Category Archives: Health Economics

Relief for Corporations, of Course. People? Let Them Eat Cake

Our feckless president and his Republican Party controlled Senate propose using tax funds to rescue corporations and fashions a rescue that cuts out the lowest earners from financial support. It gets even worse..

“But he also injected new uncertainty into the government’s response, suggesting it was not his responsibility to meet the needs of health care workers on the front lines of combating the disease. A day after he said he would use the Defense Production Act — a Korean War-era law that allows presidents to force American industry to ramp up production of critical equipment and supplies — Mr. Trump told reporters that he would rather rely on states to deliver equipment to health care workers.” (Emphasis medicynic)

“On Capitol Hill, Republicans presented a bill that would offer bridge loans of up to $10 million each to small businesses, extend hundreds of billions of dollars in loans to large corporations in distressed industries and send checks as large as $1,200 per adult to individuals earning less than $99,000 per year. The payments would phase in for earners up to $75,000 — meaning lower earners would get smaller checks — and then phase out again at $99,000. Those who did not earn enough to pay income tax would receive much less: $600.”

“The Senate bill also includes a raft of temporary changes to the tax code that would reduce the tax liability of large corporations, many of them overriding provisions in the 2017 tax overhaul that were meant to raise revenue to offset corporate rate cuts.”

Medicynical note: Where to start. In the chaos of the Trump administration we learn that our leader doesn’t think it his responsibility to assure access to competent care and testing. Where I live the PeaceHealth hospital (a several state multi hospital organization ) is reporting shortages of all types of medical materials as well as test kits. The staff feels extremely vulnerable because of the lack of preparation. This is a microcosm of the nationwide situation. Remember Trump gutted the government’s ability to anticipate and plan for a pandemic after his election. What’s happening was predicted but our guy knew better (sic) he is reaping at the expense of citizens lives and fortunes what he has sowed.

The Senate plan pointedly gives little financial support to the poorest in our society while proposing yet another large tax cut for corporations. The last tax cut, you recall doubled, the federal deficit. Trump, meanwhile, says he’s going to cut social security Medicare and Medicaid because of the large government deficits from his tax cuts to corporations and wealthy. Chutzpah combined with chaos.

So corporations under Trump receive bailouts from tax payer funds from which they want to be excused from paying. While in effect taxing the sick and elderly by cutting their Social Security and access to health care. America, something terrible is happening and his name is……..Trump.

Read Between the lines (Trump vs the Science….again)

Today Anthony Fauci of the NIH said the following about the Coronavirus regarding recommendations to the elderly chronicaly ill. 

“You don’t want to go to war with a president,” he said. “But you got to walk the fine balance of making sure you continue to tell the truth.”

FoxNewsSunday

@FoxNewsSunday

Doctor Anthony Fauci talks about staying away from political spin when addressing the American public about the risks of the coronavirus.

Embedded video

Medicynical Note:  What’s going on here?  Think there might be a conflict between the scientists and the politican?  Trump has called global warming a hoax and recently called the Coronavirus worldwide epidemic bordering on pandemic a hoax as well.  Think he has your best interests in mind?

It’s the Money $tupid– the busine$$ of dialy$i$

The Dialysis Duopoly Spends $100 Million to Protect Profits in California https://prospect.org/article/dialysis-duopoly-spends-100-million-protect-profits-california

“With Medicare for All being discussed in national circles, the situation with the dialysis providers is instructive. Faced with a single-payer system with lower reimbursement rates for their service, the dialysis industry bankrolled a charity to shift people into private insurance and jack up the cost. We don’t know what loopholes might enter the picture under Medicare for All, but the dialysis duopoly scam bears watching as a potential tactic. It speaks to how resourceful medical providers might be in their vigorous opposition to single-payer, and why politicians need to be mindful of their power.”

““I feel like it’s an unfair business practice all of us are paying for,” said Wood, who’s hopeful the bill will pass. “For me the bigger part of this is that, we’re trying to make sure we get access to care for as many people as possible, you can’t do that if you can’t contain costs.””

Medicynical note: In medicine as in other capitalistic enterprises the goal is to become a monopoly, gouge your customers and then fight like mad to protect your profits. Patient care. Access? Good outcomes? Value. All are nice goals but not a really the primary aim of the endeavor. It’s $ucce$$ is mea$ured by other parameter$$$$$.

Privatization….Doesn’t Work Without Regulation

“Beginning in 1996, the military launched the largest-ever corporate takeover of U.S. federal housing, shifting ownership of more than 200,000 family housing units on bases to private real estate developers and property managers under 50-year contracts.”

Great Moments in American Medicine: Snake Bite $142,000

Overcharging is the rule in the U.S.

The average list price for CroFab is $3,198 per vial, according to the health care information tech company Connecture. Manufacturing costs, product improvements and research all factor into the drug’s price, said Chris Sampson, spokesman for BTG. ”

“A Mexican version of snake antivenin can cost roughly $200. But it couldn’t be sold in the U.S. (More about that in a moment.)”

And

“In Oakley’s case, St. Vincent Evansville hospital charged $16,989.25 for each unit of CroFab, according to the facility’s bill. That’s more than five times higher than the average list price.”

“WellRithms analyzed Oakley’s bill from St. Vincent Evansville at Kaiser Health News’ request and found providers generally accept $16,159.70 for all four vials of the drug.”

Read the article for more.

Medicynical note: The U.S. overcharging for healthcare services seems to be more the rule rather than the exception, particularly for those in life threatening situations. If the patient is insured they will most often get a significant discount rate that cuts the bill dramatically. Ironically if a person has no insurance, hospitals and other providers bill the full amount…… to the most vulnerable patients

United Healthcare…..in it for the money

Not a big surprise

For those who thought insurance companies are in it to provide excellent healthcare……you were wrong.

“US Chief Magistrate Judge Joseph Spero issued his decision Tuesday against United Behavioral Health, a unit of UnitedHealthcare, saying the insurer created internal policies that effectively discriminated against those seeking mental health and substance abuse treatment.”

“”It is well-established that effective treatment of mental health and substance use disorders includes treatment aimed at preventing relapse or deterioration of the patient’s condition and maintaining the patient’s level of functioning. UBH Guidelines deviate from that standard,” Spero said”

Medicynical notes: Given a choice between enhanced profits or funding excellent care, the private insurer’s policy was programmed to choose the former. After all it’s their their fiduciary responsibility.

Pizza and Prescriptions.

We’ve talked about doctors receiving honoraria and other payments from drug companies to influence their choice of treatments.  Always quite righteously physician groups have responded to such allegations with drivel about their professionalism and their over riding concern for their patients.  That works up to a point but in our culture money talks.

This puts such arguments to rest:

As little as one free meal from a drug company can influence which medicines doctors prescribe for Medicare patients, according to a study using Medicare records and recently released data from the health care law’s Open Payments program.

More here.

Medicynical Note:  For the almost 50 years that I’ve been a physician drug companies have vied for face time with physicians.  Some of it is fairly legitimate education on new better drugs but most is simply  a sales pitch to get the doc to change his/her prescribing habits, almost always with limited benefit and  increased cost.  Various incentives are provided to get this access–cash payments, meals, faux jobs, deals on medications given directly to patients.  It all works and it all costs the system integrity and cash. 

But hey that’s the way America works. Check out the gun lobby and the recent assault weapons votes.  Money buys access and influence.  Doctors are not immune.