Author: pnhpf3a_student
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!
Updated Information: SNaHP Summit 2020
We are excited to welcome you to the 2020 SNaHP Summit on Saturday, February 15 at the the University of Colorado Anschutz Medical School in Aurora, Colo. (near Denver). Our theme, “Making it to the Mountaintop,” means that SNaHP is moving full speed ahead into this next decade.
Online registration has closed, but on-site registration will be available Saturday, February 15 starting at 8:00 a.m.
Keynote
Our keynote this year is PNHP President-Elect Dr. Susan Rogers.
Agenda
You can find the SNaHP Summit agenda HERE with the speaker’s list HERE. Note that in order to save paper, we will not be providing paper copies at the Summit. Instead, you will be able to scan the QR codes with your phone at the registration desk.
Map
A map of the school can be found HERE. We will be in the Ed2 North building, with meals being served in the “bridge.” We will have a light breakfast and boxed lunch available for attendees. And coffee. All the coffee.
Dress code
Come as you are. If you feel comfortable in jeans, do that. If you feel comfortable in dress slacks, do that.
Article for non-POC meet up
We will host separate breakout sessions for POC and non-POC SNaHPers. If you plan on attending the non-POC meet-up, please read this article in advance to be fully prepared for discussion.
Out-of-town students
Students who are flying in may want to share a ride with other students. Please take a look at our ride-share spreadsheet to connect with other students and coordinate ride-sharing.
The scholarship window is now closed. There will be no assigned student housing this year. Instead, scholarship recipients will be given a housing stipend, which they can use at any location of their choice. The stipend will reflect general lodging prices in Aurora. Students can group up and coordinate to split housing costs using THIS spreadsheet. If you are having trouble finding a housing buddy, please reach out to organizer@pnhp.org and we can assist you.
ACTION ALERT: The A.M.A. must support Medicare for All!
On June 8, 2019, at 1:30 PM CST, students, physicians, nurses, allied health care workers, and activists from around the country will unite in Chicago to protest the annual meeting of the American Medical Association (A.M.A.).
Representatives of a rapidly growing coalition of Medicare for All supporters, including National Nurses United, Students for a National Health Program, Physicians for a National Health Program, People’s Action, Public Citizen, The Center for Popular Democracy, The Jane Addams Senior Caucus, various labor unions, teachers, activists, and more, will be taking a stand AGAINST corporate greed, misleading advertising, and the profit motive in health care.
And FOR a system that guarantees quality health care and choice of provider for all Americans, regardless of income.
The action recalls similar campaigns waged throughout the 1960s in which members of the African-American-led National Medical Association, the Medical Committee for Human Rights and the Poor People’s Campaign picketed the A.M.A.’s annual meetings because of its refusal to take a stand against segregated medical services and for allowing local medical societies to discriminate against physicians and patients of color.
When we join together, we can send a powerful message to the A.M.A. and corporate medicine that we won’t stop until every American is guaranteed quality medical care without going into debt or bankruptcy.
Everybody in, nobody out!
Read more about the action against the A.M.A. at https://www.wearethewaym4a.org/