Standoff

 

                        AI-prompted image

Here’s reason number 48, which is one past 47, why America needs to join the rest of the civilized world and provide single-payer, universal healthcare for its citizens. But first, let’s dispense with pre-programmed responses:

One: Unless the government were to take over every hospital, clinic, and pharmacy, and unless it were to employ every doctor, nurse, and other providers of health-related care, which NO ONE is proposing, it would not, by definition, be socialism. Caregivers and hospitals could remain independent.

Two: Yes, taxes would certainly be raised, presumably on a sliding scale, but insurance premiums would disappear. And, by eliminating enormous and unnecessary costs interposed by insurers between providers and patients, it might even break even. The total amount of health insurance premiums Americans pay is around $1.5 trillion!

Three: Government takeover. Assuming we retain fair elections, we can elect legislators who’ll keep it patient-oriented.

Now to the issue: Thousands of area seniors and tens of thousands more elsewhere in Washington and Oregon enrolled in United Health Care Medicare Advantage programs will, after January 1, no longer have access to Providence-owned hospitals. As reported in the Herald, and as members learned in mailings from UHC, the Sisters have announced they’ll no longer accept those plans. At the moment, other than downgrading to “regular” Medicare, which the Sisters will accept, or traveling miles to other facilities, UHC customers must find and sign up with other plans that the hospital and their physicians will accept. Which, for old folks like me, can be daunting.

Health insurance companies provide no care, much less value. But they suck up billions of our healthcare dollars, disappearing them into the pockets of administrators and stockholders, paying employees, buying back stock, and other corporate expenses. Quoted in the Herald article, UHC’s explanation is priceless: “... [W]e must make decisions that help maintain long-term viability and access.” Right. Maintain access by reducing it. Maintain viability by cutting reimbursement so much that hospitals can’t afford to do business.

Our predicament was occasioned by Providence’s decision to stop accepting UHC Medicare plans. As a former partner and board member of the late-lamented Everett Clinic, I sympathize. We faced continual, increasingly unworkable decreases in reimbursement from insurers. In a case that made national news, we fired one whose proposed cuts would have cost us to deal with them; sent announcements to affected patients, and helped them find alternatives. Since we were large enough, desired enough, and had enough patients to make a difference, the company backed down. Whether Providence’s move will have similar results seems unlikely. Time is running short to change Medicare plans, and United Health Care, with tens of millions of enrollees nationally, needn’t care about several thousand. Here’s an example.

UHC is the insurance component of United Health Group, which includes UHC and Optum, which, in turn, owns physician practices, pharmacies, and other services. In 2025, UHG took in about $448 billion and paid out $314 billion to providers of care. The rest went to multiple overhead costs, including $1million in salary and $60 million in stock for its CEO, and profits distributed to investors. That’s around $130 billion not spent on healthcare.

There are hundreds of health insurance providers in the US, huge and small, similarly taking money away from actual care. In addition are the enormous costs to providers in dealing with them; costs far lower were there only one payer. Mega-billions of healthcare-intended dollars, disappearing into a cosmic void.

It’s a hugely complex system, which, rather than providing otherwise unobtainable benefits, stands between patients and providers. Imagine paying someone to hand you groceries before you pay the cashier. What’s happening with Providence and UHC shows how at the mercy of an irrational system we are, and how vulnerable to their business decisions.

Providence is communicating with patients who use their network physicians. Here’s a link to plans they’ll accept. Optum, so far, has been silent; perhaps because, as a major profit center for UHC, helping is a conflict of interest. Maybe local branches will commune with their Everett Clinic ancestry and offer assistance in making the change. And then, we’ll hope the need won’t happen again. (The care we get at Optum is outstanding. We don’t intend to change.)

Surely, many UHC subscribers have, heretofore, considered universal healthcare communism or socialism or some other ill-defined anathema. Maybe a rethink is in order. As long as Republicans retain control, universal healthcare won’t happen. Nor, if it were ever enacted, would it be problem-free; it’s a monstrous beast. But it’s doable, especially if a Trumpless America reorders priorities.

In the before times, we solved problems rather than creating them. Notwithstanding the current administration, America retains the expertise and means to make it work. A good start would be undoing Trump’s deficit-increasing, wealthy-benefitting tax cuts. Without risking security, we could reduce Hegsethified military spending. In the age of drone- and missile-based warfare, we could definitely do without useless “Trump-class” battleships. We could even stop unprovoked invasions of other countries. Our nation would become healthy in more ways than one.