Healthcare Reform for Idiots

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I really shouldn’t have to do this, but here we go. Healthcare Reform for Idiots:

(Disclaimer: single payer health care is  the best option. Remove the profit motive from health care. No more million dollar CEO’s getting rich by dropping folks who get cancer or other illnesses. But this guide to health care reform for idiots is necessary since single payer was destroyed by wealthy industry opponents)

#1. Congressional Republicans are NOT STUPID (well not literally, but that’s another discussion). Republicans are not intellectually incapable of understanding the problems around healthcare and what the democratic solutions are. What republicans are is MANIPULATIVE.

#2. Since the republicans are not stupid, but rather conniving weasels, the President and Democrats need to be smart. Don’t get caught up arguing that republican objections have no wings, just CUT THE DAMN WINGS! Example: DROP THE PROVISION that republicans are twisting as “DEATH PANELS”. The provision itself would simply allow physicians to counsel patients on end-of-life care, but its just red meat for the republicans.  Its just not that important, and can be done in separate future legislation.  Drop the provision, and just pull the rug out from under the R’s.

#3. Speed is essential. While the R’s are trying to find some new baloney to fiercely oppose, MOVE ON HEALTH CARE. GET A BILL OUT AND TO THE PRESIDENT.

#4. Speaking of speed, Democrats: GET YOUR FLIPPING ACT TOGETHER. Just in case that is ambiguous, let me repeat: DEMOCRATS, GET YOUR FLIPPING ACT TOGETHER. Republicans are able to toe the party line no problem–This is the first time in who knows how long when the Democrats have the presidency, the house, and the senate. DO THE DAMN THING.

North Korea has been obnoxious and obstinate in nuclear discussions. Conservatives  argue a policy of non-engagement. SO GIVE THESE CONSERVATIVES A TASTE OF THEIR OWN MEDICINE. We do not need to engage in their b.s. and beg for their votes.

#5. DON’T PASS A HALF-BAKED PUBLIC OPTION. For a public option to be meaningful, it can’t be watered down to accommodate scheming republicans.

#6. Be Clear about how you are going to pay for everything. Don’t Simply say the reform will cost $700 billion. EXPLAIN THAT WE ARE ALREADY SPENDING MUCH OF THIS MONEY ON HEALTH CARE. Its not like we are just going to tack on new spending. We are restructuring largely how we pay for healthcare.

#7. CHOOSE YOUR BAD GUY. Right now “big government” is the bad guy. Its easy for the right blame the government and rail against it. How about redirecting some of that ire where it belongs? THE HEALTH INSURANCE INDUSTRY. If you haven’t had a personal experience where you, a family member, a friend, or a co-worker was screwed over by their insurance company, you either live under a rock or  in a  FANTASY BUBBLE OF CAREFREE FOLK. Direct some of this justified anger at the industry.

#8. SUBMIT YOUR RESIGNATION if you still can’t figure out how to pass health care reform with a democratic president, house, senate, and massive public discontent with the status quo.

If you really can’t do it, I’m happy to take your job.

-kd-

Where to?

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Hello-everyone- Just a quick note to apologize for not posting in a while.  Finishing grad school and finding employment is this job market is about as tough as any cliche phrase that comes to mind, so I’ll just say its not fun.

Hopefully when I am gainfully employed and thoroughly indebted to Sallie Mae I will find more time to write.

Until then, check out the “Brain Buffet” I’ll try to keep that updated- because hey- you gotta eat!

-kd-

Here Come the Chickens

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Last fall as the American economy appeared to be slipping over the edge of an economic precipice, those in Congress were faced with some tough choices about whether to prevent giant businesses from going under– in order to spare the economy further economic trauma.

In the midst of all of the chaos and tumultuous stock tickers, then Treasury Secretary Hank Paulson made a bold announcement: he wanted congress to hand him a blank check for $700 billion so he could work his voodoo magic on the economy. In his thinly populated 3 page proposal, he also indicated that congress should mind their business about where he was going to put the money.

I was proud of the level of public engagement with elected officials, as the outrage of American’s translated into thousands of calls and emails to their representatives and senators. I was equally dismayed at the eventual decision of Congress- to essentially concede to Paulson.

Since that time the Treasury Department has doled out billions of dollars to many businesses- among them- $170 billion to AIG. What did AIG do after receiving their very own welfare check? They sent their employees to a luxury resort in California- a week long respite to the tune of nearly half-a billion dollars. Congress, in all of their indignance, rattled their sabers and made biting remarks to the media about AIG’s wasteful spending of tax payer dollars. BUT, payments to AIG continued.

Now that it has come out that AIG is distributing $169 million in bonuses to employees as a result of “contractual agreements”, Congress, and the President, are again parading around in anger. Give me a break. First of all- Congress set this all in motion last year when they opened the floodgates of corporate bailouts without significant oversight. Then, when discovering unscrupulous behaviors by AIG and others (see Merrill Lynch), Congress simply complained loudly- but made no significant attempts to right the problems.

Now we once again see the result of private businesses making decisions that would make most of us squeamish, and again the clamor is loud. Senator Grassley even went as far as to suggest AIG exec’s should commit suicide. Now the Senate & House are discussing legislation that would impose virtually a 100% tax on bonuses for companies that have received governmental bailouts.

The general frenzy with which the public, the president, and the congress have been swept up in over $169 million is almost comical. With another $30 billion scheduled to go to AIG, when all is said and done, AIG will have received over $200 billion dollars from American taxpayers- and we are upset over $169 million dollars? Seriously? Get real people. Lets direct at least some of this anger where it belongs- on congress for so poorly  regulating the dissemination of taxpayer money.

Even looking past Congress’s culpability, lets think for a minute about the actual idea behind a 100% tax on a portion of businesses spending done in a legal manner. Did I miss something? First of all- many of those receiving the bonuses from AIG don’t even work for the company any more. Taxing AIG isn’t going to do a thing about getting the money back from those payees. Second of all- Congress needs to stop sending mixed messages. Either we are nationalizing businesses- where the government takes over control, and makes decisions for the business- and maybe this is the right thing in certain instances; or the government is simply providing financial aid to a business with some stipulations attached– and maybe this is the right thing in certain instances.

But trying to retroactively punish businesses for engaging in legal, albiet shady, practices, is not the job of the government, and recouping $169 million is nothing more than a publicity stunt- especially when another $30 billion is scheduled for release to AIG in the near future.

So what are the lessons?

1- Americans need a longer attention span. Lets not forget the actions that set these unregulated bailouts in motion.

2- Americans should not be duped by this publicity stunt. Sure AIG’s actions were reprehensible, but in the grand scheme of things, is $169 million the best thing we can think of to be angry about? Seriously?

3- Bailing out businesses that are “too big too fail” should be an indication, in the sage words of a C SPAN commentator this morning, that they are indeed “failing”. Congress needs to carefully consider what the root problems are in a business or industry before blindly throwing money at it. If they did perhaps they would discover that the problems in part, were created by those whom they would give fat checks to, to fix it.

Last fall Congress hastily got itself into the business of bailouts without proper research, debate, or forethought. The chickens are coming home to roost now, and its becoming pretty amusing to watch all the fingerpointing.

I for one, am pointing my finger right back at Congress.

-kd-

The Superior Scribbler Award!

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So it turns out that some of the folks who come by this page appreciate my rambling, theorizing, and sometimes satirical take on all things political. I am honored to announce I have been awarded the The Superior Scribbler Award by fellow bloggers over at the dynamic blog: To The Wire.

The idea behind this award was started by the Scholastic Scribe, where 5 bloggers originally received recognition as “superior scribblers“. In return, these 5 bloggers passed the award on to 5 others and so on…

I’m flattered to have been included in this love fest (^_^)  and include my 5 awardees & the rules here:

  • Each Superior Scribbler must in turn pass The Award on to 5 most-deserving Bloggy Friends.
  • Each Superior Scribbler must link to the author and the name of the blog from whom he/she has received The Award.
  • Each Superior Scribbler must display The Award on his/her blog, and link to this Post, which explains The Award.
  • Each Blogger who wins The Superior Scribbler Award must visit this post and add his/her name to the Mr. Linky List. That way, we’ll be able to keep up-to-date on everyone who receives This Prestigious Honor!
  • Each Superior Scribbler must post these rules on his/her blog.

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And here are my picks:

1. Margaret and Helen These two 80-something year old women offer up daily doses of biting humorous commentary. You won’t regret stopping by.

2.The Unhappy Camper. Joe is a middle aged man living in Miami who is currently homless. He blogs from local libraries when he is not chased out, and offers his reflections, in all their honesty, about life, and how he’s feeling.

3. Pennsylvania for Change is an activist blog that offers up an interesting liberal perspective on national and state events.

4. Advocating for Freedom. This is the blog of a friend of my here at Penn. She doesn’t write on it very often, and will  likely have no idea I gave her this award, but the few posts she has written are very thought provoking, and well worth the read.

5. Quaker Agitator. This is a solid and comprehensive blog that is aptly described by its title.

Enjoy the good reads & Congrats to the new winners!

-kd-

“274 events”

sleep-apnea1 So I snore pretty loudly. Sure lots of people do, but how many of their friends would liken their snore to the sounds of a whale? I have at least one. Over the past few years I’ve grown used to being the brunt of jokes about the volume of my snore, and I’m sure the number of nights my girlfriend wakes me up complaining “babe you’re snoring!” is vastly outnumbered by the nights she rolls over and tries to fall asleep. So a few years ago, after she noticed that not only was I keeping the dead from sleeping, but that I would often stop breathing- I decided to get checked out.

At first, I wasn’t even sure I could get it checked out- as a college student, with a college student health plan, I had learned first hand that medical insurance does not always equal medical coverage. But after a few calls, I was surprised to learn that Aetna would pay for me to visit the Windham Hospital Sleep Lab.

So I called them up and arranged for an overnight study. Basically, I went to the hospital late in the evening, had dozens of wires and electrodes stuck to my body with an unfriendly goo, and hopped into bed. Trying to fall asleep knowing that the technician in the room over whose voice was omnipresent  via unseen speakers, was watching over my every toss, turn, and scratch was a tricky task. Finally , I managed to fall asleep, and 8 hours later awoke to a new morning, eager to run home and grab a couple more hours of sleep before the day began.

Shortly after, I returned to the hospital to meet with the doctor in charge of my case. Sizing me up with curiosity, he announced that I had severe obstructive type sleep disordered breathing (sleep apnea), despite the fact that I was about 20 years too young and 60 lbs too light. Then came the real shocker: I had severe heavy snoring disease. I had to chuckle inside a little at that one, and promptly noted the condition so that I could explain to my friends I was not being purposefully obnoxious when I slept.

But getting back to this sleep apnea business- what exactly did that mean? In a nutshell, during the 6.1 hours of sleep I was observed, “274 respiratory events were manifested”, i.e. I stopped breathing. That didn’t sound so great. So what did this mean for my body? Basically, every time I stopped breathing, extra stress was put on my heart as my brain kick-started things. I learned that over a period of time, untreated sleep apnea can lead to high blood pressure, heart disease, and a host of other undesirable side effects, including the “moderately severe reduction of REM sleep” I exhibited: read I miss out on the deep rejuvenating stage of sleep every night.

The answer supposedly was a CPAP machine- an awkward looking device (pictured above) that you hook up to your face before you sleep each night. It is supposed to generate a constant flow of air into your lungs to prevent the “respiratory events”. Dr. “X” told me the technicians would simply need to schedule a second night of observation during which the CPAP would be hooked up to me and calibrated specifically for my breathing. Then a order for a machine would be placed with a local supplier, who would then come to my house, set it up, and show me how it worked. Bada-bing! Problem solved.

Only not really. When the Dr. mentioned a second night at the hospital, I told him that probably wasn’t going to happen any time soon. The fact was, my student health insurance had a “per-condition, per-year” policy cap of $1500 or so. That meant spending on any one condition over $1500 came from my pocket. I told him that I would have to see how much the 1st night’s bill came to before scheduling a 2nd night. I called the billing department- and ouch! One night in the lab had not only wiped out my cap for the year- but had exceeded it.

So in the span of just a few weeks I incurred hundreds of dollars of medical debt payable by me, just to learn that I had a dangerous sleep disorder that I couldn’t schedule a follow up study for. So I grinned and beared it. I waited until my next policy year started, and contacted the hospital to set up the 2nd night of my study. It had taken a while, but at least now I could complete the process. It was a lovely idea, but the hospital thought otherwise. Apparently in waiting for my policy limit to reset, the first night of the study had become void- the data was too old to use for a 2nd night’s sleep.

By this point I was pretty ticked off. I explained my dilemma to the Dr. & staff, and they came up with a solution- they would schedule me for a split-night study. Instead of observing on night #1, and intervening on night #2, they would split one night into 2 parts, waking me up half-way through. And so I trudged back to the hospital, submitted to goo and electrodes, and fell asleep easier this time, not nearly as creeped out by the watchful eyes in the dark this time.

So finally  the problem was just about taken care of- the split night study went well,  my order went into the CPAP vendor, and I should be all set in a couple of weeks. Then came the best news of all: Aetna declined to pay for the CPAP machine. I must admit I was surprised. After all, before even embarking on this journey, I had done some homework and learned that CPAP would likely be the answer the sleep lab recommended. So when I asked Aetna if they would pay for the study, I also asked if CPAP would fall under “durable medical equipment”- which had its own cash limit. They informed me it would, and did not count towards the “per-condition” limit. So why did they turn down my medical treatment?

“It was not medically necessary”

I had to laugh. It was all too ridiculous. If Aetna denied me medical treatment now because it was not medically necessary, in 20 years, Aetna, or other insurers could deny me medical coverage for developing what they would then call a pre-existing condition: heart problems. Indeed, even if I tried to switch insurers then, I would run into problems: many insurance companies will not pay for conditions that  a “reasonably prudent” person would have taken care of in the past.

I asked My Dr. appeal Aetna’s decision, which he did,  but it was to no avail. I joined the ranks of the millions of American’s who fall into the no-man’s land of “underinsured”. Much talk is had of those without insurance, and those with insurance who pay too much- but little focus is placed on those ostensibly with insurance, who find their coverage exists only on paper.

After this experience I vowed when I moved on to grad school to drop Aetna and pick up a new carrier.  However, when the time came, after weeks of research and inquiry  I was chagrined to learn that my new grad school also used Aetna- and it was the only coverage I could afford with my now “prexisting condition”.

And so I have grudgingly been forced to enroll again with Aetna- a health insurance company that considers each one of my 274 nightly respiratory events of medical insignificance. It is in this way that 18,000 American’s die each year for want of adequate health care. My beautiful sister Holly was one of them 1.5 yrs ago, and it appears that Aetna is perfectly happy to add me to the count after they collect my premium.

With a new Health Czar, a new HHS secretary, increased money for Medicaid, funding for new health centers, and tomorrows health care reform summit, the temptation to mistake action for progress will be great. It is up to everyday Americans to make sure that Washington remembers health care reform is not just about policy options, but about people.

-kd-

Further Resources:

Kaiser Network

Obama’s Health Care Plan

Sustinet: Connecticut’s Current Universal Health Care Proposal

Pennsylvania’s Universal Health Care Efforts

United States Department of Health & Human Services

Families USA

Health Care for America Now

Universal Health Care Action Network

Too Late, New York

346px-crimesvg Today the United States Supreme Court upheld a ruling on the statute of limitations. The case in a question- a double homicide, kidnapping, rape, molestation, embezzlement, and grant theft auto, was originally brought by the New York City District Attorney against “John Doe” late last year.

On October 1st, 2008, Mr. Doe, allegedly rushed into the Federal Reserve Bank of Manhattan wielding semi-automatic weapons. Apparently Mr. Doe had been embezzling money from various charities, and was seeking to destroy the financial records of the money transfers to his account.

After storming through the front door, and being told by the teller that she “didn’t have access” to his records, he shot and killed her. The security guard, too fell victim to Mr. Doe, as he unleashed a barrage of bullets at him. Mr. Doe, unsatisfied with his inability to erase his records, in a fit of rage demanded that the manager empty the contents of 6 drawers into his canvas bag, before ordering the manager out of the bank and onto the street at gunpoint.

Once he was outside the bank, Mr. Doe then pulled over a vehicle, firing 3 shots through the windshield at the elderly driver, Ms. Patterson, an 80-year old resident of Manhattan, who suffered minor injuries, described the criminal as “a crazy young man”. Authorities say, that Mr. Doe then forced the manager to drive to his home, where Mr. Doe then allegedly raped and molested various members of the manager’s family, whose names are not being released at this time.

The saga finally ended just over a month later, in November when authorities were able to track down and arrest Mr. Doe, following a tip from a neighbor who was worried by the the “bloodied clothing” she saw Mr. Doe disposing of. The various victims of Mr. Doe’s crime scheme were later shocked though, when the NY District Attorney’s case against Mr. Doe was thrown out of court by the judge, because the “statute of limitations bars the bringing of any civil or criminal charges against Mr. Doe; despite the seemingly heinous nature of his actions”.

It turns out that New York had an old, obscure law on the books that prevents the bringing of civil or criminal charges by the state against any resident for actions that took place over 30 days prior to their arrest. This little known law, referred to as Code 47-32, is an egregious example of statute of limitations gone wrong.

Despite the lives he destroyed on that fateful October day, Mr. Doe is apparently set to walk free next week, with the Supreme Court ordering not only his immediate release, but also compensation for the time he was “unlawfully incarcerated”. As charges cannot be brought against Mr. Doe, authorities have cautioned against using the 35-year old’s name in print, as his lawyers are expected to bring a defamation suit against the state.

Okay, so if you’ve read this far, you are likely floored by the absurdity of a known criminal who wreaked so much havoc through his actions, being allowed to walk free after 30 days because the “statute of limitations” have expired.

Before you get up in arms, I caution you, you will not find this story elsewhere online because I made it up. But, before you put your arms down, I say to you this is simply an exaggeration to demonstrate a very real problem with our judicial system.

Today on NPR I heard a story about a rabbi who molested a young boy twice a week for over two months. Years later when the boy told his parent about the abuse, the parents confront the school officials, who agreed to fire the rabbi.  However, 1 week after the boy turned 23, and the statute of limitations for civil or criminal suit expired, the school hired the rabbi back. I was dumbfounded by the absurdity of this, and then I thought of Lilly Ledbetter.

At the signing of the new anti-wage discrimination bill, I was struck by how ridiculous the whole situation was. There, on national T.V., at the White House, the President of the United States of America acknowledged that Goodyear had wronged her, broke the law even, but that there was nothing he, or anyone else could do about it (the supreme court really threw out her case due to the statute of limitations).

How can our system of justice protect wrong doers from prosecution simply because of a statute of limitations? If someone commits a crime and hurts another, it makes no sense to release them from liability because a certain amount of time has passed. Essentially the message here is- breaking the law is a crime- unless you get away with it for “x” years.

While the story I told above is a dramitization, the implications are real. We need to reform our penal code to protect victims of crimes, not the perpetrators.

-kd-

A rose by any other name

rose1 Shakespeare so eloquently once stated: “A rose by any other name would smell just as sweet”. We ought to take this sentiment to heart when considering the nature of the “economic stimulus” legislation working its way through congress right now.

For once, the republicans have got it right (sort of). Many have decried provisions in the American Recovery and Reinvestment Act not as stimulus items, but as projects that democrats simply think would be a good idea. What exactly do they mean?

One representative drew a useful analogy:  former Treasury Secretary Paulson asked for funds in order to relieve banks of “toxic assets”, to which congress promptly responded by passing the Troubled Asset Relief Program (aka TARP- an apt acronym since congressional leaders evidently thought they could simply pull a financial tarp over the deep, systemic economic wounds the nation was suffering from). Then, once he got the money, Paulson decided that he actually didn’t want to buy toxic assets, but rather distribute the funds in a different fashion. So the problem is Paulson said he wanted the money for one thing (asset relief), but then used it on another.

In the same way, republican are accusing the democrats of simply pushing through funding under one name (stimulus), when they are actually pursing another goal (an agenda). A few examples: $20 billion for health information technology, $350 for military research on alternative energy usage for weaponry, $900 million to prepare for a pandemic influenza, $150 million for a repair backlog at the Smithsonian, etc…

Of course all of this spending will stimulate the economy in some way, but so would investing $250 million in toilet paper research. The question isn’t whether these programs will stimulate the economy- but whether they are the best vehicle for doing so. So what is the republican answer? Well, some of them are calling for massive tax cuts- one even proposed that all income tax be suspended for a year. The argument there is that American consumers can best stimulate the economy by  putting money in their pockets.

There are of course  a couple of problems with this philosophy, first and foremost- the previous stimulus payments made directly to consumers had very little demonstrative impact on the economy as many (wisely) choose to apply the money towards their debt burdens.  It is a reasonable assumption that in tough economic times as these, if Americans have more disposable income by way of reduced taxes they are not suddenly going to run out and purchase a new Prius, but rather pay down their debt, other obligations, or save the money. The net effect of these tax cuts would likely only enrich banks/creditors further, and only mildly stimulate the economy.

After the first round of $350 billion, the banks hardly showed an inclination towards resuming credit and investment, so it is unwise to assume that tax cuts that would largely benefit creditors would help get us out of the recession. A further point to consider is, whether the American people have been consulted on this notion of reducing taxes during a recession. By presumably borrowing money from foreign investors and making consumers involuntarily take the proceeds, we are in effect giving the American consumer a foreign backed credit card they didn’t ask for, without knowing the true future costs of that credit.

After all, if American’s really did go out and purchase big-macs, flat screen t.v.’s and Hummers, is that really how we want to try to stimulate the economy? More moderate republicans have suggested that while tax relief is indeed part of the solution, a greater part of the stimulus legislation should be focused on public infrastructure- and I tend to agree. Construction and repair of buildings, roads, homes, highways and public facilities should comprise a significant portion of the  economic stimulus as this will not only create long term benefits to the American people, but it will also immediately generate jobs and income.

The scope of the infrastructure projects that could be undertaken would be limited only by how much of the $825 billion was reserved for such purposes. Obama might be well advised to move towards a Tennessee Valley Authority or Civilian Conservation Corps type program as part of an economic stimulus. However all of this is not to say that the vast majority of spending in the stimulus legislation isn’t valuable, and  indeed necessary to the development of our nation, because it is; and it is certainly not to say that the republicans should be let off the hook and hailed as visionaries.

What Obama should do, is pursue a true program of economic stimulus spending on one hand, and then in another round of sweeping legislation, introduce and pass all of the other types of spending under a new “New Deal” type of contract with America. This would range from spending on education to healthcare to social services, and could represent a bold new policy agenda of which funding for these programs would be the beginning.

The benefit of such a strategy would be two-fold. First, if the democrats simply used the remaining $350 billion of TARP money for true economic stimulus side-by-side with separate, “New Deal” legislation that contained investment in all of the other programs they are seeking to fund, they would still get what they wanted: economic stimulus, and a new policy direction for the nation.

Second, and perhaps more strategic, by going along with republican demands that the stimulus solely consist of tax cuts and infrastructure programs they would demonstrate bi-partisanship, and then when seeking funding for a “New Deal”, they could expose the republican opposition for what it truly is: ideological opposition to spending on social services, alternative energy options, and in general, progressive, liberal programs. By removing spending for these programs from the tough-to-defend label of “economic stimulus”, republicans would only have ideological arguments to fall back on when voting against such programs.

By calling their bluff, republicans would look quite foolish in front of the American people denying the necessity of investment in education, alternative energy, health care and social service programs, during our worst economic downturn since the depression. But by trying to sneak funding for these programs in under the label of “economic stimulus” democrats try to subvert the legislative process, call the spending something its not, and give the republicans something to hide behind.

For too long, republicans have beaten the democrats at rhetoric, spin, and in general, the political game. If the democrats and the Obama administration are serious about a new mandate for America, they need to be smart and deliberate about their decisions.

After all, if we get an economic stimulus, and our social programs under different names, won’t they still smell just as sweet?

-kd-