Getting sick and going bankrupt – CVS, credit cards and crippling medical debt – The Health Care Blog

BY MIKE MAGEE

The Medical-Industrial Complex is teeming with scammers. This is to be expected when you build a purposefully complex system designed to increase profitability for both small and large players. The $4T operation that pays 1 in 5 American workers is in large part a hidden economy, one built by professional impostors, designed by Fortune 100 corporations with mountains of lobbyists, but also bolstered by friendly doctors and hospitals. who engage in large-scale small and small scams that justify their predatory actions as entrepreneurial, innovative and targeted means of necessary financial survival.

When expensive stakeholder lobbyists are called before Congress, as they did on March 29, 2022, before the House Committee on Oversight and Reform, they make it sound like Americans should embrace the privilege of being screwed over by the MIC elite. But as former Kaiser Permanente CEO George Halvorson recently recalled, “People go bankrupt if they get care, even if they have insurance.”

Suffice it to take one back to the early 1950s, when Arthur Sackler helped launch the Medical-Industrial Complex. In fact, our modern willingness to disguise health care brutality in supercilious language and fail justice is extreme enough to go back to June 9, 1954, when Boston attorney Joseph Welch was hired by the United States military to Against charges of Communist infiltration, Senator Joe McCarthy told Senator Joe McCarthy, “I never dreamed you could be so reckless and so cruel… You’ve done enough. Have you, sir, at last no sense of decency?”

Halvorson and others seem to be reaching a similar boiling point, ready to tell the MIC controllers and apologists, “Haven’t you done enough?”

The most recent tipping point comes in the form of a June 16, 2022 KFF survey showing that more than 100 million Americans, including 41% of all adults, have significant medical debt, much of it out of sight, on personal credit. Cards. Hospitals and doctors use the patient cards for payments, which drains patients, with high interest on plastic debt. 1 in 8 now owe more than $10,000, with nearly 20% saying they will never be able to pay it off.

The problem is accelerating as health insurers have pushed tight plans with deductibles that can legally reach $8700 per year per person. As I documented with Tenet Health Care Systems and their conifer collection system in 2018, the debt business has more than once saved poor hospital practices and mismanagement by medical groups. Now, four years later, 58% of debt quoted by a collection agency is medical in nature. One in ten of desperate debtors owes money to family members, and collective medical debt now exceeds $195 billion as of 2019.

As if it couldn’t get any worse, the blame (as one might expect) isn’t evenly distributed. Southern states are overrepresented because of poor insurance laws, lack of Medicaid expansion, and greater prevalence of chronic disease in their populations. Medical debt is 50% more common in blacks and 35% more common in Hispanics than whites. If you live in an unhealthy province (measured by the high rate of chronic illness), 1 in 4 has medical debt, compared to 1 in 10 in healthy provinces.

Of course, if you’re unhealthy in the US, you’re also in the crosshairs of direct-to-consumer drug advertising. The practice of pushing drugs through TV ads is only allowed in one other country in the world.

More than 1 in 3 Americans will fill those prescriptions at CVS, where whistleblower Alexandra Miller worked. Where does she blow her whistle? According to STAT’s uber-pharma investigative reporter, Ed Silverman, her lawsuit states that “As of 2015, CVS reportedly coordinated an effort that relied not only on its subsidiary SilverScript (Medicare Part D), but also on its Caremark pharmacy benefits manager (PBM). ) and its chain of CVS retail pharmacies to prevent consumers from buying cheap generics because the company benefited from making only more expensive branded drugs available to its customers….”

The kickback scheme included SilverScript, the sponsor of CVS Health’s Part D plan; his pharmacy benefit manager, CVS Caremark and CVS Pharmacies with hidden rewards flowing back and forth as patients’ credit card debt skyrocketed. As America plunges headlong into recession and the economy becomes bedridden, Arthur Sackler’s ghost rises from its gilded crypt and whispers, “It’s your own health care system that’s making you sick and broke.”

Mike Magee, MD is a medical historian and health economist and author of “Code Blue: Inside the Medical Industrial Complex.”