#single-payer — Public Fediverse posts
Live and recent posts from across the Fediverse tagged #single-payer, aggregated by home.social.
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@rchusid
Incrementally or not, ultimately the goal is #singlePayer #MedicareForAll. Otherwise we squander the savings of lower admin costs and open the door for insurance industry cherry-picking. So, yes, private health insurance industry would disappear. Status quo has been in place so long that ppl with employer insurance fear change. 1/2 -
“Of all the forms of inequality, injustice in health care is the most shocking and inhuman”*…
Why are health care costs so high in the U.S.? Harvard public health scholar John McDonough chalks it up to a “wrong turn” in 1980, and the consequences that have ensued…
“What happened in 1980?” John McDonough wondered every time he looked at the numbers.
After 1980, U.S. healthcare became far more expensive than care in peer nations such as France and Germany. In 1980, the U.S. was at the top of a tight pack of industrialized democracies. After that, the cost of American healthcare soared. By 2024, U.S. spending as a percentage of GDP was about 50 percent higher than that of peer nations.
“In the early 1980s, we can see a significant upsurge,” McDonough, professor of the practice of public health at the Harvard T.H. Chan School of Public Health, said in an interview. “All of a sudden, we jumped from the rest of the crowd and were now in a category by ourselves. Over the following 40, 45 years, the distance kept growing.”
McDonough knew what he could rule out: Any suggestion that Americans get more for their money. On the contrary, millions of U.S. citizens are uninsured; out-of-pocket costs and medical debt are high; and even people with insurance have trouble getting appointments. Meanwhile, physician satisfaction is low, leading to early retirements and migration to nontraditional models like concierge care.
When the pandemic hit, McDonough had time for a deep dive into the issue. This month, after a five-year “labor of love,” he’s presenting his answer in a new book, America’s Wrong Turn: US Health Care in the Neoliberal Era [here]. In it, McDonough links increases in healthcare costs to a new political and economic era dominated by a belief in an unfettered free market, tax cuts, deregulation, privatization, smaller government, increased immigration, and free trade.
This trend in U.S. policy — “Reaganomics” before it became “neoliberalism” — included tax, spending, and regulatory overhauls instituted during President Ronald Reagan’s eight years in the White House. But McDonough, a Democrat who served 13 years in the Massachusetts House of Representatives, isn’t just interested in Reagan. Over the next 40 years, some presidents adhered to neoliberalism’s tenets but even those who didn’t were influenced by its deep penetration into the nation’s political and economic ecosystem, he says.
McDonough found a guide in the writings of Yale University political scientist Stephen Skowronek, who suggests that presidents should be measured by the durability and influence of their ideas and values well beyond their terms in office. Skowronek identified only five singular and decades-long eras in U.S. history, those of Thomas Jefferson, Andrew Jackson, Abraham Lincoln, Franklin Delano Roosevelt, and Ronald Reagan.
While Reagan was the first president to espouse neoliberal political and economic philosophy, the core ideas date back decades, fostered by Nobel Prize-winning economist Milton Friedman, who became a key economic adviser to Reagan.
“There was a New Deal-FDR era between 1933 and 1980,” McDonough said. “The neoliberal era that Reagan kicked off saw itself as the corrective to the pro-government prior era. Important dynamic consistencies persisted among Ronald Reagan and Bill Clinton, George W. Bush, and even Barack Obama. There were sets of beliefs with a Republican conservative flavor and with a Democratic flavor that were surprisingly consistent.”
When describing the U.S. healthcare system under neoliberalism, McDonough, who worked with U.S. senators on the Affordable Care Act, cites several major effects, chief among them a permissiveness toward corporate mergers and consolidations that reduces competition, and an unleashing of private equity.
Since the 1980s, U.S. healthcare has become increasingly consolidated, dominated by fewer and larger organizations. The two largest dialysis centers have 92 percent of the U.S. market, for example, while the two largest providers of intravenous solutions control 75 percent of the market. The two largest syringe manufacturers have a 69 percent market share.
Consolidation extends to physician and hospital markets, with 90 percent of hospital markets, 65 percent of physician specialist markets, and 74 percent of health insurance markets considered highly concentrated, McDonough writes.
One argument for larger organizations is the potential for cost saving through both efficiencies and a greater ability to negotiate savings, but the cost-saving record of larger organizations in healthcare is poor, McDonough says. He cites a 2022 RAND study that indicates that price increases of between 3 percent and 65 percent accompany hospital mergers.
Private equity’s focus on generating profits to maximize shareholder value conflicts with improving patient care, McDonough argues. When private equity firms target businesses, enhance their operations, and quickly resell them at a profit, critics say the value extraction from the deals creates harmful operating cuts and dismantling rather than business improvement.
McDonough reviews other key forces in the evolution of U.S. healthcare in recent decades, including fragmentation leading to high administrative costs, low spending on public health and preventive care, unequal access and uneven quality of care, and cost shifts onto consumers via copays, coinsurance and other cost-sharing mechanisms, which result in high levels of medical debt.
McDonough offers prescriptions, but recognizes that change will require political buy-in for things such as strengthened antitrust action to break up megacompanies and stronger regulation of prescription drug pricing, both difficult in an era of sharply divided politics. Government, along with industry, needs to reaffirm a commitment to patient care as the center of its efforts, he says, while also foregrounding equity, access, affordability, and population health.
“The damage to U.S. health and medical care from the 40-year neoliberal era has left considerable harm for patients and consumers, for medical workers at all levels, and for public/population health,” McDonough said. “It will take radical action to reinvigorate the values and principles of our health system that have been lost and eroded. An essential way to do this is to understand how we got to this position in the first place.”…
How we got here and how to respond: “How to fix U.S. healthcare? ‘Radical action’,” from @harvardmagazine.bsky.social.
For a case in point, see David Oks‘ “Why American ambulance rides are so expensive” (source of the image at the top).
And for a more straightforward, but somewhat more “radical” prescription than McDonough’s, see: “Universal Health Coverage Could Save $1 Trillion and 114,000 Lives Every Year, Yale Study Projects,” from the Yale School of Public Health: “A single-payer universal health care system could cover every American, save more than 100,000 lives a year, and still cost $1 trillion less than the system it would replace…”
Finally: this is the third (R)D in a row that focuses on (some of) the consequences of the unholy infection of government by business, largely in the U.S. (though, of course, we can see the phenomenon all over the world). The focus shifts with tomorrow’s post. But before we go, Dylan Riley‘s pithy diagnosis of “the chaotic obscenity of our current moment”: “The Thesis of Political Capitalism.”
* Dr. Martin Luther King, Jr.
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As we actually make America healthy again, we might recall that it was on this date in 1793 that prominent Philadelphia physician (and Declaration of Independence signatory) Benjamin Rush alerted the city’s mayor that an epidemic of mosquito-borne yellow fever was fast emerging.
In the summer of that year, refugees from a yellow fever epidemic in the Caribbean fled to Philadelphia. Within weeks, people throughout the city were experiencing symptoms. By the middle of October, around 100 people were dying from the virus daily. Caring for the victims so strained public services that the local city government collapsed. Philadelphia was also the seat of the United States government at the time, but federal authorities simply evacuated the city in the face of the raging epidemic. Eventually, a cold front eliminated Philadelphia’s mosquito population, and the death toll fell to 20 per day by late October. By the time the epidemic ended, roughly 5,000 people had died.
Today, a vaccine prevents yellow fever in much of the world, though thousands of unvaccinated people still die every year from the disease.
The Yellow Fever Epidemic of 1793 (source) #ambulance #BenjaminRush #culture #health #healthCare #history #JohnMcDonough #medicine #neoliberalism #Philadelphia #privateEquity #publicHealth #Science #singlePayer #singlePayerHealthCoverage #universalHealthCare #universalHealthCoverage #YellowFever -
Conservative KIRO News Radio is now concerned about a report by Washington Health Benefit Exchange that “showed 66,000 people in Washington dropped their Affordable Care Act (ACA).”
"...people out here that are choosing between health insurance and rent,"
https://mynorthwest.com/kiro-opinion/health-insurance-aca-coverage/4267063
#Health #Healthcare #ObamaCare #ACA #Rent #Universalhealthcare #Singlepayer
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Interesting and important study from Yale on the US healthcare system. Most of this is just confirmation of what we already know.
"A single-payer universal health care system could cover every American, save more than 100,000 lives a year, and still cost $1 trillion less than the system it would replace, according to a new preprint study led by researchers at the Yale School of Public Health."
https://ysph.yale.edu/news-article/universal-health-coverage-could-save-one-trillion-dollars-and-114000-lives-every-year/ #health #healthcare #singlepayer
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Tell me again the reasons for not having a single payer healthcare system in the USA? 🤔
Of course, I know why insurance companies are opposed! ($$$)
"Single-payer system would save $1 trillion, 114,000 lives annually: Yale study"
Link to study (preprint)
https://www.medrxiv.org/content/10.64898/2026.07.22.26358689v1#USPol #Healthcare #UniversalHealthcare #Medicare #MedicareForAll #SinglePayer
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Not going to condone #LuigiMangione because murder is wrong.
But I will say that, between him and #BrianThompson, it was the #UnitedHealthcare CEO that harmed society more, and did more evil to more people.
The entire #US #Healthcare system is run by evil people.
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RE: https://universeodon.com/@rchusid/117086267192799800
If we ever needed it, #universalhealthcare #singlepayer #healthcare we need it now.
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The Executives concern is maintaining shareholder value, not treating patients, making this article seem part of a lobbying campaign for Congress to subsidize hospitals without providing a Single Payer system.
#SinglePayer #Health #Healthcare
https://www.nytimes.com/2026/07/30/business/aca-obamacare-health-insurance.html
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Well well well
Perhaps Hospitals would prefer a larger pool accorded by #SinglePayer l🤔
#UninsuredPatientsRiseSharply, Hospitals Report, Citing Obamacare Cuts -
Like #CA #GovNewsom, top Dem candidate for state's highest office pulls a #Gavin and quietly backs away from previous pledge to support #SinglePayer #Healthcare in America's most populous state...
#Newsom previously earned a big endorsement from state's powerful #nurses union before betraying promise to put issue on his agenda once elected.
Spokesman for former #HHS secretary under #Biden calls goal "unrealistic"
https://capitalandmain.com/in-california-governors-race-xavier-becerra-walks-away-from-single-payer
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Democrats love talking about affordable single payer healthcare...right up until they’re in a position to actually pass it. Then suddenly it’s "NOW is not the time..."
#CalCare #SinglePayer
https://www.youtube.com/watch?v=kALcSkzNCLg -
Why covid will be with us forever part 45,192:
After two weeks I still tested weakly positive yesterday. I'm now out of covid tests. I have Anthem insurance. They stopped covering at-home tests a couple years ago, as I finally found out after 45 minutes on the phone, dealing with different bots, phone trees and finally, transfers to different actual people (4!).
But, hey! I can go to urgent care and get the test done. But, oops! There's a $30 copay.
I clarified with the last phone guy that my choice was to go to the local pharmacy, pay $18 out of pocket for a single at-home test, or go to an urgent care clinic and pay $30 myself *in addition to Anthem then getting billed hundreds of dollars by the clinic*. Yep, that's their logic.
#HealthInsuranceMustDie #SinglePayer #FreeHealthCareForAll + #GuillotineForAnyPoliticianWhoDoesNotSupportIt
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Here is where the top Democrats for California Governor stand on Universal Healthcare:
SWALWELL: Supports a public option
PORTER: Supports single-payer health care
STEYER: Support single-payer health care
BECERRA: Supports single-payer health care
THURMOND: Supports single-payer health care
YEE: Supports single-payer health care
VILLARAIGOSA: Supports a public option
https://calmatters.org/politics/2026/03/california-governor-single-payer-health-care/
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Has somebody done the math on whether dealing with our #healthcare "system" itself is making people sicker?
I am personally sick of the all the convoluted time-wasting, life-wasting garbage.
Energies better spent elsewhere.
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Everybody talks about how #singlePayer would eliminate the wasted money sucked out of #healthcare by insurance companies. That misses a more important point.
If the government is going to be paying for your healthcare no matter what, then they want to keep you healthy, because healthcare costs are lower for healthy people.
An insurance company, on the other hand, can just bet on you losing your insurance because you're sick and can't work or afford it, and then you're no longer their problem. -
#Trump Trashes ‘Big, Fat, Rich #Insurance Companies.’ Progressives: ‘Wait Until We Tell You About Medicare for All’
“If we had #MedicareForAll everyone would have #healthcare with no premiums, deductibles or co-payments and we’d save $650 billion and 68,000 lives a year.”from #CommonDreams
Jon Queally
Nov 19, 2025#Medicare4All #HealthcareIsAHumanRight
#news #politics #USpol #health #medicine #SinglePayer #SinglePayerHealthcare -
@rbreich Audacity / hope / change / yes-we-can Obama sold US out in 2009-10,😡 didn't fight hard enough for public option, never mind single-payer.😡ACA further enabled insurance mafia extortion, infrastructure.😡 Former Sen. Tom Harkin: Dems "…had a huge majority in the House… 60 votes in the Senate… we blew it…"
#TomHarkin #Obamacare #Romneycare #publicOption #singlePayer #M4A #MedicareForAll #universalhealthcoverage #UHC #AmeriCare