Breaking Down: healthcare and other cultural artifacts

Visit msnbc.com for breaking news, world news, and news about the economy

Above: "Man Robs Bank for $1 To Get Health Care in Jail/"


Liz Goodwin, Yahoo: Suspected domestic abusers go free as Topeka city, county officials bicker over funds

A bitter argument over money in Topeka, Kan., means that city and county authorities have neglected to prosecute or charge people suspected of domestic battery since Sept. 8.
In other words, the local justice system has spent a month effectively sending the message that misdemeanor domestic assault will go unpunished--at least for now. The dispute started last month, when Shawnee County District Attorney Chad Taylor announced that a 10 percent budget cut to his office in 2012 meant he would no longer be prosecuting any of the city's misdemeanors, effective immediately.

The Chronicle for Higher Education,August 11, 2010 "Salary for Interim Commissioner Raises Eyebrows in Louisiana":

Should Louisiana’s interim higher-education commissioner be making $25,000 a month—plus $1,500 a month for housing and $600 for a car?


Balloon-Juice, "This class war thing is more complicated than you'd think":

Archer, 52, abruptly quit her job on Aug. 19 as the No. 2 official at the powerful Department of Administration. She made $124,000 in that position. She was to start the following Monday as legislative liaison at the Department of Children and Families, but began taking paid medical leave that day.

She is making $99,449 in that job – $39,129 more than her predecessor. That 65% pay hike was possible because Walker’s fellow Republicans turned 39 civil service jobs into political positions earlier this year.

Daniel Politi, Slate, Sep. 15, 2011
Postal Service Could Get Slower:Plan calls for shutting down more than 250 mail processing facilities and eliminate 35,000 jobs.

CNN, "Financially-strapped cities cut jobs, services"

Christian Science Monitor, "A long, steep drop for Americans' standard of living"


New York Times, "Use of Private Contractors Don’t Save Government Money, Study Finds"

The government paid billions of dollars more to hire contractors than it would have cost federal employees to perform comparable services, according to the study.

via Gary Farber who writes, "The study found that in 33 of 35 occupations, the government actually paid billions of dollars more to hire contractors than it would have cost government employees to perform comparable services. On average, the study found that contractors charged the federal government more than twice the amount it pays federal workers. Remember: government is inefficient, and privatization is wonderful!"


Louisville, Courier-Journal, September 9, 2011: "Sherman Minton Bridge closed indefinitely due to structural cracks"
via Thom Hartmann,"America’s infrastructure now ranks 16th in the world"

The Sherman Minton Bridge is just one of several bridges in danger of collapsing –- As the American Society of Civil Engineers points out, 34% of all the bridges in Kentucky are considered “structurally deficient.” Of course – Kentucky is the home state of Republican Senate Minority Leader Mitch McConnell – who opposed increased infrastructure spending in the 2009 stimulus bill – opposed it again when Republicans blocked a jobs bill in 2010 – and threw cold water last week on President Obama’s “American Jobs Act” that includes billions in transportation infrastructure products. According to a study by the Urban Land Institute – our nation’s infrastructure needs $2 trillion worth of repairs.

CNN, September 13, 2011: In one year, 2.6 million more poor

Amy Bingham, ABC News, September 13, 2011: "Tea Party Debate Audience Cheered Idea of Letting Uninsured Patients Die"

Carrie Gann, ABC News, Sept. 2, 2011:
Man Dies From Toothache, Couldn't Afford Meds

A 24-year-old Cincinnati father died from a tooth infection this week because he couldn't afford his medication...According to NBC affiliate WLWT, Kyle Willis' wisdom tooth started hurting two weeks ago. When dentists told him it needed to be pulled, he decided to forgo the procedure, because he was unemployed and had no health insurance.

I'm tempted to leave it there and let the reader make her own conclusions. But in 2014 when the so-called Affordable Healthcare Act fully kicks in, people like Kyle Willis and dollar bank robber James Varone still won't have universal healthcare, they'll have a universal obligation to purchase insurance, which isn't exactly the same thing. And if they don't they'll be fined. The plan, of course, is designed to be fully implemented after the 2012 election, and to include subsidies for poor folks.

Why was it designed this way? Was it a good-cop,bad-cop routine played out(and still playing out), not in an interrogation room on a television show, but on television screens nonetheless, before millions? Was it because the republicans are supposed to sweep in and gut funding for the Kyle Willises who need subsidies, so the democrats can't be blamed, and the GOP can tell their supporters they tried their damnedest to get rid of Obamacare altogether, but all they could do was defund it, because the courts wouldn't "let" them get rid of the individual mandate? And so the democrats who voted for the mandates could say, "let us back in power, see what happens when we're not there to protect you?"

What do you think?

Health Care Reform Will Help Everybody

Note: this is a guest post from Barbara O'Brien of the Mahablog. I realize that some may be confused by the byline below that says that it's posted by me, but that's a formality because Barbara is not otherwise on blogger. These are her views.-JV

Many Americans assume the new health care reform act will benefit mostly the poor and uninsured and hurt everyone else, according to polls. As Matt Yglesias wrote, “Basically, people see this as a bill that will take resources from people who have health insurance and give it to people who don’t have health insurance.” Those who still oppose the reform say that people ought to pay for their own health care.

We all believe in the virtues of hard work and self-reliance, but these days it’s a fantasy to think that anyone but the mega-wealthy will not, sooner or later, depend on help from others to pay medical bills. And that’s true no matter how hard you work, how much you love America, or how diligently you take care of yourself. The cost of medical care has so skyrocketed that breaking an arm or leg could cost as much as a new car. And if you get cancer or heart disease — which can happen even to people who live healthy lifestyles — forget about it. The disease will not only clean you out; it will leave a whopping debt for your survivors to pay.

And the truth is, we all pay for other peoples’ health care whether we know it or not. When people can’t pay their medical bills, the cost of their health care gets added to everyone else’s bills and insurance premiums. When poor people use emergency rooms as a doctor of last resort, their care is not “free.” You pay for it.

Another common fantasy about medical care is that the “free market” provides incentives for medical companies to develop innovative new drugs and treatments for disease without government subsidy. It’s true that private enterprise is very good at developing profitable health care products. But not all medical care can be made profitable.

For years, the U.S. government has been funding medical research that the big private companies don’t want to do because there is too much cost for the potential profit. This is especially true for diseases that are rare and expensive to treat. An example of a recent advance made possible by government grants include new guidelines for malignant pleural mesothelioma treatment developed by MD Anderson Cancer Center researchers. Another is a blood screening test for mesothelioma developed by thoracic surgeon Dr. Robert Taub. The health reform act provides for more dollars for such research, from which even many of the tea party protesters will benefit.

The biggest fantasy of all was that people who had insurance didn’t have to worry about health care costs. But the fact is that in recent years millions of Americans have been bankrupted by medical costs, and three-quarters of the medically bankrupt had health insurance. And yes, insurance companies even dumped hard-working, law-abiding patriots. But the health care reform act will put an end to that, and now America’s hard-working, law-abiding patriots are more financially secure, whether they like it or not.

Note: this is a guest post from Barbara O'Brien of the Mahablog. I realize that some may be confused by the byline below that says that it's posted by me, but that's a formality because Barbara is not otherwise on blogger. These are her views.-JV

Aaron Jamison

the verbiage at CNN reads:

Added On April 29, 2010

An Oregon man holds onto his sense of humor even though he has been diagnosed with terminal cancer. KATU reports.

I note that the public health policy dimension, the fact that this man's widow-to-be would be unlikely to face crushing debts in most industrialized countries as a consequence of her husband's health problems, goes unmentioned. Maybe the reporter realizes that in 2014 people will still have these problems, even after Obamacare is fully implemented.

cross-posted at Hugo Zoom.

the real news: Matt Welch discusses European style healthcare

My computer at home is acting up and for once I don't seem to be able to fix it without outside help. As always I am grateful for Rob Payne for more than holding up his end of the horse, as it were. the above is an interview that Paul Jay did recently with Matt Welch of Reason magazine.

Walter Bortz on FORA TV

This was posted very recently, although as far as I know Bob Graham is retired from the senate. The rest of Bortz's comments are posted here at the FORA website.

In case you missed it

In case you missed it, I think Luke Mitchell's essay awhile back in Harper's on healthcare reform, "Understanding Obamacare", is a good explication of what just happened in front of our eyes.

In conjunction with Mitchell's essay, I find the anger on the Left at Jane Hamsher for pointing out how badly the current version of healthcare reform sucks sadly familiar. And I expect in a few years the Hamsherites will be resented even more by many Dems in the blogosphere for being right.

My only quibble with Mitchell's piece is that he sees the Democratic Party as usurping the Republican Party's role of actively representing corporations. Which it has. But my guess is that the current link of extruded sausage will be so unpalatable when served to the American working class that the Democratic Party will be left holding the bag and will suffer the consequences.

When this happens, the Dems doing the work of the corporations (see: Bill Clinton, GATT, NAFTA, etc.), you get people searching for alternatives, like teabagging, death-paneling, or Contract-With-America-ing hoaxes, which get enough resonance from reactionary media outlets to put Republicans back into power.

Not that Republicans (or Democrats) are so much in power as much as in a position to serve their corporate owners. Not that all Democrats are exactly equal to all Republicans. I find the Republican brand particularly loathsome and its mythology much too close to the mid-20th Century fascist movements. Those few Democrats on the left (you know, showing some concern to the great unwashed and uninsured), unfortunately, will get tarred for going along with Obama and will get eliminated in future elections, leaving the Ben Nelsons and Max Baucuses, thoroughly protected by corporate money, to march into the future with the Democratic brand name.

So in the name of healthcare reform the Democrats will pass a health insurance bill for insurance companies, get the blame for the predictable consequences, and the Republican obstructionism will be rewarded with yet another Reich.

So it goes.

Crystal Lee Sutton and Norman Borlaug

Crystal Lee Sutton died on September 11th of cancer at 68. Norman Borlaug died the next day, also of cancer, aged 95. I'll admit I'd never heard of either. Crystal Lee Sutton, the real life inspiration for Martin Ritt's Carter-era film Norma Rae-- I just assumed she was fictional, but she was real, and apparently the most famous scene from the film really happened:

She received threats and was finally fired from her job. But before she left, she took one final stand, filmed verbatim in the 1979 film Norma Rae. “I took a piece of cardboard and wrote the word UNION on it in big letters, got up on my work table, and slowly turned it around. The workers started cutting their machines off and giving me the victory sign. All of a sudden the plant was very quiet…” Sutton was physically removed from the plant by police, but the result of her actions was staggering. The Amalgamated Clothing and Textile Workers Union won the right to represent the workers at the plant on August 28, 1974.

-from her website, www.crystalleesutton.com

I don't know if you can film something verbatim per se, but that's a trifling objection. According to the Institute for Southern Studies

Several years ago, Sutton was diagnosed with meningioma, a type of cancer of the nervous system. While such cancers are typically slow-growing, Sutton's was not -- and she went two months without potentially life-saving medication because her insurance wouldn't cover it initially. Sutton told the Burlington (N.C.) Times-News last year that the insurer's behavior was an example of abuse of the working poor:

"How in the world can it take so long to find out [whether they would cover the medicine or not] when it could be a matter of life or death," she said. "It is almost like, in a way, committing murder."


Though Sutton eventually received the medication, the cancer had already taken hold. She passed away on Friday, Sept. 11 in a Burlington, N.C. hospice.

Norman Borlaug was also an incredible person, albeit of a very different cast. After receiving his PhD at the age of 28 he went to work for the US military in WWII, first developing a saltwater-resistant adhesive that allowed US forces to jettison watertight boxes of canned food to troops stranded on Guadalcanal island. In the years after the war he was instrumental in developing disease-resistant high yield crops that helped India be able to produce enough food to feed all her people.

He won the Nobel Peace prize in 1970, and consequently his passing made a lot more news than Sutton's. I don't mean that as sarcasm-- he certainly helped a lot more people. But also it occurs to me that although they were both humanitarians, his story, broadly speaking, has a certain uncomplicated quality, at least from the point of view of corporate news outlets. American scientist helps feed world, is justifiably celebrated, dies after a long rewarding life. Sutton's story is less rewarding for the corporate media to tell, because it is less sunny, underscoring the hostile legal climate that unions inhabit in the US, as well as our vanishing industrial base.(She worked in a clothes factory in North Carolina, and today most domestic clothes production has been exported out from under us.) Even the end, with her conflict regarding her insurance, is a story the corporate media isn't so eager to relate to us. Katie Couric didn't mention that last bit on the CBS news, but at least she mentioned her.

You can find less sunny aspects to Bourlag's story if you are really determined; he was an early proponent of DDT*, for example,but so were a lot of people. Nevertheless he was always trying to help people, and there's no question on balance he did, tremendously. Yes, Borlaug was a booster of genetically-modified foods. But at least until we can figure out how to feed everybody, stop raping the planet, and substantially shrink the world population(through as-yet undiscovered, ethically and socially doable means), I'd say his way is the right way for much of the third world, handily trumping lefty-doctrinaire objections.

I'm not keen on some of the particulars of corporate farming, like counterproductive US subsidies of ethanol or patenting seeds and telling third-world farmers they're intellectual property, but screwy consequences like that were not Bourlag's doing.

I don't have a penetrating, overarching point in discussing Sutton and Bourlag-- my blogging is often simply a record of efforts at my self-education, and I wanted to take note of their passing.


"*Food Security and Agriculture" by Devinder Sharma

Regarding Hillary's 2008 plan, and individual mandates

OK Buzzcook, I read the lengthy(4,000+ wd) post you referred to in the comments,
"An analysis of Clinton's [2008]Health Plan Proposal"

Robert Laszewski talks about how H. Clinton's 2008 healthcare plan(hereafter I'll just call it HRC-08)says that there will be a public option allowing regular people to buy a plan that's the equivalent of the "Federal Employee Health Benefit Program", something a lot of pols talk about.

Yes, the healthcare plan for federal employees is pretty good, but SO WHAT? If you've ever actually looked at buying health insurance on your own, you'd see that the major companies don't offer a one-size-fits-all plan for everybody, but rather a pretty wide array of plans, with the economy plans offering negligible coverage with high deductibles, and the top of the line plans offering at least as much coverage at the "FEHBP" plan, sometimes more. If you're curious, go to www.ehealthinsurance.com and plug in your personal data and see what's available to you. Blue Cross and Humana, for example, offer an especially wide range of plans, but the prime ones are well out of my reach.

(incidentally, the reason I recommend you look at ehealthinsurance is because they don't ask you, as of this writing, for an email or home phone number, which many of the other online comparison services do, presumably so agents in your area can subsequently pester you. For the record I have not purchased anything from them, just window-shopped.)

Laszewski also discusses the HRC-08 approach to individual mandates,

"Limit Premium Payments to a Percentage of Income: The refundable tax credit will be designed to prevent premiums from exceeding a percentage of family income, while maintaining consumer price consciousness in choosing health plans."

OK, the devil in her plan finally shows itself. Tax credits are all well and good, but what if they're not enough to purchase decent coverage? Then you have to purchase sub-standard coverage(I guess that's where "consumer price consciousness in choosing health plans" comes in.)

I'm a male in my 40s, and from what I've looked at, it would cost me at least 250/month to purchase meaningful coverage, as opposed to plans with 3,000/yr or 5,000/yr deductibles* that don't cover dr's visits until the deductible is satisfied, which are often more "reasonable."

Except they're not. The canard that individual mandate proponents often trot out is that individual mandates will force healthy people to buy coverage when they're well, and quit gaming the system by waiting until they're sick, implicitly suggesting that is what the bulk of the nation's 45 million plus uninsured are doing.

I don't believe that for a moment. If I had a spare 250 dollars a month I would buy a policy, but I'm really poor. I'll wager that most people who don't have health insurance just can't afford it, and some have looked at the bargain-basement policies and figured out they're essentially worthless. And of course some had insurance and were bumped by their insurance companies, and can't find anybody who'll cover them, except at exorbitant rates.

Let's say you are a cashier or a short-order cook, earning 8.50 or 9 bucks an hour. (Let's also assume you have no dependents and no pre-existing conditions.)

Sure, maybe you could, with some difficulty, afford to enroll in a plan that only costs 80 or 90 bucks a month, assuming you can stay healthy and don't actually need that 80 or 90 bucks that month, should you actually need to see a doctor and buy some medication, something the economy plans generally wont help you with, or will only help you a spitting-in-your-poor-face, token amount.

Let's see. You're paying 80 bucks a month, 960 dollars a year, the doctor charges 80 bucks for a visit, and the 80 bucks a month plan reduces your out-of-pocket expense to 45 bucks? Wow! But you don't have 125 bucks to spare on healthcare for the month, not if you want food, and some electricity? You're a bum.

And since you're making, say,18,000 dollars/yr, that 960 bucks a year is still too little to deduct off your income tax, because even if it's more than 7.5% of your taxable income, you still don't make enough to be able to itemize.

My point, buzzcook, is that plans with individual mandates are eminently gameable-- they're designed so the politicians can take credit for dramatically reducing the number of uninsured folks while forcing a large segment of society to buy junk policies, by defunding vouchers so they only pay for worthless coverage, or by making eligibilty for tax credits that phases out below a certain point, in the same way that making something tax-deductible means only people who make enough money to itemize may benefit.

Do I know HRC created a plan with this aspect designed to be a deliberate gimmick? No, but I don't have to. It's not about her, any more than it's about Obama now that he's president. It isn't even about the democrats. It's a systemic vulnerability that's built into individual mandates and that's why it's foul public policy, period. I'm sure you've heard of unfunded mandates in other contexts.

They won't call it cutting the plan off at its knees;

they'll call it "reaching a bipartisan solution" or

"allowing the private sector breathing room to innovate"

and when a New York Times story about some Duke or University of Michigan study questioning the effectiveness of individual mandates comes out 3 or 4 years later, it will studiously avoid connecting the dots, to prove that the democrats deliberately created legislation to "allow" themselves to be played by the other guys, as they both wink at each other from across the aisle.

That's why I think my criticism of HRC-08(and BHO-09) is legitimate.

Later this week I'll post about my thought on how to fix healthcare. Maybe my ideas will be just as flawed, just differently flawed. We'll see.

(*I've even seen some companies offer 7,500/yr deductible plans, although they're still rare.)

a reminder, from February 2008

Yes, another gripe about Obama from his left. This was an ad that his campaign ran against HRC in Feb 2008. At the time somebody at dKos criticized it for being unfair. It struck me as fair, since individual mandates struck me as a public policy abomination in '08, when Obama apparently opposed them. Today, in the fall of 2009 he supports them, and they're no less foul.

The Liberal Gipper

www.reelectkucinich.com

Avedon Carol: This was not unexpected, and for some time I have felt a certain sadness in knowing that his long fight for healthcare was devolving into the mishmash of betrayal and lies we have now, after everyone made such a big deal of passing healthcare legislation at last "for Teddy", and that he was likely to go out seeing that dream once again becoming a shambles. I also feared that some people who should know better (including, it seemed, Kennedy himself), were pushing too hard for a plan - any plan - just so they could get Obama to sign it before Teddy died.

Well, obviously, if anyone was in a rush to pass the plan so Teddy could see it signed, that urgency is gone, and if any good can come of his passing, I hope it's that they rethink this whole hurry-up-and-wait-for-worse-than-nothing project the Blue Dogs (including, as near as I can tell, Obama himself) have been saddling us with.

Dennis Perrin: You can say a lot of negative things about Ted Kennedy that were true, but the man was as much of a progressive force as this rotten system allows.

Louis Proyect: "Ted Kennedy as New Dealer?"(with thanks to Dennis P. for the link.)
Jimmy Carter on Kennedy in 1979

and Carter on Kennedy in 2009[video]

My mother was in love with the Kennedy mystique, especially with JFK.And while I am close to Dennis Perrin's age, Dennis being similarly impressed with Teddy, I nevertheless have difficulty sharing his enthusiasm, or my late mother's. Dennis rightly notes Carter's rightward tilt, and certainly Carter started some of the unfortunate deregulation that Reagan subsequently kicked into high gear. All the same, I don't think Carter was as ideologically indistinguishable from Reagan as Obama seems compared to McCain-- and I wonder to what degree we have Teddy Kennedy's hubris in staying in the democratic race just past the bitter end to thank for Reagan being elected in 1980.

From my vantage point it seems that a lot of left-wing bloggers who frequently bash Obama, however right they may be in doing so, often have something of a tin ear when it comes to "less-sexy" domestic policy issues. If they praise Kennedy for being to the left of Carter and a "liberal lion", I can't help but think that they fail to see Kennedy's blindness in dealing with Obama and his wretched, poisonous, healthcare plan. The ancient Greeks used to say you could not judge the quality of a man's life until his very last breath. My primitive understanding of Western classical culture being what it is, I think they were talking about the private,personal quality of life the person experienced, as opposed to the person's public character, so it's an ill-fitting metaphor-- but I'll use it.

Yes, Ted Kennedy did some good things, like help foster the COBRA healthcare act, but he himself described universal healthcare as the cause of his life, and if you judge him by what he did to help usher it in towards the end, he blew it pretty badly.

Read his July 18th essay in Newsweek, also entitled "The cause of my life" in which he criticizes Jimmy Carter for what he calls his piecemeal approach in 1980, and says, regarding the current legislative effort, that "Incremental measures won't suffice anymore." But then Kennedy goes on to say he doesn't support a single-payer scheme because he feels it's impractical, and he does support a "public option", as well as individual mandates. (But hey, Carter's approach was piecemeal.)

Kennedy was dying and he knew it, but as far as I can tell he said nothing about the gradual gutting of the legislation over the course of the summer, nor anything about Obama's very public vacillation regarding his support for the public option. I'm not trying to be sarcastic or hurtful by speculating that maybe his cancer influenced his effectively taking a dive for Obama and the blue dogs. Maybe he was too weak at that point, maybe he deteriorated rapidly in the final weeks. Maybe, for that matter, his July op-ed(prepared with Bob Schrum)was "in the can", ready to go for some time, and was more a reflection of the political undercurrent of weeks or even months earlier.

I've already touched upon why I think that individual mandates are a poison pill that will actually make many people's access to healthcare worse and will end up costing us more collectively, but I think I need to flesh it out more next week. For now I want to close by noting the exasperation I feel with sloganeering and catchphrases being used as a substitute for fleshing out the details of how various "reform" proposals might work. You see it on both sides, actually-- whether it's the nuts who think that any sort of healthcare reform offered by democrats is "socialism" to the lock-step progressive-lite liberals who call it "the public option" and may also think it's socialism, albeit approvingly. I'm guessing that substantial people on both sides think the public option actually IS the same as a single-payer scheme.

Politicians and teevee talking heads toss these terms back and forth to obscure policy details and get the dunderheaded troops riled up, and the foot-soldiers of both sides comply, repeating them without questioning. Although some of the right-wing activists seem more in need of anti-psychotic meds then their progressive counterparts, I'm guessing they'd both be angered if somebody told them they were all just stooges for a one-party system.

But now what will happen, with Teddy gone? I avoided the telly today, so I don't know if smart teevee people were soberly chattering about this, as if the whole country didn't know he was dying. But what really makes me want to retch is the inevitable invocations (www.honorkennedy.com. No, really, it's already up.) to "do it for Teddy", i.e., to marshall another handy figure of speech, like socialism or the public option, designed to silence dissent when they sell you a rotten piece of legislation. The expected honoring of his memory may even constitute an opening to water it down further.

As Avedon Carol says, "it's time to junk the whole current proposal and go back to square one. Demand single-payer now, at the very least."

Do it for sick, broke people you've never heard of who are still alive, or simply because you may be one of them someday. If he was this great lion of liberalism that people said he was, you'd think he'd prefer it done for them.

Why I mistrust Obamacare, pt 2

A reminder(above). This is from a speech Obama gave in Chicago in 2003. I guess that was then.

See also:

San Francisco Chronicle/AP, July 3rd:
"Under Senate health care plan, either way you pay"



John Dickerson, Slate, Tuesday, July 7, 2009:
"Going Public, Quietly: Why Obama wants to be as vague as possible about health care reform"



Michael Lind, Salon, July 21st: "Healthcare reform: More raw deal than New Deal"
We need universal, citizen-based healthcare. It doesn't look like Obama and Congress are ready to give it to us



Bruce A. Dixon, Black Agenda Report,Weds, 07/22/2009:
"Is the Obama Health Care Plan Really Better Than Nothing?"

(via Skookum)


Lambert at Corrente, 7/21:
'How the Dems and "progressives" are selling you the "bait and switch" of public option'



and finally, Wikepedia's US healthcare reform article, which keeps growing. More later.


cross-posted at Hugo Zoom.

Saturday 25 July 09

Gawker's headline read:
"John Yoo Briefly Disturbed By Consequences of His Actions"

(via xymphora)

Salon commenter "mary_steyr" refers to that portal as
"the Parade Magazine of the Volvo and latte set"


not all lefty bloggers are bowled over by Obama's presumptive charm and agenda. Here's Avedon Carol:

people are starting to notice that Obama is just more of the same, only with better syntax. Maybe it's true that his ego made him think "bold" and decide to get a healthcare package this year, even if it's a crap package - but I doubt it. I think his desire to be seen as "respectable" by a bunch of right-wingers led him to shy away from presenting a plan that really works and making the case for it. He hasn't been bold at all - he's backed way off of single-payer, of ending the war, of transparency, of basically every promise he made or implied he was making. He knows perfectly well no one voted him in to give their money to Goldman Sachs and force them to buy crappy health insurance that still doesn't deliver healthcare. He's blown it because he didn't have the guts to do the business.

I wish I knew how to embed this very brief and very droll animation by Ann Telnaes.


Humana has an animation up as well, designed to explain health care reform, or to avoid explaining while seeming to, depending on your point of view. To be fair it's no worse than what various pols like Obama or Charles Grasley have been saying by way of explanations. It includes that by now familiar insinuation about how people who don't have insurance are primarily healthy people who just don't want to get insurance until they need it. The greedy uninsured, driving costs up for everyone. How many people actually believe this?

cross-posted at Hugo Zoom.

Why I mistrust Obamacare, pt 1

This is what I wrote in response to dday's "Whitling Down to Nothing" at Digby's Hullabaloo earlier this month.

First, I quoted another commenter, "pataphysician":

"I'm worried that a Health Care "reform" bill will be passed and signed that will include mandates, and taxing of Employer health benefits, with no public option and only subsidies for those who rank among the poor. Obama ran against many of these ideas, only to say now that he is Ok with them. That he says that now, makes me worried that they will happen. This would be much, much worse than our current system, as we will all be paying taxes essentially to private insurance companies for some of the crappiest care possible."

[incidentally, the comment thread led me to believe that Digby's commenters, by and large, seem to "get it" more than the people who write the blog. The bloggers are undoubtedly decent and well-meaning, but their perspective seems compromised by their apparent need to carry water for supposedly mainstream congressional democrats.-JV]

I wrote:

As Digby said earlier, if any sort of healthcare reform bill passes, the democrats will own it. Mandates and extra taxes will stoke class resentment while essentially helping nobody-- apart from the private insurance companies and people eager to paint democrats as being the stuff of the worst republican stereotypes: intrusive government(mandates), and more taxes for negligible benefits that only accrue to the very poor.


I am poor, and I don't want the democrat's plan. It's not because I'm stupid, but because it will likely cause me harm and make me poorer still. Consider: if a plan with mandates forcing employers to provide health insurance for their workers or for individuals to buy their own insurance passes, poor people like me will just have to hand over a certain portion of our very meager incomes to insurance companies for worthless insurance plans just so we can "stay legal."

Oh, but what about your employer? If your subsistence job as a cashier used to offer no benefits, now it will have to...

I doubt it. Far more likely I will lose my job and be reoffered the same job, only reclassified as an "independent contractor," doing the same work after agreeing to the new job(shh! employment contract) description in which I "voluntarily" surrender my benefits. Maybe my employer will even provide a handy toll-free number to call where I can have a call center rep offer me advice on how to score government benefits, or choose between private plans.

well, if that happens, you would get assistance paying for your insurance from the government...



I doubt this too. The 1st TNR article you quote says that subsidies presently taper off at around 88 thou for a family of four. How much do you want to bet this will be adjusted downward in the negotiation towards a final bill, and that if I get a job that pays as little as ten bucks an hour I will suddenly find myself making too much for the subsidy? (And besides, why should I be humbled into accepting a subsidy because I'm suddenly obligated to by insurance? Screw paternalistic politicians of all stripes, on both the left and the right, who want me to beg.)

Well, at least you'll have insurance...

Will I? Digby and dday, I invite you to go to some online price-comparison service that offers health insurance quotes. If you do go to such a site(they often have ads on Yahoo and other mass portals), you'll see that many of the larger insurance companies offer multiple insurance products, that range from over 500 bucks a month to less than 100/month.

If I'm making 10 or even 11 an hour, even if single and without dependents like me, the bells-and-whistles policies are essentially out of reach, and all I might hope to afford is a sub-100/month policy.

They usually have a 5,000/yr dollar deductible. I saw one company that also offered a max deductible of 7500/yr. Generally these policies only pay once you've met the deductible, period. No payment for a routine dr's visit, or even to go to the emergency room, and no prescription drug benefit.(I've also seen slightly more "expensive" plans that do offer prescription drug coverage, usually paying 50% of the cash cost, usually with a 500 or 1,000/yr limit.

So, if it plays out as I've suggested, and if I'm making 10 bucks an hour(I wish!)and don't qualify for a subsidy, maybe I'll have to shell out 600,700,800 or more bucks a year for phoney-baloney coverage, even though I'm poor, just so the government doesn't fine me and pays me my tax refund.(Money I could be otherwise spending, on say, actual healthcare, like when I need to fill a prescription.)

No thanks.


If this kind of twisted "health care reform" passes, it'll be worse if than nothing passes for the working poor.

In fact it will also make subsequent fixing of the bad law substantially harder, because the private insurance companies will fight like hell to hold on to the subsidy they gained under Obama in 2009.

Insecurity State

artist: Amanda Moeckel


Steve Gimbel in Philosopher's Playground, a new blog(well, new to me), notes that the World Health Organization recently assessed the healthcare systems of most member countries and ranked the US 37th. Behind virtually all Western European countries, but also behind Costa Rica, behind Chile, even behind Morocco and war-torn Colombia.

From his essay:

...insecurity is the most important force in shaping American society. It manifests itself in two ways. In the middle class, it is class insecurity. There is the sense that our kids will not only fail to have more than we have, but that they may fall from being middle class. This is why schools are simultaneously turned into prisons providing environments that are not conducive to learning and overburdening our kids with too much homework. If they don't get into the right pre-school they won't get into the right college and then they might not end up with a good job. The kids are so risk averse that they refuse to think interesting thoughts. Just get the B, just don't screw up. It is there in the way we create gated communities both in terms of actual gates and in terms of infrastructure. We can't build public transportation because then the wrong kind would have easy access to our homes and our stuff. It's all fear of losing our stuff and our kids not being able to get it for themselves. Look at our drug laws, look at the way we pay for schools through property taxes, look at the discussions around affirmative action. The group of voters who went for Reagan and Clinton are governed by class insecurity and both of them knew it and played them like a fiddle.

The middle class doesn't want health care reform, not because they think ours is the best system in the world, but because it is good enough for them and they are afraid that helping someone else would be a zero sum game and thereby cost them. It works for me and mine so don't mess with it. Insecurity leads to malicious, selfish inaction.

I think there's a bit more to it than that, since this is, to an extent, one of those "people are so X because of Y" arguments, when in fact our society is increasingly less homogeneous and that argument, irrespective of the particulars you replace X and Y with, gets increasingly harder to make. Maybe, as a sort of corollary to Gimbel's thesis, it would be interesting to explore the ways that popular media reinforces our more reactionary traits and deliberately avoids discussing contrasting qualities we have.


Nevertheless his blog looks like a fascinating place to visit and the essay is worth reading in full. Go read the rest here, "Insecurity as an American Social Force"

(via Helmut at Phroneisisaical.)

cross-posted at Hugo Zoom.

losing coverage

via Christy Hardin Smith, and Avedon Carol, who writes:

It's not just the uninsured; it's the outrageous fraud that people who think they have health insurance are faced with: companies that take your money knowing they will do their damnedest not to give you what you think you are paying for.

cross-posted at Hugo Zoom.