“If we desire respect for the law,” said Louis Brandeis, “we must first make the law respectable.” (1916)
"Harvard Business School professor Ranjay Gulati told the New York Times there’s an issue. “There’s a latent undercurrent here of how frustrated people are with the health care industry,” he said. “I’m not condoning the action in any way, but there’s a lot of soul-searching we have to do about an industry that consumes nearly 20 percent of our G.D.P. and yet our outcomes are not nearly as good as countries that spend half as much.”
"Societies that give citizens no way to control their own lives, but put the fate of their people in the hands of distant masters with no concern at all for their wellbeing, invite disaster. We’ve always known that. It’s one of the main reasons for the passage of our antitrust laws. So I hope we can get some control over our society again, before we truly do spin out of control."
SCOTUS, the Robert's Court, has undermined respect for the law. A judiciary and police that protects the most litigated, lawbreaking potus and major political party in American history undermines respect for the law. Monopolist billionaires partying it up while millions struggle with health care bankruptcies undermines respect for the law. Biden pardoning his son only acknowledges that our democratic system just elected a new admin that does not respect the rule of law, but in fact openly encourages violence and phony prosecutions against its political enemies.
I remain somewhat uncertain about this Medicare Advantage Trap. I recently signed up for Medicare Advantage with Kaiser, basically, because I've been with Kaiser (and Group Health before they became Kaiser) through my work for going on forty years. I don't yet, knock on wood, need health care much and after looking around a little I decided to go with what I already knew and, yeah, I liked that I could get everything I needed (health, dental, vision) in one place.
My parents, whose affairs I've managed for last few years, are a very different story. They're in the original Medicare system. In addition to Medicare they have to carry Medigap plans that cost them $300-400 a month each. And they have additional insurance to supplement coverage of their medications. They're in their late 80s and at this point require 24/7 care support.
I don't doubt they might be denied more health care services if they were on Medicare Advantage but all this coverage they already have still does deny them services on occasion. Hartmann reports that on average 18% of health care services are denied by Medicare Advantage plans. United Healthcare, the plan ran by the CEO recently murdered, reportedly, denied 30% of the health care services submitted to them for support. I take some comfort that the denial of services rates lists Kaiser at 7%, the lowest denial rate on the list Hartmann shares, but I still wonder what is the real denial of service rate in the old Medicare? It's not zero, or not in my experience anyway.
And the old system is in fact ridiculously complicated and wasteful. The original Medicare probably doesn't allow as much of the exorbitant CEO and private for profit equity skimming that Hartmann describes going on with Medicate Advantage. But once you're involved in the health care system, the Medicare and Medicaid systems, I must say it's obvious that there are lots of "termite"-like price gouging going on inside these insurance systems, hospital care and specialty services charging inflated rates to insurance plans and routine understaffing of care workers. It is a flashing red alert to me that recent nursing strikes don't mention underpay as much as understaffing levels that endanger patient care.
I definitely don't think increasing profit seeking in health care, which the private equity people like to euphemize as "choice," is the solution. Reducing it is closer to the real task confronting the health care economy in the future. And Medicare Advantage is a privatizing move, private industry trying to secure control of more public monies. But I'm not sure it's this public vs private binary either. I like the idea of Medicare-for-all, build universal health care into the tax base, no co-pays for basic health care services, but that would still by necessity include lots of private enterprise, and would have to be heavily regulated to squeeze out as much of the termite price gouging as possible.
But, most emphatically, I don't think cutting Social Security or Medicare or Medicaid would solve any of our health care problems either. Look around, senior poverty is a thing. My parents would now be destitute and homeless without Medicaid supports, point of fact. And I have no doubt cutting any of these crucial supports would mean more destitution and homelessness, for the working classes, I might add, that worked hard their whole damn lives paying taxes into these programs expecting them to be there when they needed them.
Cutting these programs will not make the law or government more respectable. It will make them less so. But this appears to be where we're at. It's that line, again, about how "the Republicans are the party that insists the government doesn't work and then gets elected and proves it." Seventy-seven million Americans voted for forced deportations, sadly, but I'm fairly certain they did not vote for cutting their own health care and Social Security?!
And doing so, obviously, won't stop random vigilante violence against health care CEOs.
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