Category: Uncategorized
Biden’s costly failure to stop Medicare privatization experiment in Ohio: Maximilian Brockwell and James Tyler Moore
Published: Feb. 16, 2022, 5:38 a.m.
https://www.cleveland.com/opinion/2022/02/bidens-costly-failure-to-stop-medicare-privatization-experiment-in-ohio-maximilian-brockwell-and-james-tyler-moore.html
Maximilian Brockwell and James Tyler Moore are first-year medical students at Northeast Ohio Medical University. Both serve on the leadership board for the local chapter of Students for a National Health Program.
ROOTSTOWN, Ohio — On Jan. 19, President Joe Biden spoke to a press conference touting the accomplishments of his first year in office, praising his administration’s COVID-19 response and approach toward health care policy. Conveniently, he failed to mention one glaring issue that will affect more than 2.4 million aging and vulnerable Ohioans — he has spent an entire year squandering the opportunity to protect them from a dangerous Donald Trump-era plan to privatize Medicare.
The pilot program, which began to roll out in 2021, introduces private companies known as “direct contracting entities” (DCEs) as middlemen between the Medicare program and health care providers. This experimental model currently spans 38 states, including Ohio. On paper, the rationale is to reduce cost by spreading financial responsibility between the government and third parties. However, under the false guise of risk-sharing, private groups can siphon massive amounts of cash away from seniors to line their own pockets.
Watchdog organizations are raising alarms about the myriad ways DCEs can take advantage of the system. DCEs would negotiate with hospitals and physician groups, and if successful, will automatically switch patients to this new insurance plan without informed consent. While there is an option to opt out after the fact, the opaque process will add to an already confusing maze of hurdles seniors must navigate to access necessary medical care. It may also lead to many patients being forced to find new physicians if they don’t want to participate.
The amount of funds distributed to a DCE is determined by the “risk scores” of their patients, a value estimating a person’s cost of care. This naturally incentivizes a trick called “upcoding,” which is a process where providers are pressured to use diagnoses with higher risk scores and thus higher levels of reimbursement. The companies then keep the difference between their allowance from Medicare and the true cost of treatment. Financial analysis has shown that just a 0.1-point increase in risk scores across the Medicare population would lead to overpayments nationwide in the range of $15 billion, including $3.5 billion in profits for the middlemen.
Perhaps unsurprisingly, more than half of DCEs already approved to participate are owned by private investors, including hedge funds with little experience in health care. Their goal is simple: increase profit margins. Efficiency will be an afterthought in this overcomplicated system, and the autonomy of Medicare patients across the country will be caught in the crosshairs.
All of this is happening under the watch of the Centers for Medicare & Medicaid Services, the federal body that oversees Medicare under the direction of the executive branch, independent of congressional oversight. The buck stops with Joe Biden, and so far, he has failed to act to prevent this private takeover of Medicare coverage.
In his Jan. 19 remarks, Biden boasted that, “We cut health insurance premiums for millions of American families,” yet Medicare premiums and deductibles are both set to increase by nearly 15% in 2022. It is hard to see how allowing the program to be taken over by Wall Street investors could have any alleviating effect on its potentially massive cost to the country or to individual beneficiaries.
Thousands of concerned health care professionals have joined together to halt this program through petitions and letter writing. There is still time for citizens’ voices to be heard, and for Biden to act, while the program is still in its infancy. Before Ohio taxpayers’ money is wasted and their right to choose their own Medicare coverage has been stripped, Biden should walk the walk of health care reform by doing the right thing and protecting Medicare recipients, not the legacy of Trump, or the profits of the middlemen.
The Need for Democratization in Healthcare Reform
Written by SNaHP member Edward Si
The one key political prerequisite required to bring about healthcare reform in the United States is to reform politics itself and make it more democratic. Polls conducted by the Pew Research Center show that 63% of Americans favor a single payer system while a poll from the Hill shows 69% support. Even if there is a margin of error of around 13% or 19% respectively, this still demonstrates popular support for universal healthcare.
The problem is that the United States is not a direct democracy. The closest thing we have to direct democracy in America is our presidential elections, but those are still not examples of direct democracy because the candidate with fewer votes can still win. In addition, unlike other countries, America does not hold national referendums in which the electorate votes “yes” or “no” on a single issue. Sure, some states have statewide referendums, but the referendum does not exist at the federal level. Perhaps a single payer system could work at the state level, but I believe the state would also need power to negotiate healthcare related costs.
Instead we have a flawed representative democracy that does not necessarily respond to the will of the people. People in congressional districts vote for a representative to Congress, but it is easy to gerrymander these districts to force a certain outcome. The two party system makes it so single-issue voters are forced to choose the party whose other policies they may not support (or likewise voters shun a party because the party has a few values they do not like). To top it all off, some representatives do not represent the interest of the people who voted for them in the first place. Instead they represent the lobbyist hired by the multi-billion dollar industry (healthcare included) who donated to their aligned super PACs. It goes without saying that the majority of people are not multi-billion dollar corporations and cannot match their influence.
It is fair to say that America is not a true democracy and was not intended by the Founding Fathers to be one. However, I believe most of our politicians and citizens will enthusiastically claim that America is indeed a democracy whether or not they understand the fine print.
It is clear that the road to healthcare reform is shared and preceded by political reform as well.
The two go hand in hand. Somewhere along the line it will be necessary to break the stranglehold that corporations have on politics and/or introduce a pass legislation to make our system more responsive to the people. Ultimately those who support healthcare reform should also support greater democratization of our political system.
source: https://www.pewresearch.org/fact-tank/2020/09/29/increasing-share-of-americans-favor-a-single-government-program-to-provide-health-care-coverage/
https://thehill.com/hilltv/what-americas-thinking/494602-poll-69-percent-of-voters-support-medicare-for-all
SNaHP Summit 2021 Agenda
The day is here! Here is the agenda for today:
ACTION ALERT: Join SNaHP’s Invite-a-Friend Campaign to Recruit Allied Professions
To achieve #singlepayer, we need allied stakeholders across the health professions.
SNaHP is expanding its membership to health professions students in cognate fields — and we need your help! If you haven’t already, we encourage you to mention SNaHP to your friends in public health, policy, management, nursing, and physician assistant programs. Invite them to join SNaHP and follow the SNaHP National Facebook and Twitter pages!
Student membership to SNaHP is free. Members hear first about organizational news and are notified about upcoming events planned by regional chapters.
Has your chapter held any events or activities for new members lately? We want to know! Post or tweet pictures and updates so that our new members can make connections as we advocate together for #singlepayer!
- SNaHP Membership for Medical and Health Professional Students (Free): https://pnhp.salsalabs.org/JoinSNaHP/index.html
- SNaHP National Facebook: https://www.facebook.com/snhp1
- SNaHP National Twitter: https://twitter.com/snahp_national
Webinar – SNaHP COVID-19 Virtual Event April 13
Hi SNaHPers!
In the midst of this pandemic many of us are wondering:
How can I help?
What went wrong with the US response to COVID-19?
Would Medicare for All help and how?
What can I do with my free time to advocate?
To answer these questions and provide a space for community discussion on what is going on, Students for a National Health Program (SNaHP) will be hosting a virtual event titled Student Advocacy During a Pandemic: Our Country’s Response to COVID-19 and What We Can Do to Help on Monday, April 13th at 8:00pm ET.
This event will feature:
- Rachel Madley, SNaHP Education and Development committee co-chair and PNHP-NY Metro Fellow – COVID-19 responses around the world and within in the US
- Dr. Miriam Laugesen, Associate Professor Mailman School of Public Health, Columbia University and Thomas Jackson, former SNaHP Political Advocacy committee co-chair – US Public Health Response to COVID-19
- Dr. Susan Rogers, PNHP President-Elect – COVID-19’s exposure of socioeconomic inequality and health injustice in this country
- Ashley Duhon, SNaHP Executive Board member – COVID-19’s effect on reproductive healthcare
- Ashley Lewis, SNaHP Political Advocacy committee co-chair – Next steps and how to advocate virtually
Please RSVP here. Zoom meeting details will be sent out on the day of the event to all attendees who RSVP.
Don’t forget to share this event with your networks, all are welcome!
Future MDs: Americans want single payer healthcare – and yes, it can work!
In light of the media’s recent attention to single payer healthcare and the release of Bernie Sanders’ proposed plan, Students for a National Health Program (SNaHP) would like to rectify public misconceptions of and clarify our stance on Medicare-for-All.
Several themes have recently emerged in online and print media in arguments against Medicare-for-All type reform. The first is the notion that, in order to cut costs, “Foreign single-payer systems pay doctors less”. While doctors from the US are some of the highest paid in the developed world, their reimbursement is not nearly as reliable as that of physicians abroad. In the US, physicians often have trouble collecting payments from private insurance companies and patients alike. Medicare, on the other hand, reimburses at a reliable rate, and while some have attempted to argue that expanding Medicare to the entire population would reduce physician income, studies of the Canadian transition showed that physician incomes actually rose after transitioning to single payer.
Why Everyone Should Take Part in #TenOne: A Chicago Student’s Call to Arms
Despite the Affordable Care Act’s undeniable success in extending health coverage to more people and in curbing some of the health insurance industry’s worst practices, recent reports show our nation still has 33 million people who are uninsured, a comparable number who are inadequately insured, sharply rising deductibles and copays, and skyrocketing pharmaceutical drug prices.
The 2010 health law clearly did not go far enough.
Student Activism: A Historical Perspective on How Medical Students Can Affect Health Justice
As a medical student without an MD and prescription pad, it can be easy to feel powerless. Asked if it felt like one were making a significant difference in the lives of patients on a day-to-day basis, the answer of almost any medical student would likely be “eh, sometimes.”
We study biochemistry and physiology, memorize treatment regimens for asthma and hypertension, and hold retractors in the operating room, amassing a fund of knowledge that will hopefully– maybe someday– help us care for our patients. We listen to stories, provide emotional support, and occasionally glean information that in some small way improves a patient’s physical condition. And though we learn from and are grateful for the small contributions we are able make on a day-to-day basis, we easily lose perspective at the bottom of the medical education totem pole, forgetting the power we possess when we use our voices collectively. In those moments when we feel we have so little to contribute to patient care, we can look to previous generations of students and trainees for strength and inspiration to affect significant change.
Community Wisdom and “Power With”: Lessons from Liberation Medicine
For one weekend in mid-August, comrades in health from around the world gathered in Seattle to discuss the work of Doctors for Global Health, liberation medicine, and social justice as it relates to health in the US and abroad. The theme was “Deconstructing the Status Quo: Building Global Health Justice” and topics ranged from the impact of the historical trauma and the boarding school injustice on breastfeeding for native communities in the state of Washington to the importance of alternative economies in community health promotion in Mexico, as well as tools and strategies for building social movements and creating social change.