Four days a week, I take calls for a Maine-based healthcare provider. The calls run the gamut: people are sick, they want to fill their prescriptions (and there are lots of pills being pushed), or they make some variation on a common theme—demanding some kind of service (often that day), demonstrating how little they know about how broken our healthcare system really is.

Back in the late 1990s, I worked for another healthcare provider. We were an HMO, back when HMOs were supposed to save the day and reinvent medicine in America. More important in this discussion was that HMOs were expected to be the cost-containment deemed necessary at that juncture. HMOs did not save healthcare.

I really liked my gig back then. The organization was locally-managed and really had a humane, quality-focused approach to healthcare. Where I’m at now often reminds me of that time 20 years ago. However, the organization with skilled local management got swallowed like Jonah getting inhaled by the whale. A corporate giant vacuumed up the business based in Freeport and almost overnight, everything went downhill.  Profit became the primary motif and most of our group who were hired together to service a block of Midwestern business, scattered to the four corners of the work world. Some of us ended up at a disability insurer I’ve often referred to as Moscow Mutual. That’s another story I’ve written about, including in a book of essays that mainly ended up being relegated to the publishing dustbin.

Elizabeth Warren, one of the bloated field of Democrats, released details recently about her Medicare for All plan, her solution for overhauling American healthcare. As soon as Warren dotted the I’s and crossed the T’s of her plan, the critics crawled out from their corners, detailing why moving from a broken system to one covering everyone, lowering costs, and improving care outcomes won’t work. Continue reading →