The forces fighting for a better health care system should spend the next two years laying the groundwork for a major overhaul of the way we pay for health care.
As always, your common sense reform proposals are on target, benefiting America's working poor and streamlining care by removing costs that add no benefits. It will require a Sisyphian effort to bring them to fruition. The pharma-insuror complex is as powerful as the military-industrial complex that President Eisenhower warned us against.
Even though Medicare finally will be able to begin negotiating drug prices, Americans will continue to pay 3 times what other developed countries pay for drugs. Resident of many "red" states have voted to expand Medicaid only to face resistance to implementation from the greedy oligarchs and plutocrats in control - just consider the adverse consequences of private equity involvement on our not-for-profit hospitals that are struggling to survive.
For-profit enterprises operate to benefit their investors and shareholders. Not-for-profit organizations operate to benefit their stakeholders. M4A was DOA, but federalizing Medicaid is a common-sense step to move our country a small step closer to providing universal access to quality, cost-effective care - something that residents of every other OECD member nation has.
The problem is, even if the Democrats adopted a sensible set of reforms in the manner you suggest, they seem utterly incapable of educating the public about such reforms, and Americans can't be bothered to watch hearings to educate themselves. Barring a sustained messaging push via Tiktok, FB, Instagram, and whatever replaces Twitter, I don't know how Americans would realistically understand such reforms.
No doubt convincing messaging of even the best-thought-out reforms represents a challenge. That's why it's important to pursue changes that are not just good policy but compelling on their face -- like federalizing Medicaid. Tax relief for every state. Let the Feds pay by repealing unnecessary tax breaks for the very rich and big corporations.
Unfortunately, there aren't 60 votes (even in a lame duck) for taxation of the wealthy and increases taxation of corporations. The capture of SCOTUS and legislators on both sides of the aisle makes meaningful reform increasingly out of reach.
The will of the people is increasingly marginalized. I'm sorry to sound pessimistic, but I don't see a path to progress. There hasn't even been effective Democratic messaging around the hard-right turn of Twitter, or anti-Semitic/neo-Nazi dinners hosted by the leading 2024 GOP candidate.
Barring a doubling of youth turnout in 2024 (less than 30% voted this month), holding the Senate will take a miracle.
As usual, timely and topical. In addition to your 3 foundational strategies, I'd add a 4th: the complete integration of healthcare and social/public health services so as to facilitate early detection and SDOH programs with enhanced preventive health and create a coherent national formulary for first line therapeutics like insulin, statins, SSRIs et al.
Thanks Paul. You're exactly right, but I would put health care/social service integration under the rubric of delivery system reform. I'm going to try to focus exclusively on payment reform in this series, although part 3 on provider-led capitation can reasonably be thought of as a combination of both.
If only...
As always, your common sense reform proposals are on target, benefiting America's working poor and streamlining care by removing costs that add no benefits. It will require a Sisyphian effort to bring them to fruition. The pharma-insuror complex is as powerful as the military-industrial complex that President Eisenhower warned us against.
Even though Medicare finally will be able to begin negotiating drug prices, Americans will continue to pay 3 times what other developed countries pay for drugs. Resident of many "red" states have voted to expand Medicaid only to face resistance to implementation from the greedy oligarchs and plutocrats in control - just consider the adverse consequences of private equity involvement on our not-for-profit hospitals that are struggling to survive.
For-profit enterprises operate to benefit their investors and shareholders. Not-for-profit organizations operate to benefit their stakeholders. M4A was DOA, but federalizing Medicaid is a common-sense step to move our country a small step closer to providing universal access to quality, cost-effective care - something that residents of every other OECD member nation has.
The problem is, even if the Democrats adopted a sensible set of reforms in the manner you suggest, they seem utterly incapable of educating the public about such reforms, and Americans can't be bothered to watch hearings to educate themselves. Barring a sustained messaging push via Tiktok, FB, Instagram, and whatever replaces Twitter, I don't know how Americans would realistically understand such reforms.
No doubt convincing messaging of even the best-thought-out reforms represents a challenge. That's why it's important to pursue changes that are not just good policy but compelling on their face -- like federalizing Medicaid. Tax relief for every state. Let the Feds pay by repealing unnecessary tax breaks for the very rich and big corporations.
Unfortunately, there aren't 60 votes (even in a lame duck) for taxation of the wealthy and increases taxation of corporations. The capture of SCOTUS and legislators on both sides of the aisle makes meaningful reform increasingly out of reach.
The will of the people is increasingly marginalized. I'm sorry to sound pessimistic, but I don't see a path to progress. There hasn't even been effective Democratic messaging around the hard-right turn of Twitter, or anti-Semitic/neo-Nazi dinners hosted by the leading 2024 GOP candidate.
Barring a doubling of youth turnout in 2024 (less than 30% voted this month), holding the Senate will take a miracle.
As usual, timely and topical. In addition to your 3 foundational strategies, I'd add a 4th: the complete integration of healthcare and social/public health services so as to facilitate early detection and SDOH programs with enhanced preventive health and create a coherent national formulary for first line therapeutics like insulin, statins, SSRIs et al.
Paul Keckley
Thanks Paul. You're exactly right, but I would put health care/social service integration under the rubric of delivery system reform. I'm going to try to focus exclusively on payment reform in this series, although part 3 on provider-led capitation can reasonably be thought of as a combination of both.