M&M - Marx & Medicine

i know, i know - an hour and 40 minute long part 3???? it’s worth it brothers and sisters. (maybe? that’s what they told me at least)

today we wrap up our long discussion on the payers of healthcare by dissecting specifically the PRIVATE payers - the private health insurance industry we all know and love (with household favorites like UnitedHealth, Aetna, Cigna), as well as the scam-fiction known as “consumer-driven healthcare” (most notably FSAs, HSAs, and their cousin the high-deductible health plans). we also touch on “managed care,” an important movement in healthcare which burst onto the scene in the 1980s; ostensibly on a mission to control costs but only really succeeding in making everyone despise how healthcare is administered and financed - except for the people that benefit from this ludicrous racket, of course. we end the episode with a fairly in-depth comparison of the healthcare systems in the United States, Canada, and the United Kingdom. we hope this is a good starting point for understanding why our healthcare system in the US is totally irredeemable and must be replaced with not just Medicare for All, but additionally, some form of a fully nationalized healthcare system.

tunes:

intro: created by fidel cashtho

1:13:00 in bloom by sturgill simpson

outro: burgundy red by sunset rollercoaster

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.marxismandmedicine.com

oh happy day (oh happy day)! it’s finally nice out and you know what that means. yes friends, part 2 of academic half-day #2 is here. we discuss the payers of healthcare, specifically the public sector payers. Medicare, Medicaid, the Indian Health Service, CHIP, the VA.. there’s actually quite a large number of public payers within the United States healthcare system. but that’s not inherently a good or bad thing; there is no essentialist character to what government is or isn’t, can or can’t be. we can make the public sector efficient and actually serve the people if we construct and fund it correctly. and considering the astronomical administrative burden, means-testing mechanism, and increased costs stemming from the fractured nature of our current healthcare payment scheme - which is a BIGTIME dissatisfier - we can easily do better than this busted ass system.

[part 3 coming soon where we discuss the private payers of healthcare, i.e. the private health insurance industry & consumer-driven healthcare, as well as make concrete comparisons of our healthcare system to other countries.]

tunes:

intro: created by fidel cashtho

outro: Paprika by Japanese Breakfast

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.marxismandmedicine.com

welcome back friends! it’s session #2 of our Academic Half-Day series, and today we’re continuing our exploration of the Medical-Industrial Complex by dissecting how we buy & pay for healthcare - the other half of the dialectic that is reflected in the question of how we provide & administer healthcare (which is coming up in session #3). ‘buckle the fuck up’ folks, because this session is a deep dive on the history and birth of health insurance in the United States. other show highlights include Bae Guevara divulging his ‘dirty bulking’ technique (double fisting different-flavored Whataburger milkshakes) and Sigmund Fraud signaling support for alternative medical therapies (revitalizing the Laudanum movement). part 2 coming soon.

tunes:

@12:32 - maple leaf rag by scott joplin

@22:17 - take five by dave brubeck

@31:26 - swing that music by louis armstrong

intro: created by fidel cashtho

outro: milkshake by kelis

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.marxismandmedicine.com

Bae outs Fidel as a literal mosquito, Fidel does an awful impression of the ‘southern West Virginia dialect’ of his youth, and Sigmund guides us through a cursed episode on the history of every medical student’s favorite gameshow: “The Match!”

…apologies for the shaky audio quality on this one. it’s the internet. they’re racist

intro: created by fidel cashtho

music:

@21:34 Begin the Beguine by Artie Shaw (original artist Cole Porter)

@26:04 Pennsylvania 6-5000 - Adios - Little Brown Jug

outro: Provider by N*E*R*D

Erving Goffman's Presentation of Self in Every Day Life

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.marxismandmedicine.com

in part 2 of our introduction to the medical-industrial complex, we move on from our philosophic and social analysis of society and focus in on the economics - the ownership, production, and distribution of resources that meet the material wants and needs of society. we set out to define some terms for our argument by investigating the public sector vs. private sector, market economy vs. planned economy, and begin to touch on healthcare administration vs. healthcare finance. this will all set up future episodes where we’ll delve into the devilish details and concoct a formal, broad-based analysis of the specific entities inhabiting the medical-industrial complex and their interactions.

tunes:

intro: created by fidel cashtho

closing music: everybody wants to rule the world by tears for fears

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.marxismandmedicine.com

good afternoon everybody - please find a seat. i hope your morning was full of rewarding patient care and skillful documentation. welcome to Academic Half Day, a new long-form recurring series that takes a considerably deep dive into the intricacies that inform our position not only as healthcare workers, but as prisoners of the hellish society known as Late Capitalism.

this is our first offering of Academic Half Day, where we ask a simple question: what in the god damn hell is the medical-industrial complex? as a massive chain of interactions between countless entities and interests, this requires multiple episodes to successfully explore; but today we offer you an introduction, or the beginnings of a metastructure for how you should think about how healthcare works in the United States. this involves some light philosophic, economic, and sociological study, so with that being said please silence your phones, set your pagers to vibrate, and let’s all learn something today.

tunes:

intro - created by fidel cashtho

closing music - behind these hazel eyes by kelly clarkson

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.marxismandmedicine.com

in part 2, the gang wraps up their presentation on private equity - an entity that is eternally in dialectical relation to seemingly unrelated things: upcoding, out-of-network providers, political economy, and - most importantly - helicopter insurance.

we relate the importance of understanding the horrors and contradictions of late Modernity as

* -a systemic, structural issue (the capitalist mode of production, whose phenotype manifests in America as bourgeois white cisheteropatriarchy)

* -that necessitates a systemic, structural solution (new social relations, arriving through the vehicle of multiracial, queer, feminist, proletarian struggle)

* -which therefore cannot be resolved through individual action alone (the primary logic of neoliberalism, which systemically reveals itself as the 3-headed-hydra of privatization, deregulation, & austerity).

incorporating simultaneous perspectives, rather than incorrectly choosing between identity politics (a social analysis) and class politics (an economic analysis), is ‘the move’ that takes us one step closer to our collective liberation.

correction: at 40:26 - medical debt is the #1 cause of *BANKRUPTCY* in the US.

music:

intro - created by fidel cashtho

closing track - you can get it by BUMPER

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.marxismandmedicine.com

the gang accidentally endorses Passive Suicidal Ideation as the official State ideology of M&M, but then gracefully recovers with a grand rounds-style presentation on the pervasive creep of Private Equity into healthcare. just what is this elite sub-class of vampiric capitalist bastards up to? u gotta hear it (because podcast) 2 believe it.

tunes:

intro: created by fidel cashtho

closing music: C.R.E.A.M. by Wu-Tang Clan

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.marxismandmedicine.com

bae rightly scolds fidel and sigmund for fomenting chaos at mcdonalds (trying the mcrib), but sigmund redeems herself by presenting a terrific case study of the historical rise and fall of Hahnemann University Hospital (Rest In Power) in Philly. winners: real estate moguls and private equity psychopaths, specifically Joel Freedman. losers: patients, students, healthcare and hospital workers, and increasingly the future of medicine in the united states.

further reading:

* long-form exposé of Allegheny Health Network’s role in Hahnemann’s eventual demise by the Pittsburgh Post-Gazette: “Anatomy of a Bankruptcy”

* “Hahnemann University Hospital real estate comes up for sale in 'generational opportunity'“

music:

* intro: created by fidel cashtho

* old timey music: blue room by benny goodman

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.marxismandmedicine.com

in part 2, we finish our discussion on philanthrocapitalism, as well as attempt to explore what 'democracy' actually means, what it should include, and what it might actually look like.

music: bill gates must die - john vanderslice

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.marxismandmedicine.com