Sure would be nice to have a Senator like Franken
What time is it? It's Saints' Season!
Health Care Realities
At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program — but the voter, Mr. Inglis said, “wasn’t having any of it.”
It’s a funny story — but it illustrates the extent to which health reform must climb a wall of misinformation. It’s not just that many Americans don’t understand what President Obama is proposing; many people don’t understand the way American health care works right now. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved, even in private insurance.
And that government involvement is the only reason our system works at all.
The key thing you need to know about health care is that it depends crucially on insurance. You don’t know when or whether you’ll need treatment — but if you do, treatment can be extremely expensive, well beyond what most people can pay out of pocket. Triple coronary bypasses, not routine doctor’s visits, are where the real money is, so insurance is essential.
Yet private markets for health insurance, left to their own devices, work very badly: insurers deny as many claims as possible, and they also try to avoid covering people who are likely to need care. Horror stories are legion: the insurance company that refused to pay for urgently needed cancer surgery because of questions about the patient’s acne treatment; the healthy young woman denied coverage because she briefly saw a psychologist after breaking up with her boyfriend.
And in their efforts to avoid “medical losses,” the industry term for paying medical bills, insurers spend much of the money taken in through premiums not on medical treatment, but on “underwriting” — screening out people likely to make insurance claims. In the individual insurance market, where people buy insurance directly rather than getting it through their employers, so much money goes into underwriting and other expenses that only around 70 cents of each premium dollar actually goes to care.
Still, most Americans do have health insurance, and are reasonably satisfied with it. How is that possible, when insurance markets work so badly? The answer is government intervention.
Most obviously, the government directly provides insurance via Medicare and other programs. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Today, Medicare — which is, by the way, one of those “single payer” systems conservatives love to demonize — covers everyone 65 and older. And surveys show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance.
Still, most Americans under 65 do have some form of private insurance. The vast majority, however, don’t buy it directly: they get it through their employers. There’s a big tax advantage to doing it that way, since employer contributions to health care aren’t considered taxable income. But to get that tax advantage employers have to follow a number of rules; roughly speaking, they can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees.
And it’s thanks to these rules that employment-based insurance more or less works, at least in the sense that horror stories are a lot less common than they are in the individual insurance market.
So here’s the bottom line: if you currently have decent health insurance, thank the government. It’s true that if you’re young and healthy, with nothing in your medical history that could possibly have raised red flags with corporate accountants, you might have been able to get insurance without government intervention. But time and chance happen to us all, and the only reason you have a reasonable prospect of still having insurance coverage when you need it is the large role the government already plays.
Which brings us to the current debate over reform.
Right-wing opponents of reform would have you believe that President Obama is a wild-eyed socialist, attacking the free market. But unregulated markets don’t work for health care — never have, never will. To the extent we have a working health care system at all right now it’s only because the government covers the elderly, while a combination of regulation and tax subsidies makes it possible for many, but not all, nonelderly Americans to get decent private coverage.
Now Mr. Obama basically proposes using additional regulation and subsidies to make decent insurance available to all of us. That’s not radical; it’s as American as, well, Medicare.
To Protect and to Serve. To Canvas and Observe.
Dr. Henry Louis Gates Jr. was taken away in handcuffs from his front porch in Cambridge. The reason according to the arresting officer was he was making a disturbance and being uncooperative. But according to Gates he showed identification proving he lived in the residence and the police officer was both guilty of racial profiling and abuse of power.
I was not there, none of us were so it is all speculation. But the account of the incident has sparked the national discussion on racial profiling and the proper way to relate to police officers. Is not being cooperative your right as an American citizen protected by the 1st and 4th amendments? Is it your job as a police officer to demand cool heads in most situations because those with guilt are rarely calm and collected?
Here is my take on Racial Profiling.
To protect and serve the community you work within as a police officer I imagine you need to canvas and observe the area you patrol. Over time there might be patterns that emerge that you notice lead to criminal behavior. There is a reason there are laws against loitering. If a group of men sit on a corner all day as cars drive by, slow down and then drive off you would assume they were dealing drugs. If a man sits in a car for a long period of time you can assume he is not waiting to pick someone up but waiting for something else. And its that vague "else" that is the justification to ask him what he is doing.
But what if these patterns involve not just actions but certain types of people. Hair style, clothing, nationality, skin color? Can you continue to act upon your assumptions or are you then racial profiling?
I don't have the answers but I do know that how people react and how people are approached in situations with this many unknowns (criminal or father waiting on daughter?) might be what really matters. If I assume you are a criminal and approach you in this way you will react one way, especially if this is not the 1st time this has happened.
I am white but I have been questioned about "what I am doing" before by police. I have been loitering. I have been up to no good. Not selling drugs mind you but having too much time on my hands and making a ruckus. I did not assume the police where doing anything other than their job. But how would they have approached me if I had been young and black?
Health Insurance Does Not Work Unless You Own An Insurance Company.
There is something morally wrong with the current health insurance industry. The act of making money off of health insurance means not paying for procedures. It means dropping people who become very sick and are in desperate need for the assistance health insurance is supposed to provide. It means cutting costs at the expense of the patient. It means private health insurance companies not allowing certain procedures because they deem them to be unecessary and thus letting capitalism determine a patient's needs rather than the health professional, their doctor.
So what should health insurance do?
Health insurance should cover you. It should not be run with profit in mind first and foremost, but with the well being of the patient as its primary objective.
I have a friend who thinks that America has a health industry 99% better than the rest of the world and we should not take on a complete overhaul of the system. I don't agree with this statistic. We are dead last when it comes to how we insure and cover our citizens in comparison to industrialized countries and our costs are twice as high compared to #1 France. I do agree that a complete overhaul of the system is not entirely necessary but I don't think that is what is happening. I think the way we are insured is being overhauled because it needs to.
He is afraid that Obama will create a health care system that is government run which will put private insurers out of business. To that I say "so be it." The only way they will go out of business is if they continue to operate as they have. They have a monopoly and if they are challenged they might drop prices and improve their coverage. But that is anti-capitalism, right? Wrong. Nothing speaks more to Capitalism than Competition.
A talking point against a public option for health care is that the government health care covered by insurance will be sub-par. If this is true then those in fear of the socialized system of health coverage have nothing to worry about. Those who have no health insurance can finally get (sub-par) health insurance and those private insurance providers lose few of their customers because they offer a superior product. In the case of the person with Humana you pay more for greater value.
But what if I can get better health coverage for 1/5 the cost? Isn't that a good thing? A great thing?
I think so.
Here is another interesting benefit to a public plan. Businesses in America pay enormous fees to cover their employees. For example, with a public plan General Motors will save over 10 billion dollars immediately and this might help save the company. If American businesses can have employees covered by a public plan they can use that new capital they sace to compete with international businesses in the global marketplace by dropping the costs of their products and services which means more exports, more money, more jobs, more capital. Is that a bad thing?
Stop with the talking points and lets see both sides have an actual discussion on this issue and see where it leads us.
Debt sucks, but how about a government that actually protects us?
Common sense policies that protect and promote justice and the health of future communities is what I look for, as do many who claim to be Progressives, but not much of what we hope for makes it into law because Congress is in the pocket of business. Real "liberal" policies can't see the light of day because no one has the guts to defend and push them forward without them being taken apart and put together as shells of their original selves.
I have thought about the buy outs and loans to businesses MANY of you hate so much and I don't think either party would have done anything differently. Business will always be protected by Congress. And I have yet to hear or see what the alternative would have been other than some fat cats losing their jobs and having "learned a lesson." You can't just restart an economy, can you?
I agree with Bill Maher there are ways to cut spending and it is in the waste that is in the military budget. Talk about fucking waste. But no one seems to want to talk about it due to fear mongering. "But what is we get attached?" Really? That is just fucking silly. Do hundreds of billions spent on new aircraft that never will be flown stop a bomb from blowing up in a mall? Its just businesses getting contracts through reps in congress who tell critics that they must hate people having jobs. I think it is disgusting and insulting to the intelligence of the American people. But then again lots of folks watch Reality TV so maybe it is just insulting to my intelligence.
Less spending but with investment in our future via infrastructure, education, safety and open dialogs with other nations. That is what I support. That means cutting the fat that big business fights for. It means not allowing for crazy assholes to go to gun shows and pick up semi-automatic riffles that day. It means talking to Iran. It means new highways and new energy projects and actual levee protection. Protection not just here but in all 100+ other areas under sea level in the US. And it means admitting the mistakes of the past and that some times there is a need for social protections like Welfare and not claiming everyone receiving government support is a lazy, freeloading beggar.
Let me say something about that last position. Government is not perfect and neither is society. The person making minimum wage, so little money that they can't afford really any of their own protections or have stability in their life, plays a role in our society that we take for granted. They are part of how American society runs. To not try and support them in some way, give them some assistance because you think they need to "learn a lesson" or not be "given handouts" is to ignore that without them slaving away doing shit work for no pay no one can achieve the American dream of becoming insanely wealthy beyond any reason other than establishing your own personal empire and then telling Congress what it can and can not do.
You can't have protections for society and then bitch when they are misused. It will never be perfect. And to have no government support programs, to be true blue Libertarian means having an ever growing cycle of fear of your own streets, neighbors and future. I would never want that. But that is just me.
Here ends the 1st Rant in some time.
The Street Car Can Save The World
"Thus, when Bush's inner circle first really came to grips with the threat of terrorism, they did so in a state of shock -- a bad state in which to develop a coherent response. Fearful of new attacks, they authorized the most extreme measures available, without assessing whether they were really a good idea."