This is super personal to me because it almost killed me. I’ve told this story on reddit, but it bears repeating:
tl;dr lost my doctors due to an insurance change 4 weeks in to a 6 week open heart surgery recovery…
In 2018, my company was in the process of being sold. No big deal, above my paygrade, nothing for me to worry about.
Then I got sick right after Thanksgiving. Really bad heartburn that lasted 5 days. It wasn’t heartburn. I had a heart attack. 12/3 I had open heart surgery, single bypass, and that started a 6 week recovery clock.
On 1/1, the sale of my company closed and we officially had new owners. I also officially lost all of my doctors because the new employers don’t do Kaiser in Oregon. They do it in WA and CA, but each state has to be negotiated and they never had presence here.
1/2 I start working with Aetna to find doctors, hospitals, etc. Beyond the cardiologist I need a new pharmacist, podiatrist, diabetes care and a general “doctor” doctor.
Fortunately, my new employer is a big enough fish, they have their own concierge at Aetna and she gets me into the Legacy system.
On 1/3 I start developing complications, but I don’t know it at the time. It starts with a cough. All the time. Then, when I try to lay down, like to sleep, I’m drowning, literally choking and gagging.
The concierge and I try to get an appointment, we’re told 2-3 months. For a dude still recovering from open heart surgery? Best they could do is 2 weeks. 1/14.
I can’t lay down to sleep so I buy a travel neck pillow and sleep sitting up.
I get to see the new doctor at the “official” end of the 6 week recovery. He doesn’t know me or my history so he wants to run tests.
I’m sitting at home playing video games and waiting on test results when the call comes… Congestive heart failure. Report to the ER immediately.
My heart developed an irregular heart beat, which caused fluid build up in my chest. They admitted me and were getting ready to pull fluid off me.
“What happened to your foot?”
“I dunno, what happened to my foot? I can’t feel my feet.”
Remember when I said I was sitting around playing video games, waiting for test results? Yeah, my foot was touching a radiator and I didn’t know it. 3rd degree burns, first four toes. Pinkie was spared.
So I’m in the hospital a week. I lose 4 liters of water per day. 50 lbs. of water. No wonder I was drowning. Regular bandage changes.
So now I’m facing two procedures. Electrocardio version to fix my heart, skin grafts to fix my toes.
This whole time the new insurance covers 80% until I reach the out of pocket maximum of $6,500. Then it will cover 100%.
The old insurance? ER visit for heart attack, hospital admission, 8 days in the hospital, open heart bypass… $250.
So we hit the out of pocket maximum almost immediately. My wife had a problem with her foot running through the Seattle airport. The doctor who did her toe amputation was decided to be out of network so that was another $1,100.
I was never unemployed through all this. I had enough vacation and sick time banked to cover it. Cobra didn’t apply. Buying my old insurance wasn’t an option, it was far too expensive without employer backing. Income is too high for assistance (thank god) and I took steps to max out my HSA account, which is good because we drained it twice.
Three 1 week hospital stays (2 for me, 1 for my wife), multiple ER visits, two more major medical procedures… That would be enough to break most people even with good insurance.
So if you read any of that, let me ask you something… Why does the quality of my health care and my quality of life have to depend on who I work for and what insurance companies they choose to work with?
This is always what I think of when I hear arguments that our health care is “free market”. If it were, you could fire AETNA and go back to Kaiser. But that’s not the case, so insurers aren’t really beholden to satisfying their users, because their users aren’t their customers.
it is free market. It actually is the definition of free market, accompanied with lobbying which is direct consequence of lack of regulations.
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and to top that up, OP could had just bought an additional care package by paying by his own pocket in the health clinic that he initially was. Completely free to do it if he wanted to pay 3 times the price. People don’t understand that in the so called free market there are actually unwritten rules set by the ones in power. They think that they would somehow be benefited from the lack of regulations while the regulations should be there in order to protect them from the greed of the mega-corps.
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Registered to vote, told this story to the Bernie Sanders campaign, told it again for 4 days at the HLTH 2023 conference in Vegas. And I’ll keep telling it until something changes…
I hate to say this, but you are asking for meaningful change in a trillion dollar industry. It’s not going to happen through stories, public awareness, or by any other peaceful means.
I survived open heart surgery, telling my story is the only action I can take these days. :)
We need EVERYBODY like you telling their story
That’s why I partnered with a company called Savvy Coop and was invited to the HLTH 2023 conference in Las Vegas last week.
I had many good meetings with providers and health companies telling my story and our team was maybe a dozen or so patients with multiple medical conditions.
It’s getting out there. I’ll be on a podcast tomorrow.
So what, they should just give up? No. Change will happen as more and more people resist the status quo.
It may seem slow, it may be painful, it may feel like it’s never going to actually work but you’ve got to keep going because one day and all of a sudden it will.
Of course they shouldn’t give up! I’m just saying, that’s not going to be enough.
It may seem slow, it may seem painful, it may feel like it’s never going to actually work but you’ve got to keep going because one day and all of a sudden will.
You’re deluding yourself. The wealthy will NEVER part with that much money willingly.
Who said anything about them doing it willingly?
They won’t part with money for 9/11 responders dying from cancer, the rest of us have no hope.
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It was rough when Bernie had his own heart event, and I use the word “event” because it sounds more festive.
I told my wife “Well, he’s done.” Even if he has the energy to be President, nobody will vote for someone with a heart condition.
It’s a tough thing to recover from, even now, five years later, I don’t have the energy, focus, or acuity I had from before. :(
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Trump is splintering his party though. Progress can’t happen as long as he’s around, Democrats have to pick up “moderates” (on the US Scale) and that puts everything else on pause. Pushing a progressive agenda now would just amplify Trump and potentially pull those moderates to him.
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This is the kind of story libertarians can’t imagine because they simply lack an imagination. We don’t choose when we get sick. Your companies merger should have had no impact on your ability to get healthcare. What an absolutely insane thing to read.
Someone at some point should have told you this, but it rarely gets communicated until its too late. If you have peripheral neuropathy, even if you are not a diabetic, you should be doing nightly foot inspections with the aid of a mirror.
It drops the likelihood of acquiring an amputation by around 70%. Pretty much all my patients who have had amputations acquired them because they didn’t know about a foot wound before it became infected and spread to the bone.
Simply flashing your feet at a mirror kept propped next to a nightstand can significantly improve your overall health outcomes.
Oh, I’m well aware, but at that time I was also sleep deprived. :(
I figured as much, though preventative healthcare is so rare nowadays I thought I’d chime in.
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It’s really for any peripheral neuropathy that includes the loss of protective sensation (pain).
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Fucking brutal, man. Murica, I guess.
Holy. Fucking. Shit. I’m sorry you had to go through that. That’s really horrible.
thank god capitalism is the most efficient system people ever imagined!
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She has had multiple problems with ill fitting shoes and infections. She was running through the Seattle airport to make a transfer for a flight, got rubbed the wrong way, by the time he trip had ended the damage was done, the infection went to the bone and the toe couldn’t be saved.
She just had too much going on, her mother had died so it was a super fast emergency trip from Portland to Kansas and back.
I couldn’t go because I was still on my back from the heart surgery, so it was just her and our adult son.
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That’s in the same category as “who would consider health care an appropriate industry for profit?”.
Who would consider it? The same people who are coming for public education.
The cruelty is the point.
Their end goal is a population of moronic wage-slaves who are living a barely subsistence lifestyle that will believe anything told of them rather than challenging the wealth, power, and right to rule of the ruling class.
They aren’t just conservative, they’re regressive. They long for the days of Feudal lordship with themselves cast as the lords.
“The cruelty is the point.”
I see this phrase often, and I disagree with it and I’m not sure why people keep repeating it.
Cruelty: inflicting pain on others. This is not the point at all. They don’t wake up every morning and say “how can I cause more pain” on individuals or the general populace.
They are almost completely indifferent to the suffering of others that they cause. They are simply greedy and selfish, they want all the money and power, so they can have it all to themselves. Fucking over everyone else is just the process to get and keep what they want. This is my opinion at least.
“Cruelty is the point” is just silly, and absolutely wrong. I also feel like it misdirects talking about the true motive, which I think is mostly greed and selfishness. Cruelty is just a side affect they don’t care about.
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Except no. In reality many people make themselves feel better by making others’ lives worse. Cruelty is indeed one of the goals for many.
In this case though, I tend to agree with the previous person that it is malignant indifference. Millionaires aren’t actively trying to hurt people, they just don’t give a shit that they’re doing it. If the same or better results could be achieved another way, they’d go the other way because it would maximize profits.
You’re right that there are sadists out there who enjoy the suffering of others, but I’d wager that’s a very low percentage in terms of people running companies or crafting legislation.
I think you’re putting a lot of weight into greed in terms of money, and it’s my belief based on watching famous rich people talk that many of them want money, power, and status. The things they say and the way they can bring other people down, those are some ways that they can demonstrate that power or status.
And that makes sense if you consider what meaning money has to the ultra rich. People who have more money than they could ever spend will probably try to get more, but that alone wouldn’t be satisfying. So then they’re going to look to other ways to feel like they’re on top of the world. One way to create that feeling is to knock others down.
You have a good point and it almost seems more malicious this way. At least with cruelty there’s a point of sorts behind the action. This way is almost indifference and feels much more sociopathic since its willful not changing those actions
I agree with you. I do think that the temporarily embarrassed millionaires who support the oligarchs quite enjoy the racist fascist cruelty that the ruling class is encouraging them to enjoy.
coming for?
I think that there are spaces in healthcare where you could safely apply a free market. “Hey, yeah, I see you have a cane, but have you tried my super luxury high speed low drag jet-powered hover cane? Guaranteed to be 1000% more like a Nerf commercial than any standard cane!”
“Woah, check it out, we built an MRI that’s way cheaper and doesn’t scare the shit out of people!”
“Hey, I found a medicine that cures baldness!” Etc.
Right? I can see the intersection of luxury (in the sense that not buying it incurs no cost, not even an opportunity cost), convenience, and healthcare being a place where there’s room for the free market. The problem is that we’ve gone and applied it to everything, including all kinds of things that shouldn’t be free market. Then you end up with all kinds of goofy fucking bullshit like corporates parenting stuff that the DOD paid to develop (Epi Pens, vaccine adjuvants, etc), GSK opting to develop a singles vaccine instead of a tuberculosis vaccine, etc, etc, etc. Oh, that last one is real. Here: https://www.propublica.org/article/how-big-pharma-company-stalled-tuberculosis-vaccine-to-pursue-bigger-profits
This is probably an unpopular take on Lemmy, but I believe that free markets generally work well where they exist. But there’s a lot of things that have no business being free markets, like healthcare, and aren’t free markets (and won’t behave like them) even if you try super hard to pretend that they are. You see, a truly free market requires the ability to say no and suffer no cost. You can buy Bob’s Widget, Jan’s Widget, or no Widget and be perfectly fine. This is not the case in healthcare. If you’re having a heart attack, your choices are:
-Agree to pay for this widget but we can’t/won’t tell you how much it costs until we’re done.
-Die
That’s not a free market, that’s not how free markets work.
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Yeah. It’s wild to me, because the Dutch actually have a private, insurance-based system and it works great for them. Their healthcare is affordable, as is their insurance. But the Dutch also aren’t afraid of regulating.
A free market cannot have oversights or constraints. If it does it’s not free. Free markets have never worked. Will never work. And simply can’t exist. Either powerful entities will seek to control the market for themselves. Or if you’re lucky benevolent people in government will do their best to control the markets against said group. Someone is always controlling it.
The best we could ever hope to have is a fair market. And the only way to have a fair market is to have a market that is completely optional. Markets that deal and necessities can never be optional. Because Necessities are not optional.
I don’t care what they charge for luxury housing or fru fru fancy food. But we can and should provide desirable public housing and basic nutritious food for everyone. And if they want a luxury house. Or fancy food. Any of us are free to work to get it should we choose to. But the point is choose to. Not be forced to under coercion for basic survival.
Not true. Without oversight, you get corruption and monopolies, and the system collapses.
Correct. But both preclude having a free market.
My comment was a bit of a simplified hot take. And your perfectly valid reasons are why I didn’t also throw housing and food right in there in the same take.
See… you kid, buuuuuut…
History lesson time: This wasn’t done on purpose. It’s an artifact of decisions made by Congress during World War II to support war production.
So many young men were away at war that it created a labor shortage, even with some women entering the work force. This led to spiraling increases in wages that were threatening the viability of critical war manufacturers.
In an effort to protect this manufacturing sector, Congress capped wage increases. But those corporations were still competing for workers and now they were no longer able to offer them higher and higher wages. So instead, they started offering them “perks” like health insurance, pensions, and paid time off.
THEN:
“In 1943 the War Labor Board, which had one year earlier introduced wage and price controls, ruled that contributions to insurance and pension funds did not count as wages. In a war economy with labor shortages, employer contributions for employee health benefits became a means of maneuvering around wage controls.”
Emphasis mine. And guess what? When those young men returned from war and re-entered the work force, they wanted those perks too. So which company was going to be the first to deescalate the arms race and NOT offer health insurance?
And those perks being so ubiquitous meant the government never had an incentive to provide health coverage directly to anyone of working age, so we only have Medicare for retirees.
And the the employer requirement and massive expansion of GMOs were added under Nixon. He and his contemporaries could have pushed for national health care but of course they didn’t.
Sorry, what does GMO mean in this context?
Had to look it up myself. I think it refers to Group Member Organizations, which would be the health insurance providers.
When you really think about it, health insurance companies are a bizarre sort of consumers’ union. Your insurance company negotiates prices with providers on your (and their own) behalf leveraging their buying power based on the size of the group. That was probably a good thing at one time, but now the system is so completely broken that if you try to get the same procedure done without insurance, and it’ll cost you double or triple what it would cost the insurance company.
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I typed horribly wrong, HMOs. However, the other person’s explanation seems to work well too.
Naturally.
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I mean, penicillin wasn’t publicly available until 1941. So at that time, we barely had healthcare that was even worth paying for. I can understand why they deprioritized it.
I think people forget we’ve had truly modern healthcare for less than a century
And you also can’t discount the role Unions played in the American healthcare system. Because not only can you get healthcare through your employer, if you’re in a union you can get coverage through your union. And there was a time when unions had their own doctors on payroll.
Nice recap. Thanks.
Wage slavery.
No small businesses want to mess with this shit. Just give everyone health insurance, all the time, without the interference of corporate greed. Doing so would reap a huge savings of scale efficiency. Get rid of the middle man.
Indentured Servitude is the point. Business want to make it difficult for you to find another job.
I don’t think that’s actually true in this particular case. Just about every single full time job has to offer a health insurance plan because all of their competitors are doing it. You simply can’t attract good labor without it. So the motivation of the company providing you with health insurance isn’t necessarily to keep you there, but rather to get people in the door to begin with. If the motivation was to keep you there, they’d offer a health insurance plan so amazing that you realistically couldn’t go anywhere else without taking a cut.
On a larger scale though, there are lots of reasons that people want to keep this system intact. In particular, the societal “benefit” of extracting the maximum amount of work possible out of its populace.
My wife and I were just talking about this. We pay $600/m and the very few times we go to a doctor we end up paying anyways. We never meet the deductible but we can’t not have insurance because we have a kid who does need it. In the twelve years we have paid we have never reached the deductible even with having a kiddo who’s had surgery. Once you get past october it seems like they charge it to the following year if your close to meeting the deductible it’s insane…
That’s not the problem with the healthcare in the US, because that eventually flips and you hit your deductible every year.
The problem is you lose healthcare if you need to quit your job and you pay more than any other country. And I attribute that simply to the middle man, aka the health insurance companies. They don’t seem to provide any benefit other than contributing at least 10% for pure profit reasons to the $3.4 trillion we spend every year on healthcare.
It’s definitely one of the many issues. In 12 years I’ve paid $86,400 so It’s hard for me to believe it will ever flip and begin benefiting.
Only 26 MRI’s and you’re toast, mister!
Sounds like you have a “low premium” high deductible plan. I had one of those. Where I paid every dollar until I hit $3.5K and then 20% until hit $7k and then paid nothing. I can see where you could get to $86k. I’d start looking for a job that comes with a better health plan. I now pay $400 a month and $20 co-pay here and there.
That’s a symptom of our system. There’s so many different plans and options, and it’s further obfuscated behind your company doing all the negotiating that it’s not actually a free market. We would be better off going to a single payer system.
Thats insane.
Here in Brazil I pay around 65-70 dollars per month and then I have full hospitalization coverage and full doctors appointment coverage.
And there are better options lol
Damn I know Brazil has its issues but clearly medical coverage isn’t one. I don’t think the US has a single insurer that covers a full hospital stay. The only doctors appointments I’ve ever seen covered is the yearly physical.
I tell anyone and everyone we will not get universal healthcare until this is prohibited. Certain votes feel having a job with benefits is something they have earned. They see it as some badge of honor or some.
Abolish it. Make it illegal.
Shit I’ve worked my way from homeless to well into 6 figures and have “amazing” healthcare. I still want universal healthcare because I’m not a fucking idiot. I want to have the option of leaving my employer and starting my own company without the massive cost of healthcare hanging over my head. I can’t understand anyone who thinks otherwise. Literally everyone would save money.
I’m still salty from working at a mediocre company and getting a $7k bill from a doctor for putting a scope into my nose for literally 15 seconds. And more recently, I went to a chiropractor (controversial I know but it helps me a lot) and got a $300 bill after being promised that it would only be $20.
I’m supposed to have great insurance too. I scratched my eye in my sleep bad enough I needed help. Went to the ER, they said come back in two hours or it would be really expensive. So I go back two hours later when the “urgent care” is open. I had to pay $500.00 for them to look in my eye and say yup its scratched, here’s a script for some drops. My insurance covered $40.00.
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That only makes sense because the system is so goddamn stupid.
The “most powerful nation in the world,” but when it comes to our health, we just let the capitalists bend us over…
don’t bend too far, unless you have employment health insurance.
The last part isn’t always true. When I stopped teaching, I was able to get a plan from the same insurance company with a lower premium and with a deductible that was about 20% of the deductible that teachers have.
It’s possible that the schoo’s group plan had some very expensive people on it, so the cost you were paying then was subsidizing them. Now your individual plan is more appropriate for your health status.
It wasn’t for the school, the plans were offered at the state level. Every teacher had 2 options, 3 if you were there long enough to get the plan with the lower $4K deductible. Otherwise, you could get a plan with a $6K deductible with a $500 premium.
When I left, I found a plan with a deductible below $1K with a ~$300 premium through the same insurance provider.
Agreed. My employers plan is easily worse than what I could get on the open market. The issue is that they contribute quite a bit towards the plan. I wish they would provide it as a stipend and let me spend it on my own plan.
For all its talk about free markets, the GOP vehemently defends this very not-free-market system. To be fair, the Democrats defend it to the death too, but they don’t pretend like they value free markets, so they’re just greedy and corrupt, not greedy and corrupt hypocrites.
What prominent democrats defend our health care system?
Hillary Clinton, a primary author of the affordable care act which builds upon the system where individuals receive insurance through their employers and Barack Obama who helped make that act law.
I don’t think she’s been prominent in politics since 2016.
It is laughable to suggest that what Hillary Clinton and Barack Obama have done is a reference to “the craziest fringe shit you can find on Twitter”. But sure, let’s get a more modern reference if one is so young to think that 7 years ago is ancient history, Joe Biden, who championed the affordable act as vice president for Barack Obama and continues to do so to this day.
The ACA was an attempt to make the current health system a little better. Sure Biden promotes it, but that doesn’t mean he’s championing the health system overall. You probably already know that the ACA was originally based on a Republican health plan. Obama went with this rather than Medicare-for-all because he thought it was the only way he could get Republican buy-in to pass any kind of health improvements for citizens. But even so the Republicans demanded all kinds of concessions and watered it down so it ended up being way less effective than intended. The bottom line here? Health care affordability problems are because Republicans don’t want to fix them.
Also let’s not forget such hits as Bill Clinton attempting a border healthcare reform which died very promptly. Which is why Obama and his advisors chose the republican approach.
Also let’s not ignore that ACA originally had the public option in it. But as always, there is always enough money in bribes to turn just the right amount of Democrats against core wins so that it was a Democrat (I forget the twat’s name) that demanded the public option be stripped from the bill.
originally based on a Republican health plan.
With such a great plan from a party known for lifting a sausage-like finger for the poors, ever, I can see why every republican has given it unanimous and resounding support every day since it was (re-)proposed.
It seriously saddens me how much 25 years of GOP propaganda against the Clintons has turned reasonable people among Democrats and those further to the left into parrots that try to pin everything on Hillary or Bill.
There are legitimate criticisms of The Clintons. But they are way less involved than people give them credit for.
To your comment, I have seen no mention of Hillary - then Secretary of State dealing with multiple conflicts - having any involvement in ACA. She had plenty other work. And there were other key advisors Obama picked that were the actually directly tasked with putting together ACA and making it pass.
The question was which Democrats support this healthcare system, and Hillary Clinton is certainly one of them. She repeatedly took credit as a primary force in what eventually became ACA. She even claims “It was called Hillarycare before it was called Obamacare”. This is very easy to find, so one wonders how long you searched. One can certainly take issue with how much credit she deserves and how much of the Clinton plan even ended up in the ACA, but one cannot possibly claim that someone trying to claim credit for ACA doesn’t support it. ACA does little to separate insurance from your employer, the topic of this article, and a serious problem with the US health care system that neither Republicans nor Democrats are addressing. Are people just talking about whatever they want on this thread, or are we talking about the topic of the article?
To be fair, fuck Hillary Clinton.
Canada’s public/private system has a lot of this as well. Drug, dental, optical, anything else are part of employer’s group benefits. There are public drug coverage options where your deductible is calculated as a percentage of your net income, and a public senior’s plan with a flat deductible.
Tell me again why soulless corporations should not be in control of essential services for humans?
Canada’s NDP wants to implement a federal public plan for these “extra” health services, recently made a deal with the Liberals to push a low-income dental benefit through, and they’re very open that it isn’t enough. Being in a union will likely negotiate you a better benefits package right now which is pretty lame considering how many people aren’t in unions.
The funny thing in the US is they don’t even get the benefit of the government negotiating prices with private health companies, their “medicare” is like a tax break but it basically just helps these companies keep their prices ridiculously high by softening the impact for patients. In the US system you’re not really a patient though, you’re a consumer of healthcare, like a customer.
It even happens in Canada, just to differing levels.
We don’t have a national pharmacare plan so any drugs you need outside a hospital will come out of pocket.
You either need to pay for private insurance or get it via a job where it becomes mandatory for full time employees (possibly past a certain enployee count)
Personal experience: having guaranteed health care not tied to my employment is a huge burden off my shoulders. I am so grateful that my wife and I are taken care of, and I vote for people who try to make it happen for everyone. But let’s face reality, there are huge entrenched interests that oppose any kind of universal plan, so the ACA with all its flaws is probably the best we will get for quite some time. Even where I live, in California, with the legislature and all statewide elected offices under single-party control for years now, it hasn’t happened. The ACA was a deal with the devil to get more people insured, yeah, but insurance is no guarantee of health care. I’m glad I have the latter.
Nixon did that
No he didn’t…this is from WWII and it unfortunately stuck around. Companies would love if they didn’t have to deal with it. It’s why so many of them hated the Obamacare and try to keep people part time.
There are actually videos of him doing it.
Lol what the fuck are you talking about? Do you think that Nixon waved his hand and said all companies are responsible for providing insurance to their employees? A video…lol what???
Like any president Nixon got on the phone with his friends on the hill to get a bill rolling. A film crew was there at the time. The Nixon library should have the clip. Truman wanted to create a single payer system and failed. Ike moved no heath care legislation. Kennedy died but set the ground work for Medicare which Johnson finished. Nixon did this.
Did you even read your own link? It clearly points out that this began during WWII…
Answer: greed
