Broadcast 1/31/2016 at 2:32 PM EST (103 Listens, 92 Downloads, 2038 Itunes)
The Rob Kall Bottom Up Radio Show Podcast
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Gerald Friedman is a Professor of Economics at University of Massachusetts at Amherst. He is a consultant and economic analyst on single payer healthcare and a labor historian and economist.
Rob: You're done so very interesting work with singer payer. My understanding is the Sanders campaign is using your findings. Is that correct?
Yes, that's about right. I might add that if the Clinton campaign decided to do the right thing, I would be delighted to work with them as well.
Rob: "The right thing" being?
To come out for single payer.
Rob: As opposed to what do you see them doing
Little tweeks on the Affordable Care Act which itself is reform of the existing private health insurance health system. A reform that has done some good things. It has brought health insurance coverage to millions of people and saved thousands of lives. But it leaves 30 million of people outside the health insurance system and tens of millions unable to access health care because of costs.
The ACA will not bring health care costs under control.
The prices of health care have been rising more and more for the past 40 years, and this rising costs have been forcing people out of the health care system and keeping people from spending on other things.
Rob: Why is it costing more and more?
rising administrative burden of operating the for profit health insurance system. They've found that using administrative red tape discourages people from using health care
rise and cost of prescription drugs. We pay 65% more for the same drugs than people in other countries and 70% more than the VA pays.
3- monopolistic behaviors by elite hospitals Mass General charges four times as much for the same services. The same thing happens all over the United States. T
The single payer can take care of all of those problems. Nothing in Hillary Clinton's program will address those.
The liberals understand that single payer will be better but they lack the political .
Rob: You've this work, these findings
United States, For Massacheusets, Maryland, one for PA, one for CO, OR, RI, New York. The NY study led to enactment by the lower house of the NY legislature
And I did an analysis for the Sanders campaign for national health care.
Rob: There's Vox article says" Bernie Sanders's health care plan is underfunded by almost $1.1 trillion a year, a new analysis by Emory University health care expert Kenneth Thorpe finds."
If you read his paper it's very hard to see where he got his $1.1 trillion. He's making outlandish assumptions. He's assuming a very small reduction in administrative expense-- the saving will be less than we would save just by getting rid of those companies. If we replace the current process with medicare we save $200 billion. He assumes there are less savings than that for the entire program.
Thorpe underestimates the savings by about $500 billion a year. He does say anything in his memo about savings from drug prices. There are $200 billion in drugs that he leaves out.
Take it all together, he's leaving out hundreds of billions of dollars in savings but we still don't get to 1.1 trillion and that's because he's assuming a huge increase in utilization of almost 40%-- that people go to doctors a lot more and cost a lot of money.
IN the past his numbers were very similar to mine. Now he's working for Blue shield, he works with the Clinton Global initiative.
Rob: Chuck Pennacchio, what's your take on Thorpe
Chuck: conflict of interest
What's wonderful about Jerry Friedman is he's an economist working for a university. With the other economists you can just follow the money.
I'd like to hear from Jerry about the state of economics in this country as compared to other parts of the world. It's a world view that's very ideologically driven.
Rob: Jerry, you want to talk about economics and economists?
Economics is a very sad discipline, and it's important to us, but the profession is in a very sad state. The dominant paradigm in economics has been thoroughly discredited. It's a failure. Even Alan Greenspan had to admit he was wrong. Why do people continue to teach it. As Chuck said, you have to follow the money. Groups from the Koch brothers, Melon Foundations, have been paying economists. There was an analysis by Jerry Epstein"
The economics profession used to have no code of ethics, no disclosure of funding sources. My colleague went to reports by leading groups and looked at which economists were used.. they found that 13 of 15 economists had been paid by the financial services industry. Some of these are egregious. For example, an economist at Columbia wrote a paper on banking in Iceland. When the banks went bust in Iceland, the economist changed the name of the paper to financial Instability in Iceland.
You pay an economist $100,000 and you can probably get them to do anything you want. Most academics are not rich people and the amount of the money on the other side is huge. If I say that we can save $600 billion next year on single payer, that is $600 billion of income for some people.
employees can get new jobs, but nobody is going to pay Steve Helmsly $48 million a year.
Rob: so you are saying that there are huge amounts of money to pay economist to say whatever is wanted.
Rob: are you saying that Thorpe is engaging in unethical behavior.
No. the standard of ethics in economics are low" I don't know the man, he may believe in what he wrote. IF he did it honestly, there will certainly be other people who do it for money. Maybe it's the economist in me but I believe that if you wave enough money, there will be some people who do what you want.
Rob: what is the failed economic paradigm.
The operations of free markets will provide for full employment and the optimal distribution of output without any conscious political intervention.
that' neoclassical economic theory. associated with Leon Volrath, with
Milton Friedman was the most prominent advocate of this
It's been associated with reducing taxes on the rich, reducing government regulation, as in health care, deregulations of interstate trucking, airlines, telecommunications, banking. We've seen the results have been slower economic growth, more unemployment, stagnation"
The golden age was a period of high taxes, active government interference in the economy. A lot of people blame this on the Republicans. I wish that was true. It started with Carter, continued under Reagan and Bush and under Clinton-- who did the Coup de Gras-- ending the Glass Steagall act.
The only Americans who have done better under the current policies are the very rich.
The richest handful of Americans own more than the bottom 50% of Americans.
Declining life expectancy for the poorest 40% of American women who have shorter life expectancies than 20 years ago. Study at Brookings institution by Barry Bosworth.
The bottom 40% have stagnant life expectancy over the last 30 years. Women have actually lost ground. The richest people have added 3-6 years of life expectance. In Canada and Europe everyone has had 4-6 years increase in life expectancy.
If you're on medicaid it's difficult to find a providers. Over 80% of employer provided health care has deductibles-- a quarter of Americans did not see a doctor when they felt they needed to because of cost.
Among the insured Americans almost 20% did not fill a prescription because of cost.
Rob: Underinsurance-- could you explain what it is and percentages
People who have health insurance but it is inadequate-- deductible or co-payment is too high, or cost sharing, like 20% of hospitalization, or limit of ten visits. Most of the people who go bankrupt because of medical costs are insured. Probably over a third are underinsured. Of people who have health ins. did not go to a doctor because of cost, almost 20% didn't fill a prescription because of cost.
Rob: Under Bernie Sanders plan what would people pay for a doctor's visit and a prescription.
Nothing. 98% of health care costs would be covered, except some cosmetic surgery, over the counter drugs, some dental. Part of the point of this is to encourage the doctor when they are sick because we believe that modern medicine helps keep people healthy.
It will mean that we will be spending more money because people will be going to the doctor when they need to. People will be sick less. Americans are sick twice as many days as in Brittain. We don't take care of problems because it is expensive to go to the doctor.
THis country is filled with senior citizens who stretch out their heart medications" poor mothers who get an RX for themselves and their children and only fill the RX for their children.
WHen you put children into medicaid their learning increases.
A majority of American children will have a period of poverty before they turn 18. There are lasting legacies of malnutrition and inadequate healthcare.
Rob: Hillary Clinton has been making claims about Bernie's plan
She should lay off these bogus attacks on Sanders. She's picked up on right wing charges. For 95% Bernie sanders will be lowering taxes because what we pay in premiums is as much a tax, since ACA requires paying for health care,
Under Sanders total economic proposal people would get free college at public institutions, people on social security would be getting real social security increases, and people would get family leave provided through the social security system. So, yeah, some taxes would go up but what people would be saving in private taxes would more.
One to three percent of Americans would be paying more.
The Sanders economic program is not just about taxes and spending an economic regulations, the $15 minimum wage" it's about economic growth. The unemployedment rate will drop to 4% and growth will go up. People will have jobs, the economy will expand, there will be a $20,000 increase under Senator Sanders plan
Rob: That's compared to a drop in income over the past 10-20 years.
If we continue what we're doing it's really discouraging. The CBO is projecting the percentage of people with jobs will decline. That's what Hillary Clinton is offering.
Trump and Cruz are offering what the right wing extremist groups in France are offering.
I feel this time is very scary. It feels like the years of Weimar Germany. Donald Trump is strongest in the areas and among workers who should be rallying to Bernie Sanders-- with low wages, stagnation".
West Virginians have been screwed by an economic program that transfers worth to the very wealthy. Hillary Clinton is not offering much better.
Rob: What about Paul Krugman? He's been attacking Bernie's plan
Because it's not politically viable. ACA is not a solution it leaves tens of millions without health care and doesn't fix the costs.
Rob: But is single payer not politically viable.
It is viable. In 1958 people said 'we can't go fast on civil rights. We can't go fast on segregation. We have to go slow." Within in six years we had civil rights. Within seven years we had a voting rights act. Hillary has forgotten that.
Rob: Has Krugman said anything about your analysis.
The problem is he knows and he's written that single payer is better.
Rob: So what you are saying is Krugman, who has a Nobel prize in economics, is not talking about economics he's talking about politics, where he does not have a Nobel prize.
Rob: we have to wrap up with Anything you want to wrap up with.
Chuck: the politics of despair, fear mongering, cynicism. We see this in the classroom, with the students. We 've got to tap into this, it's part of our American DNA
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