POLITICO Nightly: The growing distrust of the American health care system

 

By Joanne Kenen Prescription drugs displayed at NYC Discount Pharmacy in Manhattan on July 23. | Spencer Platt/Getty Images WARNING SIGNS — Long before a gunman pumped bullets into a UnitedHealthcare executive and was hailed as a folk hero by a startling slice of the American public, the longtime head of the American Board of Internal Medicine found himself increasingly aware of — and alarmed by — the creeping distrust of American health, science and medicine. Dr. Richard Baron had been a primary care doctor for years, in rural Tennessee and then in a racially and economically mixed neighborhood in Philadelphia. He had felt deeply connected to his community, and the word “community” comes up often in his conversations. But as president and CEO of ABIM and its affiliated foundation, he saw how Americans’ wariness about the health care system was growing, part of a growing sense of distrust and disconnection throughout the country. “What happens to medicine when the members of the society believe no one has your best interests at heart?” he asked. “It’s a pretty tough place to be.” Particularly when the health care system was growing more corporatized — and more disconnected from communities, he told Nightly in a conversation that took place just as police were closing in on the suspect in the murder of UnitedHealthcare executive Brian Thompson. Soon after taking the top job at ABIM, Baron had to deal with the organization’s own struggles , after an outcry over changes in how it tested and certified doctors. His efforts to restore trust, combined with his prescient pre-Covid observations about the crumbling of trust in medicine, led him to start a multi-year ABIM Foundation initiative on exploring, researching and repairing trust. Baron worked on disinformation, which has turned into a mighty online river since Covid. ABIM has also spotlighted how racial inequity in health care — historic and contemporary — has eroded trust, which became more widely recognized during the pandemic. And he’s stressed how the fear of medical debt — a side effect of the opacity of corporate health care decision-making and pricing — deters some patients from seeking needed care. “Patient-centered care” has become a buzzword in health but for many patients, it feels money-centered. In fact, in shooting suspect Luigi Mangione’s alleged manifesto , he decried big companies like UnitedHealthcare that “abuse our country for immense profit.” Early on, Baron realized that relying on facts alone to push back on the damage was not going to cut it. “People were willing to give up what I’ll call a fact- based understanding in favor of a kind of emotional relationship-based understanding,” he said. “And the messengers haven’t been paying a lot of attention to their relationship with the communities that they’re trying to message to.” If you tried to diagram distrust, it would have a whole lot of intersecting arrows pointing in every possible direction. A big cluster of arrows would point to insurers who have merger-and-acquisitioned themselves into a handful of big firms that are the arbiters of what kind of care a patient can access — or not. Others would point from doctors and nurses to the money-guys calling the shots at their health care system or practice. From minority communities toward providers. From patients to their doctors — particularly when the physician recommends against a treatment on solid evidence-based grounds but the skeptical patient thinks the doc is in the insurer’s pocket. Arrows would aim at drug companies that develop life saving medicines but with eye-popping prices — and to the subset of pharma firms and drug distributors who flooded communities with opioids while falsely promising that they would do no harm. Baron retired a few months ago, but trust and communication initiatives he started are ongoing. He knows some of the challenges are unique to medicine. Others reflect larger changes in an angry, polarized country. “Medicine swims in the same ocean that the rest of the culture does,” said Baron. Attacks on health care personnel in the workplace, both verbal and physical, have become far more common . Last week, on the streets of New York, an angry young man didn’t just point an arrow. He pointed a gun. Welcome to POLITICO Nightly. Reach out with news, tips and ideas at nightly@politico.com . Or contact tonight’s author on X (formerly known as Twitter) at @JoanneKenen .   A message from American Beverage: America’s beverage companies – The Coca-Cola Company, Keurig Dr Pepper and PepsiCo – are iconic American companies making American products with American workers in America’s hometowns. And we’re committed to doing our part to address today’s health challenges. We’ve taken real steps for more than a decade to transform the beverage aisle, like offering smaller portion sizes, more zero-sugar options and putting nutrition information right up front. Explore more at BalanceUS.org.   What'd I Miss? — Biden threatens to veto bill that would have given Trump new judicial appointments : Donald Trump is eager to appoint dozens of new judges once he becomes president. Joe Biden has other plans. The president threatened to veto a bill to expand the number of federal judges because he doesn’t want to give the president-elect new appointment opportunities, one of the outgoing president’s closest allies said in an interview. The move dooms legislation spearheaded by Sen. Chris Coons (D-Del.), who had spent months pushing for the creation of 63 new judgeships. — Time magazine to name Trump ‘Person of the Year’: Donald Trump is expected to be named Time magazine’s “Person of the Year” — and to celebrate the unveiling of the cover, the president-elect will ring the opening bell of the New York Stock Exchange on Thursday morning, according to three people familiar with the plans granted anonymity because they were not authorized to divulge the plans. Trump was also named Time Person of the Year in 2016 after he won the presidential election. He joins 13 other U.S. presidents who have received the recognition, including President Joe Biden. WHILE THE ASSAULT IN INEXCUSABLE, REP. NANCY MACE HAS BEEN PROVOCATIVE & HATE FILLED IN HER COMMENTS...THE REST OF THE WORLD IS FILLED WITH UNISEX BATHROOMS...MAYBE NANCY MACE NEEDS TO TRAVEL MORE.... — Capitol Police arrest person in alleged assault on member of Congress: The U.S. Capitol Police have arrested 33-year-old James McIntyre for an alleged assault on Rep. Nancy Mace on Tuesday night in the Rayburn Office Building, according to the department. Capitol Police, in a statement, said they responded to an incident reported by a member’s office just before 6 p.m. on Tuesday. McIntyre is facing a misdemeanor charge for assaulting a government official, according to the department, though charging decisions are ultimately up to the U.S. attorney’s office.   Billions in spending. Critical foreign aid. Immigration reform. The final weeks of 2024 could bring major policy changes. Inside Congress provides daily insights into how Congressional leaders are navigating these high-stakes issues. Subscribe today .     THE NEXT ADMINISTRATION KASH PATEL NEEDS FBI BACKGROUND CHECKS & SECURITY CHECKS....lots of issues are not being addressed! WRAY OUT — FBI Director Christopher Wray, who has faced withering criticism from President-elect Donald Trump and Republican lawmakers, announced today that he plans to resign next month . Trump announced late last month that he intends to nominate former National Security Council official and GOP congressional aide Kash Patel to serve as FBI director. If confirmed by the Senate, he would replace Wray, who was appointed by Trump in 2017 and is serving a 10-year term that expires in 2027.   A message from American Beverage:   AROUND THE WORLD Poland's Prime Minister Donald Tusk delivers a statement to the media with French President Emmanuel Macron as part of a meeting at the Elysee Palace in Paris in February. | Pool photo by Christophe Petit-Tesson POSTWAR PLANS — French President Emmanuel Macron will discuss with Polish Prime Minister Donald Tusk the deployment of a postwar peacekeeping force in Ukraine when the two meet in Warsaw on Thursday, a European Union diplomat and a French official told POLITICO. The meeting of the two EU heavyweights comes amid increasing fears that the incoming administration of Donald Trump will force the Europeans to pick up more of the military responsibilities in Ukraine. “It is true,” confirmed the EU diplomat when asked about a Polish media report in the Rzeczpospolita newspaper claiming the two countries were talking over a potential 40,000-strong peacekeeping force composed of troops from foreign countries. The diplomat did not elaborate on which countries the soldiers might come from. FOOL ME ONCE — Emmanuel Macron told leaders from across the political spectrum he will not appoint a new prime minister whose survival depends on the far-right National Rally after it spurned Michel Barnier and voted to bring down his government after just three months, according to the French president’s office. Toppling Barnier, Macron told his ministers today, “was a serious choice, a choice that will have consequences,” government spokesperson Maud Bregeon told reporters. Macron is expected to name a new premier by the end of the day Thursday to replace Barnier. Several names have been floated in the French press, but the leading rumor suggests he may appoint one of his earliest supporters, centrist François Bayrou. However, representatives from different left-wing parties have already made clear that they are against Bayrou’s potential appointment. UK BANS PUBERTY BLOCKERS — The British government indefinitely banned the use of puberty blockers by people under 18 years of age today after expert advice flagged an "unacceptable safety risk" in their use. Puberty blockers stopped being routinely prescribed to under-18s with gender dysphoria in the U.K. in March and were temporarily banned in May this year by the previous Conservative government. This prevented their prescription by European or private prescribers. National Health Service provision was restricted to clinical trials. The Department for Health and Social Care has now received advice from the government-ordered Commission on Human Medicines and today backed its recommendation to restrict their use and supply indefinitely while further work is done to ensure young people’s safety. An earlier U.K. review into gender identity services found that studies about treatment for gender dysphoria were unreliable and there was a lack of attention paid to patients seeking to halt or reverse the gender transition process. New legislation will make the ban indefinite and be reviewed in 2027.   Write your own chapter in the new Washington. From the Lame Duck Congress Series to New Administration insights, POLITICO Pro delivers intelligence across 22+ policy areas to help you anticipate and navigate change. Discover how a Pro subscription empowers you. Learn more today .     Nightly Number $135 million The amount in grants that the Environmental Protection Agency is awarding to California in order to help the state wean off fossil fuels and phase out big rigs that run on diesel, EPA officials announced today. MUST READ! EXCERPT: SAN FRANCISCO (AP) — The Environmental Protection Agency is awarding $135 million in grants to fund 13 projects in California to help the state wean off fossil fuels and phase out big rigs that run on diesel. The money will go to the state transportation department, cities and school districts, among others, to purchase 455 zero-emission vehicles to replace diesel-powered trucks, school buses and other large vehicles. It is part an EPA program that provides a total of $735 million to 70 projects across the country, officials announced Wednesday. The grants are paid for by the 2022 climate law approved by congressional Democrats. The law, officially known as the Inflation Reduction Act, includes nearly $400 billion in spending and tax credits to accelerate the expansion of clean energy such as wind and solar power, speeding the nation’s transition away from the oil, coal and natural gas that largely cause climate change. The funds, to be delivered in early 2025, “will reduce air pollution, improve health outcomes in nearby communities, and advance the campaign to tackle climate change,” EPA Pacific Southwest Regional Administrator Martha Guzman said in a statement. RADAR SWEEP AGE APPROPRIATE — As the migrant crisis worsens across Europe, border officials are increasingly turning to medical examinations to determine asylum seekers’ age . Through a series of medical assessments, they believe they can often figure out how old an asylum seeker without proper documentation is — most notably, they can decide if they are a child or an adult. But the practice of quickly trying to guess at someone’s age based on their medical information is deeply flawed. And inconsistencies within the system are often mixing up age groups and leaving legal children at the mercy of an adult asylum process. Unaccompanied children are regularly given asylum priority or distinct treatment — but as countries try to crack down on adults claiming they’re minors, other issues begin to arise. Will Coldwell reports for The Dial. Parting Image On this date in 1941: Speaker of the House Sam Rayburn (rear) presides over the House of Representatives as Irving W. Swanson reads President Franklin D. Roosevelt's plea for a declaration of war against Germany. The U.S. formally declared war against Germany and Italy three days after doing so against Japan. | AP Did someone forward this email to you?  Sign up here .   A message from American Beverage: America’s beverage companies are committed to delivering families the freedom to choose the beverage that’s right for them. And it’s working. Thanks to our innovation, nearly 60% of the beverages Americans buy have no sugar or calories. Our commitment to helping Americans find the right balance for them includes: · Offering more than 600 brands with less sugar or no sugar at all. · Putting clear calorie labels on the front of every bottle, can and pack. · Encouraging consumers to think about balance with signs on coolers and displays in store. · Voluntarily removing full-calorie beverages from schools through our National School Beverage Guidelines, which cut beverage calories in schools by 94%. In fact, the USDA Smart Snacks in Schools Beverage Guidelines were largely based on these guidelines. Learn more at BalanceUS.org.     Follow us on Twitter Charlie Mahtesian @PoliticoCharlie Calder McHugh @calder_mchugh   Follow us

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My Autopsy Initiative with Kaepernick Prepared Me For This

Ben Meiselas and MeidasTouch Network Dec 12

Written by Ben Meiselas

I wanted to share with you the story of how I created a non-profit program with Colin Kaepernick that provides free autopsies to families who lost a loved one due to police actions. This story demonstrates how we can think outside the box to create new structures and institutions that confront the challenges Americans and the world face today. Anything is possible if you set your mind to it.

Meidas+ is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.

So, here’s what happened. Before I co-founded MeidasTouch, I was a civil rights litigator. I represented families in wrongful death cases, catastrophic injury cases, and police brutality cases, where often a family member was killed. What I learned in representing families who lost a loved one in a police shooting or other excessive force incident was that family members struggled to find out the cause of death from the county or city coroner. Family members were often blocked or severely delayed from getting the autopsy report. Then, even when the family got the report, it was often incomplete, had errors, or contained information that seemed suspicious. The family members did not know what their rights were if they couldn’t access the autopsy reports, and thus, many families couldn’t retain lawyers if they couldn’t even explain what happened. Also, family members were caused great distress not knowing what happened to their loved ones when often the only public narrative of what happened came from the police and the government.

One of the things I learned in my law practice is that in many counties, the coroner and the sheriff are the same person. The coroner is often known as the sheriff-coroner. Also, many cities outsource their autopsies to the sheriff-coroner. Given the fentanyl and synthetic drug epidemic, many coroners are backlogged for months in preparing autopsy reports. Also, when the sheriff and the coroner are the same people, this creates a situation where the autopsies are not independent. The sheriff may seek to provide a cause of death for a victim that protects the officer.

For example, I had a case in Bakersfield where a person was strangled by the police and a K9 bit the victim's leg, causing death by pulmonary embolism, but the coroner reported the death as being caused by obesity, drug use, and resisting arrest. I took the deposition of the sheriff-coroner in that case and got him to admit what really happened. We prevailed, and the family settled the case.

With this knowledge, Colin Kaepernick (a client and friend) and I wanted to do something about this. We wanted to get families the answers they desperately needed when a loved one died at the hands of the police. Knowledge is power. One of the things I was familiar with was the idea of a second autopsy from a private forensic pathologist. The problem is that second autopsies with reports from private forensic pathologists can cost up to $10,000. Most families can’t afford this.

So, Kaepernick and I put our heads together, and we created what became known as the Autopsy Initiative. We brought in the top forensic pathologists in the world and got them to agree to a discounted flat rate to perform second, independent autopsies. We created detailed protocols for linking families going through the biggest tragedy in their life with the pathologists. We had to deal with logistics of transporting the body, working with funeral homes, ensuring the independence of reports, delivering news to grieving families, and raising money to fully subsidize the cost so all families who applied to the program would get a second autopsy for free.

This Autopsy Initiative started as an idea for a novel problem and is now a thriving program. Sports Illustrated chronicled our efforts here.

The reason I wanted to share this story with you is because I want you to think about your unique life experiences. Are you an accountant? Are you a chef? A teacher? A waiter? A salesperson? A dancer? A writer? What are your hobbies? What is some unique knowledge you possess? Think about it after reading this. The same way I had unique knowledge about the lack of transparency in autopsies in police cases, think about a problem you know about where you can create a solution.

Now, the fact you are reading this leads me to believe you are a member of the Meidas Mighty. That means you are already connected to a network of millions of people who can help amplify your ideas and plans. Think hard about how to turn your plan into a structure that creates and helps the lives of people.

During these difficult times, we will need to be scrappy. We will need to create new programs and structures that don’t yet exist. That may be in relation to mass deportations or other plans by Trump. Don’t be discouraged if your ideas don’t immediately take off. It took us over a year to launch the Autopsy Initiative with different starts and stops. Heck, when MeidasTouch started, our audience consisted of about 5 people who were mostly our family members.

I am confident you possess the skills to make a difference during these times. Believe in yourself. I believe in you.

MeidasTouch has zero outside investors. Please consider becoming a paid Substack member today.

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Strong winds

Robert Reich Dec 12

Friends,

I’m sitting in the United Airlines terminal at the San Francisco airport. The plane on which I was scheduled to travel to Newark, New Jersey, has already been delayed three times. It was scheduled to depart at 1 pm. It’s now departing at 4:40 pm.

They’re blaming strong winds in the Northeast. But another United flight scheduled to depart at 2:30 pm just took off on time. I asked the service attendant why the 2:30 pm to Newark had departed despite strong winds. He explained that the real problem wasn’t strong winds; it was a lack of air traffic controllers in Newark. My suspicion is United is trying to minimize the number of late flights; rather than risk two, it sacrificed my 1 pm.

I asked the attendant if he thought my flight will actually depart at 4:40, because I have to get to a Hilton Hotel in Elizabeth, New Jersey, by early enough to get a few hours sleep before attending meetings tomorrow morning. The attendant said “there are no guarantees. This flight could depart anytime, or it could be cancelled.”

When I phoned the Hilton Hotel in Elizabeth, New Jersey, to tell them I’d be checking in very late tonight, I got a menu that told me to “press 2” to change or modify a reservation. When I pressed 2, an automated voice said I could not change my current reservation but could make a new reservation. The automated voice also said if I was experiencing any difficulty I should go to the Hilton website.

I found the Hilton website, which asked me to fill in a reservation number. But I didn’t have a reservation number. When I reserved a room, Hilton had given me a confirmation number but not a reservation number. I typed in the confirmation number, but the website said the confirmation number was incorrect.

I spent the next half hour trying to find a human being at the Hilton Hotel to ask them to keep the room for me despite my lateness. Finally, I connected with someone who didn’t understand what I was asking. I asked them where they were located. They said they were not permitted to say.

It’s now 3:35 pm, and I’m still sitting here in the United terminal in San Francisco. The customer service person I just spoke with told me the plane “may or may not take off.” I’m about to phone the people I was to meet with tomorrow to tell them I won’t be there.

I relate this to you because I’ve been thinking a lot lately about the frustrations that might drive people to vote for a strongman who promises to “shake things up” even if he’s intent on destroying our democracy, or might cause people to cheer for someone who murders the CEO of a giant health insurer.

United Airlines is one of four remaining national carriers (there were 10 in 2000). In the third quarter of 2024, it had pre-tax earnings of $1.3 billion, with a pre-tax margin of 8.7 percent. In other words, it’s doing fabulously well.

Hilton Hotels is almost as profitable. In fact, its net operating profits have shot up from what they were a year ago. It’s also doing fabulously well.

Big American corporations are doing better than ever. The stock market has hit record highs. CEO pay is hitting new highs.

But American workers and consumers are being shafted with lousy service at ever more expensive prices.

Something’s got to give. Right?

Week in Review | Trump, Musk, and the GOP 'Declare War on Social Security'

 

LOST IN SPAM! STILL RELEVANT!

Saturday, December 7, 2024 ■ The Week in Review Brutal Murder of Insurance CEO Sparks Wave of Dark Humor, Including Fictionalized Denial of Coverage Letter "You don't have to sanction murder to see why so many Americans detest health insurance corporations who prioritize profit goals by routinely creating arbitrary reasons to deny patient needs," said one labor movement voice. By Eloise Goldsmith • Dec 6, 2024 'Nothing Is Sacrosanct': GOP Floats Social Security Cuts After Musk Capitol Hill Visit "They're going to put everything on the table," one Republican lawmaker said of Elon Musk and Vivek Ramaswamy. By Jake Johnson • Dec 6, 2024 Billionaire Jeff Bezos Wants to 'Help' Trump Gut Regulations "Shockingly another one of the richest guys on Earth wants to defund our government and scrap regulations." By Jessica Corbett • Dec 5, 2024 Jayapal, Sanders Offer Answer to Elon Musk's Healthcare Cost Question "The most efficiently run healthcare systems in the world," said National Nurses United, "have been proven time and time again to be single-payer systems." By Julia Conley • Dec 5, 2024 'What a Racket': CBO Finds Extending Trump Tax Cuts Would Shrink US Economy "The looting has begun," said one Democrat. "Far from unleashing record-breaking growth, the next Trump tax scam will make hardworking families worse off, shrink our economy, and blow a $4.6 trillion hole in the deficit." By Jake Johnson • Dec 5, 2024 Trump Offers Key Pentagon Job to Billionaire Whose Firm Trained Khashoggi's Murderers Stephen Feinberg is co-CEO of Cerberus Capital Management, which owns a company that provided training to members of the hit squad that murdered Saudi journalist Jamal Khashoggi. By Jake Johnson • Dec 4, 2024 Watchdogs Say World's Richest Man Elon Musk Has 'Declared War on Social Security' "Elon Musk's commission is a plot to destroy our Social Security by giving it to Wall Street executives—so that you get nothing and they get everything," warned one advocate. By Jake Johnson • Dec 3, 2024 46 Senators Call on Biden to Certify Equal Rights Amendment as GOP Control Looms "There is no excuse for leaving us all unprotected," said one advocate. By Julia Conley • Dec 3, 2024 'Unhinged' Trump Vows 'There Will Be All Hell to Pay' If Hostages Not Released "Someone tell Trump that Israel already unleashed hell on Gaza, and hostages were not released." By Jessica Corbett • Dec 2, 2024 ICC President Warns Attacks on Court Threaten 'Future of Humanity' The judge pointed to Russian arrest warrants for court leadership and U.S. threats of "draconian economic sanctions." By Jessica Corbett • Dec 2, 2024 Sanders Says There Is No Choice: 'We Must Defeat the Oligarchs' The U.S. Senator from Vermont is asking big questions about how to achieve—even in the face of Trump's return—an "economy and government that works for all, not just the few." By Jon Queally • Nov 30, 2024 VIEW ALL NEWS JOIN THE MOVEMENT As a people-powered nonprofit news outlet, we cover the issues the corporate media never will. Your contribution supports this bold media model—free, independent, and dedicated to reporting the facts every day. Stand with us in the fight for economic equality, social justice, human rights, and a more sustainable future. JOIN WITH US TODAY ■ Opinion Medicare Advantage Deadline Is Today: Get Out! Enough is enough. Let your members of Congress know it’s beyond time to fix the Court and Medicare, so scams like Medicare Advantage can no longer rip off America’s seniors while making industry executives richer than Midas. By Thom Hartmann • Dec 7, 2024 Beware the Toxic Chemicals at Dollar Stores The nation’s largest dollar stores continually fail to meaningfully strengthen their chemical policies and intervene in their supply chains to keep their shoppers safe. By José Bravo • Dec 3, 2024 Honest Math Shows That the Wealthy Aren’t Paying Their Fair Share For taxing the rich, we currently rely on an income tax based on adjusted gross income as our primary vehicle. That isn’t working. By Bob Lord • Dec 3, 2024 Welcome to Gilead. Enjoy Your Stay in Trump 2.0's America It's a real-life version of the fictionalized republic, where they really do hate women and they’re not afraid to say so. By Rebecca Gordon • Dec 2, 2024 The Democratic Party Reaped What It Sowed Without a return to authentic working class politics, the party has no future at all. By Bruce T. Boccardy • Dec 1, 2024 VIEW ALL OPINION

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