Yves here. While this article correctly calls out the cancerous growth in US health care costs, it sadly over-estimates the degree to which a Medicare-for-All program would be an effective counter. Consider the practice of the smaller drug buyer, the Australian Therapeutic Good Administration. TGA staffers read medical research relentlessly. They select, for most ailments, a single medication for treatment. They often reject the latest whiz bang improvements, such as a newer once-a-day slow release version versus a three-times-a-day original, because the newer formulations do not improve medical outcomes. But they do count as FDA “new drug applications” and allow for extension of patent life, as in preserving premium pricing.
The TGA, by concentrating its buys across fewer medications, winds up having much bigger orders for them. It then bargains hard.
Now one can argue that the result is less choice. But the result is effective medications purchased at much lower price than in the US.
Pom-pom waving for Medicare (and other big buyers of medical services in the US) ignores that too often they are price takers (or even worse, hostages of the corrupt scheme known as Pharmacy Benefit Managers).
This article mentions but does not adequately register the significance of its opening observation, that the big driver of the private insurance increases is the cost of cancer and super pricey GLP-1 medications, as in Ozempic and Wegovy.
So what is Medicare’s solution to their costs? Having requirements so that most patients can’t get it. From IM Doc via e-mail:
This may not warrant attention like the Iran War. But something is happening to regular citizens that is just making LOTS and LOTS of people overwhelmingly pissed off.
Imagine having your face filled with ads, social media, TV shows, etc for 4 years of all kinds of people taking a new drug. GLP-1s. To Lose weight. Imagine yourself going to your MD to get an Rx – only to discover it is $1400 a month – which was the cost just a few months ago. And your insurance and Medicare do not pay a dime. Imagine the rage.
Then your relief as it is announced that Medicare will cover these drugs starting July 1. Ads everywhere – Trump on TV stating THEY ARE FREE. ….. And then your MD gets the inclusion and exclusion criteria – for the “Medicare GLP-1 Bridge Program” – only to discover that added together – all the exclusion criteria pretty much excludes 95% of the population. In other words, fatso, go away and die. For example, if you have or EVER had a diagnosis of sleep apnea, you are disqualified. Since most obese patients have OSA – out they go.
This is the lamest thing I have seen in some time – and that is saying something. The amount of people absolutely pissed is just breathtaking. One of the biggest self-owns in the history of Pharma. And Trump is rightfully getting all the blame.
Just thought you would like to know. As soon as I can – I can send the CMS documents sent to us as practicing MDs.
I did not ask for the backup but I am sure it makes for instructive reading.
So the underlying issue is that many Americans are in less than very good health due to poor diets, too much stress and social engagement, too little exercise, not great sleep habits….even before getting to many are also on psychoactive meds to get thought the day in our precarious, predatory system. Those drugs often have health effects when taken long term, like the prototypical SSRI 10-20 pound weight gain. The impulse behind Make America Healthy Again is sound, even if the implementation showcases a lot of dodgy health fads. Having more American work normal and regular work days, as oppose to (for lower income workers) being subject to erratic schedules and the stress of precarity, and for higher income ones, 24/7 on call expectations, would make a marked dent in the health crisis. More free time would mean more ability to participate in social activities (a big stress reducer) and better care for families, exercise, and even perhaps prepare fresh food more often. But that means upending the neoliberal “no rights for labor” paradigm. Can’t have that!
By Brett Wilkins, staff writer at Common Dreams. Originally published at Common Dreams
US workers with employer-sponsored health insurance are expected to spend an average of $5,297 on health care this year, including premiums deducted from their paychecks, deductibles, and copayments, according to a new estimate from benefits consulting giant Aon reported Thursday by The Wall Street Journal.
That’s $388 more than last year, and the pain is expected to intensify in 2027. According to a survey conducted by WTW, another consultant, US employers anticipate their health care costs will soar 11.1% next year. That could be the steepest increase in more than two decades, and would mark the fifth consecutive year of rising employer health care costs.
As the Journal noted, expensive cancer treatments and widespread adoption of weight loss drugs are among the factors driving up spending—and costs. For workers, that means larger deductions from their paychecks, higher out-of-pocket costs, and, for some, abandoning insurance altogether.
“Employers are telling us that this is utterly unsustainable,” WTW population health leader Jeff Levin-Scherz told the Journal.
Jason Wilburn, co-owner of Paul Wissmach Glass Co. in Paden City, West Virginia—which employs 35 people—said that the company has endured double-digit premium increases every year since 2021, with health care costs now accounting for 5% of revenue. That’s a higher percentage than the company’s margin of profit.
To cope, Wissmach Glass Co. increased its biweekly payroll deduction from $40 to $50 per worker, even though the company is still paying about 90% of the total premium. The increase has resulted in some employees deciding to drop their coverage.
“It’s frustrating and sad,” Wilburn told the Journal. “Something’s got to change.”
Democrats cited the report in a statement Thursday, noting that President Donald Trump and Republicans “have spiked health care costs for millions of Americans.”
“First, they cut Medicaid by nearly $1 TRILLION—the largest cut to health care in history—to pay for tax cuts for the ultrarich,” the party said, referring to the so-called One Big Beautiful Bill Act signed by Trump last year. “Then, they refused to extend the enhanced Affordable Care Act premium tax credits, hiking premiums by an average of 58%.”
“Trump and Republicans’ cuts have already forced 3 million people to drop their coverage, with more expected to drop coverage in the coming months as premiums are expected to see another double-digit increase next year,” the Democrats’ statement continued. “More than half of Americans already could not reliably afford health care in 2025—a five-year low—and nearly 1 in 4 American workers report staying in unwanted jobs just to maintain consistent health insurance.”
“Donald Trump and Republicans’ endless cuts to health care have jacked up costs for millions of Americans,” Democratic National Committee spokesperson Jaelin O’Halloran said. “Everyday Americans are dipping even further into their savings and taking on record amounts of debt to afford a trip to the doctor’s office or lifesaving medicine—and Trump doesn’t care.”
“While Trump prioritizes his White House vanity projects and tax cuts for the rich, working families are pinching pennies to pay their medical bills or forgoing health care coverage because they can’t afford it—and they will hold Trump and Republicans accountable in November,” O’Halloran added, referring to the upcoming midterm elections.
While progressives have long argued that the solution lies in decoupling health insurance from employment, Democratic leaders remain loath to advocate Medicare for All or other universal health care options. Just this week, House Minority Leader Hakeem Jeffries (D-NY) reaffirmed his opposition to Medicare for All, a position at odds with 90% of Democratic voters surveyed in a new CBS/YouGov poll.
As Common Dreams recently reported, a recent Yale University study found that Medicare for All—as proposed in legislation introduced by Sen. Bernie Sanders (I-Vt.) and Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.)—would save over 114,000 lives annually and $1 trillion per year in US health care spending.
Rep. Ro Khanna (D-Calif.) cited that study in an interview on Sunday in which he refuted Jeffries’ stance.
“Medicare for All is arguably the most important priority,” Khanna said, calling for a vote on Sanders’ bill. “It would save money, and it would save lives.”
One would think that “population health” should be considered a national security concern, inasmuch as military personnel and the domestic military industrial workforce are drawn from the population.
Perhaps that’s the only framing that could incentivize our rulers to make population health a policy priority.
Capitalism’s demands for greater profits will inevitably hollow out the society that hosts it. Refusing to reign in corporations means a societal health epidemic, cutting corners on important infrastructure and equipment, and ultimately a society and government that can no longer maintain the structures necessary for capitalism to function.
FDR tried to save the oligarchs from themselves with “hey you can still be wealthy, but you can’t run the country”, and they threw a tantrum and proceeded to fund American fascism to undermine him, both when he was alive, and after he died.
Medicare for all means people might draw SS benefits for their longer life. Can’t have that.
Coincidentally I posted recently on links about how Medicare for all is just the start, a great problem is all the parts of the system run for maximum profit.
For pharma costs the right reform is in my opinion Delinkage. The idea is simply to not give pharmaceutical companies monopolies through patents. Instead R&D is financed directly through a mix of price money and direct financing from governments. All medicine enter the market as generic drugs and drug manufacturers are free to compete for markets in production.
Delinkage was on the WHO agenda during Obama. China and the global south were supportive and willing to pay their share. US and allies used some procedural shenanigans to shot it down. But the idea is still sound.
It has always struck me that the private sector, if they were actually concerned about health insurance costs, would be advocating for Medicare for All or similar solutions, but appear to be entirely absent from the political process. I believe that employer-provided health insurance serves to drastically increase the “power of the sack” and the more nose-bleed premiums are, the greater the power over workers. Therefore, I don’t see where the army of lobbyists necessary to overcome the army of lobbyists arrayed in favor of health insurers and providers comes from, and if there is no army of lobbyists in Congress, especially on economic matters, the result is more performance art from progressives.
There is a means to change health care which can be accomplished from the state-level: allow people on the exchange to buy Medicaid policies at cost. This has not happened at the State-level anywhere because health insurers recognize this would be the kiss of death, and lobby their hearts out against it. However, it could be instituted tomorrow, wouldn’t cost a dime in taxes, and would be the start of finding a replacement for employer health insurance.
That’s part of it, but also the people running the private sector are typically not very smart and so don’t connect the very obvious dots.
Seems to me that Medicare for all, or a reformed Single-payor system, cradle to grave, including dental and optical, would be a no-brainer for the smartest guy in the room business-owners and CEO/ CFO types.
Shift the burden to guuvy and workers.
EXCEPT, employers then lose the dominant role in employer/ employee relationships: the benefit of health insurance becomes de-linked, employers lose power. The grip of benefit package handcuffs loosens. Employees shop employers with a different lens.
The morality of lording health care /insurance over working folks is evil of the highest degree.
Folks should all become independent contractors, and see the world from the lens of starving artists, sole proprietors?
After I became responsible for my own health insurance (sic) when I was 19 years old, it occurred to me that I was connected to my job for that reason. At the time, my yearly BCBS deductible was $100 (~$641 today). No expenses at all after the deductible was met. Emergency room visits were covered 100% (that dislocated ankle was “free”). Turns out I loved my laboratory job, so I wasn’t “locked in.” But even then I realized I was one of the fortunate few.
A couple of years later (1977 or 1978) at a meeting of a predecessor of DSA in West Virginia, the late, great Michael Harrington talked about “job lock” and how it was used by business to keep labor on the leash. Of course, it is! And it is “evil of the highest degree,” recognized long before the Neoliberal Dispensation took root.
Your article seems to make two assumptions:
1) The current medical system and the drugs they offer – and basically they offer drugs and surgery – are effective.
2) That the current medical system is the only choice. It is that, or die. (FWIW, I have been offered just that choice – take our treatment or die – by a couple of doctors now, and have walked out. I am still here, and healthier for doing that.)
That was the choice you offered to “fatsos” – take the drugs or die. There are other options.
There are now an increasing number of people who are turning elsewhere for medical help when needed, and who do all possible to avoid working with the regular medical system. There are alternate forms of treatment, and there are numerous forms of self care if you are willing to put in the time and research to find them. (A lot of people woke up to that during the worst of the covid psychosis.)
It is also true that many of the standard medical treatment regimens – like our system’s barbaric,sadistic and ineffective cancer treatment regimen – are not only not the only choice, but are well worth avoiding.
As the economy continues to erode and fall apart, more or less rapidly, the current bloated and corrupt medical system is falling apart with it. For an increasing number of people, turning to other options will just be a necessary fact of life.
Your preaching tone is unwarranted,
I have experimented extensively with diet, exercise, alternative medicine and also use traditional doctorsl
I have found alternative medicine to have many well-meaning frauds. Too often treatments might work but did not on me even though they seemed sincere. I have seen many many acupuncturists (in three countries!) and go no more than 24 hours of inflammation relief, as in barely worth the bother. Homeopathy was a bust. Ayurveda seemed to help but you have to turn your life over to ayurveda, as in strictly adhere to its many requirements, which is very difficult if you have a tough schedule. An osteopath badly sprained an ankle. Two years of Alexander Technique from the best instructor in NYC did not change how I stood or walked, Neither did Rolfing.
I have found chiropractic to be beneficial
I did have a couple of very woo-woo practitioners do me some good but neither was in any recognized school of alternative treatment.
So shorter: I have had more consistent success with conventional medicine. If you made me choose, I would opt for it.
The way it appears: In the US there is no financial incentive for a healthy population. The more unhealthy people, the more people can be extorted. In total, the US has the most expensive health care in the world, by a big margin. The US also has the worst health outcomes in the entire OECD and even some developing countries.
I agree, Medicare for All is not a panacaea in fixing the extortion racket (aka “health care”) there are many more flaws (feature, not a bug) to be sorted out as Yves points out. Nevertheless, I don’t see much chance of any reform for the better.
The oligarchy has no incentive to alter their extortion racket. Ro Khanna, Sanders and a few others know that any meaningful reform has little chance of passing both houses and being signed by the emperor.
I recall back in 09, 10 when the Ds had both houses and Obama in the WH the Obama/Pelosi team said “single payer is off the table”. That should have made it clear that the D faction don’t have any interest in altering the status-quo. And the so-called ACA (subsidies for insurance oligarchy) was passed and was dressed up as a “win” for the D faction. This smelled like more kleptocracy.
If US folks want more affordable and better health care, they will need to seek it elsewhere.
Unfortunately, the population explosion and global labor arbitrage have destroyed the bargaining power of those who must work for wages. Stress, obesity, substance abuse, and exhaustion all contribute to shorter life expectancies (the USA now ranks 63rd in the world). Since 2005 High-Deductible/Savings Option plans have come to dominate the employer-provided health care that “covers” 60 percent of wage workers in the USA, throttling access to anything more than end-of-life palliative care whether you have “insurance” or you don’t.
Our Billionaire Overlords and their Professional/Managerial Caste factotums profiting from this system want us all dead anyway; it’s the simple solution to anthropogenic climate change. More room for you and more room for me!
Re: Health care costs
“. . . this article correctly calls out the cancerous growth in US health care costs, it sadly over-estimates the degree to which a Medicare-for-All program would be an effective counter.”
Hmmm? I’m unclear how explicating Australians management of pharma explains why MfA would not be a massive improvement over our present extractive system. Perhaps the assumption is that the same forces that own the present system would own MfA. If we’re in a TINA situation, then the “choice” is between continued submission to exploitation and revolution that seems to overturn the entire system. I say “seems” because a revolution would likely end up no more than a clash of which oligarchs would run whatever the revolution wrought. Shades of the marriage of Michel’s iron law and Pareto’s circulation of elites.
I hate to come down on you, but this comes off as your need to see Medicare for All as a panacea is undermining your reading comprehension.
The story says the reason for the increases in private insurance costs is increased drug prices.
Medicare is no solution, or more accurately, its solution is to restrict coverage of costly drugs FAR FAR more than employer plans do.
And on top of that, many doctors do not take Medicare, so as a patient, you face restricted choice. Of the four doctors I still occasionally see in NYC, only one accepts Medicare.
Reading a great book by Ian Frazier, “Great Plains”. He apparently was a fact-checking proof-reader at the New Yorker, which I learned reading a fun essay by John McPhee about the rigorousness of New Yorker Fact checkers. Anyhoo, Frazier was recounting some of the lore and sterotypes of the various tribes. One tidbit regarding the Crow- and it made me think of AI Tech Broligarchs, broligarchs in general, and now Big Pharma Big Med, Big ” Health Insurance” :
When asked by a Trader why the Crow did not kill the whites, they replied,
“If we kill them, there will be fewer to rob” . The self-licking ice cream cone business model in modern western capitalism.
Yell F.I.R.E. !
An amusing quote, heavily mediated by the fact that 1) the Crow were accomplices to State/settler expropriation and murder in the Northern Plains, and 2) in spite of that, in the end things still didn’t turn out well for them.
And, yes, Ian Frazier is a wonderful writer.
Most native Americans were going to be eliminated by disease no matter whom they consorted with. It was small pox not small bullets that killed a majority of natives.
Medicare for All would be an improvement, but it’s not the best solution. It may keep some people from going bankrupt, but it doesn’t stop execs in the healthcare industry from becoming squillionaires by profiting from the sickness and misery of others.
The entire healthcare industry needs to be socialized and nationalized. Health insurance companies need to go the way of the dodo – no more rich executives. That being said, I have no problem whatsoever paying taxes to ensure that the people doing the actual work, the doctors and nurses, are very well compensated.
Not looking for an “improvement”.
Looking for health care. The time for talking about “improvements” is over.
And, no, no more rich doctors either. Doctors should make a good middle class living, after accounting for their education and training, nothing more. Nurses should be paid better especially considering most Americans seldom get to see an actual doctor, more often nurse practitioners.
Doctors should be comfortable, but not to excess. By contrast, nurses and nurse practitioners should be made more comfortable than they currently are, because they do the work.
Yes, and nurses also need more professional autonomy and to be relieved of the brutal micro-management they are forced to endure.
It was an urgent care physicians assistant (PA) who resolved my recurring pulmonary issues and debilitating cough over the last 3 months. He recognized that a sinus virus was the culprit and proffered a daily nasal spray each morning. Issue resolved in 10 days.
My PCP was out-to-lunch. I would look for a new one but private equity control both available health providers in my location.
In the original Expanded and Improved Medicare for All bill HR 676 introduced by John Conyers every year from 2003 to 2017 private insurance wouldn’t be allowed to cover anything covered by M4A (which was everything – medical, dental, vision, drugs); provider entities would have to be public or non-profit; drugs, medical supplies, and devices would be covered with prices negotiated annually by the government; and there would be no cost sharing. There’s a section on how reimbursement to providers would be determined. I don’t know if all that is still the case in subsequent versions with different bill numbers or if it’s what the younger cohort of M4A proponents envision.
https://en.wikipedia.org/wiki/Medicare_for_All_Act
https://www.congress.gov/bill/108th-congress/house-bill/676
“Medicare for All would be an improvement”, hell, free witch doctors for the working poor would be an improvement for many in our lumpenprole”cariat.”
In 2010 or so I took a class on health care law from a professor who flew up to Washington, D.C. every week to consult with the Dems working group on the ACA. She (they) really believed it was a stepping stone to having the employers turn around and dump the issue on Congress, i.e. a round about way to get the Employers to push for a Congressional takeover. At least, that was the impression I got from her over several conversations. My own gut hunch is that is how it was sold to those in the working group, but something far more cynical took over.
At this point, someone’s Babe the Blue Ox sized ox would be gored by a government takeover of the industry, i.e. Medicare for all, and those folks will fight to the death to defend their “exorbitant privilege” (apologies to De Gaulle). Who knows, wouldn’t it be ironic if a collapse pushed by the Iranian war fallout and magnified by the 2026 version of World Com/Enron collapse, I mean the AI industry, helped put the people in Congress necessary to pass Medicare-For-All?
Can we now finally and fully admit that the ACA, “Obamacare” was a conscious abandonment and betrayal of the Democrats and Barack Obama?
At the time the Unaffordable Health Abandonment act was first introduced and finally passed, I was screaming on any Democratic Party fora I could find that it was an insurance company sellout.
After it passed, every loyalist Democrat I knew swooned, saying how much it helped themselves. They also propagandized repeatedly that they would make it better over time. When I said that’s not how politics works, they laughed and said they knew better.
I never personally saw any help from it other than the pre-existing conditions issue, because I did not fit the narrow criteria and I could not afford Obamacare at the time. And when I said so and that it was a treasonous sellout, I was banned from those fora. Because they got what they wanted for themselves, you see, and nobody else mattered.
It was because of ObamaUncare that I became an independent. They not only destroyed health care, they destroyed the Democrat Party.
Obama was destroyed in the 2010 midterms because of his disastrous surrender to the insurance lobby. And now they can’t get above 50% against hardcore fascists like Trump. I actually voted for Obama in his first term. After Obama’s first term, I not only stopped voting for him, I stopped voting for Democrats altogether.
Yet to this day the Democrats fail to take responsibility and wonder why they can’t beat the lowest of the low MAGA types.
This is what the Democrat Party is and why it can never succeed, because Democrat Party politics are about greasing the wheels of specific groups — mostly corporations and lobbyists — and never about benefiting everyone.
The entire health denial system needs to be scrapped and rebuilt, especially because we have separate health denial systems covering specific groups of people. Medicare. Tricare. Obamacare. Medicaid.
This Must End. We need a National Health Service, and another act to sweep up these goons. And the specialist blood profit seeking blood suckers targeting each system find refuge in systems like these, much like cockroaches find places to hide among cracks in homes. Time to sweep up the cockroaches.
Companies like UnitedHealthCare need to be nationalized and their workers put to work doing productive health care so nobody goes unemployed.
As for their executives? I know what should be done, but for the moment, their own unemployment is good enough. It’s good enough for me that health care finally starts working in America.
Who is “we” here? We were critical of Obamacare while it was being drafted as a gimmie to health insurers and Big Pharma. The bill was written by an industry lobbyist!
I agree, I should define what I mean by “we” in this context. I am not directing my fire at NakedCapitalism.
I fully respect that you were critical of the Obamacare sellout when it was first being formulated.
I am talking about political accountability from those who did celebrate Obamacare.
There should be entire episodes from people who backed Obamacare at the time, taking responsibility for their failure.
Many people who were then Democrats were vociferously opposed. Myself included. There were people such as a DailyKos writer who went by the nickname ‘nyceve’ who were attacking the scheme from the beginning.
What I mean by “we” is the many faux progressive social media sites and “progressive” media who still cannot grapple with the incredible disaster that Obamacare was.
And I also as “we” those individuals who got theirs from Obamacare regardless of who was excluded. Can they now admit that their calculation was a disaster? I have not heard much from that group.
And of course we cannot forget Joe Lieberman.
TLDR the time for talking about Medicare For All is a sellout in its very formulation.
We don’t need copays and deductibles and Medicare taking 20% from everyone except now just taking 20% from seniors. No senior citizen should be paying one red cent for the health care she needs.
Democrats came up with the phrase by doing their focus group thing and finding “Medicare” as a word popular. When confronted now, Democrats will say ‘Oh, no no, we’re talking about IMPROVED’ Medicare For All’.
Medicare is DiscountCare. That is what it is. You get some health care at a fraction of the price but if you don’t pay you’re still pursued for medical bills you can’t pay. And then you’re dinged on your credit report because you didn’t pay some doctor somewhere. And, yes, it would cover everything, and what is required for the people who need it.
The time for such messaging and telegraphing is over. It’s time for a National Health Service that covers everyone for all basic health needs without any payment at the point of service, covered by taxes, and taxes on the wealthy most of all. It would be a payroll deduction as Medicare now is.
The main problem with Medicare for All is that it would not be politically tolerable in the US for it to be Only Medicare for All. Too many people (who vote) like the line-jumping capability that “good” health insurance gives them.
All you have to do is look at the rhetoric surrounding the “endless lines” in Canadian health care – while there can be long waits, these are for unnecessary, quality-of-life treatments that are adequately managed in the short term. This allows resources to be allocated by a triage system, rather than by ability to pay.
Unfortunately, wealth being power has ascended into a quasi-moral principle in the minds of a large chunk of Americans, and there are enough to be a veto on any substantial reform propositions.
From personal experience, I concur with the article that Medicare for All, while somewhat of an improvement, would not solve our ever increasing healthcare costs and problems with accessibility. I’m fortunate enough to have very good coverage for my family by USA standards – a Blue Shield California Medicare PPO through CALPERS after working 14 years in state service. However, premium deductibles have increased almost every year like clockwork, with a greater annual percent increase in recent years, likely exacerbated by Obamacare. These premium increases not only negate any cost of living increases, but often reduce my take-home income from the year before. And speaking of accessibility, after a recent diagnosis of sleep apnea, the earliest available date I can see a specialist for a followup is April 2027.
This trend cannot continue, and per the phrase I learned here on this site if something can’t continue it will stop. The ideal would be some form of universal healthcare as a public utility with price controls, an increase in the training and employment of doctors, nurses, and other healthcare professionals, and reduction of administrative bloat.