The Zombie Democracy Shuffle

Paul Krugman's latest column takes issue with Paul Ryan's proposal to have the Congressional Budget Office use something called "dynamic scoring" (Alice in Wonderland math)  to justify more tax cuts for the rich. Despite the sound debunking of "voodoo economics," it's an idea that refuses to die a good death. As a result, Krugman fears, the very credibility of the CBO (not to mention that of the august 15% approval rating Congress) might be in jeopardy if Ryan's dream bill squeaks through a GOP senate! What a shock.

The CBO has already taken quite a few hits for being politicized, most notably from Roosevelt Institute economist Jeff Madrick, who points to that august body's prediction earlier this year that a $10.10 minimum wage "might" be a job killer. These government budget analysts have to thrive on projecting economic forecasts based on such variables of war and peace. And although the CBO hedges its bets through the practice of listing a variety of different scenarios for every eventuality, politicians from both parties have a habit of pouncing on only the choice bits, tastiest to their own agendas. So the addition of dynamic scoring would add one more flaw to an already flawed body.

  Krugman, meanwhile, seems to automatically assume that even if the GOP wins the Senate, President Obama will use his veto option against CBO manipulation and other horrible stuff.  Krugman also manages to use his column space to sneak in the current risible Democratic campaign talking points touting the Recovery under Obama, with its unprecedented part-time/temp job growth since the 2008 meltdown. But the column's main accomplishment is to ignore the de facto jobless and point fingers at perhaps the most valuable Useful Idiot that the "lesser-evil" Wall Street Democrats have ever propped up. Krugman writes,

For years people like Mr. Ryan have posed as champions of fiscal discipline even while advocating huge tax cuts for wealthy individuals and corporations. They have also called for savage cuts in aid to the poor, but these have never been big enough to offset the revenue loss. So how can they make things add up?

Well, for years they have relied on magic asterisks — claims that they will make up for lost revenue by closing loopholes and slashing spending, details to follow. But this dodge has been losing effectiveness as the years go by and the specifics keep not coming. Inevitably, then, they’re feeling the pull of that old black magic — and if they take the Senate, they’ll be able to infuse voodoo into supposedly neutral analysis.

Would they actually do it? It would destroy the credibility of a very important institution, one that has served the country well. But have you seen any evidence that the modern conservative movement cares about such things?

The Times did not see fit to publish this response from me: (I'll give them the benefit of the doubt, though, and chalk it up to a techno-glitch rather than outright censorship):

The credibility of the Senate is already shot, so why would the GOP spoil a good losing streak? If we've learned anything, it's that power has nothing to do with intelligence, that rules don't apply to wealthy crooks, and that fomenting fear and hatred for your neighbor is a sure-fire way for sociopaths to win elections in a gerrymandered system.

 Yes, Obama will be able to veto any vile stuff a GOP senate passes. But will he? Or, like President "end welfare as we know it" Clinton before him, will he bargain away the rights of the working class and poor? Will a GOP majority finally give him fast track authority to ram through the corporate coup known as the Trans Pacific Partnership? Will he try to reanimate his "grand bargain" of Social Security cuts?

Here's one clue: the Obama administration is actually siding with the temp agency being sued by Amazon warehouse workers. They're fighting to get paid for the daily half hour they're held after work, forcibly searched to prevent theft of all those cheap goods manufactured by other oppressed wage slaves in other parts of the globalized economy.

 Voodoo and greed also survive because the media let them. The same oligarchs who bankroll the parties control the 6 major outlets broadcasting 90% of all we see and hear.

 Why else is the DCCC  not supporting Ron Zerban, Paul Ryan's progressive challenger in Wisconsin?  Because it takes a village of Ayn Rand heartthrobs from hell to keep our sham democracy shuffling along.

Where would Krugman and the Democrats be without Paul Ryan to provide the impetus for all their op-eds, their relentless fundraising appeals, their free floating pseudo-outrage? Who could they possibly huddle with behind closed doors to split the difference on food stamp cuts and other austere measures to make themselves appear halfway human? Without Paul Ryan and his fuzzy math to softly kick around, we might even begin to notice that the Dems are nothing but a bunch of corporate shills instead of the party of the working stiff. Oh, wait -- that would only remind people how shamefully they've ignored the crisis of unemployment and underemployment during the mid-term elections. So-o-o-....

Another Pop Quiz

Follow this link to take Pew Research's annual test of world events. As my 9th grade world history teacher Mr. Albanese used to say before every multiple-guess treat, "Do as good as you could, boys and girls. Do as good as you could."

Full disclosure: I did as good as I could, and I still got one answer wrong, which I partially blame on what I consider to be a faulty question with a built-in supposition. More on that later, because I don't want to spoil your fun while the day is so fresh, new, and Panglossian.

Update: O.K., it is now dinnertime and time to confess my wrong answer to the question "on which of these activities does the US Government currently spend the most money?" I answered interest on the national debt, but according to Pew, it's Social Security... which I thought Pew had inserted as a "trick question," given that the Social Security trust fund is separate from the federal budget and is a pay-go social insurance program in which workers and employers contribute a payroll tax to fund current retirees. As such, Congress does not have the power to administer these funds, as it does with spending on transportation and foreign aid (other possible answers in the quiz). And the debt ceiling is a whole other story, given that paying interest on money owed used to be a no-brainer.  So, either Pew worded its question too murkily, or I over-interpreted/read too much into it. I'm quite sensitive to the arguments of the deficit hawk billionaires who are always accusing the old and disabled of bilking the government in their quest to survive. Hope they don't use the Pew poll to say "we told you so!"

The Children's Crusade for Plutocracy

 One of the creepiest aspects of the predatory class's insidious takeover of public education is the way they're using little kids as human shields. To say that hordes of children dressed in sloganized shirts are reminiscent of the Hitler Youth movement isn't really all that hyperbolic. Fascism, be it Homeland-style or Fatherland-style, is still fascism.

Taking a page from the Koch Brothers' Tea Party playbook, the hedge fund billionaires' front group known as "Students First"  has co-opted struggling parents from poor neighborhoods, sending them and their kids out on forced unwitting marches in behalf of perpetual wealth disparity. The kids get free snacks and bottled designer water and nice outfits. They get off the streets for a longer, safer school-day. They are raised up into elite "scholars" who attend such snobbishly titled places as "Democracy Prep" and "Renaissance Academy"  -- rather than the mythical gang-infested grubby P.S. Elsewhere down the block.

And the filthy rich get richer capitalizing even more on the poverty and fear that they themselves have wrought. (Lee Fang of The Nation has an excellent piece detailing the putrid financial underbelly of the charter school movement.)

Exploiting hoi polloi as an innocent means to a nefarious end is the tried and true method of fascists everywhere: present your greed and lust for power as a grassroots social movement, and cloak it with all the accoutrements of populist protest: flags, signs, T-shirts, chants, demands for "freedom" from public school "prisons," secretly-funded media propaganda campaigns. Thomas Frank  describes these big-money, Koch-tastic public demonstration/co-optation techniques in his book "Pity the Billionaire."

The latest bizarre pseudo-proletarian uprising for oligarchic freedom was perfunctorily and turgidly described in Thursday's The New York Times:

The buses arrived in Lower Manhattan from Harlem, the Bronx and Brooklyn on Thursday morning, carrying thousands of charter school supporters who put on matching red T-shirts and came out to draw attention to what organizers called a crisis in the quality of New York City’s public schools. Some of the smallest protesters, squirming in T-shirts that stretched to their ankles, were less than four feet tall.

“The whole school came,” said Angela Sutherland, whose son, a student at Success Academy charter school in Crown Heights, Brooklyn, stood quietly by her side.

The rally at Foley Square, which included speeches by politicians and a performance by the musician Questlove, was part of a coordinated campaign, organized primarily by charter school advocates, to put pressure on Mayor Bill de Blasio as he and legislators in Albany develop their education agendas in the coming months.

(snip)

On the south end of Foley Square, organizers distributed dozens of handmade signs, each painted with one of a few slogans, like “Great Schools Now” and “Don’t Steal Possible.” The buses, stocked with granola bars, fruit and bottles of water, had been hired to encourage parents and students from charter schools to participate.Many parents said the schools made calls, texted and sent their children home with fliers to ensure a strong turnout. Teachers made speeches on the buses to outline for parents the talking points of the day.Eva S. Moskowitz, the founder of the Success Academy charter network, delayed the opening of all 32 schools in her network so that children and their teachers could attend the rally. Children were required to be accompanied by a parent or guardian; those who could not make it had to make alternative child-care arrangements for the morning.

 Their "possible" is being stolen from them... which leads one to believe that not only are the charter school crowd dangerous predators who shouldn't be allowed within 100 yards of classrooms full of innocent children, they also have abysmal language skills in dire need of remediation.

Although Eva Moskowitz of the Success Academies charter school chain is the well-known public front-woman of Students First, its real financial mastermind is one Daniel Loeb, founder and CEO  of the multibillion-dollar Third Point LLC hedge fund.  The identities of the uber-wealthy investors in the charter school takeover of public education for private gain are kept largely secret, although Students First maintains close incestuous ties with the American Enterprise Institute (AEI), a plutocratic think tank which churns out one fatuous policy paper after another in the cause of profiting off the poor. Among the backers of the anti-public education movement are such corporate behemoths as G.E., the Walton Family, the Koch Brothers, and ExxonMobil. In other words, the usual oligarchic suspects running this show, now commonly known as "The Homeland."

Did I mention that Daniel Loeb sits on the board of AEI?

One of the AEI "scholars" who dreamed up the PR ploy of using using mainly minority parents and kids as social activist props in these fascistic spectacles is a young guy named Daniel Lautzenheiser. He's also helping tout the nifty idea of combining the fake protest marches of kids in identical garb with the elite "civics education" curriculum taught to the charter "scholars."

One of his AEI policy papers bears the sinister title "Charter Schools As Nation Builders." Its lede is eerily similar to the Times article linked above:

On a sunny Tuesday in June, the streets of Harlem, New York City, are filled with the usual midday crowd hustling in and out of subway stations and eating hurried lunches. One thing they are most decidedly not doing is voting. And this is a disappointment for a small army of schoolchildren dressed in bright yellow shirts.

The students in yellow attend one of the charter schools in the Democracy Prep Public Schools network and, with the help of their teachers and several parent volunteers, are waging a Get Out the Vote (GOTV) campaign. The occasion is the Democratic congressional primary for New York’s 15th Congressional District, which encompasses upper Manhattan (including Columbia University, Washington Heights, and Harlem) and surrounding locales. Congressional primaries are typically low-turnout affairs in which incumbents have a massive advantage.

It turns out that ethics-challenged Charles Rangel, a Democrat in Congress for about the last hundred years, was in some danger in his district. So the kids, dressed in identical yellow "Future NAACP Member" t-shirts, were getting a lesson in civics by being transformed into sidewalk automatons to get out the (Rangel) vote. 

To show his appreciation, Rangel sent 80 lucky Democracy Academy kids on an all-expenses paid junket to Korea, the trip funded by the usual anonymous suspects. And thanks to another $9 million grant from the Obama Department of Education, Democracy Academy is expanding its operation to another 15 schools over the next seven years.

Lautzenheiser continues explaining the charter movement's "liberal" activist approach to indoctrination civics education:

Though scholars have unpacked civic education in a number of ways, we distinguish between two basic strands. Students are taught abstract citizenship: how our system of government works, what rights and responsibilities US citizens share, and an understanding of significant issues, events, and turning points in American history. Abstract citizenship is most often taught in the classroom; it teaches students about being a citizen and why it is important.

Operational citizenship, on the other hand, teaches students how to be an active citizen. This side of civic education relates to the behaviors and attitudes expected of American citizens, such as following rules, respecting others, performing community service, and making one’s voice heard via voting, rallying, or testifying. Operational citizenship is often learned through experience, some of which can be gained in school but much of which takes place outside of the classroom.

"... teaches students how to be an active citizen." Another indication that the creative destruction crusade of the plutocrats also applies to grammar. Lautzenheimer, incidentally, came to his pro-student activism Eureka moment relatively late in his 20-something life. As a "scholar" at the University of Virginia in 2006, he editorialized against a different student rally which called for a living wage for the school's janitorial staff. Protesters were guilty, he fumed, of "disrespecting" university administrators by standing up for poorly paid custodians. And horror of horrors, they had the chutzpah to deface school sidewalks with the "10.72" wage .... in chalk, of all things.  Young Lautzenheimer made sure to go to the school administrators to personally apologize for his rowdy socialist peers and assure readers that the earned income credit was a worthy substitute for a living wage.

No wonder he got hired by AEI immediately upon graduation. No wonder he was chosen to subvert leftist student protest movements to his oligarchic bosses' own ends. He follows the rules.

Re$pect Our Rule$

Quick Quiz

  Name the person who uttered the following words:

"I actually believe that capitalism is the greatest force for prosperity and opportunity the world has ever known. And I believe in private enterprise -- not government, but innovators and risk-takers and makers and doers -- driving job creation".

Was it:

A) Mitt Romney

B) Rand Paul

C) John Boehner

D) None of the above.

Answer will be provided in an upcoming post. Meanwhile, anyone who can Name That Conservative within the next 10 minutes will receive a free subscription to Sardonicky.   

Update: Congratulations to Fred Drumlevitch, who quickly came up with the correct answer: D) Barack Obama. For anybody interested, Barry made his neoliberal remarks to a group of business students in Chicago yesterday. You can find the entire transcript on the White House website, which I refuse to link to again for fear they might think I'm an obsessive fan.

 

Ebola Does Dallas

Now that the Ebola virus is in their backyard, the obscenely wealthy are expected to finally start prying open their wallets to fight a plague that heretofore had only been afflicting "the other."

A combination of factors that include a lack of a cataclysmic event, slow-building media coverage, and significant government intervention had tempered the philanthropic community’s response during the first several months of the outbreak, according to Mr. Ottenhoff and other experts.

"When you read stories that the American government is sending 3,000 military workers and spending hundreds of millions of dollars, some donors think, ‘Well good, this problem has now been addressed,’" Mr. Ottenhoff said. "Then there are other donors who think, ‘Given all this money, where are the gaps?’ and ‘Maybe we need to hold back a little while and figure out where the funding gaps are before we commit our money.’"

Bob Ottenhoff is the director of a group called the Center for Disaster Philanthropy  which in my proletarian ignorance, I'd heretofore never known existed. So far, he says, the rate of plutocratic giving to fight a disease wreaking havoc in countries in West Africa has been, to put it euphemistically, downright mean. A relatively modest $50 million from the Bill and Melinda Gates Foundation, out of its more than $40 billion stash, has been the top donation so far to fight a disease expected to strike more than a million people. First runner-up was the Paul G. Allen Family Foundation, with $9 million to the CDC,  $2.8-million to the American Red Cross, and $100,000 in matching funds to Global Giving.  The William and Flora Hewlett Foundation gave $5-million to various international health organizations in the fight against Ebola, according to The Chronicle of Philanthropy.

The American Red Cross has only raised $98,000 thus far from individual private donors (in addition to the Allen Foundation's gift) for the treatment and prevention of Ebola. Because, let's face it --  Africa is not as conveniently close as earthquaked Haiti, or flooded New Orleans, or the superstorm-ravaged East Coast of Indispensablistan. It is next to impossible to get self-promoting politicians and celebrities to go to the scene of the action for photo-ops that show them helping in some rebuilding effort. Celebrities in haz-mat suits aren't aesthetic marketing ploys.

And anyway, the media have been bending over backwards to help assure the wealthy that It Can't Happen Here. From the New York Times:

Dr.(CDC director Thomas) Frieden told the president that the C.D.C. had been prepared for an Ebola case in the United States, according to an account of the call distributed by the White House, “and that we have the infrastructure in place to respond safely and effectively.”

The Obama administration was working to prevent a public panic over the case, using social media to describe how Ebola can — and cannot — be transmitted.

“You cannot get Ebola through the air, water or food in the U.S.,” the White House said on Tuesday night in a posting on its official Twitter account. “Ebola can only spread from contact with the blood or body fluids of a person or animal who is sick with or has died from the disease.”

Another official Twitter posting said, “America has the best doctors and public health infrastructure in the world, and we are prepared to respond to Ebola.”

USA! USA! USA! What about the 30-40 million people who remain uninsured, and where even people now receiving expanded Medicaid benefits under Obamacare often can't find a doctor willing to accept their insurance?

 Was the unidentified man now being treated for Ebola in Dallas initially sent home from the hospital where he sought treatment because of his lack of insurance in a state which is refusing Medicaid expansion? Or was it just the fantastic health infrastructure? No word yet. But if one individual's inability to pay turns out to be the cause of Ebola spreading in the US, then it also might be the impetus to finally enact a true single payer health care system in this country. After all, denial of medical care to people based on their bank accounts and social status will also have an adverse affect on the healthy wealthy who dictate social policy. All the gated communities, all the private security guards, all the private boutique hospital suites with concierge service in the world will not protect them in the horrible event that Ebola (or any other mutated pathogen, for that matter) gets out of control. You can't bribe Ebola.

Meanwhile, our leaders have been doing everything in their power to actually foment a public panic over the "cancer" of ISIS, which before Ebola made its unscripted appearance, was threatening to surge over the Texas border right along with all those hideous hordes of undocumented Illegals, threatening to kill us all in our beds unless we spend trillions on bombs and tanks and drones.

Meanwhile, officials blithely assure us that once it hits the exceptionally rich soil of the Homeland (the preferred new name for USA) Ebola doesn't stand a chance. I guess they never heard the story about how the Black Plague had morphed into two forms (bubonic and pneumonic) -- the first spread by fleas, the other, then-rarer form, by human aerosol droplets. As they say in the pathogenic real estate biz: Mutation, Mutation, Mutation.

As Sophie Delauney, director of Doctors Without Borders, told NPR recently,
"It (the actual reality of the plague) is so horrific, that once you realize how dramatic the situation is, then you just keep thinking about Ebola all the time. But until you make that step, you prefer to get away from it."

The only thing we have to fear are the fear-mongers themselves, who prefer that we think instead about fake terror groups and beheadings. What we really should all be panicking about is the latest outbreak of official ineptitude, pathological denialism, and outright stupidity of government bureaucrats and self-dealing politicians.

Party On

How does an oligarchy solve a problem like the class war? They sweep it under the rug, that's what they do. With the help of their corporate media stenographers, the ruling class has conveniently clumped their American serfs into ideological hovels attached to one of two fiefdoms: Democratic or Republican. Better to swear fealty to a political tribe and expend your energy on hating the other side, than self-identify as poor and oppressed and turn against the overseers.

The latest iteration of the Divide and Conquer method, successfully used by aristocrats to maintain control of the masses through the ages, has been dubbed "Partyism." It has now actually surpassed other measures of bias in the group-think hate sweepstakes. Republicans hate Democrats more than they hate minorities and gays and welfare moms. Democrats hate Republicans more than they hate Wall Street. What state of populist affairs could be more perfect for the One Percent?

In 1960, 5 percent of Republicans and 4 percent of Democrats said that they would feel “displeased” if their son or daughter married outside their political party. By 2010, those numbers had reached 49 percent and 33 percent.

So, if they filmed a remake of Guess Who's Coming to Dinner, the plot, instead of white parents dealing with the angst of their daughter dating a black man, might involve the angst of Democratic parents whose daughter brings home a Republican suitor. Or maybe the red state/blue state families of a pair of gay lovers would be hilariously divided in a comedy-of-errors party affiliation romp, reminiscent of La Cage. If it was a feel-good Lifetime movie, Republican and Democrat hedge fund managers would overcome their mutual disdain and start their own charter school chain just in time for Christmas. Love of money will keep them together.

 The 24/7 ideological "news" shows on MSNBC and Fox have succeeded beyond all the wildest plutocratic expectations. They have gotten struggling people to blame members of their own class (commonly divided into "libtards" and "wingnuts" in anonymous online comments boards) for whatever ails them, rather than the financial "malefactors of great wealth" who robbed everybody blind. They get us to identify with our elected leaders, to take vicarious umbrage whenever our favorite politician gets attacked by "the other side."  They thrive on ridiculing the  pretend-opposite party rather than imparting information to their viewers.

Case in point: the recent manufactured brouhaha dubbed #LatteSaluteGate, in which President Obama saluted service members while holding a cup of coffee. Disrespectful and unpatriotic, screamed Fox. And then MSNBC countered with an old clip of George W. Bush saluting service members while holding his pet dog, which of course shows how hypocritical Fox is to disrespect Obama for disrespecting the troops. And the partisan blogosphere erupted, right on corporate cue. (coup)

  Of course, hardly anybody saw fit to mention that both men were acting like elitist assholes, nor did they question the waste of taxpayer money by presidents for using Marine One to travel to party fund-raising gigs, or why and how this whole grotesque military ritual developed in the first place.

Partyism also explains why there is no anti-war movement. Democrats who should have been in the front lines of peace protests are nearly all silent --  because their "reluctant warrior" Obama is the one hurling the bombs (that he inherited from Bush, of course.)

 To make our acceptance of perpetual war even more ironclad, we're now being entertained/distracted with #PenetrationGate. Through a couple of carefully orchestrated leaks to The Washington Post, we have just learned, to our shock and horror, that two different disturbed people shot at and did a home invasion of the White House over the past few years. Congress is now holding hearings on the scandal. The upshot is that rapt viewers become all too willing to overlook the shock and horror (aka collateral damage) being visited by the "vulnerable" Obama upon vulnerable people in Arab countries. We're also lulled into thinking that Congress, so recently and rightly castigated for turning a blind cowardly eye to the same president's abuse of power, is now doing its job by scapegoating, exposing and scolding a contingent of relatively underpaid presidential bodyguards.

Starting salaries for this "elite" federal force range from a low $33,979 to $43,964, depending on qualifications. This compares unfavorably with the starting salaries of other law enforcement agencies.  New York State Police recruits, for example, are paid $50,374 while they're still in the Academy, with an almost $17,000 raise upon graduation six months later, with another $5,000 after one year. (recent graduates have included former Secret Service agents. Quel choc!)

The corporate media are not talking about the below-median salary paid to those tasked with protecting the most powerful man on earth, of course. The problem with the Secret Service, just like the problem with all members of the 99% who struggle every day to make ends meet, is cast as one of "their culture."

When it comes to issues of the security state, Partyism goes right out the window. When it comes to advancing military goals, and propping up the symbolic office of the presidency, bipartisanship is the unspoken rule: Democrats and Republicans forget their differences, pronto. And the plutocrats and the profiteering war mercenaries and the finance cartels and all their toadies in Congress party on, and on, and on. Wherever in the world there is superfluous human labor and natural resources ripe for the extracting, there's an automatic excuse for a party. And you're not invited. So back to your hovels so that the conquerors can get on with it.

  

All Obamacared Up and No Place To Go

This is a feature, not a bug:

Enrollment in Medicaid is surging as a result of the Affordable Care Act, but the Obama administration and state officials have done little to ensure that new beneficiaries have access to doctors after they get their Medicaid cards, federal investigators say in a new report.

The report, to be issued this week by the inspector general at the Department of Health and Human Services, says state standards for access to care vary widely and are rarely enforced. As a result, it says, Medicaid patients often find that they must wait for months or travel long distances to see a doctor.

Robert Pear of The New York Times writes that by 2016, an estimated one in four less well-off Americans will have been on the Medicaid rolls at some point during their lives. The Affordable Care Act mandates only that states provide adequate care for people on Medicaid, but somehow forgot to define the meaning of "adequate." To make it even more suspenseful, the public Medicaid program is now largely administered by private, for-profit insurers who, in the interests of the free market god, must also extract their fees.

In one state, the "adequate" waiting time for a sick Medicaid enrollee to see a doctor is as much as 60 days, Pear writes, while in other more humane places, two weeks is the acceptable norm. Regardless, few states ever bother to prosecute Medicaid providers who fail to uphold agreed-upon standards of care for the indigent. It's kind of the same rationale outgoing Attorney General Eric Holder uses for his failure to prosecute renegade bankers: with so few of them to begin with, the whole system would collapse upon itself if you dared punish anybody.

 The private insurance Medicaid contractors, wanting to stay in business in a bare-bones system, have also been known to deliberately falsify information on their so-called provider networks -- including the names of physicians who are no longer in business, who have already reached their quota of new Medicaid patients, or even those who've always refused to accept Medicaid patients. And in some cases, the providers listed are completely fictitious. Fraud? What fraud? 

It's not like the Obama administration couldn't have foreseen that physicians, who even before Medicaid expansion, were not accepting Medicaid patients. The reimbursements are much lower than what private insurers and even Medicare pays out. Although the Affordable Care Act provides for increased fees for physicians seeing indigent patients, these are only for the first two years of the program, like a bait and switch special introductory offer" for new cable subscribers. 

 There is also a chronic doctor shortage in the United States. There are too few medical schools training new doctors. The rural poor have more difficulty seeing a physician than the urban poor. From McClatchy Newspapers:

Of more than 1 million physicians, therapists and counselors nationwide, only 43 percent accept Medicaid, according to a new study by HealthPocket, a technology firm that compares and ranks health plans.

The situation varies by city. The study found that only 31 percent of caregivers accept Medicaid patients in Washington and Detroit, 36 percent in San Francisco, 42 percent in Philadelphia and San Diego, and 47 percent in Seattle.

“If the current Medicaid acceptance rates hold true for 2014, timely access to care for those relying on Medicaid is likely to become more difficult as enrollees compete for an already inadequate pool of doctors,” said Kev Coleman, the head of research and data at HealthPocket.

The lean physician workforce has prompted some states to try to expand the types of primary care provided by nurse practitioners, physician assistants and other non-physician medical personnel. But the HealthPocket study found that only 20 percent of physician assistants and nurse practitioners nationally accept Medicaid, less than half the rate of doctors and other providers.

But as Doctor Pangloss would say, it could always be worse in this best of all possible insurance- kludgey, exceptionally American worlds. At least the poor people who must wait weeks or months and crawl miles to see a doctor are lucky to live in states that actually are accepting Medicaid expansion. As a Harvard/CUNY research study shows, as many as 17,000 people are expected to die needlessly every year because they aren't even being afforded the right to wait in line and play the health care lottery game for the poor in the first place.

The richest country on earth not only boasts the greatest wealth inequality on earth: it's even divided its poor populations into subsets of misery depending on the party affiliation of their overseers.

Read more here: http://www.mcclatchydc.com/2013/05/13/191105/most-doctors-still-reject-medicaid.html#storylink=cpy