Tuesday, October 30, 2012

My New Book


Please check it out!

Saturday, July 14, 2012

The High Cost of Birthing

Why Health Care Reform Is So Important

In order to allay any fears that I might have been born in Kenya or somewhere like that, I am today releasing, not my birth certificate, but the bill for my delivery.

This little piece of paper, which I found among my late father’s effects, tells an astonishing story. It’s not only evidence of how health care costs have grown during my lifetime, it reveals some of the major changes that have been made in medical procedures.

As you can see, I was born on December 20, 1947, and my mother and I remained in the hospital for ten whole days! No, it wasn’t a caesarean delivery, and my mother didn’t have complications. It was just standard procedure that women who had given birth stayed in the hospital for a long time.

But, to us, what is most astonishing is the cost of that stay. It only cost $5.50 to deliver me and $8.50 a day for my mother to recuperate. (She must have just about gone mad lying in bed that long, I’d think.) Anesthetic for childbirth was standard, and that cost $3.00, as did circumcision. (I know: way too much information.) The total was $119.25.

In 1947, all the dimes, quarters, and halves in your pocket were made of 90% silver, and that continued to be the case through 1964. Now, a bag of those silver coins with $1,000 face value and no numismatic value will set you back almost $20,000. But even at 20 times the cost, $2,385, you can’t get born today for anything close, and your mother will probably be discharged from the hospital by dinner time.

That’s why reforming health care is so important. Here’s another graphic, from Wikipedia, showing the cost of health care in this country as a percentage of Gross Domestic Product. Back in 1947, people spent less than 5% of their income on health care. I might add that doctors made house calls back then.

I realize that there have been incredible changes in medicine during my lifetime. There were no hugely expensive CAT scan or MRI machines back then, and a whole panoply of wonder drugs has been developed in the meantime. Lots of people who survive major illnesses and traumas today would have died from them in 1947.

But there are other factors. St. Joseph’s Hospital was a Catholic institution and wasn’t in the business for the money. Blue Cross-Blue Shield, when it started, was a non-profit organization. There were no for-profit HMOs adding another layer of cost. There were few drugs available, but those there were relatively cheap.

Whatever the causes, and there are many, we have been paying an increasing portion of our income on medical care. As you can see from the graph, it reached 16% in 2007, and there has been no reduction in the rate of increase since then.

This increase was the impetus for Barack Obama to make health care reform a major plank in his platform when he ran for president in 2008. It was also the impetus for many voters who supported him.

He was true to his word. When the Affordable Care Act finally made it to his desk, it was probably a lot less than he had hoped, but it was a good start. It didn’t promise to reverse the trend, but the non-partisan Congressional Budget Office reported that it would reduce the rate of increase by a substantial amount over time.  

We need to give this new program a chance. The best way to do that is to vote for President Obama and the Democrats running for Congress and local offices.

Thursday, July 12, 2012

A Well-Beaten Dead Horse

Repeal and Replace – With What?

On Wednesday, after hours of debate, the U.S. House of Representatives voted for the thirty-somethingth time to repeal all or part of “Obamacare.” It was a belligerent but futile gesture to exhibit once again their contempt for that Black man that sits in the White House, whom they feel can do absolutely nothing right or praiseworthy.

Many Republicans really believed the assurances from “the bubble” of Faux News and the Limboids that the Affordable Care Act was unconstitutional, and they were really surprised when the chief justice appointed by George Bush, Jr. himself was the swing vote.

(When I was a kid, there were billboards around for years demanding, “Impeach Earl Warren,” the former Republican governor of California appointed chief justice by President Eisenhower. I wonder if we’ll soon see “Impeach John Roberts” versions.)

“Repeal and Replace” has been the recent mantra of the GOP. One wonders what they hope to replace the ACA with.

I’m a C-SPAN junkie. More precisely, I have C-SPAN2, which covers the Senate, droning on in the background much of the time. The grammar, rhetoric, and logic of the Senate are of a higher quality than those found in the House, although sometimes not by much. Nonetheless, I can only take so much of Louie Gohmert and Michelle Bachmann.

Anyway, for almost a year I watched and listened as many congressional committee sessions and interminable floor debates led up to the moment when the Democrats “sneaked” the ACA through Congress. I well remember the Republican talking points, because there were so few of them and they repeated them endlessly.

One of the only substantial proposals that I can recall was to permit interstate sales of health insurance. This was a “lowest common denominator” approach, which would allow a person in one state to buy an approved health insurance policy from any other state. No federal regulation was included, just the chance to find the state with the least restrictive insurance commissioner.

As I recall, there was also a proposal to allow corporations to join with each other to create more stable pools, and, of course, a call for some sort of individual medical savings accounts. The latter would certainly be appreciated by the banking industry, which contributes substantially to candidates and incumbents. But, I have to admit, there was some substance there.

Everything else was what used to be called a “red herring.” If the hounds are after you, drag a dead fish across your trail and throw it in the bushes, and maybe they’ll get sidetracked. That was the GOP strategy.

They spoke at great length about abortion and illegal immigration, two of their favorite topics that are always a hit with their base. The ACA didn’t give new rights to undocumented residents or expand abortion rights, but they endlessly warned that it would.

And then there was their spirited defense of the Medicare Part C program. This was a big giveaway to the insurance companies to entice them to offer policies that “wrapped around” Medicare and covered co-pays and provided extra health services. Under the ACA, this program would be cut by about half a billion dollars. That it was a bloated and inefficient program that they had all probably voted against was not mentioned.

I don’t recall them calling the “individual mandate” unconstitutional at the time, but of course that became the new mantra as soon as the measure was passed. It wasn’t mentioned that the concept had originated at the Heritage Foundation, a right-wing “think tank.” (Boy, there’s an oxymoron.)

And then there was the “death panel” issue, which had no basis in fact, and the dire warning that “the government will come between you and your doctor.” And that was it. If I’ve missed something substantive, please let me know.

There was nothing that dealt directly with the real problems of health care in our for-profit system. It wasn’t mentioned that the insurance companies routinely came between patients and their doctors and made decisions without any regulation. There was no mention of pre-existing conditions and lifetime limits and all the other excesses of the industry. It wasn’t brought up that the federal government runs its Medicare and Medicaid programs for one or two percent of the cost while insurance companies were raking in ten and even twenty percent. There was no solution proposed for the rampant use of emergency room services, at public expense, by the millions of people who couldn’t afford health insurance. There was nothing to stop the health care industry from gobbling a bigger and bigger proportion of our resources. And they didn’t have a fix for the “doughnut hole” in Medicare Part D, the prescription drug benefit, that they had created during Bush-Jr. and didn’t pay for.

So now they want to “repeal and replace” the ACA. From what the Republicans say, I take that to mean a return to the status quo ante. That would be a disaster.

Let’s face it, the Republicans don’t want a federal health insurance program. They didn’t want Medicaid either, or Medicare, or Social Security, for that matter. They really hated Brown vs. Board of Education, which is why they wanted to impeach Earl Warren, and, of course, Roe vs. Wade. If given their way, they would dismantle them all and replace them, if at all, with programs that benefit the banks and corporations, and the bigots and xenophobes, that they represent.

But, unless they can keep their majority in the House, get a filibuster-proof supermajority in the Senate, and replace the president in November, we will have this new program, long overdue, to deal with one of the major problems in our society. Is it perfect? No. Is it a step in the right direction? Yes. Is it the right thing to do? It is.

So, my suggestion is: Don’t repeal and replace the ACA. Reject and replace the Republicans.

Wednesday, January 11, 2012

Two Down, Forty-eight to Go

Who Won the GOP Primary in New Hampshire?

            With almost 40% of the vote, Mitt Romney was the obvious winner in Tuesday’s New Hampshire primary. Ron Paul was a strong second, with about 23%. John Huntsman, who worked longest and hardest in the state, was in third place, with almost 17%.
            Newt Gingrich and Rick Santorum were the losers, despite the spin they’ve tried to give their numbers. Each received less than ten percent.
            Gingrich has been dead in the water for months, but nobody has had the guts to tell him, and he wouldn’t listen anyway. He can be counted on, however, to continue throwing monkey wrenches into Mitt’s machinery while making outrageous statements that remind the electorate why he was sent off in disgrace not so many years ago.
            Santorum, the second-place winner in Iowa, demonstrated that his evangelical Christian, Islamophobic message doesn’t play well outside the Bible Belt. Thank God. He’ll probably do better in South Carolina, but he’s dead meat in the majority of states.
            So, the big winner? Once again, the Democrats. Mitt Romney is a caricature of a Republican superhero in mufti. Mild-mannered Mitt Romney, who changes into Conservativeman at night, if he can find a phone booth. All would be well in Smallville if it weren’t for that evil villain, Ron Paul, who keeps spreading deadly Libertarianite around the country and siphoning off about a quarter of Republican voters.
            Romney is the ideal GOP candidate this year, at least from the Democratic point of view. He’s boring and superficial and unprincipled. He not only repeats the mantras of corporate excess, he was intimately involved in some of its ugliest episodes. You can find sound bites of Romney espousing just about any side of any issue, sometimes in the same speech. He is anathema to the Bachmann-Santorum evangelistic faction because of some of his previous stands on issues and because he is a Mormon. It appears that faction will not have a viable candidate this year, and its members could stay home in droves.
            And Paul is the ideal spoiler for Romney’s campaign. The Republican Party is going to have to bend over backwards to keep its growing libertarian faction in the fold. Paul is not likely to beat Romney, but he and his supporters are going to want some major concessions. The rest of the party isn’t going to want to move toward personal liberty and military isolationism, but if it doesn’t, those libertarians are going to look elsewhere.
            I don’t think Ron Paul will abandon the GOP this time. Don’t forget that his son, Rand, is now a Republican senator. He probably won’t seek the Libertarian Party nomination, but whoever gets it is likely to attract Republican votes if it is felt that the GOP has let down its libertarian cohort.
            And what about Huntsman? I don’t think he’s in danger of winning the nomination, but his healthy showing puts him higher up the potential running-mate ladder. The only problem is that he, too, is a Mormon White guy (of course they’re all White guys now), and if Romney were the nominee, Huntsman wouldn’t add much to his constituency. I do think Huntsman is smarter and more consistent, but his chances are mighty slim.
            Romney’s slim margin of victory in Iowa, bolstered by this healthy win in New Hampshire, will ensure that he has lots of money as he moves to the other primaries. It will also reduce the amount of money the other candidates can hope to raise. He hasn’t gotten the nomination sewed up, but it’s going to be harder and harder for the others to catch up with him.
            As part of its coverage of the New Hampshire primary, C-SPAN aired some of the post-New Hampshire-primary speeches of the past, including Barack Obama’s from four years ago. It was that speech that convinced me to support him then, and I have gladly done so since. I put an “Obama 2012” bumper sticker on my car this week and I look forward to helping the president win a second term.
            I will also work to elect Democrats to Congress. I am particularly hopeful that many of the Tea Party extremists will be one-term wonders. I have expected this to be a very difficult political year, but as it unfolds I am delighted how far the Republicans are willing to go to ensure a Democratic victory. The new majority in the House has incurred the disgust of all but the hardest-core Republicans. The endless filibusters of Senate Republicans are as welcome as a string of pointless practical jokes. The electorate is tired of hearing that GOP senators have once again short-sheeted their colleagues or given them hot-feet or wedgies.
            Every time that President Obama speaks I feel pride that I helped elect him. He has great personal integrity, a quality sorely lacking in the other party. Off the top of my head, I can think of one Republican, just one, who has been consistent with his own values. That’s Ron Paul. I don’t agree with him on many issues, but I salute him for being true to his own convictions.
            I hope you and the rest of the electorate are sick and tired, as I am, of the hypocrisy and fear-mongering and barely-concealed racism that have characterized the GOP since that night four years ago when it became apparent that yes, we could. And we did. And we need to do it again.
            There is a place for a rational Republican Party. We used to have one and I really miss it. The wingnuts and religious zealots who have taken it over may lose it again if they keep fighting among themselves. I sincerely hope they do.

Wednesday, January 4, 2012

Who Won the Iowa GOP Caucus

It's Not Who You Think It Is

            Mitt Romney got 24.6%, Rick Santorum got 24.5% (just eight fewer votes), and Ron Paul got 21.4%. Who won in Iowa?
            Barack Obama, that’s who, by several lengths, and the Republican Party suffered the greatest loss. Here’s why:
            The three top candidates represent three distinct segments of the GOP. St. Ronald Reagan was able to form a coalition of all three that continued through the Bush, Jr. tenure, but it appears that the center can no longer hold. Each candidate has avid supporters who would find one or both of the other candidates utterly unacceptable as the party’s nominee, and that plays to the advantage of the Democratic Party and President Obama.
            You might think the division is between the Tea Party and old guard Republicans, but both of them are rent asunder by this three-way split.
            Gov. Romney represents the true core of the Republican Party, the same bunch of tycoons and magnates and power brokers who have controlled it since the 1890s: the people who have wealth and want to protect it. Romney is the corporate candidate and represents the One Percenters who have inspired so many people to camp out and play drums.
            Those who make up this wing of the party want less government intervention in the activities of business. They work to maintain high military spending and push to privatize governmental functions. These are bottom-line people and they measure their success in dollars. They brought us the current recession and they’re quite prepared to do it again.
            These people are most likely to classify other people on the basis of their net worth, so they aren’t necessarily intolerant of those with different cultures, religions, and life-styles. But there aren’t that many tycoons and magnates and power brokers around, so to win national elections they have to associate with people who do care about those things.
            St. Reagan put that coalition together, and since then the rich and the “cultural conservatives” have enjoyed a rewarding confederation.
            Former Sen. Santorum represents that other group, the “cultural conservatives.” These people care most about abortion, homosexuality, immigration, marijuana, ethnic distinctions, home schooling, prayer in school, and, obscurely, the threat of “Sharia Law.” Among them are xenophobes who long for some antebellum utopia that never existed. The parts of their lives they thought were most stable have been skewed and stretched by technology and rapidly-changing social mores. They see people who look strange and can’t speak English very well in their stores and on their sidewalks. Many worry that the United States is no longer the “Christian country” they thought it was, and there are some who are deeply offended that their country elected a Negro as its president.
            And there are a lot of them. For decades they have helped the corporate wing of the party steer its way to increasing wealth. All the wealthy had to do was vote with the cultural conservatives on abortion and the definition of marriage and all those other issues. The favor was returned with support for lower taxes, less regulation, and a big military.
            But what does a “Cultural” with a moderate income really care about the tax rate on estates over $5 million? And does the “Corporate” really care if his local county clerk issues a marriage license to John Doe and Joe Blow?
            A lot of money has been spent to keep these two groups together. The Koch Brothers spent millions to embed the phrase “death tax” in every discussion of the estate tax. The Heritage Foundation and its fellows craft the party line, which includes both the Cultural and Corporate wish lists. Subsidized publishers produce an astonishing number of conservative books each year. The Faux News-AM radio echo chamber keeps everyone in line, castigating those who stray.
            The coalition has persisted for years, but this is a three-way split, and the third faction’s wish list conflicts with the other two.
            Rep. Ron Paul is from that third group, and he didn’t come out of nowhere. He’s been saying exactly the same things for many years. Nobody can accuse him of waffling.
            There has always been a strong libertarian presence in our country: “Don’t Tread on Me.” “Liberty or Death.” Or, the motto on the state flag of Iowa: “Our Liberties We Prize and Our Rights We Will Maintain.” Or, a sign that was ubiquitous when I was young: “We Reserve the Right to Refuse Service to Anyone.”
            Ron Paul and his Libertarian supporters want smaller government, just as the Corporates and Culturals say they do, but they mean really small. They not only want to end the war in Afghanistan, they want to dismantle most of our military installations around the world. Not only does this infuriate the Corporates, it’s consistent with the views of many on the Democratic side. Faux News, the Corporate mouthpiece, has done its level best to ignore Rep. Paul or, failing, to denigrate him.
            But that’s not all. The Libertarians infuriate the Culturals, too. They don’t care if someone is smoking pot or sleeping with the “wrong” person. They are for liberty, and by that they mean do what you want but don’t expect the government to support you if your action results in injury or destitution. Once again, there are many on the Democratic side who agree.
            I think it took the recession to make the Libertarian message resonate as it has. Our citizens bump up against the government every day, in the form of parking meters and MVD lines and seat belt laws and zoning ordinances and airport security. If they start businesses they are appalled by the volume of regulations and licenses and reporting requirements. They don’t understand why the bailout of the banks was allowed to occur. And they feel they pay too much in taxes.
            Paul’s campaign is within the Republican arena. He almost certainly won’t win, but he commands enough of a presence to jam the machinery. His participation has revealed the underlying inconsistencies of the Corporate-Cultural union.
            If he wins the nomination, there will be a significant number of Democrats who vote for him. But there will be a huge number of Republicans who will vote against him (perhaps even a few for Obama), or not vote.
            If he loses, many of his supporters will drift to the Democrats or not vote at all. And this is true of the other two factions, as well. It might not be Romney-Santorum-Paul, but the three factions will still be in play, and the losers are not going to be happy. The Corporates chose Romney over Gingrich, but they’d prefer Newt to any of the others. It’s the same with Santorum and Bachmann on the Cultural side.
            The eventual winner of the GOP nomination will be bloodied and winded, and those who voted for the other two will be disappointed and apathetic.
            At least I hope so.