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?