Medicaid: Last Week Tonight with John Oliver (HBO), (28 minute video), April 18, 2024
John Oliver discusses why millions of people have been kicked off of Medicaid, why Medicaid access was difficult even before the current “unwinding”, and what would happen if fruits and vegetables could talk.
[Alert: Oliver uses profanity for emphasis]
Comment:
By Jim Kahn, M.D., M.P.H.
It’s so tragic it’s comic. Medicaid – health insurance for 90 million US poor – is a vivid example of the chaos and inefficiency that result when a program is designated and designed for individuals who lack political power and social standing. The beneficiaries are disrespected and poorly served. As HJM discussed, in most states private “managed care” insurers exploit the massive Medicaid cash cow to extract profits via restricted services and higher government spending. This essential health insurance lifeline is frayed.
What we need is a public insurance system that serves everyone, and thus is subject to natural quality control. Everybody needs it, so it works. Think social security, fire departments, and highways. They function well, fulfilling important societal functions.
In the health insurance arena, that’s single payer / Medicare for All. Successfully implemented around the world. Generous, equitable, and efficient. Advocated by John Oliver.
Oliver’s plea in this video for better management of Medicaid unwinding is appropriate, but IMO doomed to succumb to the dysfunctional dynamics of the Medicaid system. Hence my – and Oliver’s – plea for real system reform.
Universal public insurance is a heavy political lift, due to all the private entities – most of all insurers – who will lose tens of billions in profits. So we need to keep up the fight. John Oliver is our best cheerleader.
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