JustCare

Tag: Medicare for all

  • Republicans and Democrats alike love social insurance, why shouldn’t we all benefit from it?

    Republicans and Democrats alike love social insurance, why shouldn’t we all benefit from it?

    An opinion piece in MarketWatch by Brett Arends, a financial writer, makes the seemingly obvious case that if Americans love Medicare, as they do, they love social insurance. Yet, they are not far-left commies nor do they hate freedom. Given the failure of for-profit health care, shouldn’t we all benefit from Medicare?

    The failure of for-profit healthcare: If you have any doubts, read this lead New York Times story on the psychiatric hospital chain that is locking up patients who do not need hospitalization in order to continue to reap revenue from insurers. While you’re at it, take a look at John Oliver’s piece on for-profit hospices. And, check out these blockbuster stories on Medicare Advantage cash monsters and how Medicare Advantage insurers gouge taxpayers.

    Make no mistake, the price we pay for having for-profit health insurance and for-profit hospitals and for-profit pharmaceutical companies setting drug prices is not only financial. Yes, the high costs bankrupt all too many Americans; they also keep us from getting needed care. The for-proft health care industry causes extraordinary physical and emotional harm. According to one analysis in the National Bureau of Economic Review, Medicare Advantage plans lead to tens of thousands of needless deaths of older adults and people with disabilities each year.

    The government is far from perfect. We all know how much harm it can do. But, at it’s best, unlike the for-profit health care companies, it works for the people. It puts patients first, not profits. And, even when the government is not working as well as it should for Americans, government-administered traditional Medicare delivers easy access to good affordable care at far lower cost than privatized for-profit insurance.

    As Arends says, “we are forced to confront some shocking details. Senior citizens are happier with their communist Medicare than the rest of us are with our “freedom” insurance from private companies.” He goes on with some compelling data:

    “A higher share of Medicare beneficiaries was satisfied with their ability to find healthcare providers who accepted their insurance (96%) compared with privately insured people (91%),” MedPAC reported. “In addition, among beneficiaries who had received healthcare, a higher share of Medicare beneficiaries was satisfied with their ability to find healthcare providers that had appointments when they needed them (87%) compared with privately insured people (77%),” it added.

    Furthermore, MedPAC said, “In our focus groups, Medicare beneficiaries also reported high satisfaction with their insurance coverage, with the vast majority of participants rating their coverage as ‘excellent’ or ‘good.’”

    Other polls show that 81% of Americans support Medicare, including not only 89% of Democrats but even 79% of Republicans!”

    Here’s more from Just Care:

  • Medicare Advantage could be the death of Medicare

    Medicare Advantage could be the death of Medicare

    In an op-ed for The Nation, Ady Barkan, co-director of Be a Hero, makes the compelling case that Medicare Advantage, the part of Medicare administered by private health insurers, could be the death of Medicare. It could also be the death of guaranteed affordable health care for all in the US. Senator Bernie Sanders, Representative Pramila Jayapal, and Representative Debbie Dingell are trying to prevent that and breathing continued life into Medicare through their recent introduction of the Medicare for All Act in Congress, legislation that would keep corporate health insurers out of Medicare.

    Several times in the last 70 or so years, progressive policymakers have tried to ensure everyone in the US has guaranteed access to affordable health care. And, several times, their efforts failed. Most recently, advocates on the ground and in the Congress pushed for a public health insurance option, like Medicare, for all Americans. Instead, we got the Affordable Care Act, health insurance through corporate health insurers.

    During his campaign for the presidency, Senator Bernie Sanders brought to national attention the value of Medicare for All, guaranteed, government-administered, affordable health insurance. He called for an improved and expanded version of traditional Medicare that the US guaranteed everyone, with dental, vision and hearing benefits, and without premiums, deductibles and copays.

    Ady Barkan testified in the US House of Representatives on the value of Medicare for All. He understood its value full well. At 35, he was diagnosed with ALS. He explained how everyone will need health care at some point.

    “Our time on this earth is the most precious resource we have,” were his words. “A Medicare for All system will save all of us tremendous time. For doctors and nurses and providers, it will mean more time giving high quality care. And for patients and our families, it will mean less time dealing with a broken health care system and more time doing the things we love, together.”

    Barkan interviewed all the presidential candidates on Medicare for All and then sat down with President Biden to discuss health care. At the time, Barkan supported Medicare for All but did not appreciate that corporate health insurers had sunk their teeth into Medicare through the Medicare Advantage program. Now, he recognizes that if corporate health insurers take full hold of Medicare, it is not likely we will get government-administered Medicare back.

    The argument for Medicare Advantage when Congress debated it in the early 2000’s was that it would improve quality and save money through “managed care.” But, 20 years later, Medicare Advantage has always cost more per enrollee than traditional Medicare. And, several analyses show that quality of care, particularly for people with costly and complex conditions tends to be worse in Medicare Advantage than in traditional Medicare.

    Because the federal government pays corporate health insurers upfront for the care they provide, regardless of the amount they spend on care, the insurers do what they can to spend as little of that money on people’s care as possible. The less they spend, the more they profit. The consequence for enrollees can be deadly–delayed and denied care, lack of access to top quality specialists and specialty hospitals and unaffordable out-of-pocket costs.

    Medicare Advantage has become big business. Every business wants in and wants more. The insurance companies offering Medicare Advantage are buying up primary care providers in order to help control the care that people receive. To be sure, in the best of hands, this could be great. But, in the hands of corporate executives who are looking to return as much money to shareholders as possible, you can imagine the danger.

    The corporate health insurer execs are likely dreaming of a time when Congress passes Medicare Advantage for All, a time when they control the full Medicare market and the hundreds of billions of dollars that come with it. Americans should be extremely concerned.

    Without traditional Medicare in the mix, putting competitive pressure on the Medicare Advantage plans, without the tens of billions in excess payments to the Medicare Advantage plans, and without any freedom for enrollees to disenroll from Medicare Advantage, all bets are off on health care costs and coverage for older adults and people with disabilities, all bets are off on their health and well-being.

    Fortunately, members of Congress are beginning to understand the fundamental differences between traditional Medicare and Medicare Advantage. They are holding hearings focused on abuses in Medicare Advantage–overpayments, inappropriate delays and denials, misleading marketing and ghost networks, among others. And, the Biden administration is passing regulations in an attempt to rein in the bad actor Medicare Advantage plans.

    Unfortunately, the regulations are only as good as the government’s ability to enforce them. And, enforcement has been lax, to put it mildly. As of now, the Medicare Advantage plans that are engaged in keeping their enrollees from getting costly care can continue to do so, with impunity.

    If we are going to guarantee Medicare for All, free or low-cost access to good care in the US, we must keep the corporate health insurers from taking over Medicare.

    Here’s more from Just Care:

  • Socialized medicine v. incremental improvements

    Socialized medicine v. incremental improvements

    For the last several decades, David Himmelstein and Steffie Woolhandler, the founders of Physicians for a National Health Care Program, have been ardent advocates of a “single-payer” health care system, government-administered improved Medicare for All. They dismissed incremental improvements to hold corporate health insurers in check and stopped short of advocating for socialized medicine. As our health care has moved further away from Medicare for All, in a piece for The Nation they now argue that single-payer is not enough; we need socialized medicine. While that would be wonderful, with health care, slow and steady is more likely to win the race.

    Socialized medicine has always been a laudable and important goal for the US because, for the most part, it takes profit out of health care and puts patients first. The Veterans Administration and Federally Qualified Health Plans are forms of socialized medicine–in which the health care facilities are government-owned and the health care providers work for the government–that are known for their excellent care at lower cost. Members of Congress rely heavily on this type of care through Walter Reed National Medical Center, one of the best hospital centers in the nation. We could and should expand these facilities so everyone has the choice of using them.

    But, socialized medicine is a pipe dream at the moment. If we don’t focus now on curbing corporate power incrementally, it’s hard to see how there is not a total corporate takeover of our healthcare system in the near-term and fewer openings to achieve an equitable health care system down the road.

    For example, Medicaid, which had been administered exclusively by state governments, is now almost exclusively administered by corporations. With Medicare Advantage enrollment growing, Medicare is also increasingly run by corporate health insurers. And, a new government program in traditional Medicare–direct contracting–has opened the door to private equity and corporate insurers overseeing people’s care.

    We need to stop the privatization of Medicare and Medicaid. Since we can’t stop it right now, we need to slow it down. Privatization drives up costs and restricts access to care, with virtually no accountability for bad acts from the corporations. While curbing privatization is not easy, at the moment we cannot expect Congress to enact Medicare for All legislation, much less socialized medicine.

    We can galvanize Americans to speak up against our current system though. Everyone can see and feel how privatization of Medicare and Medicaid is driving up costs, restricting access to care, and hurting large swaths of the population.

    Medicare for All would save over $600 billion in administrative costs. It would generate the funds needed to guarantee good affordable coverage to everyone. It would also give everyone the freedom to choose the doctors and hospitals they want to use, eliminating provider networks. That’s not possible in our current system.

    But, today, doctors and hospitals are largely owned by corporations and private equity firms. These entities have been found to engage in practices that can keep health care providers from delivering the care people need. They put profits first and that can compromise quality of care.

    Himmelstein and Woolhandler argue that Medicare for All cannot achieve guaranteed affordable health care for all if the government is paying corporations and private equity firms to deliver care. Private equity is only about short-term gains for the purpose of sale. Corporations could be in business for the long-term, but profits always come first. Communities should be in charge of people’s health. Here’s how they describe what’s happening to health care in the US:

    “For-profits now own the vast majority of hospices, nursing homes, urgent care and dialysis clinics, imaging facilities, ambulance companies, and home care agencies. They garner nearly one-third of the total revenue of psychiatric and substance-use treatment hospitals, and control a growing share of general hospitals. Meanwhile, insurers are buying up clinics and doctors, eliminating any semblance of clinical independence. Optum—a subsidiary of UnitedHealth, the nation’s largest insurer—controls more than 1,500 clinics with 60,000 doctors, and CVS/Aetna already runs 1,200 Minute Clinics, with plans to expand its offerings in primary and behavioral care. Increasingly, Americans’ insurer is also their doctor.

    The rise of corporate ownership of American health care has been stunning. Even more malevolent actors have now entered the fray. Private equity firms’ health care acquisitions totaled about $750 billion over the last decade, more than $119 billion in 2019 alone. KKR and Blackstone now employ or control more than 40,000 doctors, physician assistants, and nurse practitioners, and provide staffing for about one-third of US emergency rooms. Those companies were largely responsible for the epidemic of surprise bills. And private equity has been gobbling up primary care practices and mental health, orthopedics, and vision care providers; they already employ nearly 10 percent of dermatologists.”

    This is all scary and bodes ill for the future of health care in the US. Still, given our Congress, the immediate fight should be to level the playing field between traditional Medicare and Medicare Advantage so that people have a meaningful choice between them and we are not overpaying Medicare Advantage plans. Congresswoman Katie Porter, Jan Schakowsky and Rosa Delauro as well as Senator Elizabeth Warren, along with 15 other members of Congress, recently led a letter to CMS arguing for a level playing field. We need scores of members signing on to these letters and driving legislation to strengthen traditional Medicare and end overpayments in Medicare Advantage.

    Traditional Medicare needs an out-of-pocket cap, so that people are not at financial risk if they do not have supplemental coverage. Right now, people in Medicare Advantage who want to switch to traditional Medicare are often locked out of traditional Medicare because, even if they can afford supplemental coverage, which can be costly, insurers in most states do not have to sell it to them.

    Here’s more from Just Care:

  • Congressional Budget Office reports benefits of Medicare for all over corporate health insurance

    Congressional Budget Office reports benefits of Medicare for all over corporate health insurance

    David Sirota writes for the Daily Poster on the latest report from the Congressional Budget Office revealing that ending corporate health insurance in favor of a publicly-administered health insurance system like traditional Medicare would help our economy, help working people and increase life expectancy.

    The CBO recounts the benefits of Medicare for all over our failing corporate health insurance system. Specifically, here’s what its report says:

    • Health care costs would fall for US households and premiums would go away entirely. Administrative costs would also fall leading to greater productivity in the US economy, better health and longer lives.
    • Working people would work less of their own volition, though they would be paid more. Reduced out-of-pocket health care costs would permit people greater freedom to engage in activities they enjoyed without compromising their living standard.
    • People would have more disposable income, which they could spend on things other than health care and could also save for the future. GDP would not be hurt. The labor force would increase, along with worker productivity across the economy and capital stock.
    • States would benefit from a budget surplus and could reduce tax rates, spend more on their needs and/or public services.

    The implication of the CBO’s findings is that employer-based health care–corporate-run health care–makes working people work harder and longer in order to pay for health insurance and medical care. With single-payer/Medicare for all, people would earn higher wages, be able to retire earlier, and would not have to work as many hours a week. Middle and lower-income households would see their wages increase the greatest percent and their out-of-pocket costs fall the greatest percent.

    The CBO looked at the effects of better coverage for home- and community-based care services. These long-term care services help people with bathing, dressing, toileting and other activities of daily living.

    But, Medicare for all in any form is going nowhere because the corporate health care stakeholders have the resources and power to control policymakers and public policy. President Biden launched his presidential campaign with the CEO of Blue Cross and promised to veto Medicare for all legislation. He favors subsidized corporate health care.

    At the state level, the situation is arguably worse. In California, a single-payer bill died in the legislature in Democratic hands. What helped kill it? Among other things, corporate political contributions, including a $1 million contribution from Blue Shield.

    Here’s more from Just Care:

  • It’s time to expand our National Health Service Corps

    It’s time to expand our National Health Service Corps

    Jonathan Michels writes for Jacobin on our homegrown army of  doctors in the US National Health Service Corps. These primary care doctors have been practicing in underserved communities throughout the US for 50 years. It’s time to expand the National Health Service Corps.

    We have a shortage of primary care doctors. One report finds that by 2033, the US will be short 55,200 primary care doctors. Today, people struggle to get the preventive care they need, along with referrals for specialty care. In the next decade, the situation is likely to only worsen.

    President Biden’s American Rescue Plan commits an additional $1 billion to the National Health Service Corps. Michels calls it “a model for universal programs.” It is not profit-driven and is designed to meet the individual needs of the people it serves.

    Members of the National Health Service Corps. include physician assistants, social workers, nurses, mental and behavioral health specialists and physicians. Most of them practice at Federally Qualified Health Centers, sometimes called FQHCs or community health centers. There are thousands of FQHC sites throughout the country treating patients of all-income levels. But, FQHCs primarily serve  people with low incomes and charge people on a sliding scale.

    FQHCs serve about 26 million people each year. About half of them have Medicaid. Among other things, FQHCs provide vaccinations and health screenings. With more staffing and resources they could serve a lot more people.

    The American Rescue Plan’s $1 billion will pay for tuition and offer loan forgiveness to people in the National Health Service Corps. Medical education is so costly and can leave students in substantial debt. The National Health Service Corps. recognizes the need for primary care doctors. It responds to the reality that few students opt to go into primary care medicine because it is not nearly as lucrative as specialty care.

    Michels sees an opportunity to enlist members of the National Health Service Corps. in the Medicare for All movement. He argues that for Medicare for All to succeed, it will need an army of doctors advocating for it. The National Health Service Corps. participants appreciate the value of social solidarity and serving the public good. They would be excellent leaders in the movement.

    Here’s more from Just Care:

  • Medical debt is far greater than originally understood

    Medical debt is far greater than originally understood

    The New York Times reports on new research revealing that medical debt is far greater in the US than originally thought. The amount of medical debt is particularly high in states that refused to expand Medicaid.

    The JAMA study reveals that, pre-pandemic, collection agencies held $140 billion in medical debt. More than one in six Americans owe money for health care services to collection agencies. On top of that, millions more Americans owe money to health care providers, which has not been sent for collection yet.

    While people hold all kinds of debt, medical debt represents the largest portion of debt that Americans hold. Because so many Americans are either uninsured or functionally uninsured–insured but unable to pay the deductibles and copays to access needed care–medical debt is to be expected.

    Hospitals increasingly sue patients to collect the huge out-of-pocket costs virtually every American must pay. The lawsuits lead to additional costs, such as legal fees. And, credit card payments often lead to large interest payments.

    In states that have expanded access to Medicaid, fewer people with low incomes have medical debt. Overall they owe $375 less than people in states that have not expanded Medicaid. Medicaid tends to reduce or wipe out medical bills that could lead to debt.

    Senators Raphael Warnock, Jon Ossoff and Tammy Baldwin have introduced legislation that would permit federal expansion of Medicaid in all 12 states that have not expanded it. While this would help millions of people, it would also give more money and power to the health insurance industry, which would see its business expand significantly.

    Rising medical debt offers another compelling argument for Medicare for all. Good health insurance both promotes access to health care and provides economic security. Lack of good health insurance can keep people in medical debt their entire lives, hurting people’s credit ratings and causing profound stress. Too bad Congress does not tend to respond to compelling arguments.

    Here’s more from Just Care:

  • Hospital prices demand government attention

    Hospital prices demand government attention

    In an opinion piece for the Financial Times, a surgeon, Nisarg Patel, argues that hospital prices are the big problem with our health care system. Hospital prices demand government attention.

    Hospitals spend crazy amounts on new glamorous buildings, fancy lobbies with luxurious stone finishes and all types of vegetation, PR, and executive compensation, driving up their prices. He’s right that “it is the prices stupid,” (as well as the administrative costs,) that are responsible for astronomical health care costs. But, Patel fails to acknowledge that Medicare for all is the only solution.

    Patel writes that hospitals have become big businesses. At the same time, they have been huge beneficiaries of federal dollars, our taxpayer dollars. During the coronavirus pandemic, they received literally billions of dollars in aid.

    Much like Wall Street after the great recession in 2008, which had become too big to fail, Patel argues that our healthcare system has become so large that it cannot serve patients’ needs any longer. It’s “too big to heal.” Hospitals have extraordinary influence in Congress. Many also have monopoly pricing power.

    Hospital prices have more than doubled in 20 years, writes Patel. Inflation has averaged 60 percent over that same time period, less than half hospital price growth. These prices account for more than three times what the US spends on prescription drugs. And, collection agencies now hold $140 billion in medical debt.

    Unless hospital prices come down, more people are going to be pushed into medical debt and poverty when they develop complex and costly conditions, even if they have insurance. Premiums are rising, as are deductibles and copays.

    The biggest hospitals are cutting deals with the big insurers. These big hospitals, in turn, are crowding out the smaller ones. And, there’s little evidence that consolidation in the hospital industry improves health outcomes or benefits our health in any material way.

    Patel offers three ways to protect against growing hospital power and address these challenges:

    1. Medicare should discourage, rather than encourage, hospital consolidation; Independent physicians should not be burdened with so much paperwork; Data on health care quality and cost should be available for public scrutiny.
    2. Government should promote investments in independent primary care and specialist care, as well as community clinics and other non-hospital based care.
    3. Government should block hospital mergers.

    Patel’s proposals are all band-aids. They will not begin to fix out-of-control health care costs in the short or long-run. They are also not more likely to become law than Medicare for all. One incremental step on the hospital side that would make a difference is all-payer rate-setting. Much like drug price negotiation, it would rein in costs.

    The only real solution to crazy high health care costs, if we care as a country about guaranteeing access to health care for everyone, keeping people from medical debt and improving health outcomes, is Medicare for all.

    Here’s more from Just Care:

  • Private sector can’t fix health care; we need government

    Private sector can’t fix health care; we need government

    This piece was originally published on the Health Justice Monitor.

    How Amazon, JPMorgan, and Berkshire Hathaway took on America’s health care system—and lost, FORTUNE, June 1, 2021, By Erika Fry

    Was it a press release, or a declaration of war?

    How else to explain the media and market frenzy that followed the announcement, issued on Jan. 30, 2018, that Amazon, Berkshire Hathaway, and JPMorgan Chase — three of the nation’s largest, most high-profile, and best-run companies, then with some $534 billion in revenues between them — were teaming up to take on the ever-more-expensive, ever-more-complex problem that is American health care.

    To those who had toiled in the world of employer-sponsored health care for decades, trying but never really succeeding to come up with new ways to control costs and improve outcomes … the statement, from three powerful CEOs, was cause for celebration.

    Five months in, the team announced another star would lead the venture: Atul Gawande, the surgeon and influential New Yorker writer whose clear-eyed analysis of America’s dysfunctional health care system had earned him the admiration of Barack Obama and Buffett. In March 2019, the venture finally got a name, Haven.

    The project officially sputtered to an end earlier this year. Even with its star power, Haven couldn’t break the black box that is U.S. health care.

    So, did Haven make a difference? Some argue the effort undermined progress by raising the obvious question: If they couldn’t do it, who can? In a recent Kaiser Family Foundation survey of very large employers, 85% of top executives think government support will be necessary to control costs and provide coverage.

    Gawande goes further and has recently argued that the employer-sponsored system can’t be fixed. Noting how many Americans lost their health insurance in a global pandemic, he said, “A job-based system is a broken system.”

    ***

    Comment by Don McCanne

    I contend that the Haven health reform effort of Warren Buffett, Jeff Bezos and Jamie Dimon, along with Atul Gawande, was a spectacular success, as an experiment in health policy. They proved beyond any reasonable doubt that the private sector is incapable of fixing our highly dysfunctional health care financing system. The only model that has shown promise is a single payer Medicare for All system. But you cannot set that up as an employer-sponsored system; it will have to be a public system for all the people.

  • Coronavirus: Medicare for all would have saved lives

    Coronavirus: Medicare for all would have saved lives

    A new Public Citizen white paper details how the US would have been far better prepared for the novel coronavirus pandemic had we had Medicare for All. Our for-profit multi-payer health care system does not afford the nation the tools to address COVID-19 effectively and keeps Americans from getting needed care. If everyone in the nation had coverage, we could have saved thousands of lives.

    The US was unprepared for COVID-19. There are huge fissures in our health care system because we rely on for-profit insurers to cover our care. For-profit health insurers cost us more than we should be spending and deliver far worse health outcomes than peer countries.

    The US has far fewer hospital beds and physicians than most other wealthy countries. We lacked the capacity to hospitalize all the COVID-19 patients who needed inpatient care. Germany and Japan, which offer universal health care, have far greater capacity to treat their residents in hospital.

    Of the 25 wealthiest countries in the world, the US is the only country not to guarantee its people access to health care. As a consequence, one in five of all people who have died of COVID-19 have been from the US, even though the US represents just five percent of the world’s population. Worse still, the toll has been disproportionately hard on communities of color.

    Eight-seven million people in the US were underinsured or uninsured pre-pandemic, and millions more were uninsured post-pandemic because they lost their jobs. Not surprisingly four in ten people who contracted COVID-19 did not have insurance to cover their care. It’s likely that many of them never got treatment. One in three people in the US report foregoing needed health care because of the cost.

    Medicare for All would have saved many thousands of lives in the US. It would make it far easier for everyone who needed care to get the care they needed. It would provide the funding that hospitals need–especially rural hospitals–to address a pandemic. It would allow for better continuity of care and coordination of care. It would promote health and racial equity.

    Here’s more from Just Care:

  • Congresswomen Jayapal and Dingell introduce Medicare for All Act

    Congresswomen Jayapal and Dingell introduce Medicare for All Act

    Today, Congresswomen Pramila Jayapal and Debbie Dingell, along with 110 co-sponsors in the House of Representatives, introduced the Medicare for All Act of 2021. The Medicare for All Act of 2021 is a win for everyone in the US, and most importantly for older adults and people with disabilities.

    The Medicare for All Act guarantees everyone coverage from the doctors and hospitals they want to use, with no deductibles, coinsurance or copays. It ends the practice of rationing care based on ability to pay and promotes health equity.

    The Medicare for All Act covers long-term care, meaning nursing home care as well as home and community-based care, so that people can age in place. Older adults and people with disabilities would no longer have to go without long-term supports and services or go broke paying for them. 

    The Medicare for All Act also improves Medicare benefits, adding hearing, dental and vision coverage. These benefits are covered in full, with no out-of-pocket costs.  

    In addition, the Medicare for All act would enable the government to collect data on what’s working and not working in our health care system and to identify and respond to problems that need addressing. Right now, private health insurers hide that data, undermining health care system improvements.

    As important, during a pandemic, Medicare for All would allow the government  to see where resources needed to be deployed and ensure that everyone received free testing and treatment. In sharp contrast, private insurers, including private Medicare Advantage plans, have kept millions of Americans from getting needed COVID-19 services and treatments. Their deductibles, copays and coinsurance have posed barriers to care.

    Traditional Medicare–government administered public insurance–has proven itself to be far more cost effective than private insurance. It gives people the open access to doctors and hospitals that they want and need. It’s transparent. It allows the government to drive system improvements.

    The Medicare for All Act expands traditional Medicare’s benefits and guarantees everyone in the US a cost-effective, high-value health care system that we all desperately need.

    For all these reasons, Just Care USA strongly endorses the Medicare for All Act of 2021.

    Here’s more from Just Care: