Saturday, July 8, 2017

A Paine-ful Weekend At Bernie's

"These principles had not their origin in him, but in the original establishment, many centuries back; and they were become too deeply rooted to be removed, and the augean stable of parasites and plunderers too abominably filthy to be cleansed, by anything, short of a complete and universal revolution."

Thomas Paine

Thomas Paine could have been writing about why the "resistance" to Donald Trump is so ineffectual when what's really needed is a global revolution against the whole rotten global financial system. No matter that Paine was talking about Louis XVI of France, who actually was more a weakling than a despot in the mold of his Trump-like ancestor, Louis XIV.

In this interim between the 4th of July and Bastille Day, with Hamburg burning as the G-20 oligarchs party and plunder, what better time to renew our acquaintance with that great global radical, Thomas Paine? He helped foment revolution in the American colonies, and in France and (unsuccessfully) in his native England, where he was thoroughly despised by the aristocracy. His particular nemesis was the anti-revolutionary conservative Edmund Burke. Were he alive today, I can almost guarantee that Burke would be writing scolding opinion pieces for the New York Times. It's probably no accident that the newspaper's star conservative columnist is diehard Burke fan David Brooks.

Since Trump and his fellow plunderer-parasites both here and abroad are indeed too abominably filthy to be cleansed, nothing short of a complete revolution will do, as evidenced by the brave people facing water cannons, tear gas, rubber bullets and other military police hardware in Germany.

Take the health care crisis here at home. Despite the overwhelming clamor for universal, government-run medical insurance from the vast majority of the American populace, response from the higher-ups has ranged from horrified, to dismissive, to tepid.

Bernie Sanders's prescription was just suddenly downgraded to the same piecemeal "reform" of our for-profit, market based insurance system as originally suggested by the Obama White House. So compared to what Thomas Paine demanded in The Rights of Man, it's quite the cynical travesty.

Bernie: "Everyone knows that the Affordable Care Act is far from perfect. Our job now is to improve it, not destroy it. Further, instead of throwing 22 million Americans off of health care, we must move to join the rest of the industrialized world and guarantee healthcare to all people as a right not a privilege through a Medicare-​for-​​a​ll, single​-​payer system."

Tom: "When it becomes necessary to do a thing, the whole heart and soul should go into the measure, or not attempt it."

 Just as Barack Obama did before him, Sanders - now the most popular politician in America - is wasting the moment and submitting to the vested interests before he even gets started. He's putting off introduction of his long-promised Medicare for All legislation and instead meekly suggesting a Medicare buy-in option for 55-and-overs, as well as a public "option" so as not to unduly discompose the predatory plunderers of the private insurance cartel. 

  What about the times that try the souls of the tens of millions of citizens who either totally lack health insurance coverage, or can't afford the premiums and deductibles of what covers only a portion of their medical costs? They'll still have to die or go bankrupt if they get sick under the existing Obamacare law, which Democrats see as the be-all and end-all of the current debate.

As health care advocates Margaret Flowers and Kevin Zeese point out,
 We are already spending enough on health care in the US to provide comprehensive health care to everyone. We have a bill that lays out the framework for a National Improved Medicare for All healthcare system: HR 676. A majority of Democrats in the House have signed on to it as co-sponsors.
So, why are they trying to convince us to accept a public option or a Medicare buy-in? It’s because they are corrupted by money – campaign contributions that they receive from the corporations that profit from the current system. You may say, well Bernie doesn’t take corporate money, so why would he go along with this charade? It may be because he has greater allegiance to the Democratic Party than he has to the supporters of Medicare for All, his base. He may fear losing positions on committees or his new position of leadership within the party.
 We have to be clear and uncompromising in our demand for National Improved Medicare for All NOW! We can’t put this fight off any longer because those in power will always try to knock us off course. The people and their families who are suffering under the current healthcare (non)system can’t wait any longer.
 If Bernie Sanders really believes that health care is a human right, then why does he accept that millions of people are being denied this right today, right this very minute? Until such time as he deems it safe to "compromise" with the predatory plunderers who'd just as soon see us all dead, people will continue suffering and dying prematurely. The gradual granting of health care rights which he espouses is as if Lyndon Johnson's civil rights legislation had "pragmatically" given relief to only half the country's black people or if his Great Society had "realistically" given Medicare and Medicaid insurance to half the country's elderly and poor people.

Either health care is a right, or it isn't. Whatever happened to justice delayed is justice denied?

As Thomas Paine retorted to Edmond Burke's treatise against the French Revolution: "Does Mr. Burke mean to deny that man has any rights? If he does, then he must mean that there is no such thing as rights anywhere, and that he had none himself; for who is there in the world but man?"

The mass psychic revolution for universal health care in the United States is already a done deal. Bernie Sanders can either accept this fait accompli, or he might as well join the Democratic Party's latest bumper sticker campaign of "We Suck Less."

As it stands now, Bernie is nothing if not an adherent of what Paine called the "caterpillar principle." Since all courts and courtiers are alike, they all consume similar policies and narratives which have little or nothing to do with people and nations. "While they agree to quarrel, they agree to plunder. Nothing can be more terrible to a Court or a Courtier than the Revolution.They tremble at the approach of principles, and dread the precedent that threatens their overthrow."

Far from voicing any solidarity with the anti-capitalist demonstrators in Hamburg, Bernie Sanders acted every inchworm the caterpillar courier in tweeting to Trump and his fellow oligarchs what their three top priorities should be at the G-20 summit:

1) Growing global economic inequality. The G20 has a major role to play in making sure the benefits of growth benefit all humanity.

(This is boilerplate neoliberal tripe. Talk about, but don't question whether this "growth" is healthy or cancerous. All of humanity sounds so much vaguer and grander than, say, mentioning the refugees and victims of endless wars of American and transnational corporate aggression.)
  2) North Korea. Trump should use the G20 to develop a consensus. Real leadership is bringing parties together to de-escalate tensions.
(Bernie fails to mention the forbidden word: peace. In his prescription pad, real leaders need not actually stop arms production and sales and reduce military spending to help pay for health care, but rather tamp down the "tensions" a wee tad in order to keep the defense contractors in business without obliterating the entire planet in the process. He needs those F-35s to stay in Vermont. Perhaps he didn't feel the need to chide Trump on climate change amelioration given that the president is already a world pariah in that regard.)
3) Russia’s meddling in our election. When Trump meets with Putin he must make clear interference is unacceptable & must never happen again.

(He not only swallows the Democratic Party's specious RussiaGate claims whole, he eagerly disseminates the propaganda to his followers. He is part of the lie.)

 In effect, Bernie deflects attention from our health crisis at the same time he pays mild lip service to it in the form of "fighting back against" one president and only one side of our corrupt Duopoly. Meanwhile, the more hardcore naysayers desperately try to do their own parts. They insist that a swift transformation to a single payer system is impossible, because most sane people would object to a tax increase. But their "math" doesn't bear out their paranoia. As economist Robert H. Frank lays out in (of all places) the New York Times, a Medicare for All arrangement would actually save us all a ton of money:
By analogy, suppose that your state’s government took over road maintenance from the county governments within it, in the process reducing total maintenance costs by 30 percent. Your state taxes would obviously have to go up under this arrangement.
But if roads would be as well maintained as before, would that be a reason to oppose the move? Clearly not, since the resulting cost savings would reduce your county taxes by more than your state taxes went up. Likewise, it makes no sense to oppose single-payer on the grounds that it would require additional tax revenue. In each case, the resulting gains in efficiency would leave you with greater effective purchasing power than before.
Since Single Payer covers everybody, the countries which now implement such systems have lower overall costs because most of the people covered are relatively healthy. Contrast that with the United States, where the government restricts public coverage to the most vulnerable and sickest groups: the elderly, the disabled, and veterans of our endless wars. We pay more and we get less. The have-nots are taught to resent the haves, entrenching the oligarchic plunderers even more securely in power. So if everybody enjoyed the same privileges, they'd have no reason to either resent one another or settle for lesser evil candidates.

And if everybody enjoyed the same benefits, it would become next to impossible for reactionary politicians, acting at the behest of corporations and oligarchs, to yank these benefits away from the whole population, united in solidarity to the tune of more than 320 million human bodies.

So let's all be realistic, and demand the impossible. Universal health care is not only a human right, it's plain common sense. Don't let the oligarchs get you down and keep you down. Vive le revolution!


Erik Roth said...

Right on!
Push has come to shove.
There is no wiggle room for complicity under the guise of compromise, or wishy-washy shelter for hiding by the cowardly.
Now we are being tested, and it's pass-fail with nothing in between.
Take note:

What we face, and must confront, is all-out oligarchy and its agenda of hell-bent hegemony.
That must be totally demolished, or we, and the ecosystem of Mother Earth upon which our lives depend, will be consumed by the demonic, pleonectic forces of the powers that be.
Only radical, revolutionary change will avert global political disaster.

annenigma said...

By his words and actions, if not the label he claims, Bernie is a Democrat and a Capitalist, not a Socialist in any way, shape, or form. Nor is he a true Independent since he admits never having voted for a third party candidate. The only thing we can be sure of is that he's a politician.

It's the nature of the Capitalism beast that everything eventually becomes privatized for profit. We're still at the relative beginning of that juggernaut. Barack Obama gave it a big lift with the ACA and promoting school vouchers, but thankfully failed with his TPP and attempt to bargain away Social Security.

Privatization is inexorable under a Capitalist regime that's global and operates through powerful institutions like International Monetary Fund, World Bank, Goldman Sachs, NATO, etc. Credit is extended by trickery and otherwise to invest in risky assets, then when countries suffer losses and cannot pay, austerity is imposed which overturns national sovereignty through forced privatization of public services and selling of public infrastructure. It's asymmetrical, financial warfare.

Sovereign wealth funds and national sovereignty can be both wiped out in one fell swoop. Just ask Gaddafi and google Goldman Sachs and Libya. Oh, right, Gaddafi is dead. That's due in large measure to Hillary Clinton who famously cackled "We came, we saw, he died". But Wikileaks leaked a Hillary email that revealed Gaddafi's plan to establish a gold-backed African currency to compete with the dollar and the Euro. We were never supposed to have known about that perceived financial threat to the financiers. But I digress again.

As long as Capitalism rules, our bodies, lives, earth, even outer space*, are treated as commodities to be exploited for profit. We're already dying for Capitalism, from wars to fossil fuels to chemical laden foods and everything in between, but now we can't even leave it on earth. In the NDAA of 2018, the National Defense Authorization Act, Congress authorizes a new branch of the military called the *Space Corps. So there will be no universal health care for us because Money, but there's always plenty to make the world/Galaxy safe for Capitalism.

Ok, I digress a lot. My rant is all over the place, just like Capitalism.

Jay–Ottawa said...

@ Erik

Thanks for those links from the front lines. I especially liked the vimeo link. Somehow, I caught none of that spirit by scanning the NY Times this morning. Could it be we're talking about two different places called Hamburg?

Good to see so many thousands in the streets, people who are bothering to protest on behalf of us all. According to one report, there is one police officer for every 5 of those 100,000 protesters.

When will the G20 conference organizers ever learn? Why not meet at a palatial resort deep in inaccessible woods somewhere close to nowhere or on an uncharted island in a no-name sea?

stranger in a strange land said...

Karen writes: [Bernie's] putting off introduction of his long-promised Medicare for All legislation and instead meekly suggesting a Medicare buy-in option for 55-and-overs, as well as a public "option" so as not to unduly discompose the predatory plunderers of the private insurance cartel.

And from the quoted Flowers and Zeese counterpunch piece:

So, why are they trying to convince us to accept a public option or a Medicare buy-in?

I thought the Public Option was synonymous with Medicare for All (whom did not have access to private coverage). The "Option" part was just that, a government-provided (Single Payer) baseline coverage for anyone who OPTS to go that route.

Am I to understand that what we're crying for here is healthcare paid for and provided by the federal government and ONLY the federal government? Or states and ONLY states? Private healthcare options would entirely cease to exist? Every single doctor in the country would become exclusively a government employee?

A Public Option sounds great to me - and would seem to, by default, discompose much of the predation and plunder of the private medical insurance industry. Am I missing something?

Karen Garcia said...

Howdy, Stranger:

The "public option" most definitely is not the same thing as Medicare for All. From Physicians for a National Health Program:

"As a matter of policy, PNHP expressly opposes many so-called gradual steps towards single-payer. Many well-meaning supporters often push these bills as 'feasible steps' to move us towards single-payer, but the history of these kinds of health reform efforts - Hawaii in 1974, Massachusetts in 1988, Oregon in 1989, Tennessee in 1992, Minnesota in 1992, Maine in 2003, etc. - shows that despite their claims of pragmatism, incremental reforms have consistently failed for more than three decades. Incremental reforms cannot garner administrative savings and redirect them to care. Hence they always founder on the shoals of cost. In addition, these reforms distract attention from the economically realistic, if politically challenging, option of single-payer reform."

The Public Option is also a taxpayer bailout of private insurers, allowing them to justify dumping the sickest patients, keeping the healthy subscribers, and thereby increasing their obscene profits even more. And since the Public Option will develop so many problems,it will eventually be deemed such a failure as to give right-wing politicians a plausible rationale to repeal it.

I suggest you read HR 676. Single payer is actually a hybrid system. For example, doctors will be paid directly by the government while still able to maintain private practice. As an added bonus, they won't need to employ people whose sole job is to fight with private insurers for payment and permission to treat. Take it from me: I loved Medicare and other government payers during my time working in my husband's practice. We could count on timely payments, within a few weeks. Private insurance companies' business model, on the other hand, is to delay and deny. Who needs them?

You can find more valuable info here:

Jamie said...

Our country has moved so far to the right that Bernie is like Scoop Jackson, the Democrat Senator from Washington. Scoop was liberal on social issues but a hawk regarding imperialism, especially involving the Boeing corporation.

Bernie has now embraced the far-right McCarthyism of the snowflakes. He voted for the F35, which could have paid for ten years of free college. This guy would be a disaster if he was president, embarrassing both guns and butter, and triangulating for the ruling class.

Carol S. said...

Bernie Sanders still cares.

I've always thought that his one limiting virtue, or imperfection, call it what you will, is his belief that people are good at heart, like Anne Frank said, and he's wrong, at least about Americans.

Perhaps Bernie Sanders' advisors finally convinced him of some of this. He undoubtedly wants to work with the Capitalist system; he always has. Maybe he now sees no revolution in sight other than full out war and that's not going to happen.

Americans are descendants of Puritans. The extreme, radical name speaks for itself. They left Europe because they believed the religions there to be hedonistic and unable to be "reformed"... Americans owned slaves.

The intense, ingrained hatred towards Blacks and other minorities cannot be dispelled to this day, particularly with talk-show demons entertaining people while they work.

Too many people here don't believe health care is a right; polls to the contrary. Socialism is a dirty and threatening word.

We in this forum, and people like us, are a tiny minority.

Zee said...

“Private insurance companies' business model, on the other hand, is to delay and deny. Who needs them?” —Karen Garcia

Well, a few years ago I was quite grateful for my “private insurance company.” While still on my old employer’s medical insurance prior to turning 65, I noticed a serious deterioration to my vision owing to (1) cataracts and (2) an inordinate number of “floaters” in both eyes.

Upon examination by an opthamologic surgeon I was operated on for both conditions over a period of two years or so. Not a single question as to “medical necessity” from my private insurer.

Following the two sets of treatments, I was stunned at the improved quality of my vision—especially at night—and now believe that before those surgeries I was truly a menace on the road. Even with my current eye problem, I still think that I’m much safer on the highways now.

Now on Medicare myself, I was recently chatting after church with an older friend of mine who is now suffering severely from cataracts, to the point where HE now feels that he’s a menace on the road.

When I asked him why he didn’t just get his cataract surgeries done—it’s easier than going to the dentist—he said that he was told by his Medicare-accepting eye doctor that his cataracts STILL weren’t bad enough to repair under Medicare.

Don’t kid yourself: Even for what most of us would regard as fairly routine and not-all-that-expensive treatments, the government can be in the business of “delay and deny,” too… at least until my friend injures or kills someone on the road. Maybe then Uncle Sugar will sit up and take notice.

Erik Roth said...

"Hoodwinked, An Economic Hit Man Reveals Why the World Financial Markets Imploded -- and What We Need to Do to Remake Them"
by John Perkins, Broadway Books, NY, 2009.

... from Chapter 14: China - A Lesson in Transformation ...

As I stood on the deck of our boat, Deng Xiaoping's description of a "market economy with socialist characteristics" popped into mind. I had learned from the students that while Mao is often discredited, Deng is revered as the father of modern China. In the early 1980s he decreed that Shanghai would lead the nation into an economic revival like nothing the world had ever before witnessed. The decry worked. He also proclaimed that "getting rich is glorious."

"The Chinese people, including Deng, still to this day are influenced by the ideas of Confucius concerning respect for hierarchy," Mandy said when I pointed out to her that Deng's words echoed Milton Friedman's philosophy. A cool breeze floated off the river, and an oil tanker passed by, a dark shadow among the lights, headed out to sea. "We grow up here understanding that serving our families is the most important thing we can do. Our families extend to our communities and the nation. Deng Xiaoping should be understood in that context."

It was a profound observation. If you promote the concept that making profits is the sole goal of business -- or getting rich is glorious -- in a culture that views the group as more important than the individual, you arrive at a wholly different interpretation of capitalism than when you apply it to a culture that emphasizes rugged individualism. The latter will look out for the greater good only when regulations mandate it, while the former will do so because the ethic is ingrained in them.

Karen Garcia said...


Medicare does not "deny" payment for cataract surgery.

Your friend's cataracts are probably not bad enough yet for a surgical repair, period. Medicare did not decide this, the physician did.

If your friend is so worried about killing someone on the road, he should a) seek another medical opinion; or b) stop driving.

So glad your private insurance is so great. Plenty of them are sadistic scams. My son had a terrible experience with his private insurer when he severely scratched his cornea a few years ago - the company refused to pay for both emergency room treatment and follow-up with the opthalmologist, because they deemed it "routine eye care." Now that they can no longer deny claims due to pre-existing conditions, they'll use any excuse they can. Adjusters in some companies even receive bonuses based on the number of claims they deny, or reduce.

These predators all deserve to be put out of business.

Again - I had years of experience billing Medicare and other government programs. They pay promptly and they pay fairly.

And as I have written before, HR 676, a/k/a Medicare for All, is not the same thing as the current Medicare program for the elderly and disabled. For one thing, it totally eliminates co-pays and deductibles.

Karen Garcia said...

Carol S.,

Bernie is not a bad guy, so he should probably change the name of his "Our Revolution" group to something like "Don't Let the Perfect Be the Enemy of the Good." And you're right, the man has come under intense fire for his liberal views from so-called liberals.

Re socialism - polls have shown that young people are increasingly in favor of it. Since they are unlikely to get fantastic well-paid jobs any time soon, the chances of them selling out in later adulthood like the Boomers did are relatively slim.


Have read and enjoyed Perkins's book, which I think was recently updated. I especially loved the parts about Hillary's nefarious doings in Haiti and Guatemala. When his book was first published, Perkins was dismissed as a kook by the corporate media. Nobody believed that Amerika could be so dastardly, going into poor countries and saddling them with unpayable debt to justify their subsequent plunder. So I am glad he's being vindicated now.

annenigma said...


Wise doctors don't rush into cataract surgery because, though it may be "easier than going to the dentist", there's increased risk for developing complications after the procedure. Did they discuss the risk of retinal detachment with you, or leave you to read it in the paperwork you were handed minutes before the procedure, when the doctor wasn't even in the room?

Of course some doctors will perform cataract surgery at any stage of cataract development. There's no down side financially for them if you develop complications. They get to see more of you while you might end up actually seeing less of them - retinal detachment can result in blindness. For me, impairment from my cataracts has to be a lot worse than it is to be worth taking that risk. Not driving at night is my treatment option at this point.

We're aging, and that means systems deteriorate. We need to weigh the risks and benefits of any treatment. We also will die, so it's a good idea to accept that fact too and plan accordingly. The profit-driven health care racket all too often balances its books on the backs of the elderly, more so at the end.

Zee said...


I appreciate your thoughtful comment, but here is my experience:

I thoroughly studied the potential complications associated with cataract surgery BEFORE i was on the pre-op table, and decided that it was worth the risks, especially when combined with the abnormal number of "floaters" that I also had in both eyes which threatened even my daytime vision and also my favorite past-times, trap and skeet shooting,

Yes, I did suffer a retinal detachment (RD) in mid-March, years after the cataract surgeries, but I may already have had a pre-dispoiltion to RD--as indicated by my many "floaters"--and also owing to the fact that I was extremely near-signted as a child. As we near-sighted folks know, our vision often gets better with age--our eyeball becomes more spherical--but guess what, our retinas don’t, and sometimes they pop off. Who knew?

So did the cataract surgery cause my RD, or was it going to happen anyway,? Was the opthamologist who did my cataract surgeries (a) just out to make a buck, or (b) was he a sympathetic fellow shooter like me, who understood the frustrations I was going through? I think the correct answer was (b).

And I’m grateful for the years of trouble-free shooting that he gave me despite my later RD.

Moreover, I have every reason to believe that with corrective lenses my vision will be close to its previous good quality, still floater-free, still able to drive at night and still able to shoot trap and skeet.

Life's a crap-shoot and ain't none of us getting out of here alive. And yes, we must all accept the limitations of aging. I gave up motorcycling last year for that very reason, but there are other limitations that I”m just not ready to accept at age 66.

You suggest that “wise doctors don’t rush into cataract surgery” because of the potential for complications. But how “wise” is a doctor who is told by his patient—my friend—that he thinks he’s unsafe to drive?

Karen suggests that my significantly older friend either get a second opinion or give up driving. Great.

All he needs to do is find another competent surgeon here in our medically-underserved community of Albuquerque who also accepts Medicare, right? But even my younger friends are having problems finding new doctors as their old ones retire,

And as for his “just” giving up driving when my friend must still work, in a town in which public transportation is non-existent, well I can’t decide whether that remark is based on East-coast ignorance, or just simple arrogance.

Maybe at his age the potential benefits of cataract surgery really do outweigh the risks, “wise doctor” notwithstanding.

One last thought: for all the talk in this forum about doctors and surgeons who line their pockets by performing unnecessary tests and procedures, what makes anyone think that it will be all that much different under single-payer?

“Bill Sprague said…

I was married to a French Canadienne. She knew lots of doctors whom we would actually visit on our too frequent trips up to Montreal and le camping and sugar houses. The doctors couldn't WAIT to come to the US where they could make some real cash instead of having universal healthcare shoved down their throats. H. Oath? You've got to be kidding. It's all about bucks. Always was, alway will be.

July 1, 2017 at 7:11 PM”

Karen Garcia said...


My suggestion that half-blind older people give up driving was not based, as you say, upon my "East Coast ignorance or arrogance", but out of concern for the innocent people he might end up maiming or killing.

My father-in-law insisted on driving while growing increasingly visually impaired. As a result, the day that he ran a traffic light and T-boned a truck was his last day upon this earth.

According to the NTSB, the older you get, the more likely you are to be involved in a traffic accident. (Of course, this is a government agency, so it's probably only interested in screwing people.)

P.S. Maybe if we had Single Payer and enhanced Social Security benefits, your friend could even stop working once he reached retirement age. But that's probably just my ignorance and/or arrogance talking.

stranger in a strange land said...

Maybe, instead of focusing so much on Universal Healthcare, we should be clamoring for a Guaranteed Annual Income. And let people buy whatever kind of coverage they want. Eliminate regulations preventing interstate healthcare provision (free the market from gov't mandated cronyism) and let people sort their options out for themselves.

Thomas Paine was an advocate for a form of a guaranteed income. Just give The People the CASH they need to participate in a free economy (exchange of goods and services) and *POOF* the predation of private cartels vanishes - their power disappears in converse relation to The People's purchasing power.

Or do we not trust The People enough to make decisions for themselves about the goods and services they need in their lives?

Karen says: Maybe if we had Single Payer and enhanced Social Security benefits, your friend could even stop working once he reached retirement age.

Retirement age should be zero, we've had the technology and prowess to provide such for decades. People don't need JOBS, they need CASH - the means of exchange.

And if my buddy's health insurance company sounds like a stinker (denying coverage for cataract surgery, for instance), guess whose health insurance products I'm probably not going to buy.

We should do away with the absolutely specious notion that everybody has to earn a living. It is a fact today that one in ten thousand of us can make a technological breakthrough capable of supporting all the rest.

The youth of today are absolutely right in recognizing this nonsense of earning a living. We keep inventing jobs because of this false idea that everybody has to be employed at some kind of drudgery because, according to Malthusian Darwinian theory he must justify his right to exist.

So we have inspectors of inspectors and people making instruments for inspectors to inspect inspectors.

The true business of people should be to go back to school and think about whatever it was they were thinking about before somebody came along and told them they had to earn a living.

~ R. Buckminster Fuller

annenigma said...

From the New York Review of Books, 'Putting Profits Ahead of Patients' is informative and well worth reading.

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal
Penguin, 406 pp., $28.00

Getting Risk Right: Understanding the Science of Elusive Health Risks by by Geoffrey C. Kabat Columbia University Press, 248 pp., $35.00

Pearl said...

From Intercept
Subject: Memo to Democrats: You Need A Clear Message for Universal Health Care

annenigma said...

Speaking of cataracts and health care, this is from the article in NYRB that I mentioned above. It may explain why some patients with private insurance get cataract surgery more readily than those on Medicare only:

As Rosenthal highlights, when doctors are turned primarily into businessmen, there can be egregious abuses of the system. Medicare tightly regulates reimbursement for cataract surgery, and in 2013 it reduced payments to ophthalmologists by 13 percent for simple procedures and 23 percent for complex operations as the technique became more efficient and required less time:

Many eye surgeons made up for Medicare’s increasingly stingy cataract payments by charging commercially insured patients more, leading to some staggering prices. Wendy Brezin, a Web designer in Jacksonville, Florida, had cataract surgery billed at $17,406. John Aravosis, a political blogger, was stunned to be billed over $10,000 for each eye.

Zee said...


I apologize for my snippy tone.

But my friend is neither extremely aged—early-to-mid-seventies at most—nor “half-blind.” There seems to be an obvious remedy to his problem, but his doctor simply won’t use it.

And unlike America’s coastal regions and larger cities, public transit for the sight-impaired is non-existent here; to be unable to drive in New Mexico is almost a death sentence in and of itself.

Moreover, my friend is mentally “sharp as a tack” and otherwise physically sound for a man of his age. Hence my irritability.

Yes, there is some potential for serious complications, but I know many people who have benefited greatly from cataract surgery even into their ‘80s—my own mother-in-law being a case in point. In fact, I know of no negative results.

So I’m trying to find out if my friend’s doctor simply refused to do the surgery, or if the doctor said “Medicare won’t pay for it yet.” I admit that there’s a difference, but in the latter case Medicare is playing with fire. We’ll see.

Or, I suppose it's also possible—per annenigma’s suggestion— that this doctor has so many well-paying, privately-insured patients that my friend’s cataracts just aren’t worth his time and effort!
Perhaps another argument for single-payer.

Yes, I know: if we had single-payer and enhanced Social Security benefits for my friend, "[he] could even stop working once he reached retirement age." But alas, we live in the world as it is today, not in a revolutionary future neither he nor I will ever see.


I will try to read the NYRB article for which you provided the link, but will have to see if I can find the books you reference at a much reduced “used” cost. At those “new” prices I’d be afraid that I’d be lining someones’ pockets beyond those of my opthamologist’s

But it is nothing new that doctors and hospitals have been charging the snot out of the privately insured for quite some time now even if the explanations have varied: “cost-shifting,” “cross-subsidization,” sheer “profiteering,” and I’m sure the list of economists’ unprovable theories and excuses can go on and on.

But doctors have always thought pretty highly of their skills, and have fretted about their independence and their compensation from time immemorial. Maybe more on that later.

It truly WILL take a revolution to change that mode of thinking.

Karen Garcia said...


Apology accepted.

Has your friend considered using Uber as he awaits his cataract surgery? Depending on the distance he needs to travel to and from work, the fare could be as low as $5. He could probably save even more if he found someone to share the ride. Maybe his senior center or church can serve as a clearinghouse, bring people in similar straits together.

Re docs refusing to take Medicare patients; I can actually believe that some ophthalmologists are taking this tack because their services are always in demand; the wait time for an appointment can be months, so I suppose they can afford to pick and choose. Their malpractice rates are also higher than average, so I imagine too a lot of them are forced to practice ultra-conservatively. First, do no harm and such.

People on Medicaid are actually the hardest put to find any kind of doctor, since Medicaid rates are so abysmally low.

As my grandma always used to say: "Screw the golden years!"

Zee said...


Thank you for your suggestion that my friend might find Uber useful. Not being all that "tech-savvy," it hadn't occurred to me as a possibility.

As my church ages in unison we are exploring a way to stay together as a community. Uber might be part of that "mix," too.

Zee said...


There's a lot of truth to what your grandma used to say!