Archive for the ‘Healthcare’ Category

In a perfect world the Sunday morning talk shows would provide some measure of clarity in an otherwise confusing and conflicted world. Clearly, it isn’t a perfect world, and just how imperfect it is was on display this morning on Meet the Press. The subject was the fiscal cliff and deficit reduction.

For example, Tom Brokaw said it is ridiculous that he should get the same Medicare benefit as his less-wealthy brother. Sounds reasonable, doesn’t it? Maybe there should be a means test where only those who need Medicare should get it. That way Medicare would be turned into a welfare program that the Right could whittle away at by adjusting the means threshold. Good idea, Tom. How about controlling run-away medical costs, instead? That might work.

Mr. Brokaw also suggested that the maybe Social Security retirement age could be increased to 67 now, and maybe even 70 in a few years. Uh-oh, this is a back breaker…literally.  Some workers, particularly those at the lowest end of the wage scale such as laborers and farm workers, spend their lives doing work that takes a terrible toll on their bodies. Are we going to ask them to work even longer before they can retire? Riding a desk is one thing, as the people in Washington do. Day-after-day physical wear and tear is something else, again. Or, how about this? There are fewer and fewer jobs to go around, now. The effect of asking people to work additional years before retirement would actually increase the labor pool, which would increase unemployment, while driving wages down even more.  Sorry to be picking on you, Mr. Brokaw, but your ideas suck.

David Brooks offered that the Republicans were going to take most of the blame if we go over the cliff, but he was critical of the president for not getting more involved in the negotiations. So, let’s see. Brooks wants the president, who ran on a clearly defined platform of how he wanted to cut the deficit, to bring the Republican caucus around to agreeing to a more conciliatory plan than he actually campaigned on, which the Republican Majority Leader John Boehner was unable to sell to his own party. Really, Mr. Brooks? You want the president to bloody himself on a fool’s errand? As a Republican flack I can understand why that would work for you, but it doesn’t work for the president or the Democats. And let’s not forget that a sizable percentage of Mr. Boehner’s caucus believes that the president stole the election in the first place (Birtherism 2.0), which would tend to harden the positions of the right-wing nut jobs who control the Republican Party.

Finally, there’s the constant banter about how important it is to get control over entitlements. This makes my blood boil. The people need Social Security, Medicare/Obamacare and Medicaid and Obama’s win makes it clear that the people don’t what Washington messing around with these programs. Moreover, the people did not create the economic mess we are in; the banks and Wall Street created it and, in the process of doing so, the inequality gap got larger, unemployment and poverty increased, more families need food stamps, wages declined and the rich got richer. And now the people’s social safety net needs to be reined in to reduce the deficit? Really? What about corporate entitlements? Defense Department entitlements. Tax dodges for the wealthy? Endless colonial wars?

WTF! It least it’s Sunday and there’s football to watch.

Advertisements

Is it possible that Mitt Romney can he put his foot in his mouth as often as he does by accident? I‘m not saying he’s trying to do it, but it’s gotten so bad that you can’t that you can’t precede the word gaff with the word latest because it probably isn’t the latest as soon as you write it.

Here’s a recent…though not the latest :)…example: In Virginia the other day Romney spoke about his compassion  for people citing his Massachusetts’ health care law as evidence. Shockingly, he went on to say that this wasn’t something he could talk about during the primaries because it wouldn’t have been “effective.” What does that mean?…that he had to duck what he actually did?

There are possible explanations for this. One is that he’s losing his grip on reality and his wife, of all people, might have elevated the probability of this explanation.  Anne Romney, as originally reported by Reuters, said “her biggest concern if her husband becomes president was his ‘mental well-being.’” Maybe she’s concerned about his current mental well-being, too.

Another explanation is one that David Brooks, the conservative op-ed writer for the NYT suggested in a recent column. He said that Mitt’s problem is that he has no overarching political ideology to serve as his political…and verbal…compass. That observation is dead on as far as it goes, but it fails to illuminate an ideology that does fuel Mitt’s quest for the White House: he believes that his wealth and privilege entitles him to the job of president the same way it entitled Bain Capital to “harvest” companies without regard to the human costs, or tell the American people that he won’t disclose any more tax returns because the people have seen enough, or tell a room full of his rich investors that 47% of the American people suck.

SceneTap - “facial detection” ... Friday debut...

But now it’s coming apart and it’s putting great stress on him and his campaign. The polls show that more and more Americans see Mitt for what he is: a political opportunist who will say anything he needs to say to close the deal. He reminds me of some liquored-up dude telling a woman at 2 AM that he’ll love her in the morning, but  isn’t around for the wake-up call.

Good luck, Mitt!

PolitiFact | Reince Priebus says health care law could mean as many as 20 million Americans could lose their employer-based insurance.

If politics is the art of compromise, where did all the artists go?

It’s like they’ve all left town, leaving in their wake a bunch of ideologically-driven, my-way-or-the-highway crazies who believe that God is on their side, and that they have the right to impose their views, religious and otherwise, on the rest of us. Well, if their objective is to piss off and galvanize the left, they succeeded.

Who didn’t get pissed off at three-plus years of endless obstructionism, the record number of filibusters, and the unwillingness to approve the President’s appointees simply to impede the functioning of his administration? And how about the birther bullshit, and the oft-heard claim that Obama isn’t “one of us”…that he’s different…that his theology isn’t rooted in the Bible, and that he channels his Kenyan, anti-colonial father?  Do you think racism has something to do with it? No matter, though, because we’re pissed off and that’s good.

We’re pissed off because protecting the profits of health insurance companies is more important than saving lives, and that no medicine at all is better than “socialized” medicine, which works just fine for the rest of the developed world, but which isn’t good enough for America. Whose America? Not yours and mine, that’s for damned sure. But no matter because pissed off is good.

And how do you feel about voter ID laws or, as they are known in some circles, Jim Crow lite? Targeted against poor and minority populations, these laws have no reason to exist beyond the Republican desire to suppress voter turnout. Yet, Republicans talk about the sanctity of the vote as if they give a damn. Perhaps they think we are no longer pissed off about Florida in 2000 and Ohio in 2004. But, alas, we are still pissed off. We’re just more pissed off, now.

Oh, lest we forget the recent assaults on women’s rights, are we really talking about contraception in 2012?

So, if pissed off leads to getting involved, being heard and making a difference, let’s give a big round of applause to all those who would make America the Christian nation the founding fathers tried so hard to prevent. Let’s make sure we bury these people at the ballot box.

Official portrait of United States House Speak...

Image via Wikipedia

Was it just the way things played out or was it a carefully crafted strategy brilliantly executed?

A year ago the prospect of a second term for Preside’snt Obama presidency looked problematic, at best. A lousy economy, high unemployment and intractable legislative gridlock will do that. And, to make matters worse, Obama’s base sent him to Washington to implement change, not compromise his way to the middle, as was evidenced by the way the health care bill was negotiated; give, give, give and get damned little back in return.

Then came the midterm elections. The house was lost and the incoming Republicans, most of them Tea Partiers, vowed to obstruct Obama at every turn even as he continued to play nicely with others. Frankly, it drove me nuts until the debate over the debt ceiling. It was here that the political calculus seemed to shift.

With the ultra-conservative ideology of the Tea Party holding sway over the House, with Majority Leader and Tea Party favorite Eric Cantor holding a gun to Speaker John Boehner’s head, President Obama held his ground, refusing to provide offsets for the debt ceiling increase. But it was something John Boehner said in a press conference that connected the dots for me. Boehner called on the President to display some leadership and to bring the sides together. In other words, he wanted the President to do what he (Boehner) wasn’t able to do within his own party. To say it another way, he wanted Obama to step into what had become an abyss of irreconcilable differences … differences that had Boehner swinging in the wind. Wisely, President Obama declined to do so in favor of allowing the inevitable dysfunction play out.

Had Obama set a trap going which actually began during the health care debate? Did he get the best deal he could get and, in so doing, keep a campaign promise? Did he wave a white flag during the midterm elections realizing that to do otherwise was a waste of political capital in the face of an overwhelming right-wing headwind against everything he stood for? Did he display an infuriating willingness to compromise with his political enemies in order to appeal to independents? Did he know that the Republican primary would turn out to be a bloodbath with no candidate emerging undamaged? And, most importantly…

…did he know that the Tea Party overreach at the federal, state and even local levels
would energize the Democratic base like nothing else ever could? (See Wisconsin, Michigan, Ohio, Maine, etc.)

Of course, from my liberal outpost in the suburbs of north Jersey I can only speculate as to what the overarching strategy really was (or even if there was one), but if ever there was a time for a trap, this was it. I believe that the Republican Party correctly sees 2012 as the biggest election in generations and, perhaps the swan song of its conservative, trickle-down-economic ideology. The reasons are many but chief among them are increasingly unfavorable demographics as non-white populations continue to increase, and baby-boomers continue to age. That creates an all-in sense of urgency that will make the 2012 Presidential election the dirtiest and the most corrupt in the history of the Republic. Fortunately, the President appears to have recovered from a couple of tough years, while the other side looks like a bunch of monkeys trying to screw a football.

These points and counterpoints were made in response to the prior post entitled “Letter to a Republican friend regarding the health care debate.”

(Republican friend) This conversation should be continued over coffee, don’t you think?

(Me) Drinks or drugs maybe, but I think I can live with coffee.

(Republican friend) I agree that greed is a huge factor in all of this, but unless and until the trial lawyers are reined in and malpractice limits are established, I don’t think we are going to be able to make this mess much better.

(Me) Karen, while the issue of tort reform is worthy of debate, its importance relative to the health care bill is open to question. http://washingtonindependent.com/55535/tort-reform-unlikely-to-cut-health-care-costs

“It’s really just a distraction,” said Tom Baker, a professor at the University of Pennsylvania Law School and author of “The Medical Malpractice Myth.” “If you were to eliminate medical malpractice liability, even forgetting the negative consequences that would have for safety, accountability, and responsiveness, maybe we’d be talking about 1.5 percent of health care costs. So we’re not talking about real money. It’s small relative to the out-of-control cost of health care.”

“Although damage award caps could slightly limit the future growth of liability insurance premiums – about 6 to 13 percent over time, says Mello, ‘it tends to be oversold as a solution and it’s pretty unfair to patients.'”

“Annual jury awards and legal settlements involving doctors amounts to ‘a drop in the bucket’ in a country that spends $2.3 trillion annually on health care, Amitabh Chandra, another Harvard University economist, recently told Bloomberg News. Chandra estimated the cost of jury awards at about $12 per person in the U.S., or about $3.6 billion. Insurer WellPoint Inc. has also said that liability awards are not what’s driving premiums.”

A”nd a 2004 report by the Congressional Budget Office said medical malpractice makes up only 2 percent of U.S. health spending. Even ‘significant reductions’ would do little to curb health-care expenses, it concluded.”

“A study by Bloomberg also found that the proportion of medical malpractice verdicts among the top jury awards in the U.S. declined over the last 20 years. ‘Of the top 25 awards so far this year, only one was a malpractice case.’ Moreover, at least 30 states now cap damages in medical lawsuits.”

(Republican friend) Too much money, too little regard for humanity…

(Me) This I wholeheartedly agree with. As I said in my response to you, this debate has never been about unmet human needs, it’s only about money.

(Republican friend) …and too much rhetoric on both sides is not helping at all.

(Me) I agree with the fact that the unfolding rhetoric is unhelpful, but it’s the nature of the rhetoric that makes it that way. This nation has a long history…going back to Truman…of trying to fix the health care system. The same arguments used against Clinton and Truman before him have been recycled to attack the current effort. The rhetoric is designed to defeat the attempt at reform, not to shape it.

President Harry Truman was among the first Americans who saw a need for health care reform. Decades ahead of his time, he was unable to make meaningful changes during his tenure as president in the late 40s and early 50s, but he’s acknowledged by some as the inspiration for the establishment of Medicare and Medicaid under the Johnson administration.

Following are a few quotes that illustrate Truman’s opinions on this matter:

“We should resolve now that the health of this nation is a national concern; that financial barriers in the way of attaining health shall be removed; that the health of all its citizens deserves the help of all the nation.”

“Millions of our citizens do not now have a full measure of opportunity to achieve and to enjoy good health. Millions do not now have protection or security against the economic effects of sickness. And the time has now arrived for action to help them attain that opportunity and to help them get that protection.”

“I do not understand a mind which sees a gracious beneficence in spending money to slay and maim human beings in almost unimaginable numbers and deprecates the expenditure of a smaller sum to patch up the ills of mankind.”

(Republican friend) While I understand what you are saying, I fundamentally don’t think government involvement in any more of our lives makes sense.

(Me) I think we can agree that the current system is broken. With the highest healthcare costs in the developed world, you would think we would do a better job at keeping people healthy. But we don’t and the reason is the fundamental disconnect between profit and care. Surely, this argument must resonate with you. Likewise, Medicare works. Is there Medicare fraud? You bet and it must be reduced. Is there a problem in paying physicians fairly for what they do? Yes, and it has to do with funding and the inability for Medicare to negotiate directly with big pharma. Medicare part D is a scam that was written by the drug lobby. That’s not an overreach for affect. It was literally written by the lobby staffers and then presented to Congress. But, going back to your point about not wanting more government in our lives, the government will not decide on if and how I will be treated. Can you say that about insurance companies?

(Republican friend) I also don’t want any more corporate money influencing our lives, either.

The Supreme Court has supported, on several occasions, the notion of corporate free speech. In fact, you might find the information at the end of this link useful: http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/09/05/corporate_free_speech_since_when/ . Since I am most certainly not a jurist or versed in 1st amendment subtleties, I can only comment as a citizen who feels trampled by well-organized and well-funded special interests whose only intent is to make money. I regard this as a frontal assault on the rights of Americans to be heard in the marketplace of free ideas. Interestingly, the rightees who claim that Obama is some sort of Fascist seem to have overlooked the incredibly close connection between business, the government and ideology of the Christian right. Under George W, the parties all slept together and they seemed to like it. I can only hope that this evil triumvirate can be broken up before the people’s push back takes to the streets.

(Republican friend) I am well on my way to becoming a libertarian like my youngest brother.  There is just so much corruption of the public good when money gets involved.  I have to fight with my insurance company every month over benefits explanations that make no sense and never go in our favor–the mistakes are always in the company’s favor.  But I also would rather do that than fight with the government over my insurance coverage every month.  At least, with the private insurance company, I can complain to my husband’s employer, and then they get involved in straightening out the insurance. But if the government runs the whole thing, where is the counterbalance?

(Me) Karen, where is the counterbalance how? And, yes, coffee sounds nice…

If people don’t want nationalized health care, will they be willing to give up Medicare or, if they are service men and service women, the VA? At the risk of sounding preachy, never underestimate the American people’s propensity to argue against their own interests. Often, they do so because they have been manipulated; the ideological right has it down to a science. Just mention the word “socialism” and rightees conjure up images of the Soviet Union or worse. Frankly, I think that the most vocal of those pushing back against the so-called public option wouldn’t know socialism if it hit them in the head.

Months ago, when the health care bill was in its infancy, I said to my son, Mike, wait until you see how the right plays this thing. The debate will not be on the merits of providing healthcare to more people; it will be about process…capitalism versus socialism…God fearing people versus the godless (aka secularists)…the founding fathers versus Karl Marx. And, sure enough, the debate ducked the moral imperative of providing for the least among us. Rather, it was about political ideology (or the misunderstandings associated with those competing ideologies).

As I said before, most people don’t know what socialism is beyond what they hear from the fear mongers. That can easily be expanded to include capitalism, too. After all, if capitalism runs the current health care system then capitalism doesn’t work, because the health care system doesn’t work. In fact, I would argue that the whole idea of for-profit medicine should be questioned, because profit and caring for the sick and infirm are at odds with one another. To make my point, a physician’s oath says nothing about economic systems, profit or anything of the like. It only defines the relationship between doctor and patient. Yet, standing between the physician and his or her patients is an insurance company whose responsibility is not to patients, or the doctor, but to stockholders and investors.

If that isn’t troubling on its face, let’s say your physician’s practice became so big that she sought an infusion of capital to make it even bigger. Being a good promoter, her capital needs were met by a few wealthy investors…you included. You were attracted by what you believed was a reasonable expectation of capital growth. Well, as it turned out, the projections were not met. During a visit to her office…you were desperate to get relief from a recurring nightmare in which you had to go to an emergency ward of an inner city hospital to seek routine treatment instead of going to your own family doctor…you voiced your disappointment in the financial performance of your doctor’s business. “What do you intend to do about it,” you demanded to know. The good doctor thought for a moment, and then offered two choices. She could either cut costs, thereby allowing a greater share of revenue to hit the bottom line. Of course, patient services would have to be cut, and people let go but, as she said, “business is business.” The other option would be for investors to simply accept the lower level of profitability.

With the options laid out, she then asked what you would do if you were in her shoes.

Well, the ideological right often talks about the founding fathers as if they could have anticipated the mess we are in. Of course, they couldn’t. Nor did they address things that are often attributed to them by some of the more outspoken right-wing manipulators. But, what the right fails to discuss is the concern that several of those founding fathers had about the inherent unfairness of capital aggregation at the expense of the common man. But that’s not why I brought up the Founding Fathers. I did so to ask if, given what we do know about the philosophical underpinnings of the Constitution, the founding fathers would approve of our current health care system. And, to take it one step further, if were they around now to start another nation somewhere, don’t you think they would include access to health care in with “promote the general welfare”? I do. In fact, I think that the founding fathers would expand greatly on the checks and balances that they built into our Constitution. And I think that they would be sickened by the influence that corporate money has on their political system, let alone our dysfunctional health care system. And I think that they would be angry as hell at those on both sides of the aisle who claim to hold the ideological high ground when all they are doing is holding on to their corporate benefactors.

The health care debate has never been about caring for the sick, or the needy, or the new moms, or the unborn, or the elderly, or the millions of children who have never had a well-care visit with a physician. It has only been about profit and greed and status quo. America, I fear, is ungovernable. While I believe that the things that divide us are more imagined than real, even imagined differences, when fueled by enormous sums of money, cause otherwise good people to lose their humanity.

Brian McCabe