PNHP

Seniors, Trump pick Dr. Oz wants to take you out of Medicare. Call your senator

Seniors, Trump pick Dr. Oz wants to take you out of Medicare. Call your senator

By Carol Paris, M.D.
The Knoxville News-Sentinel, March 5, 2025

Seniors: Who do you trust with your health care? If you’re like me, you place a great deal of trust in Medicare, which you’ve paid into for your entire working life. If you’re like most Americans, you definitely don’t trust corporations like UnitedHealth (UHC) to pay for the care you need, when you need it.

Despite public opinion, President Donald Trump’s administration is gearing up to hand even more of our Medicare over to insurers like UHC. They’re planning to push hard for the “Medicare Advantage” (MA) program, which generates huge profits for insurers while punishing seniors with restrictions, surprise costs, and outright denials of care.

Republicans have a blueprint, Project 2025, which seeks to make MA the default enrollment option for Medicare beneficiaries, and a champion, Dr. Mehmet Oz, who supports an even more aggressive plan: Medicare Advantage for All.

The “Advantage” program has been very kind to UHC over the years, boosting its profits into the billions. In 2024, UHC captured 29% of the MA market. It also captured the anger of everyday Americans trying to use their substandard insurance − as well as the scrutiny of Congress and the wrath of medical professionals who are denied the ability to care for their patients.

I know this from personal experience, having recently consulted an orthopedic surgeon for knee pain. My doctor recommended trying an injection before jumping to surgery and explained the various options. I asked what he would recommend personally.

“It doesn’t matter what I recommend,” he said, “only what your insurance will authorize.” When I told him I had traditional Medicare, not a corporate MA plan, his dejection changed to enthusiasm. “That’s wonderful,” he said. “Now I can give you my best advice and administer the injection today.”

Patients and physicians suffer because of the roadblocks thrown up by firms like UHC: prior authorization requirements, restrictive provider networks, and frequent denials of care. These tactics bankrupt patients, lead to physical suffering, and fuel an epidemic of burnout among medical professionals.

Unlike most doctors practicing in the U.S., Dr. Oz sees all this and applauds. He has consistently promoted MA plans, and even proposed putting all Americans into the program. For seniors, that would mean no more public Medicare, not even as an option for those who want it.

Mehmet Oz’s dangerous prescription for health care puts profits over patients

By Sneha Kapil, Mitchell Stoddard, Manasvi Khullar, and Erin Everett
South Florida Sun-Sentinel, March 4, 2025

“I don’t believe in antibiotics!” My patient told me, frustrated that I was not going along with her faith in the healing powers of a supplement. As a young doctor in training, I was unprepared for the current landscape of severe mistrust in health care. My patient had a bacterial urinary tract infection that has long been treated with antibiotics. However, she was refusing antibiotics despite weeks of pain, much to my disappointment. Although this happened to one of us (Manasvi Khullar), all four of us have countless similar stories.

The lack of trust in the health care system has led patients to turn to false promises, not physicians, for their health care needs. Although many failures led to this point, there are multiple people who have perpetuated lies in the name of profit. One of these individuals is Dr. Mehmet Oz, the nominee to run the Centers for Medicare and Medicaid Services (CMS) who will oversee the process of care coverage decisions, the Affordable Care Act and a $1.5 trillion budget.

Oz is a cardiothoracic surgeon, famous for his daytime talk show that reaches millions of Americans. He follows many evidence-based principles — a belief in a healthy diet, the power of activity and social connection. However, he has also often promoted questionable therapies like “magic weight loss cures” and claimed that cellphones can cause breast cancer. One study found that half of his recommendations had zero evidence. Given this, how will Oz use taxpayer money to decide what therapies are covered by Medicare? How does he plan to respond to therapies not based in scientific evidence?

One plan for CMS that Oz has touted is “Medicare Advantage (MA) for All,” which allows CMS to contract with private insurance companies to fulfill Medicare requirements. But reports show that MA patients were denied care by insurance companies that should have been covered, with the plan pocketing the difference. MA plans have also been shown to overcharge the government by adding unnecessary codes to charts. The $88 billion to $120 billion upcharged annually is enough to expand traditional Medicare to include dental, vision and hearing coverage.

Oz proposes making MA the default enrollment option, restricting patient choice and funneling $200 billion annually to insurance companies, which jeopardizes traditional Medicare. Experts estimate expanding MA to cover 75% of enrollees could waste nearly $2 trillion over the next decade without improving health care quality. Rural seniors would suffer the most, as restricted provider networks and underfunded hospitals already limit access to care in these areas. By advocating for “Medicare Advantage for All,” Oz puts the pockets of private corporate interests before quality patient care.

Oz also owns stock in many companies that he would be tasked with regulating. For example, he owns shares in the UnitedHealth Group and CVS Health Corp, the owner of Aetna Insurance. This appears at odds with past statements in which Oz said, “I’ve fought Big Pharma, I’ve gone to battle with Big Tech, I cannot be bought.”

As future physicians, we refuse to inherit a system where patients die while insurance companies post record profits. This nomination leaves millions — especially seniors and women — at risk of losing reliable health care. The American public has demanded change at all levels of government and has elected President Trump to shake things up. Oz is an out-of-the-box thinker who has claimed that he cares about the health of Americans. But senators should act urgently to confront his apparent conflicts of interest and controversial beliefs during the confirmation process. The American people deserve a gifted cardiothoracic surgeon who can provide a steady hand during a time of crisis, not a con man who will sacrifice your health and taxpayer money to make a quick buck.

Sneha Kapil is a third year MD/MS candidate at the University of Miami Miller School of Medicine.

Mitchell Stoddard is a second year DO/MPH candidate at Western University of Health Sciences College of Osteopathic Medicine of the Pacific.

Manasvi Khullar is a fourth year medical student at Touro University California College of Osteopathic Medicine.

Erin Everett is a fourth year MD/MPH candidate at Tulane School of Medicine.

The views represented in this op-ed are their own and not that of their universities.

https://sun-sentinel.com…

Looming Medicaid Cuts & Pushback

The House of Representatives budget resolution suggests massive upcoming cuts to Medicaid, likely via reduced eligibility. Voters of both parties are surprised and worried, expressing disapproval. So are potent media voices. The public values government-funded health care; imagine how popular single payer would be!

FLASH BREAKING: Major news on Republicans CUTTING healthcare, YouTube video (8 min), Feb. 25, 2025, by Brian Tyler Cohen

Liberal Redneck – On Gutting Medicaid and Food Stamps to Cover More Tax Cuts for the Wealthy, YouTube video (8 min), Feb. 26, 2025, by Trae Crowder

“I was a poor kid, I know gross, but I was I was on all these programs. Food stamps subsidized my education all through college; don’t know what I would have done without them and in the intervening years since I have paid back far more in taxes than I ever got for the government. So the point is stop looking at these programs as an endless money glitch for a bunch of freeloaders, and look at them instead as an investment in one of our most vital resources: each other. I am walking breathing talking proof that the ROI can be pretty damn good. We can use these programs to lift up countless other Americans out of poverty.”

“All right, look, giving these rich people even more money is not going to work. You know how I know? Cuz we’ve been doing it for more than 40 goddamn years. If the Blessed urine of our betters was ever going to trickle down to us, I think we’d have felt a drop or two by now. All right so I’m imploring you — wake up stop tongue-polishing the boot that’s on your throat, and recognize the value of investing in your fellow Americans.”

The Debate Over Federal Medicaid Cuts: Perspectives of Medicaid Enrollees Who Voted for President Trump and Vice President Harris, KFF (Kaiser Family Foundation), Feb. 25, 2025, by Amaya Diana, Jennifer Tolbert, & Robin Rudowitz

  • Many Trump and Harris voters said that … they did not recall hearing about changes to health care programs (including Medicaid) during the campaign. Most participants said the government has a role to play in making health care more affordable and accessible … both Trump and Harris voters [said] that state verification procedures prevent individuals from defrauding the program on a large scale …
  • … Participants opposed cutting Medicaid funding to pay for tax cuts that they did not believe would benefit them. Both Trump and Harris voters expressed fears that these changes would jeopardize the program, take away access to health care, result in worse health outcomes, and increase out-of-pocket costs. A few Trump voters did not believe Trump would follow through on the cuts to Medicaid because they believed he understood their financial struggles.
  • Both Trump and Harris voters valued their Medicaid coverage and the access to health care services, mental health services, and medications for themselves and their children it provides. Participants also valued Medicaid because it helps to protect them from financial disaster, alleviates stress, improves health outcomes and often supports their ability to work. Participants said losing Medicaid would “be devastating” and lead to serious consequences for their physical and mental health and exacerbate pre-existing financial challenges.
  • If work requirements were introduced to Medicaid, participants who were working generally felt confident in their ability to meet the requirements; however, they worried about the burden of monthly reporting requirements when those were described to them. Many participants across parties noted that access to treatment for chronic conditions, including prescription medications and mental health treatment, were key in helping to support their ability to work. More Trump voters supported a work requirement but some who were not working were convinced they would qualify for an exemption. Other participants, including both Trump and Harris voters, who were not currently working felt they would face challenges in meeting the requirements. Those who were not working said they wanted to work (and many had been previously working for many years) but were generally unable to because of disability or because they were caring for young children or a sick parent.
  • Both Trump and Harris voters wanted policymakers to focus on improving Medicaid instead of cutting it. For example, some participants said they would like to see enhanced dental benefits, increased doctor availability, and fewer prior authorization requests. Focus group participants wanted policymakers to consider the implications of federal cuts to Medicaid for people, their health, financial stability, and ability to be productive members of society.

Comment:

By Jim Kahn, M.D., M.P.H.

This week’s House budget resolution sets targets for subsequent detailed appropriation bills. The two largest priorities: cut Medicaid for the poor, and slash taxes (predominantly) for the rich. Net result: an increase in debt of nearly $3 trillion – that’s $8500 per person, >$25,000 for a family of three, while growing the ranks of the uninsured.

These strategies are widely unpopular, including the Medicaid cuts, as heard by KFF in their bipartisan focus groups.

The $880 billion in Medicaid cuts is about 10%. Where will that come from? Payment rates are already dangerously low. Benefits are slim. A GOP Congressman in the Tyler Cohen video, when repeatedly asked if he’ll vote against “cuts to Medicaid”, robotically intones with a smirk: “No benefit cuts.” What does that mean? How is that possible? Presumably: the budget cuts will arise from restrictions in eligibility (who qualifies), without removing benefits for those covered. So what’s better, less for the same number of beneficiaries, or excluding millions of beneficiaries? Cruel either way, IMO. But for the GOP rep, it’s all political subterfuge.

I do appreciate that economics was highlighted in both of these decidedly non-economic forums. Brian Tyler Cohen presents the Center for American Progress graphic summary of the budget proposals. And Trae Crowder talks about “return on investment” – his taxes as a worker far exceeding what the government invested in his healthy growing up.

Progressives have been losing the social media wars. With entertaining and whip-smart presenters like these YouTubers, we are making up lost ground!

But what’s most encouraging to me is how much a wide swath of voters like and rely on Medicaid. Not that it’s a perfect program, far from it. Despite its limitations. Just imagine how they’d feel about lifelong universal health insurance, with broad benefits, paying fair rates to providers, and no significant cost-sharing. It would be heaven. It’s called single payer. It’s an important way to unite left, middle, and right against the billionaires (but they’d be covered too).

https://healthjusticemonitor.org…

Stay informed! Subscribe to the McCanne Health Justice Monitor to receive regular policy updates via email, and be sure to follow them on Twitter @HealthJustMon.

Modern Medicare vs. Single Payer

Sadly, Medicare has been twisted into a morass of complex choices and financial vulnerability. Coverage in other nations and with single payer is simple and effective. Let’s take that path!

Bridging the Medicare Cost Gap: Knowing Your Options, The New York Times, Feb. 15, 2025, by Mark Miller

Medicare can cover most of your health care needs when you turn 65, but it doesn’t pay for everything. And one of the most significant financial challenges to watch out for are the out-of-pocket costs you can face aside from monthly premiums — including deductibles and other types of cost sharing.

Just how much you’ll pay, and when, depends on the type of Medicare enrollment that you choose: traditional Medicare, which is operated by the government and provides care on a fee-for-service basis, or Medicare Advantage, which is run by private insurance companies and operates on a managed care model.

There is no built-in annual out-of-pocket limit in traditional Medicare for outpatient and hospitalization services. Protection is available from supplemental insurance coverage – most often it means purchasing Medigap — a policy offered by private insurance companies that covers part or all of Medicare’s cost-sharing requirements.

Medicare Advantage plans come with out-of-pocket limits — but they can be high. When serious medical conditions arise, out-of-pocket costs can be a significant financial hit or make it difficult to afford care altogether. Medicare Advantage plans offer one-stop shopping and extra benefits, but they restrict care to in-network providers and have been criticized for techniques such as “prior authorization.” Traditional Medicare offers the widest access to health providers, and only a small group of medical services require prior authorization.

Medigap

Buying Medigap can be daunting, since the policies come in an alphabet soup of lettered plan choices (A, B, C, D, F, G, K, L, M and N). Medigap premium prices will differ, but the benefits offered by plans are standardized. All Medigap policies cover hospital coinsurance — the costs that you pay for longer stays after deductibles are met. Many cover all or part of the hospital deductible. Medigap plans also cover all or part of the 20 percent of fees for most physician services. They are required to also cover some or all of the cost sharing for outpatient services, and the more robust plans cover the annual hospital deductible and cost-sharing in skilled nursing facilities.

When you first sign up for Part B, which covers doctor visits and outpatient care, that’s when Medicare forbids Medigap plans from rejecting you. The opportunity is available to you during your six-month Medigap Open Enrollment Period, which starts on the first day of the month in which you’re 65 or older. After this period ends, Medigap plans in most states can reject applications or charge higher premiums because of pre-existing conditions.

Medicare Advantage

Jan. 1 through March 31 — this is the time when people enrolled in Advantage can switch plans or move to traditional Medicare. Before making a decision to move to traditional Medicare, make sure you can obtain a Medigap policy. Once you’ve identified a plan that interests you, contact the insurance company for details. The premium will vary.

High-deductible MediGap G plans are not a well-publicized option since Medigap commissions generally are a percentage of the premium, it incentivizes brokers to sell the G plans with the higher premiums.

With Advantage, the exposure can be high in years when you need lots of health care, and out-of-pocket features in the Advantage program vary by plan. It’s not necessarily true that Medicare Advantage will save you money. “The information is published, but it’s very difficult to compare,” Dr. Tricia Neuman of KFF said. “It’s really on the consumer to try to sort through which plan provides the most or least protection, and that’s tough to do.”

More generally, people enrolled in traditional Medicare with supplemental coverage are the least likely to report problems managing their costs, because they have the greatest level of protection, KFF research shows.

Health Care Affordability for Older Adults: How the U.S. Compares to Other Countries, Commonwealth Fund, Dec. 4, 2024, by Munira Z. Gunja, et al.

Nearly a quarter of older adults in the U.S. spent at least USD 2,000 over the past year on out-of-pocket expenses, compared to less than 5 percent in France and the Netherlands who spent an equivalent amount.

Comment:

By Don McCanne, M.D. and Jim Kahn,M.D., M.P.H.

We have long tried to simplify the single payer concept of financing health care by labeling it “Medicare for All,” with the idea that Medicare is a straightforward publicly administered and financed program that serves everyone well. But no longer. These days, it’s a diverse and overwhelming set of options: public traditional Medicare, dozens of supplementary private insurance options (Medigap), and hundreds of private insurance plans (Medicare Advantage) – representing massively complex variation in out-of-pocket costs, benefits, and providers. There is also dual eligibility with Medicaid to assist poor and disabled seniors. Understanding and choosing rationally among Medicare options is impossible.

Simply stated, modern Medicare is a convoluted nightmare that even trained professionals can barely understand. Imagine how intimidated the the average consumer is when receiving reams of information from Medicare, and from private insurers who seek to extract maximum profit from enrollees.

Seniors in other wealthy nations (such as in the OECD) have far superior financial protection for their healthcare, as documented by the recent Commonwealth survey.

What’s behind that success?

  • Seniors don’t need to hassle with intimidating choices. They’re just covered, like everyone else.
  • The coverage is broad and standard. There are no complex and variable rules about benefits, coverage circumstances, and provider panels.
  • Cost-sharing – deductibles especially – is modest. Skipping care for financial reasons is much less frequent, and medical bankruptcy isn’t a phenomenon.

So, we certainly don’t want to keep the current US system with its profoundly complex and expensive administrative excesses that are designed to divert health care funds to wealthy investors while limiting access and choice in health care and leaving millions of people with minimal health care or none at all.

How would US single payer help seniors? Unsurprisingly, it echoes successful foreign practices:

  • Streamlined coverage: Standardize and thus radically simplify the process to obtain insurance. Indeed, nothing would change at age 65 – just a continuation of lifelong insurance.
  • Reduced financial risk: Cover all necessary medical services, with minimal cost-sharing.

US single payer would be equitably funded by using progressive taxes based on ability to pay, ranging from free for those with very low incomes to more generous funding by our billionaires who would be able to fully maintain their current lifestyles with the riches they would retain. Thus payments into the system would be affordable for all.

We would make health care free or nearly so at the point of service, funding the system through global budgets and other rational economic methods that would fairly compensate providers. Physicians, nurses and other health care professionals would be able to devote all of their time to patient care without worrying about their incomes being based on the amount and intensity of services provided.

Everyone would receive the care they needed. It would be both universal and comprehensive.

It would be publicly administered, eliminating the excessive administrative costs and private profits of our current system.

In opinion polling in the US, two-thirds of adults say “yes” to the following proposition: “Would you support the government paying for all health care, if taxes would rise but premiums and cost-sharing would disappear?” Our online household cost calculators confirm that the vast majority of households would save money with single payer.

In today’s massive political upheaval our beneficial institutions – including public insurance programs — are being threatened. How about affordable, comprehensive health care for all (left and right politically)? Wouldn’t that be a giant step toward making America great?

https://healthjusticemonitor.org…

Stay informed! Subscribe to the McCanne Health Justice Monitor to receive regular policy updates via email, and be sure to follow them on Twitter @HealthJustMon.

Dr. Mehmet Oz holds millions from companies that he’d wield power over if confirmed, report shows

By Amanda Seitz and Brian Slodysko
AP News, Feb. 20, 2025

WASHINGTON (AP) — The wealth of Dr. Mehmet Oz, the celebrity heart surgeon nominated by President Donald Trump to lead the Centers for Medicare and Medicaid Services, has swelled in part from for-profit health care companies over which he’d wield significant power if confirmed, according to a newly filed government ethics report.

In the filing, the 64-year-old former talk show host pledged to divest from those companies within three months of confirmation and said that until then, he wouldn’t participate in any matter that could affect his investments.

Oz’s net worth is between $98 million and $332 million, according to an analysis of the disclosure, which lists asset values in ranges but does not give precise dollar figures. Oz shot to fame and made millions off his daytime talk show. His most recent disclosure shows he also holds millions of dollars worth of shares in health insurance, fertility, pharmaceutical and vitamin companies.

Oz said in the filing that he will sell off parts of his significant and diverse investment portfolio, which ranges from retail giants such as Walmart to tech companies such as Apple.

His roster of investments includes up to $5 million in Inception Fertility, a company with a network of fertility clinics; a maximum of $100,000 with pharmaceutical giant AbbVie; and as much as $600,000 with the nation’s largest health insurer, UnitedHealth Group. He also holds up to $5 million with Nvidia, an artificial intelligence company that outfits hospitals.

And his work as an adviser for iHerb, a website that sells health and beauty supplements, has earned Oz as much as $25 million in company stock, which he pledged to forfeit “as soon as practicable but not later than 90 days after confirmation.” He indicated he would also resign from his position with the company if confirmed.

His investments touch nearly every aspect of the health care system, said Lawrence Gostin, a public health professor at Georgetown University.

“He has his fingerprints and his financing all over the health care system, from services to artificial intelligence to medical products,” Gostin said. “It seems to me that those conflicts are so intertwined in his and his families finances, I don’t know how he disentangles himself from it all.”

A spokesman for Oz did not immediately respond to a request for comment.

If confirmed by the Senate, Oz would be responsible for the programs that more than half the country relies on for health insurance: Medicaid, Medicare and the Affordable Care Act.

Medicaid provides nearly-free health care coverage to millions of the poorest children and adults in the U.S. while Medicare gives older Americans and the disabled access to health insurance. The Affordable Care Act is the Obama-era program that offers health insurance plans to millions of Americans who do not qualify for government-assisted health insurance, but do not get insurance through their employer.

As the administrator for CMS, Oz would make decisions on how the government covers procedures, hospital stays and medications in these programs and the reimbursement rates doctors and other providers get for their services.

Oz ran a failed 2022 bid to represent Pennsylvania in the U.S. Senate as a Republican. During the campaign, he called to expand Medicare Advantage, the increasingly popular version of Medicare that’s run by private insurers who have been accused of defrauding the government by billions of dollars through the program.

Before his turn to politics, Oz was a renowned heart surgeon at Columbia University. He rose to fame on “The Oprah Winfrey Show” with appearances where he discussed weight-loss diets, Botox and anti-aging techniques. Eventually, he landed his own show, which was popular but attracted deep criticism from the scientific community. Some colleagues at Columbia University called for his removal over claims he made about products on TV. Senators, too, scolded him during a 2014 hearing over the weight-loss drugs he promoted.

He has formed a kinship, though, with Robert F. Kennedy Jr., who was sworn in as the nation’s top health official last week. Kennedy and Oz have shared concerns over pesticides and unhealthy foods.

Oz’s confirmation hearing to become CMS administrator has not been scheduled.

https://apnews.com…

To Attack Waste, Go After the Source, Not the Patient

By Jay Brock, M.D.
FXBG Advance, Feb. 19, 2025

It looks like President Donald Trump has given the world’s richest man, Elon Musk—who some are already calling co-president—the responsibility for cutting government spending. If Musk were serious, he would start with eliminating the roughly $1 trillion we will waste this year running our very broken health insurance system. It would save the government money, and it would save every taxpayer and consumer money.

We’ll spend around $5 trillion on “healthcare” this year. Of that, roughly $1 trillion is wasted on costs that have nothing to do with healthcare and everything to do with perpetuating a health insurance system that, unlike those in every other advanced nation, has failed to ensure everyone here has affordable healthcare.

Here are some general estimates of what’s wasted: the numbers are approximate to give an idea of the scope of the problem.

  • Administrative costs: $600 billion (in 2019 dollars) wasted in billing and other bureaucratic burdens compared to what those costs would be in a single payer system like Canada’s. Inflation has likely significantly increased that amount.
  • Excess pharmaceutical costs: $100 billion wasted each year—again, in pre-inflation dollars. (Some healthcare experts think it might be twice that amount.) We pay higher medication prices here than in any other nation.
  • So-called Medicare “Advantage” plans excess costs: $100 billion wasted/year, give or take, according to some healthcare experts. These plans are run largely by for-profit mega corporations, companies that have a fiduciary duty to their stockholders to keep profits as high as possible. If this means that as an enrollee you get less healthcare (or none at all, if your insurance claim is denied), so be it. These plans overcharge the federal government—that is, the American taxpayer (you and me)—without producing better clinical outcomes. These overcharges help the company bottom line but detract from enrollee healthcare.
  • Total profits for just the major health insurance companies averaged $25 billion/year since Obamacare was passed in 2010: $371 billion so far.

These wasted dollars are extraneous costs that have nothing to do with any actual healthcare and everything to do with growing both more profits and a bigger medical bureaucracy.

How best to save all that money? Switching to a single payer system would eliminate that trillion dollar waste. That money could then be spent on actual healthcare, cover everyone with affordable healthcare, and still save hundreds of billions of consumer and taxpayer dollars a year.

Instead, the Administration seems to be focusing more on reducing fraud and abuse regarding Medicaid recipients who are “able bodied” but not working than on making sure everyone has affordable healthcare. Trump aims to cut Medicaid funding as one way to allow him to give further tax cuts to the very wealthiest Americans.

Medicaid cuts will mean reducing access to healthcare for the very people who voted for him.

Take just one example: cutting Medicaid funding jeopardizes rural hospitals and increases the risk of their disappearing. According to a report in Becker’s Hospital Review this week, 432 rural hospitals around the nation are at risk of closing. The top five states affected all went for Trump in 2024:

  • Texas: 47 hospitals at risk
  • Kansas: 46 at risk
  • Mississippi: 28 at risk
  • Oklahoma: 23 at risk
  • Georgia: 22 at risk

Arkansas, Mississippi, and Kansas have the highest percentage (approaching or at 50%) of rural hospitals at risk.

Florida, South Carolina, Tennessee, and Missouri are also among those states with the highest percentage of rural hospitals at risk.

Trump won all those states.

Trump’s base is vulnerable to the negative healthcare impacts of reducing healthcare spending to help pay for those tax cuts.

A Hart Research poll last month revealed that about 8/10 Americans opposed healthcare funding cuts in general, including cuts to Medicaid.

You’d never know from last year’s presidential campaign that unaffordable healthcare was a major concern for a huge number of voters: it was second only to inflation as a topic voters wanted discussed during the campaign. With good reason: three-quarters of Americans worry they won’t be able to afford to pay their medical bills if they get sick.

One can make a valid argument that failing to adequately address unaffordable healthcare helped cost the Democrats the election last year: many people may have voted for Trump more out of punishing Democrats than supporting Trump’s agenda. But Trump’s agenda is what we’ve got.

It looks like Trump will pursue his agenda of cutting healthcare funding, thus reducing healthcare access for many Americans, especially affecting his political base. One can only guess how the electorate will react at midterm elections next year—and in the next presidential election in 2028 —if the Trump Administration in its turn bungles this kitchen table issue that is so important to so many Americans.

https://fxbgadvance.com…

Additional Sources

Prescription for Healthcare—What can Cuba teach us about healthcare delivery?

By Rob Stone, M.D. and Karen Green Stone
WFHB Community Radio (Bloomington, Ind.)

Part One (Jan. 4, 2025)

Part Two (Feb. 8, 2025)

PNHP board adviser and APHA past president Dr. Walter Tsou discusses his recent medical education tour of Cuba on back-to-back episodes of the Prescription for Healthcare podcast.

Dr. Tsou describes a system in Cuba that prioritizes primary care and public health, and that achieves remarkable results with significantly less spending than the United States.

In contrast, our profit-focused system “doesn’t work for Americans,” he says. “It costs too much, it covers too few, and it hurts too many people.”

full Dr. Tsou interview (part one):
https://wfhb.org…

full Dr. Tsou interview (part two):
https://wfhb.org…

Would You Fix a Flat Tire by Emptying the Ashtray?

Then why try to fix healthcare without addressing the waste associated with private health insurance?

By Jay D. Brock, M.D.
FXBG Advance (Fredericksburg, Va.), Feb. 5, 2025

You don’t fix a flat tire by emptying out your car’s ashtray. That would be absurd. But when it comes to health insurance, that’s exactly how to describe what those in charge are doing. And have been doing for generations: barely acknowledging the staggering problems built into our present health insurance system, and doing everything except the obvious to resolve them.

And the failure is largely bipartisan. Both parties’ establishments have failed to deliver on the two most important requirements of any decent health insurance system: make it universal, and make it affordable.

While a significant number of Washington Democrats support a Single Payer System called Medicare for All, which would finally make health insurance both universal and affordable, the party establishment scoffs at the idea. Support among Washington Republicans is apparently nil—their attitude seems to be that we can’t have a system that allows people to sponge off the government. So the United States remains the only advanced nation that does not have universal affordable healthcare.

President Obama recognized that no one in their right mind would deliberately design a system like ours. They would instead go for a Canadian-style Single Payer System. But thinking that you couldn’t put the toothpaste back in the tube, and yearning for Republican buy-in that never happened, he opted for incremental change, and we ended up with the Affordable Care Act (“Obamacare”). While the ACA made some significant improvements, they were incremental and failed to make healthcare either universal or affordable. Just one example: out of pocket ACA costs can reach $9200/year. That’s out of reach for too many enrollees, earning the ACA the unfortunate sobriquet “The Unaffordable Care Act.” Yet Democratic leadership still touts the ACA as the way to go. It’s an empty promise.

Regarding universal affordable healthcare, Republicans are even worse. They have tried multiple times to eliminate the ACA and its real if inadequate improvements. A group of House Republicans have recently introduced a bill to repeal the Inflation Reduction Act of 2022—an Act which limits out of pocket drug costs for seniors to $2,000 this year. The Administration is eyeing $3.3 trillion in cuts to Medicare and Medicaid—even though such cuts are unpopular, including with Republican voters.

We are still waiting for President Trump’s “concept of a plan.”

We have, however, heard from Trump’s nominee to run the giant Department of Health and Human Services, responsible for Medicare and Medicaid programs that cover about 4/10 Americans. Robert F. Kennedy Jr stumbled when he said that, regarding who pays for healthcare, “when healthcare costs hit 20% (of the economy) there are no good options, only bad ones…Shifting the burden between government and corporations and insurers and providers and families is like rearranging the deck chairs on the Titanic….Why are healthcare costs so high in the first place? The obvious answer is chronic disease.”

Good on him for recognizing the role of chronic disease. But reducing the cost burden of chronic disease will take decades to accomplish, and we need affordable healthcare now. And talk about rearranging deck chairs: RFK Jr didn’t bother to mention the roughly one trillion healthcare dollars that are wasted each year in accommodating our current failed health insurance system.

That system can’t provide affordable care for the 3/4 Americans who worry about unaffordable healthcare costs. It leaves 100 million Americans owing $200 billion in medical debt and a half million Americans medically bankrupt every year. It’s why GoFundMe’s and free clinics are an integral component of the American healthcare system. It’s why 70,000 Americans die prematurely each year when they can’t afford timely medical care.

None of this would be the case under a single payer system like Medicare for All. It would eliminate that wasted trillion dollars, enable universal affordable healthcare, and still save hundreds of billions of healthcare dollars a year.

The current Administration thinks otherwise. Instead it is on the same path that previous administrations have taken when it comes to establishing universal affordable healthcare: the path to nowhere. Its nominee for head of the Department of Health and Human Services refuses to say that healthcare is a human right. He will likely also push for the further privatization of our healthcare system, which would be a disaster unless you’re ok with your insurance company denying you the care your doctor recommends for you. The Administration intends to do what it takes to cut government spending to fund even more tax cuts for the richest among us: look for cuts to programs for the poor (Medicaid) and for not-so-poor Americans (Obamacare).

Fed up with the system? Worried it could happen to you? (You should be.) Let our smiling Washington politicians know that you disapprove their trying to fix healthcare’s flat tire by emptying out the ashtray. Ask them to support real health insurance reform: Single Payer Medicare for All.

https://fxbgadvance.com…

Key physician groups stay silent on Kennedy nomination

Prominent doctors' groups draw criticism for not weighing in on HHS nominee

By Jessie Hellmann
Roll Call, Feb. 3, 2025

The nomination of Robert F. Kennedy Jr. to lead the Department of Health and Human Services has concerned doctors and public health experts across the world who are alarmed by Kennedy’s decades-long mission to sow distrust in vaccines.

But key groups representing physicians in Washington have stayed silent in the face of what their members call a threat to public health.

The American Medical Association and the American Academy of Pediatrics, groups with tremendous influence in Washington, are among the professional societies for physicians that have not directly weighed in on Kennedy’s nomination — even after last week’s confirmation hearings in which Kennedy refused to unequivocally disavow falsehoods connecting vaccines to autism.

Dr. Ed Weisbart on CareTalk

PNHP national board secretary Dr. Ed Weisbart appeared on the CareTalk podcast on February 3, 2025. He discussed the dangerous nomination of Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services (CMS), and urged listeners to register for a “shadow hearing” hosted by PNHP alongside allies in the health justice movement.

“[Dr. Oz] wants to hand over Medicare to the for-profit insurance industry,” said Dr. Weisbart. “We know that’s an incredibly bad idea … We can’t let this happen.”

USAID Attacked

Elon Musk and his team have been set loose by President Trump to illegally shut down the most powerful US government global humanitarian effort. The financial savings are piddling, the harm massive, the need for powerful response urgent.

U.S. Agency for International Development, Accessed Feb. 3, 2025

“This site can’t be reached”

U.S. Agency for International Development: An Overview, Congressional Research Service, Jan. 6, 2025

The U.S. Agency for International Development (USAID) is the lead international humanitarian and development arm of the U.S. government.

Top Security Officials at Aid Agency Put on Leave After Denying Access to Musk Team, New York Times, Feb. 2, 2025, by Edward Wong, et al.

The two top security officials at the U.S. Agency for International Development were put on administrative lead Saturday night after refusing to give representatives of Elon Musk access to internal systems.

And the agency’s chief of staff, Matt Hobson, a Trump administration political appointee who had started his job days ago, has resigned.

Last week, Trump administration appointees suspended about 60 senior officials and fired hundreds of contractors. Mr. Trump disparaged the agency, telling reporters that it was run by “radical lunatics.” He also praised Mr. Musk as “very smart.”

“USAID is a criminal organization” Mr. Musk wrote in a social media post.

Employees of U.S.A.I.D.’s Washington, D.C. headquarters have been told to attend a Tuesday staff meeting at which they are expecting to be informed of a significant reduction in the workforce. Staffers of U.S.A.I.D. have been given strict instructions not to speak publicly about the staffing cuts or other changes underway at the agency. The U.S.A.I.D. website went dark on Saturday. Some of the signs at the agency’s headquarters have been removed.

ChatGPT, Our Inquiry: What is happening at USAID?

ChatGPT response:

The U.S. Agency for International Development (USAID) is currently undergoing significant upheaval due to recent actions by the Trump administration. President Donald Trump, with support from tech entrepreneur Elon Musk, has initiated efforts to dismantle USAID, aiming to integrate its functions into the State Department. This move aligns with the administration’s “America First” policy and involves a comprehensive review and suspension of U.S. foreign aid programs. (reuters.com)

As part of this initiative, over 100 senior career staff members at USAID have been placed on administrative leave. This action followed an incident where two senior security officials were removed after attempting to prevent personnel from Musk’s Department of Government Efficiency (DOGE) from accessing restricted areas within the agency. Musk has been vocal about his desire to dissolve USAID, describing it as a “criminal organization” and asserting that it is beyond repair. (politico.com)

The agency’s online presence has also been affected; its main website and social media accounts have been taken offline. Additionally, USAID employees at the Washington headquarters received unexpected instructions to stay home, further indicating the agency’s uncertain future. (cnn.com)

These developments have raised concerns among international partners and humanitarian organizations that rely on U.S. aid. Critics argue that dismantling USAID could undermine global humanitarian efforts and diminish U.S. influence abroad, potentially creating opportunities for other nations, such as China, to expand their reach in international development. (bloomberg.com)

In summary, USAID is facing a transformative period marked by administrative restructuring, staff reductions, and a reevaluation of its role in U.S. foreign policy. The full implications of these changes are still unfolding and warrant close monitoring.

Comment:

By: Don McCanne, M.D. and Jim Kahn, M.D., M.P.H.

Yesterday’s Health Justice Monitor discussed the human suffering caused globally as President Trump halts US foreign health aid. Today’s report describes the latest development: destruction of the US Agency for International Development (USAID), charged with providing other nations with desperately needed humanitarian assistance. The cost is only 0.6% of our federal budget; the yield in human benefit and international good will is incalculable.

Global health spending in USAID is $7 billion, with a similar amount in PEPFAR, together just 0.2% of the US federal budget. Recently, Trump also undermined global public health capacity by exiting the World Health Organization.

These actions were taken incredibly rapidly, in the 14 days since Trump returned to the White House. They are illegal (disbanding approved programs) and counter to the interests of our nation. Trump is keeping and exceeding his promises, all to benefit his government-hating billionaire supporters. In the process he is destroying US democratic governance and the post-WWII international order. Consistent with the most dire warnings during the election.

This situation constitutes an EMERGENCY: without action on our part, we will see democracy rapidly crumble around us. We must immediately respond, of course without the violence that they are wreaking. Nonviolent massive demonstrations, lawsuits (already happening), and demands that the president and his crime partners resign or face impeachment. And insistence that the Supreme Court clarify that actions taken in defiance of constitutional duties are criminal. The exact shape of the resistance is not yet clear, but we urge creativity in saving our democratic government and fostering humanitarian and national health. Failure to act quickly and powerfully will result in damage that will take decades or even longer to repair.

Enough of mere contemplation of the politics of this disastrous situation. We need ACTION!

https://healthjusticemonitor.org…

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