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The Guide's editor covers many topics for various outlets as a journalist and researcher. People in the arts -- and others who are self-employed -- should read this one, since something that just happened exposes all of us to financial ruin.
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As COVID funding vanishes, it reveals a health system driven by debt collectors and bankruptcy
U.S. banners portray images common in Europe, but aspirational, at best, here.
Wednesday, March 23, 2022, 4:55 pm
Funding ends today for the key mission of an agency you've never heard of. And wait 'til you hear what it's about. The agency is HRSA -- the federal Health Resources and Services Administration. It has been the source of funding for all the free COVID tests and vaccinations -- AND care, including long-term hospitalization -- for Americans with no other source of funded care or insufficiently funded coverage for those things.
Testing ends today. Hospital care ends today. Vaccinations end in about two weeks. We'll get to the amounts of money.
Over 30 million Americans -- a bit under 1/10 of the population -- have no other source of funded health care, whether for broken legs, pneumonia, falling off the roof, getting COVID, or anything else. That's because they live in deep red states where their GQP (not a typo) legislatures and/or governors refused to pass enabling legislation for their citizens to be covered by Obamacare. So those fellow citizens have nothing, unless they survived long enough to get Medicare, or are fortunate enough to be covered by an ever-harder-to-find employer-provided health care plan (which these days probably has paltry benefits), or are rich enough to buy their own "cadillac care" on the horrendously expensive open market.
Re: that use of "GQP": following the example of an astute reader, I've changed the "O" to a "Q" since that is now representative of the used-to-be Grand Old Party's values.
A quick point for fiscal perspective: Before Russia invaded Ukraine, our Congress added $29 billion more to this year's defense budget -- not a dime of which goes to Ukraine. But despite making that money magically appear for Big Weaponry?
Congress cut the entire $16 billion allocated for HRSA, budgeted specifically to enable every American to access COVID testing, vaccinations, AND medical care including hospitalization.
For the former -- the lavish military spending -- you can thank the majority of bipartisan Military-Industrial-Cybersecurity Complex Members of Congress and Senators owned by the militarists. Which is most of them (regardless of party) because the Defense Establishment spent decades spreading its tentacles with "quality employment" into literally every Congressional district in the nation.
But for the latter -- dumping care during a not-yet-over pandemic for the 10% of the population that's too poor or ineligible to get other health coverage?
That is, too poor to buy their own commercial health insurance, but too "rich" to get Medi-Cal in states that have it, and rendered ineligible by GQP austerity to access Obamacare? Let's be clear: Americans ineligible due to the austerity-loving (translate that to refuse-to-tax-the-rich) Republican power structure that runs their state. Well! Harumph! Go do your less-than-$15-an-hour-hour, 27-hour-a-week-job, and don't wear a mask so you can assert your symbol of freedom and defiance! But if you catch COVID, go ahead and die. If you're poor, you probably don't vote Republican, anyway.
Another quick perspective: it's the background as every hospital bed in Hong Kong is filled by patients with the latest COVID variant; as cases of the same thing are surging alarmingly in Britain and Scotland; and as a war is turning once-beautiful cities into ash and rubble and creating millions of refugees.
Refugees who are, of course, coming from places bombed to rubble, with no clean water, little or no safe food, unburied bodies everywhere, and huddled living conditions for those who can get to poorly ventilated basement bomb shelters. Conditions that are perfect breeding grounds for disease where people are as physically, emotionally, and psychologically stressed as anyone can imagine. Meaning their susceptibility to infections is exponentially higher.
And in EACH of those overseas examples, damn near everybody was vaccinated against COVID, and had access to their nation's universal free health care.
Unlike America, where anti-science zealotry, or being guided by internet/social media wackery, or misplaced devotion to creepy gray-and-white-"American"-flag "freedom" (aka Orange Imbecility) has kept a third of our population unvaxxed. In a land where no national health care keeps 10% of us from receiving any care of any kind for anything. And another 60+% of us are left with woefully inadequate care that often -- yes, often -- results in crushing medical bills that result in patients or their survivors losing their homes to the uniquely American phenomenon of medical-bill bankruptcy.
Q: How many people in Canada, the UK, Germany, Belgium, Italy, Finland, France, and dozens of other countries lost their homes to medical-bill bankruptcy last year? Zero. Or simply declared medical-bill bankruptcy? Zero. How many Americans declared medical-bill bankruptcy last year? Half a million+, each year.
How many of those bankruptcies resulted in filers losing their homes? That is hard to discern from available information.
A well-referenced January, 2022 story in The Balance, "Medical Bankruptcy and the Economy: Do Medical Bills Really Devastate America's Families?" examines numerous potential variables from the Great Recession, the implementation of Obamacare, and beyond.
It notes, with citations, "Reports from different entities are constantly published, such as the survey results of people with employer-sponsored insurance by the Kaiser Family Foundation (KFF) / LA Times Survey in 2019. The study found that 1 in 5 people surveyed have been contacted by collection agencies, while 9% of those surveyed stated they had declared personal bankruptcy due to medical expenses."
The Balance continues, "It is hard to tell what the actual impact of medical expenses is with so many different interpretations of study results. What is known is that there are many people so affected by health care debts that they need to file for bankruptcy."
Finally it presents numbers: "In 2015, the Kaiser Family Foundation found that medical bills made 1 million adults declare bankruptcy. Its survey found that 26% of Americans age 18 to 64 struggled to pay medical bills. According to the U.S. Census, that's 52 million adults."
MedAlertHelp, edited by Dr. Lina Velikova, MD, PhD, also published a January, 2022 examination. In "The Truths & Myths Behind Medical Bankruptcies," going so far as to claim presentation of "everything there is to know about the matter!"
It is a valuable read, and an especially good information source for anyone with crushing medical bills.
The piece includes this stunning base data: "According to the National Health Expenditure Accounts, the total healthcare spending in the United States has increased from $27.2 billion in 1960 to $3.8 trillion in 2019. In contrast, the cost per person rose from $146 to $11,582 per year. Even Obamacare failed to address rising healthcare costs adequately. By 2009, the increasing health care costs were consuming 19% of the total federal budget of $3.5 trillion."
She also cites, "... 9% [of Americans] confirmed [in one study] they had declared personal bankruptcy due to medical bills at some point in their lives (involving 2% who did so in the last 12 months)." And she notes, "... some [health insurance] companies denied about 25% of the claims or even canceled the insurance."
She discusses people losing their homes and ways to keep your house from the debt collectors, something absent from all the base-data medical debt studies.
Dr. Velikova's projections of what's ahead are especially alarming:
"Medical bankruptcies statistics reveal that the total US medical debt was $45 billion. Even though 58% of American retirees are in good health, the disturbing fact is that the average 65-year-old couple will face medical bills of about a quarter-million dollars during retirement, even with support from the national health insurance program of the US, Medicare. Here, the savings for retirement, such as a 401k plan, play a considerable role as a backup plan for covering otherwise unpayable medical bills and avoiding bankruptcy."
She adds, "The latest data shows that around 137.1 million Americans face financial challenges because of medical costs. Furthermore, nearly ten million adults who have health insurance coverage struggle with healthcare-related bills, so we can see that people file medical bankruptcies with insurance, too."
Most of the studies and data in that pair of 2022 features derive or come directly from published 2019 studies. So we need to look at those.
Even finance-focused NASDAQ is alarmed: "Medical Bankruptcy Is Killing The American Middle Class." They cite, "the 'financial toll of illness on American families' has perhaps gone far beyond the one-off anecdotes, such as the Nobel laureate who had to sell his medal to pay for medical bills, or 250,000 GoFundMe medical campaigns last year alone."
They continue, "... the US Consumer Financial Protection Bureau report[s]... medical bills are by far the most common cause of unpaid bills sent to collection agencies in 2014."
The citations come from a February, 2019, pre-COVID study, also the subject of a CNBC report asserted, "This is the real reason most Americans file for bankruptcy." Two-thirds of Americans who file for bankruptcy cite medical issues as a key contributor to their financial downfall. The report cited the study published in the American Journal of Public Health (AJPH)
The study's academic researchers found that 66.5% of all bankruptcies were tied to medical issues — either because of high costs for care or time out of work. An estimated 530,000 families turn to bankruptcy each year because of medical issues and bills, the research found.
The story emphasized "Health insurance is only very partial protection." And our research shows more: because Republicans refuse to enact a handfull of "fixes" to the original legislation, health insurance providers cobtinue to bilk consumers by selling them grossly inadequate, essentially "junk" insurance.
"Private health insurance is a defective product, akin to an umbrella that melts in the rain," lead author Dr. David Himmelstein, associate professor of medicine at Harvard, told the Hartford Current.
In the 2019 CNBC piece, one of the AJPH study's authors used this analogy: "I liken it [commercially available health insurance] to a hospital gown that looks like coverage until you actually inspect it." The research included 910 Americans who filed for bankruptcy between 2013 and 2016.
The Guardian spent nine months investigating before they published their look at the same 2019 study. They found one out of every six Americans, pre-COVID, with an unpaid medical bill on their credit report. That amounted to $81 billion in debt nationwide, while about one in 12 Americans went without any medical insurance at all.
Read their landmark piece, "'I live on the street now': how Americans fall into medical bankruptcy," at the link above. It gets into the factors most likely to cause medical-bill bankruptcy, like the grossly inflated cost of insulin that pads bloated corporate profits, and much more.
But while the 2019 AJPH study found no decrease in the number of medical-bill bankruptcies after Obamacare, induced poverty isn't the entire story. A 2009 Harvard Medical School study -- pre-Obamacare -- found 45,000 Americans were dying every year as a direct result of not having any medical coverage.
The GQP spent years campaigning on "repeal and replace" Obamacare, until a pivotal vote by the late Senator John McCain (R, AZ) prevented repeal, and a disgusted public finally discerned the Goppers had no plan for any replacement. So now that party's leaders openly talk of "sunsetting" Social Security and Medicare, even as they block funding to protect Americans from any coming wave of another COVID variant.
In fact, Senator Rick Scott, chairman of the national committee that elects Republicans to the U.S. Senate, has unveiled plans that made a lot of headlines. For one thing, he wants the GQP to "sunset" (set a date for the death of) Social Security and Medicare and other programs -- within five years: “26 things Rick Scott's 'rescue' plan for America would do,” CNN, Feb. 23, 2022. For another, he has unveiled an 11-point agenda that raises taxes on 100 million low- to middle-income Americans. And he wants the GQP to cut IRS funding by 50% ― allowing millionaires and billionaires, the richest 1%, to continue dodging $160 billion in taxes each year: “The top 1 percent are evading $163 billion a year in taxes, the Treasury finds,” New York Times, Sep. 8, 2021.
Sarah Christopherson, Legislative and Policy Director of Americans for Tax Fairness Action Fund, warned today, "If Republicans take back the Senate, this [the Rick Scott plan] is the plan they intend to enact... an assault on working people and seniors ― and a massive handout to the rich and powerful."
So, now for the big perspective: if you want to say "Both parties do it" and you're talking about runaway defense spending, yes.
But if you're talking about the things that genuinely protect Americans and are aimed at giving each of us, and coming generations, a future worth having?
Things like medical care and, as an integral dimension, financial protection from global pandemics -- along with guaranteeing those protections for workplace injury, any other injury, disease acquired or developed from whatever exposure or source because you live here? Protection from medical-bill bankruptcy that results because of any of the above?
If you're talking about family leave when someone at home is sick or injured and there is no provision for a professional care-giver?
If you're talking about trying to eliminate or at least reduce industrial and agricultural and consumer-product toxins?
And finally taking responsibility for human-caused climate change while time remains to reverse at least some of it?
If you're talking about getting us off our societal fossil fuel addiction and providing sustainable power and modern transportation options like nearly everybody else has, from Europe to Japan to China?
If you're talking about getting money out of politics, removing rich special interests and corporations as funders of carefully-crafted psychological warfare political messaging and disconnecting their pipelines to candidates who become their wholly-owned subsidiaries?
Those movements exist, within the system. But let's be clear: Both parties do NOT do any of that.
And as school board takeovers lead to book bans and emotional, fear-fomented, grievance-based fake populism leads to legislation to prohibit recognition of the diversity that is modern-day America? There is one party increasingly characterized by those things, and by attempting to circumvent the votes of those likely to disagree with them. It is the only party in American political history that produced no document of its goals, purposes, and agenda in a Party Platform, a heretofore essential outcome of its last national nominating convention. And those are integral reasons why the GOP is now the GQP.
The Democratic Party, despite its shrinking cadre of obstructionist "corporate Dems," is not characterized overall by any of those decidedly regressive, essentially medieval traits. Yes, it is spelled "Democratic," in name as well as character. It never dropped the last two letters of its name, despite the ubiquity of the Fox News campaign to refuse to say the name correctly. Which is all the license I need give you to adjust the other party's name, and brand Republicans as the GQP. Whether you choose to do that, if you go forth to reverse climate change, restore voting rights, civil rights, and the human right to health care, you will find one party is open to you. And you will find growing support among that party's elected officials, the staffers they hire, and within its power structure.
Both parties will not do that. Even if evermore COVID variants decimate the intransigent ranks of the GQP's austerity-demanding zealots.
The immediate fact is, the austerity-loving GQP'ers just prevented HRSA from doing its job and continuing to fulfill its unique roll: keeping Americans from contracting and spreading COVID, and keeping those who get COVID able to get life-saving care and out of the dark pit of medical-bill bankruptcy. So if you know anyone who has intransigently refused to get vaxxed, tell them they've got two weeks to get at least one vax dose, while they still can do it at taxpayer expense. Or they should be prepared to reckon with increased chances of medical-bill bankruptcy for themselves or their surviving family members to pay if they need hospitalization, and especially if that becomes long term care, for COVID or "Long COVID."
Since Republicans usually focus on keeping money from public need and paying no taxes, perhaps you have here the hard numbers you need.
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More'll be along directly, to assist you navigating Spring & Summer 2022.
Music, arts, festivals, conferences, concerts, club gigs, coffee houses, new releases, who's in the studio doing what, it shows up here.
So remember to MERGE ONTO THIS LIL' CYBER VECTOR THROUGH SPACE/TIME. It's where the sounds of string instruments and melodic voices waft in at the sweet spots on the dial, between the droning streams of crazy static from Jupiter. (Seriously. That's what those squawks, squeals and pulses are over on AM radio. You know: the stuff that's more fun to listen to on AM than all those blathering talk-show wingnut conspiracy spreaders...)
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