I wish this wasn't my country.

[pecunium]

Not just my country, but my state (which would be in the top 10-15 percent of nations in the world, if it stood alone as a nation), and what I, mostly think of as, "my city."

It's painful, and sad.

A brutal truth about American Healthcare

They came in their thousands, queuing through the night to secure one of the coveted wristbands offering entry into a strange parallel universe where medical care is a free and basic right and not an expensive luxury. Some of these Americans had walked miles simply to have their blood pressure checked, some had slept in their cars in the hope of getting an eye-test or a mammogram, others had brought their children for immunisations that could end up saving their life.

The LA Forum, the arena that once hosted sell-out Madonna concerts, has been transformed – for eight days only – into a vast field hospital. In America, the offer of free healthcare is so rare, that news of the magical medical kingdom spread rapidly and long lines of prospective patients snaked around the venue for the chance of getting everyday treatments that many British people take for granted.

This isn't country I was reaered to expect. It's been a demoralising 15 years. From the congressional lynch mob which hounded Clinton, to the orchestrated riots to suppress voting and steal the 2000 election (when one tries to suppress votes, that's stealing the process. I don't care what you think of the Bush v Gore and how it gifted Bush the Presidency. Importing operatives to scare people away from counting ballots is what thugs and tyrants do), the quescient acceptance by the Congress, the Media and the Populace of the blatant; admitted, felonies of the Bush Administration, the acceptance of torture as a tool (and make no bones about it, as a nation we have accepted it... the continued existence of the debate proves it).

Add the people who feel the need to show up at venues where Obama is speaking with guns on display (which is damned foolish, and counter to their probably aims, but I digress).

I begin to wonder if the idea which was the United States,

We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity,...

Noble fucking words. Some of the most stirring stuff I know. But then I read of things like this...

Christine Smith arrived at 3am in the hope of seeing a dentist for the first time since she turned 18. That was almost eight years ago. Her need is obvious and pressing: 17 of her teeth are rotten; some have large visible holes in them. She is living in constant pain and has been unable to eat solid food for several years.

"I had a gastric bypass in 2002, but it went wrong, and stomach acid began rotting my teeth. I've had several jobs since, but none with medical insurance, so I've not been able to see a dentist to get it fixed," she told The Independent. "I've not been able to chew food for as long as I can remember. I've been living on soup, and noodles, and blending meals in a food mixer. I'm in constant pain. Normally, it would cost $5,000 to fix it. So if I have to wait a week to get treated for free, I'll do it. This will change my life."

We need some sort of National Health care, to "promote the general welfare." It might be argued that it's in the interest of trying to, "insure domestic tranquility," because this can't go on. The gaps between the haves, the have nots, and the "just barely haves" are getting greater. The sense of a continuum is fading.

There need to be some systemic changes. Money doesn't equal speech. Corporations aren't people. "Fuck you, Jack, I got mine," is no way to run a country. The CEO of Whole Foods just had an OpEd in the Wall Street Journal where he offered, "The Whole Foods Alternative to Obamacare (which gives you an idea of the content). Suffice it to say he thinks the status quo is so-so. There is, you see, too much regulation of insurers.

What we need are high deductibles and "health care savings accounts", so people will take better care of themselves (eating more organic greens, and high fiber foods... honest, he says that). Right. That's gonna help the person with RA, the guy with congestive heart failure, the woman with bone degeneration.

The guy who breaks his leg is going to stop to negotiate a better price for treatment. He will take the time to weigh the merits of a titanium pin for $8,000, or a plaster cast for 4,000. I'm not a doctor. I'm not in a position to dicker.

But no, he offers up the idea of making it more expensive to be sick as a cure for high costs. But he wants more.

• Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.

• Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.

Got that, consolidate (that worked so well for banks), and make it easier for insurers to cherry pick the people who are either healthy, or have diseases they can nurse along for profitable sales of drugs, and equipment, under those high deductible/Healthcare Savings Accounts he likes.

This is the icing on the cake:

• Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren’t covered by Medicare, Medicaid or the State Children’s Health Insurance Program.

Got that. The rich will deign to contribute to the poor. Mercy, like a gentle rain from heaven shall drip down to us. What the hell is wrong with making a big pool and sharing out the risks. The US is ranked fiftieth in life expectency. The "best healtcare in the world can't keep up with Jordan, Puerto Rico, Austraila, Canada, France, Britain, the Cayman Islands, the Virgin Islands, and 41 other nations in keeping it's people alive.

The cherry... he says the reason we can't have some form of national healthcare is the lack of it being included in the Declaration of Independence or Constition. Well guess what dude.... corporations (like the one you run) aren't mentioned by name either, so perhaps we ought to just dissolve it.

Yeah, I'm bitter. He has no worries. No one is telling him he's uninsurable. He's never going to suffer from having one treatment cause secondary problems he can't afford to fix. "Fuck you, jack. I got mine." And the people who have theirs are convincing a lot of other people to support them in fucking the rest of us over.

The Gettysburg Address ends with the hope that "this government, of the people, by the people, and for the people should not perish from the earth. Right now I'm afraid it will; because the things needed for the people, are being crushed. The past 15 years have diminished it, and the present doesn't seem to be doing much to haul it back to any sense of where it was.

Not with a bang, but a whimper.

Comments

[aberrantangels]

A year, give or take, after delivering the Address, Lincoln predicted the very thing you and I see happening:

"I see in the near future a crisis approaching that unnerves me and causes me to tremble for the safety of my country. As a result of the war, corporations have been enthroned and an era of corruption in high places will follow, and the money power of the country will endeavor to prolong its reign by working upon the prejudices of the people until all wealth is aggregated in a few hands and the Republic is destroyed."

[feonixrift.livejournal.com]

What worries me, is how many people there likely are who are a lot like me. This is nearly exactly the world I was reared to expect. How many people aren't angry, simply because they don't know it can be any other way?

[pecunium.livejournal.com]

How many aren't angry simply because they don't know? I cannot imagine. There are a lot who are angry because they have been told all other ways are worse.

Woe betide them who led them so.

[izzydesan.livejournal.com]

This. Thank you, thank you, thank you. I wonder how many of the protesters outside these town hall meetings and the ones yelling for no healthcare reform were standing in those lines. I bet there were more than a few. Those same people who are waving their copies of the Constitution and screaming for the government to keep their hands out of this issue and how reform isn't needed. I look at the people and the faces in the pictures of the protests and unless they are in costume, they seem like lower to middle income class people, many, I am willing to bet who don't even have their own healthcare and are just lucky not to need it at this moment. They are stooges of the rich, of the right, of the healthcare megaindustry, of political celebrities such as Limbaugh and Hannity and Palin. They don't ask questions and don't even realize that they are hurting themselves because it feels so good and so much better to say "Fuck you Jack" rather than pitch in a few dollars, so that everyone can share in what should be the healthy prosperity of this nation. This issue makes me so angry that I have trouble being coherent in my thoughts. So I thank you for putting down in words what I have been feeling.

[cucumberseed.livejournal.com]

I do not see how this country can possibly recover.

[pecunium.livejournal.com]

The only way (I fear) is an active populace, a large turnover in the house; which puts the fear of god in the Dem Senators, and a large turnover on the court.


The idea that money = speech, and the right-leaning stranglehold on the people who hold the bully pulpits, those are hard nuts to crack. If we can crack them, or get people who are actually center into office (it's too much to ask for an actual left of center batch of politicians right now) then the ship of state can be turned.

But we've long favored property (in the form of business interest), which is a difficult thing to counter, as its influence accrues. Corporations don't die in the way people do, and so they can pursue their interests for decades, even centuries.

[lorebubeck.livejournal.com]

This.

Sometimes I dream about having Tom Clancy's book where the plane crashes into the joint session of Congress w/ the Justices in attendance and kills them all so they have to start over come true. (sorry for the run on....)

[schwa242.livejournal.com]

Once a year, hundreds of dentists sign up with Colorado Mission of Mercy (http://cdaonline.org/index.php?option=com_content&view=article&id=55&Itemid=194) to provide free dental care to residents of Colorado for one day. Last year, I went, as I had (and have) no medical or dental insurance. Fortunately, it was just a few miles from my house. I got there before the sun came up, about three hours before doors opened, and already the line was a few thousand feet long. There was a long period of processing, and after an initial check up (where I got oohed and aahed over being a cheek chewer that chews on both sides... most just pick one), you could pick one or two items from a list of six that you wanted dealt with (such as fillings, extractions, cleaning). I went for cleaning and fillings. I was a bit of a wuss during the novocaine injections, as any time I had fillings in the past, I had insurance and went through the gentler process of multiple injections that numb the gums before the hardcore shots go in. I had no idea how painful that medicine would be without prepping the mouth in stages. But, free is free and pain is temporary. My friend Jason went in for a couple extractions, so I'm sure he had a fun go of it.

I got xrays on my wisdom teeth, and they said it would probably not be in my best interests to extract them at the event. The roots are corkscrewed around and look like ram's horns, and would require quite a bit of additional work to deal with. So, some other time then.

Everything was housed in a large auditorium, and had an eerie wartime feel to it (at least by what TV and movies tell me). This auditorium is generally used for entertainment purposes, whether it be bike shows or judging 4H livestock. People waited in line while watching hundreds of dentists work on patients in individual chairs. Just a year prior, I had a job where my copay for a $7000 hernia surgery came to $100 (along with $200 monthly premiums... man do I miss that insurance), and now this.

My wife is looking to get time off work so we can go to this year's event next month. I work at home, so it's not a big deal for me. The people who put this on do a wonderful job putting it together, on top of being generous enough to provide free services. I'm looking forward to a happy mouth again, but I am dreading those shots.

[shunra.livejournal.com]

I'm rather afraid that what we'll see will be a rather large bang.

[pecunium.livejournal.com]

I am afriad of a lot of possibilities. The quiet ones are, sort of, worse than the loud ones. Too much Orcinus coupled with a lot of stress in my life right now.

If I were less worried about money, I'd probably be a little cheerier.

[shunra.livejournal.com]

The recession and the two wars *really* push forward the bang or the multiple whimpers :-(

Isn't that how empires always go down, spending themselves on empirical pursuits?

[niamh-sage.livejournal.com]

My god, I didn't know it was so bad. :( :( :( I really cannot understand why anyone in their right mind would oppose reforming a system that is so obviously and catastrophically broken.

Has anyone suggested anything along the lines of what exists in Australia? There, everyone pays a medicare levy as a part of their income tax, and that goes to build a health care system that everyone, regardless of economic circumstances or place of employment, can access. Private medical insurance is optional (but really pushed to those who can afford it), but everything that someone needs to maintain basic health, or might need in an emergency, is available through the medicare system. It's not always perfect and there is a wait for elective stuff, but under that system, the woman with the tooth problems in the story would never have had to wait so long or get so bad before she got treatment.

Finally, I always appreciate when you write about this stuff. You make it so much clearer than others I've been reading. Thank you. And I am really hoping that the healthcare reform works out.

[pecunium.livejournal.com]

It's been suggested. Just taking the present system (medicare) which applies to people over 65 (which allows for supplemental insurance plans) and making it available to everyone, is that very idea.

It's "socialism" if we give it to everyone, instead of something people have to survive to get.

It really does seem to be the well to do; who don't see any benefit to the less well to do being better to do, businesses which don't want job portability (which is a huge part of how we got here), and insurers/some providers; who want to keep making immoral money, acting in concert to keep things in the present morrass.

[harimad.livejournal.com]

Given the existence of Medicare and the recent creation of Part D, I DO NOT GET the cries of "socialized medicine!" We have it, people work very hard to protect it, we expand it.

Thanks to a dinner a couple of nights ago I do have a little more insight to a problem that doctors have with the Medicare model. If a dr accepts Medicare, ze has to charge the Medicare price to _everyone_ ze provides that service to. Even if that person is covered by a different insurance and even if that insurance would otherwise pay him a higher price.

[elf]

Everyone is in favor of reforming it. It's who pays for the reforms, and who benefits from them, and what exactly gets reformed, that are in debate.

everyone pays a medicare levy as a part of their income tax

A nice idea... except that a number of poor families in the US pay no income tax. (Supporting a family of four on $15,000/year means paying no income tax.)

And the basic theory pushed by the wealthy is "they should work for their medical care, not have it handed to them!" (With the unspoken corollary, "erm, or they should be lucky enough to be born into a family that provides it for them without working.")

The problem with the American rags-to-riches stories is that they are used to promote the idea that anyone who is still living in poverty is lazy or stupid or both, because obviously a hard-working, clever person can ALWAYS get an education, good job, access to a low-crime neighborhood, and so on.

Right now, Obama's presidency is being touted as "proof" that "racism no longer exists"--because if one black man can get elected to our highest office, obviously there exists no discrimination in any other places.

Similar arguments are used to "prove" we don't need national health care--here's the story of the girl who paid for cancer treatments by selling newspaper subscriptions, the tale of the housing project that collected loose change to pay for each other's dental visits, the kid from the slums who got a scholarship to medical school, and came back to his old neighborhood to treat people for what they could afford. And those who don't want national health care (which mostly means "don't want to pay for healthy strangers") ignore the thousands of cases that contradict those.

Most of the contradictions are short and brutal; some are just cruel. The kid who got hit by a car, and died in the ER because nobody recognized the internal bleeding in time because the ER is packed on a Saturday night. The woman looking at death in labor because her health insurance was canceled. (Locked post; definitely worth joining to read.) The six-week death from cancer that could've been treated any time in the last three years... if diagnostic tests weren't so expensive. The diabetic now on permanent dialysis because she couldn't afford a steady supply of insulin.

[niamh-sage.livejournal.com]

See, those sort of examples boggle my mind - people who die unnecessarily because they can't access even the most basic treatment. And the justifications used ... ARGH.

[hammercock.livejournal.com]

The more I read about John Mackey, the more I want to kick him in the groin. Repeatedly, and a lot.

[ailsaek.livejournal.com]

Can we make a party of it? I wanna join in.

[bedfull-o-books.livejournal.com]

Oooh. Me too. We can tell him it's part of our exercise plan.

Makes me never want to shop at Whole Foods again....

[(Anonymous)]

/bemusedoutsider here/

As a liberal who looks deeper than the headlines, I question whether 'Obamacare' is really a good alternative to the present -- or largely a placebo, an opiate to the populists.

Imo we should spend less attention on the Right Wingnut fringe, and more attention on the actual content of the bill, and on who is supporting it. The insurance and drug companies are budgeting lots of money for ads to support it. They have the time and resources to do their homework: if they're for it, it must favor them.

[bedfull-o-books.livejournal.com]

My friend NK posted this in his journal yesterday:

http://www.guardian.co.uk/commentisfree/2009/aug/16/nhs-us-healthcare

Make me want to move too....

[harimad.livejournal.com]

You forgot a part of the solution: we need the same tax treatment for all insurance premiums.

Right now, premiums for employer-provided coverage are paid with pre-tax dollars, premiums for privately-provided coverage are paid with post-tax dollars. This grossly distorts the market and serves to one, tie employees to their employer and two, make private coverage nearly impossible to get. Putting them on the same footing would be a BIG help. I care less which change is effected, than that a change is made at all.

[jpmassar.livejournal.com]

If you are self-employed you can deduct your health insurance
premiums, which is essentially paying with pre-tax dollars.

[harimad.livejournal.com]

Great if
1) you're self employed,
2) can afford coverage,
3) know about this and
4) can document it properly.

[jpmassar.livejournal.com]

You don't need to know about it if you use a tax program; mine just asks me if I've paid premiums and how much, and does the deduction. Even if you don't line 29 of form 1040 specifically says 'Self-employed health ins deduction'.

You don't have to document it (unless you were audited). In any case it shouldn't be very hard to do so.

2) is of course the worst problem, along with getting the coverage to begin with if you have pre-existing conditions.

1) was the premise of the comment, and the comment was made for informational purposes.

[pecunium.livejournal.com]

One of the differences to being self employed is that using actual (as opposed to technically) pre-tax dollar requires a lot more savvy on the tax code.

A payroll company/HR dept. will arrange to remove the pre-tax dollars from the money being withheld against. Further, the employee can claim all the deductions they like (and then catch up in April). The self-employed have to file quarterly payments against, "estimated taxes".

So getting the pre-tax dollars out of the way is harder to do.

[editrx.livejournal.com]

Except if you're self-employed, you have to (1) find insurance (in some states, this is close to impossible), (2) be able to afford the insurance (in most states, only one insurance carrier will cover individuals/micro-businesses [less than a dozen employees], which means no choice -- you either use their insurance, or none at all).

Believe me, after 20+ years of self-employment, I now face insurance costs that exceed what I earn by magnitudes. I have used up my savings to pay for health insurance. Why do I keep it?

I have lupus. Without insurance, I would be unable to see a doctor at all or receive proper medication in a timely fashion. It's literally go bankrupt or die.

Granted, when the money runs out, I'll die anyway, since I'll lose my insurance. We looked at our finances recently and figured out that would be around the middle of next year.

[thirstygirl.livejournal.com]

Cliff May was talking at the University of Sydney last night so I went along with an American friend of mine. Once on to healthcare, he was utterly 'screw you Jack, I got mine.' to the point where my friend, who's just discovered the wonder of not having to pay seventy-five dollars for an asthma inhaler, nearly had apoplexy.

Possibly the only part I found amusing was that he'd totally failed to adjust his language for a non-American audience. In other countries, the fact that the French top the WHO world healthcare standards doesn't actually count as a reasoned dismissal of the question. We also don't see the WHO as the patsies of the UN's OWG army and the Americans that decide to ignore this as the few, the brave, the free...

[pecunium.livejournal.com]

Who is Cliff May?

[thirstygirl.livejournal.com]

He's the President of the "Foundation for the Defense of Democracies" and one of the explicitly pro-torture Republicans.

Wikipedia entry:http://en.wikipedia.org/wiki/Clifford_May

This was him recently on the Daily Show:
http://bucknakedpolitics.typepad.com/buck_naked_politics/2009/04/the-daily-show-unedited-interview-cliff-may-wants-to-push-the-boundaries-of-torture.html

[pecunium.livejournal.com]

Then let him come here, that I might ask him some questions.