Archive for the ‘medicaid’ tag
Just because I felt like writing tonight, and really for no other reason, I scooted over to Michelle Malkin’s oh-so-learned attempts at commentary (http://michellemalkin.com/), on which I found the lead “story” to be about an 11-year-old girl, Julia Hall, who asked President Obama a health care question during a recent town hall meeting in New Hampshire. From The Boston Globe:
A girl from Malden asked President Obama a question at Tuesday’s town hall meeting in New Hampshire about the signs outside “saying mean things” about his health care proposal.
Eleven-year-old Julia Hall asked: “How do kids know what is true, and why do people want a new system that can — that help more of us?” — The Boston Globe, Aug. 11, 2009
As it turns out, Julia’s mother was an Obama supporter during the 2008 election and a donor to the campaign in Massachusetts. Malkin, however, with her sardonic, “As we always like to point out: There are no coincidences in Obama world,” seems to suggest the girl was “planted” by the Obama administration to ask the question in order to make a point it felt needed making. The girl also queried Obama about the signs outside the town hall meeting “saying mean things” about Obama’s health care plan. Obama’s reply, which Malkin fails to include in her clunky polemic, was this, from The Globe:
“Well . . . I’ve seen some of those signs,” prompting laughter. “Let me just be specific about some things that I’ve been hearing lately that we just need to dispose of here. The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for “death panels” that will basically pull the plug on grandma because we’ve decided that we don’t — it’s too expensive to let her live anymore. And there are various — there are some variations on this theme.”
According to a White House transcript, Obama continued:
“It turns out that I guess this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, et cetera. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready, on their own terms. It wasn’t forcing anybody to do anything. This is I guess where the rumor came from.”
“The irony is that actually one of the chief sponsors of this bill originally was a Republican — then House member, now senator, named Johnny Isakson from Georgia — who very sensibly thought this is something that would expand people’s options. And somehow it’s gotten spun into this idea of “death panels.” I am not in favor of that. So just I want to — (applause.) I want to clear the air here.”
“Now, in fairness, the underlying argument I think has to be addressed, and that is people’s concern that if we are reforming the health care system to make it more efficient, which I think we have to do, the concern is that somehow that will mean rationing of care, right? — that somehow some government bureaucrat out there will be saying, well, you can’t have this test or you can’t have this procedure because some bean-counter decides that this is not a good way to use our health care dollars. And this is a legitimate concern, so I just want to address this.”
“We do think that systems like Medicare are very inefficient right now, but it has nothing to do at the moment with issues of benefits. The inefficiencies all come from things like paying $177 billion to insurance companies in subsidies for something called Medicare Advantage that is not competitively bid, so insurance companies basically get a $177 billion of taxpayer money to provide services that Medicare already provides. And it’s no better — it doesn’t result in better health care for seniors. It is a giveaway of $177 billion.
“Now, think about what we could do with $177 billion over 10 years. I don’t think that’s a good use of money. I would rather spend that money on making sure that Lori can have coverage, making sure that people who don’t have health insurance get some subsidies, than I would want to be subsidizing insurance companies.
“Another way of putting this is right now insurance companies are rationing care. They are basically telling you what’s covered and what’s not. They’re telling you: We’ll cover this drug, but we won’t cover that drug; you can have this procedure, or, you can’t have that procedure. So why is it that people would prefer having insurance companies make those decisions, rather than medical experts and doctors figuring out what are good deals for care and providing that information to you as a consumer and your doctor so you can make the decisions?
“So I just want to be very clear about this. I recognize there is an underlying fear here that people somehow won’t get the care they need. You will have not only the care you need, but also the care that right now is being denied to you — only if we get health care reform. That’s what we’re fighting for.” — The Boston Globe, Aug. 11, 2009
It is, indeed, “fishy,” as Malkin states that town hall meeting participants were “bussed in” to the event, as reported by WMUR of Portsmouth, N.H. But there is no proof these folks were bussed in specifically by the Obama administration to the town hall meeting to pad the seats, as it were. Actually, it would seem very likely that the folks who would be interested in attending town hall meetings would be supporters of the president. Would I, for instance, be eager to listen to Mark Sanford, the governor of my home state of South Carolina, talk about his opposition to the bailout funds and whine about how he’s sorry for having an affair with Maria BeLen Chapur with his four kids sitting at home? I think I would rather stay right here where the walls and this computer screen are more entertaining. The same, thus, likely held true at Obama’s town hall meeting. Boston is a hop, skip and jump from New Hampshire, so it’s not unlikely that Julia and her mother were in attendance. Plus, there is no rule that I know of to require a president or elected official to randomly, as if from a hat, select one questioner over another. My point is clear at this point: Malkin’s claim, and others’ is flimsy and unquantifiable.
But, for the fun of it, let’s examine a few of the comments given in the WMUR report by folks actually protesting, or not, outside the event. Here’s a small selection:
“… And I earned my health insurance. I paid for it with my money that I work very hard for.”
“Capitalism is America”
“A little rain for health care reform? Hey, I’ll do it.”
“They didn’t fix GM. They just propped them up with our money.”
“No profits, no health care.”
On the “capitalism is America” point, a co-worker of mine wrote a good piece recently in which he detailed a few irrevocable facts, which deconstruct this claim down through history: slavery is as anti-free-market as it gets, monopolies destroy the idea of capitalism and so does deregulation.
On the “earned” health insurance argument, I would say that many, who are not in as comfortable a position as the speaker, also pay for their own health insurance and still can’t afford their medical bills. Here is the crux of the entire argument. Let’s ignore for a moment (but certainly only for a moment), the millions of folks who do not have any type of coverage. Members of, what I would call the middle class or lower middle class, may have coverage (or once did but found it too expensive), but when something arises beyond their control, the coverage they have simply is meager. We don’t have to search long and hard to find examples:
The majority of the uninsured are neither poor by official standards nor unemployed. They are accountants like Mr. Thornton, employees of small businesses, civil servants, single working mothers and those working part time or on contract.
“Now it’s hitting people who look like you and me, dress like you and me, drive nice cars and live in nice houses but can’t afford $1,000 a month for health insurance for their families,” said R. King Hillier, director of legislative relations for Harris County, which includes Houston.
Paying for health insurance is becoming a middle-class problem, and not just here. “After paying for health insurance, you take home less than minimum wage,” says a poster in New York City subways sponsored by Working Today, a nonprofit agency that offers health insurance to independent contractors in New York. “Welcome to middle-class poverty.” In Southern California, 70,000 supermarket workers have been on strike for five weeks over plans to cut their health benefits. — The New York Times, Nov. 16, 2003
So, here’s the thing: the modernized countries who have some form of universal health care all are healthier than this country of dullards who would rather die under crushing debt and medical bills than adopt policies that may help, not just a few or some or half of our citizenship, but all of our citizenship. England, which even today, is still healthier than America on the whole, has full, universal coverage and has for more than 50 years (Private insurance is used by less than 8 percent of the population there)! As my cohort notes, Japan has no bankrupties caused by medical bills, while half of the bankruptcies in the U.S. are medically related. Some system, huh?
No one in this country knows what the final form of health care reform will look like, but I side with this commenter, who said, “A little rain for health care reform? Hey, I’ll do it.” As the saying goes, “If the system ain’t broke, don’t fix it.” But it is broken. This country’s average life expectancy and health care, money-grabbing track record prove as much. The insurance companies and pharmaceutical companies have one thing on their collective, rabbit-ass minds: money, and the health and well-being of those riddled with illness, who can’t afford treatment even with insurance, be damned. We can only hope the reckoning will come soon.
The following is a running catalog of posts between myself and members of http://www.allmyfriends.org, which I love to death. I simply differ with some of them on health care.
One poster said:
It is a VERY touchy subject. Cigarette smoking is a disgusting habit and i have zero doubt it causes serious serious health problems but seems to me at this point that anyone who starts smoking knows exactly what they are getting themselves into. Medicare is a huge financial burden and its not going to get cheaper any time soon. We’ve got to have some personal accountability with things like this. Its way too easy for people to look towards the government to supply them with so many things. I dont know what the right answer is here, but its getting awfully scary as our government marches towards totalitarianism.
I said: The problem with personal accountability in regards to health care is that the insurance companies and the pharmaceutical companies are making too much money with the status quo. We can try to put stiffer controls on them, but will it do any good? I don’t know. Some lawmakers have as much to gain from the health care industry’s success as the insurance and pharmaceutical companies themselves. So, as long as people are making money, there is always going to be resistance to a universal system because greed will always get in the way of doing what’s best for everyone, rather than looking out for people who can’t help themselves. Perhaps the goal should be utilitarianism, but we, I think, have too many greedy people in high places to make that a reality.
A different poster said:
I fail to see where a company making money is bad… this is a capitalist country or rather it was. The pharmaceutical’s have programs to give reduced price or free meds to those who need them. Wal mart and other retailers now offer $4 precriptions, so maybe some folks need to let go of a value meal here or there to pay for it, but it’s not the pharmaceutical companies fault, there is just no more personal responsibility anymore. It’s always someone else’s fault.
I replied: The cost of health care is egregiously expensive, even for people who have insurance. The pharmaceutical companies have some programs, I know, and people may be able to get certain generic drugs at Wal-Mart for a few bucks (And many local counties have drug cards offering more discounts for people without other insurance coverage), but when one has regular bills to pay and then gets sick or a family member gets sick, the doctors wants tests run or drugs prescribed. Some drugs are still $60 or more with insurance, Singulair for one, of which, there is no comparable generic. My wife’s recent endoscopy ran $3,500, not counting the doctor’s fees. With insurance, that will put my tab at least $700-$800. I make over 30k a year, but I can’t just drop $700 on the desk when it comes due. So, my point was that it has nothing to do with personal responsibility. The poor certainly get left behind. They can go to the ER and get checked out, but the hospital isn’t going to treat them like they would a paying customer out of the kindness of their hearts. But the folks in the middle get left behind too. Company insurance for a family is freakin’ expensive by itself, and then when a sickness comes up, it helps, but it doesn’t help enough in a lot of cases. Companies have a right to make money, but not at the expense and detriment of others. Or heck, maybe they do; damn the rest of us. lol
The same poster replied:
Jer I dunno what ER you have around you, but my wife is a charge nurse in ours and I can tell you first hand that they don’t play favorites if you have insurance or not. The nurses don’t know (unless you’re a frequent flyer), until after they’ve already started treatment if the person has insurance or not. My wife gets pissed at people using the ER as their regular doctor, but she still treats them kindly, with respect and no different than someone who has insurance.
Cost of health care is high because people don’t take care of themselves. I’m guilty of it myself. The main reason it’s high is because of people that don’t pay regardless if they have insurance or not, we all get stuck footing their bills.
I replied: Yeah, it looks as though you and my wife were dealing with the same issue or something similar. She has complained about her stomach for at least two years and before, I was like, Jesus, I get the point: it hurts. But apparently it was a real concern. The doctor said she had gastritis and prescribed Nexium ($48 after insurance). But this health care thing is enough to piss anyone off when we know that Canada and England and others get free care, funded by an extra tax obviously, when we are having to pay exorbitant funds just for the right to get taken care of. I see the anti-tax argument clearly, but Christ, it seems like we are getting the short end of the stick and the insurance companies are reaping the rewards. Would the extra tax to pay for universal care really equal or surpass the cost of buying health care for a family through a company’s insurance plan? I doubt it. and bottom line: company health care plans are supremely expensive, so much so that at my last job, I couldn’t even afford to get my wife or myself on the company’s plan. We just did without. It’s maddening and nothing short of it.
The same poster replied:
Do some research, the “free” care isn’t free, nor is it efficient or good. My friends in Canada have insurance here so they don’t have to wait forever. Many countries that have socialized health care are wanting to move back to free market care because they can’t afford it. It’s so bad in England that they have new rules in place that refuse to treat certain things.
Obama’s plan will cost us over 2 trillion dollars, tell me who the fuck is going to be paying for that? the rich? hell no, the middle class will get fucked up the ass again for higher taxes to pay for this crap. So 2trillion (probably much more) and we’ll get the worse health care than you can possibly imagine. Oh and those of us who don’t “buy” into the socialized care will be taxed on our employer paid care, and they are talking about adding a VAT (value added tax) which is a federal sales tax, to go on top of state and local sales tax. So now that we cough up probably 70% of our money to taxes they want to push that to 90. If that happens I hope this country falls on it’s ass like Russia did. We need a wake up call to go back to freedom, free market capitalism, not this socialist/facist shit.
I replied: The plan will cost $1 trillion over 10 years, not $2 trillion, a big difference, although the TV and radio hosts may be purporting an inflated figure, it’s $1 trillion: http://www.nytimes.com/2009/06/14/us/politics/14address.html. I don’t think anyone is disillusioned enough to think tax increases won’t be imminent if the plan passes, but Obama has said he hopes to pay for it by “cutting more than $200 billion in expected reimbursements to hospitals over the next decade” and by identifying “‘an additional $313 billion in savings that will rein in unnecessary spending and increase efficiency and the quality of care.’” And: “He had already set aside in his budget what he calls a $635 billion ‘down payment’ toward the overall 10-year cost of the overhaul.”
Obama throughout has supported making the rich foot the largest bill when it comes to taxes, evidenced by the proposed tax increase for those making 250k or more. It’s certain that the middle class will see some tax increases, but is it inconveivable that the tax increases will be so astronomical that they will supercede what folks are already paying for health insurance premiums and co-pays on doctor visits and care at the hospital, which are already astronomical? It’s conjecture to say the middle class will get fucked in this thing (Unless we define “fucked” to mean any additional taxes whatsoever). That’s just anti-tax rhetoric. I personally pay 15% off the top toward health insurance for my wife and plus about 23/24 percent toward state and federal taxes. Where does the 70 percent figure come from? The economy and each family therein would meltdown in a days if we paid 70 percent of what we made to taxes.
Regarding health care, a quick look at life expectancies around the world (http://www.worldlifeexpectancy.com/sort.php) shows that most of the major European countries (and Canada) have longer life expectancies than the U.S. England bests us. Canada tops us by leaps and bounds in third place, with Singapore and Japan having the longest life expectancies. Of course, a lot of factors contribute to this – our slovenly lifestyle not the least of them – but it says something that the most developed countries in the world live longer than we do, the majority of which have some form of nationalized health care. It puzzles me that conservatives, generally, expend so much energy defending the free market system, privatized health care and the like, when it has done little more than expand the chasm between the rich and poor. Most of them do it out of ignorance (Here, I exclude you Dan, of course.), and when some other system would, perhaps, benefit them more. But they know no better, so whatever Rush or Glenn say, that’s the gospel.
On the fascist, socialist comment, we like to demonize words, and those two especially. The radio and TV conservative hosts especially like this. Again, I think, perhaps, the best bet is utilitarianism: attempt to provide the most good for the most people. I really don’t care what it’s called, but perhaps, achieving that end might be the best one. Sorry for blathering on … lol.
The same poster replied:
the 1 trillion is only for one part of the plan 1/3 if you take the other 2/3 that’s 3 trillion.
There is no way in hell that the rich will be footing this bill, it will be paid for by everyone. Obama has said 250k and up, then 200k and up then his aides said 150 and up so which will it be?
The alleged “savings” by having socialized care will never come about. the cost is so huge there is no possible way it can create savings.
We pay 20% to Feds then throw in sales tax, throw in gas tax, throw in property tax, and on and on and you can easily get to 70% now if they add tax onto our employer paid healthcare that’ll be another huge chunk of tax, and if they get their way for a value added tax which would add 14% sales tax on top of what you already pay for tax…
As for making sure everyone has everything they need… read the constitution, that is not the role of government. Sorry to all the libs and bleeding hearts, but this country wasn’t founded by laws stating the government will provided everything you need at the expense of everyone else. I have been beyond poor, and am now doing ok, not rich, but ok. If i can do it then everyone can, they just have to get up and do it no matter how hard it is. America is the biggest charitable country in the the world. We give and give and give and give and give yet we’re being FORCED to give more.. How is that right? Taking from my wife and I who bust our asses, put our lives on the line, to give to some drugged up asshat who doesn’t do anything but watch cartoons on his/her stolen tv and cable is not cool, not right, and not the American way.
I replied: We started adding to the Constitution almost right after it was written and ratified, as if to say, “Oh crap, perhaps we should have added some personal liberty laws in there (i.e. the Bill of Rights.),” so it’s not necessarily in bad taste to pass laws and add amendments as the times change. The Tea Party supporters, again taking a document written 222 years ago and attempting to apply it to modern times, seem to imply we should dismantle the Federal Reserve, Social Security, Medicaid, and the like (they deem them unconstitutional), but the latter two were, in part, created to help people who were victims, not benefactors of the sort of economy we created. In the 18th century, if someone was disabled naturally or by other means, they just stayed home and were supported by their families, who were, in all likelihood, farmers or blacksmiths or coopers or whatever. For the elderly, they would simply stop working and live with their families. Our society today is radically different. The factory boom and the industrial revolution didn’t get in full swing for this country until sometime in the early to mid-19th century, which ultimately, and eventually, dismantled the old, subsistence living lifestyle, at least in the north, and put people to work in factories. This made new generations largely dependent on someone else other than themselves for their livelihood (i.e. their bosses, their factory jobs, etc).
Some equated this new industry with a type of slavery because people largely ceased being free to make a living for themselves and made themselves laborers for someone else (This described you, me and millions of others). This to me, creates the vast divide between who we were when the Constitution was written and who we are now. Most everyone is not a subsistence farmer today. Most everyone was a subsistence farmer when the Constitution was written. So, the arguments about personal liberty and responsibility are great as they are, but 200 years have passed. We can’t dismantle everything and start over. Of course the Constitution did not lay out a plan to provide everything people needed to get by because it was not written in the 20th or 21st century; it was written at a time when we did not have the analogous problems we have now.
Where does the $3 trillion figure come from? You said $2 trillion previously. Is there a link to show that?
I didn’t say the rich would be footing the bill, and admitted the middle class and others would probably have tax increases. I indicated the rich would foot more of the bill. I hear your frustrations about the possibility of giving to “some drugged up asshat” after working hard for what you have – I work hard myself to provide for the wife and kid – but you ignore the others. Many people are hurting in this country who have legitimate, uncontrollable illnesses who are facing foreclosure and destroyed credit because their medical bills are simply too much. I point to one couple in Clayton, Ga. whom I wrote a story on a month and 1/2 ago. The wife was diagnosed with ALS a couple years ago. The husband has a chronic liver condition which forced him to stop working. They had purchased a house here about 10 years ago and were paying on it just fine until the husband got sick and had to stop working (He painted and the paint fumes would only exascerbate his condition.) Now, they are fighting a foreclosure battle and were set to foreclose and lose the house in early May. I haven’t heard what the current status was, but the husband said if his wife was forced to move, the move would literally kill her. ALS is probably the worst disease one can have because you are fully conscious mentally, while your body slowly, numbingly fails until either your lungs collapse or you choke on your own tongue.
I could care less about supporting the druggies seeking unemployment. I care about people who got sick, and found themselves in unchartered financial waters with no recourse. The crass stance of the conservatives is something to get angry about. They summon God and Jesus in every other sentence because that type of talk gets votes, but in the next sentence (or, covertly), favor the businesses who are getting rich on others’ suffering. It’s incongruous, and it’s hypocritical.
The Associated Press has reported that a few governors may opt to refuse economic stimulus money, including this guy, the governor of my home state, Mark Sanford, R-S.C.:
This, despite the fact that many of these states, including South Carolina, are in dire need of extra cash. In South Carolina, cuts in education have come frequently and local school districts are scrambling in attempts to save money, yet not have the local cutbacks affect what happens in the classroom. The state’s Medicaid program nearly dropped hospice care from its coverage to save cash and other areas are severely being short-changed because of the economy.
Thankfully, according to the AP,
… governors who reject some of the stimulus aid may find themselves overridden by their own legislatures because of language (U.S. Rep. James) Clyburn (D-S.C.) included in the bill that allows lawmakers to accept the federal money even if their governors object.
He inserted the provision based on the early and vocal opposition to the stimulus plan by South Carolina’s Republican governor, Mark Sanford. But it also means governors like Sanford and Louisiana’s Bobby Jindal — a GOP up-and-comer often mentioned as a potential 2012 presidential candidate — can burnish their conservative credentials, knowing all the while that their legislatures can accept the money anyway.
This is ironic indeed since Clyburn is also from South Carolina. Sanford’s rejection of any stimulus money, as Democratic Party chairwoman Carol Fowler seemed to imply, would be cruel to people in this state who stand to benefit greatly from the boost:
He’s so ideological. He would rather South Carolina do without jobs than take that money, and I think he’s looking for a way not to take it.
In short, Sanford doesn’t care about the best interests of the people in his state. He cares about upholding the ideals of his own party. Party over people: That’s a nice mantra, albeit, not a very endearing one … or compassionate one.
Sanford’s office responded thusly, as spokesman Joel Sawyer said,
We’re going through a 1,200-page bill to determine what our options are. From there, we’ll make decisions.
But it may not matter. Hopefully, the lawmakers in Columbia will have enough sense help out our kids, our unemployed, our sick and others who could benefit from relief from all the financial bleeding this state has suffered through lately.