Unf*cking The Republic

The third and final installment of our American Healthcare series examines the evolution of the American hospital system. There are more than 6,000 hospitals in the United States and several distinctions among them. After a quick recap of the first two episodes, we look primarily at the peculiar designation of nonprofit hospitals, their relationship to practitioners and their role in driving costs in the system. We conclude the series with a few hot takes from medical professionals, some basic proposals to improve coverage and care and ask what it would take to move toward Medicare for All. Chapters Intro: 00:01:59 Chapter One: What’s a Hospital? 00:13:59 Chapter Two: For-Profit and Nonprofit Hospitals. Two sides of the same damn coin. 00:17:56 Chapter Three: Turning Doctors into Business People. 00:31:07 Chapter Four: Bring it home, Max. 00:36:09 Post Show Musings: 00:50:39 Book Love: 01:10:43 Outro: 01:11:11 Resources OECD.stat: Health Care Resources: Hospitals EOS Surfaces: Types of Hospitals in the US AAPC: What Are Relative Value Units (RVUs)? American Hospital Association: Fast Facts on U.S. Hospitals, 2022 Becker’s Hospital Review: 82 Physician-Owned Hospitals to Know AMA Journal of Ethics: Physician-Owned Hospitals and Self-Referral NPR’s Planet Money: How Non-Profit Hospitals Are Driving Up The Cost Of Health Care LWW Journals: The Growing Executive-Physician Wage Gap in Major US Nonprofit Hospitals and Burden of Nonclinical Workers on the US Healthcare System Weatherby Healthcare: Physician salary report 2022: Physician income rising again The New York Times: Why Are Nonprofit Hospitals So Highly Profitable? Hub’s List: A data-based biweekly newsletter of medical fun facts The New England Journal of Medicine: Practicing Medicine in the New Business Climate The New England Journal of Medicine: Is Quality Improvement Improving Quality? A View from the Doctor's Office CNN: 2 charts that show just how old this Congress actually is The Commonwealth Fund: International Health Care System Profiles- France Germany Visa: Health Insurance in Germany- The German Healthcare System Congress.gov: H.R.1 For the People Act NASHP: Can We Please Stop Fixating on Hospital Chargemasters? KHN: Nixon’s Plan For Health Reform, In His Own Words CBO: Estimated Budgetary Effects of Title I, Committee on Finance, of H.R. 5376, the Inflation Reduction Act of 2022 The Lever: Where Did The Public Option Go? UNFTR Episode Resources U.S. Healthcare. This Healthcare is Killing Us. Student Debt. Book Love Paul Starr: The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry Steven Brill: America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System Nelson Lichtenstein: State of the Union: A Century of American Labor Mark Vonnegut: The Heart of Caring: A Life in Pediatrics -- If you like #UNFTR, please leave us a rating and review on Apple Podcasts: unftr.com/rate and follow us on Facebook, Twitter and Instagram at @UNFTRpod. Visit us online at unftr.com. Join the Unf*cker-run Facebook group: facebook.com/groups/2051537518349565 Buy yourself some Unf*cking Coffee at shop.unftr.com. Subscribe to Unf*cking The Republic on Substack at unftr.substack.com to get the essays these episode are framed around sent to your inbox every week. Check out the UNFTR Pod Love playlist on Spotify: spoti.fi/3yzIlUP. Visit our bookshop.org page at bookshop.org/shop/UNFTRpod to find the full UNFTR book list, and find book recommendations from our Unf*ckers at bookshop.org/lists/unf-cker-book-recommendations. Access the UNFTR Musicless feed by following the instructions at unftr.com/accessibility. Unf*cking the Republic is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com). The show is written by pre-existing conditions and hosted by declining mortality rates. Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, "Unf*cking the Republic."Support the show: https://www.unftr.com/membershipsSee omnystudio.com/listener for privacy information.

In today's Show Notes, Max and 99 continue to discuss the healthcare industry—this time with insight from some of the international Unf*ckers. Plus, 99 has the sniffles and sounds like Squidward. And, as always, (somehow) there’s singing. Enjoy! Listen to Episode 72: This Healthcare is Killing Us: The perpetual cycle of money madness. Chapters Intro: 00:00:20 Emails: 00:06:35 Twitter Shout Outs: 01:18:01 Instagram Shout Outs: 01:18:01 Buy Me A Coffee Donations + Memberships: 01:50:47 Reviews: 01:23:13 Outro: 01:24:27 Resources UNFTR Artist Submission Unf*ckers Facebook Group Media Roots Podcast: Alex Jones Part 1 and Part 2 IndoctriNation Podcast Amanda Montell: Cultish: The Language of Fanaticism UNFTR Episode: Global Order of Money UNFTR Episode: Global Order of Power UNFTR Episode: America Inc. Knudsen in the news -- If you like #UNFTR, please leave us a rating and review on Apple Podcasts: unftr.com/rate and follow us on Facebook, Twitter and Instagram at @UNFTRpod. Visit us online at unftr.com. Buy yourself some Unf*cking Coffee at shop.unftr.com. Subscribe to Unf*cking The Republic on Substack at unftr.substack.com to get the essays these episode are framed around sent to your inbox every week. Check out the UNFTR Pod Love playlist on Spotify: spoti.fi/3yzIlUP. Visit our bookshop.org page at bookshop.org/shop/UNFTRpod to find the full UNFTR book list, and find book recommendations from our Unf*ckers at bookshop.org/lists/unf-cker-book-recommendations. Access the UNFTR Musicless feed by following the instructions at unftr.com/accessibility. Unf*cking the Republic is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com). The show is written and hosted by Max and distributed by 99. Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, "Unf*cking the Republic."Support the show: https://www.unftr.com/membershipsSee omnystudio.com/listener for privacy information.

We're re-releasing our Labor Union episode in honor of Labor Day. For Unf*ckers outside of the United States, this is the day government set aside as a token of appreciation to the labor movement for eight hour days, weekends, anti-child labor laws, protection from discrimination and more. (In reality, it was a consolation prize after Grover Cleveland jailed Eugene Debs and sent federal troops to beat the shit out of Pullman railcar workers on strike.) We celebrate this glorious day by giving members of the PMC a holiday to shop at stores run by the working poor. -- From Pullman and Carnegie to Kellogg's and the PRO Act, this week we unf*ck the labor movement in the United States. No single episode can possibly do labor justice but we give it our best shot. The episode includes a blow-by-blow analysis of a recent interview with the CEO of Kellogg's to translate Wall Street speak for “how to fuck workers and influence inflation.” And we rip off a few Milton references to exercise our #FMF muscle. Chapters Intro: 00:00:42 Segment 1: 00:02:11 Segment 2: 00:04:25 Segment 3: 00:12:18 Segment 4: 00:17:46 Segment 5: 00:21:29 Segment 6: 00:28:00 Segment 7: 00:30:20 Segment 8: 00:41:22 Show Notes: 00:52:15 Book Love: 00:57:17 Pod Love: 00:58:02 Emails + Shoutouts: 00:58:45 Outro: 01:10:42 Resources American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) The New York Times: Starbucks workers at a Buffalo store unionize in a big symbolic win for labor Kellogg Company: Investor Relations The Nation: Striking Kellogg’s Workers Need the PRO Act U.S. Bureau Of Labor Statistics: Work Stoppages OECD: Trade Union Dataset  U.S. Bureau Of Labor Statistics: Union Members — 2020 Economic History Association: Labor Unions in the United States History of Recessions in U.S. Unionization rates by industry in the United States, 1880-2000 More Perfect Union: Kellogg's Factory Working Conditions Media Matters: Joe Rogan Wrapped: A year of COVID-19 misinformation, right-wing myths, and anti-trans rhetoric Book Love Philip Dray: There Is Power in a Union: The Epic Story of Labor in America Nelson Lichtenstein: State of the Union: A Century of American Labor Kurt Andersen: Evil Geniuses: The Unmaking of America Joseph Stiglitz: People, Power and Profits Robert Shiller: Narrative Economics Pod Love Economic Update with Professor Richard Wolff: S11 E47 -- If you like #UNFTR, please leave us a rating and review on Apple Podcasts: unftr.com/rate and follow us on Facebook, Twitter and Instagram at @UNFTRpod. Visit us online at unftr.com. Buy yourself some Unf*cking Coffee at shop.unftr.com. Subscribe to Unf*cking The Republic on Substack at unftr.substack.com to get the essays these episode are framed around sent to your inbox every week. Check out the UNFTR Pod Love playlist on Spotify: spoti.fi/3yzIlUP. Visit our bookshop.org page at bookshop.org/shop/UNFTRpod to find the full UNFTR book list. Access the UNFTR Musicless feed by following the instructions at unftr.com/accessibility. Unf*cking the Republic is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com). The show is written and hosted by Eugene Debs and distributed by the Pinkertons. Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, ‘Unf*cking the Republic.’Support the show: https://www.unftr.com/membershipsSee omnystudio.com/listener for privacy information.

The first installment of our healthcare series encapsulated the magnitude of the industry that accounts for 20% of our nation’s GDP and how efforts to pursue universal healthcare were scuttled over the years. Today’s episode examines the role of private insurance in our system and details how Obamacare came to life with little discussion around a public option or the possibility of Medicare for All.  Chapters Intro: 00:01:58 Chapter One: Understanding the scope of healthcare. 00:03:12 Chapter Two: The Insurance Class System: 00:16:29 Chapter Three: Making the Sausage: 00:26:32 Post Show Musings: 00:46:27 Outro: 00:51:50 Resources The New York Times: U.S. Life Expectancy Falls Again in ‘Historic’ Setback Health System Tracker: How does health spending in the U.S. compare to other countries? The Atlantic: Did a Conservative Think Tank Really Invent the Individual Mandate? The Henry J. Kaiser Family Foundation: The Burden of Medical Debt: Results from the Kaiser Family Foundation/New York Times  UnitedHealth Group: Annual Report Humana: 2021 Annual Report Anthem, Inc: Annual Report National Association of Insurance Commissioners: U.S. Health Insurance Industry Analysis Report  Book Love Paul Starr: The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry Steven Brill: America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System -- If you like #UNFTR, please leave us a rating and review on Apple Podcasts: unftr.com/rate and follow us on Facebook, Twitter and Instagram at @UNFTRpod. Visit us online at unftr.com. Join the Unf*cker-run Facebook group: facebook.com/groups/2051537518349565 Buy yourself some Unf*cking Coffee at shop.unftr.com. Subscribe to Unf*cking The Republic on Substack at unftr.substack.com to get the essays these episode are framed around sent to your inbox every week. Check out the UNFTR Pod Love playlist on Spotify: spoti.fi/3yzIlUP. Visit our bookshop.org page at bookshop.org/shop/UNFTRpod to find the full UNFTR book list, and find book recommendations from our Unf*ckers at bookshop.org/lists/unf-cker-book-recommendations. Access the UNFTR Musicless feed by following the instructions at unftr.com/accessibility. Unf*cking the Republic is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com). The show is written by means and hosted by regression analyses. Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, "Unf*cking the Republic."Support the show: https://www.unftr.com/membershipsSee omnystudio.com/listener for privacy information.

In today's Show Notes, Max and 99 continue talking about the student debt announcement and its impact, address more feedback from the healthcare episode, plus feedback from the last show notes re: Big Pharma, natural medicine and vaccines. Listen to Topical Cream 6: Biden’s Big Student Debt Announcement. Chapters Intro: 00:00:20 Emails: 00:09:22 Facebook Shout Outs: 01:37:40 Twitter Shout Outs: 01:45:19 Buy Me A Coffee Donations + Memberships: 01:50:47 Outro: 01:51:16 Resources UNFTR Merch Store Trust Me Podcast: Virginia Heffernan: Edge, Jeffrey Epstein, & the Intellectual Dark Web Conspirituality Podcast Maintenance Phase Podcast Unf*ckers Facebook Group UNFTR Episodes: Libertarians Are Exhausting Part One and Part Two. UNFTR Episodes: Corporate (Ir)Responsibility Part One and Part Two. UNFTR Episodes: F*ck Milton Friedman. ProPublica: How a Secretive Billionaire Handed His Fortune to the Architect of the Right-Wing Takeover of the Courts The Intercept: Joe Biden’s Role In Creating The Student Debt Crisis Stretches Back To The 1970s SocialMarketing.org: Generations X,Y, Z and the Others -- If you like #UNFTR, please leave us a rating and review on Apple Podcasts: unftr.com/rate and follow us on Facebook, Twitter and Instagram at @UNFTRpod. Visit us online at unftr.com. Buy yourself some Unf*cking Coffee at shop.unftr.com. Subscribe to Unf*cking The Republic on Substack at unftr.substack.com to get the essays these episode are framed around sent to your inbox every week. Check out the UNFTR Pod Love playlist on Spotify: spoti.fi/3yzIlUP. Visit our bookshop.org page at bookshop.org/shop/UNFTRpod to find the full UNFTR book list, and find book recommendations from our Unf*ckers at bookshop.org/lists/unf-cker-book-recommendations. Access the UNFTR Musicless feed by following the instructions at unftr.com/accessibility. Unf*cking the Republic is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com). The show is written and hosted by Max and distributed by 99. Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, "Unf*cking the Republic."Support the show: https://www.unftr.com/membershipsSee omnystudio.com/listener for privacy information.

Lily Geismer wrote an incredible book called Left Behind. Unf*ckers who listened to our three part series on the Clinton years are familiar with it and know how important it was to framing this series. We had some follow up thoughts and questions for this esteemed author and are thrilled she obliged. Max and Lily have a wide ranging conversation about her book and the long tail effect of Clinton’s brand of neoliberalism in the second installment of Phone a Friend. Resources UNFTR Episode: The Clinton Years (Parts One, Two, and Three) Lily Geismer: Left Behind: The Democrats’ Failed Attempt to Solve Inequality Lily Geismer: Don’t Blame Us: Suburban Liberals and the Transformation of the Democratic Party Nathan J. Robinson: Superpredator: Bill Clinton’s Use and Abuse of Black America UNFTR Episode: The Economics of Racism: Bootstraps, Black Banks and Redlining Michelle Alexander: The New Jim Crow: Mass Incarceration in the Age of Colorblindness Mehrsa Baradaran: The Color of Money: Black Banks and the Racial Wealth Gap Richard Rothstein: The Color of Law: A Forgotten History of How Our Government Segregated America Gary Gerstle: The Rise and Fall of the Neoliberal Order: America and the World in the Free Market Era Lily on Twitter -- If you like #UNFTR, please leave us a rating and review on Apple Podcasts: unftr.com/rate and follow us on Facebook, Twitter and Instagram at @UNFTRpod. Visit us online at unftr.com. Join the Unf*cker-run Facebook group: facebook.com/groups/2051537518349565 Buy yourself some Unf*cking Coffee at shop.unftr.com. Subscribe to Unf*cking The Republic on Substack at unftr.substack.com to get the essays these episode are framed around sent to your inbox every week. Check out the UNFTR Pod Love playlist on Spotify: spoti.fi/3yzIlUP. Visit our bookshop.org page at bookshop.org/shop/UNFTRpod to find the full UNFTR book list, and find book recommendations from our Unf*ckers at bookshop.org/lists/unf-cker-book-recommendations. Access the UNFTR Musicless feed by following the instructions at unftr.com/accessibility. Unf*cking the Republic is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com). The show is written by Max and hosted by 99. Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, ‘Unf*cking the Republic.’Support the show: https://www.unftr.com/membershipsSee omnystudio.com/listener for privacy information.

It’s here! It’s finally here! Today we review our predictions for student debt relief and square them with Biden’s proposed plan. There’s a lot to like about the announcement, several unanswered questions and some gaping holes in the plan going forward. Max breaks down the politics, the details and biggest misses of the Biden student debt relief plan and why it’s in danger of being PITOTWIU. Resources The Balance: How Much Trump's Tax Cuts Cost the Government World Population Review: Average Family Income 2022 PBS NewsHour: President Biden announces decision on student debt forgiveness Committee For a Responsible Federal Budget: New Student Debt Changes Will Cost Half a Trillion Dollars Penn Wharton Budget Model: The Biden Student Loan Forgiveness Plan: Budgetary Costs and Distributional Impact Josh Mitchell: The Debt Trap: How Student Loans Became a National Catastrophe UNFTR Episode Resources Student Debt. Modern Monetary Theory. Corporate (Ir)Responsibility (Part I) and (Part II). -- If you like #UNFTR, please leave us a rating and review on Apple Podcasts: unftr.com/rate and follow us on Facebook, Twitter and Instagram at @UNFTRpod. Visit us online at unftr.com. Buy yourself some Unf*cking Coffee at shop.unftr.com. Subscribe to Unf*cking The Republic on Substack at unftr.substack.com to get the essays these episode are framed around sent to your inbox every week. Check out the UNFTR Pod Love playlist on Spotify: spoti.fi/3yzIlUP. Visit our bookshop.org page at bookshop.org/shop/UNFTRpod to find the full UNFTR book list, and find book recommendations from our Unf*ckers at bookshop.org/lists/unf-cker-book-recommendations. Access the UNFTR Musicless feed by following the instructions at unftr.com/accessibility. Unf*cking the Republic is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com). The show is written and hosted by Max and distributed by 99. Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, "Unf*cking the Republic."Support the show: https://www.unftr.com/membershipsSee omnystudio.com/listener for privacy information.

In today’s Show Notes Max and 99 talk for 30 hours…Okay, exaggeration. But they talk for a long while, because there’s a lot of U.S. healthcare feedback to run through, as the Unf*ckers are so smart and dedicated (as usual). All hail Nettie. Listen to U.S. Healthcare. Chapters Intro: 00:00:20 UNFTR Healthcare Update: 00:03:13 Emails: 00:08:13 Facebook Shout Outs: 01:57:12 Twitter Shout Outs: 02:02:30 Instagram Shout Outs: 02:05:05 Substack: 02:06:57 Buy Me A Coffee Donations + Memberships: 02:10:34 Reviews: 02:14:42 Resources Nettie's Fund Ron DeSantis Standing Maintenance Phase Podcast      -Weight Watchers      -Super Size Me      -Jordan Peterson Part 1 and Part 2 Unf*cker-run Facebook Group Majority Report with John Abramson Nathan J. Robinson: The Intellectual We Deserve An Arm and a Leg Podcast Elisabeth Rosenthal: An American Sickness: How Healthcare Became Big Business and How You Can Take It Back UNFTR Artists -- If you like #UNFTR, please leave us a rating and review on Apple Podcasts: unftr.com/rate and follow us on Facebook, Twitter and Instagram at @UNFTRpod. Visit us online at unftr.com. Buy yourself some Unf*cking Coffee at shop.unftr.com. Subscribe to Unf*cking The Republic on Substack at unftr.substack.com to get the essays these episode are framed around sent to your inbox every week. Check out the UNFTR Pod Love playlist on Spotify: spoti.fi/3yzIlUP. Visit our bookshop.org page at bookshop.org/shop/UNFTRpod to find the full UNFTR book list, and find book recommendations from our Unf*ckers at bookshop.org/lists/unf-cker-book-recommendations. Access the UNFTR Musicless feed by following the instructions at unftr.com/accessibility. Unf*cking the Republic is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com). The show is written and hosted by Max and distributed by 99. Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, "Unf*cking the Republic."Support the show: https://www.unftr.com/membershipsSee omnystudio.com/listener for privacy information.

A note for one of our original Unf*ckers. Sending our love, light, and thank yous to Nettie for being the patron saint of this show, and making us all better. If you're able, please consider donating to Nettie's fund: www.facebook.com/donate/1765854323761747/2174011309435518.Support the show: https://www.unftr.com/membershipsSee omnystudio.com/listener for privacy information.

Today we’re doing some level setting on healthcare in the U.S.—a long requested topic. We navigate this unf*cking based on direct queries from the Unf*ckers, creating a baseline that helps establish a foundation for related features down the road and an understanding of the moving parts and shared language for the challenges we face. Stay tuned, as next week we’re going to delve deep into the Affordable Care Act. Chapters Intro: 00:01:28 Chapter One: 00:02:40 Chapter Two: 00:09:31 Chapter Three: 00:18:32 Chapter Four: 00:32:54 Post Show Musings: 00:38:54 Book Love: 00:46:12 Pod Love: 00:48:03 Outro: 01:12:14 Resources The New York Times: Big Changes Are Coming for Health Care Costs Health System Tracker: National Health Spending Explorer GovTrack: H.R. 5376: Inflation Reduction Act of 2022 CMS.gov: NHE Fact Sheet Milton Friedman: How to Cure Health Care Medtronic: Annual Report Abbott Laboratories: Annual Report Stryker: 2021 Comprehensive Report HCA Healthcare, Inc: Annual Report Fierce Healthcare: Kaiser Permanente reports $8.1B net profit in 2021 despite shrinking operating income UHS: Annual Report UnitedHealth Group: Annual Report Humana: 2021 Annual Report Anthem, Inc: Annual Report Pfizer: Annual Report Merck & Co: Annual Report AbbVie Inc: Annual Report CNBC: The wealthiest 10% of Americans own a record 89% of all U.S. stocks Book Love Paul Starr: The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry Steven Brill: America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System Pod Love Congressional Dish: CD255: Pharmacy Benefit Managers (PBMs) Sawbones -- If you like #UNFTR, please leave us a rating and review on Apple Podcasts: unftr.com/rate and follow us on Facebook, Twitter and Instagram at @UNFTRpod. Visit us online at unftr.com. Join the Unf*cker-run Facebook group: facebook.com/groups/2051537518349565 Buy yourself some Unf*cking Coffee at shop.unftr.com. Subscribe to Unf*cking The Republic on Substack at unftr.substack.com to get the essays these episode are framed around sent to your inbox every week. Check out the UNFTR Pod Love playlist on Spotify: spoti.fi/3yzIlUP. Visit our bookshop.org page at bookshop.org/shop/UNFTRpod to find the full UNFTR book list, and find book recommendations from our Unf*ckers at bookshop.org/lists/unf-cker-book-recommendations. Access the UNFTR Musicless feed by following the instructions at unftr.com/accessibility. Unf*cking the Republic is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com). The show is written and hosted by costs and distributed by outcomes. Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, ‘Unf*cking the Republic.’Support the show: https://www.unftr.com/membershipsSee omnystudio.com/listener for privacy information.