Episode

8/9 U.S. Healthcare: A “Sick” System; What’s Next For SAG-AFTRA w/ Moe Tkacik & Nicole Cyrille

August 9, 2023

It’s Hump Day! Sam and Emma speak with Moe Tkacik, investigations editor at The American Prospect, to discuss her recent suite of pieces in this month’s issue on the U.S. healthcare system. Then, they’re joined by Nicole Cyrille, member of the SAG-AFTRA negotiating committee, to discuss the recent developments in the strike and what to expect going forward. Sam and Emma start off the show by reacting to the big victory in Ohio surrounding Issue 1, the ballot measure that Ohio Republicans were attempting to utilize to make it harder for Ohioans to codify abortion rights into the state Constitution in the fall. Ohio Secretary of State Frank LaRose spoke with Steve Doocy on Fox & Friends this morning, to make clear that actually, it’s totally fine that his side lost by millions of votes! Then, they’re joined by Moe to discuss her astounding amount of reporting in this month’s issue of The American Prospect about the U.S. healthcare system, and its frankly near-criminal origins. Moe traces back how the healthcare industry as we know it, dating back to the 1960’s, was essentially created by crooks, leading to the essential codification of healthcare law that is rarely ever enforced, and which essentially benefits a sprawling network of middlemen at the expense of actual patients. The structure of this policy Moe claims, ultimately leads to adverse outcomes: making patients sicker then healthier, while a smaller group of individuals become richer and richer. Moe also traces some of the history of the American Medical Association (AMA), the standard for healthcare administration prior to the 1960’s, as well as an organization characterized in opposition to socialized medicine. Moe then tells the story of United Healthcare, one of the premier organizations that characterized and revolutionized the inequitable structure of U.S. healthcare through the advert of HMO’s, or health maintenance organizations, and how, through their financing structure, HMO’s make it extremely difficult for medical professionals to maintain a successful practice via lowballing them, while also making pains to only offer coverage for necessary care. Sam, Emma, and Moe, discuss how United Healthcare and the HMO model is essentially a vertical integration model, and how that model spread from United Healthcare to other aspects of the industry, like drug pricing. Moe enlightens Sam and Emma on the weird tale of Pharma Bro Martin Shkreli actually *taking on* price gougers of a certain drug before he got into his own troubles doing some price gouging of his own. Moe also breaks down pharmacy benefit managers (PBM’s), the distributors of pharmaceuticals and their presence within the supplying of drugs to pharmacies and customers, and the inherently corrupt bargain that legitimizes them in the healthcare supply chain. Moe finally breaks down some potential solutions to the inherent corruption, grift, and mismanagement within the U.S. healthcare system, including a more robust enforcement of Medicare fraud laws.

Then, they’re joined by Nicole to discuss some updates on day 26 of the SAG-AFTRA strike and Day 100 of the WGA strike. Nicole gives a brief rundown on the main issues for SAG-AFTRA in their labor action(being treated with dignity and respect by streamers, corporate executives, and producers, raising minimum wages in a new agreement so actors can qualify for healthcare.) Nicole breaks down the discrepancies between linear network TV and the streaming model that has taken over, with syndication benefits no longer applying to shows on streaming, an enormous sea change in the industry that is ultimately penalizing creators while the people behind streaming platforms get more rich of the backs of those same creators. Nicole elucidates how there has still been no clarity on the metrics behind the success and failures of shows on streaming, which gives them leverage to not have to give in to any demands to the creators because there’s no mutual frame of reference. This, as Nicole explains, the companies hire analytics companies like Parrot, so that they have this information while the creators themselves aren’t permitted access to that data. Sam asks Nicole if he thinks there’s a potential to any cleaving between the wants and needs of a subscription model for a business like Netflix compared to a business like Amazon, something Nicole says, while she can’t confirm this, is hard to fathom because 1. They’re beholden to their shareholders and 2. They don’t have to adhere specifically to a fall schedule like producers did under the linear model. Nicole offers her perspective as a member of the disabled community in show business, an audio description narrator, and how both of those groups are even further marginalized by the inequities inherent within why SAG-AFTRA is striking for better conditions. They then touch on “interim agreements” and what they entail, as well as the AMPTP trying to strike a wedge between the WGA and SAG-AFTRA (unsuccessfully) before Nicole jumps off.

And in the Fun Half: Sam and Emma dive into the absolute messaging flop carried out by Ohio Republicans on Issue 1, and how seemingly no one has learned their lessons as to what is salient for voters when it comes to trans issues and abortion rights. They then discuss a great story of workers with the Houston-based organization Food Not Bombs being let off on charges of…feeding the homeless in public…, before getting into the ever-deepening hole that Steven Crowder keeps digging for himself because he can’t stop defending exposing himself to his employees (allegedly!) They then finally check in on Donald Trump, sweaty and nasty as ever, reveling in his groupies in New Hampshire. Plus, your calls & IM’s!

Check out Moe’s work at the Prospect here: https://prospect.org/topics/maureen-tkacik/

Find out more information about the SAG-AFTRA strike here: https://www.sagaftrastrike.org/

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