Category Archives: Health care

The Least Generation.

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If the heroes of WWII were the Greatest Generation, how would you describe those who have followed in their footsteps? I’d have to say the reviews are mixed.

Take my generation of so-called Baby Boomers.  We started out by fighting for Civil Rights. When confronted with a lame and unjustified war in Vietnam, many of our generation fought despite reservations while the rest of us fought to end wars against those who never attacked our shores. A few years later, we fought to win equal rights for women. And many of us took up other noble causes such as fighting for a cleaner, safer environment.

All of that was admirable. But what have we done lately? Moreover, what has the post-boomer generation (those who are now in their 40s and 50s) done? Let’s just say they may be remembered as the Least Generation.

While the Greatest Generation believed in shared sacrifice in order to obtain lofty goals, such as overcoming the Great Depression and overthrowing despotic dictators such as Adolph Hitler, the Least Generation voted to give themselves tax cuts. While the Greatest Generation built our nation’s infrastructure with hard work and tax dollars, the Least Generation has stood idly by and watched that infrastructure crumble.

While the Greatest Generation toiled and sweat to earn a better future for their children, the Least Generation has mostly reserved its sweat for the athletic club. While the Greatest Generation fought for labor unions and workers’ rights, the Least Generation has fought to destroy them.

While the Greatest Generation scrimped and sacrificed to maintain the war effort, the Least Generation has mostly patted soldiers on the back with a very public “thank you for your service” and privately told themselves “thank God that’s not my son or daughter.”

In recent years, politicians from the Least Generation such as Michelle Bachmann and Eric Cantor have shown they’d rather play partisan politics than do what’s best for our country. They have voted to end welfare. They have cut Medicaid, public education, Early Family Childhood Education and social services while cutting taxes for millionaires and billionaires. They have fought to maintain subsidies and tax loopholes for the world’s largest and most profitable corporations while refusing to extend benefits for the unemployed.

They have voted to cut Social Security rather than raise the cap on FICA contributions for those making more than $106,800. They’ve voted to end Medicare rather than root out the causes of inflated medical costs or negotiate the cost of pharmaceuticals with manufacturers. And they were willing to risk government default rather than risk alienating their wealthy contributors by raising taxes.

Let’s hope the next generation does better. But I’m not optimistic.

Teapublican Lie #16.

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“Cutting Medicaid and Medicare will save money.”

Anyone who would say this is either lying or doesn’t understand how the healthcare industry works. 

If you kick millions of people off of Medicaid and raise the cost to seniors for Medicare, they will put off going to the doctor as long as they can. Minor ailments then become major ailments. When they’re finally forced to seek help, they have no place to go except the Emergency Room where the costs of treatment can be as much as 100 times that of a doctor’s office or clinic. Since most hospitals are mandated by law to accept all patients, regardless of their ability to pay, the costs are passed along to patients who have health insurance.

So the Teapublicans who don’t want to help pay for someone else’s healthcare treatments through an efficient, well-managed government program will actually wind up paying much more through the rise in premiums for their health insurance policies, through increased taxes, or both.

Our nation’s healthcare costs are already four times the cost of healthcare in other advanced nations. Cutting Medicaid and Medicare will only make things worse.

“Obamacare” (more precisely, Nixoncare, Dolecare or Romneycare, since they proposed the program first) will definitely help. It will offer healthcare insurance to 55 million people who are currently uninsured, and it will institute some cost containment measures to an industry that has seen costs rise at a rate more than ten times the rate of inflation.

But it doesn’t go far enough.

According to a hospital CEO whose opinion I respect, this nation needs to return to a form of managed care (Health Maintenance Organizations). Under the system, the healthcare providers would be charged with keeping us healthy. The providers would also be charged with following best practices, which have been shown to produce the best outcomes, and limiting unnecessary or unproven care.  (Or, in Teapublican terms, “death panels” with the responsibility to review extreme procedures that are proposed for patients with terminal diseases.)

This is one of the most important steps in solving our healthcare crisis as noted in a 1990s study by the MIT Sloan School of Management.  That study showed that, in the US, more than 70 percent of all healthcare expenditures occur in the last six months of a patient’s life. In other words, we tend to ignore our health until something goes drastically wrong.  Then we spare no expense to prove that the diagnosis of a fatal condition is essentially correct.

It’s clear that we need an entirely new approach to healthcare and “Obamacare” is an important first step.  Repealing the Patient Protection and Affordable Care Act will only make things worse. So will the other Teapublican proposals.  We can’t throw the poor off of Medicaid, cut Medicare for the elderly, maintain our out-of-control health insurance system and cut the deficit.

The healthcare industry and the economy are like a large, overinflated balloon. If you push one place, it expands somewhere else.  To make improvements, you have to change the entire entity at once.

The Kings and Queen of Mean.

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So far, the debates between Teapublican presidential candidates have been very entertaining. Watching them is somewhat like watching Voldemort, Simon Legree, the Joker, Scrooge, Alfred E. Neuman, Lex Luthor and the Wicked Witch of the West face off to see who can be nastier, more spiteful, more repugnant and more snide.

Yet the sentiments of the audiences have been even more revealing.

In one debate, an audience of upper middle class white Californians actually broke out in applause upon the mere mention of Gov. Perry’s 234 executions. In another debate, when confronted with the question of whether or not the government should allow a hypothetical uninsured young American die, members of the pitchfork crowd in Tampa screamed “yes.”

And these are the religious so-called “values” people?

If voters are unwise enough to put them in charge of our country, we won’t have to build a bigger fence to keep immigrants out of our country. We’ll have to build one to keep our own citizens in.

World’s Greatest Nation? Really?

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Although many Americans are fond of calling the US the greatest nation on Earth, that hasn’t been true for many years. Certainly we have the world’s most powerful military, but that’s no criteria for greatness. Neither is the fact that we are still the world’s richest nation, despite the downgrade in our credit rating by Standard & Poors.

But greatest?

Does a great nation tolerate an ever-widening gap between billionaires and the working poor? Does a great nation leave tens of millions of its citizens without access to health care? Does a great nation allow millions of its children to be homeless? Does a great nation allow its education system to become third-rate? Does a great nation allow its infrastructure to decay and collapse merely to give another tax cut to large corporations and the wealthy?

Does a great nation use its financial and military power to prop up brutal dictatorships around the world? Does a great nation bankrupt the small farmers of neighboring countries by subsidizing corporate farms then demonize those farmers when they cross the border looking for jobs? Does a great nation demean those who labor to build things with their hands, to put out fires, or to teach its youth? Does a great nation begrudge a comfortable retirement to its elderly? Does a great nation allow large corporations and the wealthy to elect its politicians?

How can a nation be called great when it rewards greed and corruption? When its judicial system rules that corporations have rights superior to those of its citizens? When its financial institutions are allowed to grow so large they are immune to failure from their own mistakes? When its corporate lawyers are tasked with seeking out financial and legal loopholes that allow their clients to game the system? When its politicians are more concerned with scoring political points than the welfare of its voters? When its citizens are more interested in the antics of its celebrities than those of its government? When it allows its previous leader to run up a huge debt, and then blames the leader who inherited it?

We didn’t need Standard & Poors to tell us that our nation is on the verge of bankruptcy. When it comes to fairness, ideas and ethics, the US has been on the verge of bankruptcy for many years.

If Teapublicans Have Such Great Ideas, Why Do They Lie So Much?

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Why do they generate and circulate a seemingly endless number of blatantly false and misleading chain emails that demean our President?
Why do they try to shout down everyone with whom they disagree?
Why do they parrot talking points instead of rationally debating issues?
Why do they protect the obscenely wealthy and attack the poor?
Why do they complain about immigration then hire illegal immigrants to do their landscaping or repair their roofs?
Why do they preach small government then pass laws giving government power to prevent gay marriages and lawful abortions?
Why do they fight to ban abortions while, at the same time, fighting against sex education and the contraceptive practices that would help avoid them?
Why do they revere police and firefighters for responding to 9/11 then try to take away their right to collective bargaining and health care?
Why do they praise those in the military and ignore veterans in need of help?
Why do they revere President Bush for adding $7 trillion to our national debt and crashing our economy then attack President Obama for adding $1.4 trillion in trying to fix it?
Why do they complain about the excesses of Wall Street bankers while trying to block laws that will regulate them?
Why do they slash budgets for education while complaining that the US is falling behind other nations?
Why do they complain about unemployment as they cut federal budgets to force even more layoffs?
Why do they complain about government health care while telling the government to keep its hands off their Medicare?
Why do they complain about passing health care reform after a 10-month debate then pass a bill to kill entitlements with virtually no debate.
Why do they talk about helping small businesses then undercut them with policies that only benefit large corporations?
Why do they refuse to eliminate tax loopholes for corporations that claim an offshore P.O. Box as their corporate headquarters?
Why do they subsidize big oil companies and refuse to subsidize renewable alternatives?
Why do they call themselves conservatives when they’re against conservation of our environment?
Why do they demand compromise then refuse to consider alternate ideas?

Republicans In Denial (As In Denial Of Any Democrat Proposal)

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Today, Congressional Republicans pulled out of negotiations to resolve the deficit.  And (here’s a shocker) they blamed Democrats.  Their reasoning is that Democrats insist on tax increases rather than merely relying on more than $1 trillion in cuts to Medicare and other programs. 

“Let me be clear.  Tax hikes are off the table,” said House Speaker John Boehner. 

So, according to Republicans, even though the major cause of the deficit is the Bush era tax cuts (primarily for the wealthy), the only way to cut the deficit is by cutting spending for Medicare, Medicaid, Social Security, Planned Parenthood, Public Broadcasting, the Environmental Protection Agency, the Consumer Protection Agency, the Department of Education, etc.  At the same time, Republicans refuse to consider cuts to subsidies for Big Oil and corporate agriculture which they say would be tax hikes.  Of course, they also want to repeal the Affordable Care Act and repeal regulations on the financial industry.

So according to Republicans, when it comes to deficit negotiations, everything is on the table.  Except anything that Democrats want.

I guess that’s what passes for “bipartisan negotiations” these days.

Republican Agenda Has Never Been More Clear.

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Following the vote by House Republicans to cut Medicaid and turn Medicare into a certain-to-fail voucher system, Senate Republicans filibustered a bill that would end oil subsidies to the most profitable companies on Earth.  They followed that by doing the same to a bill that would end subsidies for Ethanol.

In doing so, Republicans have made it abundantly clear that they don’t care about cutting the deficit.  Not really.  If they did, they would gladly trim these subsidies from our budget resulting in savings of billions of dollars.

As evidenced by their assault on Medicare, Medicaid, Social Security, unemployment insurance, education, women’s health providers, the environment, labor unions, first responders and teachers, they certainly don’t care about ordinary citizens.

What Republicans do seem to care about is protecting the profits of their corporate masters. You know, the large corporations that were given all the rights of citizens by the conservative-dominated Supreme Court so they could anonymously spend millions to elect Republican candidates.

The connection couldn’t be more obvious.

One man’s solution for Medicare and the health care crisis.

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Now that House Republicans have voted to end Medicare and Medicaid as we know them, I believe it’s time to look at the real problems with the system. In addition to Medicare fraud, many of the problems are structural. Not with Medicare. But with the health care industry itself.

Unless the skyrocketing costs of health care are controlled, we will not be able to fix our social insurance programs such as Medicare. Moreover, we will not be able to control our deficits. That is precisely why President Obama and the Democratic Congress chose to focus on health care reform in 2009. Unfortunately, the resulting bill was a compromise with Republicans hell-bent on protecting the insane profits of the health insurance industry and PhRMA (Pharmaceutical Research and Manufacturers of America).

Therefore, I humbly offer the following suggestions for consideration:

1 – Create a medical triage system with the entry point being Board Certified Family Nurse Practitioners, rather than MDs. These people are Registered Nurses with additional education and training. They are more than capable of identifying and treating the majority of illnesses and symptoms, as well as writing prescriptions, and they can refer patients to a physician or specialist as needed. However, they are billed at a lower rate than physicians. Implemented nationally, this system could save millions, if not billions, of dollars.

2 – Encourage patients to call medical professionals more often. Ignoring symptoms usually doesn’t make them go away. Patients of all ages tend to avoid talking to medical professionals until they absolutely have to. This often results in illnesses being allowed to advance which, in turn, makes them more difficult (and expensive) to treat. All patients should be encouraged to call or visit with Nurse Practitioners whenever they notice a change in their bodies or a symptom of concern.

3 – Eliminate unnecessary tests and treatments. Currently, (some) doctors order a battery of lab tests and treatments in order to maximize their profits. They also claim to do this as a defensive measure against potential malpractice suits. I believe it’s time to recognize that everyone makes mistakes (including health care professionals). We should try to limit the number of malpractice suits and the size of the awards. At the same time, the medical profession needs to more aggressively weed out those who are responsible for the most egregious errors.

4 – Regulate the cost of pharmaceuticals. Currently, Big PhRMA is able to charge whatever it wants for its products. In some cases, the mark-up on pharmaceuticals is astronomical. An inhaler used by millions of Americans costs $38-$40 in the US. But in other countries, its price is as little as 5 cents!

5 – Create incentives for family practice physicians. Too many of our medical students focus on specialties that offer the greatest return on the investment of their medical education. They reason that, since they will be faced with the daunting task of paying off tens of thousands of dollars in loans, they should choose the specialty that pays the most and faces the least probability of legal issues. As a result, the percentage of family practice physicians and OB/GYN physicians is dwindling. This could be fixed by offering more government scholarship awards and tax benefits to those who choose the traditionally lower paying specialties.

6 – Eliminate the need for the poor and uninsured to use Emergency Rooms for primary care. We’ve all heard stories of people who call an ambulance in order to be transported to the ER to be treated for a common cold. Of course, since many of these people can’t afford to pay for their care, the costs are absorbed by the hospital and passed on to other patients.

Recognizing that many of the stories are likely exaggerated, it is true that people go to the ER when a simple visit to a doctor’s office would suffice at a fraction of the cost. But rather than complain about the phenomenon, we should look at the cause. Often it’s simply because these people don’t have ready access to any other form of care. By creating more and better access such as clinics staffed into the night by Nurse Practitioners, people would be encouraged to seek care through more appropriate means.

7 – Demand that health care providers publish outcomes for the most serious ailments and treatments, and encourage patients to seek out the most successful providers. It is a well-accepted fact that it is less expensive to seek treatment from the most successful providers, even if that means traveling out of state. There are fewer complications and patients tend to recover faster.

8 – Last, and most important, take the profit out of the health care industry for those who aren’t directly involved in providing care. In other words, contrary to Republican beliefs, eliminate the middle men (insurance companies) and allow the government to finance care through taxes and/or withholding. I’d much rather have the government determine the accessibility of medical care than large corporations whose primary goal is to limit care in order to maximize profits.

Maybe the best way to fix the deficit is to do nothing.

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While the government and the media debate the pros and cons of President Obama’s and Congressman Ryan’s competing deficit reduction plans, Ezra Klein of the Washington Post suggests another possibility.  Do nothing.

That’s right.  Do nothing to address the deficit and growing national debt!

Using a graph based on the Congressional Budget Office’s September numbers, Klein shows what will happen if Congress fails to act.  Our national budget would begin to balance itself in two years.  And despite the so-called “crises” of Social Security, Medicaid and Medicare, the budget would remain balanced into the forseeable future.

Given the doom and gloom scenarios of the teabaggers and their Republican allies, how is this possible?

It’s the result of allowing the Bush tax cuts to expire at the end of their 2-year extension, implementing the program that changes the way doctor payments are handled in Medicare, and allowing the Affordable Care Act (so-called Obamacare) to be fully implemented.

That’s it!  No privatizing Social Security, no ending Medicaid and no changing Medicare to a voucher system that will likely drive up the cost of health care while dramatically adding to the insurance industry’s bottom line.  All we have to do is keep the politicians from further messing things up!  (Of course, it wouldn’t hurt if we could stop bleeding money and lives in Iraq and Afghanistan.  It’s estimated that those wars have already cost us as much as $3 trillion.  A number that’s increasing by the day.)

Remember this as the debate over the deficit escalates between now and the 2012 election.  The choice is likely to be between a Republican plan of pulling the safety nets out from under our most vulnerable citizens while lining the pockets of the wealthy.  Or enacting President Obama’s plan which will reduce the deficit while continuing to care for the poor, the sick and the elderly.  Or doing nothing and returning to Clinton-era tax rates.Personally, I vote for one of the last two options.  After all, unless my memory fails me, the decade of the 90s was prosperous for most everyone.  Not just the super-wealthy.

What will be the Boomers’ legacy?

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The generation that began with so much promise – helping to improve civil rights, volunteering for the Peace Corps, and forcing an end to the Vietnam war – is now at a crossroads.  As we reach retirement age, the Baby Boomer generation has to consider what our legacy will be.  Will we be remembered for the aforementioned accomplishments?  Or will we be remembered for unparalleled greed, selfishness and hate?

The answer depends on what we do next.

You see, I believe that Boomers have enjoyed advantages few other generations have.  Unlike our parents, Boomers have enjoyed relative peace and prosperity.  Most of our parents worked hard and scrimped to send us to college in record numbers.  Many of our parents passed along modest estates.  And, unlike our parents, we didn’t face great economic hardships until late in our careers when our retirement funds should have been nearly complete.

Our generation has enjoyed rising salaries, inexpensive food, and inexpensive energy.  Our taxes have been lower than previous generations, so we have had the opportunity to keep more of our earnings.  We have had more machines to help with our labor.  We have had more leisure time.  We have traveled more.  And we have had more options for entertainment.

The real question is, what have we accomplished as a result of all these advantages?

We have consumed a disproportionate amount of the world’s resources.  We have polluted the planet, resulting in dramatic climate change.  We have failed to address poverty and hunger in our own country, let alone around the world.  And though we contributed to the end of the Vietnam War and the Cold War, we have opened new battlefronts in the Middle East to protect our oil interests.

So now what?  As we reach retirement, will we display the greed and contempt for the poor as the Tea Party has done?  Or will we devote at least some of our retirement to charity?  Will we help end poverty in the U.S. and the world?  Will we make health care affordable for all – not just the wealthy and the connected?  Will we find ways to curb pollution?  Will we force our corporations to pay their fair share of taxes and create jobs in our own country?  Will we finally level the playing field for minorities and women?  Will we find ways to end homelessness in our own nation – find shelter for the approximately 2 million homeless children?  Will we contribute to the rebuilding of our crumbling infrastructure built at such sacrifice by our parents and grandparents?  And will we properly fund education, so our grandchildren and great-grandchildren will have many of the same advantages we enjoyed?

Our generation has the education, knowledge, experience and resources to accomplish great things and to achieve a legacy comparable to “The Greatest Generation.”

But, although I’m hopeful about our generation’s legacy.  I’m not optimistic.