Protest Rally at Humana: “Stop the Wall St. Takeover of Medicare”

In the windy, late morning of Saturday, December 11, Kentuckians for Single Payer Health Care and community allies gathered outside the headquarters of Humana in downtown Louisville where they demanded an end to Medicare Direct Contracting Entities (DCEs), a program that could fully privatize Traditional fee-for-service Medicare without a vote by Congress.


Humana is one of 53 for-profit DCEs into which seniors who have chosen traditional Medicare can be placed without their consent.

As the post tornado winds howled through Humana’s marble pillars, Stephen Bartlett played his trumpet.  Dr. Garrett Adams and the Rev. Ron Robinson read a poem about DCEs, “How the Grinch Stole Medicare”, while Steven Katz, in full Grinch costume, performed.  Jill Harmer and Brian Daly led the group in holiday and health care songs, including one by Lee Stanfield of Tucson with the line about Medicare “Don’t Privatize It, Supersize it.”

Ann Hagan-Grigsby spoke from her vast community health care experience to point to the need to both save Medicare from privatization and to win a national single payer system that will cover everyone.

Kay Tillow urged everyone to take action by calling congress (1-202-224-3121) and Health and Human Services Secretary Xavier Becerra (1-202-205-5445) demanding that they end the DCE program.  Local singer, songwriter John Gage had everyone joining him as he closed out the event with Pete Seeger’s “God’s Counting on Me, God’s Counting on You.”

Photos here and herePress release

Ron Hargrove 3 min video

Rolf Friis 36 min video


Thank you to Harriette Seiler for providing the sound equipment, taking photos, and handling the media release, to Peg Box and Charlie Casper for making the phone calls, to Ron Hargrove and Rolf Friis for videos (see above), to NationalSinglePayer.com for the poem, and to all who worked and participated to make it happen.

As a result of publicity about the December 11 protest at Humana, Kentuckians for Single Payer Health Care has had the opportunity to do a number of interviews on DCEs.  Here are two of them.

Building Bridges with Mimi Rosenberg and Ken Nash

Talk World Radio with David Swanson
 

Protest: How the Grinch Stole Medicare!

Event by Kentuckians for Single Payer Healthcare

Join our protest at the Humana Bldg

500 W. Main St, Louisville, KY 40202

Save Medicare from Wall Street–Stop the DCEs

Don’t Privatize It, Supersize it!

Saturday, December 11, 2021, at 11:00 am EST

There must be a public outcry or we will lose Medicare.

Under a Center for Medicare & Medicaid Services (CMS) program now underway, more than 30 million seniors and disabled who chose traditional Medicare could be placed into largely investor-owned Direct Contracting Entities (DCEs) without the beneficiaries’ understanding or consent. We must not allow hedge fund managers to oversee our health care.

We will hold our protest in front of Humana headquarters because Humana has been identified as a DCE.

DCEs are yet another scheme to privatize Medicare. Like Medicare Advantage plans sold by the big insurers, the DCE program threatens traditional Medicare, and is designed to thwart the system our nation desperately needs–a publicly funded, improved Medicare for All. Everybody in; nobody out!


Tell Health & Human Services (HHS) Secretary Xavier Becerra to put a stop to DCEs. Call 1-877-696-6775.
Also call your member of Congress urging a hearing on this topic. House 202-225-3121; Senate 202-224-3121. Learn more about DCEs at www.nationalsinglepayer.com

Kentuckians for Single Payer Health Care www.kyhealthcare.org (502) 636-1551

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Press release: http://kyhealthcare.org/news/kentucky

https://www.facebook.com/KSPHmed4all/photos/gm.1236096000134715/2431752350290784/

U. S. Health Care — Down the Rabbit Hole

Reprinted from:  Louisville Medicine, VOL. 69 No. 6/ November 2021, https://glms.org/

AUTHOR Michael Flynn, MD

Michael B. Flynn, MD

All of the other first world/industrial countries have health care systems whose function is to provide health care to all the citizens of each country. The purpose is simple in that the goal is to provide universal health care managed by the government. The method varies from government provided health insurance to a totally government-run health care system as in the United Kingdom. Funding also varies involving an assortment of taxation methods ranging from general taxation to multiple source funding, such as combinations of taxation (central and local), employer, employee and out-of-pocket sources. Some countries allow private health insurance, regulate fees, supervise and regulate drug costs. Health insurance is mandatory/compulsory in most and some countries do not allow for-profit health insurance.

The Scandinavian countries, the European Union, the United Kingdom, Canada, Australia, New Zealand, Japan, South Korea, Taiwan and some South American countries all have different forms of universal health care, functioning market economies and have not been bankrupted by providing this benefit to their citizens.

In the US, we have a health care industry, which functions in a magical arena, the competitive medical market place. While all those other first world countries consider health care an essential public service, in the US health care is a commodity to be exploited by an assortment of profit-seeking entities.

Most other first world countries have health care systems managed by the central government. In the US, we have a patchwork or more correctly a crazy quilt of different entities, some focused on providing health care and others focused on extracting profit from the health care industry. Medicare is government health insurance for older citizens and some with disabilities. Medicaid provides government health insurance as a federal/state collaboration for the poor and individuals with certain disabilities. Medicaid covers different things in different states. The US Public Health Service is trained to respond to national health crises and emergencies. The Army, Navy and Air Force all have health care systems within the Department of Defense providing health care to active-duty military and their families, retired military and dependents and politicians. Senators McCain and McConnell and Presidents Reagan and Trump were all treated at military facilities without cost. The VA health system, while not without challenges, generally does a good job caring for veterans.

And then we have the uniquely American approach to health care, over 1,000 for-profit health insurance companies whose primary goal is profit, not providing health care. Actually using the revenue from premiums charged to customers anticipating health insurance is considered a “Medical Loss Ratio”.1 The Medicare administrative costs are in the 2-3% range, for-profit health insurance companies are allowed to keep 20% as administrative cost as per the ACA and often find ways to keep higher amounts in certain plans.2 Each health insurance company may have 10-30 different plans with a range of premiums and coverage. The end result is an insanely complex and confusing health care environment inflicted on the American public.

How did we get into this mess? From the mid-1970s to the mid-2010s, the number of administrators/managers has increased by an astonishing amount: over 3,000%. There are now 10 managers/administrators for each physician.3 These people do not work in ICUs or ERs, they do not do COVID-19 tests or vaccinate. They may help, but they also interfere and are paid salaries that are often multiple times higher than the nurses, respiratory therapists and physicians who provide medical care.

The pharmaceutical industry functions without restraint, a very different situation compared to most other first world countries. Medicare is prevented by law from negotiating with the pharmaceutical companies, an astonishingly stupid economic policy.4 The for-profit health insurance companies extract hundreds of billions of dollars annually out of our health care as profit, outrageous administrative costs, advertising, political contributions and investor dividends.5 Over 60% of bankruptcies filed in the US are the result of citizens unable to pay medical bills, a situation that simply does not exist in most other first world countries.6

As disturbing as the current situation is, it is already getting worse. Private equity firms are purchasing nursing homes, hospitals, health systems, physician practices, outpatient surgery centers, laboratories, imaging facilities and whatever else they can get their
hands on.7

The Wolves of Wall Street are about to devour US health care. The process involves buying the non-professional component of a practice, “improving efficiency” with the expectation of a return on investment of 15-30% annually and selling for a profit in three to five years.8 This is not meant to be a long, happy marriage. The investor invasion into health care creates the fundamental conflict of interest. “You can’t serve two masters. You can’t serve patients and investors”.7 About 70% of US nursing homes are investor owned.9 The resulting “improved efficiency” involves reduced staffing, increased use of medications and decreased quality of care.

The horror stories of patients left on toilets for hours, or lying in bed with unchanged loaded diapers abound. In one nursing home in Florida, a patient died from a feces-contaminated decubitus ulcer.10 When the family was understandably unhappy and hired a lawyer to determine accountability, they encountered a nightmare corporate structure. One company owned the building, another company obtained the license to run a nursing home, another company provided professional staff and another the custodial staff. The owners and managers had spread control among 15 companies and five layers of firms.

A large dermatology practice in California purchased by a private equity company produced a disturbing lesson in corporate governance.7 The practice’s “nonclinical” assets were bought by the private equity company, leaving the physicians in control of all medical decisions after agreeing to pay a management fee to handle administrative tasks such as billing and marketing. The new management team established daily and monthly financial goals, rewarding the offices meeting the goals with cash rewards. The performance of revenue enhancing procedures, Botox, laser treatments and Mohs surgery, for instance, was encouraged. Private equity groups buy existing labs and hire pathologists. The doctors are encouraged to send biopsy specimens to company owned labs and pathologists. Corporate approval was necessary to get office supplies, even toilet paper. Without consulting the medical staff, a manager changed to a cheaper brand of sutures and needles. The quality was so poor that needles would break off during injection and physicians had to dig them out of the skin and repeat the injection.

These are just a few examples of the litany of conflicts of interest between the goal of providing good patient care and the goal of feeding the investors’ profit demands. Sadly, we are left with the unanswered fundamental question of whether health care in the US is a commodity, to be exploited by for-profit companies and private equity investors, or is it an essential public service and a government responsibility. The rest of the first world knows the right answer.

REFERENCES

1 www.healthinsurance.org/definitions

2 healthcare.gov/health-care-law-protections

3 New York Times, Business Section, June 9, 2019

4 cnn.com/2015/09/28/health/us-pays-more-for-drugs

5 New York Times, Sunday Review, November 17, 2019

6 Am J Med 2009, 122:741-6

7 www.bloomberg.com/news/features/2020-05-20/private-equity-is-ruining
health-care-covid-is-making-it -worse

8 pe-insights.com/news/2020/05/21/hoe-private-equity-is-ruining-ameri-
can-health-care/

9 New York Times, Sunday, September 6, 2020

10 www.nytimes.com/2007/09/23/business/23nursing.html

This article was based on a number of radio programs on health care issues that were discussed on Single Payer Radio on Forward Radio WFMP-LP 106.5 FM. These programs are archived and can be listened to as podcasts by logging onto forwardradio.org-programs-single payer radio.

Dr. Flynn is a retired surgical oncologist.

Dr. Ana Malinow on the Wall St. Takeover of Medicare

Save Medicare from Wall St.—Stop the DCEs!

There must be a public outcry, or we will lose Medicare.  Under a Center for Medicare and Medicaid Services (CMS) program now underway, more than 30 million seniors who chose Traditional Medicare could be placed into largely investor-owned Direct Contracting Entities (“DCEs”) without the beneficiaries’ understanding or consent.

DCEs are another scheme to privatize Medicare. Like Medicare Advantage, the DCE program threatens Traditional Medicare, as well as a future public and nonprofit Medicare-for-All program. 

• Tell Health and Human Services Secretary Xavier Becerra to stop Direct Contracting Entities now!

200 Independence Avenue, S.W.
Washington, D.C. 20201

Toll Free: 1-877-696-6775

• Call your member of Congress demanding a halt to DCEs!  House 202-225-3121,  Senate 202-224-3121

• Learn more about DCEs:

www.nationalsinglepayer.com,

Kentuckians for Single Payer Health Care www.kyhealthcare.org  (502) 636 1551

Sign the Petition to Stop the privatization of Medicare

 
September 24, 2021

Dear single-payer supporter, 

Thanks to everyone who attended last night’s webinar on Direct Contracting Entities (DCEs), featuring Rep. Katie Porter, PNHP board member Dr. Ed Weisbart, journalist and scholar Trudy Lieberman, and David Lipschutz from the Center for Medicare Advocacy. If you missed it, I encourage you to watch the recording HERE

In short, the DCE program was quietly launched last year by the Trump Administration as yet another scheme to privatize Medicare. Under this model, CMS could auto-assign more than 30 million beneficiaries who have chosen Traditional Medicare into largely investor-owned Direct Contracting Entities (“DCEs”) without the beneficiaries’ understanding or consent. Like Medicare Advantage, the DCE program poses an existential threat to Traditional Medicare, as well as a future public and nonprofit Medicare-for-All program. 

I believe that we can stop the DCE program, but we must act quickly.  Starting today, we are launching a petition demanding that HHS Secretary Xavier Becerra immediately halt the DCE program that was started under the Trump Administration, and protect Medicare as a public good for future generations.

While the petition is open to all, we have a specific goal of one thousand physician signatures before the end of OctoberSign & share the petition If everyone who signs their name also collects ten additional signatures, we can reach our goal very quickly. 

I know that the commercialization of Medicare — and DCEs in particular — are complex topics. Be sure to explore and share these resources as you talk with your colleagues and neighbors:

DCE one-page fact sheet
Dr. Ana Malinow’s interview on the Thom Hartmann show (12 minutes)
Dr. Ed Weisbart’s slide set: DCEs — Handing Traditional Medicare to Wall Street
Webinar: Direct Contracting Entities — Handing Traditional Medicare to Wall Street
Template for letter to elected officials

Traditional Medicare is in the crosshairs. Let’s sound the alarm about DCEs and demand the Biden Administration keep Medicare a public good for generations to come. 

In solidarity,



Susan Rogers, M.D.
President
Physicians for a National Health Program
29 E Madison St Ste 1412 | Chicago, Illinois 60602
312-782-6006 | info@pnhp.org

Direct Contracting Entities: Handing Traditional Medicare to Wall Street

 
August 25, 2021

Dear colleague,

Please join us on Thursday, Sept. 23 at 8:00 p.m. Central / 9:00 p.m. Eastern to learn more about the quiet plan to privatize Medicare. Direct Contracting Entities (DCEs): Handing Traditional Medicare to Wall Street — What they are and how to stop them
Register Now
This webinar will be co-hosted by PNHP and National Single Payer, and co-sponsored by Public Citizen, Social Security Works, All Unions Committee for Single Payer, UAW Region 1A Retirees, Kentucky State AFL-CIO, Kentucky Alliance for Retired Americans, and Western PA Coalition for Single Payer Health Care (so far).

Scheduled speakers include: 

Rep. Katie Porter, (D-Calif.), signatory to a letter written to HHS Secretary Becerra asking for the immediate halt to DCEs

Dr. Ed Weisbart, Chair, PNHP-MO

Trudy Lieberman,
contributing editor, Columbia Journalism Review, and contributor to Health News Review and the Center for Health Journalism

David Lipschutz, JD, Associate Director, Center for Medicare Advocacy 

What are Direct Contracting Entities and why should single-payer supporters be concerned? In 2020, the Trump Administration launched a new CMS experiment, the Global Professional Direct Contracting (GPDC) model, that was designed to privatize traditional Medicare. GPDC transfers cost and care management to private for-profit insurer and investor contracting entities (DCEs). Under this model, CMS could auto-assign more than 30 million beneficiaries who have chosen traditional Medicare into entities managed by private for-profit companies, without their understanding or consent.

Instead of halting this program, the Biden Administration has accelerated it, threatening the future of Medicare as we know it.  If you care about preserving traditional Medicare for future generations — as well as for a future Medicare for All! — please join us on Thursday, Sept. 23 for this important webinar.

If you know of other organizations that would like to co-sponsor the DCE webinar, please contact Dr. Ana Malinow at anamalinow@gmail.com.

In solidarity, 
Susan Rogers, M.D.
President

On July 24 Marchers for Medicare for All took to the streets in Louisville and 55 other cities

On July 24, 2021, many thousands of people in 56 cities participated in the March for Medicare for All, initiated by a new coalition that called for urgent action for health care as a human right and a basic freedom.

How can we have life, liberty and the pursuit of happiness when we live in constant fear of illness, bankruptcy, or homelessness because of the outrageous for-profit healthcare system,” said the coalition.  “One event can ruin your life, even if you have insurance.  The industry can always say ‘no.’ We need a big fat ‘yes’!

Kentuckians for Single Payer Health Care (KSPH) brought together a coalition of 23 organizations to cosponsor the Louisville event on the lawn of the Mazzoli Federal Building.

Ann Hagen Grigsby

Ann Hagan Grigsby, (photo left) President and CEO of the Park DuValle Community Health Center opened with a call for single payer health care.  Her foster mother, she said, died before the age of 65 from lack of health care, “and it’s still happening today.”

Speaking as an individual, she said that even though her clinic is a national quality leader, it still cannot fill the gaps that patients face.  “What happens when you need a surgeon?   What happens when you can’t afford all the medications that you need.?”

“Until we as a people decide to tell members of Congress that the system is broken, that we will not take it anymore, it will not change.  We need to put people before profits,” she concluded.

Greg Tichenor, Board Member of the Kentucky Alliance Against Racist and Political Repression (KAARPR), said, “We as a society have accepted some people as disposable.  Money interests cannot be louder than the peoples’ interests.”  He called on the crowd to make their voices heard with their representatives and at the ballot box.

Marcellus Mayes, President of the Metro Disability Coalition spoke “as a blind American and a Kentuckian representing people with multiple sclerosis, muscular dystrophy, Parkinson’s disease, developmental disabilities, stroke patients, cerebral palsy and all who have pre-existing conditions.  Single payer health care is essential and necessary for people like me and those I associate with,” he said.  “We as Americans should all look to each other, nobody should be treated differently whether you are gay, straight, disabled or otherwise.”

“We claim to be a compassionate city, but so many people are being left behind” he said.  “You need to show us grace and mercy and provide us with single payer health care.”

Patricia Bautista-Cervera, MD, MPH, Community Liaison and Health Empowerment Coordinator at La Casita Center, explained why the Center is advocating for a single payer national health care system.

“The community we serve, is composed of essential workers: restaurant, factory, cleaning services, construction, yard work.  All these workers have continued to work their job sites,” she said.  “The pandemic has brought for those affected an increase in medical bills, loss of income or the loss of jobs due to the economic crisis that resulted from it.  Most of them don’t have health insurance.”

“According to a recent report, the debt owed to collection agencies by Americans stemming from medical care is 140 billion dollars. What I have described represents an enormous problem, imagine if we make it worse by adding several layers of barriers such as language, culture, education, income and the history of confronting traumatic events.”

She spoke of the Center’s organization of seven successful vaccination clinics that distributed 1,169 vaccines.  “Health care is a human right,” she said,  “Let’s keep working together to achieve this common goal.”

Bill Londrigan, (photo right) President of the Kentucky State AFL-CIO, noted that over 607 union organizations including 146 central labor councils and 43 state AFL-CIO federations had gone on record in support of national single payer health care legislation. Bill Londrigan, President, Kentucky State AFL-CIO

“I am really proud to say that the Kentucky State AFL-CIO was the first of the state federations to support single payer.”

He spoke of the difficulties in bargaining for wages, retirement, and other benefits because health care costs continue to skyrocket.  “What we want to do is take health care off the table.”

“We are absolutely tired of this corrupt system which is based on greed.  We need to take that profit motive out.  We need to stop paying CEOs tens of millions of dollars.  We need to stop these corporations from lowering benefits and denying people care.  This is wrong and that’s why our cause is so positive and so great.”

He pointed to other current issues such as the PRO act which would make it easier for workers who want to organize to have an opportunity to do so.

He urged everyone to support single payer, Medicare for All, and “get it through congress so we can transform this nation into one that stands with people instead of trying to deny them this basic right.”  He ended by saying “And we will win.”

Rev. Ron Robinson, a member of the steering committee of KSPH, stated that this Kentucky single payer group has been working on this issue since 2003.

“We’ve been in a war of consciousness over this immorality,” he said.

“You are the foot soldiers of consciousness.  When this war is won, then the disenfranchised will have access to Medicare.  When this war is won everybody will be able to go and say I need help and the doctor won’t say how much insurance do you have.”

“Like John Lewis said, we’re going to make good trouble.”

Kirk Gillenwaters, President of the Kentucky Alliance for Retired Americans, said that his organization represents retired union workers of Kentucky.  “One of the things about being unionized, we’ve all been receiving the benefits of a defined medical benefit.  Even though we are blessed with having the quality of life that we have, we know that this can be reversed and taken away with just the stroke of the pen, by denying us our secondary health care.”

He said that his United Auto Workers Local 862 was one of the first unions to join up with Medicare for All.  “That was almost twenty years ago.”

He spoke of the profits in medicine.  “You look at the top providers that manage our health care.  Humana hit $471 per share of stock yesterday.  United was $417.  Blue Cross Blue Shield $387.  That’s the profit off of our backs and the benefits that we’re supposed to be having—by the profit that they’re taking out of our health care.  This is why we’re asking for change.”

Garrett Adams, MD, MPH, former President of Physicians for a National Health Program, was the last rally speaker.  He noted that this month marks Medicare’s 56th birthday.

“We recently celebrated Juneteenth, the day honoring the end of slavery, the end of the despicable practice of buying and selling people as commodities, trading people as a business.

“Today all Americans are once again under the thumb of people who want to profit from us, the medical-industrial complex.  Health insurance companies, medical supply companies, and big Pharma.  We must throw off the yoke of business profiteering on health care.”

He said that several years ago the CEO of McKesson, a medical supply company had take home pay of $148 million.

“We must focus on health care not wealth care.  That is improved Medicare, comprehensive, high-quality care, including dental, vision, hearing, mental health and long term care paid through a national plan.  Privately delivered but paid for by our government.  The economists repeatedly have shown that we can afford this.  And the people including an increasing number of physicians want it.  We must build the political will to demand it.”

The participants, banners unfurled, then marched the half mile to Breewayy, Jefferson Square Park, where KAARPR had assembled large portraits of Breonna Taylor, who was murdered in her home as police carried out a baseless no-knock warrant.  There Mary Radford, RN, member of the KSPH Steering Committee, placed flowers in her memory and spoke:

“As an EMT and former Emergency Room Tech, Breonna undoubtedly experienced firsthand the consequences of a healthcare system that consistently failed the most vulnerable of our citizens. Based on everything I have learned about her, I have no doubt she served our community with grace, and empathy. I’ve also learned that the next step in her life of service was to become a nurse, and I can say with confidence I would have been proud to have her as a colleague.

“And while we take this moment to honor this Louisvillian, this Kentuckian, this hometown hero: taken from her family and her community through police violence, we also acknowledge the multiple black lives that have been taken in similar travesties throughout this nation.

“Through an unjust healthcare system, through gentrification, through police brutality and so many other ways, our fellow Americans are dying. We cannot stand for this any longer.”

The marchers returned to where they began.

The national March for Medicare for All continues the struggle with a human rights violation complaint to be submitted to the United Nations and the planning of a public UN panel discussion.

Harriette Seiler has put together a collection of photosSpectrum News covered it.  So did WLKY.  Rolf Friis, an independent Louisville videographer, showed the rally live on Facebook and put it on youtube.

Louisville and 54 other cities plan March for Medicare for All, July 24, 2021

Rally and march for improved Medicare for All.

Sat. July 24, 2021, at 11 AM

Mazzoli Federal Bldg., 600 Dr. Martin Luther King Jr. Pl.

We will begin at 11 AM in the park in front of the Federal Building where we have permission from the city to use the site.  We will set up under the trees near the corner of 7th & Chestnut so speakers and participants alike will be in the shade.

We will have speakers (brief) and music then march and/or caravan to Breewayy, the square at 6th between Liberty and Jefferson.

There we will place flowers in honor of Breonna Taylor, to connect with her profession as a healer, and to link the struggle for health care with the fight to end systemic racism.  We will return to where we began and share refreshments and socialize.

University of Louisville medical students advocating for single payer health care
University of Louisville medical students advocating for single payer health care

We will also be celebrating Medicare’s 56th birthday.  We hope you will join with us in demanding that Congress take action by passing a national single payer, improved Medicare for All plan.  Such a plan would end the tragic denial of care that causes so much suffering and unnecessary loss of life.

Cosponsors: (list in formation)

Kentuckians for Single Payer Health Care, Physicians for a National Health Program-KY, Kentucky Alliance Against Racist and Political Repression, Greater Louisville Central Labor Council, Independence Seekers, Movement for a People’s Party-KY, Clifton Universalist Unitarian Church, Kentucky Alliance for Retired Americans, Metro Disability Coalition, UAW Local 862, Central Kentucky Council for Peace and Justice, Anne Braden Institute for Social Justice Research, Carl Braden Memorial Center,  Association for the Study of African American Life and History, La Casita Center, Louisville Fellowship of Reconciliation, Fairness, Louisville Showing Up for Racial Justice, Kentucky State AFL-CIO, LIUNA Local 576, Lexington DSA, Sowers of Justice, Louisville State Chapter of the National Action Network

National Events list.

The national website is here

Further info:  Kay Tillow (502) 636 1551, nursenpo@aol.com

Print the flyer

People in other countries find the U. S. healthcare system is shockingly inhumane—a 6 minute video from NY Times Opinion.

“Why is it so expensive?”

https://www.nytimes.com/2021/04/28/opinion/healthcare-us.html?action=click&module=Opinion&pgtype=Homepage

Play video.

Byzantine health plans. Impoverishing deductibles. Exorbitant drug costs. Soul-crushing surprises lurking in the fine print.

The American health care system is — to put it mildly — totally perplexing, an exercise in patience and a test of financial resilience.

And that’s for its participants.

So imagine what the system must look like to people from other countries, especially those with universal health care, where citizens don’t live in fear that the next bout of the sniffles might somehow lead to bankruptcy.

In the video above, we gathered people from around the world and introduced them to the American health care system. We presented them with dizzying examples of insurance plan options. We showed them how much medical services cost. And we revealed some of the survival strategies of the tens of millions of Americans who are uninsured (drug purchases in Mexico, GoFundMe campaigns, consultations with “Dr. Google”).