Category Archives: Health care

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.

A Political Quiz:

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Would you vote for a candidate who promised to gut public education?  Would you vote for a candidate who promised to make the rich richer at the expense of the middle class?  A candidate who promised to steal billions from individual retirement accounts and give it to greedy Wall Street bankers?  A candidate who promised to send millions of jobs overseas and reward corporations for doing it?

Would you vote for a candidate who promised to take health care away from millions?  A candidate who promised to eliminate Social Security?  To cut taxes on corporations while raising sales taxes on necessities?  To eliminate collective bargaining for workers?  To eliminate safety nets for the poor?

Would you vote for a candidate who promised to prioritize firearms over children?  To prioritize corporate profits over our environment?  To torture political enemies?  To start wars without an attack, or even a threat of attack?  To bankrupt local, state and federal governments in pursuit of his/her ideological agenda?

Would you vote for a candidate who promised to tell any lie necessary to be re-elected?

No?  Then why would you ever vote for a Republican again?

Who Do Republicans Really Represent?

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As most of you know, the Republican mantra is “lower taxes, less government.”  But for whom?  The past couple of years have revealed the Republican agenda as never before.

Take the Bush taxes cuts.  Democrats want the tax cuts for millionaires to expire, which would save $700 billion over the next 10 years.  But Republicans have made an extension of tax cuts for the wealthy their top priority.  And Republicans are willing to filibuster an extension of unemployment benefits to get their way.

This past election cycle, Republicans and their phony Tea Party candidates ran as populists, claiming to represent all Americans.  Yet Republican legislative votes tell another story.Just today, Republican Senators voted against a bill that would provide health care to 9/11 responders.  They have consistently voted against extensions of unemployment benefits for those struggling in the recession created by Republican policies.Republicans fought against regulation of Wall Street.  They fought against health care reform that would limit the obscene profits of large pharmaceutical companies and giant health insurance while providing health care access to more than 30 million working Americans.  They fought against stricter regulation of oil companies following the Gulf oil spill, and even apologized to BP when the Administration held BP accountable.

Republicans have successfully fought to eliminate estate taxes on large inheritances.  They have fought to lower capital gains taxes on investments.  They have voted against closing tax loopholes on large corporations that ship jobs to other countries.  They have fought against regulations against large corporations that create P.O. Box “headquarters” in other countries in order to avoid paying U.S. income taxes.  They have promoted no-bid contracts for private contractors to take over military functions such as “security”, transportation and food preparation.

Republicans have reduced funding for public schools while increasing funding for private and parochial schools.   They have made it easier for corporations to clear-cut our forests, for large mining operations to remove mountain tops, and for large electric generating companies to pollute our air and lakes.  At the same, they have refused to support alternative energy that would create competition for Big Oil and Big Coal.

Republicans claim that all of these actions create jobs and reduce taxes – a theory that has been thoroughly disproven.  So why do working class Americans continue to support the party that has so obviously sold its soul to large corporations and the wealthy?

You tell me.

Another WTF? Vote.

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For some time, I’ve wondered why my Republican friends continue to vote against their own self-interest.  I do have a few wealthy friends who benefit from Republican policies.  But the majority are more often harmed by Republican initiatives.

For example, Republicans talk about tax cuts for the rich being good for small business owners who generate most of the jobs in this country.  That may sound reasonable.  However, you have to look at what Republican leaders consider small businesses.  By their definition of limited ownership, Cargill (the world’s largest privately-held corporation) and Koch Industries (the world’s second-largest privately-held corporation) are “small” businesses.  And, of course, extending the Bush-era tax cuts would be very good for them.

The reality is that eliminating the Bush tax cuts for the wealthy would affect only 3% of small business owners.

Republicans have also been at the forefront of providing tax breaks for corporations that ship jobs overseas.  They refuse to entertain penalties for large American corporations that move their “headquarters” off-shore to avoid U.S. taxes.  Republicans rail against common sense regulations that prevent greedy corporations from destroying our environment and robbing our citizens.  Indeed, Republicans actually apologized to BP when the Obama administration demanded it pay for damages to those affected by the massive Gulf oil spill.  And virtually all Republicans voted against reform of Wall Street after it collapsed our economy!

So what have Republicans done to earn my friends’ loyalty?  Social Security?  Nope.  That was passed by Democrats over the protests of many Republican.  Medicare?  Nope.  That was passed by Democrats with little to no help from Republicans.  Corporate-provided health care and profit-sharing?  Wrong again.  Employee benefits are the result of labor union fights (literally) against greedy company owners.

So what does the Republican Party do to deserve the undying loyalty of those who work for a living?  They lie.  And they are very good at it.

Beware The “Pledge To America”

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Republicans have just announced their new “Pledge to America” in an attempt to persuade independent voters to put them back in power.

Among other things, they promise to repeal “Obamacare” (leaving 33 million Americans without access to health care), reduce the deficit (which was largely created by Bush and Reagan), cut taxes (for corporations and the wealthy) and cut the size of government (so more Republican-led corporations can get government contracts to provide services at higher cost). They also pledge to cut all government funding for abortions (as if such a thing still existed).

What they fail to mention is that they also intend to privatize or eliminate Social Security (because homeless seniors are so entertaining), eliminate Medicare (because funding health care for those who are 65-plus is obviously a waste of money), eliminate unemployment insurance (if workers were any good, they wouldn’t be laid off), and ban gay marriage (only heterosexual Christian Americans should enjoy the full privileges of citizenship).

Before you join Republicans in taking the pledge, remember what happened the last time they were in charge. They immersed the nation in an unnecessary war costing more than $3 trillion.  And their policies of deregulation led to massive deficits, a run-up in oil prices, an ecological disaster in the Gulf, and the collapse of financial institutions which created the worst economy since the 1930s.

Based on those facts alone, I suggest we all take a different pledge – to never vote for a Republican again!

What Republicans Really Stand For:

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Since Republicans like to attack any (make that every) Democrat idea, I thought it might be useful to look at what Republicans want.

1. Guns for everybody, no training required, the more the better.

2. Elimination of income taxes. Replace them with sales taxes, so the rich are taxed disproportionately less.

3. Elimination of labor unions. Who needs collective bargaining when corporations are so caring and generous to their employees?

4. Elimination of welfare, unemployment benefits, Social Security and Medicare. Only the wealthy deserve entitlements.

5. Elimination of public schools. After all, who wants children learning about such controversial issues as evolution anyway?

6. The criminalization of abortion, birth control and sex education. You can never have enough unwanted, uneducated children, right?

7. Repeal of health care reform – if you can’t afford health care on your own, you deserve to die.

8. Unlimited campaign contributions from corporations, but only for Republicans.

9. Deregulation of Wall Street, Big Oil, mining, Big Pharma, military contractors, commodities and any other campaign contributors.

10. Elimination of community organizers – you know, anyone who will fight for the underpriviledged and, most importantly, anyone who will register poor people to vote.

11. Elimination of mandatory minimum wages. It’s a drag on business to have to pay employees a living wage.

12. Downsizing of government, except for Homeland Security, I.C.E., border patrols, and any agency that looks out for wealthy Americans.

13. Privatization of the military, the Post Office, National Parks, and almost every other branch of government. There’s no profit for shareholders if the government does it.

14. Elimination of the Environmental Protection Agency. Climate change is just a myth perpetuated by Al Gore and those tree-hugging liberals. Besides, what good are natural resources if corporations can’t exploit them? Right?

15. Recognition of Christianity as the state religion. God bless America.

If you think I’m exaggerating, you just haven’t been paying attention.