Summary: Dr. Glaucomflecken and John Stewart offer a master class on how to concisely convey what’s wrong with US health insurance and why. A dozen 2-minute videos.
Dr. Glaucomflecken, 30 Days of US Healthcare, September 2023, videos (2 min each)
Deductibles
Co-insurance
Surprise Billing
Pharmacy Benefit Managers
Insurance Kickbacks [to PBMs]
DIR Fees [PBM fees on pharmacies]
Out of Pocket Maximum
Hospital Price Transparency
Payment Processing Fees
Family Medicine Negotiates with UHC
And … An American Gets Health Care Abroad [2022]
Medicare and Corporate Lobbyists in Congress [600 lobbyists: no drug price negotiations part D], The Problem With Jon Stewart, August 30, 2023
Comment:
By Jim Kahn, M.D., M.P.H.
Health policy discussion is often laden with technical jargon. Dr. Glaucomflecken’s amusing skits (in which he plays all roles), and John Stewart’s interviews provide an excellent antidote – they distill fundamentals into biting 2-minute snippets.
Here’s a quick tour of the story they tell, progressing through the videos …
1) Problems with current insurance.
The health insurance “job benefit” actually lowers salary (the worker is paying!). The insurance seems barely worth it … First comes the deductible … thousands of dollars before coverage kicks in. Followed by co-insurance and surprise billing (incompletely resolved with recent legislation, eg ambulances omitted). Pharmacy benefit managers (owned by insurers) manipulate the drug formulary and payment process to extract profits, including dropping generic drugs in favor of brand name (and overcharging for generics). Finally, you hit the out-of-pocket maximum – but beware non-network and excluded services. No wonder medical debt is sky high.
Hospital price transparency is a farce: ignored and incomprehensible for consumers. Electronic billing (efficient, right?) is an excuse to impose a 5% processing fee on providers.
And, the insurers are buying up the doctors.
2) There’s a better way abroad.
In all other wealthy nations, everyone is covered with little or no cost-sharing. Pick your phrase: not rocket science, known technology, best practices.
3) Why, then?
Because, as Stewart says, health industry lobbyists and the donors who hire them control Congress. See the PBM video too – if you earn enough money, you make the laws. Is the Inflation Reduction Act, which the drug companies so hate, a harbinger of real reform?
It’s time for the people to dismantle the fragmented and dysfunctional system in favor of a simple approach that works for patients – single payer.
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