Thursday, October 3, 2013

Still Shut Down and Out

Well, wonder of wonders. The New York Times finally got around to noticing that the majority of poor people will be barred from getting health insurance under Obamacare. The exclusion, of course, is due to those nasty, red, mainly southern states opting out of Medicaid expansion, which the Supreme Court obligingly allowed them to do at the same time it gave the thumbs-up to taxpayer subsidization of the private insurance predators. But still, the numbers are downright shocking, worse than I imagined:
A sweeping national effort to extend health coverage to millions of Americans will leave out two-thirds of the poor blacks and single mothers and more than half of the low-wage workers who do not have insurance, the very kinds of people that the program was intended to help.....
 The 26 states that have rejected the Medicaid expansion are home to about half of the country’s population, but about 68 percent of poor, uninsured blacks and single mothers. About 60 percent of the country’s uninsured working poor are in those states. Among those excluded are about 435,000 cashiers, 341,000 cooks and 253,000 nurses’ aides.
“The irony is that these states that are rejecting Medicaid expansion — many of them Southern — are the very places where the concentration of poverty and lack of health insurance are the most acute,” said Dr. H. Jack Geiger, a founder of the community health center model. “It is their populations that have the highest burden of illness and costs to the entire health care system.”
So this begs the question: since Obamacare is shutting out poor people and minorities, why on earth are the Republicans so dead set against it? I thought their whole raison d'etre was the denial of health care to the poor and the darker-hued. Did they just shut down the government for no reason at all?

The Times article does not even touch upon the de facto exclusion of those opting for the high-deductible and co-pay "Bronze" junk packages that still leave "better-off" subscribers vulnerable to bankruptcy when they can't make their out-of-pocket costs. We won't know the full extent of the damage until cheap plan subscribers attempt to actually use their shiny new cards and then get those unexpected bills in the mail. Assuming, of course, that they can even log on to apply, which assumes they have an internet connection in the first place.

The Down and Out are getting a lot of unexpected The System Is Down messages on their screens. Do you suppose The System is trying to tell us something?

Meanwhile, with every day that goes by in the continuing contrived Shutdown Saga of the Crazy Pols vs. the Pragmatic Pols, the end-game is looking more and more obvious. The alcoholic in charge of the Crazy Caucus is now willing to play the sober president's longed-for Grand Bargain game of safety net cuts in exchange for giving up the Tea Party's fight against Obamacare. He might even sacrifice his Speakership in exchange for a lucrative spot on Fox or CNN. As I have repeated ad nauseum: heads they win, tails we lose.

Old people, widows and orphans, veterans and the disabled will "share the sacrifice" through the imposition of Chained CPI, giving up some meals and extras in order to placate Wall Street tycoons. The middle and working classes will be asked to give up just a little more so that their fellow citizens can morph into full-fledged health care "consumers."

And most people, who have already picked the blue team or the red team, will never know what hit them. One day we'll wake up to the glorious news that yet another crisis has been averted behind closed doors, in the wee hours. The Panda Cam will be turned back on! We'll be able to get forecasts from the National Weather Service! The Centers for Disease Control will be able to track down the source of the latest Salmonella outbreak from the unregulated factory farms!  Kids with cancer will be admitted back into NIH trials.

And one day, so gradually that we won't even notice, our monthly Social Security checks will start shrinking. If we're among the 50 million and  growing "food-insecure" people who need to sign up for SNAP subsidies because of unemployment or underemployment, those stipends will pay for maybe two weeks worth of food instead of three. We'll be helping the richest nation on earth, a nation that is nowhere near going broke, meet its "long-term fiscal challenges", as the president assured Wall Street yesterday.

Reports are contradictory on possible unilateral presidential action. According to Wall Street mouthpiece CNBC, Nancy Pelosi has said that Obama will ignore the Constitution and refuse to invoke the 14 Amendment so that the nation's bills can be paid. According to the New York Times, though, she is urging him to apply the 14th. Default or bust. Keep us confused, churn up the phony uncertainty and crisis atmosphere so that the market can make the necessary bets, in which heads they win and tails you lose.

 According to the transcript of his CNBC interview, aptly headlined with the word Politic$, Obama craftily sidestepped those 30 million health care rejectees. "I am exasperated," he droned in his usual monotone, "with the idea that unless I say that 20 million people, 'you can't have health insurance, they will not reopen the government.' That is irresponsible."

And the beauty of it is, he seems to have quietly relinquished what had been the main sticking point for Republicans. He is no longer even insisting on a "balanced approach" of revenue from the rich in exchange for entitlement cuts. He is not insisting on the repeal of the Sequester either. As a matter of fact, he is offering decreased corporate tax rates to encourage low-wage manufacturing jobs coming back to our shores. I'll say it again. Heads they win, tails we lose. 

So take your pick. Would you rather die quickly at the hands of a raving lunatic with an axe, or slowly by the scalpel of a cold-blooded psychopath who anesthetizes you first?


Zee said...


I stumbled across this pair of quotes today, and they reinforce my opinion that the so-called “conservative” wing of the Republican Party has simply gone mad for political blood—anybody's blood—in much the same way that the French Revolution started out with great ideals and noble intentions, yet—as I understand it—descended into a bloody reign of terror when its objectives were taken over by paranoid leaders who were bent more on revenge than reform. The ensuing instability ultimately led to assumption of absolute power by Napoleon Bonaparte, not a king, but an emperor. Some "revolution."

(I understand that several of you out there are reading a massive tome about the French Revolution, whereas I only have my high school World History class and Wikipedia to rely on, so please don't judge me too harshly if I've glossed over the details or oversimplified things.)

Talking about the ObummerCare-inspired government shutdown and the possibility that it could lead to yet another debt-limit crisis,

““This is not just about Obamacare anymore,” centrist Rep. Michael Grimm, R-N.Y., said.

“We’re not going to be disrespected,” conservative Rep. Marlin Stutzman, R-Ind., added. “We have to get something out of this. And I don’t know what that even is.
(My bold emphasis.)

The last sentence is telling.

Stutzman sounds like some big-city gang member who shot and killed another kid because “the kid looked at me funny,” not because there was anything to be “gained” by the murder.

The Tea Party types have lost any sense of philosophical purpose or objectives to which they might once have laid claim. They launched this “fight” just because they could, and now, backed into a corner, they invent other reasons for the fight and will die rather than be “disrespected.” And they don't care how many innocent bystanders they “take down” along with themselves.


Gaston said...

Did you notice the buried explanation for not writing this story earlier? Here it is:

"The federal government provided the tally of how many states were not expanding Medicaid for the first time on Tuesday."

How can they print such a lame excuse for another obvious case of being the administration's ass-kissing puppet?

pedant said...

Jay - Ottawa said...

"[T]he ACA is a sick system...."*

Not to worry. You'll do just fine as long as you're born to parents with faultless genes. Then, throughout life, avoid accidents and never succumb to disease.

If you or someone you know must now sign up for the ACA without a savvy lawyer at your elbow, here's an article you should read before completing the forms. It's and exchange between an AIDS activist and a good doc from the PNHP.

Karen Garcia said...


Jay - Ottawa said...


In all your studies you've yet to discover good reason to reject the ACA? Let me help you, friend. Start here: logic, economics and statistics galore. Come back when you've finished your homework.

Fred Drumlevitch said...

Off of the main topic, but since Karen’s post is about social spending and national priorities, the following things are relevant:

On the one hand, the Swiss are considering a version of a guaranteed annual income:

On the other hand, the U.S. devotes its energies, and money, to the development of ingenious war machines --- that, in addition to being a waste of scarce financial resources, may one day turn on us!:

Be sure to watch the video in the above link. I wonder if it's hacker-proof?!

And the Pentagon awarded billions of dollars in military contracts just prior to the governmental shutdown, and will apparently continue to award contracts even during the shutdown (but won't announce them):

I'm looking forward to some Sardonic observations from tropical storm Karen!

Zee said...


Thank you for the link to the Truthdig discussion between Scott Tucker and Dr. Don McCanne, and also for the link to the PNHP home page.

The Truthdig article is very long, and though I have read through it on-screen, it will take some time to absorb all the details so I've printed it off so I can refer back to it. I've also bookmarked the article because every time one of my Progressive friends at church waxes rapturous about the virtues of ObummerCare for the nation's poor and middle-class, I'll send her/him the link. But I'm sure that—coming from me—they'll just blow it off as a link to a “conservative hoax page” designed to “smear” ObummerCare.

A couple of things that stood out to me immediately:.

Early in the Truthdig interview, Scott Tucker observes that

“When the ACA was pushed through Congress, even the limited “public option” was deliberately removed from health policy debates in congressional hearings... The message of career Democrats was that the ACA was the best they would give us, so we’d better be grateful. That remains puzzling to many people who know that other industrialized democracies spend less per capita on health care, do better in health outcomes, and extend health coverage for all citizens.” (My bold emphasis.)

Why should this be “puzzling?” Only because the garden-variety Democrats and many so-called liberals refuse to understand that “career Democrats” are as much bought-and-paid for by the healthcare industry as are their Republican counterparts? C'mon!

In traditional liberal defensive fashion, however, Dr. McCanne still tries to put all the blame on the Republicans: “Even though single payer legislation has been introduced in Congress, it is not realistic to expect any action when one party—the Republicans—currently has an agenda of obstructing government. With gerrymandered districts [the default defensive posture of the left*], it is unlikely that that will change in the near future.”

But Obama had the luxury of Democratic control of both houses of Congress when ObummerCare passed, yet even then he could not get a “public option,” let alone “single-payer.” This is “proof-positive” that the Democrats are just as much a stumbling block to single-payer as are Republicans. When will the Left wake up and put forth a real alternative to career Democrats?

(OK, OK. I know: When will thinking conservatives put forth a real alternative to career Republicans who also aren't irrational Tea-Partiers?)

My other “first-read takeaway” from the Truthdig article?

“The moral of the story? Don’t let the rants of cynical demagogues like Cruz confuse you—it is entirely possible to be a freedom loving capitalist and also believe in a strong government role in health care.” --Matt Miller

It will take some time to drill down through the PNHP site, but this article caught my immediate attention:

“We didn't get this right. A [required] gold standard for Congress and a lesser standard for the people?” i—Dr. Don McCanne

Conservatives aren't the only ones who see a certain injustice when Congress entitles itself to better than the American public (so what else is new?), and then tries to pass it off as nothing more than plain ol' “employer-provided healthcare.” I have employer-provided healthcare insurance too, but my former employer gives me a range of cost/coverage options, even when I hit Medicare in two years. They don't “require” that I buy a “gold” plan or better, as members of Congress must do, with correspondingly higher subsidies.

Yet the American public seems to be accepting this without question. Jeeze.

Pearl said...

Karen: to add to my comment sent in today about the original article you
wrote your column about.

"A Population Betrayed" in today's NYTimes by the Editorial Board is another excellent commentary about health care only for the better heeled in the U.S.A. The comments once again are numerous and outspoken. They are finally doing a commendable reporting job on this important issue and one can only hope something will begin to change in this area. The health of citizens should never become a political football.

Zee said...

And for any of you who are friends, followers, or clients (Just joking, I'm sure!) of Walter White, the Albuquerque Journal has run his obituary today:

May he rest in peace.