Healthcare on the Ropes
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A Good Day To Advocate for Better Healthcare
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Insurance Slow Roll
It is not uncommon for people to delay actions when they don’t want to do them.
I attended a meeting this week with the Universal Health Care Commission head in Washington State. They are tasked with designing a universal healthcare system for all Washingtonians. I am sure they are nice people but they are not motivated to do anything and have spent years producing nothing of value and have made no progress towards getting everyone in the state covered. PS there are almost a half a million in Washington with out health insurance.
Here is a story from New Orleans, Louisiana. St. Charles Surgical Hospital and Center for Restorative Breast Surgery, a privately owned surgical facility is known as a specialist in rebuilding the breasts of cancer patients. They have had a lawsuit against Blue Cross of Louisiana for 7 years because they have not been paid.
This week they won their case having convinced a jury in Orleans Parish Civil District Court that Blue Cross committed fraud when it authorized some 7,800 surgeries from 2015 to 2023 and then paid only about 9% of the bills. The jury took 2 hours to reach a verdict. This was extreme slow rolling. The hospital will use the funds to clear the patients accounts.
Part of this was retribution against the surgery center for dropping out of the Blue Cross network. Remember that insurance companies create these networks and then try to offer discounted payments in exchange for increasing the volume of patients available. Hold that network thought.
US Healthcare System - Race To The Bottom
The healthcare provided in the US is a very mixed bag. We have some of the greatest innovations and discoveries and they are often unavailable to millions.
The Commonwealth Fund just released their assessment of healthcare country by country. We are not doing well.
The report covers 10 peer industrialized countries. It also accounts for the impact of COVID-19 on health system performance.
The report compared access to healthcare between residents with above-average and below-average income. It also considered how well the systems performed for men and women and considered rural and non rural settings. Here is a link to their methodology.
Here are the results in a table. You can see that the US does well with respect to care process but fails the population in pretty much all other measures. Care process is a measure of the care that is delivered to a patient. More about that in a moment.
Here are the results graphically
In terms of cost, of course, we are pretty much double what other countries spend.
We do lead the pack in barriers to accessing care.
Back to that care process. One possible explanation for the good rating there is that we have vigorous pay-for-performance, or value-based care, efforts that private and public payers in the United States have undertaken in recent years. Think of managed care that so many Medicaid systems use, or Accountable Care Organizations that Medicare is trying to force its enrollees into or just HMOs. They may have succeeded in increasing systemwide conformance to guidelines for preventive services. But despite comparatively high performance on care process, health outcomes (which includes things like life expectancy, treatable and preventable deaths etc.) in the U.S. are the worst of the 10 countries in this analysis. So managed care may not be the best answer.
I have been reading these reports for years and the results always seem to be the same. We are innovative but our population does not have access and we waste half of our money not providing care to tens of millions.
Every other country in the report has found some way to cover everyone. Some do with with a public insurance trust, some do it with non profit insurance trusts, some use commercial insurance. Some have copays (like France) some don’t. But everyone is covered.
There is an answer and it is to have a universal healthcare system that covers all of us. Let’s remind those we elected that we deserve better.
ACTION
Let’s let our elected representatives know that we deserve a healthcare system that works for all of us.
If you want to call/email here is a link to contact them or use RESISTBOT via [Apple Messages / WHATSAPP / MESSENGER] or by texting SIGN PJQISD to 50409 on your cell phone to send this message.
“The Commonwealth fund just released their review of healthcare in 10 industrialized nations and we are dead last. While we have become more standardized on what preventive care is we have tens of millions with out access to healthcare. We have medical bankruptcies, we pay twice as much as other countries and don’t get what they get; access to a doctor and longer life expectancy.
We need universal healthcare and you know it. We pay $400 billion too much every year in overhead costs (per the CBO). Insurance companies delay, deny, and slow roll payments. Medical networks that get capitation payments (Medicare Advantage, Medicare Accountable Care Organizations, Managed Care groups, and Insurance networks) keep what they don’t spend on care and we get less care.
I want you to pass universal healthcare and stop setting up your constituents to be cheated by insurance companies and medical networks. Enough. Get HR 3421 the vastly improved Medicare for All Act to a vote.
PS Here is a link to the Commonwealth Fund Report for you, https://www.commonwealthfund.org/publications/fund-reports/2024/sep/mirror-mirror-2024. Thank you.”
RESOURCES
Find My Elected Officials
Contact State and Federal Representatives - phone and email
Healthcare Advocacy (Us) Website
Our Newsletter resources including reproductive healthcare - Healthcare Advocacy Reading List
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water RESISTBOT write up
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