News flash: our health care system is broken. That is to say, it is broken from the standpoint of the people who need medical treatment. From the industry investor standpoint, it’s working just fine. People are making a killing, quite literally, from COVID and other illnesses, lending credence to that line from our song Well, Well, Well: “from every misfortune a fortune is made.”
I say this on a week when women’s health is under attack to an even greater extent than usual. The Texas anti-abortion law, which the U.S. Supreme Court has allowed to go into effect, has effectively made abortion illegal in the lone star state, regardless of what their moronic governor claims. This inevitably will be followed with similar restrictions in other “red” states. But even under the best of circumstances, women have trouble accessing and affording care precisely because of the kind of system we still have.
Promises, promises
When he was running for president, Donald Trump promised that he would replace the ACA (“Obamacare”) with something much better, a plan that would cover everyone, etc. Of course, that was a transparent lie that he had no intention of even pretending to make good on. Then last year, when he was running for president, Joe Biden promised adding a public option to the ACA. No sign of that yet, either.
I don’t know what Biden’s plans are for the reconciliation package with respect to health care. What I do know is what he said during the campaign. Back then, he claimed that workers loved their employer-based healthcare and suggested that they had “negotiated” for it. I pointed out back then on my podcast Strange Sound that this was balderdash. Less than 15% of American workers (generously) have union contracts. No one other than a subset of unionists ever “negotiates” the particulars of their health coverage with their employer. The plain fact is that employers provide substandard coverage to their employees, by and large, and that it leaves tremendous gaps.
The six thousand dollar man
As some of you know, I spent about a week in the hospital at the height of the COVID first wave back in April 2020. (It was an ailment unrelated to COVID, as it happened.) After I got out, I got bills that amounted to about $6,000. Now let me be clear – if I did not have health insurance, provided by my employer, the cost would have been much higher. But with this great insurance that Joe Biden suggested I love so much, I was six grand out of pocket over an unexpected illness. I opted for a payment plan with the hospital (which, I should point out, receives a lot of public subsidy).
That is not the way it works in civilized countries. In civilized countries, they do their best to make you well, and that’s it. No bill, or none of any consequence. In Britain and France, I believe, they even give you money when you leave the hospital, under certain circumstances. Why are we not a civilized country? I don’t know. Ask Joe Biden. And every other president, for that matter.
I am fortunate that i had the resources to bear that cost with only minor sacrifices. Most people – including many with employer based coverage – are not that lucky. We need a system that works for those people, not the people who seek to profit from our misfortunes.
luv u,
jp
Those are the two best things I can say about the late senior senator from Arizona. The fact is, he spent his entire political career pressing for war every time the opportunity arose; it was central to his brand. He simply never met a war he didn’t like, from Reagan’s proxy wars in Central America and elsewhere, to the Gulf War, to Afghanistan, Iraq, Libya, you name it. He was pressing for direct American involvement in the Syrian civil war early on. And in spite of his celebrated vote against the Obamacare repeal, he has supported Trump’s legislative agenda more than eighty percent of the time, most notably voting to pass the $1.5T tax giveaway to the richest people in the country – a bill that also hobbled the ACA by canceling the mandate.
This entire situation – I won’t say “debate” because there hasn’t been any – is ridiculous largely because no one in Washington will admit to what the ACA’s core problems are. The Republicans, and to a certain extent many Democrats, continue to insist that competition and a freer market in health insurance will deliver affordable coverage to everyone; just pull those sick people out of the system and into an underfunded high-risk pool, and the market can do its magic.
That’s the stuff conspiracy theories are made of. So … why does he keep fucking doing it? If there turns out to be no serious collusion between Trump’s people and the Russian government, his administration is the most productive conspiratorial smoke machine ever constructed. Major administration advisors had conversations with Russian officials during and after the campaign, lied about it, then fessed up when the lie was exposed. If it’s above board, why don’t they just effing say so? I don’t get it.
Our current Congress member, Claudia Tenney, won a three-way race with about 47% last Fall. Since her election, she has been a little hard to pin down. It took some weeks to open a district office in the Utica area – she blamed this on the bureaucracy, of course. Up until this week, Tenney has been knocking down any suggestion of holding a town hall-style meeting in the district, having seen what’s been happening to her colleagues. Her big announcement this past Wednesday was that she would call a town hall, though no announced date. Also, she says she’s been receiving threats. Well, welcome to being famous, Claudia. Anyone who raises their head above obscurity in this culture gets threatening emails, Tweets, posts, etc.
The challenge this time around is being able to move fast enough to make a difference. The GOP-run Congress is going to ram a stack of legislation through over the next few weeks that will disable the ACA (so called “Obamacare”), cut back or restructure (privatize) Medicare and Medicaid, cut Social Security (perhaps privatize as well), and more. We need real-time information on specific legislation that’s being proposed, voted on, etc. Sourcing that will be crucial. We also need to organize on a local, Congressional district level, to apply pressure where it will have the greatest impact.
It’s vintage American political theater, kind of like the ubiquitous flag pin. (Pin on, hero! Pin off, traitor!) We are so obsessed with symbolism that we invariably miss the fundamentals. Reverend Barber was talking about this over the last few days, countering a lot of the happy talk about everyone coming together and pulling down that offending flag. Seriously, when I watched Nikki Haley making her dramatic announcement, all I could think of was the thousands of working families in South Carolina – many of whom are African-Americans – who could benefit from Medicaid expansion under the ACA, if only she and her party would allow it. Sure – symbols mean something to those who have suffered under them. That’s reason enough to pull the stars and bars down. But let’s not stop there.
Now, technical issues like this have historically been corrected by an act of Congress. This was the case with many major pieces of legislation, such as Medicare. But because our Congress is ideologically driven and dysfunctional in the extreme, this is not even a remote possibility. So it is left to the courts, thanks to the determination of many on the right to hobble and destroy the ACA, as well as many thousands of families who depend upon it. It’s manifestly obvious that disallowing subsidized coverage through the federal exchange will dramatically drive up the cost of health insurance in the affected States, crashing the system and throwing 9 million subscribers into chaos. Just as bad, it will initiate a death spiral of rising rates and canceled policies that will affect many millions more.
That potentially catastrophic confrontation-in-waiting apparently can withstand mock-invasions of North Korea and simulated bombing runs without being “provocative”. So, why are the Russian exercises any worse? If there’s a return to Cold War mentality, it’s on the part of our corporate media. (Most of our politicians have never left that particular ideological space.)
it before implementation of the Affordable Care Act, sure, you can keep that dog – it’s grandfathered in. The insurance companies simply can’t continue selling those policies now that the law is in effect because – and this is important – THEY SUCK TOO BADLY, and because of that, they do not comply with the law.