Money and Healthcare

A free public service for a better community

Jan 16, 2024

A Good Day To Advocate for Better Healthcare

If there are subjects you’d like to see or improvements made, please let me know using the comment button below. Videos of these newsletters appear on Youtube on this channel. Let me know what you think.

Last Day for ACA Enrollment

The Affordable Care Act's health insurance marketplace will hit a record high for sign-ups this year, topping last year's record high. That's according to an analysis from the Kaiser Family Foundation. Let’s remind our family and friends that open enrollment ends on today, January 16 and this is the link to use. (Thanks to Rogan’s List)

It Matters When It's Your Health

When she arrived in Congress last year, Representative Anna Paulina Luna, a hard-right Republican from Florida, joined the rest of her party in staunchly opposing proxy voting, a practice adopted by House Democrats to allow for remote legislating during the pandemic. Then, in August, she gave birth to her first child and her perspective changed. Now, Ms. Luna is pressing to allow new mothers in Congress to stay away from Washington immediately after giving birth and designate a colleague to cast votes on the House floor on their behalf.

Long COVID Update

We wrote about Long COVID a few days ago. Now it turns out that the Senate Health, Education, Labor and Pensions Committee (HELP) will be holding hearings on the effects of Long COVID, Thursday January 18th, 2024 at 10:00 am EST. You can watch the hearings here.

Financialization of Healthcare

I have some friends who are studying private equity in healthcare. The New England Journal of Medicine just published “The Financialization of Health in the United States” by Joseph Dov Bruch, Ph.D., Victor Roy, M.D., Ph.D., and Colleen M. Grogan, Ph.D. This team of researchers sought to determine the effect of financial-sector ownership and influence in the U.S. health care system.

There is a nice summary and commentary of the article at the Health Justice Monitor. (Thank you to Heather for the tip).

Just a Reminder

In the past decade, Private Equity (PE) firms completed more than 8000 transactions involving health care entities, with an estimated combined value of nearly $1 trillion. Leveraging capital from institutional investors (e.g., state pension plans), PE firms fully acquire hospitals, nursing homes, physician practices, dialysis clinics, hospice operators, and a range of other health care operators at a rapid speed. Strapping these acquired health care companies with large amounts of debt, PE firms then engage in quick buy-and-sell turnarounds to make a profit for their partners.

We have already reported that the mortality rate in PE nursing homes is 10% greater.

We see doctors and hospitals selling medical care contracts and credit cards (with significant interest rates) that will only push more people to bankruptcy.

Facilities have distorted priorities in that they focus on the services that generate the most profit and often shed services that provide less income like labor and delivery, mental health and primary care. It is worth noting that non-profits are not immune to financialization.

Financialization changes the focus. Instead of aiming for good outcomes and healthy patients, the industry is focused on how much cash can be generated as quickly as possible. The patient is only a means to a cash end. And the patient suffers for it.

What if hospitals and medical networks didn’t have to worry about paying for their salaries and infrastructure, if they knew that was covered - would that help?

What if there were a single insurance company that could negotiate all prescriptions to a fair price, would that help?

What if we had a system that trusted the doctor to know what the best course was for the patient instead of denying medical treatment to hold on to money longer, would that help?

American taxpayers footed the bill for at least $1.8 trillion in federal and state health care expenditures in 2022 — about 41% of the nearly $4.5 trillion in both public and private health care spending the U.S. recorded according to the annual report released by the Centers for Medicare and Medicaid Services. On top of that $1.8 trillion, third-party programs, which are often government-funded, and public health programs accounted for another $600 billion in spending. This means the U.S. government spent more on health care than the governments of Germany, the U.K., Italy, Spain, Austria, and France combined spent to provide universal health care coverage to the whole of their population (335 million in total), which is comparable in size to the U.S. population of 331 million. AND WE DIDN’T COVER EVERYONE.

For that kind of investment we should be getting a system focused on patient outcomes - not the quick buck. Let’s remind Congress to take better care of our money by enacting Universal Healthcare.

ACTION

You can send the email below to your Senators and Members of Congress by texting SIGN PJCKWX to 50409 on your cellphone. Or you can send an email/call them - their contact info is in the Resources section.

“I am your constituent and I just learned that our healthcare system is increasingly becoming financialized. Private Equity firms executed 8000 acquisitions in the last 10 years for a value near $1 trillion. They focus on dollars over patients as is evidenced by the significantly higher death rate in PE nursing homes (+ 10%). They squeeze the life out of medical facilities then distribute the profits and then sell off the assets. In the process important functions like labor and delivery and mental health services are shed traumatizing communities.

The US government pays upwards of $2.4 trillion each year for healthcare and patients are not at the center. Put patients first and enact Universal Healthcare like HR 3421. It will provide global budgets for medical facilities so their costs are covered, it will allow for negotiation of all prescription drugs for all of us and it will cover every one of us cradle to grave. I know you care about your constituents so show them and enact Universal Healthcare. Thank you.”

Ghost Networks Revisited

Yesterday we discussed how health insurance companies do not keep accurate lists of in-network providers. These faulty lists help to lure consumers to purchase a particular company’s policy but many times do not deliver because the doctor or provider you thought was covered is not available. It is a form of consumer fraud.

Sometimes state insurance commissioners refuse to take action unless there is legislation to back them up. Let’s call for that legislation at the state level today.

EXTRA CREDIT ACTION

Text SIGN PROFJY to 50409 on your cellphone to send this message to your state senators and representatives and your governor.

“I am your constituent and we all deserve a health care system that works for all of us. I just learned that health insurance companies often maintain inaccurate listings of in-network providers. There are so many errors that these are called Ghost Networks. We the consumers are lured into purchasing their health insurance with the goal of having access to those providers. It is a disaster when they are not available. U.S. Senator Ron Wyden and the staff of the Senate Finance Committee conducted a study recently that found systematically checking the directories of 12 insurance providers in 6 states they were only able to make appointments 18% of the time because 1/3 of the providers were unavailable due to inaccuracies and unresponsiveness.

Look, this kind of thing is out of bounds with universal healthcare, but we need help now. I want you to build legislation that demands that health insurance companies maintain accurate lists of in-network providers and has penalties if they don’t. We need accurate data to be good consumers and that can only come with your help. Thank you.”

RESOURCES

Healthcare Advocacy (Us)

Website

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Find My Elected Officials

Contact the White House https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

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.