Tag Archives: Health Care

Dumba$$

red

Hi Middle America, poor white people, and everyone else so mad that the world was no longer favoring just you and your shitty circumstances, that you voted for a maniacal egomaniac—it’s me, your liberal, elitist, east coast friend judging your dumbass choices. I used to feel sorry for you, but now I’m vacillating between abject pity and sadistic joy as I watch you freak out now that you’ve realized that the “salt of the earth,” “middle America” senators and representatives you elected don’t give a shit about you. Did you think it was just people with dark skin they were going to target? Are you just now realizing that they do not care if you are white. They only care if you are rich, and you are NOT.   Note, if you are rich, great for you!  Team “the rich get richer” crushed it in the last election.

For everyone else, I’m here to walk you through this difficult time. Actually, forget that, I’m here to point out some hard truths and hopefully help you confront the reality of your new, soon-to-be even worse, financial situation. I also want to try to point out in a soft and supportive manner how stupid you must feel—I’m a good friend.

 After Hillary lost by winning 3 million more votes than Trump—I know, math is confusing– the party line was that Democrats lost touch with “real America.” Middle America (a/k/a real America) didn’t feel loved, and so to show the world how mad y’all were (look, I’m reaching out by using your vernacular), you opted to vote for someone who fires people for fun—you know like a regular American. You opted for Trump because “he told it like it was” and because maybe you could call women Tits McGhee and slap them on the ass all while having people applaud your clever nickname—like the good ole days. I know. It sounded like an amazing world, where we had a wall to keep out Mexicans, who aren’t even illegally immigrating in a fashion that a wall would address because most illegal immigration is now happening from people flying into the country and over staying their visas—wait, how tall is this wall? Oh it doesn’t matter. We can make the wall a million miles high to keep those planes out, and Mexico is going to pay for it!!! And by Mexico I obviously mean tax-payers.

 I know you probably feel pretty shocked right now, and that’s where my joy comes in. I know you might be thinking that I’m mean, but really, it’s that I’m fair. Let me explain. I’m fair because you are now being forced to live in a world you were happy to create for others. You fell for it. You believed them when they talked about welfare queens, and illegal immigrants taking all your free government stuff. It’s not that you have a problem with free government stuff, it’s that you think only you have earned it. You’re not a taker. THEY are takers. So of course we should cut funding for Planned Parenthood—only takers need cancer screenings. And SNAP benefits? Only illegal immigrants and non-whites need food when they live in poverty, right? No way my Senator would get rid of the parts of the Affordable Care Act that actually save lives, like no life-time max benefits, children’s insurance, pre-existing condition bans. They are only getting rid of the “Obama” part of “Obamacare” right? RIGHT?

So here you are, 30 million people are about to be without health insurance because you fell for the insurance companies’ line when they told you that your rates were only rising because of the black president. You fell for it when they blamed rate increases on illegal immigrants being covered. Because insurance companies, like you, are the salt of the earth working people who we should believe. They would never price gouge essential medicine like epi-pens. I know you guys hate socialized medicine, but LOVE your Medicaid which makes me laugh until I pee a little. Nothing warms my elitist heart like hearing people complain about socialism then watching them arrive at an ER with a sick child and no insurance to pay for the life-saving treatment they need, and then getting to pay for that treatment myself by watching my rates creep up to compensate for your socialist ass. Your socialism is so much better than mine. Morons—oops, I mean friends.

But at least you still have your guns. Hopefully when you get pneumonia your gun will save your lungs. Or maybe the Republican plan of “have you tried not being poor” will work out for you. Either way enjoy living in the fuckery-filled world you sought to create for others.

Americans Hate Insurance Companies and Really Like Medicare

This outfit called Morning Consult has done some polling to gauge American attitudes towards some aspects of our health care system and then created a word cloud of the responses. Interestingly, “expensive” and “greedy” are associated with insurance companies, pharmaceutical companies, medical device companies and hospitals. Americans are more positive about nurses and Medicare. I’m posting the two word clouds for Insurance Companies and Medicare (thinking that the idea of being able to buy into Medicare as a Public Option was really a missed opportunity by Congress), but you should go over and see all of their word clouds — it is an interesting narrative:
In a word or two, could you please tell me what comes to mind when you think of health insurance companies?

In a word or two, could you please tell me what comes to mind when you think of Medicare?

This is most interesting to me as this is pretty much the reverse of how Congress prioritizes dealing with these items. In the main, the portions of the system that consumers like and value are the bits that Congress is least likely to support. And the portions of the system that consumers are least happy with are the portions that the government is most interested in supporting and funding– and those portions are also the parts of the system with the most money to spend on campaign contributions and lobbying.

The Difference Between Being Broke And Being Poor

Re-posted, in its entirety, with permission by the author, Richard Mayhew of Balloon Juice.  There is a big difference between being broke and being poor.  Keep reading.

 

Being broke is not being poor

 Posted by at 12:15 pm
Jan 282014

 

Paul Krugman is reraising a common and key insight into poverty which is not well captured by federal poverty guidelines:

“By security, I mean that you have enough resources and backup that the ordinary emergencies of life won’t plunge you into the abyss. This means having decent health insurance, reasonably stable employment, and enough financial assets that having to replace your car or your boiler isn’t a crisis.”

There is a clear distinction between being broke and being poor from this insight.  Being broke means having no cash available, but having access to sufficient resources that the every day minor oh-shit moments are not a crisis as resources were available to manage the problem.  Being poor means the minor oh-shit moments can easily become a crisis because there are no resources available.

When I was in college, I was consistently broke.  I lived in a flophouse one summer with anywhere from seven to sixteen other people paying some share of the monthly rent.  The most I paid was $86.75 for August.   I sold myself to science as the pay and food was good, and I knew where there was free food offered by every department.  As a student I was broke and under federal poverty guidelines, I was poor.

However, I had resources.  I had good health insurance through my parents.  When I woke up and my knee was swollen to the size of a grapefruit while the patella had dislocated itself, I swore in pain but not in concern about how to get through the day without seeing a doctor.  I went to student health services after calculas, and then hopped a bus to see an orthopedic surgeon.  She  drained 38 CC of fluid.  I owed $20 in co-pays and had to buy a cane. I would have rather spent the $20 on beer, but oh well, I could walk well enough in three days.   When I was scrambling to come up with a security deposit for the first apartment that I would share with my girlfriend and now wife, I could go to my parents and ask that the security deposit and a good dinner with family be my graduation present.

This is a crucial distinction between being poor where there are few good choices over the long run as people operate from scarcity thinking  and being broke.  I was able to access resources and behave almost a Friedmanesque lifetime income hypothesis individual.  (As a side note, this is why I discount the experiences of the 1% who claim they were poor in college — they might have been broke, but mommy and daddy could take care of anything)  This is a weakness of the poverty guidelines as they are income based and not resources based.  Some people may have rather low incomes but have the ability to call on resources in an oh-shit scenario, and others may have slightly above poverty level incomes but have no resources that turns an oh-shit scenario into a crisis.

Health insurance is one of the most important resource that is an on-call and hopefully not needed resource, so two individuals with the same income but where one has decent health insurance and the other does not have two very different abilities to absorb bad news from a doctor.

This post struck such a cord with me.  I had to contact the author and ask permission to repost.  Luckily, he graciously agreed.  And as the mother of a sophomore in college this post resonates (if you aren’t there yet, just wait!).  Resources matter.  Big time.

Thanks again to Richard Mayhew.

 

Comparing the Health Care Systems of 11 Industrial Countries

I was going to post this in the Single Payer thread and in the Open Thread for today, but this turned out to be its own post.  This year’s Commonwealth Fund International Profiles of Health Systems (PDF) is out.

This is particularly useful in detailing how governments cover the health care of their citizens (as in, “single payer” looks different depending upon where you are — instructive) and in summarizing overall outcomes of these systems. We get middling quality care and pay more than anyone else for it — 17.7% of our GDP (and this is without covering everybody) vs The Netherlands (the next highest) at 11.9%. We’re in the bottom third of countries able to get same day appointments and in being able to get after hours care. We’re the highest in the number of avoidable medical system deaths and in the bottom third of overall satisfaction with the medical care system.  So much for the greatest medical care in the world.

Definitely take a good look at how other countries fund and administer their health care systems.  They aren’t all the same, even though we often talk about them as though they are.  Plenty of these countries run a national health service, but note how many rely on private insurance too.  Single payer has many faces and those of us who want that need to be more articulate about what we’re pointed towards.

It isn’t all bad news, but as you review this (especially looking at costs), always remember that you are looking at US numbers that do not cover all of us. Obamacare certainly isn’t going to destroy health care in this country — that destruction was happening on its own.

And bookmark this — this is genuinely useful data.

Blandly Watching Someone Die

I heard about this story yesterday, but didn’t listen to the 911 call until this morning.

March is only four days old, but this month’s “man’s inhumanity to man” award goes to Glenwood Gardens and the folks who work there. The senior living facility in Bakersfield, Calif., has a policy of calling 911 in emergencies and waiting with the afflicted until medical assistance arrives. But the lack of urgency — the seeming indifference of the personnel to the 87-year-old woman who collapsed in the dining room Feb. 26 — is stunning.

The Bakersfield Fire Department released the 911 call on Saturday is simply chilling. For seven minutes, the 911 operator tried to get someone, anyone, to administer CPR to Lorraine Bayless as she lay on the floor barely breathing.

Dispatcher: I understand if your boss is telling you you can’t do it. but if there’s anybody, as a human being, I don’t, you know. Is there anybody that’s willing to help this lady and not let her die?

Glenwood Gardens nurse: Not at this time.

Stunning and chilling are accurate descriptions.  Go listen to the 911 call.  The only person concerned about the dying woman is the 911 operator.  Everyone else acts as if the 87 year old woman lying on the ground has a hangnail.

I’m not going to get into whether the woman would have lived if she’s received CPR.  I’m not even going to dwell on Glenwood Gardens corporate death panels.  What stuns me is the staff’s complete and utter lack of humanity and compassion.  Have you listened to the 911 call yet?  You really need to do that.

The Glenwood Gardens staff, one of which declares herself a nurse, is completely unmoved.  There is simply no emotional reaction, no sense of urgency whatsoever.  That’s what’s chilling.  In fact, the only time a staff member showed emotion was when it came to herself:

Meanwhile, the nurse told someone on her end that Halvorson (911 operator) was “yelling at me and saying we have to have one of our residents perform CPR. I’m feeling stressed, and I’m not going to do that, make that call.”

She’s feeling stressed?  Why?  Because someone is dying in front of her?  Nope. She’s upset because the 911 operator is “yelling” at her to help the dying woman.  Why even call 911?  Why not just skip the middleman and call the funeral home instead?  Bet this stressed nurse really needed a cup of coffee after her ordeal.

I get that Glenwood Garden’s policy is sterile, stupid and heartless.  Why do they even hire nurses if they won’t allow them to, you know, be a nurse?  What I don’t get is the employees reaction, or should I say lack of reaction.  They aren’t the least bit upset that their hands are tied.  That’s what’s so shocking about this incident – the complete lack of compassion and humanity.  As they spoke to the 911 operator I kept envisioning them rolling their eyes.  That’s what shocked me.

As I listened to that 911 call I couldn’t sit still.  Even though I knew how the incident ended (the woman died) I kept thinking someone would intervene.  It just seemed so instinctive.  I kept thinking… okay, these nurses aren’t going to help, but they’re going to start yelling for someone who can.  They are going to do something.  But they did nothing.  They didn’t even seem to care, and that’s what’s chilling.

Dick Perry Wanted to Go Bi

Way back when during a time when Dick Perry had an open mind, he said this:

Legislation authored by border legislators Pat Haggerty and Eddie Lucio establishes an important study that will look at the feasibility of bi-national health insurance. This study recognizes that the Mexican and U.S. sides of the border compose one region, and we must address health care problems throughout that region. That’s why I am also excited that Texas Secretary of State Henry Cuellar is working on an initiative that could extend the benefits of telemedicine to individuals living on the Mexican side of the border.

Oops.

The Idea Of Seniors Shopping For Health Insurance Is Insane

If you have ever had to purchase individual health insurance you know exactly how insane Paul Ryan’s senior health insurance vouchers are.  If you haven’t then you might want to read a post I wrote in November 2008.

Fact:  Individual health insurance is only cost competitive if you’re young and healthy, because health insurance has nothing to do with health care and everything to do with risk assessment.

So… which insurance companies are going to insure our older citizens?  Perhaps they’ll simply take them – and their vouchers – for a year, then raise their rates and watch as seniors drop out. Frankly, I’m having trouble seeing them take them at all.  Seriously, why would a business based solely on assessing risk take on the riskiest demographic in this country?  It’s bad business, and one of the driving forces as to why Medicare came into existence.

Which brings us back to Paul Ryan’s plan for future seniors and what it really means to everyone.  Via Gooznews in a post entitled “Attention Future Seniors: Republican Plan A 100% Estate Tax”

So here’s the real argument young and middle-aged people need to hear, and the real reason why the “more skin in the game” argument can never work for seniors or other vulnerable populations, including them when they reach that age. Seniors and the poor account for over half of health care spending. Within those groups, 5 percent of the population accounts for 50 percent of health care costs; and 20 percent of the population accounts for about 80 percent. These costs come for the most part at times when economic incentives have no influence at all on medical decision-making: in medical crises; in treating chronic conditions; and, for most Medicare patients, in the last six months of life.

That’s why a voucher program for Medicare, which will shift an increasing share of those inevitable costs onto the elderly themselves, can fairly be categorized as a 100 percent estate tax or death tax. People under 55 need to know that if the plan crafted by Rep. Paul Ryan were passed, most of them will never have a cent to leave to their children. It will all go to the health care industry to support the American way of dying.

In the end, the Republican plan is a death/estate tax.  It is a plan that will bankrupt the majority of Americans and lays waste to the GOP cries over their freedom loving right to be able to leave their hard earned dollars to their children.  In many cases, children will be trying to help their parents make up the difference between the voucher and the actual cost of care, which, in turn, will leave them less prepared for their own golden years.  In many other cases, no one will be able to help the senior, which has led me to start calling the Republican plan the Bring Out Your Dead! plan.  (h/t Monty Python)

Socialized Health Care Before There Was Socialism

Who would have thought that the Founding Fathers were a bunch of Socialists!

Teabaggers around the country are eating crow tonight. They just found out that our Founding Fathers, those gentlemen who teabaggers place on a pedestal and worship every night before going to sleep, mandated that private citizens purchase health insurance.

In July of 1798, Congress passed – and President John Adams signed – “An Act for the Relief of Sick and Disabled Seamen.” The law authorized the creation of a government operated marine hospital service and mandated that privately employed sailors be required to purchase health care insurance.

Surely you jest. How could Congress do something that Frau Bachmann and the House Crier call unconstitutional? Well, because it wasn’t unconstitutional.

Keep in mind that the 5th Congress did not really need to struggle over the intentions of the drafters of the Constitutions in creating this Act as many of its members were the drafters of the Constitution.

And when the Bill came to the desk of President John Adams for signature, I think it’s safe to assume that the man in that chair had a pretty good grasp on what the framers had in mind.

Holy Stethoscope, Batman. I can’t believe this. You mean that Rush and Glenn and Sarah have been lying to us about this?

The law did a number of fascinating things.

First, it created the Marine Hospital Service, a series of hospitals built and operated by the federal government to treat injured and ailing privately employed sailors. This government provided healthcare service was to be paid for by a mandatory tax on the maritime sailors (a little more than 1% of a sailor’s wages), the same to be withheld from a sailor’s pay and turned over to the government by the ship’s owner. The payment of this tax for health care was not optional. If a sailor wanted to work, he had to pay up.

And for those teabaggers who still think this is balderdash, think about who was running Congress when this law was enacted.

As for Congress’ understanding of the limits of the Constitution at the time the Act was passed, it is worth noting that Thomas Jefferson was the President of the Senate during the 5th Congress while Jonathan Dayton, the youngest man to sign the United States Constitution, was the Speaker of the House.

Don’t you just love it when facts (and history) prove teabaggers wrong?

Kucinich: GOP Might Give Life to Public Option

Rep. Dennis Kucinich (D-OH) said on Fox News that if the Republicans try to dismantle the healthcare legislation passed in the last Congress they may “paradoxically be creating the opening to push single-payer forward again”.

If you demolish the new bill and we go back to square one, you still have 50 million who don’t have any coverage, then what’s the option if you can’t have the government, say, by private insurance, which — believe me, as someone would has fought that system I understand that — then the only other option is to say what other industrialized democracies say, healthcare is a basic right, we’ve got to provide for everyone, we’ll have a single-payer system.

Hey, I Found Those Republican Death Panels

Heartbreakingly cruel.

PHOENIX — Even physicians with decades of experience telling patients that their lives are nearing an end are having difficulty discussing a potentially fatal condition that has arisen in Arizona: Death by budget cut.

Effective at the beginning of October, Arizona stopped financing certain transplant operations under the state’s version of Medicaid. Many doctors say the decision amounts to a death sentence for some low-income patients, who have little chance of survival without transplants and lack the hundreds of thousands of dollars needed to pay for them.

“The most difficult discussions are those that involve patients who had been on the donor list for a year or more and now we have to tell them they’re not on the list anymore,” said Dr. Rainer Gruessner, a transplant specialist at the University of Arizona College of Medicine. “The frustration is tremendous. It’s more than frustration.”

Why am I not surprised that this is happening in Arizona.

Guess Republicans weren’t lying when they warned about Death Panels.  Their motto: If you’re poor, you die.  Perhaps they could kindly STFU about the sanctity of life.

The New Chicken Barter Economy

I was wrong that Republicans don’t have new ideas! Nevada GOP Senate candidate Sue Lowden thinks health care reform is wrong and she has a better idea:

Sue Lowden, the likely GOP nominee for U.S. Senate in Nevada, has a novel plan for health care reform: haggling with your doctor over prices.

Lowden offered her proposal last Tuesday in Mesquite.

I think that bartering is really good. Those doctors who you pay cash, you can barter, and that would get prices down in a hurry. And I would say go out, go ahead out and pay cash for whatever your medical needs are, and go ahead and barter with your doctor.

Did she really mean barter? Like taking medical services in trade? The answer is yes: she really means barter.

Sue Lowden, the likely Republican nominee against Harry Reid, is doubling down on her widely ridiculed proposal that people should haggle and barter with doctors to bring down prices.

Appearing yesterday on Nevada Newsmakers, Lowden said:

I’m telling you that this works. You know, before we all started having health care, in the olden days our grandparents, they would bring a chicken to the doctor, they would say I’ll paint your house. I mean, that’s the old days of what people would do to get health care with your doctors. Doctors are very sympathetic people. I’m not backing down from that system.

I’m not sure how I’m going survive in this new economy. I don’t have any chickens.