Thread by @doctorow

US healthcare is the worst of all worlds. Unlike other wealthy countries, the US leaves insurance to the private sector, where your health and your life come second to profits. Worse: the majority of "private" insurance companies earnings come from public subsidies. 1/

If you'd like an essay-formatted version of this thread to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

pluralistic.net/2022/10/13/sic… 2/

In other words, the US has a privately run health care sector that is publicly financed, without any public accountability or duty to the public good. Insurance companies take ever more billions from the federal government and deliver ever less care to their customers. 3/

Cigna-exec-turned-whistleblower @wendellpotter has just published a new report that breaks down share of federal subsidies in the largest US insurers' bottom lines

wendellpotter.substack.com/p/the-majority… 4/

Public subsidy as percentage of revenue:

* @Humana: 91%
* @molinahealth: 89%
* @Centene: 86%
* @Aetna: 73%
* @UnitedHealthGrp: 72%
* @ElevanceHealth: 68%
* @Cigna: 42%

See that? The *vast* majority of US insurers' income is public funding. 5/

That's because of #MedicareAdvantage, a privatized Medicare service that 27 million older people have been tricked into signing up for, which consistently delivers worse service with higher out-of-pockets, while billing the US government for billions. 6/

You should not sign up for Medicare Advantage, nor let anyone you love do so. Medicare Advantage will deny you care you are entitled to and leave you to sicken and die, while draining the last of your savings in co-pays:

nytimes.com/2022/04/28/hea… 7/

The insurers aren't done. They raised their prices *by 24% in a single year*:

wendellpotter.substack.com/p/the-price-of… 8/

Despite these massive profits, spiraling fees, and mounting premiums, the Biden admin is on track to let the insurers raise their prices *again*, though not by as much as originally announced:

cnn.com/2022/09/27/pol… 9/

The health insurance scam isn't limited to Medicare. If you've got an #ObamaCare subsidy, you are helping to transfer billions in public money to insurers, even as these #ACA plans grow steadily worse. ACA plans deny *one in five* claims:

kff.org/private-insura… 10/

Meanwhile, the out-of-pocket expenses your ACA insurer can rook you for just went up to $14,700/year:

healthcare.gov/glossary/out-o….

ACA coverage is so poor that many of the people paying for it are best understood as #FunctionallyUninsured:

forbes.com/sites/forbesbu… 11/

ACA was sold as a brokered compromise between public healthcare advocates and private healthcare cultists. 12/

It created a situation where private insurers could grow larger, more powerful, more profitable, and less accountable to government, patients or doctors, so that care would steadily erode and prices mount. 13/

ACA set the stage for Medicare privatization through Medicare Advantage. It teed up a future where we finally get the wildly popular #MedicareForAll, delivered by the same murdering profiteers it was supposed to replace: Medicare *Advantage* For All. 14/

As @davidsirota writes in @LeverNews, Biden's 2020 campaign promised a public option where "premiums could be substantially lower than those of private plans," but "Biden hasn’t once mentioned a public option since becoming president."

levernews.com/health-insurer… 15/

When Congress gives billions in public money to the health insurers, it also gives millions to *itself* - Congress is awash in health insurance company dark money, and Democrats - including some in the Progressive Caucus - are carry its water:

bettermedicarealliance.org/wp-content/upl… 16/

Giving for-profit insurance companies more public money will not translate into better care. The CEOs of every one of those publicly subsidized insurance companies took home *more than $20 million* in pay last year. 17/

86% of Centene revenues came from the public coffers. Its (recently deceased) CEO Michael Neidorff paid himself $20.6 million. 18/

It doesn't have to be this way. We know how to fix this. Biden laid it out in 2020: "Give Americans a new choice, a public health insurance option like Medicare."

joebiden.com/healthcare/

People are angry at their insurers, and justifiably so. 19/

Cigna isn't just raising prices and co-pays, it's committing fraud: "exaggerat[ing] the illnesses of its Medicare members to obtain higher payments from the federal government." Also credibly accused of Medicare fraud: Unitedhealth and Elevance.

modernhealthcare.com/insurance/doj-… 20/

In 2019, I published *Radicalized*, a collection of four novellas subtitled "four tales of our present moment." The title story, "Radicalized," was frightening and upsetting to write, but I couldn't stop myself. 21/

It's a story about angry men who watch the people they love the most slowly and agonizingly murdered by care-denying insurance companies, who meet on message boards where they plot to murder health-care executives.

us.macmillan.com/books/97812502… 22/

Having grown up in Canada and then spent more than a decade in the UK - and now become a US citizen - it's incredible to me that Americans tolerate this ghastly, worsening system. Not that I *want* to see terrorist violence! The very idea is sickening and terrifying. 23/

But it is baffling to me that there are Americans who shoot each other over road-rage and yet as far as I know, the $20m/year vampire CEOs of profiteering, fraud-addicted insurance companies are living in comfort and safety. 24/

It's one of the great paradoxes of the American psyche: all of that macho, don't-tread-on-me posturing turns to vapor when the person who's literally condemning your family to die is a distant corporate executive. 25/

All that anger has to be out there, somewhere, channeled by cynical operators into scapegoating and nihilism. It's a ticking time-bomb. 26/

Imagine the political win that would accrue to the party that made *saving your life and the lives of the people you love* its political centerpiece. 27/

A party that met astroturf with naming names, hauling insurance execs into Congress to confront grieving mothers, fathers, children and spouses. 28/

A party that refused to let Lucy yank the football again with a "compromise" that gives us a privately managed, publicly funded service that only serves shareholders and executives. 29/