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Saturday, October 20, 2007

The SCHIP Tragedy....Lets get Down to What it Means to Us All....Even if You Don't Have Kids....Even if You Have Private Insurance!
Posted by Melina | 12:21 PM

On the day after the day that Bush stood in front of the press corps and threatened world war 3 as if it was a joke; as if it was some sort of sitcom he had just been watching in the oval office, the overwhelming feeling seems to be one of fatigue and disbelief... ho-hum, such nonsense, whatever....He isn't taken seriously and he is treated lately like the crazy uncle chained in the attic; which is something, I guess, after all these years. But in the wake of the SCHIP defeat and the kiddie swiftboating that has been going on, I've been again wringing my hands and wondering what country I'm living in. It seems to me that the real danger here is in not giving Bush enough weight...he talks, chuckles, guffaws, and we ignore him for the most part (is it possible that his eyes have grown closer together? Is Laura really living in a hotel? Is he drunk? What meds could he possibly be on?)

But what is scary here is that he still wields enough power to make himself relevant at the expense, less of little blond children, than of countless inner city communities full of children who are suffering as I type this. You see, Bush is really FOR a program like SCHIP;
in that is he is for the Medicaid side of it if we could make the people poorer, and get rid of the Medicare side altogether.... because we wouldn't want to pass anything that might actually ensure that slightly less than dirt poor Americans might possibly ever lift themselves too far above the poverty line. The swiftboating of the Frosts points to the chilling reality that the middle class are indeed in the cross hairs of this administration.

It wouldn't do to open the door a crack to allowing the struggling middle class who might maybe own a house, to hang onto it if they fall into illness. The outrage over a family that makes 50 grand per year and owns a house that has grown in value to be worth maybe a quarter of a mil...the outrage over them being offered a medical plan that they would have to buy into...the outrage over them not having to lose their house over a medical catastrophe that would crush most families, is insane! When did that part of the American Dream become something that we should be MAD at our fellow citizens about?

This is why I could never be a politician. When the crazy idea comes up that maybe some of the health insurance is going to poor adults, and maybe its wasted somehow in that way, I just think "so?...and the pallets of money in Iraq? How many years would it take a state to waste that amount of money?"
This argument about how poor is poor enough is so crazy because what they are talking about is poor...really poor...and if anyone thinks that a welfare payment of $300 per month for a kid goes far...well, the real world is out there if you just leave your delusion for a while and take a walk....
I may live in one of the most expensive counties in the country, but even the people in the cheapest have to start to realize that 50 grand is just not a whole hell of alot for a family of 4 anywhere, and to allow the tone to be set by mega millionaires who want to squeeze every struggling American out of basic necessities while they wave from their limousines, is like walking off a cliff with the rest of the lemmings. S\See, this is where we are supposed to turn on eachother and argue about how much 50 grand per year is, and if its OK to own a house that is worth a quarter mil and still participate in government programs that might be deemed "socialist" (like our army, by the way and many other services in this country.)
Lets get it straight: 1 million dollars in the bank...cash...invested safely, throws off 40 grand per year. That is probably taxable income...so in order to be "rich" you would have to have investments worth many millions of dollars. In order to even run a mansion or a boat or whatever the lotto dream is today, you would have to have alot of money. The taxes and upkeep alone are more than a million in the bank could support.

A house worth $250,000, doesn't pay the bills unless you rent it out and rent another place for your family to live...and if you need catastrophic care like the Frosts did, its not even a drop in the bucket. The state generally would have a medicaid case spend down their assets until they had something like a few thousand dollars worth of possessions, and then they would kick in. So a family like that would lose everything, and maybe end up homeless or a struggling burden on society. So even in a cold dollars and cents way, it cuts costs to offer programs like SCHIP.

We are in a big bucks economy here, and the kind of money that the people who are running this thing have is massive. So, as you are being manipulated into looking at your neighbor and squabbling over who is a true patriot and who is some sorta commie, get it straight that the highways, police, military, and just about every other public service, could be deemed "socialist," and a certain level of "socialism" is an integral part of any democratic society that is going to function. We have seen a little bit of what deregulation and privatization does, and it clearly doesn't work. So, lets just cut to the quick of this thing and get real about what it means.
There are some necessary services that should be funded by our tax dollars. If you look at the dollars and cents of government run medical services vs. private insurance,there is no comparison. If this were a low bid contract, the government way would win out...but it doesn't seem like the government gets to bid in these matters....


(h/t to Think Progress for this YouTube)


The criticism against families like this seems to be that they should have planned better. They should've had to go out and find insurance on the open market because otherwise the taxpayer is paying for their insurance and maybe they are stealing from the system. Because the insurance business is best run by the unregulated insurance corporations and not the government, which might demand, at sometime in the far, distant future, some accountability or regulation. Because a country set up to give a leg up to families on the brink or right over the line on their way at a slightly upward angle towards the Dream, might be construed as socialist! Because if things change significantly the insurance and drug companies might not be able to keep or renegotiate their cushy deals.


Part 2.... Its Better Than Nothing:

Well, its not always that easy. I live in a state that offers mandatory children's health care, and I am someone who prices into the maximum premium; which is coincidentally roughly double what I used to pay for private insurance in this town, before one large corporation (Conseco) bought up all of the small insurers and proceeded to shut them down in favor of offering only corporate insurance policies. The state mandates that any insurance company left that carries private insurance must write a policy for us regardless of pre-existing conditions, as long as there is no lapse in coverage, but it does not mandate what they can charge for it. It also does not mandate what type of policies are offered....so, welcome to the world of the most strict and archaic HMO's and PPO's ever designed. Just the coverage books alone are daunting and so difficult to understand that its scary to think of giving up the devil that you know in favor of the unknown in the private, private, sector that is unregulated...and that can and will change regularly....I know because Ive had my insurance switched around at the drop of a hat and Ive also lost it suddenly.

The big question is this: Is it preferable to us as tax payers to have the Frost family have lost their house and ended up on welfare with all sorts of far reaching problems, or is it preferable to offer a little support before the big tragedy...with the full knowledge that not everyone will have a catastrophic accident or disease? Do we want to do preventative work or should we live in the fantasy that everyone should be able to provide somewhat for their families regardless of their background and should also be able to benefit from the system that they pay into.
The one thing that privatized mandatory health care does well is to cover the catastrophic, and ultimately, that saves alot of people from disaster. There is so much more that is necessary, because disaster comes in many forms, but at least we can realize that in the Frost's case, this thing WORKED!! Was it a handout? No! Should they be vilified for telling their story? No!
Do we not fucking want to know from our neighbors what is going on? Are we not supposed to compare notes from state to state to try to find what is best for all of us and to avoid the pitfalls that have ruined the lives of others? It seems like the voices that have screamed the loudest and shown the most venom are again the ones who want to shut down discourse with this "loose lips sink ships" mentality that somehow sends the message that we are not supporting the troops or looking for Bin Laden if we talk about not what we can expect from the system that we pay into..and the system that is really OUR system. It works for US...it belongs to us....right?

We have seen over and over that what we are creating is a permanent underclass that does not want to be where they are, but often not only sees no way out, but knows no other way to exist. The operative function here is fear, and the advertising gurus who toiled for those many years under Karl Rove have worked hard to expand and exploit the fear base. That fear costs more money than any imperfect SCHIP plan, and its shortsighted...unless the government WANTS it that way. Its the devil you know as opposed to the boldness of America and taking a chance on a better life. Its what happens when you are told over and over that you have too much and all that is left is to protect it, because surely any movement will endanger everything you've ever known...the mushroom cloud, WW3...ho hum...but it reverberates in the lower and immigrant classes where not only most of the soldiers come from, but where many, many of the people have actually seen real poverty and death and war.

Pt 3...I Am Guilty...We Are All Guilty...

How does the insurance industry work? Not everyone uses more than they have paid into the system; which makes sense and can be a good model...That is, until the insurance company goes public and suddenly the company's first responsibility is to the stockholders and being able to pay big bucks to the top executives. What follows is the downward spiral of ethics and medicine vs. the bottom line. That is the story of these certain Americans who are way too wealthy to be eligible for SCHIP, right? They are a huge liability going forward for any insurance company, and if they didn't have this service they not only would have lost everything to save their kids, but they would have been uninsurable later on. And I would like to see any of the critics out there try to live on 50 grand per year in that town, much less 80 grand in this town!


Politically speaking, I understand compromise in the bigger sense, and I understand partial victories. I am one of the first to gather in and hang onto any little bit of goodness that wafts off of that DC garbage dump. But the problem for me is that in order to block the struggling lower-middle and middle class Americans out there from getting what is being talked about on the right as if its a handout, the really poor of this country get the shaft totally. Whats the harm in the possibility that a tiny segment of a struggling class might get a little bit more than the absolute minimum that society can offer? Its OK to throw cash at any private enterprise that is fighting our war with private security guards; Pallets of cash....Its OK to destroy and rebuild an entire country and plan war after war...its OK to hand out no-bid contracts left and right and then rebuild the flawed structures built by unregulated business...but its not OK to allow an American family to buy affordable insurance that is overseen somehow by the government, and that might prevent them from struggling quite as hard? Everything should be as hard as possible for those people because...? Why? Both parents should work because...? Why? Because my tax dollars shouldn't go towards someone else's comfort?

How about our tax dollars going towards us , for once, making long term plans and looking at what becomes of our society when a huge portion of it struggles. Do we want to have programs and education or do we want to have chronic illness, chronic poverty, chronic lack of education and skills, and the ongoing problems that come with those things, such as huge prison populations, teen pregnancy, and the feelings of helplessness and hopelessness that comes along with the knowledge that you are never getting out of debt, and your kids are on their own when it comes to college.

We have a generation of kids who have two parents struggling to make ends meet; who own nothing but debt; and who's kids, in the best case scenario, end up wandering in the afternoons. Lessons, and the minivan Mom being around for homework and interaction of the sort that the family values people espouse, are more and more reserved for the rich, as the middle class falls between the cracks. And I would slide right down with them if I did not have family help with medical bills and education and the like. I can only keep thinking, "what do other people do in this situation? What do poor people who cant speak English do?" Because I can say that my experience, in my family and in helping others, is that its a full time job to deal with illness, chronic or catastrophic, to deal with poverty and the walls put up to prevent people from getting services, to deal with getting approvals for the basic things that you need to stay alive, and to try to be a person with some pride in whatever they have scraped together, keep a house and a job that pays nothing, raise kids, and try to unravel the impossible maze of insurance in this country. So many people just don't...and then its too late.

It seems to me that whether or not one supports programs that help the poor or disabled, they are somewhat necessary unless we want to go back to a draconian system of orphanages and people dying in the streets. I would like to know what the alternative plan is on the right? Privatization has not worked, regardless of what the talking points are. The numbers bear it out that privatization has failed. And to talk to those who say stoically that government waste is the big problem...well, I guess that you could accuse this administration of that, but you've got to point out that one program that actually does work well is Medicare, and that even though the rates paid are not as high as some private insurance companies, they do pay the providers pretty easily. Providers actually TAKE Medicare with little problem because of that; getting a payment is half the battle in this thing. It boggles the mind that one of the first big "problems" to fix that the right brought out in this administration was the supposed "failure" of Medicare.

They then bent over backwards to mandate the insane Medicare part D, which began as a failure in its strange design that required phone banks of customer representatives to direct patients to the proper plans...and then plans proceeded to change their rules. The old and infirm had to hold on for a representative for over an hour in those final weeks before "fines" were going to be levied if a plan wasn't chosen....and then the details were so strange and intricate, that the plan would have to be selected according to the drug, (oh, and the prices of the drugs were and are non negotiable, so the government is mandating a program that pays top price for bulk supplies of drugs to big pharma,) and then the cost. The lower priced plans obviously offered less drug availability and more of the downside, such as the insane "donut hole." Who designed this thing? There is no way that anyone could have seriously sat down and designed that as a workable plan for real people. The reality of it is like some sort of pot induced bullshit session about what would be the WORST plan ever for the old and disabled!

Medicare D is constantly adjusting in that the insurance companies participating in that big kickback have been allowed to change their terms, which drugs they cover , and what their premiums are. I personally know of one Medicare D insurance company, Humana, that was sold as a premium company which charged more in order to guarantee its subscribers that they would not have a "donut hole." Well, at the end of the first year of the program, Humana informed its subscribers that they had made a mistake in that they need the donut hole in order to be...er...profitable or to break even...?... and going forward there would be a donut hole. Not only that, but the premiums were going up and also the drugs covered would be changing...ha!
But what if there was a loss in the beginning of this thing and the companies that took the chance had to just eat it as part of an investment in the future of making the thing work? Isn't that the way things used to be done in new ventures? You get a chance to be one of the few companies allowed to provide this special insurance, but maybe you lose or break even in the first year or two in advance of profits...right? Why is it that in the face of a program that is a failure from the start, the failure part of it is shifted to the people it supposedly serves as opposed to the huge corporations, which could write the failure off anyway or the government that mandated it. Medicare D is also only a part of what the company does. So how is the "failure" figured anyway? Is there any regulation on any level of this thing? Is there anyone to even look at it?

The donut hole causes seniors and the disabled to suddenly find that their regular prescriptions cost as much as a couple of grand a month. One week they go into the pharmacy and the bill is HUGE...and it remains huge until another amount of out of pocket expense has been met. My friends at the local pharmacy have told me of people paying thousands for necessary drugs....which might get them out of the donut hole faster, but it might also make them not eat for that month! I know of people who have gone without medication lately because they were surviving on doctor's samples and ran out. I know people who have missed work because of illness caused by not taking their medicine. And I know of people who have ended up in the hospital on the state's dime...that's you and me....because of no preventative care and not enough money for medications for things like blood pressure.

Extrapolate that situation out to children who have become orphaned because of this...children who lose their home and end up wandering the system...the overburdened system that cant possibly handle everyone, and especially not the ones who are doing seemingly OK. Extrapolate that out to teen pregnancy and prison time. I could cite studies, but I'm tired of the war of studies. I know how these things are done, and what they control for. And I know what first hand experience and logic shows, along with the literature. If you don't spend some money in preventative care on every level, socialist or not, the cost to the society is going to be much larger than any privatized bullshit program could have imagined. And the real rub here is that the private companies can easily go out of business...but the government can't.


[Pete Stark on SCHIP]

Pt 4. What Does This Mean in the Real World?

This is mostly the middle class and senior side of these things and that is almost necessary to understand what goes on for the really poor folks in this country. Ive been lucky enough to have a muted view into what really goes on and what its like for the people who have been, as Liza says at Culture Kitchen, thrown under the bus this time round, and I have to constantly apply that to "real" inner cities like they have in NYC and LA; our inner city here is so much better than what I grew up around.


The people who have to wait during the big government argument about how to help the people who are just scraping by, are the people who are not scraping by, and who have no way out.
First, as some sort of background, I should say that as a white, articulate, writer, I have been able to wage an ongoing fight against the system here in Connecticut, which is one of the few states to supposedly cover all of its children with health insurance.

This is, after all, the state helmed by the likes of Joementum Lieberman, (late of the CT For LIEberman Party, newly again a Democrat,) and Chris Shays, (with his nose still brown and stinky from climbing up the ass of the Blackwater witnesses, not to mention his ongoing support of the war, except for in the weeks before an election, and his many, many trips to Iraq with his good friend Joe...way to go Chris...oh, and bye bye next cycle boys!) who never hesitate to pat themselves on the back and blow their own horns in their wonderful foresight in covering all kids...etc, etc, etc.....Beyond that I'd really like to know what Senator Dodd thinks about this. Shays just denies that it is possible that this information is correct...but it is my personal experience, and he is going to have a much harder time dismissing me than he does dismissing people with no voice. This is what Shays does: He treats every complaint or argument as a very strange and interesting atypical situation, in his experience. He then, in his quiet voice, earnestly says to call (insert woman's name here) at his office, and turns to one of his aides and says "give then the private line" and then the complaint is GONE. This is a good way to derail dissent in a townhall meeting situation, but it doesn't address the systemic flaws that abound in his shiny, shiny ornament of a kid's health plan. I have no doubt that individual problems can be solved with a call from Shay's office, but I also think that its not happening very often. His town halls tend to be in places where the inner city folks cant reach because of bus service...or its in the government center during work hours. This is just what Ive noticed...who knows if its planned...but when I stand up in a meeting and I see only older white faces, its hard to address problems with the state's kid's health care plan.

CT's Husky plan is one that directs all business to 3 or 4 private insurance companies, run by the likes of Healthnet and Blue Cross/Blue Shield of CT. Yeah, its a huge kickback in no uncertain terms because the state pays for anyone making less than something like $24,000 per year (which in southern CT is the extremely low 200% of poverty or whatever their rule of thumb is, and then the rest of us are charged according to our incomes with a maximum of $221 per month, per kid.

After being forced onto the Husky program, my son almost got kicked out of his long time pediatric practice because they, like just about all other southern CT practices, had closed their boards to the Husky kids. Fortunately, Will had gone to nursery school with the kid of the senior doctor there, and we still see each other at social events and have common friends, so he had a partner's meeting and they allowed us to join the boards retroactively. This is the practice that we had been with for his whole life!! I was first told by the doctor to go and get a job with health insurance... to which I answered : Ha Ha!! I don't even know if the hospital jobs in this town offer health coverage anymore, but that must be some kinda joke. What would that sort of a statement sound like to an immigrant who is trying to get by and doesn't want to make waves?

They have passed a law in CT saying that as long as your insurance hasn't lapsed that insurance companies cant turn you down for insurance. But that doesn't mean that they cant sell you the worst HMO plan with the highest premium. I think that the last time I looked it was going to be something like a grand a month to cover us both. Will has a hereditary joint problem which caused his tendons to remain short after he began toddling, and over the years it became clear that he needed an operation to lengthen them. For some reason the physiatrist at the clinic , who we were compelled to see for this rather than an orthopedic specialist, kept him in PT and leg braces for a couple of years with little result. I questioned and questioned, as I had done since he was just past toddler stage and his heels hadn't gone down to the floor. Finally, the physical therapist told me that I had to take him to a surgeon and gave me a name.

The Husky program has NO orthepedic surgeons in southern CT who participate, (not even in the clinic,) nor do they have any in Manhattan, which is very close to us. So we went to a surgeon at Columbia Presbyterian Hospital who is very well known and was also very kind and flexible with us upon learning that we were paying cash for the consult, due to the fact that I was tired of waiting six months to get an approval. ( We had just lived through the hell of waiting for a dermatologist approval that caused a plantar wart on his foot to grow into a real problem.) The doctor was willing to personally take whatever his office could negotiate for the operation and his office would take care of the hospital approval and the rest.

Thus began 1.5 years of craziness in trying to get the negotiations and approvals done. Neither the doctor's insurance office nor the hospital's insurance office were up to the task of getting an approval from this arm of Blue Cross and Blue Shield. I dealt with them extensively and I let them know that it was clear to me from my past and current dealings with Blue Cross and Blue Shield's other plans, that this was a set up. I know that they are not that inept, and some decision has been made to force their policy holders to jump through hoops to get anything.

Besides the surgery being canceled on the night before it was scheduled, because the hospital still hadn't gotten a confirmation number from the Blue Care people, and then reinstated in a few days, after the surgeon agreed to come in especially to operate on Will on a Friday that he was scheduled to go away...and finally, having finished the surgery, the doctor told me that Will was the oldest patient that he had ever done this surgery on. That it was supposed to be done years earlier and that he was glad that we didn't have to wait longer. Will had no calluses on his hells and his heels were half the width that they were supposed to be for his size. His tendons were so short that they were in danger of snapping if he had any sort of sports injury...and Will had gotten not only a black belt in Shaolin Kempo on his toes, but he had played LaCrosse that year for the first time on the school team...on his toes.

The doctor then sent us off with Will in double casts, which he had to wear for the summer. When they came off he was so weak that he had to go to physical therapy every day in order to walk properly. What was not lost on me was that if he had done this during the window that it is supposed ot be done, I would have had a much easier time in lifting him and caring for him...it was not easy; he is a very big kid...bigger than me already now at 13 years old and expected to be 6'4" by the time this growing thing is over.

It might sound like I was joking if I said that the hospital was still billing me for the use of the operating room 18 months later, but apparently it would have been OK to do the surgery on the kitchen table as far as the insurance company was concerned. They never properly approved the hospital room.

The point of all of telling stories is one of relativity of situations. I can talk and reason about this thing from my point of view without fear of retribution from the insurance company in any way...and as busy as I am, I know my rights. I already passed on suing them because I was caring for a big boy in double casts and immediately was also dealing with an elderly grandfather, and the rest of the craziness of life. It wasn't worth the time to engage in something so flawed....and its law...would I even have a case if I sued because bureaucracy caused my son not to get treatment until it was almost too late?

It shouldn't be so hard for us to get care...And now, we pay cash for Will's psychological care and just about everything outside of prescriptions and basic pediatric care. He has pneumonia currently so I've had an office visit and a prescription refill for $11, in a month that actually cost us $221 for our premium, plus $600 for therapy, plus $500 for Psychiatry, plus the additional prescriptions, and besides the antibiotics today...and I don't think I can even go into the other medical bills this month that were not covered... The thing is that I know people who would not even get the kind of care that we have fought for, nor would they try. And an inner city child with this problem could easily end up crippled. If it had not been for the saintly PT who became my friend along the way and talked ot me at great length about all sorts of things; if it had not been for her goign outside of the lines and recommending against what the clinic Drs were saying, he would still be on his toes or in painful leg braces, trying to stretch out tendons that were long past stretching.

The same system that serves poor kids in the public school, served William during most of his leg problems, and the therapists there were unable to help him unless the problem got in the way of his school work. In other words, if it had been his hands, and if he had not been able to write, he would have had OT and PT for that. If the school had stairs they would have addressed his legs a bit more. For the most part their hands were/are tied.

No specialists or regular doctors outside of clinics take this insurance, and many more are jumping off the rolls. Our current pediatrician runs the largest pediatrics practice in the area with 8 or 9 other doctors and alot of patients. They participate in the hospital clinic on a rotating basis like everyone, and they have done their part for the community. I guess that it was the amount of work to get the compensation and the levels of compensation they get that caused them recently to cease to accept the insurance altogether, even from those who had been grandfathered onto the boards previously. Apparently around 5-10 patients were kept as personal friends of the practice and one of those was US. The secretary, (who I know because she used to work at my vet's office,) told me in a whisper, that patients left in droves. I didn't even know this had gone on.

Why not use the clinics? Well, in a system that touts being able to choose your own doctor it is a little disconcerting to sit on line for an hour or two with spitty babies to get to see a doctor not of my choosing...I have seen many doctors in my life and they are not all good or even passable, and when you are dealing with surgery and the psychological and physical well-being of your child, you would like to know who you are seeing. I have heard stories of the city clinic in this town making mistakes with tests....important tests...enough said...
The few private doctors that are taking Husky and serving the immigrant community...well, lets say that the one who's office I have frequented most recently keeps a pretty dirty place, and is so busy with the overflow of kids who have been thrown out of the other private practices lately, that he doesn't seem to have the help to even put water in the fish tank or have the waiting room cleaned. This doctor is fine for school physicals but when I questioned him about Lyme disease which is at an all time high around here, he knew little about the basic testing procedure and its flaws. I find him to be basically intelligent and he was open about the high false negatives of the Elisa test, but I would definitely want a second opinion on anything important. He is definitely someone who has to put off important issues and concerns because of parent's financial considerations. He can list off what is covered by Husky and which private plan is the best to be on through Husky. He is pretty good at picking what is the most pressing, but why should he have to? He prescribes from their formulary and chooses the tests that they suggest. I dont think that is good, and I've never met a doctor who operates that way.

This area has a cost of living that approaches Palm Beach, and yet the Husky program won't adjust the customary rates for doctors who are paying much more for rent and malpractice insurance. Nor will they adjust their purposeful bureaucracy, which a child could see is created to make the patient give up trying to get care or trying to get reimbursement. The few who take it are overrun by kids, have long lines, are burned out, and cant possibly process all the paperwork that is necessary to keep accepting this plan. And yet they do, because someone has to serve these children besides the emergency room.

So how does this situation effect an immigrant family?
Well, let me add also that the forms are so complicated in order to get and remain ON the Husky program, that they send a step by step instruction manual. I have a college degree, I research and write on politics regularly, and I was previously a film coordinator and producer, and even I have to use the instructions and sometimes call the 800 number to fill out this crap because it is written so poorly and is so daunting. In fact, the social workers at all of the cities agencies have to take a CLASS in how to fill in the forms for this program....

I pay the maximum premium, and I still have to prove, and then prove again, my qualifications to pay that maximum...OK...apparently that is in case I ever make less and want to try to pay less...huh? Remember, no child can be turned down...but if money were no object, one would surely buy really good insurance that their doctors actually take and that doesn't take up all of their time. Why would anyone with money or good insurance choose this? The government would have to offer a plan so sterling, so wonderful, that people would give up what they have in favor of it, and short of offering all Americans what is offered to congress and the senate...and/or Medicare...I cant imagine that there is something coming down the pike that would budge busy Americans from where they are.

The idiots who say that if there were more insurance and good health care available it would be used more, are dead wrong. Rather, I've found that people are working so hard that they hardly have time for the well visits required to put their children into daycare or school. I see people putting off basic care all the time because of lack of time. The only people who I see going to the doctor regularly are the very old or the disabled....and those populations should go to the dr. all the time...on Medicare!

Here is an example from right now, today: I filled out the daunting forms to help a non English speaking single mom get the Husky program. They claim to have sent her a letter requesting further documentation. In Huskyland that means that they want the original of your child's birth certificate, your marriage or divorce decree, proof of your earnings, and your green card or citizenship papers; The originals...brought in person to social services. The letter was lost somewhere in the children messing the house up and the mother working all the time and she was very confused about what they wanted and if they were going to TAKE HER PAPERS AWAY. So, rather than deal with it, the Mom let it slide. I urged her over and over to call and ask for what information they needed, assuring her that I could bring the items to them and then bring them right back.

Finally, after I gave her a carefully written step by step note on what to say, she called from work. She then called me and said that she has been unable to reach the Husky people all day and that when she did, and asked for an interpreter as I had instructed her, the interpreter just referred her to a social services office, but didn't explain why. The number they gave had no answer or voice mail. She called and called and finally got through...at which point, or shortly thereafter, I got a call from a nasty, exasperated social services worker, who was telling me that the application no longer exists because the woman had not responded within the two week time frame, and that she had called and left messages....as I explained that the woman is working all the time and has to take time off to make all of these calls. She was very nasty and said that the woman would have to refill out an application and start again. I said that I had a copy...oh, a copy?? Well, then I just have to get her to sign and date it again.

I asked her to list for me again the things that need to be brought to social services. To which, she sighed a long sign and said, in a totally exasperated voice, birth certificate for the child, original...proof of income through original paystub or letter from employer (and when I said that there was no paystub but that she was being paid by check, the nasty said,"oh, so she is working illegally??"...NO, of course not! But if you said that to any one who was already nervous about their life and having to prove who they are over and over...well...)....divorce decree and information on the father...But he is out of the country and has no telephone; it doesn't matter...(I know this story...then you have to get a notarized affidavit stating that fact, which sounds more scary than the little letter that you get notarized at the bank is.) They need to know who the father is regardless of if he is on the moon or if they can collect any sort of support from him.

And does she have to bring the items personally? No. And who should I ask for? Well, this snotty girls is actually changing jobs so she wont be there anymore...actually she has missed many of the Mom's calls because she was in training for the new position. uh-huh.

As an aside, I knew that the snotty girl had left something out, but I just let it go. See, the first time she said green card or citizenship papers, original; she said it all really fast...but the time I was supposedly writing it down and going over it, she left it out.
So the Mom would normally take the morning off of work and go to the bank, where she has been unsuccessful in getting a bank account because her green card and her DMV ID dont match, because she is using the name of one of the other father's of her kids...whatever...and they need more ID to take her money and make an account. So, going to the bank to notarize the affidavit letter that I will instruct her to write is probably out of the question, because you have to have an account with the bank to get things notarized for free. So she will have to go to the check cashing place and pay a premium. Then she will have to go to the social services with her papers...but she will find that the snotty girl on the phone didn't tell her to bring the citizenship papers, so she will not be able to complete this mission. It will be a week until she can try again.

That is why I am going to copy the forms, have her re-sign and re-date them, gather the pieces of her existence, and bring them over for her. Because the snotty girls who mess with me have another thing coming, even though Ive found more and more that there is a feeling, even in social services, that they have all the power and that the security of the country is in their hands...which gives them a real attitude problem. Truthfully, there is some bad blood between different groups of African Americans and also within their groups, who is a church goer and who is not, and the bloods vs. some Haitian gang, and the Spanish speaking population from anywhere, (who have quickly become the majority of the minority.) And then the hateful attitude encouraged at the desks by bad management, mixes in a bad way with the prying into of the lives and the original copies of these American's documents, be they permanent residents or full citizens, and the tension between the different groups of neighbors there, to create a situation where many people just walk away. They are waiting for a long time to get basic care and aid...most of them work and pay taxes...and they are struggling. I guess that they can still get emergency room care on an anonymous basis. The ones who walk away might be ignoring serious medical problems. And even the cruelest of conservatives can see that people who don't take their medication or see a doctor, stand a risk of costing the economy much, much more in the long run.

So imagine that you work crushing hours for less than minimum wage and you barely scrape by with kids to care for and a household to keep. Imagine that you apply and apply for help and your applications go unanswered, either because you're too damned busy to cover everything or because the snotty girl sets the stage for failure. Imagine that you come home on the weekend and have a room full of laundry to do, and a house to clean, and marketing to do...kids to nurture, paperwork to fill out, and bills to pay. Imagine that one or more kids are in trouble at school and that you're expected for a school event or to see the principal because someone is in trouble, someone is sick, and you can just never get ahead. Then, here comes the neocons who are literally trying to kill you because you're poor and you use the system, which should not exist or should be private...and look how well the privitized system works; especially in conjunction with the government systems that are trying to prove who people are and if they are here legally.

What will you do? When do you get a break? What about your poor family back in the old country who are begging for money all the time? What about these people who say they want to help but keep asking for your papers?

I was told recently by a social worker that a certain client was not as dumb as he appeared. That he had been working the system for his whole life and that its important to be able to recognize that. This wasn't a welfare king, or even someone doing partially well. It was someone who seemed inept, trying to raise a family and navigate a system that is complicated to say the least. If in the last 20 or 30 years we have not created some sort of a savvy generation of poor in this country, then what have we created? My point is that we certainly can't hate the poor if they know the system that they live in. The system is what they do to survive, and its not designed to elevate anyone up and out of that spot.

So, the grand idea to reform welfare is just a failed theory...and let me say that as far as I can see on the ground in this microcosm of the country, it never worked. We have to decide what we want in this country. Not everyone is going to rise up from the ghetto to own a home and put their children through college. The opportunity should be there, but trying to force everyone out into the workplace creates empty homes and aimless children...and an army of fast food workers who can't afford anything more than they could when they were on the dole.
The reality of any large country could be that there are bound to be non-retired people who are permanently on the social services rolls. Maybe if we got real about that fact, we could move on to create programs for the kids to enable them to get out and have a chance. It could be that immigrating to a country, raising a family above poverty, and all upwards movement in a democratic society does not necessisarily apply only to the generation that we are faced with, but with multiple generations and a gradula progress. Blaming and limiting the entire family because the parent is unable to move with the speed that we have applied to the study of immigrants and poor people, does no good.

I am surrounded by people who want to work. But there are few jobs that make it worth upsetting the apple cart of Husky, housing, taxes, and childcare for. I also know people who fear letting their children out of their sight because of real dangers in the city, like shootings and muggings, not to mention the influence of other kids that they might not even know because they work all the time..

So, watch the societal costs roll out of these neighborhoods and watch the anger roll in from the middle class, who should be directing their anger upwards to the top earners who have tax breaks and every accounting trick onboard in the first place...The upper classes are only where they are thanks to this system, that allowed their parents and then them to stand on the shoulders of others in the hierarchy...and also to use the resources created by the pool formed by our tax dollars...So, should they pay back in according to how well they've done? Hell yes!! It is purely egotistical to claim to have made it to the top with no help....say what you will, but unless you fly, you have walked these streets, gone to these schools, for better or worse, and if you breathe this air, you have a part in this society...so do your part...more if you can.

The nature of what social services has become, in the rush to reform it, is to put a band aid on the problem and then to falsely try to help people move upwards towards the dream. The truth is that very few of the people living there now will be able to get out. If their children can, it will only be because of almost impossible diligence or finding a strong mentor to help them every step of the way. The truth is that the American Dream for many immigrants is not that they will rise from poverty, but that their children will have a shot.

If we were realistic and if the powers that be in this farce really wanted to do away with poverty, we would accept people as they are, and try to help those who we are able to help. But that takes money and manpower and programs and the kind of society that we don't have anymore...and I expect that we won't have it again unless and until we suffer another huge disaster like the great Depression that leaves Americans on the side of the road. Its a crime that we need to see dead children before we take action...and who knows if that even works anymore, because the dead Iraqi children on every newspaper don't seem to make a dent.

We are all Americans, all colors, all languages, in this melting pot of insanity...How is it supposed to work out in the end? How did the framers foresee it? Its an ongoing experiment...but its painfully clear from where I stand, that the cards are stacked against certain portions of the population...and we can debate endlessly about the new underclass to be: the middle class, and by what bar they should be measured for services, but we've got to keep in mind that every time we table a bill that could help with programs and systems for kids who don't even have the pain in the ass of having to live through the bureaucracy and kickback laden crap that any health care coming out of this government is going to be, we stop the really poor kids from getting any care at all, besides emergency care, which costs us all alot more than we ever would bargain for in dollars and cents but costs the most in the loss of our very identity as human beings and as Americans.

WW3..?...It seems to me that the real WW3 is the class war being waged on normal Americans, and the devastating changes happening through out the world due to our aggressive form of globalism , looking for an ever cheaper workforce and then pulling up stakes and moving on.
The reasons to be afraid of the Bush Administration have more to do with the looting of the entire global social infrastructure for the gain of big business and cronyism ...and for the denial of basic services and the rights of every person to the basic necessities of health care, housing and food....WW3 is less about a mushroom cloud than about the war on people.


[Olbermann on Stark and Frosts and SCHIP]



[Bush warns of WW3]



Crossposted from RIPCoco

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