Thursday, March 27, 2014

Here's Sand in Your Eye, America

"How many times do I have to tell you!" HHS Secretary Kathleen Sebelius impatiently fumed the other day. "When I say bed, I mean bed. Lights out on March 31st. No ifs, ands or buts!"

Um.... what's that you say? You need one more drink of water? You forgot to brush your teeth? You didn't do your homework? You're stoned? Well.... never mind. You can stay up just a few more minutes, but only until April, mind you! And no more excuses after that. I really mean it this time.

Another day, another Obamacare deadline extension in the ever-shifting sand. Another day to shop till you drop within the nightmare maze of the virtual predatory insurance marketplace, ignoring the grim reality that destitution is only a paycheck away. I mean that quite literally. Nearly half of us have so few liquid assets that coming up with the first premium --  and worst case scenario, having to come up with the first co-pay and deductible --  will absolutely wipe out our checking accounts.

But anyway, join the 6 million (out of more than 48 million uninsured) of your fellow citizens who reportedly have signed up so far, and try wending your way through the O-Care Funhouse in the Mall of America. As the lottery commercial says, you gotta be in it to win it. You gotta "sign up" -- that is, enter for a chance to win:

(graphic courtesy Kaiser Health News)

To accommodate the alleged last minute crush of contestants, the Obama administration, all the while screeching that "America Needs a Raise" has just added one more passive-aggressive layer of sludge to the incomprehensible kludge known as Obamacare. From the Washington Post:
Federal health officials say March 31 is still the deadline for enrolling in health coverage and that they're only making sure anyone who tried to apply by the deadline can get coverage.... The Obama administration has been adamant that the latest enrollment announcement isn't a deadline extension.
If you made an honest effort to go up to your room, but tripped or passed out on the rickety stairs,  you will not be punished. We'll pretend that you made a good faith effort to comply with our curfew. Your trip to the woodshed will be delayed because otherwise we'd look like ineffectual meanies instead of simply ineffectual.
CMS (Center for Medicare and Medicaid Services_ is going with the honor system. People submitting their applications on or through a call center after March 31 "attest" that they had trouble enrolling before the deadline.
So, will CMS make any effort to verify a person's attestation? CMS spokeswoman Julie Bataille fielded that question multiple times during a Wednesday afternoon press call before she was eventually asked straight up whether the agency is relying on the honor system. Her response: pretty much, but people don't like lying to the government
Are you kidding me? Lying to parents and other authority figures to save their own hides is an essential survival skill learned early in life by all normal people. That whole George Washington and the cherry tree tale is a big fat scam to instill guilt into little liars. Humans lie because they want to protect their butts. Politicians, of all people, should realize this. As it is, there are so many winks and nods breaking out in the Beltway that platinum Obamacare coverage for treating elite puffy eyelids and stiff necks can't come soon enough.

Oh,and there has been such a surge of pliable little citizens rushing to comply with Lights Out that a totally unexpected gridlock of bodies is occurring in the virtual queue. Ergo, CMS is providing a "window of opportunity" within the Mall Maze for the folks to jump through in order to comply with the curfew rules. This, no doubt, is at the top of the "ladder of opportunity" envisioned by Obama to span the income chasm and lift people out of poverty through the magic of their grit, determination, and bootstraps.

Surge, my butt. Six out of ten Americans didn't even know about the March 31 deadline, according to a recent poll, and half of them (coincidentally, the same segment teetering on the brink of poverty) say they plan to stay uninsured.
In the past six months, 33 percent of the uninsured said they tried to obtain health coverage, either through an exchange (18 percent), Medicaid (14 percent) or directly from an insurer (13 percent). The poll didn’t say what prevented them from getting coverage.
Maybe because the pollsters didn't bother asking them? How about that whole "we ain't got no jobs, we ain't got no money!"impediment to a shopping spree in the virtual insurance predator marketplace? How about the fact that quite a few people are hesitating to sign up for coverage for fear that their undocumented family member would be deported?

What a totally preventable mess. What a monument to neoliberal greed and political malpractice  -- all so that a relatively small percentage of the uninsured can get partial subsidies for their medical needs. Had our political leaders followed the will of the majority back in 2009, when Obama had majorities in both Houses, everybody in America would have had a Medicare card in their ever-thinning wallets by now. The Democrats would not be fretting over their diminished re-election chances. The Tea Party might never have seized power in the first place. The phrase "death panel" would be permanently stuck in Sarah Palin's craw.

Physicians for a National Health Program estimate a Medicare for All plan would save the American people $350 billion in the first year of implementation, not to mention untold thousands of lives and millions from the specter of bankruptcy and depression and preventable illnesses. The proposal (HR 676) would actually expand upon and improve the current Medicare program by eliminating co-pays and deductibles. It would be financed through progressive taxation and not be means-tested.

Do you have a pounding headache? Is your chronic fatigue the result of an O-Care murketing campaign hangover? If so, here's a refreshing video antidote.

No shopping is necessary. No paper, plastic, bronze, silver, platinum or gold is required. Everybody's in, nobody's out. Because health care should be a right, not a neoliberal lottery. 


Pearl said...

Even if you get a rocky foothold in Obamacare, there are no guarantees. The connections to the insurance companies who dole out the care and costs, are
still not in place with possibilities for changes down the line not in favor for patients. It is affecting the decisions of doctors whether or not to be
involved under these flexible circumstances and there is still no discipline for hospital costs. The projections of what will be coming down the road are
not favorable and continually shifting the regulations will create more chaos.

No health care set up will be effective until it is removed from the private sectors, and made a single payer national coverage administered and
controlled by the government with no ties to jobs, or kinds of medical needs of a patient or freedom of hospitals to charge what they want. We have to
start with a really progressive tax system before a viable health care system is in place. Merely stretching Medicare to everyone eventually is also a problem since it presently only covers 80% or less of patients' needs
and is dependent on the private sector for purchases of equipment and with no regulation of costs for the salaries of medical personnel.

As I have said before, in Canada it is a centralized set up with a fraction of the price for the paperwork alone, regulated salaries for medical personnel, hospital costs covered, drugs purchased in bulk, etc. This is how most of the other industrialized countries take care of their citizens and
nothing else will work. Obama has left us with an albatross for the future and in more areas than health care unfortunately.

Karen Garcia said...


"Medicare for All" as a title is actually kind of misleading, since there would be no 20% co-pay, no private insurance involved whatsoever. I added another link to my post explaining the legislation in greater detail. Medicare for All really would be single payer and not "Medicare as we currently know it."

Karen Garcia said...


Agreed, actual impending passage of Medicare for All would bring out armies of lobbyists the likes of which we have never seen. Just the part about how doctors get paid would cause a mass outbreak of conniption fits. However, since many docs are already being priced out of private practice and working for salary anyway, I have a feeling that only the big conservative guns of the AMA would truly raise a stink.

The point is, the Dems never even tried. I like to write "what might have been" rants every now and again, especially now that the Dems are paying such a heavy political price for their fecklessness. And deservedly so.

I have a feeling Obama will welcome a GOP super-majority so that he will be "forced" to become the Republican he already truly is. Fasten your seatbelts.

Zee said...


Although I have said it before, I will say it again just in case the memories of some here at Sardonicky are shorter than others: I support a Canadian-style, single-payer health care system here in the United States because health care is one of those issues that is now too large and too important to be left to the private sector.

Still, scientist that I am, I am always curious about how things work. Or about how they were supposed to work, but didn't. Or how the latest plan was supposed to make things better, but wound up making things worse.

After 30+ years of working in a dangerous laboratory, I've pretty much seen it all save for—Thank God—any mistakes that led to loss of life, limb or hugely expensive equipment.

So a couple of thoughts about “Medicare For All” come immediately to my mind that perhaps need to be considered and dealt with before just jumping in with eyes closed and fingers crossed, à la ObamaCare.

First, as of 2007, the health care insurance industry employed some 444,000 people:

I've tried to find some more recent and “official” figures which suggest that as of January,2014, “direct health and medical insurance carriers” employed some 482,000 employees. This is consistent with the growth that is likely since 2007, but I confess that I'm not exactly certain what I'm looking at:

In any event, if we go with a single-payer system and do away with the entire health care insurance industry with a single stroke of the legislative pen, what happens to these close-to-half-a-million private-sector employees? Do we just put them out of work without any consideration, saying “Sorry about that?”

And what happens to the stockholders in this almost-$1Trillion per year industry, of which, through my 401(k) retirement investments, I'm sure I'm one?

And maybe some of you are, too?

Do we—not all of us wealthy rentiers, mind you—bite the bullet for the public good as GM's bondholders were—IMHO, illegally—forced to do when GM was bailed out?

In addition to overcoming the colossal lobbying effort that the health care insurance industry will exert to fend off single-payer as we have seen in the past, these are a couple of additional, more "grass-roots" issues that I have heard no one remark upon when talking about a transition to single-payer

And I'm sure that there will be other surprises along the way that will impede the transition to single-payer.

Murphy's Law—and its many correlaries—apply far beyond the laboratory, as ObamaCare supporters are now discovering to their chagrin.

Forewarned is forearmed.

Pearl said...

Zee@ Your worries about releasing many insurance workers without redress for jobs, etc. can be easily overcome. Most of the underlings are mainly doing clerical style work under supervision which can be changed to working for organizations doing some good in the world such as environmental, etc.Also, any change in health care will be gradual with every inch fought over and can allow for adjustments. As for the owners or CEOs of the insurance companies, train them to repair roads, infrastructures, or any useful occupation needed and pay them from our hopefully more progressive taxes.If all else fails they can empty bed pans in the hospitals. Let them learn what their perpetration of a lousy system does to people who cannot find work.

Yes, even our wonderful health care system in Canada has its problems. A friend of mine who had serious 8 hour surgery on the veins of a leg was sent home and when I asked him what antibiotics he was on said none, without question. I was appalled but didn't want to frighten him and sure enough within 3 days he developed a dangerous infection that required massive doses of antibiotics and required a long while for his leg to heal. When I recently called his wife to find out how he was faring she told me he had been in the local hospital all week from a bloody nose they couldn't stop (and from which he fainted), had to be sent to the hospital in an ambulance and for 3 more days they were unable to stop the bleeding in the ICU despite several blood transfusions until finally it stopped. Why? He had been put on blood thinners many weeks before and neither he or his wife were told to have his blood checked regularly to test clotting, etc. which I immediately knew about. Their ignorance and the doctors' neglect almost cost him his life. I have found tremendous ignorance with doctors throughout my life and in the lives of my family and friends both here and in the United States and as a result have educated myself thoroughly regarding medications and procedures and prevented some real mishaps as a result.

Pearl said...

Part 2

Doctors are over booked and spend little time with patients, they intimidate them and don't encourage questions and the results are catastrophic according to a thorough report in the New York Times a year or so ago of problems with patients who needn't have suffered or even died as a result of ignorance or neglect. This is true here and in the States and I can count on one hand how many doctors I can remember who knew what they were doing and diagnosed problems properly over the years. I do not hesitate to speak up when necessary and believe me there were instances when my health and the health of family members were jeopardized.

We can figure out the problems if we think about it - who gets into medical school - how they are trained and are they interested in the money and prestige more than the patient. And in Canada, the doctors are not completely enamored of our health care
system feeling constrained in fees and requirements of rigid reports to the
government. They were completely opposed to instituting universal health care in the beginning but were over voted by the public, thank goodness. So my worship of doctors is now confined to the wonderful cancer research workers I have become acquainted with who are a different breed. There are
good and decent doctors around but this is a rarity unfortunately.

So no matter what kind of health care we fight for, there will have to be some real changes in the education of future doctors which recent reports indicate are not that great.

I am writing all this to encourage those of you dealing with medical personnel, to use the internet to get all the nformation you can find,write down questions and don't leave until you get answers. It may help save your health and life. I can't tell you how many stories I have heard about people who have not been diagnosed or checked out properly with possible serious problems and frightening results. I know this from bitter experience of friends and family members. And it all ties in with getting a better health care system by getting better people in place all around.

And Zee, if you are worried about your investments, it will be hopefully replaced with decent health care at minimum cost to you and you can save your money and invest it in less lousy companies. There are some good ones to help out. We as individuals can do a lot in speaking up to friends, to medical people, to educate people about health matters, especially you, Zee. as a scientist. There is a lot to be done all around to help others in this regard.

I won't apologize for the length of my comment since I have to compete with

Zee said...


I would never ask you to apologize for a lengthy post, nor would I expect you to do so.

I usually find what you have to say to be interesting and informative--and often sad when you tell us younger Sardonickistas about your experience during the McCarthy era--and if it takes a longer post to say what you've got to say, well, I'm all for it.

Better "long and clear" than "brief and obscure," I say.

And besides, it's not me that you need to keep happy, but Karen.

James F Traynor said...

If it were just the health care problem itself it wouldn't be that bad - but it's damn near everything. And yes, relative to us, Canada is a shining light. But, as truly feckless as we are, we are still the biggest economy in the world shakily holding up the second biggest, China. And if we go, everything goes, Canada included. And it damn sure looks like we're going to go, with a whimper or a bang, but go we will if we keep up business as usual. And that's just the economy.

Then there's the climate business, an absolute bloody shambles and not from the scientific end.
Yeah, Zee, I know all about the politics and infighting of Science, but science at the low end has been doing its pain staking, bit by bit gathering of evidence and it sure looks like the model boys are pretty much on the money (much as I feel their grandstanding is a pain in the ass). But we still continue to ignore the evidence.

Then there's this military crap. It's more than 80 years later and Smedley Butler is still right. And we're still not listening. This latest fiasco of trying to solve our problems by reinstitution of the Cold War is a perfect example. The media is simply awash in neocon, flag waving, democracy spreading bull shit. And the public is largely buying it.

And yeah, Zee, I know all about unintended consequences, but I also know about planning yourself into immobility. In other words, Get off the fucking tracks, the train is coming!

And I can't believe I've wasted my time like this, pissing into the wind. Well, I'm an old fart with not much else to do. In partial restitution, the lower reference is an interesting read from yesterday.