Saturday, August 22, 2020

Medicare For All

Medicare For All 


Sixty-nine percent of registered voters in the April 19-20 survey support providing Medicare to every American, just down 1 percentage point from a Oct. 19-20, 2018 poll, and within the poll's margin of error.



By JM Hamilton (8-22-2020)


Progressives in the United States support Medicare for All and are continually snubbed by the establishmentarians in both the Democratic and Republican parties.  Americans want to choose their doctors, they want to choose their health plan, Americans don’t want socialized medicine… are the familiar rebuttal arguments.  (And that might be true for a handful of very wealthy Americans.)  But is that true or is the establishment just protecting their financial interests, the Healthcare stocks within their portfolio, which are wildly profitable?  Is the establishment merely projecting their desires, and interests, upon the American people once again? 

Poll after poll shows that the majority of Americans want Medicare for All.  And as the next Great Depression hits the economy, and more & more Americans lose their health insurance, the numbers supporting Medicare for All will surely climb… well beyond a simple majority. 

As both an American & Canadian, I believe I have unique insight into the healthcare systems of the two nations, but perhaps more revealing is how the two systems stack up in a time of crisis.

Last Fall, early Winter, I chucked my thirty-plus year career in the United States and moved to Canada.  The Goddess smiled upon me, as my timing was perfect. I moved into my apartment in Canada, the second week in January 2020, w/ no idea that a pandemic was about to hit. I met my Canadian doctor w/in a week or two, the handful of medications I take were filled at the local pharmacy, and despite one or two visits, no bills or deductibles or copays ever arrived in the mail.  

Before I left the US, I had several medical procedures performed, and while my doctors in the US were great … my Canadian doctor is equally wonderful.  But the cost for American medical insurance was outrageous, kept me tethered to my employer, and the copays and deductibles that arrived - in a never-ending stream - felt like the financial equivalent to being waterboarded.

In fact, the United States pays double what many Western democracies pay for their Universal Care plans.  Nearly twenty percent of US GDP goes to healthcare, while American life expectancy is reported to be in decline.  Meanwhile, among Western democracies, other than the US, healthcare spending is nine to twelve percent of GDP.  Thanks to predatory healthcare cartels and monopolies – Insurance Companies, Big Pharma, and Pharmacy benefit managers, often, stand out as the most egregious offenders – the American healthcare system is a drag and a tremendous tax upon the overall economy. 

Let’s do the simple math.  Pre-pandemic US GDP was approximately 20 trillion.  Twenty percent spending on healthcare means four trillion in US GDP goes to medical care.  If our Western allies, like Canada, spend half that amount, in term of GDP, vis a vis the US… this means Americans and the US economy are paying an extra two trillion dollars a year for a system that produces substandard outcomes.  And in many instances the US healthcare system is a death sentence for lower income and poor Americans. (True, Canadians do pay higher income taxes, but the differential is, most often, a shadow of the costs Americans pay for health insurance.)

That’s two trillion dollars that could go into alternative products and services w/in the US economy, instead of into the pockets of insurance companies, pharmacy chains, Big Pharma, and healthcare stock dividends and stock appreciation (that only benefit a privileged few Americans). 

Just for emphasis: Two Trillion Dollars flushed, annually.  Enough to pay off all outstanding American student debt, with nearly half a trillion left over. 







And the pandemic has only revealed - w/ tremendous honesty – how catastrophic the current US healthcare system is.   The US leads the world in virus cases and virus deaths.  It’s embarrassing and a stain on a nation that prides itself on exceptionalism.  To be fair, and clear, the healthcare crisis in the United States cannot be laid entirely at the healthcare industry's doorstep… the catastrophe had a sizable push by the political duopoly, which constantly puts donor and financial interests before the interests of the American people.

Americans forego healthcare in the United States because they are afraid of the outrageous fees and charges… a situation that has only grown worse with Private Equity’s entrance into the healthcare arena (see shock & awe billing).  Canadians don’t forego healthcare.  Based upon my observations: Americans live to work; Canadians work to live.  That’s a huge distinction, and I see it – and saw it - every day. 

To watch the US go down in a ball of flames, the economy and the healthcare system, greatly saddens me.  But what makes me happy is the Canadian economy is rebounding sharply, significantly outperforming the US.  I have a considerable amount of family in the US and they are all in my prayers daily.  But what is outrageous, as it is sickening, is the abject failure of the politicians in the US from both major parties.  And their perennial inability to respect the wishes of the disenfranchised – their voters, who they rely upon to get into office – all so that they, and their donors, can go on extracting a monopolistic tax from the US economy and indentured citizenry. 


Democratic and Republican leadership, at the national level, should be ashamed.  Healthcare is just but one of many examples, where the duopoly - as well as, business leaders - are not looking out for the good the nation, at the expense of the American people and the economy. 


Copyright JM Hamilton Publishing 2020

Sunday, August 9, 2020

Crazy after all these years

Crazy after all these years 


ESG investing often marches under the same banner as “stakeholder capitalism,” which maintains that corporations owe obligations to a range of constituencies, not only their shareholders. Erisa [the Employee Retirement Income Security Act] requires something different of retirement plans, however: A fiduciary’s duty is to retirees alone, because under Erisa one “social” goal trumps all others—retirement security for American workers.


By J.M. Hamilton 8-9-2020

Late cycle neoliberalism appears to center on two central business models: either becoming so monolithic, that said enterprise becomes a nation state (the Silicon Valley approach); or strip a firm bare, bust out its credit line, slash labor, and extract rents from the consumer before the horse gives outs (the Private Equity/Wall Street method).  

At the center of these two business models are two central themes, the desire to control every aspect of the business environment, to better ensure profitability, and given what we’ve seen as of late, a whole lot of crazy. 

And the methodology for attempting to control the business environment has been well documented: 

Competition… Eliminate or merge w/ it and become bigger; 
Government & Regulatory bodies … co-opt, capture, and own; 
Consumer… Make sure you’re the only game in town, so said consumer has few or no alternatives;
Labor… Utilize monopsony power, destroy unions, and line the Federal Courts & SCOTUS with reactionary/anti-labor jurists;
Taxation… Dodge it at all costs to starve the government of revenue;
Monetary Policy… Free money for financial engineering, industry consolidation, speculation, and to finance unearned dividends; and
Consolidation & monopoly… achieve zero oversight and M&A w/out limit.  


And it is this very desire to control & guarantee profits that has led to government paralysis in a time of crisis.  A nation governed by special interests – by profit motive – to the exclusion of all other considerations – is a nation destined for collapse.  The U.S. and the world are witnessing the culmination of special interest rule – profit rule (i.e. neoliberalism) – with the Trump Administration’s badly botched pandemic response.  A nation drowning in debt, bailing out banksters & financing credit card wars… certainly is ill prepared for a true existential threat. 







And as the two aforementioned business models become preeminent, the more we see American companies, government, management, and ownership do & say crazy.   

See Elon Musk praising communist China and telling America and US labor that basically - I paraphrase - they suck. 

We read that the Private Equity model is so ubiquitous that 20% of all US corporations are now zombies, per Deutsche Bank… that is, so indebted, and so lacking in income, that they can’t make their interest payments.  Welcome to deadbeat Corporate America, brought to you by unmitigated greed and the Federal Reserve. 

Americans survive the virus only to go immediately into bankruptcy with million-dollar medical bills, as private equity – not content to have destroyed American retail – dives into US healthcare.  And if you think Americans pay the most, per capita, for healthcare (w/ substandard outcomes), the United States hasn’t seen anything yet. 

PPP, under the CARES Act, is raided by the connected and powerful – a program designed to keep small business afloat – only to see thousands of Main Street and family run enterprises go under.  

Then there’s the optics of Trump attacking, perhaps, the only Western nation the United States runs a trade surplus with, Canada, when including services. Trump's latest tariff on Canadian aluminum smacks of desperation, election year theatrics, and misdirection.  


And finally, there was the visual of four Tech Utility CEOs completely choking in front of Congress.  And Dems, actually, surprisingly, appearing to have done their homework, unlike the billionaires in the docket defending their monopolies.  Post- November, it will be time to ramp up the FTC and Justice Department and to immediately begin breaking up the Tech Utilities. 


Absolutely strange, but perhaps the most surreal story JMH read in the last two weeks was the Bloomberg piece on Labor Secretary Scalia.  Going along with the themes of controlling your environment (good luck with that), and doing crazy, Mr. Scalia’s bright idea is to dictate to pension/retirement fund managers that they must invest based purely on shareholder value and short-term returns (irregardless of all other considerations). 

Mr. Scalia’s proposal, of course, is in retaliation to stakeholder capitalism and sustainable investing, or ESG investing, which is a direct affront to a huge GOP donor, Big Oil & Gas

Scalia appears to have tapped into the ultimate forms of control and crazy: Telling fund managers exactly how they must invest.  

Perhaps Mr. Scalia hasn’t noticed… but if America’s pension & retirement funds were to take up Mr. Scalia’s proposal, the first stock to dump – based upon a shareholder first focus – would be the planet killing, Big Oil stocks (which have been crushed by the pandemic). And these stocks will, likely, suffer additional fallout, before this crisis is over. 

All of this is very odd.  The more the GOP and their corporate supporters beat their chest about freedom and the evils of socialism, the more their actions betray them as dictators in love with big government & welfare for the 1%. 


Copyright JM Hamilton Publishing 2020