Showing posts with label Medicaid expansion. Show all posts
Showing posts with label Medicaid expansion. Show all posts

Thursday, June 29, 2017

The Right's PR Lackeys Cry and Lie About Their "Better Care" Baloney

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"I just can't believe this is happenin'! I can't!"

It was amusing  reading the WSJ Op-Ed  pages today to see the rhetorical backflips being done to try to portray the Republicans and the Right as having a poor little misunderstood law. Their "better care reconciliation act"  won't really toss millions off of healthcare! How dare the Dems and their activist base lie like that!

First there was Karl Rove ('Obamacare Health Care Audacity'), aka "turd blossom",   as noisome as ever since outing Valerie Plame (and letting Scooter Libby take the rap) belching about "the Left's new club", i..e. that 23 million will lose insurance if the GOP bill passes, "since only 10 million get coverage through Obamacare exchanges". But he misses the point! Because the Medicaid expansion puts its enrollees technically under the ACA, that means that any loss of Medicaid insurance is also a loss of Obamacare insurance.

Rove also tries to argue cleverly that in any case the Left has "misunderstood" and that no one is ruining Medicaid. It will simply continue to grow at a slower rate.  But see, the devil is in the details.  If that means (and it does) that the growth rate is slower than the rate of medical inflation, then indeed it is taking a "meat axe" to the program as one commentator put it last week. 

Further,  if federal expansion of the program is reduced - say from 72% to 50%,  that does mean states will have to take on the burden and most lack the money, or budget flexibility to do so. Look at Illinois, now facing insolvency, as reported in the WSJ of June 27 (p. A1). Here in Colorado, diminution of Medicaid funding would definitely mean exploding budget deficits and much more stringent qualification requirements which too many low income earners could not meet.

By any reckoning that spells catastrophe, and yeah, deaths - if  medical needs - such as for cancers, kidney disease, diabetes - go unaddressed. And no, it isn't a matter of "choice" as assholes like Rand Paul try to make out. If people lack the money and their health care is set against food or rent, that's a Hobson's choice not  a real one.

So when 'Turd blossom'  goes off on Elizabeth Warren ("the bill uses tax cuts as blood money")  or Hillary ("if Republicans pass this bill they are the death party")  he isn't losing points except for himself Also, when he takes the Center for American Progress to task for its finding that "217,000 Republican - caused deaths will ensue over the next decade"

Rove tries to mock it for its precision, but the Center never claimed it be exact but rather an estimate projected from likely removals of beneficiaries from state Medicaid rolls.

The WSJ Op-Ed (next page) actually tries to outdo Rove for desnity of baloney published per square inch. For example, this chestnut:

"The bill is carefully designed to avoid overreach and would save taxpayers $772 billion compared with what Medicaid would otherwise spend under current law."

But it is in fact exactly that money that Medicaid would need to spend, state by state, to: keep frail oldsters in nursing homes, to keep disabled people in their homes and functional, to keep opiod addicted people in states like Ohio with naxalone, and to keep children in low income homes suffering from leukemias, autism, bone diseases etc. from being warehoused in some rat hole.

That money then, is not just "free up"  money that can be jettisoned like most Reepos would their granny if she cost too much.  Moreover, the "taxpayers" aren't just ordinary Joes like you or me, but the top one percent who'd take home $54,000 a year on average (for $1 m income earners).  In other words, it is the taxpayers who can most afford to part with these ill  gotten gains - if the bill passes.

Then we have this giveaway clue:

"The GOP can't meaningfully ...increase defense spending without fixing Medicaid and replacing Obamacare".

That the GOP wants to use that extra money from defunding Medicaid expansion for defense spending too. $641 b to be exact, for FY 2018.  It doesn't take tons of insght or genius to see that the Goops want to decimate tens of thousands to get their precious bag of silver...for the rich...and for defense. Then they wonder why we refer to them as reptiles

Any party that would rather use $$$ for defense (already we spend more than the next 13 nations, including to operate 800 bases around the world) than on the health security of its people is a nation doomed to fail, to go into massive decline. Especially when it puts tax cuts for the rich above human needs too.

But the bastards are now caught out and no matter how much Bitch McConnell tries to sneak the next iteration under the rug it won't work. We're onto them and him, and the activist resistance is now waiting for the rats....errrr ...reptiles, to show up at their town hall meetings.

Stay tuned.

See also:



Saturday, June 24, 2017

The Wall Street Journal's Misplaced Malarkey On The Senate "Health Care Advance"

These days words and meanings are everything, and are often deployed with special aplomb to distort and divert inquiring minds from truth. I've already - in previous posts  - noted many historical examples, such as the substitution of the vanilla term "scandal" for actual, multi-layered conspiracies such as Watergate and Iran -Contra. The effect being to divert the historically purposive mind from political conspiracy to well, something "scandalous" - like the Clinton- Monica Lewinsky nonsense. Thus are events riven with historical and political gravitas reduced to gossip-style, forgettable one offs.

Similar word twisting perversion occurred with using the term "death taxes" for estate taxes, the better to spare the wealthy from having to pay their fair share in a democratic, supposedly fair society.  Now, the latest addition to this sordid verbal jui jitsu involves the terms used for the atrocity known as the Senate health care bill which demolishes Obamacare and has cynically been named the  'Better Care Reconciliation Act. of 2017.'

The Wall Street Journal added to this perversion in its editorial yesterday ('The Senate Health Care Advance') by first using the term "Senate" when only the Reepo contingent pushed it through, and second, calling it "health care" when in it is all about tax cuts, and third, using the word "advance" when it is in fact a major regression for 75 million fellow citizens.

There are other aspects of the WSJ editorial I also want to call into question and criticize from a historical, economic and political perspective. Why? Because getting at the true nature of this misbegotten piece of "legislation" requires doing so, at least to the same degree as when I take care to classify solar flares by their x-ray output.   Hence, I cannot in good faith conflate an X-1 flare with an X-9 event, like the WSJ does with its ACA and Medicaid "facts".  But WSJ editorials are not known for being factual but circulating  Rupert Murdock propaganda.

For example:

"The legislation replaces Obamacare's subsidies with tax credits for people who buy insurance on the individual market"

The use of "tax credits" betrays the true intent of this bill as a tax plan, as opposed to a health care bill. Tax credits are the standard conservo solution to genuine fiscal holes, but are really useless gestures. After all, they do absolutely nothing for people in  serious medical distress, say to be able to afford actual, meaningful tresatments. They are little better than a useless dollop or dressing, and as one mother of an autistic child put it in a TIME essay last year, would barely cover $1200 of her $30,000 yearly needs.  But they do create the illusion of offering something, I mean look at the term "credit",  after all.  But in terms of health care which I already noted increases inexorably, it is subsidies that pay the freight, not "tax credits!"!

And subsidies would more than be the solution if this country pared back its defense spending to half the GDP proportion, say to what it was before 9/11.  After all, a nation that outspends the next 13 together in defense can't possibly be "on the ropes"! Only a moron would believe so.  Hence, as former defense analyst Chuck Spinney once put it, let's cut the defense share of GDP  back to 2.4 % to 2.2 %. THEN we can make room for providing subsidies via the original ACA which, let us be clear, was the reincarnation of an original REPUBLICAN health care law (also known as "Romney Care")

"Medicaid was originally meant for poor women, children and the disabled - which Obamacare opened to able-bodied, working age adults above the poverty level".

This takes no account whatsoever that health care access (and needs) must expand as a population increases and economic legislation alters over time.  Point of fact, the population of the U.S. was about half what it is today at the time (1965) Medicaid came onstream. In addition, the poverty level has barely changed since then, remaining far too  statistically "lowballed" for the very purpose of limiting access to benefits.

Now add in the economic forces of globalization - globalized labor markets (and destruction of the U.S. manufacturing sector), and mass corporate downsizing in the 90s, and the case can be made that the original intended beneficiary base of Medicaid was simply way too meager, too small, by 2000. To put it another way, most lower middle and working class citizens - even with jobs - were in essentially the same economic position as "poor women and children" in the late 1960s.  Of course, it is in the Journal's best propaganda and spin interests not to process this.

To fix ideas,  consider the Denver Post article ('4 in 5 Adults Face Poverty At Some Point In Lives', July 29, 2013).   According to the article:

"Although ethnic and racial minorities are more likely to live in poverty, race disparities in the poverty rate have narrowed substantially since the 1970s, census data show.

Economic insecurity among whites also is more pervasive than is shown in government data, engulfing more than 76% of white adults by the time they turn 60, according to a new economic gauge to be published next year in the Oxford University Press."

The Post article further notes that "measured across all races" the risk of economic insecurity rises to 79% or nearly 4 in 5. Pardon me, but this indicates a nation of rising inequality and the degradation of most citizens in terms of their economic welfare. Above all, it shows the need for vastly expanded medical benefits given the deplorable economic inequality ensures most can't afford the health care they need- so must depend on a decent federal government to provide it.  An "entitlement"? Perhaps, but how else will our people get the medical treatments they need and deserve?

"The Senate waits four years instead of three but pegs the (block) grants to inflation with no adjuster."

As former Medicaid administrator Andy Slavitts observed last night ('Last Word') this translates on average to a state cut of 25 percent per individual beneficiary.  This portends serious losses of benefits for most of a state's population especially given no adjuster. But again, this exposes this sham law for what it is, a tax cut plan for the rich as opposed to providing for the most medically disabled and adversely affected among us. Unless states trapped in a zero sum budget scenario compensate - say by taking funds from roads or preschool-  thousands of state citizens will be left to scramble.  The very Darwinian nature of the Repuke bill is here exposed, pitting one segment of citizen interests (and citizens) against all others. In other words, a return to the law of the jungle but in economic warfare form.

"The Senate includes about $100 billion for a stability fund .....and could be used by creative Governors to support insurance markets in states like Maine and Alaska"

In other  words, the Reep Senate bill creates a slush fund that can be used to bribe state Governors (especially in high premium states)  to cooperate with the for -profit sharks to set up costlier protection rackets - passed off as health insurance. (See William Rivers Pitt's sterling analogy at the end of yesterday's  post.) By use of creative accounting the state Governors can then make it appear health exchanges are really working - as they would be under a properly redone ACA- when they're only on temporary support from the limited slush fund. When the slush fund is exhausted the premiums across the board will shoot through the literal roof.

"The Senate wouldn't allow states to apply to relax the community ratings regulation which limits how much premiums can vary among individuals with different health risks."

In other words, if instead of being a  70 y/o Medicare beneficiary with prostate cancer, I was ten years younger and lived in a high premium state (e.g. AK) , insurers could charge me up to five times more in premiums (say $5,000 a month instead of $1,000) precisely because my health risk would be recognized as greater from being diagnosed with prostate cancer. It doesn't take a genius to figure out that the end result of this sort of draconian solution would necessarily see fewer men going in for PSA tests, for the very reason they would wish to escape a possible negative diagnosis with adverse consequences to their insurance premiums.  By the same token we'd likely see fewer people going in for colonoscopies as well as skin exams (which I also recently had - with one suspicious mole removed for biopsy).

"Importantly, the Senate bill also repeals all of Obamacare's tax hikes .....including the 3.8 percent surtax on investment income."

Left unsaid is that it was precisely these tax hikes that helped pay for the individual subsidies for the low income citizens with unmet health care needs.  What the Reeps have done is to basically cut out the tax hikes and gut the subsidies, replacing them with "tax credits". So, whereas before a citizen might have had $20,000 to cover the costs of a prostate cancer treatment he will now be lucky to get a chump change $500 tax credit.  This would barely be enough to cover his pain meds and basic tests, far less any kind of real treatment (say focal cryotherapy) Again, all of this exposes the Senate bill as an outright sham, a tax cut bill NOT a health care bill.  For reference  a person with a $1 million annual income would gain $54,000 each year in tax cuts. Almost enough to buy a new Lexus.

The Journal even confirms this tax cut imperative when the editorial states:

"Some Senators pushed to keep the surtax to avoid the tax cuts for the rich label and spend the revenue on something else."

Too late now, assholes, you're busted! We all know this is a damned tax cuts for the rich   Trojan horse being rolled out like a new health plan.  Only a certified halfwit would believe otherwise.

"It's not too much to say that this is a defining moment for whether the GOP can ever reform runaway entitlements. If Republicans, the next stop is single payer."

Then by all means let us hope they fail and miserably!

To summarize, these are the facts not processed in the WSJ's editorial:

1) There are vastly more poor citizens than rich in the U.S. of A.

2) The medical needs of an expanding population with few resources, income to begin with will always grow exponentially in relation to economic budgets for which yearly predictability is sought.

3) At the same time the costs of those medical needs must always expand, never decrease because medical inflation always exceeds other forms.

4) Therefore, by dint of (1)-  (3) it is budget allocations for genuine health care which must always be given priority in a nation that seeks genuine national security. After all, a sick population can never be a secure one, nor - by extension - can the nation they inhabit.

5) Tax cuts even disguised in a health care bill (so called) can never work and have  been proven not to work. They only increase deficits by cutting revenue and make a country less able to come to terms with its long term liabilities. To use economist Paul Krugman's term, they are a "zombie idea" because the Repukes keep bringing them back even after their efficacy has been disproven.

See also:

http://www.smirkingchimp.com/thread/robert-reich/73691/it-s-time-for-medicare-for-all

Friday, June 29, 2012

It's Manifestly Clear Now What Obama & Dems Must Do!

Now that the dust has settled and the media hype died down, somber heads can finally prevail and - based on the Roberts Supreme Court decision yesterday - move forward on a number of fronts, including: (1) selling the benefits of the new health care law, (2) shoring up its funding, including for the critical expansion of Medicaid (to cover 17 million more people) and (3) Using (1) in combination with old Romney speeches on behalf of his "Romney care" in Massachusetts, to do an end run around this asshole's attacks (including reminding the millions of beneficiaries of the new law what they stand to lose if this guy is elected in November and tries to gut the law or repeal it as he vowed yesterday.)

Let's first grasp, as Rachel Maddow observed on her show last night, that the primary reason negative perceptions on the Patient Protection and Affordable Care Act have abounded is because of: 1) the long lead time in getting its provisions implemented, and 2) the lackluster way the Dems have sold it since its passage.

Both of these have forged a vacuum in which the Rightists and their naysayers - whether in the blogosphere or the 24/7 cable media -talk shows, have been able to sow fear and distortions. They have essentially been able to make up virtually anything they want because the other side (that crafted the law) has been so passive in its advocacy.

Meanwhile, in Massachusetts (as Maddow noted) 6 years after 'Romney care' was implemented, 98% are insured in that state, the highest proportion in any! One huge reason it succeeded was an advertising blitz campaign (some examples of which Maddow broadcast on her show) and a short lead-in time to implementation, of barely 1 year. Meanwhile, because of the manipulations of jag-off conservative Dems the provisions in Obama's health reform law had to be delayed for 4 years! (That is four years of the other side being enabled to paint it negatively).

These idiot, jag-off fifth columnists (one reason the Dems didn't REALLY have a filibuster proof supermajority despite the Right's claims to the contrary) demanded an artificial ceiling of no more than a trillion dollars to pay for it, leaving the Congressional Budget Office (CBO) to be the ultimate arbiter of its costs. Since the CBO -bases its budget ratings on 10-year cycles it meant the costs could only come in under $1 trillion if 4 years of the 10 were 'subtracted". Thus, instead of starting in 2010 the main provisions had to be delayed to 2014. A terrible mistake, and costly, given how the negative PR has been ramped up against it.

Now, to make up for it, the Dems need to get off their asses and at least repeat the positive aspects of the law until blue in the face. Obama gave the model yesterday in his response speech to the Roberts decision. He for once enumerated and expatiated on the benefits, including vulnerable people not being dinged because of exceeding insurance payout limits, or other sickly people being prevented from access because of "pre-existing conditions" or young adults being prevented frmo being covered under their parents' plans. This is good, now Dems overall need to replay it and emulate it....and Obama needs to keep repeating it.

Then there was the critical Medicaid decision, which many liberals have misinterpreted. Not realizing that it was 6-3 against Medicaid expansion but two of the ones in the '6' group were 'liberals'. (Stephen Breyer and Elaine Kagan). Had those two not defected to the side of the 4 conservatives, the Medicaid expansion would have passed. So one is led to inquire why these two would take that position, and the only logical or acceptable conclusion is because they are sending a message that the tax support needs to be increased for all Americans. (See also my previous blog related to the need for higher taxation, including letting ALL the Bush tax cuts expire.)

Lastly, Dems need to wake up and realize if Romney or his jag-offs corporatists get into office the new health law will likely be pecked to death even if Romney fails to repeal it as he vowed, e.g. proclaiming like the school yard, batshit crazy bully he still is:

"I will act to repeal Obamacare from my first day as president of the United States”

As blogger Robert Scheer noted, this is "a prescription of destructive gridlock for a program already well under way."  In other words, if Mitt Romney is elected Americans now so tired of gridlock won't see less of it but perhaps five times MORE! This is why I still can't believe the polls showing Romney and Obama in a dead heat. How can so many of the putative "99%" be for this corporate job exterminator, who - as reported recently in a TIME special article - dispatched even more American jobs overseas than first believed. How can any self-respecting, white (or black) working class man or woman seriously vote for this guy who will be guaranteed to make their lives a hundred times worse? It boggles the mind!

Anyway, the way to best and beat Romney when he keeps publicly vowing to end Obama's health care law is to keep showing Mitt's own speeches (avaialble via dozens of news clips from 6 years ago) promoting his own Romney care version in Massachusetts. And then also showing how that program, so reviled during the Repug debates, now features the largest percentage of insured citizens in the nation. So why the fuck is Mitt running from his success?  The only answer is that the man has to posture negative reaction to appease the Tea bagger vote! But if he does that, he's not only a liar but a hypocrite! DO people - voters really want such a guy in the White House?

The way forward for Dem success is clear, and the Roberts court decision 'tea leaves' show the way. What remains is for the Dems to have the balls to use it instead of running from their shadows.