Jeffrey Kivi, PhD, was receiving monthly infusions of Remicade to treat psoriatic arthritis, an autoimmune disease he’d had since childhood. The drug enabled the high school science teacher to stand all day in his classroom and to walk down the school’s hallways. Each monthly infusion cost $19,000, which his insurance covered.
Then his doctor switched hospitals.

The cost of Kivi’s infusions ballooned, soon surpassing $132,000 a month. He still wasn’t responsible for any of the cost, but he was stunned. What could account for this disparity in price?

Plenty of factors, writes Elisabeth Rosenthal, MD, in her new book An American Sickness. The new hospital spent more on amenities and marketing. It held the patent on Remicade, and stood to benefit from its administration if profits were high enough. And Kivi’s insurer didn’t push back against the higher price — instead, it paid three-quarters of it. Kivi was so appalled he switched to a medication he could take at home.

...Why did EmblemHealth agree to pay nearly $100,000 for each of Jeffrey Kivi’s infusions, even though they cost only $19,000 at another hospital just down the street? First, it’s less trouble for insurers to pay it than not. NYU is a big client that insurers don’t want to lose, and an insurer can compensate for the high price in various ways — by raising premiums, co-payments, or deductibles. Second, now that they suddenly have to use 80 to 85 percent rather than, say, 75 percent of premiums on patient care, insurers have a new perverse motivation to tolerate such big payouts.

In order to make sure their 15 percent take is still sufficient to maintain salaries and investor dividends, insurance executives have to increase the size of the pie. To cover shortfalls, premiums are increased the next year, passing costs on to the consumers. And 15 percent of a big sum is more than 15 percent of a smaller one. No wonder 2017 premiums for the most common type of ACA plan are slated to rise by double digits in many cities, despite economists’ assurances that the growth of health care spending is slowing.

To some extent insurers do better if they negotiate better rates for your care. But that is true only under certain circumstances and in a limited way. “They are methodical money takers, who take in premiums and pay claims according to contracts — that’s their job,” said Barry Cohen, who owns an Ohio-based employee benefits company. “They don’t care whether the claims go up or down 20 percent as long as they get their piece. They’re too big to care about you.”

https://stanmed.stanford.edu/2017spring/how-health-insurance-changed-from-protecting-patients-to-seeking-profit.html

Durham, New Hampshire (CNN)Sen. Elizabeth Warren said Wednesday that she will "of course" consult with Sen. Bernie Sanders about her soon-to-be-released plan on how to pay for "Medicare for All," but that she has not yet discussed those details with him.

"I'm glad to talk to Bernie about this," Warren told reporters after a campaign rally in Durham, New Hampshire.

...Sanders, who authored the Medicare for All legislation, said in an interview with CNBC published Tuesday that he did not believe a full financing plan was necessary "right now." But he has, both in 2016 and more recently, released white papers articulating a set of potential pay-fors.

...Warren in New Hampshire reaffirmed her support for Medicare for All and again promised that she would soon release a clear outline of how she would pay for it. "I continue to work on parts of it that need more information," she said. "For me, one of them is about talking about what the cost is. You may know, the cost for Medicare for All estimates vary by trillions and trillions of dollars. So I'm going to have a plan to talk about what the cost is and I'm going have a plan to talk about how we can pay for it."

Asked what she made of the recent "flak" she's come under from other candidates, Warren downplayed the attacks and argued that, for all the recent noise, the differences among the Democratic candidates are mild in comparison to what distinguished the party from its GOP opponents.

"Actually, I don't see it as flak. I see it as people who are wrestling with the question of how we make sure that Americans get covered by health care," Warren said. "You know, it's the other side, the Republicans, who think it's just fine for millions of people not to have health care coverage at all, for insurance companies to be able to discriminate against people who have preexisting conditions, who are right now pursuing a lawsuit so that the entire Affordable Care Act would be repealed."

https://www.cnn.com/2019/10/30/politics/elizabeth-warren-bernie-sanders-medicare-for-all/

John Harwood: One of the constraints has been fiscal. Senator Warren is producing plans to pay for Medicare for All. You’ve identified revenue sources for about half of it. Do you think it’s important to identify revenue sources for the other half? Or do you believe, as those who subscribe to modern monetary theory believe, that we’ve been a little bit too constrained by concerns about the deficit?

Bernie Sanders: We’re trying to pay for the damn thing. At a time of massive income and wealth inequality, it is my view that the wealthiest people in this country, the top 1/10th of 1% should be paying substantially more than they’re paying right now. You have an insane situation. Let my Wall Street friends there tell me why it makes sense.

... John Harwood: But you still have more revenue to go to make it fully paid for, yes?

Bernie Sanders: The fight right now is to get the American people to understand that we’re spending twice as much per capita, that of course, we can pay for it. We’re paying it now in a very reactionary, regressive way. I want to pay for it in a progressive way.

You’re asking me to come up with an exact detailed plan of how every American — how much you’re going to pay more in taxes, how much I’m going to pay. I don’t think I have to do that right now.

John Harwood: You think it’s foolish that Senator Warren is trying to?

Bernie Sanders: I’m not saying it’s foolish. All that I’m saying is that we have laid out a variety of options that are progressive. We’ll have that debate. At the end of the day, we will pay for every nickel of Medicare for All, and it will save the overwhelming majority of the American people, who will no longer pay premiums.

More at https://www.cnbc.com/2019/10/28/bernie-sanders-lets-not-make-people-overly-nervous-about-socialism.html

When Julián Castro walked off the Miami debate stage in June, his campaign staff felt confident he’d had a successful night. They weren’t the only ones.

U.S. Sen. Elizabeth Warren sent him a text congratulating him on his performance.

For any other sharp-elbowed politicians competing for their party’s nomination, the exchange might have been unusual. But Warren and Castro have, at various points in the primary, acted more as friends than foes.

Perhaps more than any other pair, the two candidates have shared tender moments throughout the presidential race, raising eyebrows across the nation. A photo of the two embracing at the Iowa Steak Fry, tweeted by Warren with a caption calling Castro a friend, racked up 13,000 likes.

https://twitter.com/ewarren/status/1175540969292410881

Castro, mired at the bottom of most national polls and on the brink of not making the cutoff for the November debate stage, has found an ally in Warren, whose profile continues to climb. It has led to speculation — or palpable hope for fans of both candidates — that Castro might be a leading choice for vice president on a Warren ticket. While Castro previously gave no indication he wanted to throw in the towel early, a recent fundraising email showing his campaign on the ropes has only intensified the scrutiny.

The two make an unlikely pairing. On the one hand is a cerebral, young Hispanic man who is a former Cabinet member and exudes poise bordering on robotic — a “LatinObama,” according to the comedy writers of “Saturday Night Live.” On the other is a white woman, dozens of years his senior, who’s running an upbeat, “I’ve got a plan for that” campaign and isn’t shy about speaking her mind.

Both candidates’ campaigns declined to comment for this story. But those close to Castro’s campaign say the two developed a healthy working relationship when he was U.S. housing secretary under then-President Barack Obama. Warren sat on the Senate Committee on Banking, Housing and Urban Affairs while Castro was at Housing and Urban Development, and he frequently worked with lawmakers overseeing HUD’s budget and programs. Over months of touring the country to court Democratic primary voters, that initial respect developed into genuine camaraderie. It was cemented, in part, by shared progressive ideals and a love for wonky policy proposals...

More at https://www.texastribune.org/2019/10/29/elizabeth-warren-julian-castro-friendship-2020/

So the federal budget deficit just hit $1 trillion (actually $984 billion, but close enough). That’s about $300 billion more than the Congressional Budget Office was projecting in the summer of 2017, before the Trump tax cut was enacted. And basically everybody yawned.

Were there fiery speeches in Congress, denouncing fiscal irresponsibility? No. Was there intense media coverage? No — the story was tucked deep inside major newspapers. Was there severe market reaction? No — interest rates are substantially lower than they were before the deficit surge.

This lack of reaction to a deficit that would have been considered shocking only a few years ago is sort of the fiscal policy equivalent of Sherlock Holmes’s dog that didn’t bark in the night. It tells us a lot about economics, politics — specifically the utter hypocrisy of the G.O.P. — and the news media, which on economic matters has a de facto conservative bias.

...When progressives propose new or expanded social programs, they face intense media scrutiny bordering on harassment over how they intend to pay for these programs. Republicans proposing tax cuts don’t face anything like the same scrutiny; they are seemingly able to get away with blithe assertions that tax cuts will pay for themselves by boosting economic growth, even though every single piece of evidence we have says that this is nonsense.

We’re talking about big numbers here. As I said, the Trump budget blowout, overwhelmingly driven by tax cuts, seems to have raised the deficit by around $300 billion, or around 1½ percent of G.D.P. Over the course of the next decade, that would amount to something like $3.8 trillion — substantially more than, for example, the combined cost of all of Elizabeth Warren’s proposals other than Medicare for All, which we’re still waiting to hear about.

And the truth is that proposals like universal child care are far more likely than tax cuts to repay a significant fraction of their upfront costs, partly by freeing up adults to work, partly by improving the lives of children in ways that will make them more productive adults.

The point is that the media clearly leans conservative in covering budget issues. Progressives face intense grilling over the cost of fairly modest social programs, while conservatives get a virtual free pass on budget-busting tax cuts.

More at https://www.nytimes.com/2019/10/28/opinion/us-budget-deficit.html

U.S. Rep. Katie Porter, a native Iowan and a rising star in the Democratic Party, confirmed to the Des Moines Register Saturday that she is endorsing U.S. Sen. Elizabeth Warren for president.

"Elizabeth will be the best leader for this country (because of) her ideas and her ability to translate those ideas into policies and structures that really change our country for the better," Porter, a freshman congresswoman from California, said in an interview.

...Porter, who was born in Fort Dodge and taught at the University of Iowa, was Warren's student at Harvard in 2000. She said watching the fallout from the 1980s Farm Crisis was among "the most powerful experience of my childhood," and taking Warren's bankruptcy course gave her the framing to understand that problem and refocus on helping struggling families.

"I have the notes from that class to this day," she said.

Porter will be in Iowa next weekend to participate in events with Warren around the Iowa Democratic Party's Liberty and Justice Celebration — a key event that comes as the caucus campaign enters its final 100 days. She will attend a town hall in Davenport and a canvass kick off in Iowa City.

..."Katie is a relentless fighter for the protections that safeguard consumers and force banks to give families a fair shake," Warren said in a statement. "I'm honored to have her support in our fight for big, structural change."

https://www.desmoinesregister.com/story/news/elections/presidential/caucus/2019/10/26/katie-porter-endorses-elizabeth-warren-2020-democratic-primary-iowa-native/2457272001/

...More than a thousand people came to Elizabeth Warren’s event on Thursday at Dartmouth College in Hanover, N.H., and students waited in line to take a selfie with the Senator and to pet her dog Bailey. Sanders came to Dartmouth in late September and spoke to a crowd that was roughly the same size, and many of the students at the Warren event said they had also gone to the Sanders one.

Some said they supported Warren because they saw her as Sanders’s natural heir. “I love Bernie,” said Jackson Harris, a 21-year-old geography and computer science major at Dartmouth. “He’s done a lot of really great things in his life, but this is not his time for the Presidency. It’s time for Warren to get it done.”

“He’s so old, and Warren’s so similar to him,” said Harris’s friend Juan Lainez, a 21-year-old senior majoring in government and Latin American studies. “Everyone who was for Bernie four years ago is now for Warren.”

Underneath it all, the students said they wanted someone who could win. “I think Warren can pull it off,” says Em Morris, a 22-year-old graduate student in experimental and molecular medicine who enthusiastically supported Sanders in 2016. “Any of them can win, but I think Warren will put up the best fight.”

A few hours later, at an event at Newport Opera House in Newport, N.H., Warren gave a nearly identical speech to a much older crowd, but the selfie line was just as long. Here, the crowd was full of people who had voted for Clinton in 2016, who were skeptical of Sanders’s far-left ideology and saw Warren as a more practical alternative. Many were senior citizens themselves who were concerned about Sanders’s age.

“Bernie’s not a bad guy, but she’s more plan-oriented,” says Sally Caltrider, a 65-year-old registered nurse who voted for Clinton in the 2016 primary. “I was upset with Bernie at the end of the primary last time, I don’t think he did enough to support Hillary.” Besides, she added, “his health concerns me.” Other older voters shared that concern. “Bernie’s too old,” said Lisa Matthews, 64, “I wish he’d get outta there.”

“If she can’t beat Trump, nobody can,” said Mary Edes, 71, a retired teacher who also voted for Clinton in 2016. “I’m hoping it’s not going to be a man.”

“I think some people think she’s too far left, but if people listened to her, they will come away with a different opinion,” says Cindy Martin, a 66-year-old retiree. “I don’t think she’s aligned with the far-left socialists. She’s not as far left as Bernie Sanders.”

More at https://time.com/5710602/elizabeth-waren-new-hampshire-bernie-sanders/

BALTIMORE — The widow of Rep. Elijah E. Cummings said at his funeral Friday that attacks by President Trump on the congressman’s beloved hometown “hurt him” and made the final months of his life more difficult.

Maya Rockeymoore Cummings, chairwoman of the Maryland Democratic Party, said her husband was trying to protect “the soul of our democracy” and fighting “very real corruption” as chairman of the House Committee on Oversight and Reform, where he played a central role in investigating the Trump administration.

Trump lashed out at Cummings this summer, calling Baltimore, the heart of his district, a “rat-infested” place where no one would want to live. Cummings did not respond directly to the attacks, but his wife said Friday that they left a lasting wound.

Rockeymoore Cummings spoke near the end of a lengthy funeral program at New Psalmist Baptist Church, where Cummings worshiped for decades — showing up regularly on Sunday mornings for the 7:15 a.m. service.

She was followed by former presidents Bill Clinton — who visited the church with Cummings in the 1990s — and Barack Obama, the nation’s first black commander-in-chief, both of whom hailed the longtime lawmaker as an inspiration and a friend.

More at https://www.washingtonpost.com/local/md-politics/elijah-cummings-funeral-obama-clintons-to-eulogize-longtime-lawmaker/2019/10/25/ae286a76-f6b6-11e9-a285-882a8e386a96_story.html