The Commentariat -- Nov. 21, 2013
CW: I will be away most of the day, & will update when I can.
Jonathan Weisman of the New York Times: "Janet L. Yellen took a giant step on Thursday toward becoming the first woman to lead the Federal Reserve Board when the Senate Banking Committee sent her nomination to the full Senate with a 14-8 vote.... Three Republican senators -- Bob Corker of Tennessee, Mark Kirk of Illinois and Tom Coburn of Oklahoma -- voting in favor of her nomination. One Democrat, Senator Joe Manchin III of West Virginia, voted against her. "
White House: "President Obama awards the Presidential Medal of Freedom to 16 individuals who have made especially meritorious contributions to the security or national interests of the United States, to world peace, or to cultural or other significant public or private endeavors":
Jonathan Capehart: "The GOP is out to destroy the country." CW: Capehart admits his headline is over the top, but I'd say it is also on the mark.
Jeremy Peters of the New York Times: "Senator Harry Reid of Nevada, the majority leader, is poised to move forward on Thursday with a vote on what is known on Capitol Hill as the 'nuclear option,' several Democrats said. Mr. Reid and the senators who have been the most vocal on stopping the Republican blockade of White House nominees are now confident they have the votes to make the change." ...
... ** UPDATE: "Senator Harry Reid, the majority leader, set in motion on Thursday a series of procedural steps that, if followed through, would eliminate the use of the filibuster against nominees to cabinet posts and the federal judiciary, a change that would mark the most fundamental shift in the way the Senate functions in more than a generation.... Senate Democrats moved toward a vote late Thursday morning." The Washington Post story, by Paul Kane, is here. ...
... Jamelle Bouie in the Daily Beast on the Senate filibuster: "Yes, there's value in being able to block right-wing nominees and legislation. At the same time, a GOP president also has the right to staff government as he sees fit, to say nothing of the fact that the filibuster has been a historic burden for liberals, not an advantage. And honestly, if Republicans win the Senate, I have a hard time believing they won't end the filibuster as a matter of course, regardless of what Democrats do. Better for Reid to do this now, while there's still something to gain, than to wait for the other side." ...
... Gail Collins on the Senate filibuster: "Change the rules."
Kelly Kennedy of USA Today: "Buoyed by a report showing that health care spending has risen by the lowest rate ever recorded, White House officials said Wednesday a continuation of the trend could lead to more jobs and lower-than-expected costs. Reduced health care costs for employers could lead to 200,000 to 400,000 new jobs per year by the second half of the decade, said Jason Furman, the chairman of the Council of Economic Advisers.... The Affordable Care Act is, in part, responsible for the lower costs, Furman and other health experts agree, while Republicans say the declining rate of increases comes purely because of the slowed economy An economy hobbled by the recession and the economic crisis in 2008 played a role in some of the reduced spending growth, Furman said, but the report cited 'structural change' caused, in part, by the law." ...
... Steve Benen: "It looks like the law's many detractors will have to cross another complaint off their list.... It's the sort of thing Republicans should be pretty happy about -- which generally means they'll ignore the news and/or issue a press release declaring the opposite, assuming no one will know the difference." ...
... Sandhya Somashekhar & Ariana Cha of the Washington Post: "As Americans have begun shopping for health plans on the insurance exchanges, they are discovering that insurers are restricting their choice of doctors and hospitals in order to keep costs low, and that many of the plans exclude top-rated hospitals.... A number of the nation's top hospitals -- including the Mayo Clinic in Minnesota, Cedars-Sinai in Los Angeles and children's hospitals in Seattle, Houston and St. Louis -- are cut out of most plans sold on the exchange.... A number of the nation's top hospitals -- including the Mayo Clinic in Minnesota, Cedars-Sinai in Los Angeles and children's hospitals in Seattle, Houston and St. Louis -- are cut out of most plans sold on the exchange." ...
... Sarah Bosely of the Guardian: "Secret conversations are taking place in Florida between healthcare stakeholders and the legislature that will most likely lead to the Republican-controlled state accepting Medicaid expansion money, according to senior figures in the health industry."
... Jonathan Kaminsky of Reuters: "Oregon, a state that fully embraced the Affordable Care Act, is enduring one of the rockiest rollouts of President Barack Obama's signature healthcare law, with an inoperative online exchange that has yet to enroll a single subscriber, requiring thousands to apply on paper instead.... Nearly 25,000 individuals and families have so far submitted hard-copy applications..., with nearly two-thirds of those applicants eligible for Medicaid.... But none of those applicants has actually been enrolled, with manual processing of the paperwork slowing the process dramatically." CW: That makes Healthcare.gov look pretty slick! ...
... But Not Slick Enough. Amy Goodnough of the New York Times: "Despite weeks of work by a small army of software experts to salvage HealthCare.gov, navigators in states that depend on the federal insurance exchange say they still cannot get most of their clients through the online enrollment process. Those navigators said they had seen improvements in the system since its disastrous rollout on Oct. 1, particularly in the initial steps of the application process. But the closer people come to signing up for a plan, the more the system seems to freeze or fail, many navigators said." CW: See Victoria D.'s remarks in today's Comments. ...
... Paul Krugman: "... at this point there's enough information coming in to make semi-educated guesses — and it looks to me as if this thing is probably going to stumble through to the finish line. State-run enrollments are mostly going pretty well; Medicaid expansion is going very well (and it's expanding even in states that have rejected the expansion, because more people are learning they're eligible.) And healthcare.gov, while still pretty bad, is starting to look as if it will be good enough in a few weeks for large numbers of people to sign up, either through the exchanges or directly with insurers.... Obama personally may never recover his reputation; Democratic hopes of a wave election in 2014 are probably gone, although you never know." ...
... Today's Munch Prize goes to Tom Edsall of the New York Times, who is nearly beside himself with doom and gloom. Here's but one of many bad tidings of discomfort & misery: "The increasingly complex and technical character of the health care system ... is what has turned the disastrous rollout of the HealthCare.gov portal into an ever escalating political crisis. This crisis has in turn generated a pervasive fear that the services provided under the Affordable Care Act, once they are finally in place, will themselves be subject to fatal technical glitches." One of Edsall's major points is that the ACA redistributes benefits from middle-class white people to poorer "those" people, which neither Medicare nor Social Security does.
"Cruz Care." Greg Sargent: "... the Democratic Senatorial Campaign Committee is set to launch a new campaign designed to refocus the debate on the Republican position on health care, which Dems will widely label as 'Cruz Care.' With Ted Cruz set to roll out his own health plan -- one that will probably look like the usual grab bag of GOP reform ideas, which just aren't a reform alternative to Obamacare -- Dems plan to tar GOP Senate candidates across the country with it...." ...
... Jonathan Weisman & Sheryl Gay Stolberg of the New York Times: lacking any policy agenda of their own, the GOP strategy has been to develop & hammer a series of attacks on the ACA: "The effort has its roots in a strategy developed last spring, when House Republican leaders -- plagued by party divisions that were thwarting legislative accomplishments -- refocused the House's committees on oversight rather than on the development of new policies." ...
... Woe Is Mitch. Jon Terbush of the Week: Kentucky's "exchange marketplace has been one of ObamaCare's early bright spots. And continued success, coupled with a turnaround for the law at the federal level, could make ObamaCare relatively popular there over the coming months. That would put [Senate Minority Leader Mitch] McConnell [R-Ky.], facing challengers on both his right and left, in a tricky bind." Via Greg Sargent.
** David Dayen of Salon: The big $13 billion JPMorgan settlement is a scam!
Christopher Drew & Danielle Ivory of the New York Times: "Emails obtained by criminal investigators show that from 2009 to early 2011, several ship crews and contracting officials filed complaints about [Leonard Glenn Francis's] 'gold-plated' fees for fuel, port security and other services. In 2010, the Naval Criminal Investigative Service opened investigations into questionable charges in Thailand and Japan by his company, documents show. Despite those red flags, in June 2011, the Navy awarded Mr. Francis $200 million in contracts, giving him control over providing supplies and dockside services for its fleet across the Pacific."
NEW. Josh Gerstein of Politico: "The Obama administration has ordered a government-wide reassessment of how almost 5 million Americans have been granted classified information security clearances and whether each person currently approved to see sensitive national security secrets truly has a need for such access." ...
... NEW. James Glanz of the New York Times: "The National Security Agency is authorized to spy on the citizens of America's closest allies, including Britain, even though those English-speaking countries have long had an official non-spying pact, according to a newly disclosed memorandum.... The memo, provided by the former N.S.A. contractor Edward J. Snowden, is labeled secret and 'NOFORN,' indicating that it may not be shared with any foreign country."
Ari Shavit of Haaretz, in the New York Times: "The Bush administration's decision to go after Iraq rather than Iran was a fatal one, and the long-term consequences are only now becoming clear, namely a devastating American failure in the battle to prevent a nuclear Iran, reflected in Washington’s willingness to sign a deeply flawed agreement."
Marisa Kendall of the Fort Myers, Florida, News-Press: "U.S. Rep. Trey Radel, R-Fort Myers, will take a leave of absence after pleading guilty to a possession of cocaine charge, he said during a packed news conference Wednesday night." With video of Radel's Wednesday night news conference. CW: But really, folks, it's all about me, Trey Radel. ...
He would talk about his life, of being a traveler. He would talk about hiking, taking his backpack and hiking in Colombia. And, you know, it always led to, because of who Colombia is, it always led to drugs. We'd go to break and I'd say 'Man, I bet the coke was crazy' and he’d say, 'Oh my God, you have no idea.' -- Mike Adams, radio producer, on Rep. Trey Radel (RTP-Fla.)
... David Fahrenthold, et al., of the Washington Post: "Rep. Trey Radel (R-Fla.) pleaded guilty to possession of cocaine in D.C. Superior Court on Wednesday morning, admitting he had purchased the drug from an undercover officer in Dupont Circle last month.... If Radel completes probation, he won’t have a conviction on his record, according to the U.S. attorney's office.... Charging documents say he purchased cocaine in the nation's capital on several occasions." ...
... Ed O'Keefe of the Washington Post: Although he was caught by DEA agents last month, "Radel first informed House Speaker John A. Boehner (R-Ohio) of the situation Tuesday afternoon, according to a senior GOP aide familiar with the conversation. Radel had requested the meeting earlier in the day before reports of his arrest first surfaced, and the meeting occurred in Boehner's office at the U.S. Capitol shortly after the news broke, the aide said." ...
... After pleading guilty Wednesday to concaine charges in Washington, D.C., Rep. Trey Radel (RTP-Fla.) will hold a news conference in his Cape Coral office at 10:30 p.m. Wednesday. Indications are that he will not resign his Congressional seat. The Fort Myers News-Press is liveblogging developments. ...
... Fort Myers, Florida, News-Press Editors: "U.S. Congressman Trey Radel, who ran on family values, must resign immediately." ...
... Dana Milbank: Radel "acted Wednesday as though the most important thing was his job, not his recovery. He plans to 'continue serving this country.' Rather than checking himself into inpatient rehab, as then-Rep. Patrick Kennedy (D-R.I.) did after crashing into a Capitol Police barricade in 2006, Radel opted for outpatient treatment, and his attorney made only a vague reference to his plans to undergo inpatient treatment later."
Local News
Monique Garcia of the Chicago Tribune: Illinois "Gov. Pat Quinn today signed a historic measure into law making Illinois the 16th state in the nation to allow gay marriage. The Democratic governor put pens to paper at a desk brought up from Springfield that his administration says President Abraham Lincoln used to write his first inaugural address. That speech, delivered on March 4, 1861 as the Civil War was unfolding, called on Americans to heed 'the better angels of our nature.'" CW: Maybe Quinn should have hunted down the desk of Lincoln's predecessor James Buchanan, who was gay and might have married his long-time lover had they had the benefit of today's state laws.
News Ledes
$$$. New York Times: "After spending more than a decade behind bars for the murder of a teenage girl in Greenwich, Conn., Michael C. Skakel, a cousin of the Kennedys, was ordered free from prison on Thursday to await a possible retrial."
Los Angeles Times: "The Dow Jones industrial average closed above 16,000 for the first time, a testament to investors' hope that the plodding economy can gain momentum in the coming year."
Business as Usual on the Afghan Front. Washington Post: "President Hamid Karzai told a national assembly Thursday that he supports a newly forged agreement to allow U.S. troops to remain in Afghanistan beyond 2014, but then he raised new uncertainties by saying he won't sign the deal until next spring. Karzai spoke a day after U.S. officials said the accord's language had been finalized, and as an assembly of 2,500 Afghan officials began considering it."
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Reader Comments (32)
I'm getting fed up with the New York Times reporting on the ACA. You would think the only adjectives they know are "calamitous" and "disastrous" as opposed to, say,"problematic" or "sub-par." These loaded, apocalyptic terms may be irrevocably affecting public opinion of the whole Act. And half the time the Paper of Record fails to distinguish between the problems of the website and the content of the Act itself.
I am seriously disappointed in the Times.
Akhelius' favorite president strikes from the past: http://www.dailykos.com/story/2013/11/19/1256818/-No-Beds-Available-The-Subtext-of-the-Creigh-Deeds-Tragedy?detail=email
Re: workers: Joe Hill had advice for them:
"Work and pray.
Live on hay,
You'll get pie in the sky
When you die"
Woops, maybe not:
http://www.washingtonpost.com/local/virginia-politics/state-mental-hospital-in-staunton-had-room-for-deedss-son-on-monday/2013/11/20/5faeccaa-51fd-11e3-9fe0-fd2ca728e67c_story.html
Even so:
http://www.washingtonpost.com/blogs/all-opinions-are-local/wp/2013/11/20/va-gets-another-mental-health-wake-up-call/
As the columnist points out Virginiaa's neglect of mental health and love of guns go together.
Just finished reading Thomas Edsall's piece before I clicked over here on RC and saw he received the Munch Prize. Well deserved! His opening sentence was a fine start "Health care as a necessity comes only after food, shelter and income security." but from there it was downhill as it wandered into an unhelpful blame game. There was the usual 'anecdotal' tales of 'losing my $98 a month insurance' without further explanation that maybe the individual had a crummy $98 a month insurance plan in the first place—which we've seen in similar stories, when further checking ACA plans that offer better coverage than that bargain-priced insurance ever did. Edsall didn't impress with this one.
@Marie, I might have commented earlier, but have been out feeding the sled dogs. How was the swim?
Elected officials who abuse drugs and alcohol should have neither sympathy nor understanding. About these matters I am not tolerant, broadminded nor worldly in my views. If you can't stop yourself from rocking the terminal ignorant in public or you are unable to comply with the law, you aren't worthy to hold elected office. There should be no discussion about misdemeanors being acceptable. You are not fit to represent others no matter how much you invoke the name of Jesus, promise to seek help and apologize to your family. You are free to make as many "mistakes" as you want, but those mistakes should require that you forfeit the position of trust for which you were elected. I hope your rehab is successful, but not on your constituency's time or dime.
I am not looking for the guy next door who knocks back a 6 pack every night to be my elected representative. I want somebody who is smarter than me, has a rock solid moral compass and can leave the booze and the drugs alone.
Instead of providing a personal standard to admire, scum suckers like Ford and Radel provide a perverted model of public service that attracts more scum suckers. The more this behavior is tolerated and framed in terms of a "mistake", the more it undermines legitimate governance in the US.
What I Don't Get about Hospitalization Insurance.
The WashPo story above brings to mind my personal experience. About 10 years ago, before I was on Medicare, I was hospitalized, & the total hospital bill was $27,000. My insurer -- UnitedHealth -- got the bill reduced to $9,000, of which they paid 80 percent & I paid 20 percent.
The hospitals that attended to my husband's last illness -- which are county-run -- charged about $24K. Medicare paid
$2K & changeabout $2,600, and UnitedHealth -- through which we have a supplemental policy -- paid close to $800. The hospital system billed me $450 as a Medicare co-pay. So I asked the hospital, what about the other $20,000? "We wrote that off," the rep said. "Every Medicare patient who comes in is an automatic loss."Yesterday I read that a hospital had "automatically" cut a young patient's bill in half because she wasn't insured.
So what I don't get is this. How is it that the insurers pay only a fraction of the hospital bill? Is it all a scam? Who does have to pay 100 percent of a hospital bill? If the insurers aren't going to pay the whole bill anyway, why not let patients go to the hospitals they prefer?
I'd be most grateful if someone could explain this to me.
Marie
Marie, insurers negotiate deals with each hospital they accept. Obviously if they don't like the deal, the hospital is off their list.
As far as the hospital 'bill', the number is pure bullshit, part of the negotiation and used to bill people with no insurance. So if you have insurance you pay $2500 and if you don't have insurance you $25000 for the same service. Or to put it another way, the 'bill' is an act of fraud.
@Marie
To add to Marvin Schwalb's above comment: insurers are "double dippers." They negotiate "deals" with hospitals, AND they charge their paying clientele ever larger fees for insurance. Their explanation is that they have to do this because they would otherwise lose money. The insurance companies and hospitals do not, as we know, end up losing money, but those with "regular" insurance often end up paying exorbitant bills in the form of large co-pays, and extra $$ for services "not covered." Also, some doctors who are on-call in the ER do not get paid. My husband, a psychiatrist, rarely got paid when he was on call at Fairfax Hospital in Falls Church,VA. because patients who come to the ER for psychiatric emergencies were/are seldom insured. The ACA will change that, but not as much as single-payer would have. And yes, under single-payer (i.e., Medicare) doctors and other providers must agree to be reimbursed less. My husband always considered it "community service." As did I in my therapy practice. However, Medicare always paid--in their own good time--while most other insurers (United and Aetna being two of the worst) often denied claims for stupid, irrelevant reasons. Fighting their bureaucracy turned out never to be worth it, so I resigned from "managed care" early on in my practice. I charged a sliding fee--took Medicare--and did just fine.
Speaking of "outlaw" insurance companies sabotaging the ACA. I signed this petition from Daily Kos and hope you all will consider doing so as well--if you have not already.
https://www.dailykos.com/campaigns/577
There is no one clear explanation about hospital billing, Marie. Practices differ from hospital to hospital and from hospital system to system.
Stephen Brill's 20+ thousand word article, "Bitter Pill," in an early March 2013 Time magazine summarized some hospital billing practices but neither his reports of general policies or billing rubrics nor his adumbration of individual cases and how they were handled made those practices wholly clear. He had some answers but not all. Tho' I have not read the book that followed the article, I would guess he did not identify a thread there either that tied it all together.
We can make two generalization, however. First, as Marvin says, Medicare patients and holders of good policies do get better deals because costs for both are negotiated beforehand and each organization has a combine's clout. Brill makes the point, tho', that insurance companies for a variety of reasons are losing some of theirs. In any case, that leaves the un- or inadequately insured holding the bag. According to Brill, they are the ones most often expected to pay what the hospital decides the freight ought to be. When they don't, they get to deal with collection agencies or bankruptcy courts. Again, those least able to afford it get socked, or soaked, the hardest.
More generally, Marie, you cannot make sense of it all because considered instance by instance, it does not make any. Furthermore, the Right, which touts itself as ferocious upholders of individual responsibility, are doing all they can to make sure that medical billing procedures and the real costs of doing business remain locked in a black box, so that no one can possibly know how rational or irrational, how fair or unfair, any of the pricing and billing really is.
The Right's worship of responsibility here again ends long before it has to set foot inside the moral universe. I'm hardly surprised at that, but cannot understand the reluctance of these "friends of business" and the "marketplace" to nudge the medical-industrial complex in the direction of being actually behaving in a businesslike (in the old no-nonsense middle of the last century sense, when that word used to be a compliment) manner.
Is it possible they're just spoofing us to the tune of tens, if not hundreds of billions a year, the fruits of which end up in the pockets of their supporters and then in their own? I do remember something about Max Baucus' wife's ties to the health insurance industry....
(A last ignorant thought: Since most large hospitals are organized as non-profits (that pay their CEO's in the millions) and do not pay taxes on their net, their accountants might see a need for them to have substantial write-offs in the form unbilled charges and uncollected debts. Any accountants out there who could speak to this?)
Kate, actually a large percentage of hospitals are losing money. A principle reason is empty beds. It turns out that we have made significant improvements in health care technology that help patients but hurt hospitals. My best example of the problem is the fact that 40 years ago I had a kidney stone and spent 4 days in the hospital. Then I had another stone about 12 years ago and spent about 4 hours getting the same diagnosis and procedure.
The extent of same day care has drastically effected occupancy. So hospitals are now trying to buy medical practices so that they are more into that piece. But the sum is the fact that because we have a for profit system, there is absolutely no effort to make matters more efficient. In a high density place like NJ the matter is even worse because we have too many hospitals near each other. I am a 15 min drive from 4 major hospitals.
Yes, Marvin, here in my neck of the woods Yale New Haven Hospital has taken over a medical group that my internist is part of. Before the take-over we never had problems with the billing dept. After the take-over we got a call from a collection agency telling us I owed $350. First of all I was horrified––a collection agency? In my whole life I have always paid bills on time, always! so you can imagine my confusion and anger. Turns out Yale billing never sent the blood work I had done to Medicare and my supplemental. Told my doctor about this and he said they had done the same thing to him. About six months later the same thing happened only now the collection person said I owed many thousands––that's nuts, I tell her, I haven't even been to the doctor, just had some blood work. She said the bill was for my two day stay at Yale N.H. hospital. What??? Now I'm screaming into the phone––I was never IN the hospital. We called Yale billing and sure enough, they screwed up. I suspect that many of these mistakes are due to tech glitches or Yale has really dumb people in the billing dept.
@Diane -- if I had the ability to form the words as well as you did in your comment about legislators on drugs you could have taken them right out of my mouth. Beautiful.
And just a word on James Buchanan who was one of the worst presidents we've ever had. The explanation for the failure of his presidency lies, perhaps, in the personality and character of the man. Despite his caution and prudence, Buchanan was an erratic trimmer who twisted this way and that, and once he made up his mind, he stubbornly adhered to his positions. Having filled his administration with southerners, he was hardly the kind of impartial leader the country needed in the 1850s. How his homosexuality played into his leadership is anybody's guess, although if he could have had the freedom to express it openly he might not have been such a sour puss. How fortunate we were to have Lincoln succeed him.
@Marvin Schwalb -- "...hospitals are now trying to buy medical practices..." Yes, that's the new game in town. Then when you go to the doctor, they can charge you a "facility fee" on top of everything else.
Re; costs and cures; in my home town there is only one health care system; non-profit,makes millions. The costs are sometimes double or more compared to hospital systems thirty or forty miles away which my insurance prohibits me using. "CrappyCare" claims costs are high because of the non-insured and the high cost of living in my area.
Some time in the past I heard that Blue Cross offered a low cost insurance for those who lived close to the border with Mexico. They would cover you if you went to T. J. doctors and Hospitals. I was interested but did not qualify because of distance from border.
I do know of people that go south for dental and are happy with treatment. Same holds true for car repair. Is that great or what? Tune up for the truck; back surgery for me.
Krugman is my guy, but I think it is premature to suggest that ACA is the death knell to Obama's reputation. There's a lot of history to unfold, both domestic and global. The attention span of the public is fleeting and shallow. As I have suggested many times, the President has a nearly unnatural reservoir of perseverance and patience. The GOP have relentlessly targeted Obama as illegitimate on every level and he was elected twice, much to their fury. I'm confident history will judge Obama well and not merely on the basis of him being the 1st.
Harry Reid needs to get those judicial appointments confirmed by any means necessary. While fussing over potential GOP appointments years from now, the fox is reeking havoc in the hen house - today. We KNOW what GOP appointed judges are doing in the here and now. Fill as many vacancies as possible ASAP. Choose the youngest, most capable people. This is the best opportunity to combat the regressive policies of the right and the window is closing while there's a lot of unnecessary hand wringing and soul searching. Oh... and don't fall for the McConnell grift again.
After hunting around and around finally found the skinny on Dan Bongino, ex secret service agent, who has written the "hot new seller" "Life Inside the Bubble." Hannity had him on last night–––from there he will appear on ALL the right's foxy news––touting his book as "the bubble that will burst the Obama administration." He talked for less than seven minutes giving us no bursting bubble on Obama, but rather criticizing the Washington way of governing, but the right's news will continue to tout the book all on the evils of the Obama administration. See for yourself: Here's Ed Rogers piece in the W.P. Read his review of the book first––he gives the link––and then read Dan's reply. Such a juicy story.
http://www.washingtonpost.com/blogs/post-partisan/wp/2013/11/15/the-insiders-former-secret-service-agent-responds-to-criticism-of-book/
Barbarossa,
Far too often we forget history, to our peril. So it is appropriate not to lose sight of the terrible legacy left by the man most admired by Republicans.
Reagan, like Bush II, was largely unconcerned about things he didn't understand or know much about. Must be nice to go through life like that, blissfully ignorant, smiling, waving, joking, as your horribly wrong-headed, ill-advised and willfully imprudent policies create an ever widening gyre of suffering.
But no matter. As long as you don't have to hear the moans of pain and see the agony on the faces of those whose lives you have jeopardized, it's all good, right?
Interestingly, for such a commie hater, Reagan's deinstitutionalization of tens of thousands of mentally ill Americans early in his presidency, mirrored a similar program of Fidel Castro's. At around the same time Reagan was emptying beds of dangerous and disturbed patients, Castro was emptying his own facilities for the mentally ill, along with criminals, and sending them to the US so, I suppose, they could confer with their American counterparts. And in his distaste for treating mental illness, Reagan would have fit right in with Red Chinese officials who harbored a similar antipathy for those with such problems.
I guess ol' Dutch thought that those lazy mooching mentally ill people should get out of bed, jump on the horse, just like him, clear some brush out on the lower forty somewhere, and pull themselves up by their bootstraps. Lazy bastards. Reagan, no doubt, was one of those who believed that most people with mental difficulties are nothing but lying fakers.
And in a weird Karmic twist, Reagan himself fell victim to mental illness. But unlike those poor souls he imperiously tossed to the wind, he and his family never had to worry about how they would care for him. The final twist was that, unfortunately, Reagan, as he descended into dementia, was never aware enough to recognize the irony and appreciate the reality and heartbreak of mental illness.
History must never be lost as we wend our way forward. Knowing how we got here, and why, invests our journey with a deeper meaning and understanding. Stuff just doesn't happen on its own. Another reason Republicans strive to rewrite history books. The less people understand about the truth, the better chance they have of staying in power. Lies are their friends.
Hmm....sounds a little bit like a form of mental illness to me...any beds available?
So the R's claim the recent modest rise in healthcare costs is due solely to the bad economy? Does that mean we can expect them to take credit for it? Can't wait for the TV and radio spot. "We did all we could to destroy the nation's economy in order to keep healthcare costs down! And we succeeded."
Now there's a compelling platform to run on. All the voters without a job, who have lost their unemployment or had their food stamp allowance cut or are working two jobs at minimum wage couldn't help but be grateful.
Agree! Diane's comment on what Harry Reid needs to do. Charlie Pierce weighed in previously. It is time. There's really nothing to lose at this point, much to gain. Nuclear option NOW. Go for it, Harry!
My other peeve: Health insurance billing statements which are frustratingly impossible to decipher! Even after I became part of Medicare, I was glad to be healthy and have been loathe to require services. My husband who was years older and had had numerous medical/surgical procedures tossed the job of 'managing the statements' to me. Nothing made sense. I developed file folders in a 36' wide file cabinet that accumulated voluminous paperwork of THIS IS NOT A BILL ...countless times over. Trying to match up details with services provided was always a futile exercise.
Billing statements are purposefully confusing and intended to perplex patients. Wouldn't it be grand to receive one simple, clearly-itemized, one-sheet statement from the doctor/hospital provider is all that is necessary. One column for (realistic) charges, next column for insurance payments (Insurer A, B, and/or C)...all issued from a single source. Plus the additional billings from laboratories for blood work, other health service providers should be part of the entire statement. Third column, for deductibles or what you might owe. Totals at the bottom.
Single-payer! Now! Single billing source! Now!
AK: and let's not forget Reagan's refusal to address AIDS until Rock Hudson came out and then died from it. Even then he skirted around the issue–––homosexuality made him terribly uncomfortable. Larry Kramer, the gay activist, called Reagan a murderer, knowing how many deaths could have been prevented if this issue had been front and center–-warnings of the dangers of unprotected sex. I'm not sure we can blame R.R. for all those deaths, but we can certainly hold him responsible for not addressing the issue.
Part of the reason for the present hospital billing system is because, technically (cough, cough), hospitals cannot charge different patients a different rate for the same procedure. Under Medicare or Medicaid, the hospitals know they are only going to get a very small percentage, so the jack up the fees so that they can collect more from the privately insured and the uninsured. Medicare doesn't negotiate a discount; they agree to pay a set amount per procedure.
For example, lets say a certain procedure costs $500, but they know that Medicare/Caid will only pay $200 for that procedure, so they will have to write off $300. What they do is jack us the cost of the procedure to, say, $1,000. They will still get the same $200 from Medicare, but now an insurer with a negotiated 30% discount will now pay $700 for a procedure that they were paying $350 for before. And an uninformed, uninsured patient will pay the whole $1,000 unless they know to go in beforehand and negotiate a lower price. Of course, a single patient doesn't have the clout that a big insurance company with lots of customers has, so the single patients deal isn't usually as good. It's a billing scam.
For those who missed Elizabeth Warren on Rachel Maddow, here's a link:
http://elizabethwarren.com/maddowsocialsecurity?source=20131121em
She's correct. SS DOESN'T contribute to the deficit. Cutting it makes no sense, as she explains in detail. Logically, SS should be expended. Warren is the leader of the Democrats' rediscovered "Economic Populism." Shades of William Jennings Bryan!
Go Liz!
This just in: Reid just pulled the trigger (12:09 ET). It's game on!
Harry Reed's tweet says it all:
http://twitter.com/SenatorReid/status/403548538656677890/photo/1
I am following the show on c-span but I am not familiar enough with the procedure to understand it.
PD,
We certainly can hold Reagan responsible for inaction on HIV and AIDS information. We can hold him responsible for many terrible things. The list of detrimental things he bequeathed to Americans who aren't wealthy and white (and straight) are legion. Tens of thousands of Americans died before he even uttered the word AIDS in public, very late in his presidency.
Not long ago Patti Davis came out and declared that Reagan would have been a supporter of gay marriage. Hard to believe that when his public statements at the time indicated that, whatever his personal beliefs may have been, he was taking his public cues from haters like Jerry Falwell, Pat Robertson, both of whom have made insane declarations about gay culture, and from Reagan's own communications director, Pat Buchanan, who sneered that AIDS was punishment for the gay lifestyle. If Reagan didn't believe those things he should have disavowed them, if he was the big man Republicans believe him to have been.
No, we must judge leaders by what they say and do. It never mattered to me that I believed in my heart that Barack Obama didn't have a problem with gay marriage. He came out against it. I realize it was a political move, but he's on record stating that gays and lesbians should not be allowed the same rights as other married straight couples. He has since moved that position, to his credit, but had he not, it doesn't matter what we thought he was thinking. It matters what he did.
Reagan too.
Finally some balls by Democrats. I realize that there is a train of thought that this is all a nefarious plan by Republicans to get Democrats to hamstring the filibuster so they didn't have to get their hands dirty doing it and can continue their reign of judicial terror next time one of their minion take control of the White House, but the filibuster never seemed to be a very good weapon for Democrats anyway.
And what else can we do? Let these assholes bottle everything up for another two years? And pack me no packing of the courts. Are they kidding with that crap? Like Reagan, Bush I and II haven't injected enough toxins into the system to keep it thrashing to the right for decades to come.
Fuck that.
Pull the plug on these traitors and let's get back to work.
Oooh! Lord have mercy! There will be a lot of GOP tantrums and bed wetting. It will be interesting to see if they can top the numerous displays of faux outrage they have previously perpetrated. Senator get-off-my-lawn McNuts may have a coronary before its over. Good on Harry. Plow forward, full speed ahead and don't look back. You are finally acting on behalf of the people.
Re: Elizabeth Warren: I meant SS should be EXPANDED.
From the Too Funny Department comes one more in the never ending line of "Christians are Victims" stories.
It appears that a Costco near LA is in hot water with fundies for labeling Bibles as "fiction". Someone had a momentary burst of reason or truth in labeling, it appears. But not for long. Costco is doing the grovely-mea culpa-grovel for the "victims".
I want to know what the new "Victim Approved" label says.
If it isn't fiction, what is it? History? Non-Fiction? Biography? Memoir?