Archive for the ‘Medical Coverage Crisis’ Category

Why “Medicare for All” won’t work…

Tuesday, September 19th, 2017

The reasons are rather simple: doctors and the AMA, hospital conglomerates, insurance companies, and Big Pharma are against it. They all have various justifications for their opinions, but they all can be summarized in one word: greed. We got trapped into the for-profit business model in health care long ago. Even when Nixon and the CEO of Kaiser Permanente sat down together and invented the HMO concept, the death knells were already sounding. We took the wrong road; European and other countries took the right one. The end of Robert Frost’s “The Road not Taken” sums it all up (maybe the whole poem?): “Two roads diverged in a wood, and I—I took the one less traveled by, and that has made all the difference.” (My apologies to Mr. Frost for using his poem in this way, but it works here).

I’ve been worried about health care for a long time. Fact: we have the most expensive health care system in the world yet one of the largest populations without quality coverage. Fact: The whole system is geared to make money for the providers. Doctors charge exorbitant fees. While medicine has always been the “golden career” for too many, the situation is critical now. There’s a lack of internists (AKA primary care physicians) because doctors know specialization pays more. There’s a lack of nursing personnel because they’re paid less by clinics and hospitals in order to pay the doctors too much. You might find a few needs-based facilities scattered around, but they’re scarce, and they generally don’t offer quality care. There are cases of dumping—hospitals, especially ERs, that kick patients out if they have no insurance or bad insurance. A profit-driven system not only is contrary to the Hippocratic Oath, it leads to graft and corruption.

While Full Medical, my first novel, is a sci-fi thriller, it’s dystopian in the sense that it projects what the for-profit motive in health care will bring the U.S. and the world to by mid-century—that’s the theme woven in and around the plot (hence the title). Dangerous extrapolation, some critics might say, but I see it all coming true faster than I thought it would.

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The mental health crisis…

Tuesday, August 8th, 2017

One item proposed in the GOP Senate’s “Better Care Act” was more cuts to mental health care. Fortunately that didn’t pass, but these cuts have been going on for a long time. Mental hospitals have closed and there never seems to be enough competent staff. People with mental health problems have nowhere to turn. Some have worried families and friends who don’t know where to turn either. Others live homeless on the streets of America’s cities. And others have come home from wars broken in mind and spirit.

The shooting in NYC of policewoman Miosotis Familia by mentally disturbed Alexander Bond is an extreme example of the tragedies that can occur. One congressman was attacked by his own son; the father hadn’t been able to find a facility for him. An obviously deranged fifteen-year-old girl encouraged her depressed boyfriend via cellphone texts to commit suicide (she received a 2.5 year sentence but she should have been committed). These are only three cases that made the national news where persons with a mental illness didn’t have the care they needed. Too many don’t.

And I’m talking about quality care, not more copies of that cuckoos’ nest immortalized in the movie. While no modern mental ward seems as bad as that or Salieri’s in Amadeus, they can be bad. Patients in care are often treated inhumanely with drugs and shock therapy instead of being cured. These “cures” can be easily ordered by mental health professionals and applied by an army of nurses and barely qualified technicians, so the cost is low. The institutions still functioning often sacrifice good care because of budget cuts. Add to that the closing of mental health facilities everywhere, you have a crisis.

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Irish Stew #63…

Wednesday, June 28th, 2017

International

Trump’s Saudi policies. Saudi Arabia wasn’t on Trump’s list of countries whose Muslim immigrants, many escaping horrible situations in their home countries, are the targets of his bans in his executive orders, contradicting his belief that all Muslims are terrorists. And Mr. Trump negotiated a weapons deal with the duplicitous Saudis to make the military-industrial complex happy during his whirlwind tour in the Mideast.

The Saudis aren’t our friends. They’re not even the enemies of our enemies. They are the enemy. The majority of the 9/11 terrorists came from Saudi Arabia because the Saudi royal family’s state-sponsored religious schools have a continuing policy of brainwashing young boys and men to hate the West. And they have continuously attacked Yemen where they are responsible for mass murders of innocents. They probably support ISIS too, because ISIS hates Shi’ites, and they’re the Saudis’ enemies.

Sad! Trump is supporting duplicity and murder. Guess he believes in that.

National

Malthusian politics? The CBO hasn’t published its financial analysis yet, but the Senate’s proposed healthcare bill is meaner than the House’s. They’re both an attack on the middle class and poor, especially those who don’t have any financial means and depend on Medicaid as a life preserver—elderly in nursing homes, people with serious disabilities, and very sick children. Too many without any other coverage.

Not just sad but doing the Grim Reaper’s work so the GOP can give tax breaks to the rich elites. These aren’t healthcare bills—they’re thinly disguised tax breaks. And Rand Paul thinks they don’t go far enough? This guy has no compassion at all. No wonder he was a failed doctor! Next thing we’ll see from the GOP? Maybe death ovens for the sick and infirm with Dr. Death running them?

Is Obama to blame? Not as much as the GOP and American media are saying! They’re still supporting the attack on the ex-president for not divulging what he knew about Putin’s personally directed attack on our electoral system. Why? It’s not “fake news” if they hide the real truth that Obama’s desire to secure bipartisan support to inform the American public was rejected by the GOP members of congress Obama approached. OK, maybe Obama was stupid to believe that HRC was a shoo-in, but Trump had been yammering all during the campaign that the system was rigged. What if Obama had decided to divulge all he knew? They’d have said he was unfairly supporting HRC! Damned if you do and damned if you don’t.

For eight years the GOP practiced obstructionism against the Obama administration. And Trump dares to accuse the Dems and Obama of being obstructionists? Of course, I’m waiting for HRC to say Obama was responsible for her losing. Sad! You can’t trust politicians or the media these days.

Wild weather. Last Saturday morning NJ received a taste of Midwest weather. I saw my first tornado in Kansas when I was thirteen visiting my grandfather—an awesome sight even if it was off in the distance. Now we had two in Howell, NJ. A smack across the face from Mother Nature to wake us up to the problems of climate change? She should concentrate on Trump who believes it’s all a hoax. Hey Mother Nature, why don’t you go after Mar al Lago or one of his many golf courses—Bedminster would be a good start? Just give the innocents a warning.

Sports etc.

Cosby and Hernandez. I never bought into the theory that the ex-Patriot tight end committed suicide. He had just won acquittal for one charge and was going to appeal the conviction that put him in jail. Why would he be suicidal?

MA law says a conviction that is being appealed must be vacated. Sleazebag prosecutors want to change that law. They must be related to the DA prosecuting Bill Cosby.

DAs who are running for office or have nefarious agendas shouldn’t be allowed to prosecute anyone because they are just trying to win points for being “tough on crime.” Political campaigns interfere with objectivity. So do many careers in general. Of course, most lawyers, prosecutors or defense attorneys, aren’t known for objectivity or a commitment to the truth—they’ve sold their souls to the Devil for their clients.

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And so it goes…

Trumpcare…

Tuesday, March 14th, 2017

So we have another horror story associated with the current White House AKA the DC Dark Place. The Warlock-in-Chief is championing his new healthcare bill, although people like Paul Ryan and Mitch McConnell have also pranced around the bubbling cauldron to conjure up the best poison they can find for the infirm and elderly in America. Let’s first analyze the chief features of this wicked potion.

The individual mandate of the ACA will be repealed. While even that wasn’t enough to drive millennials and other youthful citizens to participate in ACA and thus increase the healthy people in the insurance pool because in some areas the ACA insurers had stiffer premiums than the fine, instead of fixing the latter, Trumpcare will make it worse. The employer mandate will be repealed. Larger companies will now be able to tell people not to look for healthcare as an employee benefit. Subsidies for out-of-pocket expenses—deductibles and co-payments, will be repealed. Insurance companies will have a field day with that. Medicaid expansion will be killed. Planned Parenthood will be defunded (why aren’t anti-abortion activists more worried about the lives of the living?).

Premium subsidies will be eliminated and replaced by tax credits. Let’s consider the implications of that one a bit further. Will the GOP send money to a poor person if her or his tax credit is more than what s/he would pay in taxes (sometimes zero)? If the answer is yes, that’s a subsidy. If the answer is no, that person won’t bother with healthcare insurance and return back to the old days when s/he went to an ER after getting too sick, virtually eliminating preventative care, increasing death rates and lowering lifespans, and driving up hospital costs—not to mention the evil implicit in penalizing the poor and rewarding the rich. The latter is consistent with the overall reverse-Robin Hood policies of the GOP, of course. Until every American has the same healthcare as a congress person, America will still have a healthcare problem!

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Post-mortem of a speech to Congress…

Tuesday, March 7th, 2017

In some dilating time machine or Mr. Trump’s parallel universe, ages have passed since he gave that speech to Congress. In real life, it was only a week ago—can you believe it? Everything he said is meaningless now, so dissecting that rambling rhetoric of a delusional man is anti-climactic. But let’s do it anyway because the president left the Twitter-sphere long enough to sound presidential and hide his narcissistic psychosis.

It’s curious that the media, after the president declared them to be the “enemy of the American people,” fell all over themselves to state that his “state of the union” (read: state of Trump’s parellel universe, that one that circulates among the dark energy and matter of his mind) set a new tone. Il Duce was even called presidential because he sounded presidential. But not for me—he’s not my president! He never will be my president, and isn’t the president of a majority of the American people.

What I heard was empty rhetoric reminiscent of Goebbels’s 1930’s propaganda in Germany—in other words, fascistic spin and appeal to populism playing on the fears of good Americans. His handlers, Bannon, Conway, and Miller, who take turns at the puppet strings—yes, he’s a marionette, even stringing himself along—carefully planned this atrocious display. If it was some crazy attempt to reach across the aisle, Dems won’t buy the snake oil from this charlatan, and didn’t—the thumbs-down from the Dem women in white were refreshing and evidence for their general mood—Trump the misogynist is women’s rights worst enemy. Narcissus the Wonderful shows no concern about women’s issues—we know he sees them only as objects—and on abortion, he’s as much a right-wing bigot as they come.

Let’s consider a few points. On trade, Trump might have sounded a wee bit like Sanders. There’s a huuuuge difference, though. Both men were born in Brooklyn, but the two are light years apart—Trump might actually live in one of those other multiverses where his marionette strings are tangled with those of general string theory. In particular, where Bernie was an earnest and honest champion for the working class, Il Duce doesn’t really give a rat’s ass about their plight—it’s all just show. He follows the time-tested fascist strategy of pretending to do so, of course—that’s how Franco, Hitler, and Mussolini came to power in the 1930s! U.S. workers should be wary about buying anything from this snake-oil salesman. Pay attention to his false promises at your own risk!

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Apocalypse redux…

Thursday, March 2nd, 2017

Redux = brought back, revived. We’re talking about the apocalypse again. Apocalypse is the event. While a dystopian society can cause it or be its aftermath, post-apocalyptic is reserved for the aftermath. There is a resurgence in these themes now. Everyone knows the reason: what’s happening in the U.S. right now as well as across the world has frightening parallels with 1930’s Germany, Italy, and Spain as well as with the darkest days of the Cold War. There’s nothing religious about this apocalypse.

Most dystopian, apocalyptic, and post-apocalyptic tales in the past were associated with the two world wars or the Communist threat. Brave New World was dystopian; Ape and Essence was post-apocalyptic. Even The Time Machine was post-apocalyptic. 1984 and Animal Farm were dystopian. Later sci-fi novels like Not This August were post-apocalyptic. Many classics can be found in these subgenres. Many soon-to-be classics like Wool are too. They all are warnings about what could happen. It’s common that interest in books and movies in these subgenres reflect troubled times in the world.

The bombs dropped on Hiroshima and Nagasaki changed the world. As that hand on the Doomsday Clock inches toward midnight, these sci-fi subgenres become more popular. Some readers ignore them, burying their heads in the sand by reading schmaltzy romances and fluffy adventures that avoid most serious themes of any type. Which group is right? Beats me. I just tell stories. If one of them comes out apocalyptic or post-apocalyptic, so be it. Almost all my stories have serious themes, though, but not all of them are in the aforementioned subgenres.

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Does Trump have a human side?

Tuesday, February 28th, 2017

Or his cronies and supporters, for that matter? Compassion and human kindness seem to be absent as the ogres lash out at all their perceived enemies. During the long campaign, I guessed he and like-minded individuals were lacking in these qualities, but I never guessed it could be so bad, and there’s every indication that it will become worse as parallels with 1930’s Germany continue to increase. One Facebook friend likened his takeover of the government to this generation’s Pearl Harbor. That attack was about war, so maybe my friend has a point: we’re in a social war as we fight to save the soul of America. Right now he’s taking us straight to a hell of his own creation. Let’s consider the evidence for answering the question of the title in the negative.

A pig farmer in a town hall meeting with Sen. Charles Grassley, who like many has been in the Senate far too long, pointed out that old Chuck had spoken of death panels in his criticism of Obamacare. The farmer went on to say that the GOP was going to create death panels AKA Congress and insurance VIPs denying coverage to millions, all across the entire country, and not just for the elderly, if Trump gets his way and kills Obamacare. Indictment number one: Trump, Grassley, and others of their ilk don’t care who dies, as long as the healthcare industry is a money maker for insurance companies and Big Pharma. Although at times Trump almost sounds like a fan of Medicare for all—hence his lies to Florida retirees about preserving Medicare and Social Security in order to gain their votes—all evidence indicates that he’d just as soon not waste money on sick people. Maybe he wouldn’t pull the plug on his own family members, but I suspect that complete strangers who are sick are just hunks of rotting meat to him.

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Irish Stew #60…

Monday, January 30th, 2017

[Note from Steve: Lots of mini-comments, mostly related to Mr. Trump. Don’t worry—I’m not responding to every tweet!]

International

Welcome to fascist America! That’s what needs to be on the Statue of Liberty now, thanks to Il Duce Trump’s most recent executive order which led to the detainment of Muslim travelers in the nation’s airports. This decree from a small-minded and arrogant SOB is as unconstitutional as it is unconscionable and represents a blatant pandering to his bigoted and hateful followers.

In the dragnet, Muslims who have helped the U.S. military, CIA, and state department in their fight against terrorism, Muslims who are war refugees who have legal visas after 2+ years of extreme vetting, parents visiting their children in the U.S. who have visited them many times before, and others were detained, some forced to sign papers allowing DHS to return them to their place of origin, action which mostly likely puts their lives in danger at the hands of the true terrorists. Others are left in limbo with no place to call home. Still others who have already immigrated and are contributing here in America shouldn’t leave the country, even to Canada, for fear of not being able to return. The stay granted by a federal judge in Brooklyn seems to affect only green card holders. That’s not enough!

What’s next? Muslim-Americans being required to wear crescent patches? Internment camps? Goose-stepping troops marching down Pennsylvania Avenue and in front of Trump Tower? The parallels with 1930’s Germany are scary!

“Build the Wall!” Trump’s campaign slogan is a sophism. Most claims coming out of his big mouth are sophisms. His executive orders are sophisms and carefully worded to hide his administrations racism and bigotry. American taxpayers will have to build the wall, not Mexico. Illegal immigrants will tunnel around it or come in on temporary visas, as the majority already do, most staying as good workers who do jobs Americans won’t do, raise their children to be responsible members of immigrant America, and stay out of trouble. The wall will do nothing more than another pandering to Trump’s bigoted and hateful supporters.

America’s greatness lies in its immigrant tradition. Building the wall is the least intelligent thing we can do for immigration reform. And intelligent people know that. The president of Mexico knows that, which is why he blew Mr. Trump off, among other reasons. Why waste time talking to a psycho?

Europe’s turn to the right. French and German progressives and many others are feeling the heat. Mr. Trump was the first, but he might not be the last as the world turns to right-wing demagogues. now called “populists” in the new doublespeak (see the next item). I’m the first to acknowledge that conservatism has its place—change for change’s sake can never be a sound governmental policy. Every action has at least one reaction and careful consideration must be given to whether a policy change will create unintended consequences and have negative impacts—that requires logic and reason driving careful analysis, not ideological and illogical rants.

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Accessible doesn’t mean affordable…

Tuesday, January 24th, 2017

Believe me, I want to give Mr. Trump a chance. At least he speaks out against the Washington insiders. In spite of disgruntled naysayers, he is our legitimate president. He played by the rules and won fair and square. Yes, I understand these rules are rigged: the GOP has twice lost the popular vote in recent memory and won in the Electoral College. But those are the rules; he won.

Mr. Trump, a newcomer to the political scene, is an unknown factor, although we’ve had strong and troubling hints in his rhetoric. This business mogul and reality TV star goes his own way. Unfortunately, unlike on “The Apprentice,” the American people can’t fire him very easily. First among my worries about the new administration is his role in foreign policy and as commander-in-chief. A person who shoots from the hip doesn’t belong in that role. That said, I find Congress and the Supreme Court more worrisome.

Congressional Republicans have been waiting to wreak revenge on liberal policies for years. Now that they control both houses, the Supreme Court, and the White House, expect fireworks displays of pent-up anger. They might even go against Mr. Trump who has occasionally shown signs that he will stand up against congressional rancor. The bullies in Congress, though, are the most vociferous about the Affordable Care Act (ACA) AKA Obamacare. Their mantra has been to repeal it in spite of having zero viable alternatives. In many ways, they now should be called congressional death squads.

McConnell and Ryan are their leaders; Price their hired assassin, and maybe Trump; and they’re all sycophants of the insurance companies and Big Pharma. I’m talking about a Republican takeover of our government that is going to result in early and needless deaths for millions of Americans as the ACA is dismantled and Social Security, Medicare, and Medicaid become dismembered. The GOP administration will be willing agents of the Grim Reaper marching to battle with their scythes swinging. Here are the estimates, courtesy of the Urban Institute:

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Irish Stew #59…

Monday, January 9th, 2017

International

Classic Putin? His refusal to expel U.S. diplomats in response to Obama’s retaliation for Russian hacking and inviting the diplomats’ kids to a Christmas party made me wonder if a bare-chested Putin would ride in to the party on a reindeer sporting the rest of Santa’s costume. Even without the latter, Putin’s response makes Putin look like a PR genius (can I hire his PR people for my books?) and Obama look like a chump. McCain rightly states that Putin is a murdering thug, though, and certainly not on Santa’s “nice list,” so maybe Trump’s chump for SecState won’t be approved by the Senate. Trump is swimming in dangerous waters! No one likes Putin except Trump and the narcissistic despot himself.

I’ve been very careful to separate the sleazy practices at the DNC exposed by the Russian hackers from the criminal actions of the hackers and the man who commands them, Vladimir Putin. Obama is right to say that we should be on the same page about Putin’s nefarious attempts to undermine the American election, now established by U.S. intelligence leaders—Putin is the enemy here. But I’m not alone in wondering if Obama and other Dems would give a rat’s ass about this if it had been the RNC that was hacked, or if HRC had won. Those who would say HRC lost because of the hack in spite of the findings from the intelligence community, and the continue to blame the FBI director, should just move on. Trump won, figure out why, and never let it happen again. Moreover, let’s work our butts off to keep this psycho Il Duce from destroying the world!

The art of the deal? To many one-percenters, war is a business. Either Trump wants to pander to these ghouls, or he wants a piece of the action. The U.S. sells more arms to the rest of the world than any other country and, of course, the Pentagon still wants their new and improved toys too. People get rich off war. Il Duce Trump, not content with the endowment Nature gave him, wants to extend it by forging new swords to brandish internationally. “Let’s have another arms race,” he says, “because we’ll have bigger and better bombs.” (OK, I couldn’t find the direct quote, but that’s the idea!). We have a recipe for disaster on an international scale. At the very least, I can see international conflagrations occurring as more bodies, Americans and others, are poured into the maws of Mars. Insane!

National

What’s with deifying Elizabeth Warren? This faux-progressive is becoming Mother Teresa and Joan of Arc for all HRC’s liberal faux-progressives licking their wounds after the presidential election. I can imagine “liberal Catholics” (now there’s an oxymoron!) proposing her for sainthood. Just remember, ye true progressives across the land, she campaigned for HRC in Massachusetts and elsewhere in the primaries instead of Bernie Sanders. Remember that guy, the one who could have beaten Il Duce Trump? Warren and the rest of HRC’s sleaze-team got what they deserved. And Warren is part of that crowd! She just announced she will run in 2018. I’m hoping there’s a true Massachusetts progressive candidate who will run against this faux-progressive in the primary.

Healthcare. Mitch McConnell says the first item on the agenda for the new Congress is to end the Affordable Care Act AKA Obamacare. McConnell, Ryan, and others in the GOP are already talking about slashing Medicare and Social Security, and Medicaid is on the way out. Do the American people really want to turn back the clock to when health insurance meant insurance that you would die young? When insurance companies dropped you as soon as you contracted something serious? When millions of people’s insurance reduced to emergency visits to ERs?

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