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luigi mangione
Improved Medicare for All Can Heal This Sick Country
A system that collects money from patients and employers then profits by withholding the promised care is not a business but a fraudulent, diabolical scam.
Jan 17, 2025
It’s the beginning of the end for corporate control of health care. The tsunami of outrage against the health insurance industry in the wake of the shooting of United Healthcare CEO Brian Thompson, can propel an urgent, unyielding demand for the removal of profit from healthcare and the enactment of a universal, national single payer system. That is, if the single payer, Medicare for All, national health service movement can summon the vision and audacity to rise to the occasion.
The myth, promoted by health care think tanks and policy experts, that people in the United States are satisfied with their health insurance was exploded in the social media rage unleashed in the aftermath of the killing of the United Healthcare CEO.
Fifteen years after the passage of the Affordable Care Act (ACA), our failing health care system is exposed with all its cruel denials, debt, disease, despair and death at the hands of the investor-owned companies for whom patients are merely pawns for the extraction of profit.
Health care in the United States comes in dead last when rated against comparable countries. The U. S. is at the bottom in overall performance, health outcomes, equity, access to care, and efficiency. As the Commonwealth Fund states: “In fulfilling this fundamental obligation [the ability to keep people healthy], the U. S. continues to fail.”
Health care in the United States comes in dead last when rated against comparable countries.
People in the United States aren’t living to their full potential. Already, the U.S. is 55th in life expectancy, behind Panama, Albania, and Czechia, and will fall in its global rankings by 2050 if the country continues the same trajectory. Years of life are lost to a health care system that serves profit over the value of life.
Our maternal mortality rate would be the shame of many of the poorest nations. In 2020, U.S. maternal mortality rate was higher than in Gaza. In 2022, there were 22 maternal deaths per 100,000 live births in the U.S. This is easily double, and often triple, the mortality rate in peer nations, which can be as low as 5 per 100,000 live births. Black mortality rate is criminally worse: 49.5 per 100,000 live births.
Over one million in the U.S. died in the pandemic, a rate much higher than other nations. Over 330,000 of the pandemic deaths in the U.S. were avoidable. Those lives could have been saved had we had a healthcare system that left no one with inadequate coverage.
Cancer patients must not only fight for their lives but also for the economic survival of their families. The newest treatments with so much hope are beyond the means of those who have insurance policies but no great wealth. About 30% of cancer survivors report lasting financial hardship.
Cancer patients are nearly 5 times more likely to experience bankruptcy, and the medical burden forces many to forego care.
Those who have employer-based insurance were assumed to have the gold standard in health care. Now even the highest paid workers are subjected to premiums, deductibles, and co-pays that impede their care despite the family plans that average $32,000 per year. More have insurance that covers less than a hospital gown. Gold has turned to scrap metal.
As people struggle to pay for the premiums, deductibles, and co-pays, revenues of the seven largest health insurance companies in 2022 reached $1.25 trillion and profits soared to $69.3 billion. That’s a 287% increase in profits in just one decade, when profits were $24 billion.
The toxicity of the health care profit makers that spread unnecessary suffering and death generates the hatred that is poisoning the land.
Medicare, our best health care program, publicly funded and open to all, is now strangled in the grip of the privatized Medicare Advantage plans and the Accountable Care Organizations facilitated by the Center for Medicare and Medicaid Innovation (CMMI). Medicare Advantage now controls a majority of recipients, not because it is better, but because the law that established it and the regulators that control it have allowed it to charge less in monthly premiums—plans that are also allowed to delay and deny care yet are overpaid by billions every year. CMMI issues waivers to the private plans exempting them from fraud and abuse laws and allowing kickbacks, self-referral, and illegal benefit inducement.
Millions on fixed incomes cannot afford the alternative of traditional Medicare plus a prescription drug plan and a supplementary Medigap plan. Those who have managed to escape the clutches of Medicare Advantage can still find themselves assigned, without their knowledge, to “value-based” payment schemes such as ACO REACH and other Accountable Care Organizations (ACOs) which privatize traditional Medicare. “Value-based” payment models are touted, without evidence, as reducing costs for Medicare, yet encompass a multitude of for-profit entities and subject patients to physicians incentivized to deny care. There is ample evidence that “value-based” payment schemes do not lower costs for Medicare. Nevertheless, the privatization of Medicare, through Medicare Advantage or ACOs, is now official policy.
The hoax of “value-based” payments, promoted by CMMI, is exposed by the fact that, despite all the assertions of promoting equity, the inequities of health care are expanding.
Medicaid, the program for children and adults with low income, is almost completely privatized, subjecting the recipients to delays, denials and restrictions imposed by the private managed care organizations that control it.
The Center for Medicare and Medicaid Services (CMS) is hurtling down the wrong track. They invite venture capital and health care investors into the Health Care Payment Learning and Action Network (LAN) that they created. CMS holds conferences, seeking advice and collaboration from the very profiteers that are the cause of high cost, low-quality care. The “value-based” payment scheme promoted by CMS has advanced the power of the profit makers, raising costs, cutting care, and pretending to promote equity for minorities and low-income patients.
It’s time to end the chaos. No more foxes in the hen house, no more poison in the system, no more profit in health care.
The toxicity of the health care profit makers that spread unnecessary suffering and death generates the hatred that is poisoning the land.
It’s time to end the chaos. No more foxes in the hen house, no more poison in the system, no more profit in health care. The nation has rejected the insurance company health care model that delays and denies care, demands skin in the game, asserts that there is massive unnecessary care, throws up barriers against care, and walks away with billions. A system that collects money from patients and employers then profits by withholding the promised care is not a business but a fraudulent, diabolical scam.
This system built on profit cannot be tweaked or regulated into better performance. Runaway trains are not deterred by guardrails.
There is one way to heal the nation. Put single payer on the nation’s table and focus the steaming rage to move the engine of change. Raise the demand for removal of profit and enactment of an Improved Medicare for All free from profit to a level commensurate with the damage that our current failing system is causing the patients’ and the country’s goodwill.
Some look at the current Congress, make the assessment that it’s not possible to pass single payer, then change their demand to a lesser proposal. But incremental changes are at the root of the privatization and profit schemes we are locked into now. Fifteen years after the ACA we have a failing health care system. We have witnessed that more incrementalism does more harm than good. Power concedes nothing without a demand, and the demand must be equal to the solution needed.
There is one way to heal the nation. Put single payer on the nation’s table and focus the steaming rage to move the engine of change.
As Marcia Angell, former editor of the New England Journal of Medicine, taught us, in our current private profit-based system, proposals that lower costs also decrease care, and proposals that increase care, raise costs. To improve care and control costs, we must turn to national single payer, free from profit or a national health service.
The status quo is deadly, and people are demanding a stronger more effective fight. We must organize and educate, locally and nationally with a new determination. In every town hall, classroom, union, organization, and neighborhood, people must hear the message and join the fight. Redirect the rage into a positive force for change.
The new anger in the nation makes possible what we could not do before. Many are now discussing the possibility of setting a National Day of Action in 2025 to demand freeing health care from corporate profit and covering everyone under a national single payer plan. That’s a great idea. Actions across the country lifting up that demand could inspire the movement we need.
National Single Payer—an Improved Medicare for All free from profit with everybody in and nobody out. Nothing less can heal the nation.
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And the Winners of the 2024 Shkreli Awards for Worst Healthcare Profiteering Are...
"All these stories paint a picture of a healthcare industry in desperate need of transformation," said the head of the think tank behind the awards.
Jan 07, 2025
The "winners" of the annual Shkreli Awards—named after notorious "pharma bro" Martin Shkreli and given to the 10 "worst examples of profiteering and dysfunction in healthcare"—include a Texas medical school that sold body parts of deceased people without relatives' consent, an alleged multibillion-dollar catheter scam, an oncologist who subjected patients to unnecessary cancer treatments, and a "monster monopoly" insurer.
The Shkreli Awards, now in their eighth year, are given annually by the Lown Institute, a Massachusetts-based think tank "advocating bold ideas for a just and caring system for health." A panel of 20 expert judges—who include physicians, professors, activists, and others—determine the winners.
This year's awardees are:
10: The University of North Texas Health Science Center "dissected and distributed unclaimed bodies without properly seeking consent from the deceased or their families" and supplied the parts "to medical students as well as major for-profit ventures like Medtronic and Johnson & Johnson," reporting revealed.
9:
Baby tongue-tie cutting procedures are "being touted as a cure for everything from breastfeeding difficulties to sleep apnea, scoliosis, and even constipation"—despite any conclusive evidence that the procedure is effective.
8: Zynex Medical is a company facing scrutiny for its billing practices related to nerve stimulation devices used for pain management.
7: Insurance giant Cigna is under fire for billing a family nearly $100,000 for an infant's medevac flight.
6: Seven suppliers allegedly ran a multibillion-dollar urinary catheter billing scam that affected hundreds of thousands of Medicare patients.
5: Memorial Medical Center in Las Cruces, New Mexico allegedly refused cancer treatment "to patients or demanding upfront payments, even from those with insurance."
4: Dr. Thomas C. Weiner is a Montana oncologist who allegedly "subjected a patient to unnecessary cancer treatments for over a decade," provided "disturbingly high doses of barbiturates to facilitate death in seriously ill patients, when those patients may not have actually been close to death," and "prescribed high doses of opioids to patients that did not need them." Weiner denies any wrongdoing.
3: Pharma giant Amgen was accused of pushing 960-milligram doses of its highly toxic cancer drug Lumakras, when "a lower 240mg dose offers similar efficacy with reduced toxicity"—but costs $180,000 less per patient annually at the lower dose.
2: UnitedHealth allegedly exploited "its vast physician network to maximize profits, often at the expense of patients and clinicians," including by pressuring doctors "to reduce time with patients and to practice aggressive medical coding tactics that make patients seem as sick as possible" in order to earn higher reimbursements from the federal government."
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1: Steward Health Care CEO Dr. Ralph de la Torre was accused of orchestrating "a dramatic healthcare debacle by prioritizing private equity profits over patient care" amid "debt and sale-leaseback schemes" and a bankruptcy that "left hospitals gutted, employees laid off, and communities underserved" as he reportedly walked away "with more than $250 million over the last four years as hospitals tanked."
"All these stories paint a picture of a healthcare industry in desperate need of transformation," Lown Institute president Dr. Vikas Saini said during the award ceremony, according toThe Guardian.
"Doing these awards every year shows us that this is nothing new," he added. "We're hoping that these stories illuminate what changes are needed."
The latest Shkreli Awards came just weeks after the brazen assassination of Brian Thompson, CEO of UnitedHealth subsidiary UnitedHealthcare. Although alleged gunman Luigi Mangione has pleaded not guilty, his reported manifesto—which rails against insurance industry greed—resonated with people across the country and sparked discussions about the for-profit healthcare system.
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Murder of Health Insurance CEO Exposes Depth of Rage Over Corporate Greed
The killing of Brian Thompson, as horrendous as it was, forced us to confront the injustices we’ve been taught to tolerate.
Jan 02, 2025
Call him a misguided hero or villain, but the man who killed the United Healthcare CEO struck a nerve, exposing a deep rage shared by many Americans across the political spectrum—anger at an industry that earns obscene profits from the suffering of others. His chilling act shifted the national conversation from immigration to corporate greed. Finally.
For too long, Americans have hesitated to criticize the super-rich. Chalk it up to our tribalist nature that has so many convinced that our financial struggles are caused not by wealth hoarding but by those we view as outside our clan.
History offers many examples. In Nazi Germany, Jews were blamed for a financial depression triggered by the American stock market crash. My parents and grandmother barely escaped; many in my family did not.
Decades later, Ronald Reagan handed the wealthy the largest tax cuts in U.S. history while vilifying the “Welfare Queen” who leached from the feeding trough of “Big Government.”
This racist caricature was meant to distract from policies that began a 40-year transfer of wealth from the 90 percent to the one percent, producing the largest wealth gap in a century. It’s a story about the undeserving poor vs. the deserving rich.
Today, we face a similar narrative. Immigrants are blamed both for stealing jobs and freeloading despite their essential role in propping up our economy given our shrinking workforce. After being fed a steady anti-immigration media diet, it’s not surprising that nearly four out of five Republicans support placing undocumented immigrants in internment camps.
The greater the wealth imbalance, the more the wealthy need to distort the truth. They peddle the long-discredited Trickle-Down theory, claiming that what benefits them benefits us all. But rising tides don’t lift all boats when some people have no boat at all, or when their boats are sinking because the superyachts are capsizing small craft in their massive wake.
We have to stop believing that billionaires have working people’s interests at heart. In fact, they’re mutually exclusive. A gangbuster stock market depends on keeping wages low and unions banished. Outsized campaign contributions ensure that corporate taxes are slashed and regulations meant to keep us healthy, safe, and not impoverished are gutted.
It makes complete sense that the wealth lobby exploits fears of “socialism” to keep people voting against their own interests. It’s no coincidence the U.S. remains the only developed nation without universal healthcare. This is where our anger should be directed.
But redirecting anger is not easy. Six of the richest US corporations control 90 percent of our media and their profits depend on algorithms and news coverage designed to keep us divided, misinformed, and distracted from this billionaire plunder. “You know the media has failed,” says essayist Rebecca Solnit, “when people are more concerned that a trans girl might play on a softball team than that the climate crisis will destroy our planet.”
During the next four years it will be critical to get people to see through this deception. When we start feeling the fallout from a second Trump term, the scapegoating will intensify. Tariffs, more tax cuts for the rich, and the loss of immigrant labor will send prices soaring and balloon the deficit. Many may lose healthcare, Social Security, and worker protections. The wealth lobby will no doubt point fingers elsewhere.
Change is possible though. As a grant writer for 30 years, I’ve seen campaigns shift public opinion on issues like marriage equality, net neutrality, and climate change. Recently, several states won historic economic reforms after decades of trying. In Massachusetts, RiseUpMass won the nation’s sixth millionaire’s tax by debunking claims it would harm retirees.
In Washington state, the Balance Our Tax Code, a coalition of over 80 diverse groups, from home health aide workers to members of the Yakima Nation, was able pass a capital gains tax, calling out Amazon and Microsoft for avoiding their share of taxes. “The biggest lesson we learned,” said campaign communications manager Reiny Cohen “was that when we come together and tell the same story, lawmakers have no choice but to listen.”
In other words, changing minds requires a coordinated echo chamber. The #MeToo movement showed how the right framing, amplified through the media, can shift perspectives and galvanize action. Imagine if we could help more people connect the dots between stagnant wages, failing schools, a burning planet, unaffordable housing, and the greed of the one percent.
But the message must go beyond bashing billionaires. It must present a compelling vision of what is possible if we stand up against the ultra rich. The We Make Minnesota coalition was able to pass a tax increase on the wealthiest one percent by countering anti-Somali rhetoric with a “We’re Better Off Together” message. Instead of using a “Stop the Cuts” framework, the campaign emphasized the subsidized health care, free preschool, and tuition-free college programs the state is now able to offer.
This isn’t about destroying capitalism. A healthy balance between a free market and protective government is essential. But when the richest among us prioritize profit over the well-being of the majority, it’s no longer about politics—it’s about survival.
The murder of the United Healthcare CEO, as horrendous as it was, forced us to confront the injustices we’ve been taught to tolerate. This moment must unite us against the true enemies of the American dream: unchecked greed and exploitation of the many for the benefit of the few. We can either remain manipulated by scapegoating and fear or see the truth and demand change. Only then can we build a society where no one feels driven to such desperate measures again.
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