Sunday, October 06, 2019

WHAT ELIZABETH WARREN NEEDS TO EXPLAIN ABOUT HEALTHCARE

I injured my shoulder 6 months ago - it’s a long story best left untold - and went to physical therapy for 2-3 months with no improvement. When I finally saw an orthopedic specialist, he took an x-ray and then sent me for an MRI. The imaging lab preferred by the surgeon is Epic Imaging, a private company. The MRI was done, and I’m waiting to see the orthopedist again. 

I was curious about Epic, so I did a bit of online research. Epic is owned by CDI (Center for Diagnostic Imaging) headquartered in Minneapolis. CDI has a few dozen offices around the country. CDI, in turn, is owned by Onex Corporation, a Canadian company in Toronto that “manages capital on behalf of Onex shareholders, institutional investors and high net worth clients around the world.” I counted 97 companies on the Onex website that are owned by the firm. These include consumer & retail, financial services, healthcare, industrials, services, and technology, media and telecon. Onex assets total about $39 billion and they claim a return above 20%. 

So what’s the point? Well, this is but one small example of how health care in America is a for-profit industry. In this example there are three levels of corporation that take profits from the business revenues. It’s no wonder health care costs in America are among the highest in the world. 

I favor some kind of single payer health insurance in my country, such as the Medicare for All plans being put forward by some of the Democratic Party presidential candidates. This idea is controversial, and fraught with misunderstanding. I’m on Medicare. I can go to any doctor I want (who will accept me as a patient) anywhere in the country; there is no “in-plan” and “out-of-plan.” I pay a monthly premium, and have a $185 per year deductible. Medicare pays 80% of the charges they approve, at the rates established by Medicare. I also have, and pay a monthly premium for a Medicare Supplemental Plan with a private insurance company that pays the remaining 20%.* In my discussions with friends and family, it seems that I pay comparable amounts or less for my health insurance than others do for private insurance. 

So what does Elizabeth Warren need to explain, in my humble opinion? She needs to explain, succinctly and in simple terms, exactly how a Medicare for All plan would work, what it would cost people in taxes and/or premiums, what it would cover, why it would be so much less complex and comprehensive than the present system, and how it can be sustained. She should also explain how it would work for medical providers, and how they would be fairly compensated for the services they provide. In other words, dispel the many myths and lies presently swirling around in the health care debate and give voters the information needed to make reasoned decisions. (Cynical note: assuming most voters are capable of making reasoned decisions.) 

Senator Warren also needs to tie in her battle against corporate/government corruption and the health care industry. She needs to clearly explain how the present system is dominated by for-profit entities (see above) that pay armies of lobbyists to make sure the government structures things in ways that benefit corporate profits. And she also needs to clearly acknowledge that a huge Medicare for All government bureaucracy will not be perfect, [will be subject to the whims of Congress and the lobbyists who influence them, and how it can be structured and guarded to be as efficient as possibly for the benefit of American citizens, not corporations. A tall order, but if anyone can explain all this, it is Senator Warren.

Now if only Elizabeth Warren subscribed to this blog....
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*Note: Interestingly, I usually pay more in premiums for the Medicare Supplemental plan than the 20% the plan pays out per year, so I might pay less if I dropped that plan and paid the 20% out-of-pocket. I’m still doing the math on that one.

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