Cheryl Cashin
@cherylcashin.bsky.social
Health economist passionate about equity and Universal Health Coverage.
Essential reading if you want to understand how sick the US health care system is and why #Medicare4All is NOT a radical proposal to fix it. 👇
“The US system is drowning in private-sector bloat and bureaucracy. .The result is staggering inefficiency: roughly one in four dollars spent on health insurance goes to something other than care, like marketing, billing, profits, or middlemen.” open.substack.com/pub/yourloca...
5 ways our health care system has become utterly insane
A deep dive into the U.S. health care system: rising costs, corporate takeover, and why reform keeps failing.
open.substack.com
November 17, 2025 at 3:50 PM
Essential reading if you want to understand how sick the US health care system is and why #Medicare4All is NOT a radical proposal to fix it. 👇
No surprise here. Get profit out of health care! #people>profits #Medicare4All
Deaths are higher in emergency rooms of hospitals owned by private equity firms, per Harvard.
They did the math: It’s cheaper to let someone die than save them with a procedure they can’t afford.
This is what happens when profits take precedence over people.
They did the math: It’s cheaper to let someone die than save them with a procedure they can’t afford.
This is what happens when profits take precedence over people.
November 16, 2025 at 11:51 AM
No surprise here. Get profit out of health care! #people>profits #Medicare4All
Exactly! Health insurance premiums, deductibles and co-pays are taxes!
BUT they are regressive and revenue accrues to insurance company profit lines not government coffers.
AND it is taxation without representation since insurance companies are accountable to shareholders not taxpayers.
BUT they are regressive and revenue accrues to insurance company profit lines not government coffers.
AND it is taxation without representation since insurance companies are accountable to shareholders not taxpayers.
Maybe I’m too Norwegian, but it’s weird to me that Americans don’t consider health insurance a form of taxation.
November 12, 2025 at 10:52 AM
Exactly! Health insurance premiums, deductibles and co-pays are taxes!
BUT they are regressive and revenue accrues to insurance company profit lines not government coffers.
AND it is taxation without representation since insurance companies are accountable to shareholders not taxpayers.
BUT they are regressive and revenue accrues to insurance company profit lines not government coffers.
AND it is taxation without representation since insurance companies are accountable to shareholders not taxpayers.
Reposted by Cheryl Cashin
81 years ago, FDR proposed a second Bill of Rights to guarantee every American the right to employment, healthcare, education, housing, and a living income. His words are as relevant now as they were then. Watch.
November 12, 2025 at 2:31 AM
81 years ago, FDR proposed a second Bill of Rights to guarantee every American the right to employment, healthcare, education, housing, and a living income. His words are as relevant now as they were then. Watch.
Reposted by Cheryl Cashin
Socialism is what they called public power.
Socialism is what they called social security.
Socialism is what they called the growth of free and independent labor organizations.
Socialism is their name for almost anything that helps all the people.
—Harry Truman, 1952
Socialism is what they called social security.
Socialism is what they called the growth of free and independent labor organizations.
Socialism is their name for almost anything that helps all the people.
—Harry Truman, 1952
November 7, 2025 at 9:30 PM
Socialism is what they called public power.
Socialism is what they called social security.
Socialism is what they called the growth of free and independent labor organizations.
Socialism is their name for almost anything that helps all the people.
—Harry Truman, 1952
Socialism is what they called social security.
Socialism is what they called the growth of free and independent labor organizations.
Socialism is their name for almost anything that helps all the people.
—Harry Truman, 1952
Reposted by Cheryl Cashin
I helped make a film, out this week, called “Rovina’s Choice,” about the deaths this man without conscience or accountability has caused — already 600,000, ⅔ of them children.
November 6, 2025 at 10:34 PM
I helped make a film, out this week, called “Rovina’s Choice,” about the deaths this man without conscience or accountability has caused — already 600,000, ⅔ of them children.
Administrative burden is a barrier to health care. This one is an easy fix.
November 5, 2025 at 1:55 AM
Administrative burden is a barrier to health care. This one is an easy fix.
Reposted by Cheryl Cashin
Earlier this year, I met a Croatian journalist who was in the US doing a piece on America’s politics and I asked her what surprised her. And she said, “What you all call the far left is just being normal.”
November 4, 2025 at 3:37 PM
Earlier this year, I met a Croatian journalist who was in the US doing a piece on America’s politics and I asked her what surprised her. And she said, “What you all call the far left is just being normal.”
Through his voice and his research @awgaffney.bsky.social provides unrelenting clarity around the failure of the US health care system and the greed at the root of that failure.
@madhupai.bsky.social thank you for amplifying this
@madhupai.bsky.social thank you for amplifying this
The title says it all!
Health care in the USA: money has become the mission
@thelancet.com review on "the damage wrought by decades of market-based policies that have stimulated profit-seeking by insurers and health-care providers"
@awgaffney.bsky.social et al
www.thelancet.com/journals/lan...
Health care in the USA: money has become the mission
@thelancet.com review on "the damage wrought by decades of market-based policies that have stimulated profit-seeking by insurers and health-care providers"
@awgaffney.bsky.social et al
www.thelancet.com/journals/lan...
Health care in the USA: money has become the mission
Despite extraordinary scientific and medical resources, the US health-care system
underperforms. In this Review we consider the damage wrought by decades of market-based
policies that have stimulated ...
www.thelancet.com
October 24, 2025 at 1:25 PM
Through his voice and his research @awgaffney.bsky.social provides unrelenting clarity around the failure of the US health care system and the greed at the root of that failure.
@madhupai.bsky.social thank you for amplifying this
@madhupai.bsky.social thank you for amplifying this
Reposted by Cheryl Cashin
The title says it all!
Health care in the USA: money has become the mission
@thelancet.com review on "the damage wrought by decades of market-based policies that have stimulated profit-seeking by insurers and health-care providers"
@awgaffney.bsky.social et al
www.thelancet.com/journals/lan...
Health care in the USA: money has become the mission
@thelancet.com review on "the damage wrought by decades of market-based policies that have stimulated profit-seeking by insurers and health-care providers"
@awgaffney.bsky.social et al
www.thelancet.com/journals/lan...
Health care in the USA: money has become the mission
Despite extraordinary scientific and medical resources, the US health-care system
underperforms. In this Review we consider the damage wrought by decades of market-based
policies that have stimulated ...
www.thelancet.com
October 23, 2025 at 7:57 PM
The title says it all!
Health care in the USA: money has become the mission
@thelancet.com review on "the damage wrought by decades of market-based policies that have stimulated profit-seeking by insurers and health-care providers"
@awgaffney.bsky.social et al
www.thelancet.com/journals/lan...
Health care in the USA: money has become the mission
@thelancet.com review on "the damage wrought by decades of market-based policies that have stimulated profit-seeking by insurers and health-care providers"
@awgaffney.bsky.social et al
www.thelancet.com/journals/lan...
Reposted by Cheryl Cashin
Health insurance costs jumped for workers & employers in 2025.
This will get worse if the GOP refuses to extend ACA subsidies.
Meanwhile, the seven largest health insurance companies made a combined $71B in profits in 2024.
Still not sure we need Medicare for All?
This will get worse if the GOP refuses to extend ACA subsidies.
Meanwhile, the seven largest health insurance companies made a combined $71B in profits in 2024.
Still not sure we need Medicare for All?
October 22, 2025 at 8:45 PM
Health insurance costs jumped for workers & employers in 2025.
This will get worse if the GOP refuses to extend ACA subsidies.
Meanwhile, the seven largest health insurance companies made a combined $71B in profits in 2024.
Still not sure we need Medicare for All?
This will get worse if the GOP refuses to extend ACA subsidies.
Meanwhile, the seven largest health insurance companies made a combined $71B in profits in 2024.
Still not sure we need Medicare for All?
Reposted by Cheryl Cashin
Trump hosted a dinner last week for donors helping fund his ballroom project.
Today, crews are starting construction and literally tearing down parts of the White House.
It's day 20 of the government shutdown and this is what he's prioritizing?
Today, crews are starting construction and literally tearing down parts of the White House.
It's day 20 of the government shutdown and this is what he's prioritizing?
October 20, 2025 at 8:58 PM
Trump hosted a dinner last week for donors helping fund his ballroom project.
Today, crews are starting construction and literally tearing down parts of the White House.
It's day 20 of the government shutdown and this is what he's prioritizing?
Today, crews are starting construction and literally tearing down parts of the White House.
It's day 20 of the government shutdown and this is what he's prioritizing?
There are some things that should never be for profit....
Psychiatric hospitals, prisons, basic health coverage to name a few.
Psychiatric hospitals, prisons, basic health coverage to name a few.
Around 80% of the psychiatric hospitals in the U.S. that have violated the Emergency Medical Treatment and Labor Act in the past 15 years are owned by for-profit corporations.
Only a few have faced any repercussions from regulators.
By @emcahan.bsky.social
Only a few have faced any repercussions from regulators.
By @emcahan.bsky.social
For-Profit Corporations Are Buying Up More Psychiatric Hospitals. Some Flout Federal Law With Scarce Repercussions.
Psychiatric hospitals — increasingly owned by for-profit corporations — are illegally turning away patients during crises. Yet only a handful face penalties, with fines that are trivial, a ProPublica ...
www.propublica.org
October 14, 2025 at 1:06 PM
There are some things that should never be for profit....
Psychiatric hospitals, prisons, basic health coverage to name a few.
Psychiatric hospitals, prisons, basic health coverage to name a few.
Truth.
October 13, 2025 at 8:59 PM
Truth.
Reposted by Cheryl Cashin
@cgdev.org’s new paper proposes a framework for financing healthcare supply chains in low- & middle-income countries — bridging health financing & logistics to strengthen access to essential medicines.
🔗 www.cgdev.org/publication/...
@peterbaker17.bsky.social @cherylcashin.bsky.social
🔗 www.cgdev.org/publication/...
@peterbaker17.bsky.social @cherylcashin.bsky.social
Financing of Healthcare Supply Chains in Low- and Middle-Income Countries: A Novel Conceptual Framework
Healthcare supply chain financing is critical to health system performance but remains neglected—often fragmented, donor-dependent, and inefficient—leading to stockouts and high out-of-pocket costs. W...
www.cgdev.org
October 6, 2025 at 1:47 PM
@cgdev.org’s new paper proposes a framework for financing healthcare supply chains in low- & middle-income countries — bridging health financing & logistics to strengthen access to essential medicines.
🔗 www.cgdev.org/publication/...
@peterbaker17.bsky.social @cherylcashin.bsky.social
🔗 www.cgdev.org/publication/...
@peterbaker17.bsky.social @cherylcashin.bsky.social
Reposted by Cheryl Cashin
With ACA tax credits, a 60-year-old couple making $85,000 pays ~$7,000 for their annual premium.
Without ACA tax credits, the same couple could be forced to pay nearly $30,000.
I know Republicans only speak "billionaire"—but middle-class families can't afford this.
Without ACA tax credits, the same couple could be forced to pay nearly $30,000.
I know Republicans only speak "billionaire"—but middle-class families can't afford this.
October 2, 2025 at 7:43 PM
With ACA tax credits, a 60-year-old couple making $85,000 pays ~$7,000 for their annual premium.
Without ACA tax credits, the same couple could be forced to pay nearly $30,000.
I know Republicans only speak "billionaire"—but middle-class families can't afford this.
Without ACA tax credits, the same couple could be forced to pay nearly $30,000.
I know Republicans only speak "billionaire"—but middle-class families can't afford this.
Reposted by Cheryl Cashin
If Congress doesn’t act to extend the ACA’s enhanced premium tax credits, KFF’s latest analysis finds that premium payments would more than double on average in 2026.
See the data: https://on.kff.org/3WfWxjj
See the data: https://on.kff.org/3WfWxjj
September 30, 2025 at 2:42 PM
If Congress doesn’t act to extend the ACA’s enhanced premium tax credits, KFF’s latest analysis finds that premium payments would more than double on average in 2026.
See the data: https://on.kff.org/3WfWxjj
See the data: https://on.kff.org/3WfWxjj
Reposted by Cheryl Cashin
“Complexity in medicine cannot be reduced to a billing code. A patient with hypertension, diabetes, or depression may look “routine” on paper, yet the visit may involve reconciling medications, coordinating referrals, addressing side effects, screening for complications, and navigating barriers…”
An insurance company is introducing a new threat to American medicine
Prior authorizations were once a narrow tool to contain costs. Downcoding could be next.
www.statnews.com
September 29, 2025 at 12:10 PM
“Complexity in medicine cannot be reduced to a billing code. A patient with hypertension, diabetes, or depression may look “routine” on paper, yet the visit may involve reconciling medications, coordinating referrals, addressing side effects, screening for complications, and navigating barriers…”
The slide into autocracy can be reversed and often is. It takes time and persistence. We can do this!
The concept of democracy u-turns is helpful. 70% of states that descend into authoritarianism return to democracy, sometimes stronger than before. Avg time at the bottom is 8 years. We can learn from these u-turns - what are common factors and how to fund them? www.tandfonline.com/doi/full/10....
When autocratization is reversed: episodes of U-Turns since 1900
The world is in a “wave of autocratization.” Yet, recent events in Brazil, the Maldives, and Zambia demonstrate that autocratization can be halted and reversed. This article introduces “U-Turn” as ...
www.tandfonline.com
September 26, 2025 at 10:53 AM
The slide into autocracy can be reversed and often is. It takes time and persistence. We can do this!
Guaranteed universal health coverage would solve this and so many other dysfunctions. #Medicare4All #NYHA
A new article assess consumer experiences of health insurance coverage uncertainty in 2009, 2014, and 2021. The authors found high rates of coverage uncertainty are associated with delayed access, inability to effectively care for chronic conditions, and heightened anxiety about medical care costs.
The Shadow Price of Uncertainty: Consequences of Unpredictable Insurance Coverage for Access, Care, and Financial Security | Milbank Quarterly
Context: Health insurance reform in the United States has focused on expanding enrollment, a goal inhibited by complex insurance provisions. Research
www.milbank.org
September 25, 2025 at 3:06 PM
Guaranteed universal health coverage would solve this and so many other dysfunctions. #Medicare4All #NYHA
Reposted by Cheryl Cashin
Curse of private equity.
After US hospitals were acquired by private equity firms, patient death rates in the emergency depts rose by 13% compared with similar hospitals.
PE cut staffing, wages, investment; hiked profits.
People killed for profit.
Yet UK handing healthcare to PE.
After US hospitals were acquired by private equity firms, patient death rates in the emergency depts rose by 13% compared with similar hospitals.
PE cut staffing, wages, investment; hiked profits.
People killed for profit.
Yet UK handing healthcare to PE.
Death rates rose in hospital ERs after private equity firms took over, study finds
The increased deaths in emergency departments at private equity-owned hospitals are most likely the result of reduced staffing levels, researchers say.
www.nbcnews.com
September 25, 2025 at 7:09 AM
Curse of private equity.
After US hospitals were acquired by private equity firms, patient death rates in the emergency depts rose by 13% compared with similar hospitals.
PE cut staffing, wages, investment; hiked profits.
People killed for profit.
Yet UK handing healthcare to PE.
After US hospitals were acquired by private equity firms, patient death rates in the emergency depts rose by 13% compared with similar hospitals.
PE cut staffing, wages, investment; hiked profits.
People killed for profit.
Yet UK handing healthcare to PE.
This makes me feel incredibly sick and ashamed of the U.S. government and its cruel disregard for the lives of precious children around the world.
The next few years are going to be littered with millions of untold stories like this. Mothers watching their babies die of starvation because Musk took a woodchopper to USAID www.cnn.com/2025/09/21/a...
A US-funded nutrition program was helping to keep this woman’s baby alive. Days after the program was cut, he died | CNN
Weeds cover the grave of Yagana Usman’s baby – a painful reminder of the months that have passed since she lost her infant twin to malnutrition. Her surviving twin’s fate now hinges in part on decisio...
www.cnn.com
September 22, 2025 at 6:12 PM
This makes me feel incredibly sick and ashamed of the U.S. government and its cruel disregard for the lives of precious children around the world.
Looming Federal Health Care cuts will double the uninsured population, skyrocket premiums and force hospital closures.
The New York Health Act will ensure that everyone receives upgraded and comprehensive healthcare, save families money and keep hospitals open.
The New York Health Act will ensure that everyone receives upgraded and comprehensive healthcare, save families money and keep hospitals open.
September 16, 2025 at 4:16 PM
Looming Federal Health Care cuts will double the uninsured population, skyrocket premiums and force hospital closures.
The New York Health Act will ensure that everyone receives upgraded and comprehensive healthcare, save families money and keep hospitals open.
The New York Health Act will ensure that everyone receives upgraded and comprehensive healthcare, save families money and keep hospitals open.
Reposted by Cheryl Cashin
Commentary: The tax cuts in the “One Big Beautiful Bill Act” are offset by spending cuts, including deep cuts to Medicaid. These cuts have often been framed in the context of limiting governmental waste and overspending, but they'll make it harder for some hospitals to stay solvent.
How Medicaid cuts will hurt every hospital — including yours
Regardless of your political views, we can all agree that hospitals have to be solvent to stay open, write Anesu Karen Murambadoro and John Wixted. The Medicaid cuts included in the One Big Beautiful ...
www.wbur.org
September 16, 2025 at 9:53 AM
Commentary: The tax cuts in the “One Big Beautiful Bill Act” are offset by spending cuts, including deep cuts to Medicaid. These cuts have often been framed in the context of limiting governmental waste and overspending, but they'll make it harder for some hospitals to stay solvent.