It’s that time again folks… time for a Mailbag Episode! We reached out to our whole audience and all our supporters to find the pressing questions on everyone’s mind. Or at least we would have if Gillian hadn’t been too busy eating turkey to email our list. So instead, Gillian reached out personally to some of our superfans (anyone in her contact list who had previously admitted to listening to the show once) to find out what they wanted to hear from us. And here we are, with questions about everything from Ronald Reagan to elder care to dinner table conversation from some of our favorite stans!  

https://www.youtube.com/watch?v=pesLv7rekVY

Show Notes

Question from Liam Meyer in Massachusetts:

"Maybe discuss this on your podcast: Facing Financial Ruin as Costs Soar for Elder Care - The New York Times."

"You could also talk about elder care and how wildly fucked up it is. One especially galling bit is how Medicaid is basically built to just ignore cognitive stuff. Almost all metrics are about physical health so, like, if someone’s grandpa **could** theoretically cook and shower themselves (ie, “He can stand up and walk, he still has hands!”), Medicaid says it all good even if grandpa doesn’t know where the shower is, leaves the stove on all the time, and continually eats spoiled food."

Answer: "elder care" is a vague term that mooshes together lots of kinds of care for seniors. But "long-term care" is better defined, and has been a major focus of ours in recent years, needed not only by older folks but anyone with a physical or mental disability that means they need help with day-to-day living. Most of us will need long term care at some point in our lives.

What’s wrong with the U.S. long-term care system?

We don’t have one! 

Very few people are insured for long term care

Medicaid covers the vast majority of long term care services - you have to be or become poor to qualify (except in California, where Medicaid asset limits will be eliminated starting January 1, 2024!) We've heard many stories of people who have had to sell homes or farms, affecting their whole family, in order to become eligible for Medicaid.

Institutional bias: Medicaid will pay for long term care in a setting like a nursing home, but not home-based care which is cheaper and better for quality of life.

Check our our long term care episode for much more.

Questions from Geri Katz in Minnesota:

"Have you listened to the 1961 Ronald Reagan Speaks Out About Socialized Medicine LP? Why has the AMA historically opposed single payer?"

Answer: in 1961, before Medicare passed and before he was elected Governor of California, Reagan was a washed up actor talking about how "socialized medicine" would ruin our country. He sounds like a ghoul: “One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it.”

Reagan was paid by the American Medical Association (AMA) to deliver this speech, which was printed on an LP so you could host a house party with your socialism-hating friends. The AMA has a long history of opposing healthcare reform, such as:

In 1948 when Truman proposed a national healthcare program - which was supported by an estimated ⅔ of americans - the AMA decried it as socialism and used member dues to fund a political campaign against Truman’s plan.

After passage of Civil Rights Act in 1964, the AMA continued to allow medical societies to discriminate against physicians of color.

The AMA has been involved in campaigns against Social Security, Medicare and Medicaid.

The AMA is a scam! According to Dr Linda Girgis, “Perhaps the biggest example of how doctors lost their trust in the AMA is the way they are funded.