to drive off the climate cliff? What if we chose to radically change course and save both our habitat and ourselves?

What if we actually pulled off a Green New Deal? What would the future look like then?

This is a project unlike any we have done before, crossing boundaries between fact, fiction, and visual art, co-directed by Kim Boekbinder and Jim Batt and co-written by Ocasio-Cortez and Avi Lewis. To reclaim a phrase from House Speaker Nancy Pelosi, it’s our “green dream,” inspired by the explosion of utopian art produced during the original New Deal.

And it’s a collaboration with a context and a history that seems worth sharing.

Back in December, I started talking to Crabapple — the brilliant illustrator, writer, and filmmaker — about how we could involve more artists in the Green New Deal vision. Most art forms are pretty low carbon, after all, and cultural production played an absolutely central role during Franklin D. Roosevelt’s New Deal in the 1930s.

We thought it was time to galvanize artists into that kind of social mission again — but not in a couple of years, if politicians and activists manage to translate what is still only a rough plan into law. No, we wanted to see Green New Deal art right away — to help win the battle for hearts and minds that will determined whether it has a fighting chance in the first place.

Crabapple, along with Boekbinder and Batt, have been honing a filmmaking style that has proved enormously successful at spreading bold ideas fast, most virally in their video with Jay Z on the “epic fail” of the war on drugs. “I would love to make a video on the Green New Deal with AOC,” Crabapple said, which seemed to me like a dream team.

The question was: How do we tell the story of something that hasn’t happened yet?


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Medicare for All: A Prescription Against Deadly COVID Capitalism


By Amy Goodman and Denis Moynihan


The United States, the wealthiest and most powerful nation in world history, is also number one in COVID-19 infections and deaths. As White House coronavirus advisor Dr. Deborah Birx warned last weekend, “It is extraordinarily widespread. It’s into the rural as equal urban areas. To everybody who lives in a rural area, you are not immune or protected from this virus.” President Donald Trump responded by calling Birx “pathetic.” Six months into the pandemic, he’s offered no national plan to stop the spread of the virus, which is thriving.


As Trump daily demands rapid reopening of schools and the economy, the lines for tests stretch ever longer, and the ever-expanding wait for test results, in many cases up to two weeks, renders the results essentially useless, making contact tracing and isolation of infected people virtually impossible.


The American Association of Medical Colleges recently released “A Road Map to Reset the Nation’s Approach to the Pandemic,” urging the Trump administration to invoke the Defense Production Act to overcome the unconscionable shortage of personal protective equipment, or PPE, testing supplies, and therapeutic drugs.


Further, and more fundamentally, the AAMC calls for addressing systemic racism and other inequities that exist in our healthcare system and for a massive increase in funding for our beleaguered public health infrastructure. Included would be the fair, equitable and rapid distribution of a safe, effective vaccine when one becomes available, not only nationally, but globally.


This roadmap sounds sensible, but what chance does it have with a science denier in the White House more concerned with his TV ratings and reelection than addressing the greatest pandemic in a century? Trump is providing socialism for multinational corporations, doling out billions to big pharmaceutical companies, supposedly to develop vaccines. Public Citizen’s Peter Maybarduk has said Trump’s $6 billion, taxpayer-funded program benefitting private companies has “a striking lack of transparency.” Pharmaceutical company insiders are making millions through stock options, as poor and uninsured Americans are left to fend for themselves in the “free market.”


A simple, overdue step would be to immediately expand Medicare, the national health insurance system for people 65 years old and above, to cover all Americans from birth. Medicare for All would separate health insurance coverage from employment status or wealth, saving trillions of dollars and, most importantly, saving lives.






‘They Are Correct to Never Waver’: Sanders Campaign Co-Chairs Applaud DNC Delegates for Continuing Medicare for All Fight

“We stand with the grassroots activists who understand that the party must stand for extending Medicare to everyone.”

All four of the national co-chairs of Sen. Bernie Sanders’ 2020 presidential campaign on Friday applauded the more than 700 delegates to the Democratic National Convention who have so far vowed to vote against the party’s platform if it doesn’t include a plank supporting Medicare for All.

“We stand with the grassroots activists who understand that the party must stand for extending Medicare to everyone,” said former Ohio State Sen. Nina Turner, Rep. Ro Khanna (D-Calif.), Ben & Jerry’s co-founder Ben Cohen, and San Juan, Puerto Rico Mayor Carmen Yulin Cruz in a joint statement.

“Many hundreds of delegates are speaking out now with clarity to insist that Medicare for All belongs in the Democratic Party platform,” the statement continues. “They are correct to never waver in this fight for healthcare as a human right. During the last few months, millions of people in the United States have lost their jobs. They should not lose their healthcare.

The co-chairs released their statement after the DNC Platform Committee on Tuesday overwhelmingly voted down an amendment that would have inserted support for Medicare for All into the Democratic platform, which is set to receive a final vote at the virtual Democratic convention next month.


Turner called the Platform Committee’s vote against the single-payer amendment “shameful as hell.”




More Than 700 Democratic Delegates Vow To Reject Platform If It Doesn’t Include Medicare For All

With the Democratic National Convention approaching in August, a growing number of Democratic delegates, led by Senator Bernie Sanders’ Nevada delegation, are joining a pledge to reject the Democratic platform if it doesn’t include Medicare for All, representing the Democratic Party’s latest struggle to unite its progressive and moderate wings and bring Sanders voters into the fold ahead of the November election.

More than 700 delegates—mostly representing Sanders, though some back presumptive nominee Joe Biden—have signed on to the pledge, which calls on delegates “to vote against any platform that does not include a plank supporting universal, single-payer Medicare for All.”


The organizers cite the current pandemic as making the need for single-payer healthcare even more urgent, writing in their petition that the widespread job losses resulting from the pandemic “has highlighted the need to separate healthcare from employment.”


Major progressive groups have backed the pledge, including and the Progressive Democrats of America.


The current draft of the Democratic platform acknowledges but does not outright support Medicare for All, writing that the party “welcomes advocates who want to build on and strengthen the Affordable Care Act and those who support a Medicare for All approach; all are critical to ensuring that health care is a human right.”


Activists supporting the pledge say that the pledge is distinct from their support of Biden’s candidacy, with co-founder Jeff Cohen telling Forbes that “defeating Trump in November is our number one priority.” READ MORE


Without Medicare for All, This Isn’t ‘the Boldest Democratic Platform in American History’

700 Democratic delegates signal they will oppose a platform that fails to renew the party’s commitment to establish a national health care system.

By John NicholsTwitter

The Democratic National Committee’s platform committee approved a draft of the party’s 2020 agenda this week and committee cochair Denis McDonough promptly described it as the “boldest Democratic platform in American history.”



It’s not—unless your definition of “bold” includes a tepid health care stance that rejects the single-payer Medicare for All agenda that enjoys overwhelming support from Americans in this Covid-19 moment.



The proposed platform also pulls its punches on a host of other issues, from marijuana legalizationan end to qualified immunity for police officers, the placing of conditions on aid to Israel, a federal jobs guarantee, and a comprehensive approach to developing and implementing a Green New Deal. READ MORE

The Democratic National Committee’s platform committee approved a draft of the party’s 2020 agenda this week and committee cochair Denis McDonough promptly described it as the “boldest Democratic platform in American history.”The Democratic National Committee’s platform committee approved a draft of the party’s 2020 agenda this week and committee cochair Denis McDonough promptly described it as the “boldest Democratic platform in American history.”N95 mask in the ER at Oakbend Medical Center in Richmond, Texas. (Mark Felix / AFP via Getty Images)N95 mask in the ER at Oakbend Medical Center in Richmond, Texas. (Mark Felix / AFP via Getty Images)Twitter

Bernie Delegates Mount Convention Rebellion over Medicare for All

July 27,2020


A revolt is brewing among Bernie Sanders delegates three weeks from the Democratic National Convention.

More than 360 delegates, most of whom back Sanders, have signed on to a pledge to vote against the Democratic Party’s platform if it does not include support for “Medicare for All,” the petition’s organizers told POLITICO. They argue that single-payer health care is an urgent priority amid a worldwide pandemic and the biggest unemployment crisis since the Great Depression.



History Shows That Sustained, Disruptive Protests Work

“I don’t think in a social revolution you can always retain support of the moderates.”

Protesters march against racism and police brutality in Amityville, New York, on July 5, 2020., Thomas A. Ferrara / Newsday RM / Getty Images.  READ MORE

Ed Yong on the “Disgraceful” U.S. Pandemic Response & How Medicare for All can Help



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