Read All About It In the Sunday Papers-July 19 Edition
Were El Somnambulo El Presidente of the Internet Mundo, he would demand that reader responses be thoughtful and on point. (Of course, by that standard, the Beast Who Slumbers would have to ban himself, but he digresses.) His point is that certain stories deserve much more than boilerplate talking points, and today’s lead story is one of them. Engage your brain, then engage here with your thoughts:
LEAD STORY-NY Times Sunday Magazine: Should Health Care Be Rationed?
Before the instinctive knee-jerk responses from ideologues on either side of the issue, please read this thoughtful and thought-provoking piece by Peter Singer, a bioethicist from Princeton University:
Health care is a scarce resource, and all scarce resources are rationed in one way or another. In the United States, most health care is privately financed, and so most rationing is by price: you get what you, or your employer, can afford to insure you for. But our current system of employer-financed health insurance exists only because the federal government encouraged it by making the premiums tax deductible. That is, in effect, a more than $200 billion government subsidy for health care. In the public sector, primarily Medicare, Medicaid and hospital emergency rooms, health care is rationed by long waits, high patient copayment requirements, low payments to doctors that discourage some from serving public patients and limits on payments to hospitals.
…Rationing health care means getting value for the billions we are spending by setting limits on which treatments should be paid for from the public purse. If we ration we won’t be writing blank checks to pharmaceutical companies for their patented drugs, nor paying for whatever procedures doctors choose to recommend. When public funds subsidize health care or provide it directly, it is crazy not to try to get value for money. The debate over health care reform in the United States should start from the premise that some form of health care rationing is both inescapable and desirable. Then we can ask, What is the best way to do it?
Singer’s is not merely a hypothetical think piece. And this is not former Colorado Gov. Richard Lamm (“Old people have a duty to just get out of the way”) saying something for effect. Singer writes about the real world of health care and the real world issues that must be considered. Highly recommended for thoughtful readers. ( Major Tip of the Sombrero to Unstable Isotope for bringing this article to ‘bulo’s attention.)
The (UK) Independent: US Neocons Propping Up Right-Wing Coup in Honduras?
8-Ball Sez, “Signs Point to ‘Yes’.
And, whether or not the linked story is 100% or some lesser percentage true, can someone from the American 4th Estate (which like that Gibraltar property, appears to be both in receivership and disrepair) please explain why they are not providing any context to this story?:
For some of the plotters it is their second attempt to overthrow an elected reformist government in Latin America: the group includes prominent figures involved in the 2002 ousting of President Hugo Chavez of Venezuela, who was kidnapped for 48 hours and sent to a Caribbean island before being restored to office after widespread popular protest.
Financial backing for the coup is identified by some as coming from the pharmaceutical industry, which fears Mr Zelaya’s plans to produce generic drugs and distribute them cheaply to the impoverished majority in Honduras, who lack all but the most primitive health facilities. Others point to big companies in the telecommunications industry opposed to Hondutel, Honduras’s state-owned provider. Parallels are being made with ITT, the US telecommunications company that offered the Nixon government funds for the successful overthrow of President Salvador Allende of Chile in 1973.
A key figure is Robert Carmona-Borjas, a Venezuelan active against Mr Chavez in 2002, who later fled to the US. He runs the Washington-based Arcadia, which calls itself “an innovative ‘next generation’ anti-corruption organisation”. Its website carries three video clips alleging, without evidence, that Mr Zelaya, his associates and Hondutel are deeply corrupt. Behind Arcadia are the US-funded National Endowment for Democracy (NED) and the International Republican Institute (IRI), the well-funded overseas arm of the Republican Party. Currently active among the Uighurs of western China, the NED has this year funnelled $1.2m (£740,000) for “political activity” in Honduras.
For those of you who might’ve forgotten why you couldn’t stand Hillary Clinton, she appears to be pushing back against President Obama’s more forceful condemnation of the coup:
The conservative-minded Mrs Clinton retains John Negroponte, an ambassador to Honduras under Ronald Reagan, as an adviser. He also represented George W Bush at the UN and in Baghdad. Democratic Senator Chris Dodd attacked Mr Negroponte in 2001 for drawing a veil over atrocities committed in Tegucigalpa, the Honduran capital, by military forces trained by the US. Mr Dodd claimed that the forces had been “linked to death squad activities such as killings, disappearances and other human rights abuses”.
During his time in Tegucigalpa, Mr Negroponte directed funds to the US-supported Contra terrorists seeking to overthrow the government of Nicaragua. He assured them of arms and supplies from the Palmerola airstrip, the main US base in Central America. As President Rafael Correa of Ecuador is in the final stages of closing the US base in his country, Mr Negroponte is conscious of what the US could lose if a Zelaya government banned its presence at Palmerola. For their part, Hondurans have noted that when Mr Zelaya tried to return on 6 July, and his plane was refused permission to land at Tegucigalpa airport, no room was found at Palmerola.
In other words, a sponsor of state-supported terrorism is Clinton’s leading adviser on Central American policy.
If there are any remaining employed (or just-furloughed journalists) reading this site, please try to explain why this story has gone largely unreported by the American press.
Al Jazeera: Can the US Really Win in Afghanistan?
8-Ball Sez: Signs Point to ‘No’:
And, whether or not…oh, bleep, just fill in the same rhetorical question ‘bulo asked in the previous segment. And, here’s how the reporter got this important story. He ’embedded’ with American ground forces for two weeks. If bleeping Al Jazeera can do this, can’t America’s (possible oxymoron alert) leading practitioners of journalism at least do the same? Especially when it looks like Afghanistan, not Iraq, is the real ‘New Vietnam’?:
It is not the first time America’s been overrun by insurgents. There were clear instances of it in Vietnam, for example.
But one would not expect it from a war that many Americans thought was all but over.
It was George Bush, after all, who declared on July 4, 2002, that in “Afghanistan we defeated the Taliban”.
That was never a true statement.
And, as the Obama Administration takes ownership of this war nearly eight years since it first began, there is mounting evidence to suggest the opposite may be true.
The (UK) Guardian: Investment Bankers Rake in Billions on the Other Side of the Pond
Like wind and rain at the Open Championship, some things are inevitable. Looks like investment bankers being immune from economic downturns and financial regulation must be added to the list:
Barclays is to pay tens of millions of pounds to its investment bankers, who have made huge profits from trading in government debt, derivatives and foreign exchange.
Some of the biggest payouts are expected to go to former Lehman Brothers traders hired by the British bank after it took over Lehman’s US operations at a knockdown price in September. Some Lehman staff were granted guaranteed bonuses to ensure they stayed with Barclays rather than jump ship and sign up with rivals.
The bonuses are expected to cause outrage among Barclays UK employees, who are being balloted by the Unite trade union on strike action over the scrapping of the firm’s final-salary pension scheme.
Will someone please explain why there is so little outrage directed at these vultures who create nothing on their own,who wantonly destroy economies and lives, but who are still living high on the hog? Mr. Carper? Mr. Castle?
Philadelphia Inquirer: Green Energy Jobs Bringing Real Hope to Factory Towns
Influx of new green manufacturing job brings hope to Newton, Iowa, formerly a ‘Maytag town’.
It’s not the full-bore full employment that Maytag one offered many years ago, but it’s what’s gonna have to drive an economic revival:
Once, Maytag jobs financed the middle-class dream in this former company town about 35 miles east of Des Moines: houses, steaks on the grill, vacations at the lake, college for the kids. Now, Maytag is just a nameplate on appliances made by Whirlpool at factories in Mexico and Ohio.
When the plant closed, a victim of globalization, confidence in a way of life was shattered, an all-too-common occurrence in the manufacturing belt of the Midwest.
Luckily, with the help of state and county tax incentives, Newton attracted two new factories in the burgeoning clean-energy industry.
One, TPI Composites, makes the massive blades for turbines that turn wind into electricity. Nearby, Trinity Structural Towers has retrofitted the old Maytag No. 2 plant, location of the former production line, to build the towers that hold the blades and turbines.
After a time commuting nearly an hour to a job at a heavy-equipment plant, Versendaal, 56, works at TPI as a team leader.
“It’s exciting,” he said. “Now I’m working on something that could benefit all mankind and make the country more energy-independent. I think wind power is going to be a big thing.”
LA Times: Conservative PAC Extorts Corporate Millions For Support
How the American Conservative Union came to back UPS over FedEx in a legislative showdown:
Reporting from Washington — In an unusual look inside Washington’s lobbying culture, a sequence of letters published last week exposed how a conservative nonprofit advocacy group apparently tried to sell its clout in a legislative battle between FedEx and UPS.
For a fee of $2.1 million to $3.4 million, the American Conservative Union offered to “strongly support” FedEx’s position and “rally [the] grass roots,” according to a June 30 letter from Vice President Dennis Whitfield to a top lobbyist for the package carrier.
After FedEx rejected the offer, the group’s chairman, David Keene, joined seven other conservative leaders in signing a July 15 letter supporting United Parcel Service Inc. and blasting its competitor for “false and disingenuous” statements made in trying to fend off legislation that would have increased organized labor’s power at FedEx Corp.
It’s never about principles with this scum, it’s always about the principal plus interest. And from the “Why Is ‘Bulo Not Surprised Deparment”, neither David Keene nor Grover Norquist were available for comment. Unprincipled and unaccountable.
Finally, in solidarity with our own ‘Geezer’, ‘bulo says, “Go, Tom Watson!” How cool would it be if the 59-year old actually wins the Claret Jug?
Tags: Media
The rationing piece is really interesting. I believe Americans have a right to basic preventive care, but we don’t have the right to get every treatment we can ever desire – and this is where the ability to pay will come in. Rich people will always be able to get these treatments while poorer people won’t. I think we’ll need to find a system that is fair to everyone, but I think almost anything will be better than what we have now where rationing is strictly on ability to pay.
I’m glad you also picked up the article about the ACU’s flexible ideology. I have no idea why this isn’t a bigger scandal.
In the healthcare piece, I’d like to see the data and detail collected in WI that showed the higher mortality in the uninsured MVC customers (page 2). Trauma almost never pays at 100% cost anyway, but those figures seem dubious when weighed against my experience (although I’ve never collected any data of my own). One reason could be the expense of transport from community based hospitals to regional trauma centers. Helicopters are expensive to operate and man therefore could be one of the very things “rationed away” anyway.
I was struck by how uncontroversial Singer’s piece actually was, for a guy who pretty routinely causes controversy. Basically he argues for making the hidden decisions already made for rationing of health care much more visible by better quantifying what gets paid for by insurance or by the government. It makes sense to let people know the real limits of their coverage, so you know that you may have to pay directly for extraordinary procedures or drugs or have to get additional insurance to cover that kind of thing. This seems more straightforward than our current system of pretending to have an all-you-can-eat coverage system. Because as everyone with insurance already knows, yearly or lifetime limits on drugs or hospital payments or mental health treatments start the rationing already. And some of this rationing is based on the fact that Americans pay higher prices for almost all medical services; and especially in the case of drugs pay those higher costs to subsidize the drugs sold around the world at a much heftier discount. You can bet there will be much sturm and drang over this article mostly by the wingnuts — largely because they’ll never admit that the healthcare we have now is very much rationed, unless, of course, you walk in the door with cash or credit for procedures or drugs not covered.
Peter Bergen has another view of the American possibilities in Afghanistan.
Bergen was one of the saner and more prescient voices on the original effort to topple the Taliban as well as on he Iraq cock-up. Which isn’t to say that the al-Jazeera article is wrong, just pointing out other views.
You’re right Cassandra about having rationing front and center so that everyone knows what is and isn’t paid for. I think a lot of people come in for a shock when they run into lifetime limits or get dropped from their insurance because of recission. I think the industry has done a really good job of covering these things up. Honestly, I still don’t understand why people get shocked when these things happen to them.
Of course all resources are rationed. Ours is quite efficient. Theirs is sometimes inefficient. What is this long wait crap mentioned in the article? I would rather wait 2 to 4 hours than 2 to 6 months. That would be a long wait.
You wingnuts! Today, Sunday News Journal had a single payer article, not a frickin word from any of you! Are you all acting like you know something about the issue, when in fact you know so little about the issue you cant even comment on it. So glad 32 statewide organizations are engaged and informed!
There is no rationing of care under the single payer system. Its not a government run program either. In fact, you would have coverage for medical, dental, mental, vision and everything else and it would only cost l.5% to administer right here in Delaware. Want the insurance company beancounters to stop over ruling your doctor? Want you and your doctor to come up with your treatment plan then you must ask yourself this question. Why did the insurance company put another 350,000 lobbyists on the payroll~~paying them out of your insurance premiums to make sure the deadbeat, hate american worker repukes can continue to pull the wool over your eyes.
I thought you all supported Dr. Howard Dean? He says, “if there is no public option, WE should ALL be opposed to the next big giveaway to the health care whores and prostitutes.
Anon is correct on all points. Dr. Dean, in his Delaware visit was very explicit about that point re public option, (single payer)
John K.
Of course there is rationing. There will always be some form of rationing. Will your health plan of yesterday, today or tomorrow pay for accupuncture, massage, mandibular myotomy or dolphin therapy (I wish I was joking)? OK, then if these really are the things that will make some portion of the country feel better, then only the people that will be able pay for them will get them. That is a form of rationing.
Just because a procedure is available and effective doesn’t mean that it should or will be done. I think I heard Al Mascitti describe the range of treatments available for prostate surgery. They range from hundreds of dollars in cost to hundreds of thousands of dollars. Which will the new plan pay for?
I am all in favor of getting everyone in America some form of basic care so that we can guarantee that all of our residents have access to safe and effective medical care. But let’s be realistic. There will be compromises, and hopefully they will be in the edges, not the core of care.
God, David you are so full of it. Do Republicans remember that there are 50 million Americans with no insurance at all and countless more with junk insurance? Let’s stop pretending that we’re talking about waiting one month or six months for a hip replacement.
I’m sorry anon, but geek is right. Single payer rations healthcare as well. You can’t get everything you want unless you can pay for it. Single payer gives everyone basic care and is much more cost efficient than what we have now. I wish we could get there but it doesn’t seem to be in the cards.
Congratulations, UI….someone in Delaware actually knows it’s ‘preventive,’ not preven-ta-tive.