Tuesday, August 25, 2009

Staggering Immorality

The whole health care “debate,” if you can call our national shouting match a debate is very disheartening for about a dozen reasons. The truth has been distorted by a coordinated campaign of scare tactics and disinformation; right-wing crazies have been let off their leashes, and what should have been a serious national conversation about how we care for our young, our sick, our infirm and our elderly has been cast as socialism and a government take over of private health insurance.

It’s total bullshit. The truth is that health insurance companies bring nothing to the health care table. All insurance companies do is cherry-pick the healthy and blacklist the sick so that they collect premiums and avoid paying claims. That’s how the formula works, and if you check insurance company profits, this formula works really, really well. Naturally, the insurance companies and their powerful lobbies want nothing to do with a “public” option or with any government intervention that might tilt the equation in favor of patients rather than profits.

Medicare is a single-payer health insurance plan. Patients choose any physician who accepts Medicare, access the care they need, and Medicare pays the bill. The physicians and laboratories are not in the employ of the government – all the government does is facilitate payment to providers for services rendered. Socialized medicine? Old Karl Marx wouldn’t recognize it as such. No reasonable person would, either. Smart people understand that Medicare’s administrative expenses are absurdly low compared to private insurance companies.

Why does the United States treat health care like a commodity – like oil or soybeans or rubber – while every other industrialized nation treats it as a human right that will, sooner or later, need to be exercised by every one? Why do we spend more per capita on health care and have crummier outcomes than almost every other nation on the planet? Why are so many Americans uninsured or under-insured?

Capitalism, baby, the free market myth that claims government can do no right and unfettered business no wrong.

Too many of the big players – Senators, Representatives, Administration officials -- who are supposed to be working on our behalf to improve our silly system are pimps, sluts or whores, with cozy monetary ties to health insurance companies or the health lobby that render them incapable of doing regular citizens any good. In other words: they have a vested interest in maintaining or enhancing the status quo, not helping working people gain access to affordable health care.

My employer’s health insurance premium went up by something in the neighborhood of $1.5 million this year, an increase that must be passed on to everyone covered under the plan. So, deductibles for office visits rise, co-pays rise, some services are reduced or eliminated altogether, and employees see less take home pay at the end of each month. Yes, we are damn fortunate to have health insurance, but keep in mind that even people with insurance are very often overwhelmed by medical expenses and forced to declare bankruptcy. Small, medium and even large businesses cannot afford sky high premiums either. A couple of more years of $1.5 million premium increases may force my employer to drop health insurance coverage – adding another 2,000 souls to the ranks of the uninsured.

Our health insurance system isn’t about health – it’s all about money, lots of money, which is why it’s so hard to change.

Wednesday, August 19, 2009

Duck, Cover & Cave

The battle is as good as over. President Obama sodomized his supporters over health insurance reform, just like he did when his administration had a golden opportunity to rein in Wall Street criminals. Despite his smooth style and golden tongue, Obama has caved to pressure from the GOP right and the all-powerful insurance lobby. The bastard wouldn’t even call the so-called public option by its proper title: Medicare for All.

The status quo wins again. This is no real surprise – even with a highly popular president whose party controls both houses of congress – because the insurance lobby has stymied health insurance reform for decades. When the dust settles in the next month or so, and a weak, ineffective bill emerges from congress, Obama will claim victory, but it will be of the pyrrhic variety. Millions of Americans will remain uninsured, and millions more will continue to lose battles with Cigna, Aetna and United Health over care decisions that belong in the hands of physicians but are made by insurance underwriters based on profit not health; personal bankruptcies resulting from medical expenses will also continue largely unabated.

Eric Alterman, who writes for the Nation and other national publications, said last fall that Obama would disappoint us; I figured he would, too, but hoped he would wait until at least midway through his first term. Like Bill Clinton, Obama talks a great game, hits the right notes in his speeches and public appearances, but when push comes to shove and his opponents go on offense, Obama folds like a dandy-lion in a hurricane.

Another similarity between Obama and Bill Clinton is Obama’s love fest with corporate interests. Obama had everything necessary – public opinion, numerous examples of corporate greed and incompetence -- to rein Wall Street in and instead abrogated his power by surrounding himself with the likes of Lawrence Summers, Tim Geithner and Robert Rubin, not to mention a number of lesser alumni from Goldman Sachs. No wonder that Obama went soft on the speculators, crooks, and swindlers who brought our financial system to the brink and laid an enormous hurt on average working Americans.

Inauguration Day was the high water mark of the Obama Administration and the trip has been downhill since. Our President has no one to blame but himself for a fatal absence of cajones. Think back to when George W. Bush and the GOP held sway – that posse of greedheads and power mongers rammed bills through congress and treated Democrats like lackeys. Hell, Bush even sold the world a war without a shred of factual justification, and when the world balked, Bush laughed and pulled the trigger anyway. Because of Dick Cheney, Bush had a better understanding of power politics than Obama or any Democrat since Lyndon Johnson. Politics is war, and in war you don’t seek to make friends with your opponents, you destroy them.

Typical fucking Democratic Party. Give them Congress and the White House and they still can’t get anything of consequence accomplished. This is change we can believe in? This is the second coming, the end of business as usual? Another bill of goods has been sold by a graduate of the Ivy League.

Monday, August 17, 2009

The Distortionist

Rush Limbaugh compares the President of the United States to Adolf Hitler and the media establishment yawns. And why not, what with the ongoing adventures of Jon and Kate, and Paula Abdul possibly leaving American Idol? The media must keep up with these breaking stories, right?

But I wonder if the establishment would have yawned if Keith Olberman had compared George W. Bush to Hitler? Would Limbaugh have let that pass? How about Michael Savage? Bill O’Reilly? Ann Coulter?

No, the right-wing yakkers would have gone totally apeshit and demanded Olberman’s head; they would have declared that the left-wing media was depraved and dangerous, a threat to the nation; the story would have bounced in the echo chamber for days on end, picked up and pushed by Matt Lauer and Diane Sawyer and the editors of the Wall Street Journal.

If Rush Limbaugh is the de facto leader of the Republican Party, hasn’t the GOP slandered the President of the United States?

Where’s the outrage? OK, forget outrage. What about accountability? Why aren’t Limbaugh’s corporate sponsors dropping him and running for the aisles? Why does Limbaugh get a pass to say such outlandish, untrue, stupid things?

It’s money, of course. Audience and advertising revenue.

Look, I despised George W. Bush. I believe that Bush was an illegitimate president, and that he was one of the dumbest, if not the dumbest, men to ever occupy the White House, but I can’t remember comparing him with Adolf Hitler. Despising a political figure is one thing, complete ignorance of history is another.

Rush Limbaugh and others of his ilk are symptoms of a more serious malady that is deep inside our body politic. We saw it during the financial crisis and see it today in the war of misinformation over health insurance. Sense doesn’t matter, logic doesn’t matter and accuracy doesn’t matter; only volume and repetition matter. Limbaugh distorts, obfuscates, lies, exaggerates, misconstrues and maligns to advance his political agenda. From the safe distance of his studio, where few, if any, competing voices are allowed entry, Limbaugh bludgeons those he disagrees with. It’s not reasoned discourse that aims to find the truth or some middle ground that reasonable people can agree on -- it’s polarizing and divisive, designed to inflame an audience made up largely of people who cannot think critically or independently.

It’s propaganda, in other words, designed to play to people’s fears and prejudices.

I don’t know how our imperfect democracy can survive when our public discourse is as degraded as it is today. Except on rare occasions, common ground seems impossible to find.

Tuesday, August 11, 2009

Under the Microscope

Weird times, and no end in sight. I know it’s a bitch to fill twenty-four hours of airtime every single day, but from time-to-time the angle CNN takes on stories perplexes me. There’s the Lou Dobbs “Birther” charade, an absolute waste of time. Memo to Lou: Barack Obama was elected President of the United States. He’s been vetted. Get over it. Go back to scaring people about illegal immigrants. There’s Michael Jackson, Paula Abdul, Jon and Kate, fires and floods, bombings, drought, and corporate-sponsored protests about health insurance.

Yep, there’s no end to the weirdness, the trivia, the hyperbole and the BS. We’re a nation of idiots, spoon-fed misinformation day and night.

A day or two ago I happened to see this headline on CNN: Obama under the microscope. Three talking heads were speculating on Obama’s first eight months in office, and whether or not these months can be termed successful. One of the heads said, “It appears that President Obama has discovered that it’s one thing to win an election and another to govern the country.” Wow, bright people on CNN. I don’t remember the illegitimate Bush presidency being slipped under the CNN microscope eight months in, when all Bush had accomplished was passage of a massive tax cut for the richest Americans. Whooppee.

Remember that it was in August 2001 when Bush essentially ignored intelligence warnings that Osama bin Laden was intent on striking within the United States. Bush was too busy cutting brush on his Texas ranch to spend much time worrying about a stateless Muslim fanatic with an axe to grind against the Great Satan. The rest is, of course, history. Bin Laden struck and the nation freaked out, allowing Bush and Cheney to trash the Constitution in the name of “security.” Remember how twisted things became in the aftermath of 9/11? In order to protect our freedom and liberty, we consented to give up our freedom and liberty. Insane and misguided. We started detaining people all over the globe, some of them innocent, though we tortured many of them anyway, just to be sure they didn’t carry Bin Laden’s satellite phone number. Insane and cruel. Then we invaded and occupied a country that had nothing to do with 9/11. Insane and stupid.

Obama entered the White House on a tide of hope and optimism, but trapped beneath one of the biggest Eight Ball’s in American history, a cluster-fuck of epic proportion caused by eight years of misrule; the economic system was on the brink of collapse, workers were losing jobs at a precipitous pace, retirement savings had vanished overnight due to massive fraud and manipulation, nothing worthwhile had been done on the environmental front for eight years, and we were (still are) bogged down in two failed wars. CNN has already forgotten the shitty hand Obama was dealt on Day One.

Given his near-total capitulation to Wall Street heavies however, I think some criticism of Obama’s presidency is warranted, but we must be fair and remember what the man had to work with when he assumed office.

For the good of the country in the long term, a perspective rarely taken in American politics, we need the Obama Administration to propose, and Congress to pass, real regulatory reform of the economic system, laws with enough teeth to keep the Titans of Finance on the straight, narrow and honest path, and reduce the iron-grip corporations have on the nation’s politics. Will this happen? No, we’ll get a Band-Aid instead. We also need a reorientation back toward the real economy of productive work and wages, but Obama seems deaf to the plight of working Americans – the economic system is still tilted in favor of investors and speculators and those “too big to fail.” We desperately need a complete overhaul of our health insurance system to make it more accessible, logical and humane, but the Kansas City Royals will win 110 regular season games and the World Series before that happens. We’ll get some tinkering on the margins, but nothing substantial or meaningful; millions will still be uninsured, under-insured, subject to the whims of insurance companies focused on profits rather than care.

I never thought the Obama Administration could reverse eight years of abject failure in eight months. Seems the talking heads on CNN have mistaken Obama for a magician rather than a politician.

Thursday, August 06, 2009

Waiting for an Epiphany

I recently had my first colonoscopy. While I was sitting in the waiting area with six other men, all of us dressed in dark blue hospital gowns, with locker keys around our wrists, not one of us venturing to say anything, I began thinking about health insurance and health care, and why the insurance system in the United States is so haphazard, cruel and inefficient. Thirty minutes earlier I had plunked $250 down for this procedure because my Aetna insurance, provided by my employer, does not completely cover a colonoscopy, even though it’s a vital tool in the early detection of cancer, the treatment of which, as most everyone knows, can be extraordinarily expensive. In terms of medical care, requiring a $250 deductible makes no sense; in terms of Aetna’s profit, it makes total sense.

And that, in a nutshell, is the great American health care dilemma. Everything is fine and dandy until a corporation’s desire for profit smacks head on into a patient’s need for medical care. Insurance companies love “subscribers” who pay premiums and never get sick; they hate “patients,” particularly those who need blood transfusions or organ transplants. To put that another way: insurance companies make money by collecting premiums and denying care.

Sitting there in my blue smock, I thought about the 535 members of Congress who enjoy comprehensive, taxpayer-provided health coverage. Not only should average Americans envy the lucky folks in Congress, we should also ask: if a “public” health insurance system is good enough for our elected representatives, why isn’t it good enough for everyone?

Have you ever heard a Congressman or woman complain about access to health care or the quality of the care provided? I haven’t. And it almost goes without saying that they don’t sweat deductibles, pre-existing conditions or pre-authorizations – in other words, the frustrating, often mystifying health insurance tango that most Americans (at least those fortunate enough to have health insurance) must endure in order to access the care they need.

Ours is a fouled up, inefficient, piss-poor system. I’d like to believe that our elected officials will experience a collective epiphany and realize that the United States spends too much money per capita on health care, that health care outcomes are frequently laughable, and that it’s time to let go, once and for all, of the myth that the private, for-profit model is not just the best way to go, but the only way. Conservatives thump the drum and bang the gong for the “free” market approach to health care, when it’s obvious to most Americans that the market is controlled, manipulated and fixed by a few major players who do not have the best interests of the public at heart. In this respect, health care is exactly like the banking system: a game rigged by the few for the benefit of the few.

Every time any momentum builds to reform the financial or health care systems, the drumbeat against the idea begins on talk radio, on Fox News, from the lobbyists who prowl the halls of the capital looking for politicos they can influence (actually, “bribe” is the correct word) with hefty campaign contributions, and from the “experts” who appear on Meet the Press and Face the Nation. We hear cries of “socialism,” “communism,” “Bolshevism,” not to mention horror stories from Canada of patients forced to wait three weeks to have a wart removed. We don’t hear the flip side news that those same Canadian patients receive the primary care they need to prevent minor ailments from becoming major health problems, or that they can afford the prescription medications they need without having to take out a second mortgage or sell a child into slavery. Among industrial nations, only Americans are forced by an inhumane insurance system to choose between medicine and food.

Conservatives believe that, outside of waging war (and with warfare being outsourced to companies like Blackwater and Halliburton even this former government monopoly is slipping away) government – federal, state or local – cannot do anything right, let alone manage something as complex as medical insurance. The popularity and success of the Medicare program makes no impression on conservative true believers, just as Wall Street pyramid schemes are not viewed negatively enough to insure that reasonable external controls are passed into law; conservatives would rather believe that the bad guys can regulate themselves.

There will be no collective epiphany on health care. The industry lobbyists and their craven puppets in Congress will see to that. The bill that finally emerges from Congress will be watered down, convoluted, ineffective, weak, and utterly reliant on “voluntary” rather than mandated reform. In other words, lots of sizzle but no steak. While the legislation may improve the lot of a relative few, it will do nothing for the struggling many. At the end of the day, the insurance companies and financial interests will still maintain control, though the Obama Administration will claim a great, epochal victory.

Sooner or later Americans will mature as a people and see the error of our ways. We may be a second-rate nation by then, living in the shadow cast by China and India, but we’ll get there because there won’t be any other choice.