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Thursday, June 28, 2012

Winners and Losers: The Affordable Care Act

Bet you didn’t see that decision coming, did you?

I know I didn’t.

Over the last couple of weeks a number of readers have written asking me why I haven’t been speculating on the (then) pending Supreme Court decision regarding the Affordable Care Act.

I haven’t speculated on the pending decision because guessing which way the Supreme Court will jump, especially given the makeup of this particular bench, is a sucker’s bet.

And Today’s decision on Obamacare is a pretty good example of that.

Look at the last two weeks, it’s as if the Supreme Court is suffering from some kind of identity disorder:

First a win for traditionally conservative interests, i.e. Wall Street, SuperPACS, the wealthy with bag loads of money to throw against whatever political cause they feel like, in other words pretty much everybody other than the individual American that this country is supposed to be about.  Now to be completely honest, the decision I’m talking about is a win for Unions as well, but by definition Unions look out for what’s best for their own interests as organizations, not the interests of the individual.  The decision we’re talking about here is the court’s rejection of corporate spending limits for political campaign contributions. Despite two years of having to live with the obvious threat to nearly every aspect of individual the liberty the United States was founded to protect and nurture, the Supreme Court of the United States declined to reconsider its 2010 Citizens United ruling. The vote was split along party lines with the four liberals dissenting from the decision. Justice Anthony Kennedy writing for the majority declared that independent expenditures by corporations "do not give rise to corruption or the appearance of corruption." Unlimited money doesn’t give rise to corruption? Unlimited and anonymous money doesn’t give rise to the appearance of corruption? Seriously? The overt and obvious signs of corruption in our political system resulting from unfettered corporate money are all around us right now, in every direction you care to look, in every level of the process from local to state to federal elections. Whether there is real corruption or not, the vast majority of Americans certainly believe that there is – come here to Alaska and ask us if we think Juneau has been corrupted by oil money. Look at Grover Norquist’s direct control over more than half of the elected legislature. What gives him more right, more power, more influence than any other citizen? Money, pure and simple. Ditto the Koch brothers. Ditto Rupert Murdock and Donald Trump and every other mover and shaker.  If you think your vote is equal to theirs, you’re an idiot. But five members of the court appear to be utterly oblivious to this fact and equally blind to the negative impact it is having on the citizenry’s confidence in their government, not to mention its direct contribution to the growing bitter partisan divide in this country. A better argument for justices getting out of their ivory tower every once in a while there never was. But, for now, corporations and PACS and unions will remain people, rich supremely powerful people whose rights and votes and influence far, far, far outweigh that of any other ten thousand individual citizens combined. The Court’s refusal to reconsider the Citizens United decision effectively fractions America into castes, everybody has one vote but all votes are not equal and not all votes count. The results of this inequality are readily apparent in the current election cycle and it’s only going to get worse. In fact, it’s getting worse even as we speak. An obvious sign is that like the nightly body counts during the Vietnam War, the media now obsessively broadcasts daily updates on political fundraising totals, pitting the size of one side’s cash pot against the other in a measure of political value and popularity. America has been teetering on the verge of a de facto plutocracy almost from the beginning, but Citizens United made it official in name as well as deed and removed any limits on it. Corporations and big money interests, both domestic and foreign funded, don’t even have to pretend anymore. People are wound up about the Affordable Care Act, but the Citizens United decision is going to have a far more detrimental and far longer lasting impact on their basic freedoms than any provision in Obamacare and has already reshaped our nation in a manner that bodes unwell for the average citizen. A thousand years hence, when history looks back on the ruins of the great experiment, Citizen’s United will be where scholars draw the line and say “here, right here, was when the republic began to die.” 

But then, in a sort of win for the liberals, the Supreme Court struck down automatic life sentences without the possibility of parole for juvenile offenders. Again in a five to four decision (Kagan, Kennedy, Ginsburg, Breyer, and Sotomayor vs Roberts, Scalia, Thomas, and Alito), the court ruled that it is unconstitutional for states to impose mandatory life in prison sentences for juveniles convicted of first degree murder. They didn’t say judges couldn’t impose such a sentence, only that they didn’t have to. “We hold that mandatory life without parole for those under the age of 18 at the time of their crimes violates the Eighth Amendment's prohibition on 'cruel and unusual punishment,"' said Justice Elena Kagan, who wrote the opinion for the majority.

On the same day the court acknowledged that even juvenile murderers have some basic civil rights, they announced that people of color don’t – at least in Arizona. Sort of. Maybe. Or maybe not. The court struck down three key parts of the Arizona immigration law: 1) the provision making it a crime for an illegal to work or even seek work in Arizona, 2) the provision which authorized state and local police to arrest people without a warrant if the officer felt the person in question might be an illegal, and 3) the provision which would have required Jews immigrants to register with the government and wear a Star of David on their clothing. The liberal media trumpeted the decision as “Victory for Obama, SCOTUS strikes down key provisions of Arizona Immigration law!”  However, conservative outlets phrased it as “Loss for Obama, SCOTUS upholds key provision of Arizona Immigration Law!” because the Court left intact the part of the law that requires police officers to verify the citizenship status of anyone they stop for “legitimate” reasons if they suspect that person might be an illegal.  Supporters claim this won’t lead to racial profiling and they’re right, it won’t – because Arizona law enforcement is already profiling people they deem suspicious, you can’t be led to something if you’re already there. Doh.

And then in a decision that flabbergasted military veterans such as yours truly, SCOTUS handed a victory to lying shitbags everywhere by striking down the Stolen Valor Act.  Anybody may now legally claim to be a SEAL, an Airborne Ranger, a Medal of Honor recipient, or any other flavor of veteran they like to whatever fraudulent end they desire even if they’ve never served a day in the military, let alone seen combat.  I expect that every politician in congress will now suddenly remember that they are a highly decorated war hero instead of the craven recipient of five draft deferments, but I digress.  I, like many other veterans, cannot begin to describe how utterly disgusted I am by this blatant ass rape of the First Amendment but I’m not surprised. After all it’s perfectly legal for Fox News to make up whatever nonsense they like and claim that it’s “Fair and Balanced” so it wasn’t any great shock when SCOTUS decided that identity theft is ok, so long as it’s a only a military member’s honor and integrity you’re stealing, you know the only goddamned things that really matter to us. But hey, on the bright side so far as I know, it’s still illegal to pretend to be a judge.

If you’ve been keeping track that’s one and a half for conservatives, one and half for liberals, and one for lying shitbags of either persuasion.

So, yeah, as I said, attempting to guess which way this bizarrely schizophrenic court would rule on the Affordable Care Act wasn’t something I was willing to engage in.

Now that the decision has been handed down, I’ll say quite frankly that I thought that the best the President could hope for would be that at least a few of the more popular provisions of the act would be upheld.  Worst case for Obama, of course, would have been for the entire thing to have been struck down.  Frankly I was prepared for the later.

And I think today’s ruling vindicates my caution.

Because I don’t think anybody saw this decision coming.

Nearly every prediction by nearly every pompously overinflated self-important pundit, prognosticator, politician, and prominent personality was incorrect. Of course, they’re all busy right now explaining how they didn’t really say what they clearly said and that they totally knew that the law would be upheld (of course, of course) but it’s still unconstitutional and socialist and spawned from Hitler’s ass sweat.

Both FoxNews and CNN were so eager to be the first trumpeting Obama’s supposed failure that they blundered full speed straight into a Dewey Defeats Truman moment like the Titanic plowing full steam into the iceberg. Within seconds of the announcement CNN’s on-screen news ticker blared, “BREAKING NEWS: INDIVIDUAL MANDATE STRUCK DOWN! Supreme Court finds measure unconstitutional.”  At the same time Fox News’ ticker was gleefully broadcasting, “SUPREME COURT FINDS HEALTHCARE INIDIVIDUAL MANDATE UNCONSTITUTIONAL.”  CNN later apologized and issued a mea culpa. Fox News took a different tack, Fox’s executive vice president issued a statement explaining how they weren’t actually wrong, just reporting the “news” as it broke, so it was really their viewers’ fault for not understanding the nature of the situation, and besides other networks sucked even more, so there – or words to that effect.

Predictably Sarah Palin clenched up her sinewy red, white, and blue butt cheeks and squeezed out a star spangled tweet, “He said it wasn’t a tax. Obama lies; freedom dies.”  Because, as I’m sure you know, freedom and liberty can only survive when a significant fraction of the population are uninsured – I think Ben Franklin or John Wayne said that. Or maybe it was Grover Norquist.  Question, if freedom dies when a president lies, how is it that freedom managed to survive Richard Nixon and Ronald Reagan and Bill Clinton amongst others of recent note? Hello? Is this thing on? But I digress.

Following Palin’s lead, conservatives took to Twitter to express their outrage, making the SCOTUS ruling the top trending topic within minutes of its issue. In accordance with their stated principle of “America, love it or leave it,” many of them declared their intention to leave for a land where socialist healthcare won’t be forced down their throats. Canada. 

Yes, you may go ahead and make the facepalm. I’ll wait.

The usual pundits have designated Chief Justice Roberts as a traitor and enemy of America. Glenn Beck called Roberts a coward (ironically, Beck usually sings Roberts’ praises. No greater wrath than sweaty man-love scorned, I guess). Beck is offering t-shirts for sale on his website with Roberts’ face printed over the word “Coward” – because apparently that’s what you call a guy who stands up to his entire party and ideology.  Frankly, I’m not sure that Beck understands what the word actually means, but then I’m not sure Beck understands what a lot of words mean.

When Karl Rove wrote his memoir, Courage and Consequence, he devoted an entire chapter to how he, the only non-lawyer in the room, had the keen intellect and the penetrating insight into human nature to select John Roberts from other, more liberal, candidates and promote him to President George W. Bush for nomination to the bench.  Be sure to send Karl and George a thank you note, won’t you?

Louisiana’s Governor, Bobby “Jeff Davis” Jindal, declared rebellion, “We’re not going to start implementing Obamacare. We’re committed to working to elect Governor Romney to repeal Obamacare. Here in Louisiana we have not applied for the grants, we have not accepted many of these dollars, we’re not implementing the exchanges.” Because, really, screw the poor and uninsured – in both categories of which, poor and uninsured, Louisiana leads most of the nation.  My own state governor, Sean “Little Sarah” Parnell, here in Alaska – a state with a huge percentage of uninsured – is considering a similar course.  So are the other red states. Funny, isn’t it? How quickly those folks who claim to be the only true Americans, who declare their belief in the sacred institution of America, who claim to love the American system best of all, immediately turn their back on it and start talking about rebellion and secession and shooting their neighbors when they don’t get their way?

Within minutes of the announcement, Mitt Romney was on the air, his voice dull and defeated, bitter at the unfairness of it all, sounding for all the world like Tricky Dick declaring that we wouldn’t have Richard Nixon to kick around any more. Mitt proclaimed himself America’s only hope.  Elect me, he promised, and my first priority will be to repeal Obamacare – not fix the economy or create jobs or all the other stuff he’s been talking about, no his first priority will be to repeal Obamacare and replace it with something else, presumably Romneycare. Oh, the irony, but I digress again.  House and Senate Republicans echoed Virginia Governor Bob McDonnell, “…the priority right now is to elect a new president and a new senate so this law can be repealed.” Really? That’s the priority? When the bridges fall down, when the poor go hungry, while Colorado burns and the housing market flounders and the jobless prowl the streets of America like emaciated zombies, and hundreds of thousands of shattered veterans wonder if they can really come home again, repealing the Affordable Care Act and replacing it with something that looks pretty much exactly the same after a lengthy and protracted partisan battle is the priority? Really?

As they say on Mythbusters, well there’s your problem.

I was in traffic when the Court’s decision was announced, and you could certainly tell who was who. Liberals were all smiling and waving happily at each other, conservatives were beating their steering wheels and screaming in rage at the radio.

And that’s the real problem, right there.

Conservatives haven’t got a damned thing to rage about. Period. This law, like it or not, was written by the Legislature and passed by a majority of the House and Senate – and conservatives could have gotten involved in the process at any point, instead they acted like spoiled rotten petulant brats and refused. If conservative politicians don’t like the Affordable Care Act, they should have rolled up their sleeves and done their fucking jobs – that’s what they get paid for. If conservative citizens don’t like the Affordable Care Act, they should have demanded that their representatives get involved in the process instead screaming about Nazis and Kenyans and other such idiotic make believe bogymen.  The Act was signed into law by the Executive. It was challenged at all levels of the Judicial Branch – all the way up to the Supreme Court. This is how the system works. You don’t get to cherry pick the parts of America that you like and discard the rest. For better or worse, this is now the law of the land. Now it is certainly the right of Conservatives to work towards repeal, but here’s the thing so pay attention: the vast majority of Americans – something approaching more than eighty percent – want most of the things in the Affordable Care Act.  They want affordable healthcare. They want to be insured. They want their kids to be able to stay on their coverage until they can stand on their own. They want insurance companies brought to heel and prevented from dropping coverage for arbitrary reasons or condemning them to suffer and die for pre-existing conditions. They just don’t want Obama’s name on it. They’d rather watch their children die of untreated cancer than reform healthcare if Obama gets credit for it.  These are the same perverse idiots who decry freeloaders and the lazy shiftless poor getting access to “free” healthcare on the public dime and who constantly talk about forcing the poor and uninsured to take responsibility for themselves, but then start screaming about Nazis when the government passes a law that will make those same people buy their own health insurance. What they really want is for the government to tell everybody else what to do, but not them. 

Liberals haven’t got a damned thing to gloat about. Period.  Sure President Obama has a right to feel vindicated and democrats have a right to be happy for him, but this law is a huge infected sucking chest wound. It’s a piece of shit. It’s a kluge. It’s a mess.  Conservatives are right about that. As it stands it’s not going to make healthcare affordable. It’s going to make a lot of insurance companies unbelievably wealthy – and if you own stock in the insurance industry then you’ve already seen the surge in your portfolio, drinks my friend, are on you – but people who are barely hanging on have every right to be concerned about having to buy insurance or face a penalty on their tax return. It doesn’t matter whether you call it a tax or a fine or whatever, a lot of folks simply cannot afford even twenty bucks more in expenditures a month. Now supposedly there’s going to be financial help for these people, but they don’t know that. The economy is in the shitter, it’s an election year, Europe is teetering on the brink of collapse – people are scared and they’re frightened about the future.  Now they have to worry about how they’re going to pay for insurance. Sure it supposed to be affordable, sure the government is supposed to help and where have we heard that before and why should anybody believe it now? The Administration needs to do a hell of a lot better job addressing these concerns and they need to do it right now. 

Here’s the rest of it: The Supreme Court, including Justice Roberts, didn’t say the Affordable Healthcare Act was a good law. They didn’t say it was a bad law. Only that it was, mostly, constitutional. 

What it is, is a starting point.

The question of its legality has been resolved.

Those opposed to this law protest that the government has taken away their right to choose. Bullshit.

You have choices.

People who don’t have or can’t get medical coverage are the ones who don’t have choices. And those of us who have to pay for their visit to the emergency room every time their kid has a sore throat don’t have choices.

This law gives people choices.

I didn’t say they were great choices, but you didn’t have any good choices to begin with. Sometimes that’s just how life is. But what you need to bear in mind here is this: you, as an American, your shittiest choices are still a hell of a lot better than about what seventy percent of the rest of the world is faced with every single day – maybe you ought to go see for yourself sometime. Be prepared though, unless you’re a complete dick it’ll change how you see things, it sure did for me.  Regardless, you have choices. Good or bad, that’s the way it is, stop whining and deal with it.

And we, as a nation? We have two choices.

We can agree that healthcare is a basic human right for all Americans. We can agree that in a country as advanced and as rich and as exceptional as ours, that it is immoral and unethical and goddamned unAmerican to allow forty million of our fellow citizens to go without. 

Or Not.

Those are the choices.

If you believe the later option is the correct one, then stop your goddamned raging and bitching and complaining, vote for Ron Paul and let them die.  And you can live with the consequences, all of them.

If you’re split between the two choice and you think there ought to be some kind of overhaul but you just can’t stand the thought of liberals getting credit for it, quit bitching and get out there and vote for Mitt Romney, then you can spend the next four years refighting this same exact battle over the same exact ground until you get the same exact thing except you’ll be calling it Romneycare, The Do-Over. All it will cost you is another couple of hundred billion and four more years.

Or if you believe the first option is the correct one without qualification, then stop your goddamned gloating, vote for Barack Obama, and demand that the Affordable Care Act be overhauled until we get it right.

It is long past time to stop the talk of secession and rebellion and treason and cowardice and hatred and all the rest of it.  It’s time for our government, all of it, to start living up to its responsibilities. It’s time for citizens, all of us, to stop acting like a brainless mob and start living up to our role in the republic.

The one thing this country cannot afford, monetarily, politically, morally, is yet another vicious divide.

The truth of the matter that there are no winners and no losers in the Supreme Court’s ruling.

It’s simply a starting point, nothing more.

What comes next, good or bad, is up to us.

83 comments:

  1. Well put, Jim. Have to disagree with you on one point, however. You suggest that by not participating in the formulation of the healthcare bill, the Repubs weren't doing their jobs. But stonewalling IS their job. Making sure the Dark Lord can't get anything done, seeing that he is a one-termer was and is their stated goal.

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  2. Excellent post, as usual.

    I think you meant to write "secession" instead of "session" -- down near the bottom, where the paragraph starts "It's long past time..."

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    1. Actually, I did that twice. It's fixed

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    2. All right, now go make "faceplam" into "facepalm".

      Other than that (and your allergy to paragraphing), kudos on yet another home run, sir. In my Facebook profile, for "Politics", I entered "Stonekettle Station", and have never regretted it.

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    3. Fixed.

      And I was bitten by a feral paragraph as a child and to this day tend to avoid them.

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    4. Actually, I prefer "faceplam", it's so much more descriptive.

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    5. Just tring to find the best way to post commnents on the site.

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  3. ACA is a good first step, but that's all it is. Even after it is fully implemented in 2019 there will still be around 20 million Americans not covered by the act that Democrats are now gloating will give all Americans access to health care.

    In addition, the court allowed states to opt out of the Medicare expansion program, which was to provide health coverage for an estimated 19 million low income Americans. Without going into grinding math for a more a bit more accuracy, 26 states were in the challenge, and will likely opt out, so that's somewhere in the realm of 9.5 million Americans nationwide tossed under the bus by SCOTUS (or by Congress for doing a shitty job of writing the bill in the first place).

    Now getting the number of Americans not covered by health insurance down from ~50 million to around ~29.5 million is in its way laudable - but by any standard but that of government work it falls far short of being any sort of real success.

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    1. I think you tend to forget (on purpose?) that those states opting out are Republican controlled. So lets call a spade a spade the Republicans are throwing 9.5 million American under the bus.

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  4. The US Healthcare system needs even more reform than the Affordable Care Act provides. But is it a start. IMHO: the best part has been the decrease of for-profit healthcare insurance companies. Money spent for healthcare should go towards healthcare, not to someone's vacation home. It's batshit logic that thinks that everything we do as capitalists has to be for profit. Sometimes it's for the betterment of society. Still, that the Affordable Care Act was upheld is a good thing. I'm just waiting to see all the conservative pundits leave for Costa Rica or apologize like they promised 3 years ago. Granted, I am not holding my breath.

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  5. The question you should have been asking, Jim, is this: Cui bono? Who benefits? Once you ask that question, you realize that this Supreme Court *had* to figure out some way to render the health care mandate legal, because that mandate benefits the health insurance corporations. Same deal with the part of the law they *did* overturn, the part mandating expansion of Medicaid coverage... Medicaid isn't as much profit for corporations as instead forcing those people into the subsidized coverage pool to pay money to insurance companies.

    As for the Supremes saying lying is legal, once again, if they said lying *isn't* Constitutionally protected, then all of Congress is a criminal class since they're all lying liars or they wouldn't have gotten elected (since the *last* thing that the American electorate wants to hear is the *truth*). So clearly the political class is cui bono here -- if lying could be outlawed, the entire political class could be outlawed!

    Continue down the line. Who benefitted from the Arizona decision? Who benefitted from upholding Citizen's United? Continue on down the line, and you'll see that this court is probably the most corrupt since the days of President U.S. Grant, when the court routinely took bribes in exchange for decisions. About the only decision they made that I *can't* fit into that framework is the decision regarding juvenile offenders... probably because there wasn't enough money involved in that one to affect the decision. Otherwise, to figure out how the current court will rule on anything... Follow The Money!

    - Badtux the Corruption-smellin' Penguin

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  6. Just one minor correction -- the Court indicated that the Stolen Valor Act would have passed muster if there had been a requirement that the false statements regarding military service or honor were made for the purpose of some kind of material gain. The Act as written didn't have that additional requirement, and punished the lie regardless of its purpose. So under a proper Stolen Valor Act, a candidate for political office could not claim service or medals with impunity.

    I for one hope Congress makes this correction soon.

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    1. Concur, but as it stands right now, SCOTUS gave free rein to lie about your alleged military service and decorations for gain - as the case in California exemplifies.

      I agree with you though, I hope once Congress completes their current high priority goal of replacing Obama with his conservative copy and replacing Obamacare with Romenycare they'll find the time to make the proper constitutional corrections to the Stolen Valor Act. But I'm not holding my breath.

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    2. Jim, I want to agree with you on the stolen valor act, but that puts me on the side of Thomas and Scaliwag

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    3. Absolutely agree with you, Jim, on the Stolen Valor Act. And like a stopped clock, even Thomas and Scaliwag are occasionally right about something.

      Anyone who would represent him- or herself as a highly decorated veteran when he or she is not is indeed a lying shitbag. I hope the lying shitbags get what's coming to them. Karma's a bitch.

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  7. Standing ovation. Wolf whistles. Stomping of the feet.

    Exactly right. This is a beginning. We must all stop being divisive and work together to make health care for all a reality.

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  8. Again, I find myself nodding. I've long called it the "Parasite Protection Act" specifically because of how it's a serious boon to the health insurance parasites... organizations that exist to funnel money OUT of health care into their own pockets.

    Regardless of all of that, however, it's still much, much better than the alternative. And isn't that a frightening though?

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  9. Frightening THOUGHT. Seriously, keyboard, what's your problem? Or is it my fingers? Must investigate.

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  10. Yes, repeal Obamacare and replace it with Romneycare. Why? Romneycare included abortions. But let me pop popcorn first.

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    1. But isn't Romney against Romneycare these days?

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  11. Thank you. I've been trying to explain this to a few of my conservative and liberal friends, and they just stare at me as if I've leapt from the turnip truck, arms flapping. Now I'll just send them here.

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  12. "Conservatives haven’t got a damned thing to rage about. Period. This law, like it or not, was written by the Legislature and passed by a majority of the House and Senate – and conservatives could have gotten involved in the process at any point, instead they acted like spoiled rotten petulant brats and refused. If conservative politicians don’t like the Affordable Care Act, they should have rolled up their sleeves and done their fucking jobs – that’s what they get paid for. If conservative citizens don’t like the Affordable Care Act, they should have demanded that their representatives get involved in the process instead screaming about Nazis and Kenyans and other such idiotic make believe bogymen."

    Hell, if conservatives didn't like it, they shouldn't have written it.

    This is one of the biggest things that pisses me off about the whole fiasco: Republicans have railed on about how the ACA was pushed through, shoved down their throats, the Democrats didn't compromise, etc. But the ACA was the compromise: the ACA--and the much-loathed individual mandate--was modeled directly after a Heritage Foundation (a conservative think tank) proposed alternative to Clinton's healthcare reform proposals, a Heritage Foundation proposal that was largely implemented by a Republican governor (who, by an amazing coincidence, is now running for President). About the only reason any liberal put this turd up for consideration was because it seemed highly unlikely that the more efficient, cost-effective and fairer alternative progressive reform--single-payer healthcare or "Medicare for all"--would pass. So certain liberals, naively and almost sheeplike, basically said, "Okay, well, we need to fix this, so how about that idea you guys had? You'd support your own proposal, right, and something's better than nothing?"

    Not with President Obama's name on it. No way, no how.

    (cont.)

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  13. (cont.)

    "Liberals haven’t got a damned thing to grin about. Period. This law is a huge, giant, sucking chest wound. It’s a piece of shit. It’s a kluge. It’s a mess."

    Exactly. Almost exactly. Because I sure as shit ain't happy about the individual mandate or lining the pockets of the insurance companies, and I will say it again in case anyone visiting your blog doesn't get it, Jim: writing as a dyed-in-the-wool, bona-fide self-identified left-wing democratic socialist, I don't know of a single liberal who really likes the ACA on its own terms, including people who helped get it passed. Except: Joe Biden was right, it is a big fucking deal; I think our mutual friend JTS is fond of quoting the adage, "Don't let the perfect be the enemy of the good"--the ACA isn't even quite good, but it does mean that a lot of people who couldn't have gotten medical care will get it, it does mean that people who would have been rejected for insurance coverage for pre-existing conditions can't be, that the insurance companies can't back out of offering coverage to parents for their dependent young adult children (that provision was so popular, many insurance companies had announced they would honor it even if the ACA were struck down; now they have to), etc. It isn't a grin, but it is a grim sigh of relief.

    What may be more troubling to liberals--and less of a reason to smile than anything--is if the fallout from Roberts' opinion is to gut the Commerce Clause, which has essentially been the lynchpin for modern Federalism for--well, for most of the modern era. I was listening to an analyst on a podcast today saying she thought the opinion was too narrow to have any such effect, but Bush v. Gore was a "narrow" opinion that's been cited quite a few times now by lower courts despite SCOTUS' attempt to confine the decision to the facts of the 2000 election; which is predictable and what happens, and an example of how clueless the SCOTUS seems to be these days.

    I should add: for what it's worth, I haven't seen a whole lot of gloating amongst my tribe. Some brief celebration, yes, but also a whole lot of concern that President Romney would be likely to do everything he could to gut or neutralize the ACA, concern that so many people still don't seem to know what's in it, some anger and contempt at the bullshit of fucktards like Rand Paul who apparently missed "judicial review" in fifth-grade civics (here's a hint: if a bunch of people say something is Constitutional, and they happen to wear black robes to work every day and they work in a big marble-columned building in D.C. and their job description is "Justice" and there are five or more of them saying it, then it's Constitutional even when it isn't, and, yes, "just because they said so", end of line), etc. I imagine there probably are some folks rubbing someone's face in it--there always are--but I don't think it's that significant a number. I could be wrong.

    (cont.)

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    1. (cont.)

      One last point to tie together much of the above: it may be enough, for now, that the ACA lives to fight another day. Because while it's far from good, it's also as good as we seem to be capable of getting at this political moment. And if it cuts costs (as it should) and helps rein in the budget (as it should) and provides affordable care to many who wouldn't have it otherwise (as it should) and it doesn't bring down Western Civilization (seriously?), then that's when we can maybe take the next step in reform. Sure, I could write a better piece of legislation sitting on the crapper tonight, starting from scratch and looking at how every actually civilized country in the world takes care of its citizens, but you and I know it would be DOA as soon as it arrived in the relevant House subcommittee. Because 2010 left the House largely in thrall to the fucktards and ignoramuses.

      But if the ACA rides a couple of years, and does what it's supposed to? Maybe then we can look at evolving to the next step.

      (Sorry for length--too burned out to properly edit.)

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    2. Sorry for the length?

      Shit no, I was hoping you'd weigh in. You know I value your opinion on all things legal, you scum sucking liberal lawyer you.

      I don't know too many liberals who are out and out rejoicing over the ACA per se, but they are rejoicing that Obama "won." The glee is running a bit high in certain circles. That said, the victories are few and far between these days and you just can't help but feel a little joy when things go right for the president. I feel the same way myself, yesterday after the announcement I couldn't help tweeting: "I think we can all agree, the most significant takeaway from today's SCOTUS decision is this: Bawahaha, fuck you, Mitch McConnell!" Because really, fuck you, Mitch, you sanctimonious asshole.

      I do see a lot of folks commenting under ACA reports on liberal press sites who don't seem to quite grasp that this isn't over and that we're likely looking at opening yet another front on the Liberal/Conservative Abortion/Choice war. Which is the last goddamned thing we need.

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    3. yup, yup, yup Eric.lots of agreeing with you here, lots of stomach acid over the same things...
      thank you.
      Jim- I really, really want you to be wrong this about "this isn't over and that we're likely looking at opening yet another front on the Liberal/Conservative Abortion/Choice war. "
      I don't think you are. Bleah.
      Alaska Pi

      Delete
  14. Just one problem I have with your article, well maybe two:

    1) You imply that someone who cannot afford health insurance (he who is barely hanging on) will have to pay the penalty. This is not correct. In fact the government will assist in monetary support for a health care plan. But even if you decide not to have a plan, you won't be charged. And AND even if you ARE charged, you CAN avoid paying it without consequence.
    2) I think liberals have everything to smile about here. Of course the ACA needs some work, it is by no means the final word, but there would be no chance at all to accomplish that if it was struck down, even partially. This is a HUGE win for liberals. It has taken the wind right out of the hate Obamacare sails, as far as Independents go. The ones who hate Obamacare will always hate it. The ones who simply say they don't like it because they've been brainwashed to believe "Obamacare" is bad, but as you noted above, like everything that's in it except the part where they have to pay for it, can still be reached.

    Democrats now have a way to win more than they did before, because now the clock is reset on the messaging. It's NOT unconstitutional, that ship has sailed. The Democrats have to get out there and push the good qualities of the ACA, rather than railing against it as you suggest. Any admission of a fault in the law will be seized upon to great effect so that the whole thing can be torn down. There is no middle ground on this. It HAS to be supported and pushed as a good plan. Congress can spend time working to fix the parts of it that need minor fixing once they have enough non-crazy people on BOTH sides of the aisle. And then they can push for single payer/Medicare for all. (Actually, they can push for Medicare for all NOW, and they might even get more conservatives to start rushing to the left to support Obamacare so that doesn't happen. It would be a nice change)

    Bottom line is - this IS a win. All that talk about not spiking the football if it's overturned? That was BS. They surely would have. FOREVER. They would have used it as a reason to declare that Obama really does wipe his ass with the Constitution. But instead, they have to instead argue that it's just plain BAD, which is more of an uphill battle without their 3 year long argument about how unconstitutional it was.

    There's plenty more to say but there is every reason to believe this is a huge win. It doesn't guarantee victory in 2012, mind you, but it is either a help, or zero-sum. Let NONE of this be seen as so confident that I am not going to vote. Because you bet your sweet ass I'm going to vote - Obama 2012.

    ReplyDelete
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    1. You imply that someone who cannot afford health insurance (he who is barely hanging on) will have to pay the penalty. This is not correct. In fact the government will assist in monetary support for a health care plan. But even if you decide not to have a plan, you won't be charged. And AND even if you ARE charged, you CAN avoid paying it without consequence.

      Absolutely correct, but unfortunately a lot of folks don't understand this. Much of the chatter I hear this morning is about how Obama is going to force them to chose between feeding their kids and healthcare. They are afraid, very much so - the fact that their fear is based on false information doesn't make them any less afraid. Which is exactly what I meant when I said the administration needs to do a much better job of explaining the ACA and countering the public's fear - and countering those who are engaged in a willful disinformation campaign designed to scare these people silly. I should have probably phrased the paragraph better, I'll provide an update as soon as I get a chance. Thanks for pointing that out.

      Democrats are certainly entitled to smile, but gloating is bad form. And it is certainly a win for Obama and he's entitled to feel justly vindicated, I certainly would.

      Nevertheless, the law is a piece of shit and needs immediate attention - which is what Congress should be attending to instead of digging the partisan divide deeper. The problem is that about half the legislature simply cannot stand anything that appears to give Obama a win and they will make us all suffer for it - and by that standard we all lose. Again.

      Delete
    2. I am not seeing much partisan divide coming from the left on this. They are smiling, but I don't see much spiking. A lot of what I see at least in actual (not in classic misunderstood terms) liberal media is the law being talked about and explained. Sometimes the people are even asking each other questions about the law they never thought of before and remain unanswered for a lot of people.

      Even my coworkers (I guess figuring I'm the most knowledgeable on this) are asking me questions about it I don't have an answer for, but the kicker is no one is doing that to "gotcha," they're doing it because they're genuinely curious now! I can see a great opportunity here to get on top of the message.

      Now I could be wrong about the partisan divide part, in terms of making it deeper. But I am not seeing it from the left. I am CERTAINLY seeing it from the right, but it's not really new, so I don't see it as being very effective at being more divisive than it already was. I think we've pretty much nuked the entire political landscape already.

      Aside from that there really is no reaching the right at this time, and possibly not until after the election, if at all. They are pretty bound and determined to harumph at anything the left supports, with a seeming intent on getting the left to GO AWAY rather than just agree with them, so they can just have total control and THEN they'll be reasonable? I don't think there's any point in reaching across that table. There are a few things that the guys who have been there a while can still hammer out, as we've seen recently. So they can do that, and Democrats can keep pushing their message in the reasonable and calm manner we've seen while the right continues to meltdown. They'll either start to see they need to calm down, or they won't and will instead continue to lose in the long term.

      In essence, we aren't going to have the ACA addressed until after November, and if the election predictions that I find reliable are correct as they usually are, we're going to have to wait to see how 2014 elections turn out before that can be addressed in anything other than "REPEAL REPEAL!" The only 2 ways to fix the ACA is going to be if the Democrats get a decisive win over the Republicans, so much so that even their screaming will do no good, OR if the Republicans suddenly stop being crazy. And I find either eventuality unlikely in the near future.

      Delete
    3. However, as far as my OWN spiking? I am so not apologizing for it and I won't stop until it bores me to continue. This constant drumbeat about how evil Obamacare is from before it was even law, from before I even knew they were fighting seriously over this, from before I even moved back to my home city 3 years ago... Frankly as far as I am concerned, personally, everyone who ever thought of this thing is evil and unconstitutional deserves to have their asses handed to them over this. And I realize that is pure emotion but seriously, screw them. You don't get to pound 3 years worth of vitriol in my head, only for me to sit back and take the high road immediately after being vindicated over my own stances.

      Delete
    4. ou imply that someone who cannot afford health insurance (he who is barely hanging on) will have to pay the penalty. This is not correct.

      Absolutely correct, but unfortunately a lot of folks don't understand this. Much of the chatter I hear this morning is about how Obama is going to force them to chose between feeding their kids and healthcare. They are afraid, very much so - the fact that their fear is based on false information doesn't make them any less afraid.

      Nor does it make their sources any more reputable. Remember, OBAMA'S COMING TO TAKE ALL YOUR GUNS AND AMMUNITION!!!!!1111Ffour WOE!

      The gun stores around here are *perpetually* sold out of ammunition unless you're they're the day it comes in on the truck, because of that. Damned near four years into his Presidency.

      The thing that really, REALLY scares me is, some of the things these people are saying, if they were saying them about ANYTHING that wasn't political...they'd be locked up in an asylum for, strapped to a bed and forcibly medicated for, because they're SO detached from reality as to make them dangerous. Call it a "mainstream" political raving, and it's suddenly no problem that they're painting gun or archery targets on the homes of people they don't like.

      I strongly believe in free speech, but I do not believe encouraging delusions is free speech.

      Then again, I live in Texas, and these mofos are K-A-R-A-Z-E-E-E.

      Delete
  15. 1.
    "Funny, isn’t it? How quickly those folks who claim to be the only true Americans, who declare their belief in the sacred institution of America, who claim to love the American system best of all, immediately turn their back on it and start talking about rebellion and secession and shooting their neighbors when they don’t get their way?"
    - Yes, it doesn't get any more anti American than this.

    2.
    "If you believe the first option is the correct one, then stop your goddamned gloating, vote for Barack Obama, and demand that the Affordable Care Act be overhauled until we get it right."
    - I think you've hit the nail on the head, at least we are moving the ball forward.

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  16. Thanks for your entry. Very insightful (as always.) I am personally torn on the bill, perhaps because it is poorly written - though I don't see how they can do much more without completely replacing it.

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  17. All of you have said it so well, I shall just AGREE and send you my gratitude.

    Yesterday was for celebrating this admittedly flawed beginning.
    From today on we must educate others in order to embark upon a better future for all.

    fromthediagonal

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  18. ::respectfully nods his head at the writer::

    ::shakes his head in sorrow for his cousins south of him::

    ::fans self with health card because Mr. Wright expects some kind of Canuck smirkiness::

    I'm crossing my fingers for you guys!

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  19. "Feral paragraph?" My husband is said to have been vaccinated with a phonograph needle...

    Fine post, Jim!

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  20. Great article. A lot of whiners would do well to read it.

    My favorite comment to follow the ruling came from an "analyst" asked for his reaction by a public radio reporter. He said, "I had several statements prepared to choose from, depending on the outcome of the ruling. And now none of them fit. I can't use any of them." Just the thought of a pundit being forced to provide a reaction by, you know, reacting ... well, it gave me a small moment of glee.

    ReplyDelete
  21. Another great one Jim!

    "Funny, isn’t it? How quickly those folks who claim to be the only true Americans, who declare their belief in the sacred institution of America, who claim to love the American system best of all, immediately turn their back on it and start talking about rebellion and secession and shooting their neighbors when they don’t get their way?"

    That made me think about a recent Alternet post about "True Americans", did you come across this yet?

    http://www.alternet.org/story/156071/conservative_southern_values_revived%3A_how_a_brutal_strain_of_american_aristocrats_have_come_to_rule_america_?page=entire

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  22. Well done, as always. Here's the best explanation of the ACA in simple terms that I have seen so far. It is long but the comments are worth reading and remembering for when the idiots start quoting Faux.http://www.reddit.com/r/politics/comments/vqory/supreme_court_upholds_affordable_health_care_act/c56sc5m

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    1. Oops, should have spaced down after the word Faux. That is NOT part of the address.

      Delete
    2. Thanks for the link. It does make the law a bit clearer.

      I can see one good thing in the law. It makes the insurance companies insure everyone, no matter what. That gives them a vested interest in keeping people healthy. Now if someone get too sick, they can just drop them.

      Delete
  23. This may be mentioned elsewhere, but the day before the ruling, Robert Reich (the Clintonite) had an article in Huffpo predicting it would be upheld 6-3. (He thought Kennedy would uphold..as well as Roberts) His reasoning on Roberts was that SCOTUS was becoming so partisan and unpopular, that for Roberts to vote to strike down would forever tarnish the legacy of this (the Roberts) court.
    Charlie Pierce at Esquire summed it up pretty nicely though,paraphrasing... at the end of the day, Roberts still hasn't rendered a decision which would any way darken the golf game of any corporate executive....In this case, he certainly unpuckered the asses of a lot of insurance execs....
    Either way, just one small aspect of it: if a family of four, currently paying 12k a year, is going to see their insurance premium dropped to 3k? (CBO)...we are talking some major cheddar injection in to the the economy. In the long term...this is much bigger than anybody is really letting on...and I for one am damn glad about it...

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    1. The Surpreme Court - the best Law that money can buy.

      As a resident of Montana, we are still reeling with the idea that the corrupt Washinton has told us - in no uncertain terms - that we are not allowed to protect ourselves from businesses and wealthy individuals purchasing politicians.

      I honestly believe that the greatest threat to American Society today is corporatism. Chimpy won't be remembered by history for starting his illegal war in Iraq. He won't be remembered by history for putting our economic system in the toilet. What he will be remember for is appointing two Wingnuts to the Supreme Court - the gift that keeps on giving.

      Delete
  24. This comment has been removed by the author.

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    1. and since I saw all the people who are going to move north because of the SCOTUS decision


      Citizenship and Immigration Canada
      Note: As of July 1, 2012, CIC has temporarily stopped accepting applications for the federal Investor program to focus on processing the applications we already have while the program is reviewed. This pause on new applications will continue until further notice.
      http://www.cic.gc.ca/english/immigrate/business/investors/index.asp

      ed to fix the link

      Delete
  25. In regards to the victory for the lying shitbags, I'm a veteran myself and I think in the long term, this isn't going to be a victory for them at all. Once you take out the SSN (for Privacy Act of 1974 purposes), a DD-214 is a public document, not a private one. People who start claiming apparently fraudulent service and awards are going to very quickly see investigators come up with a copy of their DD-214s and publicly post them for all to see. Those who aren't lying shitbags aren't going to be particularly bothered by this. Those who are are going to be terrified by it.

    While the 4th Amendments guarantees individuals the right to be secure in their private papers, records of government service are not private papers. You claim to have medals, it is going to be relatively easy to verify, particularly if you're seeking public office.

    ReplyDelete
  26. What difference does it make whether we have affordable health care or not?

    Suppose the government came up with a plan to address the problem of hunger. They mandate that every family, every person, will receive so many pounds of food per week. Then everybody starts arguing about whether it is affordable, feasible, fair, etc. etc. Nobody is concerned about the fact that the "food" mandated by the government is horse turds.

    That is the situation we have with health care. We will now all have access to ineffective, expensive, and often deadly "health" care. The only winners in this situation, no matter what the decision of the SCOTUS was, are the big pharmaceutical companies, the insurance companies and medical providers.

    If you don't think our medical system is "horse turds", think again.

    Pharmaceutical companies test their drugs and report their findings and the FDA OKs them or not. That's the theory, anyway. Big Pharma tests the drugs all right, but they hide results they don't like, use poorly constructed studies and just generally cheat and lie to make their newest drug look good. The "placebos" they use to test the drug against are often not inert and side effects of their drug are often swept under the rug.

    If, for some reason, the FDA does not approve the drug, they market it in another country. Chances are, however, the the FDA will approve the drug because upper level, cooperative employees in the FDA are all but guaranteed a plush, well paying job in a pharmaceutical company when they leave the FDA.

    The medical business has vested interest in keeping as many people as sick as possible. Cancer, diabetes and obesity are their cash cows. To keep these diseases at high levels, they dispense bogus information to doctors, dieticians and other health professionals.

    The American Diabetes Association and receives huge donations from the Pharmaceutical Industry. The PI helpfully gives training on diet and treatment to doctors and nutritionists. The diet they push will kill a diabetic, but that is ok because they just happen to have a pill that will take care of that.

    They absolutely do not want a cancer cure. Neither do the various cancer associations. There are cancer cures out there, some of them quite good. Anyone foolish enough to promote them is ridiculed or threatened. Woe unto a doctor who prescribes a treatment that is not one of the accepted cut, burn or poison treatments recommended by the establishment. The AMA and the government are complicit in this because the AMA is in the PI's back pocket, as is the FDA.

    Again, because the PI is instrumental in providing training to medical personnel, they make sure that foods that cause obesity are included in a "healthy" diet. The Food industry is right there with them, proclaiming that high fructose corn syrup, processed anything and GMO's are, if not actually beneficial, at least harmless.

    When hospitals are closed down by strikes, the death rate goes down.

    Places like the wilds of Montana and the Dakotas have a higher longevity rate than urban and suburban areas with access to top rated medical facilities.

    The medical system is one of the leading causes of death in this country. Side effects from medications taken as prescribed, improperly prescribed drugs, infections acquired in the hospital, vaccines, unnecessary surgery, improperly prescribed drugs, wrong diagnoses, are some of the ways that modern medicine kills. This is not including the drugs that are manufactured legally but end up as illegal drugs.

    Explain to me again why it is important for everyone to have access to this particular plate of horse turds?

    ReplyDelete
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    1. Jeanne wrote: "Explain to me again why it is important for everyone to have access to this particular plate of horse turds?"

      Well, I'll give it a try Jeanne, but I don't think you'll listen.

      When human beings get sick they need someone trained in caring for them to help them get better. That training takes a long time and so it is expensive, so the caregivers charge a lot of money for their work. (Let's not be naive, there is also an element of greed and self-aggrandizement involved.) A big sickness needs a lot of care, so it costs much more than most people can afford. Good societies pool their resources to care for their ill who cannot pay for care all at once. Bad societies let them die and or go bankrupt. The U.S. is somewhere in the middle, leaning far towards the second set (especially the Tea Party and Libertarians). This does not mean ours or any medical care system is perfect, but it's far better than putting your sick relative out into the gutter or even treating them at home with no tools and no skills.

      As far as the rest of your comments, you started out sounding like a skeptical consumer, but you didn't notice where you took a hard turn onto whack-a-loon road. Fewer people don't die when hospitals are closed. That's just incredibly poor comprehension of statistics... and reality. (Besides, in most towns when a hospital closes, there's no one to write the freaking death certificates.) Vaccination is a centuries-old medical treatment with well known risks and bigger benefits; so good, in fact, that people like you have never learned first-hand just how bad life was suffering with the diseases that vaccines have stopped. Of course, the anti-vaccination crowd is bringing preventable diseases back, so everyone will learn, especially infants, the sick, and the elderly.

      Jeanne, there is a big difference between being "open-minded" and having a hole in your head so big that your common sense falls out. You are spreading some of the biggest, craziest conspiracy theories out there. You sound like you've fallen for just about all of the anti-medicine nonsense out there. Do you find yourself saying "but They don't Want you to know" or "he's a ____, he must be in on it" a lot? Haven't you noticed when people start edging away from you when you start talking about this subject? Then you are a whacko conspiracy theorist (here's your sign). Just because big insurance and big pharmaceutical companies are businesses run by greedy MBA sociopaths, just like many other corporations, does not make all doctors and all medical treatments bad for you. I just hope that younger or less well-informed people will read what I wrote after your screed, and follow another road.

      Delete
    2. Thank you, Jerry. I was going to reply but was having trouble being polite because I know my mother, who has been a health care provider since 1973, and I know that she is vested in making patients *well*, not in making patients *sick* as Jeanne claimed in her bizarre conspiracy theory that is, alas, common amongst lunatics of both the far-right *and* the far-left. My mother's not an idiot, if some drug she tried with her patients made her patients sicker, she wouldn't use that drug anymore. Duh. For Jeanne's conspiracy theory to work, all doctors and nurses would have to just prescribe drugs blindly without noticing whether the drugs helped or not, or they would all have to be evil villains who rub their greedy hands together at the thought of killing patients with bad drugs -- and I simply don't know any doctors or nurses who are like that.

      The places where the current system fails are the places where things are run by corporations rather than by doctors and nurses, where quality standards have dropped horrifically because quality costs money. Do not ever, ever go to a corporate-run hospital if you get sick if it is at all possible to avoid it -- find one run by a non-profit, or heck, even a public county hospital usually provides better care than a corporate-run hospital. Not that specialists in life-threatening illnesses are blameless for the high cost of U.S. healthcare -- people are coming in with a loaded gun to their head that basically is saying to them, "your money or your life", i.e., if you don't get treatment for leukemia when you need it you *die* so you pay whatever you have to pay to get the best care possible just as if a mugger in Central Park points a gun at you and says "your money or your life" you don't argue, you hand him your wallet (unless you *want* to be heroically dead, but that's another issue), and while most of these guys certainly don't want to hurt patients they're also not ignoring that wallet being handled to them as the patients stare down the dark barrel of the loaded gun of mortality. But to say they *want* patients to get sick and would do things that made patients sicker... total nonsense.

      Delete
    3. Your reply to my post is insulting, smug and self serving. You spend most of your time making assumptions about me and then reprimanding me for things I never said or for being who you think I am.

      I WAS around before most modern vaccinations were available. Polio, measles, rubella, hepatitis, etc. were a threat when I was a child. Young women used to hold Rubella parties so they would catch it before they got pregnant. You know nothing about my views on vaccinations.

      Death Certificates are signed by doctors, not hospitals. If a hospital closes, there are still local doctors. I never talked about hospitals closing or death certificates, so I don't know what this is all about.

      I am at a loss to know exactly what conspiracy theories I am spreading. I didn't even know there was a conspiracy. There is greed, lack of integrity, lying, cheating, and dishonesty. I think that is quite sufficient without a conspiracy besides.

      Actually, no, I haven't noticed anyone edging away when I talk about the subject. Probably because I seldom do, and when I do, it is because I am asked. Generally, people are very interested in alternatives to medical treatment.

      You said:
      Just because big insurance and big pharmaceutical companies are businesses run by greedy MBA sociopaths, just like many other corporations, does not make all doctors and all medical treatments bad for you.

      Um... yeah. And your point is? I never said one word about doctors, nurses, lab techs, and lower level medical workers. I spoke solely of Big Pharma, the FDA, the Cancer Societies, and such. I never said anything about all medical treatments being bad for you.

      I can't really make much of a reply to your post because I am not sure who you are talking to. I have no intention of defending remarks I did not make or beliefs that you have assigned to me.

      Delete
    4. Badtux, the above reply was to Jerry.
      I did not in any way, shape or form say anything at all about the motivations of the people in the trenches. Where you got that idea from, I have no idea.

      I do not subscribe to any conspiracy theory. There is no need for it. But I must say that if you think that the FDA, Big Pharma, Health Insurance Companies and the Food Industry have your best interests at heart, you are sadly mistaken.

      Apparently, because there are conspiracy whacko's out there, you assume that anyone who doesn't toe the party line is one of them. There are people who don't fall for the propaganda of the Pharmaceutical companies, but also don't think there are a bunch of nefarious people out there who want everyone ill for some reason.

      But if you want to believe that Pfizer, Merck, GlaxoSmithKlyne, Wyeth, et al. are all benevolent big brothers that are looking our for your best interests, go right ahead.

      As for me, I am tired of defending what I did not say. If anyone else has comments on my post, please read it carefully and only reply to what I said, not what you think must be my opinions on subjects I did not cover.

      Delete
    5. Everybody please relax, we're all friends here.

      Jeanne, I will say this: I have good friends who are also regular readers and commenters here, one of which is high up in a well known pharmaceutical company both as an administrator and as a scientist, and one of which is a doctor with the FDA. Both of these folks I know personally and they are good friends of mine. I can personally attest that both, very very much so, have your best interests in mind at all times.

      Do the organizations they work for share similar viewpoints? Perhaps, perhaps not always, and perhaps they place policy or profit above human beings - of course the same could be said about nearly any other organization on the planet from the Salvation Army to the Church. Certainly large organizations are not "benevolent big brothers" but neither are they automatically evil organizations bent to our destruction and I would argue that without big Pharma and the FDA our lives would be shorter and far more unpleasant. Perhaps I have a different viewpoint because without both big Pharma and the FDA I'd likely by dead several times over by now, but I don't see your (apparently) automatic distrust of both outfits all that different than Jerry and Tux's automatic assumption (incorrectly as it turns out) that you're a conspiracy nut.

      Delete
    6. Addendum:

      Of course, that said, I'm also on the VA's Gulf War Syndrome watchlist because I was issued certain anit-nerve agents during one of my tours in the Middle East. Those damned tablets were created by big pharma and approved for use on military folks (but not civilians) by the FDA. So, yeah, I do see your point.

      Delete
    7. JEANNE SAID: "Your reply to my post is insulting, smug and self serving. You spend most of your time making assumptions about me and then reprimanding me for things I never said or for being who you think I am."

      Yes, I was insulting, and sarcastic, and just plain not very nice. People who spread misinformation but are well-meaning are wrong and deserve to be corrected, maybe gently. People who spread well-known lies about healthcare, who could have looked up the facts but did not bother, have other people to believe them, can cause those other people to avoid real medical care. Your misinformation can hurt people. I will not be polite or gentle to people who recklessly hurt others. My tone may be less than drawing-room polite, but lady, spreading your beliefs can hurt people. I'd rather be seen as rude and right than a polite, genteel, well-bred killer.
      .
      JEANNE SAID: "I WAS around before most modern vaccinations were available. Polio, measles, rubella, hepatitis, etc. were a threat when I was a child. Young women used to hold Rubella parties so they would catch it before they got pregnant. You know nothing about my views on vaccinations."
      JEANNE ALSO SAID ABOVE: "Side effects from medications taken as prescribed, improperly prescribed drugs, infections acquired in the hospital, vaccines, unnecessary surgery, improperly prescribed drugs, wrong diagnoses, are some of the ways that modern medicine kills."

      You stated that "...vaccines... are some of the ways that modern medicine kills."
      I quoted the whole sentence so you cannot accuse me of being misleading by quote-mining. How are you _not_ warning people against vaccines? In fact, how are you not warning people against most aspects of modern medicine?
      .
      JEANNE SAID: "Death Certificates are signed by doctors, not hospitals. If a hospital closes, there are still local doctors. I never talked about hospitals closing or death certificates, so I don't know what this is all about."
      JEANNE ALSO SAID ABOVE: "When hospitals are closed down by strikes, the death rate goes down.
      Places like the wilds of Montana and the Dakotas have a higher longevity rate than urban and suburban areas with access to top rated medical facilities."

      In your own words, you talk about hospitals closing lowering death rates. I mentioned death certificates, because that-is-how-the-medical-system-tracks-death-rates. You are now denying your own words? (continued below)

      Delete
    8. (continued)
      .
      JEANNE SAID: "I am at a loss to know exactly what conspiracy theories I am spreading. I didn't even know there was a conspiracy. There is greed, lack of integrity, lying, cheating, and dishonesty. I think that is quite sufficient without a conspiracy besides."

      There is a growing movement against vaccination and drugs versus disease parties and "holistic" medicine, homeopathy (water pretending to be medicine) and other alt-med. You are using many of the same words and phrases they do. You may not know about them, but you are deeply in their crowd.
      .
      JEANNE SAID: "Actually, no, I haven't noticed anyone edging away when I talk about the subject. Probably because I seldom do, and when I do, it is because I am asked. Generally, people are very interested in alternatives to medical treatment."

      Like dying. The alternative to medical treatment is dying.
      There is mostly quackery in 'alternative medicine'. Almost all 'alternative medicine' that has been rigorously tested has been shown to be no better than no care at all, and much of it is worse simply because it drains personal and societal resources, and takes people away from the stuff that works. I don't remember who first said it, but 'You know what they call alternative medicine that works? Medicine.'
      .
      JEANNE SAID: "Um... yeah. And your point is? I never said one word about doctors, nurses, lab techs, and lower level medical workers. I spoke solely of Big Pharma, the FDA, the Cancer Societies, and such. I never said anything about all medical treatments being bad for you."
      JEANNE ALSO SAID ABOVE: "Side effects from medications taken as prescribed, improperly prescribed drugs, infections acquired in the hospital, vaccines, unnecessary surgery, improperly prescribed drugs, wrong diagnoses, are some of the ways that modern medicine kills."
      JEANNE ALSO SAID ABOVE: "When hospitals are closed down by strikes, the death rate goes down."

      You are warning people away from "medications taken as prescribed", "vaccines", and "hospitals", which together have been responsible for the largest reduction in mortality rates in the last 150 years. This is, essentially, most of modern medicine. When you remove drugs, vaccines, and hospitals from health care, what's left besides a friendly local GP holding your hand while you die? How are you _not_ against medical treatments when you are speaking against almost everything that works?
      .
      JEANNESAID: "I can't really make much of a reply to your post because I am not sure who you are talking to. I have no intention of defending remarks I did not make or beliefs that you have assigned to me."

      How are these not your own words? Your only defense to being wrong and spreading all sorts of anti-modern medicine nuttery is that I am rude and that you did not write the words and sentences that you wrote? That's not a defense, that's an insanity plea.

      Delete
    9. Jim,
      I'm sorry, I posted my fairly intemperate reply before I saw your words. I can delete them on the basis of being impolite (but not accuracy, I believe) if you object.
      Jerry

      Delete
    10. Jeanne,
      My heart rate is down as is my emotional state. I apologize for my tone, and for calling you a killer. You may not know it, but you hit all of the words in the anti-medicine Bingo card. That sets me off, as you may have noticed.

      That doesn't mean I'm defending big Pharma, corporate medicine, or for-profit insurance companies. I have stated here and other places that I'd rather see a single-payer system than what we have now. I want to see medicine become evidence-based and scientific rather than a "practice". Self-regulation is a good ol' boys club that sweeps the deaths from malpractice under the rug. I really want to see people put before profits. I'm probably delusional, given the GOP's preference for insurance company death panels rather than Medicare for all. Yeah, there is a lot to fix, but deriding most of what has made modern medicine advance past bead-shaking shamanism and leeching is not the way to do it.

      Delete
    11. Jerry, it wouldn't bother me if you rewrote your comments to be more polite, but at this point it's probably moot. Thank you for apologizing to Jeanne, I appreciate it.

      Both you and Jeanne are entitled to your respective positions. I can see Jeanne's viewpoint though I don't agree with it. I can see your viewpoint and I can understand your passion.

      That said, I emphatically don't like flame wars in my comments section and I'd don't want this to turn into a monkey shit flinging fest. I like you both and I'd like to keep it that way.

      If you guys want to continue this conversation, let's everybody take a deep breath and start over with the assumption that that the other person isn't an asshole. Please be polite. Regard it as a debate, not a personal attack.

      OK?

      Delete
    12. Yes, Jim. I am willing to call it done.

      One of my goals is to try to reduce my resemblance to a poo-flinging monkey. Shaving won't do it, so I guess it'll have to be with the "take a deep breath before posting" approach.

      Delete
    13. Thanks, Jerry.

      The conversation doesn't have to be done, but let's just please proceed with a little less passion and a little more patience on both sides.

      With the amount of traffic I get, it's inevitable that people with diametrically opposing views will rub up against each other in the comments section. It's also inevitable that I'll get commenters whose opinions are anathema to others - or even myself. However, having been victim of a particularly obnoxious and infamous bit of shit flinging on a famous site that I used to frequent and used to enjoy, I'm extremely cautious about allowing it to happen here. I remove entire comment threads to prevent it because I was incredibly saddened by watching other sites, ones that I once respected very much, devolve into childishness and be eaten by angry mobs once they got popular. I will not allow that to happen here.

      Delete
    14. Automobile accidents are a major cause of death. The government says so. Therefore, the government is advising you not to drive or ride in automobiles.

      People have died from surgery, horseback riding, falling off of bicycles, swimming, and any number of other things. Saying that these things can cause death is not saying don't do them. It is saying use a little sense. Hell, the only cause of death is birth. Therefor, don't be born.

      I see. I am not allowed to use the same words that someone you don't agree with uses. I have news for you. I use the words I want to use, and I use my own ideas. I don't care if the government says it, or a myriad of experts, or the Bible, or Koran, or anything else. My beliefs are individual, and you cannot predict what I will believe on one subject by knowing what I believe on another. The fact that I don't think highly of Big Pharma is not evidence that I believe that all of medicine is some big conspiracy.

      Jim - and it is not evidence that I believe everyone who works for Big Pharma is evil or ill intentioned. Most are not. Unfortunately, those who control things are not all well intentioned.

      I will say it one more time. You are taking my words and saying, "People who believe this also believe that" and then saying that I therefor believe that. It doesn't happen to be true that Belief A = Belief B. It may be that most of the time someone who believes A also believes B, but you cannot assume that everyone does.

      It's ok to post an fairly intemperate reply to me, because, after all, I am wrong, spreading horrible conspiracy theories, misinformation and deserve to be corrected. People who do not agree with your point of view deserve to be rudely awakened by your display of infinite wisdom.

      Delete
    15. Jeanne, please read my previous comments. Please see Jerry's apology.

      Delete
    16. Ooops, I missed the apology in this morass of verbiage.

      Jerry, I think we pretty much want the same thing and can agree that medicine as it is practiced is not a Good Thing. My main point originally was that medicine needs to be changed, cleaned up, improved, so why all the fuss about getting an inferior product delivered? That's all.

      Delete
    17. The fuss from me, Jeanne, was that you implied that doctors and nurses are morons who won't notice that drugs and procedures they're prescribing don't work. Or evil and don't care. One or the other. The reality is that if a drug or procedure doesn't work, they won't use it after they prescribe it for a few cases and it doesn't help. And if it harms their patient, then it's one of those famous drugs that gets recalled. So yes, drug companies are evil. Yes, the FDA is bought. But for the sort of bad things you imply to happen on a routine basis to happen the way you say, doctors and nurses have to be incompetent or evil or both.

      The bigest problem we currently have in the system other than lack of access on the part of large segments of the population or the fact that it is outrageously expensive is with corporate hospitals, which have compromised cleanliness and care standards in search of profits, in turn causing an epidemic of patient infections and deaths caused by medication errors or neglect. But let's not forget that the US has the fewest hospital patient-days of all OECD nations. That is, on a per capita basis, we have the fewest number of people in hospitals of any OECD nation, things are done outpatient here if at all possible rather than take up hospital beds. So death rates at hospitals will *always* be higher than outside of hospitals, because we only send the sickest of the sick to hospitals and keep them there only until they're well enough to send home. And the sickest of the sick have this bad habit of dying, it's sorta a given, that if they're the sickest of the sick, some of them simply don't get well. Implying that this higher death rate inside hospitals is part of some sort of medical professional conspiracy for profit simply misunderstands how the practice of medicine works, and we have a word for people who talk out their **** about things they don't understand, and it rhymes with "hole".

      So anyhow, now you know why *I* was personally offended... implying that my mother is a moron or an idiot who wouldn't notice that the drugs and procedures that she is involved with don't work or harm patients (the most charitable interpretation of your claims) is offensive in and of itself. Just sayin'.

      Delete
    18. Damn! Every time I show up with a handful of monkey shit to start flinging, some reasonable prick has just come along and blown the no more monkey shit flinging whistle.

      I think what we've run into here is the sad fact that individuals may generally be good, but put them into a large organization where money and pride and "screwing that guy over in accounting who always takes my parking spot" are involved, and it all turns to shit. We call that shit Bureaucracy.

      Bureaucracies are not intrinsically evil, but evil loves bureaucrats. No-one takes the whole decision, no-one is responsible, no-one is to blame. When evil occurs, a scapegoat is found. The bureaucracy abides.

      Big Pharma, Big Government, Banking, Big Oil, Big Anything - in the end they are just bureaucracies.

      Still, 150 years ago, before they existed, most people died in their first year of life. Of those who survived, most died by 5. If you got past that, you were probably dead by 20. If you made it past 20, you had a good chance of making it into your 60's.

      So... are there problems with our health care system? Absolutely. Are there individuals who don't give a damn about anything but profit? Sure, but not so many as you think - as noted here, most people in health care (and the FDA too) are really trying to do right by patients. Are things a damn sight better than they used to be? Abso-fucking-lutely.

      I accepted modern medicine the day it saved my 2 month old daughter from pneumonia. She's sixteen now. Without modern medicine, she'd have surely died.

      Oh, and don't get me wrong - an accounting glitch caused the insurance company at the time to tell me she wasn't covered. Talk about a butt-puckering moment! But that little incidental evil was a minor blemish on the miracle of modern medicine of that moment.

      So what is my point in all this ramble? Progress is made in small steps. As Jim pointed out with his usual good sense, PPACA is a small step.

      Delete
  27. Another great post. Well done.

    For anyone looking for a straightforward explanation of PPACA, I found this today:

    http://www.reddit.com/r/explainlikeimfive/comments/vb8vs/eli5_what_exactly_is_obamacare_and_what_did_it/c530lfx

    It seems accurate and includes a link to a discussion of one of the provisions I find troubling:

    http://www.reddit.com/r/explainlikeimfive/comments/vb8vs/eli5_what_exactly_is_obamacare_and_what_did_it/c537rqi

    I defer to those more knowledgable regarding the accuracy of these articles.

    On another subject, I wonder whether Romney would actually try to repeal the law should he get elected. It's a great campaign plank, for sure. But it would take all his political capital to get it done and, really, I just don't think he cares that much about it beyond the electoral mojo it provides.

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    Replies
    1. If you can find anything that Romney cares about - other than living in the white house and flying in AF1 - do pass it on.

      Delete
  28. But. But - what about the part of the bill where all of us will be required to get a microchip implanted in our foreheads or risk not being able to receive health care or purchase anything? Isn't having the mark of the beast inside of our skin unconstitutional? How could you all be so blind as to miss the part where universal health care means that the end of world is coming? The sky is falling! The sky is falling! Wait. What? It's not in there?! But. But - my church going god fearing conservative acquaintances all seem to think it is! May all your blog posts end up on religous websites for children, Jim! Keep up your fantastic commentary on all things. You never disappoint!

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  29. As a death before taxes, states rights rule, kill them all let God sort them out (unless they are unborn), dont touch my guns conservative, I cant argue. I dont think it is a GOOD law. But it is a law, which my duly elected Congress wrote. And it is Constitutional. Im not sure HOW it is Constitutional, but SCOTUS says so, therefore it must be. So I comply and if I dont like it, I work to elect a Congress who wil fix it. (Luckily, I get free health care for me and mine for the next 5 years, so I wont have to deal with the requirements until Uncle Sam allows me to retire.) Anyone who doesnt understand this needs to go back to high school and re-take Government.

    -Jeff K
    -Elizabethtown, KY

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  30. I'm gonna go against the tide here on the Stolen Valor Act; I think the court was right and that they're protecting the First Amendment. That being said, I see no reason the Federal Government can't Trademark all military decorations and go after people for Trademark infringement for improper use. Also, there are already plenty of laws on the books to punish profiting from fraud.

    I think, ultimately, whether it's legal or not to falsely claim a decoration, there's nothing preventing anyone else from calling out the delusional and/or the scheming shitbags. A politician who gets caught in that particular lie is deservedly done-for. And your run-of-the-mill asshole can be shamed into oblivion as easily as prosecuting him.

    ReplyDelete
    Replies
    1. Indeed, Roberts specifically pointed out in his decision that there were already laws punishing profiting from fraud and thus the Stolen Valor Act was not needed to prosecute that, but the core issue is that this decision specifically states that lying is Constitutionally protected. To a certain extent lying and free speech are connected -- I am, in fact, not a penguin, and I don't own a tux whether bad or not, and this is necessary for me to exercise free speech because of the threat of blacklisting if potential employers can google my real name and see that I'm not a happy right-wing drone like they want to hire. But with the Stolen Valor Act we're not talking about the sort of lies that are commonly used to engage in anonymous or pseudonomynous free speech, we're talking about lies that have no connection at all to the free expression of political views and opinions -- the kind of speech, remember that the 1st Amendment was created to protect.

      So I repeat: This decision had nothing to do with free speech, and everything to do with Roberts' corporate masters wanting to retain the right to lie about things like global warming, Obamacare death panels are gonna rip babies out of incubators and bash their skulls in before shipping the still-warm carcass to the White House for President Obama to personally eat their brains, yada yada... if Fox News didn't have a Constitutionally guaranteed right to lie about factual matters, they'd have 15 minutes of programming per day. You want to know why the Stolen Valor Act had to go, there you are -- outlaw lying in one case, and it's a slippery slope that could outlaw Fox News. And that would be a disaster, right?

      Delete
    2. As I posted above, I agree that the Court ruled correctly in the Stolen Valor Act however it is a victory that the lying scumbags are going to regret in the long term. The 4th Amendment guarantees that people will be secure in their private papers and possessions. One's military record is NOT a private paper, it is a public document of government service. Individuals have the absolute right to lie about their service and people have an identical absolute right to get the government documents concerning that service and distribute them as widely as possible.

      Delete
  31. What I also think is hilarious is those who shouted the loudest "No Federal Government Interference in our State Affairs" and "Leave it up to the States" are the ones who voted in the Governors, who mouthed the same sentiments, who are now refusing to set up those State Exchanges (which, was their party's idea in the first place, and what they wanted) which will force the Federal Government to run the damn things for them.

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  32. What seems to be missing from comments here as well as elsewhere regarding the healthcare issue, tho I may have missed any, is; if single-payer were to have been put into effect, what does one do regarding the insurance companies and associated industries, employees, shareholders, if the effect is to put them out of biz rendering this multi-billion dollar industry valueless? I recall reading not long ago about the 10 highest paid CEOs had several in the healthcare carriers including the #1 at about $140 mil/year or so.
    Does anyone think that this possibility, if true, can be ignored in any understanding of why it is so difficult to get a single payer system like the rest of the industrialized nations?
    Without some viable alternative, why wouldn't this industry, along with their people in gov't power, do anything, everything, to avoid this great loss?
    If this is a correct presumption, then why is it not front and center in discussion on the more intelligent and credible blogs?

    Please excuse the "anonymous" for now; not sure how to put in what I want for handle except the one I use at other sites; ie, van59

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  33. As I posted over on HCDSM, I received this news via FOX in the grill room of the local country club waiting for my tee time. Not exactly a hotbed of left wing sentiment! Knowing that any comment I made would only be inflammatory and really just wanting to tee off and enjoy my day, I kept my trap shut and just smiled, until one of our group came to me and asked, "How can Obama just ignore the Constitution like that?" . . . Ok Sancho, I see an evil windmill that must be battled . . . I turned to him and said, "How do you figure that? The president introduced a bill in to congress, that bill was debated and passed by both the house and the senate, the president signed the bill, the bill was challenged in the court system and the Supreme Court ruled and upheld the law. That is exactly how our system of government, defined by the articles of the Constitution, is supposed to work." Therein followed 10 seconds or so of blank look from this gent and I noticed quite a few heads turning in our direction. I thought I was going to get off easy when his response was, "you just don't understand," and he walked away, but no. Another "gent" yelled out, "What would your father say if he heard you now?" Dad was a well known conservative, loved a good argument and passed away a year ago in February. Now I was pissed off, especially because I knew Dad thought the commenter was a world class tool. I turned to this asshole and said, "If dad were here, he would ask them to change the channel so we can watch some golf and tell me that he hoped I kick the shit out of you in the money game today. Dad's gone, and don't ever use his memory like that with me again." Nearly all of my very conservative golf cronies later told me that they were glad I said what I did, which gives me just a tiny bit of hope for the future, but only a little. There's so little room for intelligent debate and exchange of views. People decide which side they are on, and then seek only the information that confirms their viewpoint. Buffoonery in the shape of punditry prevails and any reasonable voice is lost in the shouting. My hope is, the SCOTUS decision will allow the debate to continue as it leaves the law in place to be modified as future events dictate. My fear is, reality and pragmatism will have little to do with those future modifications.

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  34. One of my main problems with the current healthcare system is that - any system based on insurance (let's just call it what it is - peice work health care), will inevitably objectify the patient. No, not all doctors will do this - at least not consciously - but it will happen. There is a reason there are so many unnecessary tests ordered each year by physicians - they get paid for each test. I went to the doctor with Bronchitus (admittedly a reoccuring problem due to decades of smoking) and the doctor ordered a heart test. WTF? Her justification was that if I had chest pain (due to coughing straight for three days) then she must rule out a heart attack. I told her that A) I wasn't having a heart attack B) I didn't want the test. Not only did I end up getting the test anyway, she also had the nurse give me nitro (you want to talk about an instant headache...). These two unnecessary procedures cost over $3,000 - money that the insurance company and I had to pay.

    Do all doctors do this? probably not. I doubt even most doctors do this... yet. But the current system is designed to reward those doctors that do. This is one hell of an incentive.

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    Replies
    1. Moorcat,
      In my experience, other doctors do the same thing, so much so that prescribing unneeded tests has a name, "defensive medicine". The name does not refer to being paid by the test (that's called "I have a boat payment due"), but rather that doctors order tests to protect themselves from the possibility of lawsuits (the fear that some people think any bad diagnosis is malpractice). Another fear is the idea of losing idiotic and entitled patients because the doctor is not "doing something", when the actual best course of treatment would be to rest, wait, and let your body heal itself.

      One philosophical point: When a doctor "orders" a test, that only means the test is authorized to be performed by a technician. It is the technician who is receiving the orders, not you. You have every right to refuse to undergo any test, take any medicine or heed any advice. While I _prefer_ to listen to medical advice, I know that ultimately it's my body, my life, and my responsibility. I have refused antibiotics when they were offered to me for an upper respiratory _viral_ infection, where I knew antibiotics were utterly useless. (They were offered only because this MD is used to idiotic, entitled patients who always demand "doing something".) Granted, I do have training in biochemistry, so I understand living organisms and most medical tests at least as well as the MDs, so I'm probably more knowledgeable than most people in that respect, but the basic principle is the same. I'm not sure what amount of argument convinced you to go from "it's not needed" to "I'll take the tests and medicine", but I hope you know it should have been your choice. regards,
      Jerry

      Delete
    2. When doctors in McAllen, TX were asked why they ordered so many tests and procedures, they claimed "defensive medicine". When pointed out that they order many more tests and procedures than doctors in El Paso, TX, which serves the same basic patient base under the same set of state laws, and that Texas has strict limits on medical tort liability that basically makes it impossible to sue doctors, they had to shrug their shoulders.

      So yes, money *is* a factor in ordering tests and procedures, since the more tests and procedures you order, the more you get paid as a doctor -- especially in the case of McAllen TX where doctors own the testing centers thus get paid twice, once to see the patient and once when the patient goes to the testing center and undergoes the test. This is one reason why ObamaCare won't reduce healthcare costs -- it doesn't eliminate this perverse incentive. On the other hand, as mentioned, a doctor can't force you at gunpoint to undergo an unnecessary test....

      Delete
    3. Hi BadTux,
      I never said that doctors don't order unneeded tests out of greed- see my remark about boat payments. I let Moorcat know the definition of "defensive medicine" which is distinct from, but does not exclude, greed. You gave a great example of greed in medicine, which I was not denying or even discussing.

      Delete
  35. BadTux and Moorcat,
    On re-reading, I think I side-tracked the topic. You're probably right. I don't know that "defensive medicine" is the cause of so many unneeded tests or just an excuse for greed.

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  36. *flings poo*

    Just kidding. Honestly this couldn't have turned out better for the country given the mitigating circumstances. Single payer Medicare for all is best, but until we actually VOTE PEOPLE IN who agree, that won't change.

    Use your vote.

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  37. Bravo! Bravo!

    WELL SAID!

    I am one of the uninsured. At 60, I do not make enough income from three part-time jobs (can't find a full-time one) to pay the exorbitant costs for insurance with such a high deductible that I would pretty much be paying for no coverage.

    I live in fear of an accident or illness that will cost me my home and anything else I have, or my life.

    Of course, according to some it's all my fault. I should work 20 hours a day, not 16.

    Maybe now we can work on getting this thing right.

    Thanks, Jim.

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  38. Yeah, I didn't see it coming. I thought it was a sure thing we wouldn't have to worry about healthcare changes. Guess I was wrong. Every doc in the country can't be wrong though.

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