I can’t speak to the Warren/Markey bill but the bottom line is there will be no way to stop Wall Street from strip mining healthcare as long as candidates are addicted to campaign cash from the wizards of finance.
We must make voters the donors who fund election campaigns. Then Washington will answer to us, not special interests.
Says the guy who has made political donations to Democrats. Unions are one of the biggest sources of campaign cash and much to the detriment of their members. So tired of people saying "save democracy" but only if it's their candidate that's going to do it...
I see union potical donations compared to corporate donations alot. I've love to see the numbers breakdown. My gut feeling is union money is probably a fraction of corporate.
Whether the bribes, err, contributions come from unions or big companies, the result is the same. You're arguing whether you'd rather be hit with a 9 iron in the left eye or right eye.
Yes Mick, when either party complains about the other party’s campaign finance, it’s hollow because both parties take the big money. And I don’t see that either party even knows what democracy is: government by the people, which they don’t want because they think we’re children and we have little money to donate to their campaigns. Thanks for the comment.
We don't elect people willing to act against their own self interest. Here's a video explaining this phenomenon through the lens of comparing Star Wars and Star Trek: https://www.youtube.com/watch?v=12JDlGnMiTM
You can’t mount a viable campaign for national office without raising a ton of money. So candidates self censor to avoid alienating potential donors. That’s why they have little for us beyond slogans and personal attacks on their opponents. Indirectly the need for campaign cash does massive damage, though no one is actually buying votes. Thanks for commenting.
I suggest you examine Dave Brat's success against Eric Cantor, or Ms. Ocasio-Cortez knocking off Joe Crowley.
The big payoff on campaign contributions is being able to bank them, which certainly helps not-particularly-wealthy "public servants" become millionaires over time.
Yes, the court has gutted almost every limit on what big donors can spend, because campaign cash supposedly is a form of free speech.
For this reason, the only path to game changing reform - short of amending the Constitution - is a public financing system that creates an alternative pool of money candidates can use without selling out to special interests.
Of the public financing mechanisms, Voter Dollars is best because it gives every voter the power that comes with campaign cash.
Then he's going to want special interest groups to not independently spend, so AARP, NRA, unions - all the people that were on the Citizens United side - get shut out of the political process. Hmm, what does that leave?
The current US financial system, with the instant creation of new dollars (in the form of debt) at its root, is inherently corrupting--and over many years has been slowly, and now relatively more quickly, strangling (and/or exporting) the real economy of goods and services.
Money, new and old (or more precisely, the holders and managers thereof) is continually chasing "investment opportunities"--income streams--that can be extracted from the goods-and-services economy (or from individuals more directly, such as in taxes spent for the benefit of the financiers). That's part of how we get outrageous defense system pricing, outrageous public health costs, and other outrageous government spending. (Example: ~$1,800,000 is spent per estimated covid hospitalization prevented and ~$50,000,000 is spent per estimated covid death prevented in the 6 mos. through 4-years cohort for the CDC-recommended childhood Pfizer covid vaccine--yet the recommendation stands--and appears on every child's "vaccination schedule.")
Monopolized currency creation corrupts not just the financial system and its incentives, but society at large, including politics. (Though politics would likely be corrupt even without financial corruption, I admit.)
Fundamentally, the power of issuing new *unsupported* currency should not exist--or it should be available to all--because wherever it does exist and is monopolized, corruption and oppression follow.
My daughter-in-law is a PA that recently started work for an equity healthcare play, not a hospital but a multi-practice mini-conglomerate. I'm still puzzled that doctors will sell off their practices and become employees of the company they sold to - but apparently they are. Locally to me, everything has become corporatized - my own primary care is now part of a state-wide "system" (even though not PE).
Older physicians are looking for an exit strategy from a long held practice, most younger physicians now have an enormous amount of educational debt and no way to buy into a practice. There is also little appetite to run a medical practice as the overhead/compliance expense can easily exceed 60% of revenue. Not to mention thetime required to run a practice and the lack of business education that physicians receive. The PE offer is often the best lump sum payment option available. The contract typically requires 2 to 5 years of continued employment at the practice, as the “good will
“ of the original physicians is the biggest asset in the sale. For any older physicians, this is the opportunity that exists.
Physicians use to be entrepreneurs. Now, especially the younger generation want steady paychecks and predictable hours. They would rather have a boss than work weekends
Private Equity is a symptom, not the problem. Since the Global Financial Crisis,(the "GFC") the Federal Reserve has printed so much new money that they've had to invent "investment sponges" out of thin air to store it all. Hence, private equity, special-purpose acquisition corporations (SPACs), cryptocurrencies, NFTs, leveraged EFTs, thematic EFTs, the Green New Deal, the AI tech craze, etc.
Too much money created to keep an unsustainable economy afloat with the bulk of it being syphoned off by the same Wall Street playbook that created the GFC in the first place.
There are so many reasons, it would take an article, not a comment. However, some quick hits:
1. I believe the "basis trade" will trigger a liquidity crisis requiring Federal Reserve intervention to avoid a cascade of bank failures.
2. Japan and China, the two largest foreign owners of US Treasuries are dumping their holdings into the market. Japan is doing it to support the yen. China is doing it to wage war against the US dollar. In both cases, the Treasury market is being flooded with excess product
3. Due to high interest rates, Janet Yellen refinanced all notes and bonds that came due with short-term bills. Thus, Scott Bessent is now faced with refinancing $12 trillion in US debt every 30, 60 and 90 days. And having to do so in a market already being flooded with Treasuries due to #2 above. We're one failed Treasury auction away from possible default, a scenario that would cause a global depression.
4. Everyone on Wall Street wants the Fed to cut rates. However, the Fed cutting rates doesn't, in fact, cut rates. It creates money, which will then have to pursue assets, artificially driving up prices (the point of my initial post). Not only is this inflationary, it's a house of cards where value is being created from thin air.
In summary, the US economy is a juggler with too many balls in the air. Once one drops, they'll all drop.
Yes, private equity can be rapacious, and this is an exceptionally ugly example. But time and again, PE does exactly what it claims to do: I worked at and retired from a company that benefited enormously from the infusion of PE financial and intellectual capital. It’s difficult to make the case, as the author seems implicitly to favor (and his lede suggests), that government should draw lines around industries and bar PE from them.
Instead, I take two lessons from this debacle and its possible repetition: 1) notice that the Steward hospital “conglomerate” was already struggling long before Cerberus got their fangs into it; the US medical industry struggles generally under a nightmarish burden of multi-governmental regulation, perverse third party financial incentives, and poor administration. These problems existed before Cerberus appeared on the scene. Cerberus did not cause these problems, but they sure took advantage of them. There are many things that could be done to improve the efficacy and financial sustainability of medical providers, especially regional and rural hospitals, and none of them have anything to do with getting rid of PE.
And 2) this is *another* example of the need to simplify the US tax code, strip it to the bare essence of revenue generation, and get out of the special interests games. Money follows opportunity, and our lazy, not very bright, and easily bought legislators have been all too happy to make tax arbitrage more important than value creation. Remove the arbitrage incentives that riddle the IRC and state equivalents. All sorts of things will start to make more sense.
Very true. The point of investment of capital is to provide what is needed for an economy to run and thrive. Capital investment is not a charity and everyone is in this game through their ira, 401ks and 403b, not to mention their jobs which produce the capital. Gov feeds off capital it does not create anything.
Agree. The parent organization had already run it into the ground. They could have used the same sell/lease back mechanism to recapitalize the system, but voted to sell out. Probably an all volunteer board that was not going to spend excess time on a problem of their own creation. So they sold to Cerberus as an easy fix and could wash their hands of the problem.
Now do a story on the compensation of top executives of non-profit health care organizations. Non-profit organizations can't pay a return to owners, but some employees do very well.
The hospitals should have mortgaged their real estate and used it for the betterment of its institution.
But community hospitals have weakened and disappeared for a much bigger reason - the socialization of medicine when Medicare and Medicaid were created.
Before then, medical care wasn’t a financial backbreaker. Religious institutions sponsored many of the hospitals. Think, for example, in NYC Presbyterian Hospital, Mt. Sinai, St. Vincent’s and many more.
But Medicare/Medicaid became mandatory customers - they passed a law saying people couldn’t be denied care based upon inability to pay without creating any reimbursement mechanism. It’s like if you owned a grocery store and had to give away groceries without foodstamps or snap cards that pay you back 100 cents.
With Medicare and Medicaid, they don’t pay 100 cents.
So someone has to pay.
I had a hip replacement a few years ago and went out of network at my doctor’s recommendation. My insurer only paid $1,800 or so - they, like most other plans based on out of network reimbursements on the reimbursement rate established for the zip code where the service is provided.
The only person who would remove a hip for $1,800 works in the meat department of your local supermarket. My surgeon’s fee was $10,000.
A financially healthy hospital gets about 30% or so of its revenue from private pay patients. Mostly insurance and cash pay patients.
Those two non-governmental payers have to make up the shortfall. I paid my $8,200.
Insurers who control huge flows of patients can negotiate lower rates than the “book” rate. But it’s still way higher than the Medicare/Medicaid reimbursement. So all of you who pay health insurance premiums are paying a hidden tax.
So much for not taxing the middle class…..
Medicare itself is a scam.
When it started in 1965, the highest anyone had to pay annually in Medicare FICA payments was $27.10 a YEAR. Retirees were automatically grandfathered in and got lifetime retirement health benefits without having paid in a dime. Those working but halfway there got full coverage.
And it slowly went up, before it exploded under Clinton in 1994 when the Medicare wage cap was eliminated.
Here’s an extreme example of how crazy it’s gotten….Juan Soto, a 26 year old who makes $51 million together with his employer pays nearly $1.5 million a year for retirement health insurance that he can’t use for 40 years - even while he pays his current year insurance policy.
It is the cost shifting that has made health care so expensive for the average person. And it is Medicare and Medicaid that have destroyed hospitals.
"They" wanted to replace my hip 12 years ago. I got an antique hand-me-down cane instead. I'm 87, doing just fine, no assisted care, no maid, no cook, drive to the grocery, do my shopping, eat very well. Medical services are a joke, no price list. My auto mechanic and butcher are honest. Hey, thanks for that tip about the butcher. $1,800, huh? Not bad. To copy the late, great jack Benny, "I'm thinking it over."
Thanks for the illuminating article Matt. Very sad indeed (but not surprising). Never thought the day would come that I would agree with Elizabeth Warren, but then again I won’t hold my breath for her and Mark to get anywhere on this.
Here is where universal health care paid for by your tax dollars might make a lot more sense. Non-profit and no more vampire squids sucking every last dollar out for private gain. I live in Canada and yes the quality of care can be less than desirable and we certainly have issues of inadequate funding resulting in long wait times for everything but sure beats this nonsense.
What we have clearly isn’t working, but there is no sane person who can advocate for turning more of the healthcare system over to the federal government. I really don’t know what the fix is going to be.
The fix is to be healthier, and provide more low cost access like the Doc in a box model. Blood tests are cheap and readily available and they give you the results with comparisons to healthy results. You don't need to even see a doctor to get a blood test and the results are pretty easy to understand.
That’s probably how it will evolve. I notice in my own case I try to avoid doctors and hospitals, if I can. If enough people get pushed the same way, the demand changes, so naturally the type of services and costs change, too. Taking care of your own health better would be a key factor.
Same here but it shouldn’t require a doctorate in navigating a broken system to get normal healthcare. Grandma Average can’t find her way through the maze of a broken system and that’s not ok.
My mother lived to be 101 in a small town in Canada. She had superb care her entire life. I've heard complaining about Canadian health care, but I never observed any problems in her case or those of her friends. When she was 95 she suffered a broken hip late Christmas Eve. The local surgeon came in Christmas Day and gave her a new tip.
There is a problem here, but it would be crazy to expect Warren and Markey to make things better. The real targets of their exploitation of the issue will be elsewhere.
Warren and Markey could have joined the MAHA movement, supported Kennedy and the other appointees in reforming healthcare, but their concerns stop at political boundaries.
Exactly. The common political playbook begins with an attention grabbing title for a bill. This will become the main marketing headline. Then the actual work of negotiating the pork allotments begins. The bill, which by the time of a vote is anything but what it's title implies, is simply a stealth vehicle used to camouflage the politicians' pay outs to their loyal donors.
This is the definitional sign of our times, society wide. Anywhere I look I see a now common transgressional violation of what were formerly taken as boundary norms, now pushing egregiously to the point of grotesquerie against our limits of honor, of self-respect, and yes, the essence of 'love' itself, in a meme-like, staring into the mirror quality of "At last, at long last, have you no decency, sir?"
How can we not hear the sirens, see the multi-hued flashing lights, even the moans of the victims from behind the camouflage of rationalization "becuz profit" behind this thus far implacable and relentless, teeth-gnashing loss of self respect as we witness our overwhelming by the utter wretchedness of these perpetrators of society's own core self-destruction?
That was/is an horrendous situation, but ask yourself what would have happened had Cerberus not purchased those struggling hospitals. They would still have gone bankrupt, just 11 years earlier. Were there other buyers at the time, ready to bail them out? I truly don't know, but I doubt it.
My own limited experience is that hospitals are usually poorly managed, whether they are for profit or not. And I don't know what the solution is, but I don't believe that banning private equity purchases is going to advance quality care in US hospitals.
Single site community hospitals just don’t have the scale of operations and customer base to support all the specialties and associated costs. As medical tech expands that trend becomes more pronounced. It is a really hard business and the bigger not for profit chains have obviously focused on consolidating with the best community hospitals instead of the least attractive.
That is not to say that this case is free from criticism. But the underlying financial issue isn’t the ownership model.
Rural hospitals also have a higher percentage of Medicare and Medicaid patients which, as another commenter pointed out, reimburse at rates that are below cost. As the hospital doesn't have enough private insurance patients to make up the difference, it ends up squeezed into insolvency.
Not for profit healthcare systems aren’t any better. They grift a different way by not paying taxes in the towns they operate. Not for profit seems like noble cause in medicine. It’s not. All that means is at the end of the year there’s zero profits. That doesn’t mean the presidents of these companies isn’t getting paid handsomely plus the bonus they get to make sure that zero comes up in the profit margin. Our hospital in town has purchased every house surrounding the actual hospital in case it wishes to expand in the future and we are talking streets of houses that have now been taken off the property tax rolls. Ethical? I think not.
Terrible stories and believable in every way. Glad to be retired from internal medicine after several decades of seeing the degradation of medicine, in all manner possible. I just could not stand it any more. Lizzie whines a lot and wags her finger pretending to be bitter, but she’ll never lift a hand to help this situation. She talks big, though. Sickening. And even more sickening, is that so many simpletons still believe her!
I can’t speak to the Warren/Markey bill but the bottom line is there will be no way to stop Wall Street from strip mining healthcare as long as candidates are addicted to campaign cash from the wizards of finance.
We must make voters the donors who fund election campaigns. Then Washington will answer to us, not special interests.
www.savedemocracyinamerica.org
People run for Congress in order to quickly become multi-millionaires. Influence peddling is now universal.
No argument there! Thanks for responding.
Says the guy who has made political donations to Democrats. Unions are one of the biggest sources of campaign cash and much to the detriment of their members. So tired of people saying "save democracy" but only if it's their candidate that's going to do it...
I see union potical donations compared to corporate donations alot. I've love to see the numbers breakdown. My gut feeling is union money is probably a fraction of corporate.
Whether the bribes, err, contributions come from unions or big companies, the result is the same. You're arguing whether you'd rather be hit with a 9 iron in the left eye or right eye.
SEIU alone in 2024 spent $200-million. The comment below is a pretty accurate comparison of the difference between corporate and union donations.
Yes Mick, when either party complains about the other party’s campaign finance, it’s hollow because both parties take the big money. And I don’t see that either party even knows what democracy is: government by the people, which they don’t want because they think we’re children and we have little money to donate to their campaigns. Thanks for the comment.
this would not work unless the law also banned contributions coming from outside a Congressional district
Term limits, one policy that left and right can agree on.
We don't elect people willing to act against their own self interest. Here's a video explaining this phenomenon through the lens of comparing Star Wars and Star Trek: https://www.youtube.com/watch?v=12JDlGnMiTM
Those are the exceptions that prove the rule.
Sure, because every dollar buys a vote, right? How many dollars to buy yours?
You can’t mount a viable campaign for national office without raising a ton of money. So candidates self censor to avoid alienating potential donors. That’s why they have little for us beyond slogans and personal attacks on their opponents. Indirectly the need for campaign cash does massive damage, though no one is actually buying votes. Thanks for commenting.
I suggest you examine Dave Brat's success against Eric Cantor, or Ms. Ocasio-Cortez knocking off Joe Crowley.
The big payoff on campaign contributions is being able to bank them, which certainly helps not-particularly-wealthy "public servants" become millionaires over time.
OK that's two out of hundreds of races....
The Supreme Court would like a word.
SCOTUS could be relevant in several ways. How do you mean?
Numerous rulings on campaign contributions and this has been tested in the Supreme Court over and over.
Yes, the court has gutted almost every limit on what big donors can spend, because campaign cash supposedly is a form of free speech.
For this reason, the only path to game changing reform - short of amending the Constitution - is a public financing system that creates an alternative pool of money candidates can use without selling out to special interests.
Of the public financing mechanisms, Voter Dollars is best because it gives every voter the power that comes with campaign cash.
www.savedemocracyinamerica.org
So hire some lawyers and bring a case, pretty simple, right? I assume you would ban unions from donating and other similar groups, right?
Then he's going to want special interest groups to not independently spend, so AARP, NRA, unions - all the people that were on the Citizens United side - get shut out of the political process. Hmm, what does that leave?
The current US financial system, with the instant creation of new dollars (in the form of debt) at its root, is inherently corrupting--and over many years has been slowly, and now relatively more quickly, strangling (and/or exporting) the real economy of goods and services.
Money, new and old (or more precisely, the holders and managers thereof) is continually chasing "investment opportunities"--income streams--that can be extracted from the goods-and-services economy (or from individuals more directly, such as in taxes spent for the benefit of the financiers). That's part of how we get outrageous defense system pricing, outrageous public health costs, and other outrageous government spending. (Example: ~$1,800,000 is spent per estimated covid hospitalization prevented and ~$50,000,000 is spent per estimated covid death prevented in the 6 mos. through 4-years cohort for the CDC-recommended childhood Pfizer covid vaccine--yet the recommendation stands--and appears on every child's "vaccination schedule.")
Monopolized currency creation corrupts not just the financial system and its incentives, but society at large, including politics. (Though politics would likely be corrupt even without financial corruption, I admit.)
Fundamentally, the power of issuing new *unsupported* currency should not exist--or it should be available to all--because wherever it does exist and is monopolized, corruption and oppression follow.
Not just PE owned hospitals. Teaching university hospitals have been transformed into Money Machines in my state.
My daughter-in-law is a PA that recently started work for an equity healthcare play, not a hospital but a multi-practice mini-conglomerate. I'm still puzzled that doctors will sell off their practices and become employees of the company they sold to - but apparently they are. Locally to me, everything has become corporatized - my own primary care is now part of a state-wide "system" (even though not PE).
Older physicians are looking for an exit strategy from a long held practice, most younger physicians now have an enormous amount of educational debt and no way to buy into a practice. There is also little appetite to run a medical practice as the overhead/compliance expense can easily exceed 60% of revenue. Not to mention thetime required to run a practice and the lack of business education that physicians receive. The PE offer is often the best lump sum payment option available. The contract typically requires 2 to 5 years of continued employment at the practice, as the “good will
“ of the original physicians is the biggest asset in the sale. For any older physicians, this is the opportunity that exists.
Physicians use to be entrepreneurs. Now, especially the younger generation want steady paychecks and predictable hours. They would rather have a boss than work weekends
Private Equity is a symptom, not the problem. Since the Global Financial Crisis,(the "GFC") the Federal Reserve has printed so much new money that they've had to invent "investment sponges" out of thin air to store it all. Hence, private equity, special-purpose acquisition corporations (SPACs), cryptocurrencies, NFTs, leveraged EFTs, thematic EFTs, the Green New Deal, the AI tech craze, etc.
Too much money created to keep an unsustainable economy afloat with the bulk of it being syphoned off by the same Wall Street playbook that created the GFC in the first place.
Why do you think the economy is unsustainable? Asking seriously
There are so many reasons, it would take an article, not a comment. However, some quick hits:
1. I believe the "basis trade" will trigger a liquidity crisis requiring Federal Reserve intervention to avoid a cascade of bank failures.
2. Japan and China, the two largest foreign owners of US Treasuries are dumping their holdings into the market. Japan is doing it to support the yen. China is doing it to wage war against the US dollar. In both cases, the Treasury market is being flooded with excess product
3. Due to high interest rates, Janet Yellen refinanced all notes and bonds that came due with short-term bills. Thus, Scott Bessent is now faced with refinancing $12 trillion in US debt every 30, 60 and 90 days. And having to do so in a market already being flooded with Treasuries due to #2 above. We're one failed Treasury auction away from possible default, a scenario that would cause a global depression.
4. Everyone on Wall Street wants the Fed to cut rates. However, the Fed cutting rates doesn't, in fact, cut rates. It creates money, which will then have to pursue assets, artificially driving up prices (the point of my initial post). Not only is this inflationary, it's a house of cards where value is being created from thin air.
In summary, the US economy is a juggler with too many balls in the air. Once one drops, they'll all drop.
Thanks, ummm I guess 🥺. Not that I disagree, but seeing it in writing wakes me from a blissful ignorance slumber.
I don't think wall street employees will one day repend, see the error of their ways and get real jobs.
Yes, private equity can be rapacious, and this is an exceptionally ugly example. But time and again, PE does exactly what it claims to do: I worked at and retired from a company that benefited enormously from the infusion of PE financial and intellectual capital. It’s difficult to make the case, as the author seems implicitly to favor (and his lede suggests), that government should draw lines around industries and bar PE from them.
Instead, I take two lessons from this debacle and its possible repetition: 1) notice that the Steward hospital “conglomerate” was already struggling long before Cerberus got their fangs into it; the US medical industry struggles generally under a nightmarish burden of multi-governmental regulation, perverse third party financial incentives, and poor administration. These problems existed before Cerberus appeared on the scene. Cerberus did not cause these problems, but they sure took advantage of them. There are many things that could be done to improve the efficacy and financial sustainability of medical providers, especially regional and rural hospitals, and none of them have anything to do with getting rid of PE.
And 2) this is *another* example of the need to simplify the US tax code, strip it to the bare essence of revenue generation, and get out of the special interests games. Money follows opportunity, and our lazy, not very bright, and easily bought legislators have been all too happy to make tax arbitrage more important than value creation. Remove the arbitrage incentives that riddle the IRC and state equivalents. All sorts of things will start to make more sense.
Very true. The point of investment of capital is to provide what is needed for an economy to run and thrive. Capital investment is not a charity and everyone is in this game through their ira, 401ks and 403b, not to mention their jobs which produce the capital. Gov feeds off capital it does not create anything.
Agreed.
Agree. The parent organization had already run it into the ground. They could have used the same sell/lease back mechanism to recapitalize the system, but voted to sell out. Probably an all volunteer board that was not going to spend excess time on a problem of their own creation. So they sold to Cerberus as an easy fix and could wash their hands of the problem.
Now do a story on the compensation of top executives of non-profit health care organizations. Non-profit organizations can't pay a return to owners, but some employees do very well.
Yes, ours made millions a year on the backs of the nursing and ancillary staff, always cutting, cutting, cutting.
The hospitals should have mortgaged their real estate and used it for the betterment of its institution.
But community hospitals have weakened and disappeared for a much bigger reason - the socialization of medicine when Medicare and Medicaid were created.
Before then, medical care wasn’t a financial backbreaker. Religious institutions sponsored many of the hospitals. Think, for example, in NYC Presbyterian Hospital, Mt. Sinai, St. Vincent’s and many more.
But Medicare/Medicaid became mandatory customers - they passed a law saying people couldn’t be denied care based upon inability to pay without creating any reimbursement mechanism. It’s like if you owned a grocery store and had to give away groceries without foodstamps or snap cards that pay you back 100 cents.
With Medicare and Medicaid, they don’t pay 100 cents.
So someone has to pay.
I had a hip replacement a few years ago and went out of network at my doctor’s recommendation. My insurer only paid $1,800 or so - they, like most other plans based on out of network reimbursements on the reimbursement rate established for the zip code where the service is provided.
The only person who would remove a hip for $1,800 works in the meat department of your local supermarket. My surgeon’s fee was $10,000.
A financially healthy hospital gets about 30% or so of its revenue from private pay patients. Mostly insurance and cash pay patients.
Those two non-governmental payers have to make up the shortfall. I paid my $8,200.
Insurers who control huge flows of patients can negotiate lower rates than the “book” rate. But it’s still way higher than the Medicare/Medicaid reimbursement. So all of you who pay health insurance premiums are paying a hidden tax.
So much for not taxing the middle class…..
Medicare itself is a scam.
When it started in 1965, the highest anyone had to pay annually in Medicare FICA payments was $27.10 a YEAR. Retirees were automatically grandfathered in and got lifetime retirement health benefits without having paid in a dime. Those working but halfway there got full coverage.
And it slowly went up, before it exploded under Clinton in 1994 when the Medicare wage cap was eliminated.
Here’s an extreme example of how crazy it’s gotten….Juan Soto, a 26 year old who makes $51 million together with his employer pays nearly $1.5 million a year for retirement health insurance that he can’t use for 40 years - even while he pays his current year insurance policy.
It is the cost shifting that has made health care so expensive for the average person. And it is Medicare and Medicaid that have destroyed hospitals.
"They" wanted to replace my hip 12 years ago. I got an antique hand-me-down cane instead. I'm 87, doing just fine, no assisted care, no maid, no cook, drive to the grocery, do my shopping, eat very well. Medical services are a joke, no price list. My auto mechanic and butcher are honest. Hey, thanks for that tip about the butcher. $1,800, huh? Not bad. To copy the late, great jack Benny, "I'm thinking it over."
Thanks for the illuminating article Matt. Very sad indeed (but not surprising). Never thought the day would come that I would agree with Elizabeth Warren, but then again I won’t hold my breath for her and Mark to get anywhere on this.
I used to agree with Elizabeth Warren a lot. Then she decided to enter politics...
I used to agree with Warren until she wasn't an Indian any more
Here is where universal health care paid for by your tax dollars might make a lot more sense. Non-profit and no more vampire squids sucking every last dollar out for private gain. I live in Canada and yes the quality of care can be less than desirable and we certainly have issues of inadequate funding resulting in long wait times for everything but sure beats this nonsense.
What we have clearly isn’t working, but there is no sane person who can advocate for turning more of the healthcare system over to the federal government. I really don’t know what the fix is going to be.
The fix is to be healthier, and provide more low cost access like the Doc in a box model. Blood tests are cheap and readily available and they give you the results with comparisons to healthy results. You don't need to even see a doctor to get a blood test and the results are pretty easy to understand.
That’s probably how it will evolve. I notice in my own case I try to avoid doctors and hospitals, if I can. If enough people get pushed the same way, the demand changes, so naturally the type of services and costs change, too. Taking care of your own health better would be a key factor.
Same here but it shouldn’t require a doctorate in navigating a broken system to get normal healthcare. Grandma Average can’t find her way through the maze of a broken system and that’s not ok.
I think the fix is to remove barriers to the market, and also to reconnect payment with consumption.
Oh, what I thought you were going to say is, "What we have ... 'here is a failure to communicate.'"
The problem is our culture. What does the government provide efficiently? VA health care? We all need to take more responsibility for our own health.
Yes, with a healthy dose of reality about life and longevity and health.
My mother lived to be 101 in a small town in Canada. She had superb care her entire life. I've heard complaining about Canadian health care, but I never observed any problems in her case or those of her friends. When she was 95 she suffered a broken hip late Christmas Eve. The local surgeon came in Christmas Day and gave her a new tip.
It’s a real problem now. Lots of Canadians come to thenUS for care due to long waiting lists
Cerberus in Greek mythology is the 3-headed hound that guarded the entrance to Hades.
There is a problem here, but it would be crazy to expect Warren and Markey to make things better. The real targets of their exploitation of the issue will be elsewhere.
Warren and Markey could have joined the MAHA movement, supported Kennedy and the other appointees in reforming healthcare, but their concerns stop at political boundaries.
Exactly. The common political playbook begins with an attention grabbing title for a bill. This will become the main marketing headline. Then the actual work of negotiating the pork allotments begins. The bill, which by the time of a vote is anything but what it's title implies, is simply a stealth vehicle used to camouflage the politicians' pay outs to their loyal donors.
This is the definitional sign of our times, society wide. Anywhere I look I see a now common transgressional violation of what were formerly taken as boundary norms, now pushing egregiously to the point of grotesquerie against our limits of honor, of self-respect, and yes, the essence of 'love' itself, in a meme-like, staring into the mirror quality of "At last, at long last, have you no decency, sir?"
How can we not hear the sirens, see the multi-hued flashing lights, even the moans of the victims from behind the camouflage of rationalization "becuz profit" behind this thus far implacable and relentless, teeth-gnashing loss of self respect as we witness our overwhelming by the utter wretchedness of these perpetrators of society's own core self-destruction?
That was/is an horrendous situation, but ask yourself what would have happened had Cerberus not purchased those struggling hospitals. They would still have gone bankrupt, just 11 years earlier. Were there other buyers at the time, ready to bail them out? I truly don't know, but I doubt it.
My own limited experience is that hospitals are usually poorly managed, whether they are for profit or not. And I don't know what the solution is, but I don't believe that banning private equity purchases is going to advance quality care in US hospitals.
Single site community hospitals just don’t have the scale of operations and customer base to support all the specialties and associated costs. As medical tech expands that trend becomes more pronounced. It is a really hard business and the bigger not for profit chains have obviously focused on consolidating with the best community hospitals instead of the least attractive.
That is not to say that this case is free from criticism. But the underlying financial issue isn’t the ownership model.
Rural hospitals also have a higher percentage of Medicare and Medicaid patients which, as another commenter pointed out, reimburse at rates that are below cost. As the hospital doesn't have enough private insurance patients to make up the difference, it ends up squeezed into insolvency.
Just another example of how the entire western medical establishment is imploding.
They make Soros look like an angel.
Nothing could make Soros look like an angel. But I get your point.
Not for profit healthcare systems aren’t any better. They grift a different way by not paying taxes in the towns they operate. Not for profit seems like noble cause in medicine. It’s not. All that means is at the end of the year there’s zero profits. That doesn’t mean the presidents of these companies isn’t getting paid handsomely plus the bonus they get to make sure that zero comes up in the profit margin. Our hospital in town has purchased every house surrounding the actual hospital in case it wishes to expand in the future and we are talking streets of houses that have now been taken off the property tax rolls. Ethical? I think not.
I've said it before and will say it again: "Not for profit" is a tax status, not a business model.
Terrible stories and believable in every way. Glad to be retired from internal medicine after several decades of seeing the degradation of medicine, in all manner possible. I just could not stand it any more. Lizzie whines a lot and wags her finger pretending to be bitter, but she’ll never lift a hand to help this situation. She talks big, though. Sickening. And even more sickening, is that so many simpletons still believe her!