Death to for-profit health care

This is from the lead article in The American Prospect's current issue, which is devoted to this country's profits way, way before people health care system.

The problem is, because the country essentially lacks any institutions designed to broadly improve public health, our medical advances are funneled through a veritable gauntlet of gatekeepers, distributors, middlemen, subcontractors, loophole-exploiters, conglomerates, and monopolies, all under the watchful eye of Wall Street investors. Managing a hospital or clinic today requires hiring an ever-mushrooming cadre of lobbyists, consultants, and contractors to navigate this confusing new world. The science of health care points to a bright future; the business of health care points directly backwards...

Where is the money for the most expensive health care system in the world going? The cut of gross national health care expenditures commanded by administrative overhead and waste has ballooned to an estimated 30 percent; the portion that pays doctors and nurses has fallen. Experts estimate that fraud comprises at least $10 of every $100 the U.S. government spends each year on health care. And how much does the government spend policing that fraud? In 2021, that figure was two cents, according to the HHS inspector general. Wealth extraction has become so normalized in American health care, it can barely be considered illegal. - The American Prospect

Hospice needs to get back to what it was

This is one of the best examples of how contemptible the for-profit privatizers are.

From the beginning, hospice was as much an ethos as a health care job. The earliest providers were uniformly nonprofit endeavors. With the 1982 advent of full Medicare reimbursement, hospice came to provide exceptional and humane end-of-life ministration, with nurses and counselors prepared for everything from palliative care to bereavement support to spiritual advice for families.

Yet in the last two decades, at first slowly and then in an onslaught, the field of hospice has been transformed. An influx of for-profit operations, drawn to potentially vast profit margins, dominates the field. Now, in some corners, cost-cutting and profiteering are the order of the day, with direct consequences for patients. And of course, Medicare, the public dollar, is underwriting their extraordinary returns.

There are well-operated, humane for-profit hospices, to be sure. But for the more cynical operators — and there are many — compassion, and a peaceful and dignified death, are no longer the care standards; the aim is profit alone. - Truthout

Medicare Advantage fraud spikes

There is a wide range of opinions about, and experiences with, Medicare Advantage. I'm not prepared to condemn the whole program, outright. But it absolutely needs to be under far more strict and enforceable regulation.

Insurance companies and other brokers are making false or misleading claims to dupe senior citizens into purchasing Medicare Advantage plans, according to a report published (November 3) by the U.S. Senate Finance Committee.

The report, which comes midway through this year's Medicare enrollment period—described last year by healthcare writer Susan Jaffe as "open season for scammers"—reveals that the number of Medicare beneficiary complaints about dubious private sector marketing tactics more than doubled from 2020 to 2021...

Dr. Jessica Schorr Saxe, a retired family physician, noted in a recent Charlotte Observer opinion piece that "earlier this year, the federal government reported that 13% of denials in Medicare Advantage would not have been refused under traditional Medicare," while "Medicare Advantage plans are also increasingly ending nursing home and rehabilitation care before providers consider patients ready to go home." - Common Dreams

The infrastructure bill isn't all great

They had to do this, to get "bipartisan" support. That is, the votes of many legislators that were provided only at the behest of their corporate masters. I'm not just referring to Party of Trumpers, either.

The recently passed $1.2 trillion bipartisan infrastructure bill will provide desperately needed federal dollars to fix our roads, water systems and other public infrastructure. But the bill is not all sunshine and rainbows.

A provision in the bill incentivizes state and local governments to hand control over some of the new projects to corporations and private investors. And that will create opportunities for bad things to happen.

Much of the new federal spending will go to fill potholes, repair bridges, lower the cost of high-speed internet, and build other things our communities need. But for large, federally supported transportation projects, state and local governments will be required to consider additional funding from private investors.

The danger is that this additional funding comes with strings attached. The private investors negotiate contracts — called “public-private partnerships” — that allow them to profit from raising water rates or hiking tolls on highways, or from charging the government expensive lease payments.

These contracts are not only more expensive than if the state or locality used traditional public financing, but they also often empower private investors to shape public policy. - The Progressive

Where the VA is at

Trump & Co. didn't get too far with their heinous effort to open the Veterans Administration to being strip-mined for profit by the greedheads, aka "privatization." But that doesn't mean everything's cool. This is a comprehensive recent overview.

Denis McDonough, the new secretary of Veterans Affairs, is only the second nonveteran to take the helm of the VA since it became a Cabinet-level department in 1988 and only the second person whom Congress did not confirm unanimously for the post.3 He will have his work cut out for him. Not only does Secretary McDonough have to manage a large and complex organization, but he is also facing a series of unprecedented challenges—all compounded by the fact that the VA’s top leadership is in turmoil following the Trump administration, which had five deputy secretaries4 during the former president’s four-year term.

Secretary McDonough’s challenges may be placed into seven categories:

- Addressing the ballooning VA budget
- Expanding veterans’ access to disability benefits
- Reducing the veteran suicide rate
- Slowing the privatization of veterans’ health care
- Prioritizing the women and LGBTQ people who have and still serve in the military
- Rebuilding the department’s infrastructure and staffing
- Helping veterans transition into civil society - Center for American Progress