Ring of Fire's Mike Papantonio may be one of the only couple of good things left on Air America these days, and here Pap Attacks the health insurance corporations with the help of Rep. Alan Grayson (D-Fla,) who is so refreshingly logical that he makes me want to cry.

Why is it so hard for Americans to get their minds around the concept of shaking up a corrupt industry in order to help our neighbors stay healthy and alive? How could we have gotten to a point where we are more interested in protecting huge corporations and when did we decide that we would prefer these same corporations to be in our lives and running our health care into the ground while stealing us blind?

It must be that people are bamboozled by the lobby's doublespeak...it has to be that people think they are saving on taxes or something, and cant see that in the big picture there will be savings all around. But, honestly, if that is really what its about, then there is something wrong with America. All of the religious folks out there who feel like they do their duty by going to church on Sunday or Temple on Saturday or Mosque whenever, have to reassess what is important in their lives. We cant just let people be sick and die, some 44,000 per year, so that we can have a tax break. No one is more deserving than anyone else; we all rely on luck in this country, and every one of us stands, in some way, on the shoulders of the person who went before us and who stands beside us.




To learn more about Grayson's background listen to part 2. This is a guy with the kind of prior experience to be a profound force in the progressive movement, and hopefully an important player in higher office. What has he done to block fraudulent contractors from receiving funds via contracts from our government?
What do we need to do to effect real change? Grayson explains it all here:



h/t to Go Left TV for bringing us video coverage of many of the high points of the debate out there. Go there and subscribe to their feed!

c/p RIP Coco

Labels: Air America, Alan Grayson, health care, insurance industry, Papantonio

Because you can never have too much Alan Grayson. Today, a litany of the dead:

Labels: Alan Grayson, health care, insurance industry, just another outrage

Oh fer cryin' out loud....is it the thin air out there?

Last week it was the Colorado baby denied health insurance because he was too fat. Now a Colorado toddler has been denied health insurance because she is underweight.

I shit you not:

The parents of a two-year-old girl in Colorado are unable to obtain health insurance for their daughter because the insurer, United Healthcare Golden Rule, claims she is too small. In a letter sent to the family of the child, Aislin Bates, United Healthcare Golden Rule writes, "we are unable to provide coverage for Aislin because her height and weight do not meet our company standards." According to a Colorado news station, Aislin weighed six pounds, six ounces at birth, and now weighs 22 pounds.

When Robert Bates, the girl's father, left his former job to start his own business, he was forced to seek out his own health insurance, and enrolled his family in an insurance plan with United Healthcare Golden Rule. "It took me by surprise," Bates told ABC 7 in Denver. "I didn't think that her size was that abnormal and that it was something that you'd consider to be unhealthy."


Read more at: http://www.huffingtonpost.com/2009/10/20/aislin-bates-colorado-tod_n_327309.html

It's a good thing I'm not a small child now. I would have been hit with a double-whammy -- being overweight AND shorter than most children my age.

Why don't these companies cut the crap and come out and admit it: Life is a pre-existing, terminal condition so anything for which you might file a claim is not covered.

Labels: health care, insurance industry, just another outrage, You can't make this shit up

So look who gains under whatever health care "reform" package is going to come out of Congress:

Lashed by liberals and threatened with more government regulation, the insurance industry nevertheless rallied its lobbying and grass-roots resources so successfully in the early stages of the healthcare overhaul deliberations that it is poised to reap a financial windfall.

The half-dozen leading overhaul proposals circulating in Congress would require all citizens to have health insurance, which would guarantee insurers tens of millions of new customers -- many of whom would get government subsidies to help pay the companies' premiums.

"It's a bonanza," said Robert Laszewski, a health insurance executive for 20 years who now tracks reform legislation as president of the consulting firm Health Policy and Strategy Associates Inc.

Some insurance company leaders continue to profess concern about the unpredictable course of President Obama's massive healthcare initiative, and they vigorously oppose elements of his agenda. But Laszewski said the industry's reaction to early negotiations boiled down to a single word: "Hallelujah!"

The insurers' success so far can be explained in part by their lobbying efforts in the nation's capital and the districts of key lawmakers.

The bills vary in the degree to which they would empower government to be a competitor and a regulator of private insurance. But analysts said that based on the way things stand now, insurers would come out ahead.

Yes, the companies that right now reap huge profits collecting premiums and then dropping you when you get sick are the winners of the health care reform battle.

Does Barack Obama think that the people who donated $25, $50, and $100 at a time last year are going to do it again in 2012 for a president/candidate who not only snubbed them the minute he got into office but who was so intent on getting a bill -- any bill -- that he not only threw the Democratic base, but also the independents who helped push him over the top, under the bus? Does Rahm Emanuel think the Democrats are going to be able to retain both houses of Congress after selling out the entire country to the very same insurance company thieves that caused this mess? Congresscritters don't have to worry; Americans are so fucking stupid that they elect these clowns every time they come up for election. They and their Senate counterparts pocket so much money from businesses like insurers that they can saturate the airwaves enough that lazy Americans will vote for the name that's at least marginally familiar through the haze of American Idol and Glenn Beck and endless E! specials on Michael Jackson's plastic surgeries.

And then after the Republicans take over, the insurance companies can finish the job they started.

Enjoy your vacation, Mr. President. Perhaps you might spend some time thinking about what it's going to feel like on January 20, 2013 as you hand over power to the likes of Sarah Palin or Newt Gingrich or whatever other Republican lunatic defeats you because you were too busy being "bipartisan" to recognize what you were dealing with at the same time as you sold your soul to Rahm Emanuel and your corporate masters.

Oh, and here's something else that happens when you are too timid to stand up to Republican bullies.

Labels: Democratic sellouts, despair, insurance industry

As reported by blogger D-Day, the fireworks were bright over in Starbucks-land this morning.

"Excuse me, but if America is so bad, why is it that if I got sick or one of my loved one's got sick, well America is the best....?" best, best, best?
That was Maria Bartiromo on Morning Joe, arguing with Matt Tiabbi about the health insurance issue. What she didn't say is that she has great health insurance as an anchor at CNBC and so has everything that American medicine can offer available to her. And, its worth mentioning, as she spews out verbatim talking points, that she also is married to the very rich son of an investor, CEO of an investment services company, known as the "reinventor of the index fund," a company that specializes in exchange traded funds; (... supposedly a vehicle which holds certain stock and bonds, much like a bundled mass of crap, but what do I know? Supposedly these ETF's have the value of whats inside, but then so does everything have an underlying value and a possible value depending on the market...isnt it all gambling on what the value will or won't be?) which he designed himself, and Ms. maria never really has to worry or work a day in her life. Its easy to have total confidence in the American system when you are a have.



The fact that Bartiromo has such a glaring conflict in her financial reporting is something that I have never heard stated on NBC, and I'm an avid NBC viewer. Now that I've looked at the research, I have to say that I cant imagine why NBC would allow this to go on without constant disclosures, considering her stock holdings and lack of transparency while interviewing the titans of industry. She sure has a big opinion, even if it was written by the wingnuttia out there who float the talking points these days. When faced with actual figures she is comfortable stating that she just doesn't buy them because they include illegal aliens. Huh? ...there are so many things I could say to that but maybe its best to just let it swelter, like a fine wine...

The great part always in all of this muck is that Taibbi has so many clear facts that he didn't need to pull the conflict of interest card, the talking points card, or the screeching over the other person card; he is unflappable, and just keeps coming with those facts. I think that's why the wingnuts are in such a ruffle over him and how he is merely a "hack." The truth, apparently, hurts.

Tweeted thusly by Morning Joe hisself:

Video: Taibbi: Health care 'can't be fixed': Aug. 20: Rolling Stone's Matt Taibbi joins Morning Joe to discuss h.. http://bit.ly/3lJNUsabout 4 hours ago from twitterfeed"

To which Bob Cesca awesomely stated:

Maria Bartiromo isn't a very smart person. She just tried to tell Matt Taibbi on Morning Joe that America has the best healthcare system in the world because people from other nations come here for procedures.

I feel like someone went to the mat for me and all I got was this lousy tweet! Hah!

According to Heather at Crooks and Liars:

Taibbi thinks a deal was cut from the beginning between the White House and the insurance and pharmaceutical industries and that they never intended to have a public option.

And without that the dems are not going to vote for it at all.

h/t Crooks and Liars and D-Day for Maddow video

According Taibbi in Rolling Stone and on their special web only special video page for Americans who don't or cant read,

Taibbi breaks down the five steps Congress took to be sure no bill would pass — aiming low, gutting the public option, packing it with loopholes, providing no leadership and blowing the math — in his story, which is available on stands now. In a series of video interviews for RollingStone.com, Taibbi explores one of our system’s most severe flaws, explains how the government wedged itself into an awkwardly damning position, and looks at how the proposed bill would change the ordinary American’s life

Even a child could understand Taibbi, in these videos, explaining the situation and the obviously sensible solution. Unfortunately, the government here is run by the Insurance Industry, and the lobbyists have an army of armed, disgruntled, fringe whack-jobs out there to make sure that we don't even discuss our options. We seem to need total collapse of any particular system before we seriously look at any reality...and even then...the light of truth is just a little bright for most Americans, clutching their remote controls and chips.

Meanwhile, back here on the ground, Maria can get all the healthcare she wants or needs, so can Morning Joe and the CEO of Starbucks...but millions of Americans remain uninsured or underinsured, and its unclear what the answer will be for the rest of us in the free market; Freedom's just another word for nothing left to lose....
Just go here and watch the videos...and buy the new Rolling Stone! Its one of the few magazines worth having in your hands these days!

c/p RIP Coco

Labels: health care, insurance industry, lies, Republican lies, Taibbi

..Where as Jon Bon Jovi played Central Park, just out the window; "its my life...now or never..." wafting through the hot apartment here, the hard work of life and death was being folded over and decided upon like a napkin tossed to the side in any sidewalk cafe up here on the new gold coast. Not so many days...oh maybe a week or 3 ago, wasn't I planning my little silly trip to Austin and the Netroots Nation? Us girls going to blog in our little world of the in-crowd of our own device? Our beautiful writerly posse looking at the entourages float by with a new sort of pop star leading the way, and us just looking; trying not to laugh.... But then, it seems like each step of this thing has played out at its own speed. I am not the boss here. I follow the powers of a secret medical schedule, ancient yet somehow strong internal organs, dramas unfolding as equipment and supplies slowly come and go with the tides, and the very delicate nature of the line between life and death controls the days and nights in these halls and rooms full of my childhood. I can vaguely hear in the background the leaping and chirping of those who want to say "Me too! My life too! 70 years of it!" like a buzzing fly from a long time ago, sitting in court eating apricots...but no, this is my story and these are my ideas of how a family, much less a society, should run. So, I will hear no more of all that...no more...

No sooner had I touched down at the Rooster Ranch, Wednesday before last, or before that as days blend into weeks, having left laundry and all that silly straightening up nonsense for my glorious days sans kids to get all that stuff done, when I got a call from my grandpa's doorman that he had fallen in his kitchen and was being taken to the hospital. I guess I was bringing Ben to an appointment when the call came in, so I talked to the ambulance driver, my grandpa who was being wheeled past apparently, and figured out where he was going and dumped Ben off, called Mom to pick him up, and jumped on the highway to the city.... the rest is part of the ongoing story that this time unfolded from St Luke's, the very nice cardiac wing part of the scary horrible downtown Roosevelt emergency room, where we spent quite a few hours deep into the night that first night....

This is just part of life when you're 98, and the details don't really make much of a difference except that it gets a little more real and alarming every time we find ourselves crammed into a spoke in another triage-in-the-round, with too many beds on wheels close together and lots of doctors discussing quietly in the middle of the wheel what the disposition of each spoke will be....I could almost grab and hug those scruffy guys from the relief; on duty too long and digesting alot of information very quickly, they take the time, explain whats happening, and then disappear around the wheel again.

So with him finally ensconced in an elite specific department, 70 or so blocks north, I had been able to actually sit for moments at a time and try to get through the pieces of the NY Times that I'd been carrying around and get some of this down.... To that end, I'd been hauling my laptop envisioning throwing up a post or two on the go. All I ended up with was bits and pieces and some long parts that I am still trying to beat into shape somehow. Honestly, Ive spent more time staring at people magazine and on the phone than being productive at all.

That's always hard for me, because there is just-so-much-to-do, between 2 households, family drama and whats going on with the man... and if I'm not jumping up every few minutes, I'm trying to sort the receipts so as to account for one place or another and to keep up with my bank, and also, as always when I interact so much with the system, the real lives being lived by the people who care for the sick and elderly in this country take me over. This guy, my granddad, is not so much sick as he is old, and as much as we overlook this population, they are us; not the Christian charity of the beggar in the street us, but the flesh and blood of where we will definitely be one day whether we turn away from it now or not, us. Never have I seen this with as much clarity as I do now.

This fall, a day on the floor with the I've-fallen-and-cant-get-up button left on the bedside table, heart attack, pneumonia, whatever, has been a serious occurrence in our lives that has incapacitated not only the faller, but the one-who-brings-the-groceries, (and other stuff as necessary.) I see alot of denial around me about the reality of this thing and what it could have been, almost was, and is. But grandpa and I keep looking at each other and exclaiming about how bad this is, because we've been through this together a few times already and we have what to compare it to. The confusion that the hospital causes in the elderly, not to mention the young at this point, is really hard to handle, and my aunt, accidentally in town this time, took the opportunity to manipulate words and take seriously what he thought he was saying to me...lets just say it was a battle that I didn't deserve after all of these years. Not that it wasn't expected.

For the first week I kept thinking that at least this happened before Netroots Nation in Austin, because if I could possibly get everyone situated, I may have been able to actually go forth without that familiar nagging lil' what-would-I-do-IF, scenario playing out. I love the thought of Grandpa having a couple of nurses trading shifts and keeping him company, such as that is. It's really, really hard to be this old and to remain so sharp and aware. Its really hard to be someone who was always so independent and to have the decline play out in slo-mo to a clear head....and its very hard for me to witness up close the very physicality and resultant disappointment of it all.

But, we are finite, and there is a reality to all of this that is inescapable. This lump of flesh and all that we hold on to is the same natural matter that the woods envelope and suck down each time a tree falls or an animal dies... in my woods where somehow the questions of heaven and hell don't matter much because nature just makes sense on a very basic level.

I suppose that the real deal of the experience of who you have been, how you have made amends for your trespasses, and how you have contributed to this rotting culture, may be all that matters ultimately. What becomes of the complaints and broken hearts of this world? What about wrongs and crimes committed by masters of war? Their names are uttered throughout our brief history to be forgotten except by a few historians, whatever that will look like, in some future world with a different history that matters, or maybe it'll all be just spun into the sun when this place is done.

But here and now, for whatever its worth, what of the fringe of society next to us in the rolling bed, waiting for a pain shot for his sickle cell, all defiant and crude?... or the other side crying after some altercation, with the cops leading her around? Tattoos and flabby stomach, her tired puffy face having seen better days. My Mom would have listened and figured out everyone's story there, but I was weary and lonely under the huge responsibility and the task ahead. I could hardly look at what had become of grandpa, tiny there in that bed after a day on the kitchen floor.

I just kept thinking "Isn't our strength as a society measured by how these exact people are treated? How can we even know who they might have been when they have already been treated so badly that all that's left is their anger, and then the returned anger from the nurses and doctors who have heard this story over and over and are tired as shit, but somehow have to maintain professionalism? How can you love and serve that? The same old guy that is my grandfather there is also looked at as a 98 year old with no mind, to be handled as such...and even in good shape sometimes confused.

The burn speed of any of us seems to be directly attributable to how much real change we can effect in people's lives and how much support we get from those around us; even a boss, family member, co-worker, or our government caring rather than putting up roadblocks.

Tied hands in the face of swarms of the needy, in a corporate America with a bottom line to meet, brings to light the reality that treating the masses and preventative care costs too much if not subsidized somehow more than is currently acceptable in this society. At the same time an uninsured population can cause corporate failure, so in order to stay in business, if that's what medicine is to be reduced to, a certain clientele must be attracted; one with certain profitable diseases and good insurance. ...well, not even that happens in a bubble and it takes some very special people with a keen interest in bodily fluids and all that entails, to wake each day ready to go out there and help people; all people, regardless of their ability to pay. Though upstairs somewhere, the calculators in the corporate office cant help but drive the agenda and push back just a little at the practitioners, making it just a little harder to get a test or a service...just a little more paperwork and time...just a few more hoops to jump through.



The only good part about this thing has been that I have met some pretty fabulous and dedicated people who are changing lives every day in profound ways. These are people who should be leading our medical establishment rather than struggling to make ends meet and hoping that their own health insurance isn't changed again so that they can't see even their own doctors.

Here we are in the supposed richest country in the world, in the most fantastic city ever, surrounded by tourists, and families documenting every step and breath of the memories that they create on vacations, in weddings and anniversaries...because that kind of white-wedding-American-happiness leading to the big forever-maybe is what we are all entitled to in this greatest country in the universe and beyond! Whoever said that it was going to be rose gardens and a yearly trip to Disney? I know that story. I've seen American Beauty just like the next Sam Mendes fan, and I never aspired to anything close to Disney or even an outside cabin on the cruise. The thing is that maybe if we can't get the house, we can make it to Disney or NYC to create those American memories. But does that make up for the loss of lifetime security that the crumbling American dream has left us with? I suppose that we can look to our photo albums and videos in our old age, but where will we be when we're clutching those few relics left over from a life of trying to make it OK by continuing the pattern without having the foundation from which to support it all? This is what I call the "shiny, shiny!" distraction method, where the fireworks go off at the magic Kingdom at the stroke of it's-too-f'ing-late-to-secure-your-retirement time. In other words, all the big vacations and weddings in the world amount to nothing when you're old in a state run home.



I guess that I've found that ultimately the things that matter the most are the little day to day experiences that make up our lives rather than the grand experiences that we've been told are necessary to make us whole. I wasn't raised to want that wedding or much of anything actually, and yes, my happiness tends to spark around funny little chickens running across the lawn after a moth or a wiggly pup. And whats wrong with that? A rumbling subway or a train groaning through Glenbrook when Ive been at the bird store....I couldn't want a diamond that would give me more than that. But then there is love, of course.

Yes, and Will and Ben; will we ever look back and say "remember the year that everything went to shit?" or will it just fall into line with so many other shit years? They seem to line up these past 8 or so years (yes, I am trying to blame this on Bush!)...or maybe I just don't know how to be happy (turn off the news, maybe? I hear it works...) Who knows? I am acutely aware that things could still go further down before it drags slowly back uphill. But something that I've grasped hold of pretty hard lately...well, for a while...is to try very hard to do everything that I do for a really pure and real purpose. Not to go into anything expecting something back or feeling like there is some other purpose other than just the quality and feeling of the task at hand...does that make any sense?

I am very good at it some of the time, and mainly because I find that these days I don't really want alot as far as the material things go. The things I want are more in the way of a feeling of order to the world again, that might indicate that the American culture wasn't really falling to shit and that Americans weren't becoming selfish pigs worse than they had been. I want some sort of feeling of being less alone, and that has nothing to do with lying to myself about forever companions or love, but just the community that seems to wax and wane around me as life gives or takes our time...I sometimes wonder if I will have anyone like me in my life when I am as old and infirm as grandpa, and more, if I could even stand it if I did.

They say that time goes by so fast, and even knowing that and trying to hold on to the important moments with pictures and movies, or consciously basking in the experience (my little trick that doesn't work too well in the long, long run,) inevitably you wake up one day and you can't remember how you even made it through one year or another, while you marvel at how all the children you know are now towering over you.... In wonder at how time passes so quickly, and scared at the prospect of time speeding by faster and faster till you are the one in the triage bed, old and scared, with hopefully a semi-sane family member nearby.

So, amidst that accidental aunt (accidentally was in town for the big fall down/heart attack) acting horribly towards me, and the most incredible array of scary rotten home health aides and a few sterling examples of what our health care system should reward, came the most fantastic and incredible Visiting Doctor of the Visiting Doctors of Mt Sinai Hospital. This is a program that I had found over 2 years ago after Hi had ended up in the emergency room at NYU medical center and had gotten such horrid treatment, and such neglectful aftercare from his longtime physician, that it became clear that he needed a geriatric specialist. There was another practice on the east side, but this was one was close by and ended up amongst the printouts I sent him, even though I still had doubts about Mt Sinai as a whole. He got on the waiting list like everyone else, and began to have home visits from an array of doctors and specialists from this practice that does most of their work in the home.

I had never personally met the doctor that grandpa ended up with after the one that I did know left to have a baby , and then the next one moved on. Because they spend their time in the field seeing patients, you've got to be around when they come or you end up on the phone with them. And I've got to say that in a world of worry and getting the old guy home and not knowing how I was going to manage this thing between the visiting nurse late on a Saturday, no supplies, and a wonderful aide who probably saved my life that weekend, (while my aunt decided to frantically "clean" and throw away all of grandpa's things that seemed dirty to her,)...no sleep for days and then, like a super hero, this young Dr, infamous to me already for how much Ive heard his words of advice and instructions, strode into the hall with a student in tow, tall with long hair, and maybe all of 30-something, and proceeded to not only take control of the situation there and get my grandfather in a good frame of mind, but then continued to call and check in and come back on his own time, actually spending a few hours here with IVs hanging from a nail in the wall at one point, and checking everything. This is the kind of treatment that we don't get in America anymore, and I'm sure, that it saved his life. I've heard the same sorts of stories of other practitioners from this service, and its incredible to find such a simple idea being put to such great use in helping so many people.

This doctor put himself through medical school and works 3 jobs to pay back his loans. A brilliant young practitioner who goes into the homes of his geriatric patients all the time should be spending any extra time he has doing studies and writing papers about this population. He has insight and access to research that can't be done any other way. But, instead he chips away at a mountain of debt in a country where money piles up every day in the coffers of the rich, and too many of the elderly are hitting the insane donut hole in their prescription insurance, which means that they will have to somehow come up with 2 and a half grand out of the air to pay for the rest of their prescriptions until they reach a catastrophic level and qualify again for coverage. If by then their nutrition and bill situation hasn't hit catastrophic.... then maybe they can make it through another year. Well, yeah, my grandpa was one particular person who was only on one pill and an eye drop, but that's unusual...and what can any of us do in the face of government plans that seemingly come straight out of Soylent Green?...It reminds me of that Morning Sedition bit where the Bush Administration unveiled their new Social Security plan by burning old folks on a pyre.

I've again also come up against the disparity in pay between the health aides and the CEOs...not only at Mt. Sinai, which I wrote about last year, but at Visiting Nurse Service, which has managed to screw up quite a bit of this case. That there are people being paid $7-$9 per hour to totally physically care for the elderly and infirm in this country is a shame. The quality of caregivers varies and the the best and brightest will often move on to other areas of care giving or only work 3 shifts per week in order to get their health insurance and do private work the rest of the time. The helpless are often not in a position to refuse a bad caregiver; even my grandfather, if left alone here with an aide, would not have been able to use the phone and would have had a very rough time telling anyone with him what he needed or if anything was wrong.

The healthcare workers union has made a bad deal with no varying levels of experience within the Aide job description, and no merit pay. So a 20 year veteran at this makes maybe a dollar and a half more per hour than a newly starting aide and the people who book the cases don't know one aide from another and don't even get much feedback on them, unless its negative. Not only that, there are always some people out there with attitude problems and quite a problem with English skills.

I have had a parade of some of the best and worst through here, and because my grandfather has been instrumental in building a VNS hospice as part of what he does philanthropically, he should have been treated as some level of a VIP. Not that we demand that, but there is a huge disconnect in that not one of us "clients" can call the person handling our case and find out who the person is thats coming to our house for the next shift. No one in the very busy office has worked with this person? No one knows if they speak English?
Some of the aides that arrived here were unclean and smelled so bad that I couldnt have stayed in the apartment with them for a day. A man who supposedly spoke English and Russian was actually Chinese and deaf. He sat and did Soduku for 12 hours and couldn't hear either of us calling him, nor did he look up regularly. By the time I had walked up to him and waved in his face I might as well have moved grandpa myself!

I cant blame the aides, though some aides blame others for not taking enrichment courses or taking advantage of whats available out there. I guess that 12 hour shifts of dealing with differing levels of sickness and trying to go to school and have a home might be too much...who knows? I just would like to know, as I get older myself in an uncertain world, that the very corporate healthcare system will take the time to know who they are sending out to bathe and dress their patients. Many of the aides cant even speak English well enough to call 911. And someone's brilliant idea of an automated check-in and out system for the workers ensures not only that they are further removed from the case managers but also that there are snafus within the system that maddeningly screws up the paychecks. The aides are faced with a menu of what services they performed within their 12 hour shift, which they must enter numerically on the touchpad...and often they are on a cell phone or an old phone or in a hospital room....This is drive-through healthcare but, someone, somewhere down the line from the efficiency experts, is the person who actually touches the patients, and if that patient is your family member you might want to have some idea of what goes into finding the perfect caretaker, if you can even afford one past the 21 hours per week that Medicare allows.

Through all of this grandpa has been railing at how its gone and how difficult its been. I know that the lack of continuity in aides and the slowness of organizing the equipment delivery hurt his recovery greatly, probably costing more in the long run, (if one were counting dollars and cents.) Its also allowed us to find some wonderful people and strengthen ties with the few wonderful people that we had found before. I just know that it doesn't have to be this way, and I wonder how the upper management, who are no doubt trying to make ends meet on their own level of existence in this most expensive city, throw up their hands at what is not working as if they are looking at a political election and saying that one vote cant possibly count (see Bush v. Gore, 2000.)

My point is that there are no more Norma Raes or Ceasar Chavez' out there who are gonna try to make it better. Everyone is just so under it that there seems to be no way out. The long term plan of the neo-conservativism begun surely before Reagan, and back to Nixonian plans for a higher order in the executive branch, has worked and is working in that no job is safe, workers are disposable, and if it can be outsourced you'd better believe that it will be. Thats your taxes, your medical records, your credit cards...and there are no good secure jobs for the middle class. What do you get for struggling to become a doctor? mountains of debt and multiple jobs to pay it off....that is unless you're from a rich family or you jump to a specialty that will enable some profit in the future.

Brilliant at Breakfast is going to be fed directly to the Air America front page this week, and somehow I thought it best to publish what is probably a too long and too personal post on the day before. But really, healthcare and the disposition of the poor and middle class in their later years is a serious political issue that we cant overlook in the face of our stimulus checks from uncle Bush and just running fast enough to keep afloat. Make no mistake about it, there are elements out there who are trying to destroy the middle class and who hold the poor in such disdain that they actually don't care if they all die...if we all die...and, by we, I mean the middle class, if I even qualify, considering that Ive been lucky enough to come from a family that could help me with an array of things like medical and school expenses.

So, anyway, he lived to fight another day. He was clearly not ready to go, much to the surprise of those who stood around saying that he would never get up from that bed. If its for 2 months or 2 years, or even 2 days, hes walking a little, getting around, and watching TV happily...Obama has been on today and is looking mighty presidential.

Reasons to be cheerful!




c/p RIPCoco

Labels: insurance industry, medical malpractice

Between John McCain's magic plan to win the Iraq War by staying the course and his magic health care plan, you'd think that having been a POW not only insulated him against all criticism for anything, it also gave him the ability to just say something and make it so.

Here in New Jersey, we used to have a high-risk pool for insuring drivers. It was called the Joint Underwriting Association, and it was funded partially by premiums paid to private insurers, and partially by a surcharge paid by ALL drivers. The New York Times editorialized about this system in 1988 and a full history is here.

The main problem with the JUA was that insurers were allowed to dump pretty much any driver they wanted into the high-risk pool. Mr. Brilliant and I were dumped into this pool for a while, despite having clean driving records, solely by virtue of being apartment renters instead of homeowners. Our insurance guy told us that the actuaries believed renters to be "less responsible" (a laughable notion today, given the real estate/mortgage frenzy of the last couple of years and resulting crash) so all non-homeowners were dumped into the pool.

For all that former governor Jim McGreevey is now a well-deserved national laughingstock, and for all that he was for the most part a terrible governor, he deserves credit for once and for all setting the state's auto insurance system back into something vaguely resembling viablility.

John McCain's health care plan involves creating a similar high-risk pool, the effect of which will be to allow insurers to continue to cherry-pick whom they cover and limit coverage to only those least likely to use significant services. In fact, the very existence of such a high-risk pool for those rejected by insurance companies (who will continue to be able to expand their massive lists of reasons to deny access to their plans), as we saw with auto insurance here in New Jersey, virtually assures that the insurers will do just that. Why should a for-profit insurance company take on the risk of people over the age of 50, or people with a BMI over 25, or people who are genetically predisposed to high cholesterol, or people who don't belong to a gym, or people with blue eyes, or any arbitrary exclusionary factor the suits that run it deem relevant, when it's just as easy to deny coverage and funnel those people into the high risk pool?

The purpose of group insurance and of mandates that insurers take on all comers combined with universal coverage mandates is to spread the risk around. Our experience with the JUA in New Jersey has shown us here that when you allow insurers to refuse to do this by creating a pool of so-called high-risk people, you ensure that ALL people are deemed for some reason to be high risk -- which differs little from where insurers are trying to go now -- insuring ever-fewer numbers of people.

Labels: health care, insurance industry, John McCain

In case there is anyone left in America who believes that even the laws that appear on the surface to protect workers do anything but protect the corporations that employ them, guess again.

This just boggles the mind:

Dying of cancer, Thomas Amschwand did everything he was told to make sure his wife would collect on the life insurance policy he had through his employer.

"He was obsessed with dotting every `i' and crossing every `t'," Melissa Amschwand-Bellinger recalled about her husband, who died in 2001 at age 30.

But Spherion Corp., the temporary staffing company where Amschwand worked, told Amschwand-Bellinger she would not receive any of the $426,000 in benefits she believed she was due. When she went to court, Spherion succeeded in getting her lawsuit thrown out. The Supreme Court on June 27 refused to review the case.

Amschwand-Bellinger received a refund of the few thousand dollars in insurance premiums she and her husband dutifully had paid. The total, she said, would not cover the costs of his funeral.

The story has played out often under the federal Employee Retirement Income Security Act. Designed to protect employee benefits, the law has been used by employers as a shield against suits.

Federal appeals courts, interpreting Supreme Court decisions dating to 1993, consistently have said companies that offer health, life and retirement benefits under ERISA cannot be sued for large amounts of money, or damages. Instead, they can be sued only for typically smaller sums such as Amschwand's insurance premiums.

Several federal judges have bemoaned the unfairness even as they have felt constrained to rule in favor of employers.

"The facts ... scream out for a remedy beyond the simple return of premiums," Judge Fortunato Benavides of the New Orleans-based 5th U.S. Circuit Court of Appeals said in the Amschwand case. "Regrettably, under existing law it is not available."

The Bush administration has argued that the appeals courts are misreading the precedents and has asked the high court at least twice to clarify the earlier rulings. So far it has refused.

Congress, which could amend ERISA to make clear such suits are allowed, also has taken no action.

The result, in the view of ERISA experts, the administration and some lawmakers, is perverse.

"The beneficiary under the policy didn't get the promised benefit," said Colleen Medill, an expert on ERISA at the University of Nebraska-Lincoln. "To say we're just going to return your premiums, that's a total farce. That's not what they paid the premiums for. They paid them for the benefits."

Sen. Patrick Leahy, chairman of the Senate Judiciary Committee, said at a recent hearing that before ERISA became law, employees clearly could sue for benefits in state courts.

The court rulings, said Leahy, D-Vt., have left people "more vulnerable than they were before the law was passed."

Spherion's decision to deny benefits to Amschwand-Bellinger turned on an odd set of facts. Spherion, which employs about 300,000 people, switched insurers after Thomas Amschwand was diagnosed with a rare form of heart cancer. The new policy did not take effect until an employee worked one full day. Spherion never informed Amschwand of the requirement.

Amschwand asked repeatedly whether there was anything else he needed to do and was told no. He asked that the new policy be sent to him. Spherion never did so.

He died without returning to work. His widow said he easily could have worked a day if that was what it took to activate the new policy. Spherion could have waived the one-day-of-work provision, as it did for other employees but not for Amschwand.

Spherion spokesman Kip Havel issued a brief statement when contacted by The Associated Press after the high court declined to review the case. "We are pleased the court has made its decision and the matter has finally been resolved," Havel said.

This is what happens when laws are written in a hurry; when laws are given names that seem to benefit ordinary people but are actually written to give all the power to big business. This ERISA provision is so egregious that even the Bush Administration isn't defending it.

So why the hell isn't it being changed?

Labels: insurance industry, just another outrage

TGIF!

I've been running round on the ground in the health care wars this week, and let me tell you, friends <*snark*,> its not pretty. The overwhelming reality of what too many parents live with; the trade- offs and choices that go round on a roulette wheel, with the possibility of a disastrously wrong choice as the winning number. It may be a necessity for some parents to just turn a blind eye to what is missing in the struggle just to keep a roof over their heads, but the tragic legacy is allaround the neighborhoods where impossibly young girls push strollers and young thugs shuffle by with pants around their knees speaking in an indecipherable language. When you relegate an entire portion of society to a certain part of town you cant really expect them to be able to integrate themselves back into general society on command; at some point they are going to make their own culture, and that will ensure their separateness forever.

And much like I'll talk to people about dogs...and say that the doggy dental was SO expensive, as well heeled pure-bred dog owners will say, matter offactly, that they don't go in for that dental stuff, because we never used to do that for our pets in the old days. Well, I guess you couldn't say that about a child, could you? But what if you come from a country where medical or dental care is not readily available, and what if the clinic lines, hours away from work, and co-pays, and even the daunting process of applying for state aid, are an impenetrable wall. What difference will it make for an inner city kid to lose his teeth, as he or she is growing up and trying to get themselves out of the neighborhood? What puts someone over the edge? Is it the lack of skills? The lack of language or growing up around people who are not really aware of what is going on in the world? The lack of just having someone to talk to and some small choices in life?... The lack of any empowerment at all.

So, why do Medicaid, and similar services for the very poor, only provide for the pulling out of teeth and not for the saving of teeth? Isn't it incredibly short sighted for the government to not realize the ramifications of saving a tiny bit of money now only to have to spend heavily later? Its not just the bone loss in the face from not having teeth. Its the loss of self assurance and the loss of clear speech in some cases. Its all of the complications that happen later in life regarding nutrition and health. This should not happen to anyone, much less a child! Oh, there are programs to find out there to help with these tough cases. What I've found here are far away clinics that demand transportation and time to sit on line. You take the appointment you're given, and you don't complain...and hope that your job is still going to be there when you're done. And then, of course, the specialist only comes in once a month, so the first available appointment is months away.

Some people are not going to be able to pull themselves up by their bootstraps and realize the American Dream in the way that has been advertised, but their kids might be able to. So, in the interest of giving the second generation, at least, a chance, and in the interest it seems, of maintaining the maze of bureaucracy that is involved in getting care, why not let the parents care for the kids rather than making them work a minimum wage job that is not possibly enough to lift their family out of poverty, but which does assure that their children spend an inordinate amount of time either alone and wandering, or in daycare, cared for by others who are getting maybe just above the minimum.

Here we have a mother who is working 24/7 as a home health aide. Because she is making some amount below the poverty line her children are able to get the Husky plan,here in CT. Because her income surpasses some line in the sand, her children are forced off of the A plan, which is reserved for the very poor and which has no premium, and on to the B plan, which is for the slightly less poor and has reduced premiums based on what she makes. Because she makes so little there is no premium. The difference? The A program covers many more services, more fully. Why is that? Would the citizens of Connecticut want to cover the children of the very poor more than the children of the slightly less poor? The maze to even get into this program is daunting, and there certification every year is a nightmare.

To hear the mayor of this town boasting about his lean machine, reminds me of how Rudy notes cutting the budget of New York City partly by making the maze to social services more difficult to navigate so that people had to give up on trying to get services. Where is the morality in trying to deny care to anyone? How does that provide for a happy life for anyone? How does someone who boasts of that sort of behavior sleep at night?

If there is a God, which seems pretty unlikely in the face of all of this, maybe this is just a huge test....and really, it could go either way. because if what science has learned is true in that the fittest need to survive in order to better the race, then it's wrong to bring along the weaker members; they should be cut loose on an ice floe, and I'm the overly empathetic weak one. What I see happening here though, is that many of the kids of the very rich, raised in a bubble and unaware of how things fit together in the world, are more likely to be the weak links in a Darwinian sense. The hard working immigrants are tough as nails and those who work hard can really make a life. Take away the cushy surroundings from most of the rich kids around here and they couldn't survive. There is seemingly an active campaign against the poor brown kids pouring into this country, because they are tougher, and it could be that the only way that we have to fight them is to keep them part of the underclass, lest they overtake us.

With an eye to the crumbling middle class, and many in the upper classes having to downsize, it will be a pretty telling time regarding who is resilient enough to survive. Money is a construct that used to based on something valuable kept in a vault somewhere, but its so much more abstract than that. Just as a foreign government can buy our debt or an official can raise or lower interest rates, or print more money, its all just an idea. The only truth worth holding on to is that we are really only one or two steps removed from the homeless person on the street or the hardworking immigrant trying to scrape together enough money to take their kid to the doctor. Just as we don't torture people because we don't want our soldiers tortured in other lands, we cant deny care to anyone lest we be denied ourselves.

There is no doubt that this country needs a single payer health care system with no qualifiers. it needs to cover everyone and it needs to cut the insurance corporations out of the process. There are enough issues to overcome as a human being on this planet, without having to worry about what should be a right to everyone; not just the rich.

I don't know why, but to me the saddest part was that after the tooth cleaning, the kids didn't even get a new tooth brush, much less that array of samples which is like a prize for being good.

That was the dentist...next came the pediatrician, the blood lab, the psychologist...and school...




c/p RIPCoco

Labels: health care, insurance industry

Last year, after much anxiety and trauma, I finally had the colonoscopy you're supposed to have when you turn 50. It was done at an outpatient surgical center, with sedation (propofol) administered by a board-certified anesthesiologist. I felt woozy, and the next thing I knew I was awake. Piece of cake.

Given that propofol has no reversal agent, and I am terrified of anesthesia, the fact that an anesthesiologist was on the case helped alleviate any fear of never waking up.

Some people have reported waking up during the procedure, others tell horror stories about memories of the procedure occurring later on, despite the amnesia effect of the other, more commonly used drug, Versed.

Colonoscopy is one of the procedures people dread most. That dread is the reason most people put off having one, when any polyps that are found can be removed before they become cancerous. That mine was so trauma-free is the main reason why I don't have any qualms about having another one when it's time. In theory, this should reduce my risk of incurring large bills for cancer treatment later on.

The other reason I have no qualms about another colonoscopy is that my insurance provider is not Aetna. Because it took a serious outcry to get Aetna to back off its plans to stop covering the use of anesthesiologist-administered propfol for colonoscopy:

owing to critics who contended it was putting profits before patients, Aetna said Wednesday that it had suspended — at least temporarily — a plan to stop paying for routine use of a powerful anesthetic in a procedure to screen for colon cancer.

The drug, propofol, provides quick and reliable sedation for patients who are undergoing a colonoscopy, an examination of the lower intestine with a flexible probe that provides the most thorough form of screening for colon cancer.

Because of federal regulatory recommendations and, in some cases, specific state regulations, propofol is often administered by an anesthesiologist instead of the doctor performing the colonoscopy.

Aetna said in December that it would stop paying for the use of propofol in routine cases as of April 1 because research showed the participation of an anesthesiologist added $300 to $1,000 to the screening costs without improving outcomes.

Aetna cited the practice as an example of unnecessary spending. It said doctors in many parts of the country who used propofol in just 10 percent of their cases were achieving the same results as those in areas like the New York City region, where close to 80 percent of patients received the drug.

Critics had said that restricting use of propofol would discourage patients from undergoing a colonoscopy. Cancers of the colon and rectum trail only lung and prostate cancer in cancer deaths among Americans, according to the Centers for Disease Control and Prevention, but survival rates are high when they are caught early.

Insurers have been split on whether to cover propofol for colonoscopies. Humana and WellPoint are among the large players that, like Aetna, have sought to curtail coverage while UnitedHealthcare, which has 26 million members, has advertised its intent to support propofol in all screenings. Medicare leaves the decision up to its local carriers, most of which have restrictive policies.

Some doctors maintain that propofol helps them by keeping patients calmer during screenings than the traditional cocktails they administered of sedatives like Versed and tranquilizers like Valium. And, because it wears off sooner, patients can go home more quickly.

Propofol has no reversal agent, so it must be administered by someone who knows what s/he is doing. On the plus side, it has a short half-life so overdosing is unlikely. But it must be titrated continually through the procedure.

This is a perfect example of insurance companies trying to cut corners at the expense of patient care. Colonoscopy is so effective in improving outcomes for patients where cancer is found because it can be detected early, and also effective in finding polyps before they can become cancerous or precancerous, you'd think that methods that make the procedure less frightening would be a no-brainer.

But then you'd have to believe that health insurance companies are in the business of health. And by now we all know that it's more profitable to cover patients who die younger than to cover procedures that might keep them around longer.

Labels: health care, insurance industry

Sound like one of those "Oh, they'd never do that" scenarios?

Guess again:

Mortgage lenders aren't the only ones showing more interest in your credit score these days – the health industry is creating its own score to judge your ability to pay.

The new medFICO score, being designed with the help of credit industry giant Fair Isaac Corp., could debut as early as this summer in some hospitals.

Healthcare Analytics, a Waltham, Mass., health technology firm, is developing the score. It is backed by funding from Fair Isaac, of Minneapolis; Dallas-based Tenet Healthcare Corp.; and venture capital firm North Bridge Venture Partners, also based in Waltham. Each kicked in $10 million for the project.

The score is already raising questions from consumer advocacy groups that fear it will be checked before patients are treated. People with low medical credit scores could receive lower-quality care than those with a healthy medFICO, they argue.

"How much assurance do I have that they're not going to look at this medFICO first, before they decide whether to treat or not?" asked Linda Foley, founder of the Identity Theft Resource Center in San Diego.

Post-discharge checking

That will not happen, says Stephen Farber, chairman and chief executive of Healthcare Analytics. Hospitals will check the score, which will be based on the patient's medical bill payment history, only after the patient is discharged, he said.

"We only come into play once the patient has been treated and discharged, and the bill already exists," said Mr. Farber, who has visited hospital executives nationwide over the last six months to sell the concept. "We just help figure out what sort of relief a hospital should grant the patient."

And I am Marie of Rumania.

Do you honestly believe that hospitals are only going to look at this AFTER the bill exists?

Let's look back at Nataline Sarkysian again, shall we? Here's a situation where the hospital deemed that a liver transplant was appropriate, and CIGNA Insurance refused to pay for it. The wingnut apologists for the highly profitable insurance industry insist that it's the hospital's fault that she died because they didn't go ahead and do the transplant anyway. Given the battles that hospitals are fighting with insurance companies; battles that eat up physician time and hospital resources, why shouldn't the hospital just evaluate the patient's ability to pay beforehand and make a decision based on that?

Dday over at Hullabaloo nails it:

Seriously, this is hideous. It used to be that the medical care industry, particularly the insurance companies had to use some prior injury as a basis to deny coverage. Now it's some years-old debt that hospitals can use to hang over your head and deny care. Enough. Health care is a human right. It's not a privilege of the wealthy. Willingness to pay is a metric that can be abused to the nth degree to deny treatment to the sick. It will create another tier to the medical system; you have the uninsured, the wealthy who can afford the best, and now the discount class who can't afford access to the good stuff.

Labels: health care, insurance industry

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

Labels: health care, insurance industry, World War III, You're not paranoid if they really are out to get you