Wednesday, February 22, 2012

Misunderstandings About Class Warfare

Like Warren Buffet said, "There's a class warfare all right, but it's my class, the rich class, that's making war, and we're winning."

The letter that Dave Zweifel wrote about in The Capital Times underscores the fact that the rich are winning, and they are winning because they are pitting working people against each other. Apparently, some of the working people fail to grasp simple realities, as "Brenda"'s letter illustrates. The article is a must read.

Tuesday, February 21, 2012

Insignificant Markers

So the Dow Jones reached 13,000 for the first time since 2008. Hooray, yes? Could there be a better example that the index that measures the (supposed) health of public companies in this country is completely meaningless in terms of how the American middle class fares?

This is an important point, because all the measures and indexes that you hear quoted on a given day in all of the mainstream media are meaningless? Productivity? Gone up. Unemployment? Down. Wall Street? Up. They are all numbers that are designed to make us feel good and mean absolutely nothing to most of us. How is your purchasing power now, compared to 10 years ago? How did your salary fare in the last ten years? How much of your income goes toward non-discretionary expenses every month? If you look at those numbers, they all probably look worse now than they did last year, five years ago, ten years ago. That's why you never really hear them mentioned in polite Washington conversation. On the upside? Access to contraception would be much, much more difficult if Republicans have there way. That'll fix your life, won't it?

Sunday, February 19, 2012

You Don't Own Me

Mark Sumner wrote an interesting post at the Daily Kos, titled You Don't Own Me. The framing is a little weird, as it seems to start out as a North-South diatribe, but the contents are nonetheless worth a read. So, read it. Comments are welcome.

Friday, February 17, 2012

The Dishonesty and Hypocrisy of Republican "Stars"

I am often appalled by the idiocy and the hypocrisy of mediocre Republican figures. but when the idiocy and the hypocrisy come from one of the supposed "rising stars" of the Republican party, I find it even more appalling. Take the example of Gov Chris Christie.

In vetoing a bill that legalized same-sex marriage in New Jersey, Gov. Christie made the following statement: "I am adhering to what I've said since this bill was first introduced – an issue of this magnitude and importance, which requires a constitutional amendment, should be left to the people of New Jersey to decide." If that statement does not bother you, think again: it should.

We live in a nation that established representative democracy as a form of government: We elect representatives to legislate and execute laws on our behalf. If we do not like what our representatives do, we can vote them out, and someone else in, at the next election. By this measure we judge everything our representatives do: Increasing or lowering taxes, enhancing or reducing social services, strengthening or . weakening law enforcement powers vs. the protection of individual rights, and so forth.

It really bothers me when some politicians think that some things are too sacred to be decided by legislators and sent the back to voters for further approval: The majority of the people already voted you in, so do you fucking job, which is to make a stand on principle from time to time, call an issue as you see it, and make decisions on our behalf, without making pitiful excuses.

Often, appeals to voters are made by reactionary politicians who want to maintain the status quo, and know that it is easier for 30-40 somewhat enlightened representatives (or 3, 4, or 5 judges) to repair a wrong, than it is for millions of voters that often include a majority of backward-thinking, religiously-motivated dullards who think that (their) God's view of morality be driving their vote, instead of rational, humane considerations. Do you think we should have patiently waited for the majority of Americans to eliminate racial segregation, antimiscegenation laws, or to decide whether Genesis or the theory of evolution by natural selection should be taught in science classes? If so, you need to live in a gated community of like-minded freaks. It's better for all of us if you do.

Referenda are the means that voters can use to right what they perceive to be a wrong perpetrated by a minority (their elected representatives or a handful of judges) after a decision has been made that is contrary to their general sensibilities. And courts have the final say because they are supposed to be composed of individuals of above average intelligence and education (and hopefully, some sense of impartial justice), who can recognize when a law goes against constitutional principles.

What bothers me even more is that referenda are often called into play with the excuse that the issues they are meant to decide are of foremost importance and consequence, but which in reality are fairly trivial, like gay marriage, the legalization of pot, the legalization of gambling, and so on, when compared to things that are hugely consequential in people lives. I would like to be called to vote on whether corporations are "people", in the sense that they should enjoy the same privileges that individuals do, without suffering any of the ill effects (like being sentenced to death when they wreck the world economy.) I would like to be called upon to decide whether we should have a national health care system, with a good deal of government intervention, versus a fragmented one in which the influence that power players exert (health care corporations, insurance companies, and Wall Street) greatly exceeds the ability of individuals to oppose them. I would also be liked to call to decide whether the water that I drink, or the food that I eat, or the drugs that I take, should be safe, whether the fuck the politicians want them to be or not. But that's not what happens as a matter of routine.

As a matter of routine, we let politicians represent us in the hope that they will weigh the public interest versus the private, and that they will legislate in good faith. And if, and only if, we disagree with the decisions they make, do we then have recourse to the courts or to undo what they did via referenda. For a number of reasons that make eminent sense,  that's the way things should work and that's the way, for the most part, they have worked. I am sure that Gov. Christie knows that; which is why he is both a hypocrite and dishonest when he says that "an issue of this magnitude and importance... should be left to the people of New Jersey to decide." But if there is no dishonesty or hypocrisy in his statement, that might be an even worse fault, because it would be a sign that the governor does not understand how representative democracy works. If so, he is not fit to be a leader in one, and the people of New Jersey would do well to replace him as soon as they get a chance. And the rest of us should so hope that he never ascends to higher power than that of Governor, if that's his idea of how politics should work.

Tuesday, February 07, 2012

Health Care Failures in the USA (UPDATED)

UPDATE: So, the bill for part of the surgery finally came in: $171,900. No, it wasn't a transplant, it wasn't open heart surgery. It was pretty routine surgery, the kind many women undergo every year. Yes, $171,900 seems a bit overpriced. As would have $71,900, as would have $50,000. In fact, I'd be really interested in finding out how much hospitals and surgeons in other countries charge for the same type of surgery. I'll do my best to find out.

I wonder: Does God only unleash hurricanes and other national calamities on "gay-infested cities" like New Orleans, or does he get pissed when doctors, hospitals and insurance companies combine to swindle the American public? Because, if He doesn't, His priorities are out of whack. Honestly, if I hear one more American sing the praises of the American health care system and rail against socialized health care I am personally going to beat the crap out of him.

So I finally have my own U.S. health care/health insurance horror story to tell.

I am among the lucky ones, I guess. Through my employer, I have a health care plan that covers most of my expenses. The only thing I have to worry about (until I find out otherwise) are my co-pays, which are fortunately manageable. Around 2 a.m. last Saturday, my wife (L.) started screaming for the pain in her lower abdomen. She was nauseous and could barely move. It was immediately clear that there was something seriously wrong with her, so I quickly got dressed and drove her to an E.R., which I will refer to as ER-1 from here on out.

We were at ER-1 from approximately 2:30 to 6 a.m. After ordering a complete blood count and a urinalysis, and after administering fluids, painkillers and anti-nausea meds to L., the doctor concluded that the best thing to do was to send her home and keep her on painkillers and anti-nausea for 12 hours, at which point if things hadn't improved we should return to the ER for a CT scan. (This visit was billed by ER-1 to our insurance company at $5,700 and change, and I had to write a check for $50 for the co-pay)

Come 6 p.m. things weren't better, they were the same. So, as instructed, we returned to ER-1, where L. was given CT contrast liquid in preparation for a CT scan, which she promptly threw up. Still in pain and as nauseous as she was in the morning, we asked for her to be admitted to the hospital. Armed with new negative blood and urine tests, as well as a CT scan), the doctor left us with a (botched) diagnosis of possible food poisoning, or viral gastroenteritis, or ielitis (an inflammation of the colon). The appendix was cleared as a culprit and we were advised to make an appointment with a GI for a colonoscopy on Monday. No antibiotics were administered, just the same painkillers and anti-nausea meds. We were sent home in spite of the fact that L. was evidently no better than when we first visited ER-1, some 15 hours earlier. (This second visit was billed at over $10,900 and I had to write another $50 check for a second co-pay).

Things did not get better on Sunday, and before we had a chance to make an appointment for a colonoscopy, L. woke up shivering and gnashing her teeth. She was running a fever of 103° F, and on the way back to ER-1 she threw up for the fifth time in 60 hours.

Back at ER-1, the admitting nurse told us to go and sit in the waiting room, which--contrary to the two Saturday visits--was quite crowded. I was quite shocked that they would tell us to wait, since they must have seen from their computerized records that L. had already been there twice on Saturday already even if they did not hear us say it when they taking information from L. 30-40 minutes after our arrival, we were still waiting to be called, so I decided I'd had enough of waiting, particularly since L.'s pain and nausea seemed to have abated, so I told the admitting nurse that we wished to sign a release and walk away, which we did to the nurse's seeming relief.

Since the situation was far from resolved, I immediately took L. to see her primary care doctor. While I parked the car they had already given her a urine test and measured her temperature and blood pressure. With that data in hand, they told me that in fact we needed to return to an E.R. and seemed to be wondering why we decided to leave ER-1. (I stand by my decision to leave because, while the emergency seemed obvious to me--a layman--it seemed equally obvious that the E.R. staff did not share my view.) We were advised to go to a different E.R. in the suburbs, which  I will call ER-2, which we did.

At ER-2, doctors were visibly concerned with her low blood pressure and oxygen levels and treated her with a sense of urgency I had not yet seen. After a 9-hour visit in ER-2, which included another CT scan, ultrasound, blood and urine analysis, the administering of fluids, antibiotics, painkillers and anti-nausea meds, L. was admitted to the hospital at around midnight. Just over 24 hours later, she was scheduled for emergency surgery since she had failed to respond to treatment with antibiotics and she had been diagnosed with acute infection of several organs, as well as sepsis.

I am glad to report that the surgery went well and that, barring any unforeseen complications, L. is on the mend, pending a 6-8 week convalescence and absence from work. But the experience has left her scarred, figuratively and literally, and has left me drained. Since sepsis and low vitals were involved, it was a closer call than I probably realize. We were lucky that I did the "wrong" thing, by refusing to let my wife wait for treatment in a busy ER. We were also lucky that at ER/Hospital 2 L. received very good treatment, the kind most Americans imagine when they speak of the U.S. health care system, which they dogmatically believe to be the #1 in the world. And we are also lucky that our financial exposure should be limited to a series of manageable co-pays, thanks to my employment. (I have yet to see all the bills, but my insurance plan should cover all the costs after the co-pays; we'll see.)

However, no matter how good the care L. received at ER/Hospital 2, the fact remains that the staff at ER-1 did not seem to perceive the gravity of the situation, that we live with a system that discourages hospitalization as a diagnostic step, and that their inaction could have cost L. her health, even her life. That our insurance company was billed approximately $18,000 for two visits which amounted to barely 7 hours of work only adds insult to the injury that L. sustained, and further shows that even outrageous amounts of money (unless you think that $18,000 is a fair price for 7 hours in an ER and a handful of routine exams) cannot buy us good health care.

I shudder to think what would have happened to a couple who makes barely enough to fall outside the net of Medicaid, but not enough to buy insurance that covers all medical costs.

I wrote this very personal post because a reader of this blog who describes himself as a centrist blamed my disappointment with President Obama on the fact that he (the president) is not the flaming liberal I would like him to be (John, that's you). I blame President Obama not for being too much of a centrist, but for failing to fix (or even show that he was committed to fix) a system that fails the people it is supposed to serve. When President Obama ran away from true health care reform and into the arms of the insurance companies, doctors, and hospitals he had claimed he'd reform, that's when he lost me. It was a betrayal of trust that explains why I, and many people like me, are disgusted with politics as usual. It should not take a flaming liberal to take on and fix powerful interests that disrupt people's lives; only a person with a basic sense of justice fairness.
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