Let our journalists help you make sense of the noise: Subscribe to the Mother Jones Daily newsletter and get a recap of news that matters.


The administration promises that managed competition will guarantee quality of care. Indeed, Clinton’s health-security plan proposes an elaborate structure to assure quality that relies almost exclusively on data collected from patient-satisfaction surveys. The problem is that such mechanisms fail to grasp how HMOs can rig the game.

As one health-care professional puts it, “Most patients don’t have the strength or the energy to scrutinize quality of care.” To do this, they need help from providers. But managed-care companies have little interest in constructive criticism. At McLean Hospital in Belmont, Massachusetts, for example, executives were told that Blue Cross/Blue Shield did not award them a managed-care contract in part because the staff had taught patients how to stand up for themselves and family members. BC/BS learned through patient satisfaction surveys that physicians and nurses had even suggested that patients sue the insurer for refusal of care. They informed the hospital that unless its staff ceased such practices, no future contract would be awarded.

This kind of economic blackmail muzzles providers who have firsthand experience of assembly line health care. Almost every doctor and nurse we spoke to about the cost-driven practices that increasingly dominate the health-care scene was afraid to talk on the record. Tracey McKnight, director of a nonprofit home health-care agency in Holland, Michigan, expressed their worry: “How active do you become exposing all this, when you might lose referrals?”

SIX TRUTHS

Reclaiming power from those who abuse it often starts with telling the truth. And in "This Is How Authoritarians Get Defeated," MoJo's Monika Bauerlein unpacks six truths to remember during the homestretch of an election where democracy, truth, and decency are on the line.

Truth #1: The chaos is the point.

Truth #2: Team Reality is bigger than it seems.

Truth #3: Facebook owns this.

Truth #4: When we go to work, we're in the fight.

Truth #5: It's about minority rule.

Truth #6: The only thing that can save us is…us.

Please take a moment to see how all these truths add up, because what happens in the weeks and months ahead will reverberate for at least a generation and we better be prepared.

And if you think journalism like Mother Jones'—that calls it like it is, that will never acquiesce to power, that looks where others don't—can help guide us through this historic, high-stakes moment, and you're able to right now, please help us reach our $350,000 goal by October 31 with a donation today. It's all hands on deck for democracy.

payment methods

SIX TRUTHS

Reclaiming power from those who abuse it often starts with telling the truth. And in "This Is How Authoritarians Get Defeated," MoJo's Monika Bauerlein unpacks six truths to remember during the homestretch of an election where democracy, truth, and decency are on the line.

Truth #1: The chaos is the point.

Truth #2: Team Reality is bigger than it seems.

Truth #3: Facebook owns this.

Truth #4: When we go to work, we're in the fight.

Truth #5: It's about minority rule.

Truth #6: The only thing that can save us is…us.

Please take a moment to see how all these truths add up, because what happens in the weeks and months ahead will reverberate for at least a generation and we better be prepared.

And if you think journalism like Mother Jones'—that calls it like it is, that will never acquiesce to power, that looks where others don't—can help guide us through this historic, high-stakes moment, and you're able to right now, please help us reach our $350,000 goal by October 31 with a donation today. It's all hands on deck for democracy.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate