John Kass Better Hope He Never Gets Old

Chicago Trib hack John Kass has shot another round to try to launch an inter-generational war with his piece 'Geezer Zombies, Soon to be a Reality' (Denver Post, Oct. 6, p. 5D) While comparing Senate "geezers" (let's recall the Senate is the biggest, most elite millionaires' club in the country) John McCain and Dick Durbin to zombies and even extending the comparison to "the old woman crawling across the ceiling in the hokey horror film 'Legion') he then loses his way entirely by conflating the example with ordinary seniors.

According to Kass:

"The prospect of McCain and Durbin scurrying on the ceiling followed by Mitch McConnell and Harry Reid is horror indeed. So it's a guaranteed money-maker. And that hit will prompt others like 'You Better Kill Everyone Over 30 Before They Drink Your Blood'.

Really, Kass? Why everyone over 30? I can think of select subsets right now that - with stakes driven into their hearts - would make this nation a whole lot better, but you neatly skirt the issue. But you expose your crappy hand when you claim "the real conflict isn't partisan, but inter-generational" then add this claptrap:

"Establishment pols continue bickering over crumbs while refusing to do much about those fiscally ravenous and unsustainable entitlement programs like Medicare, Social Security and Obamacare"

And thereby he places himself in the same category of other Neoliberal rats trying to make us believe seniors can easily do without essential social insurance - thank you very much - while turning a blind eye to the military -industrial- spy complex which is gobbling up massive chunks of the treasury each year.  This Military malignancy has already drained us of over $4 trillion via 2 unpaid for occupations  and it may well be much more, when all the medical needs of the returned Iraq and Afghanistan vets are tended to, as well as their future disability benefits finally paid for.

But does Kass even try to impute the defense -spy state nuts? Oh no, that's off base. But let's take aim instead at ordinary seniors who can end up destitute with one fall, or god forbid, Alzheimers. Instead, Kass piles it on even more, scribbling:

"Unfortunately, the unsustainable federal spending ...will drain today's teenagers and 20-somethings of vital nutrients like cash and jobs. Among the young unemployment rages, job prospects are poor and many figure they will never own a home. Young people know this, or at least feel it as Washington continues to print money."

While Kass appears obsessed with the Federal Reserve's quantitative easing policy ("printing money") he takes his eyes off the real ''ball': vast defense contracts (for toys like the F-35 at $600m each, to build 2,400 of them) and a surveillance state whose budget has now grown to a half trillion a year, including to pay thousands of private contractors to compile meta-data on Americans, and with black budgets.

How can any columnist be so patently blind? Perhaps he willingly does so and wants an inter-generational war on top of the new Civil War brewing now between Southern Tea Party types and northern style liberal governance where all get a piece of the pie.  To confirm this he goes on to spew nonsense about the "baby boomer undead and the teenage zombie hunters" then - to make sure we know he's as crazy as shit house rat, he writes:

"Less than 50 years ago, nearly 30 percent of America's elderly lived below the poverty line. No more. They've switched places with the young and the young don't get it yet. But they will. And if that's not a recipe for conflict, I don't know what is."

So wait, Kass,  you really want to return us to the era of thirty percent elderly poverty?

In fact, the poverty rates for those over 65 and the younger set (21- 34) are nearly exactly the same: 15.6% vs. 15.4% (according to 2012 Census stats) so it's not as if they've "switched places".   Kass' narrative is that greedy seniors are robbing the young blind, but the truth is that the military-industrial spy state is robbing both blind. Rather than put the tail on the military-surveillance expansion it's much easier not to rock the boat of the Neolib paymasters - and blame oldsters instead. Never mind, whatever the predicament of the Millennials now they are much more resilient than the elderly. They have much more TIME and opportunity to bounce back from a setback - economic or physical (especially if they have the sense to sign up for the ACA) than the elderly do. They aren't looking at a prolonged death from Alzheimers, after all, or being confined to a nursing home after a fall. (Or paying more than $4,000 a month to stay under nursing home care!)

Given this, we need to be aware of how the entrenched Neoliberal political Elite continues to make up lies as it attempts to destroy our social insurance infrastructure. If you want to see the real swine behind it go to www.petersonPyramid.org )

The next time Kass or any other overpaid, self-important hack thinks of playing the "generational war" card they need to be reminded of the following:

Seven million children currently live with grandparents - who depend on Social Security to care for them

- 8.5 million other children (including college kids that find themselves jobless and live at home) who live with elder parents that depend on Social Security to make do.

- The tens of millions of 50-plus Americans who, through their tax dollars and Social Security monies, pensions, provide voluntary contributions to support public schools, child health programs, grandparent guardianship programs as well as other charities that care for homeless kids (e.g. Covenant House).

 Concocting war between the generations, pitting young against old, therefore serves no useful or moral purpose. It is merely a cheap, malicious tactic to take attention from the REAL problem: the malignant growth of the Military Industrial Complex to the detriment of all of us outside it!

Meanwhile, the best strategy for right thinking Americans is to fight on for a single payer, Medicare- for- all system, which ultimately would save us at least a trillion over ten years, and eliminate the 120 Americans per day who perish for lack of health insurance. 'Socialized medicine' ? Not any more than the healthcare provided by the VA! 

TIME’s Exposé of the Medical Complex's Price Gougers (2)

It is easy to see that a recurring theme in Steven Brill’s TIME article ‘Bitter Pill’ is the chance nature of most American health care. Live in the wrong place, be the wrong age, or just have an accident, and you are up the creek and liable to be clobbered with costs via “charge master”. This is the automatic billing machine now operating as a deus ex machina in most non-profit hospitals and contributing mightily to soaring medical costs to the tune of $750b waste each year.


For those with excellent health insurance, like my niece (who works at Oracle) and who just yesterday  underwent partial mastectomy for breast cancer, the excruciating pain from medical bills is held at bay. She is effectively insulated, so there is no suffering on top of the physical agony, of say having to undergo cancer treatment. For many others it’s not so clear cut or painless cost-wise.


For example, there’s the sad case documented by Brill of Emilia Gilbert (p. 28) now 66, who merely had the misfortune to slip and fall on her face one evening in 2008 – at the age of 61 and before Medicare eligibility. Her nose bleeding heavily she had to go to the ER at Bridgeport Hospital. She ended up with $9,418 in medical bills which still have her “hyperventilating”. The CT bills alone (for 3 CTs) came to $6, 538, while Medicare would have paid $825. (The Bridgeport Hospital had an operating profit of $52 million in 2010)


Worse for Gilbert, she only learned too late that the health insurance offered by her employer as Cigna (a top name) was not its top tier version but rather from a Cigna subsidiary called ‘Starbridge’ offered for low wage workers. (As usual, the low wage workers are the ones that get screwed in this country) That meant she was “on the hook for about $7,000 of her $9,400 bill)


Then there was the case of ‘Steven H.’ who went into Mercy Hospital in Oklahoma City for a simple outpatient procedure (laparascopy) that ended up costing $87,000. (Part of the multitude of costs rung up by the hospital’s charge master: $32 for a blanket to keep patients warm). The hospital is evidently run by the Sisters of Mercy hospital chain (p. 33) which collected $337m for fiscal year ending June, 2011 of which $34 million was its operating profit. This from a group that professes as its mission: “to carry out the healing ministry of Jesus by promoting health and wellness.”  Well, pardon me, but I doubt Jesus would have taken $34 million in profits for his healing!


Most shocking regarding outpatient procedures such as those experienced by Steven H. are that they are responsible for nearly two-thirds of the $750b in medical waste overspending each year. According to Brill:

“This includes work done by physicians, laboratories and clinics- including diagnostic clinics for CT scans and blood tests- and same day surgeries and other hospital treatments like cancer chemotherapy. “


TIME’s Brill further cites a McKinsey survey that outpatient Emergency room care averages an operating room profit of 15%, compared to inpatient care which has a margin of only 2%.


The reason? According to one medical economist:

“You get 10% or 20% more patients in there every day who don’t have to board overnight and that goes straight to the bottom line.”


Hmmmmmm….sounds awfully similar to the reasons the airlines have for continually decreasing the seat pitch for economy class to pack more hapless passengers in and rack up the profits!

One of the saddest cases Brill investigates is that of ‘Steven D.’ (p. 37) who had the misfortune to get lung cancer at the age of only 42. His treatment had an initial price tag of $348,000 but his wife Alice was later able to secure the services of a billing advocate who got the Seton Medical Center in Daly City, Calif. to write off $297,000 of the bill. Just as well after seeing what was originally itemized, including: $24 (each) for niacin pills and a $77 charge for simple gauze pads (p. 38).

One year after the death of Steven D. his wife Alice enunciated the primary lesson she learned from the ordeal (ibid.):

“I’m never going to remarry, I can’t afford the liability.”


This was after she had to cover the balance of her hubby’s medical bills, including shelling out $30,000 of her own money and still owing $142,000. Imagine that! She can’t afford to remarry because the next  potential husband may be another medical liability. Do I blame her for evincing a crass attitude? NO! I blame a nation that would allow and enable a system that drives its citizens to such economics over all desperation. It is a reminder of the famous words of Charles Reich in his ‘Opposing the System’ (p. 183)::


"When society itself comes to be modeled on economic and organizational principles, all of the forces that bind people together are torn apart in the struggle for survival.  Community is destroyed because we are no longer 'in this together' because everyone is a threat to everyone else. "

BINGO!

But some of the worst travesties are to do with the ‘Cancer Drug Profit Chain’ (p. 43), for example the case of the drug Flebogamma which features an astounding mark-up. Compounding the travesty is that drug makers are free to set their own prices. This seems to make sense in a “free market” economy until one considers, as Brill does, that the drug is a one-of-a-kind life saving serum. In this case, we no longer have a free market but a "controlled market". This means patient "choice" is a sham: You either pay $6,000-odd a month for the life-saving drug or you die. Some deal!

Brill notes (p. 46) that “our laws do more than prevent the Government from restraining prices for drugs the way other countries do, it also restricts the single biggest buyer Medicare – from trying to negotiate drug prices”


Of course, this is totally whacked out double down insane, and shows the country has no real vested interest in controlling medical costs or I would argue, the long term deficit. Never mind the rhetoric coming out of D.C., the facts belie any serious interest in debt control, but rather expediently piling added financial burdens and social insurance cuts onto the most vulnerable to support the lifestyles of the wine -and -brie plus twin- Bentleys class, be they "liberals" or conservos.


To show how insane and hypocritical this country is, consider this: Sloan Kettering researcher Peter Bach reported in a 2009 article in the New England Journal Of Medicine (p. 46) that “Medicare’s spending on the category dominated by cancer drugs ballooned from $3 billion in 1997 to $11 billion in 2004..” He projects it may now be over $20 billion.


Bach, on the basis of this finding, pushed with other experts to establish a Patient-Centered Outcome Research Institute to expand comparative research investigations. Such efforts would be able to ascertain, for example, that if cancer drug A works better than drug B and is less expensive, then A ought to be selected for Medicare (Part D) Prescription Drug Formularies over drug B. 


Alas, a Repuke- dominated congress jumped in and added eight provisions to fuck the deal. These provisions restricted how the research could be used, with the primary one spelled out as (p. 46):

“Findings shall not be construed as mandates for practice guidelines, coverage recommendations, payment or policy recommendations.”

As Brill notes:  “With those 14 words the work of Bach and his colleagues was undone and costs remain unchecked.”

Are the Repukes and their ilk really interested in cost-management and “preserving entitlements” for future generations? Hardly! Like their determination to protect the wealth of the richest 1% they are determined to milk Medicare dry by any means they can to protect the out-sized profits of the Medical Industrial complex.


As for the citizens (victims) snared by this gluttonous, greedy and egregious system? They can catch as catch can, scrape by while being pursued by bill collectors, maybe rob a bank to get $$, kill themselves or simply refuse to remarry since the next partner may be a “liability”. (But they better pay those medical bills NOW...and oh yes, no trying for Chapter 11 bankruptcy!)

No wonder this country is in such sad and sorry shape! I recommend that interested readers get hold of the whole Brill article (March 4, TIME) to find out how profoundly fucked our whole health care system is and the extent to which it’s driving up our national debt! Which, evidently no one in D.C. really cares about, whether the politicos or the Medical Complex's grubby lobbyists.

TIME's Exposé of the Medical Complex's Price Gouging - And Why We Need to Expand Medicare, NOT Cut It! (Pt. 1)

Well, one never ceases learning! The recent (March 4) TIME 24,200+ word article ‘Bitter Pill’ delivered a shock to me and I thought I was au fait with most aspects of our payola health care system. As it turns out, what I knew barely scratched the surface of how Americans are being gouged and their pockets repeatedly picked to the tune of $750 billion a year in medical wastrel spending.


While the putative journalist cognoscenti usually dismiss TIME as “bubble gum” piffle for the hoi polloi, the fact is that it often contains salient and insightful essays. And every now and then ‘TIME’ hits one out of the park with a thorough investigative piece worthy of The Columbia Journalism Review. Such was the case with ‘Bitter Pill’.


The article ranges over 5 effective sub chapters from how people are clobbered in routine care, to the issue of catastrophic and “prestigious care”. One of the stories (p. 18) is that of Sean Recchi, 42, who learned he had non-Hodgkins lymphoma. Before the guy could even be examined for treatment, and before a treatment plan was devised, he had to cough up $48,900 in advance. This was more than the total I had to pay for my prostate cancer treatment back in September.

The total cost to pay for Sean’s initial treatment including initial chemo came to $83,900. Further shocks awaited after 344 lines of hospital bills were printed out, most by a little known automatic program called ‘Chargemaster’ – which computes most of the medical billing.


In perusing the Chargemaster billing, Sean and his wife found one generic Tylenol pill came to $1.50. Cheap? NO! As the article notes you can buy 100 of them on Amazon.com for $1.49, and this without a hospital’s purchasing power. Similar other outrageous mark-ups were found including $283 for a simple chest x-ray for which the hospital was usually paid $20.44 when it treats a patient on Medicare.


Meanwhile, there were Recchi’s blood and lab tests which came to $15,000, while TIME noted that had Sean been old enough for Medicare the full tab would have been “a few hundred dollars”. TIME learned that M.D. Anderson the putative ‘non-profit’ that delivered Rechhi’s care earned a profit of $531 million in the most recent report it filed with the U.S. Dept. of Health and Human Services. As the article put it:

“That’s a profit margin of 26% on a revenue of $2.05 billion, an astounding result for such a service-intensive enterprise.”


Meanwhile the President of M.D. Anderson is paid handsomely, with a total compensation of $1,845,000 last year. TIME notes this salary is “nearly triple the salary paid to the president of the entire University of Texas system” of which M.D. Anderson is a part!


TIME concludes in the case of the Recchis:

“You see nothing rational- no rhyme nor reason- about the costs they faced in a marketplace they enter through no choice of their own. The only constant is the sticker shock for patients who have to pay.”


No wonder, as the article goes on to observe, “people spend almost 20% of the gross domestic product on health care” compared to less than 10 percent in most developed nations.  And further:


‘Yet in every measurable way the results of our health care system produce no better results and the outcomes are often worse than those other countries.”


How did such an atrocious abomination of a system come to be? LOBBYING! TIME cites the Center for Responsive Politics that the Medical Industrial Complex (organizations representing doctors, hospitals, HMOs, nursing homes, Big PhRMa etc) spent $5.36 billion since 1998 lobbying in Washington, which dwarfs that $1.53 b spent by the defense and aerospace industries. No surprise then that with this noisome establishment of parasites we are set to spend $2.8 trillion this year on health care.

No wonder our national debt is exploding (along with monstrous defense spending) !


Note also that this same Medical Industrial Complex is also the one – in league with the Peter G. Peterson bunch, screaming to prevent special bidding by Medicare (say for the best prescription drug prices)-  that has sought to prevent expanding Medicare beyond its current population. But that expansion, by virtue of more rigorous control of costs via standardization, is exactly what would cure our overspending in the medical arena.


Another case highlighted was that of Janice S. (p. 22). Janice made the mistake of calling for an ambulance after experiencing chest pains. It is a “mistake” most of us are asked to make to save our lives, if we even think there’s a remote hint of a heart attack. But see, “Janice” had been out of work for a year and had no insurance. (She was 64, one year shy of Medicare)


As she was rushed to the Stamford Hospital, she might well have jumped out if she’d known in advance she’d be billed $995 for the ambulance ride, $3,000 for seeing the doctors (most of it racked up as waiting time) and $17, 000 for the “testing” – all in all $21, 000 for what turned out to be a false alarm.


One of the series of tests done was “Troponin I” for which she was billed $199.50 each by the hospital’s charge master. Had she been on Medicare, she’d have paid only $13.94 for each Troponin test. Meanwhile, she was billed $157.61 for a CBC (complete blood count) while if she’d been on Medicare, the bill would have come to $11.02.


TIME’s article takes note that many “grouse about Medicare’s payment rates” but goes on to add (ibid.):

“But an annual expense report that Stamford Hospital is required to file with the federal Department of Health and Human Services offers evidence that Medicare’s rates for the service Janice S. received are on the mark”


In actuality, in perusing the Hospital’s actual filing it charged patients $293.2 million for tests similar to the lab tests of Janice S. but which actually cost $27.5 million. In other words, Stamford charged about 11 times its costs.

What is an even worse travesty in all this over-billing, is that “no hospital’s charge master prices are consistent with those of any other hospital, no do they seem to be based on anything objective, like cost”.
HUH? Are you kidding me? And then you have dildo-brains like Boehner’s Repukes and Tea Peas screaming to let Medicare eligibility rise to age 70??

Re: the variant charge master billings, TIME reports “they were set in cement a long time ago and just keep going up almost automatically”.  Great! A deus ex machine billing monster with no one in control!

The TIME author (Steve Brill) adds (p. 23):

“That so few consumers seem to be aware of the charge master demonstrates how well the health care industry has steered the debate away from why bills are so high to who should pay them”
Most revealing? The exorbitant difference between the costs actually indicated and the charges Brill spied by all these “non-profits”. As Brill puts it (p. 26):


“Judging from the difference I saw in the bills examined between a typical charge master price and what Medicare says the item cost, this would mean that ‘$39.3 billion’ in charity care cost the hospitals less than $3 billion to provide. Incredibly, “under Internal Revenue Service rules, nonprofits are not prohibited from taking in more money than they spend”. Holy Samoley! Would that those of us with de-mutualized insurance shares had even half that benefit after taking losses on paper of more than 50%! (A recent court case in January, 2013 in California has asserted the IRS has the right that all such shares have ‘zero’ cost basis, hence if such shares are sold you pay capital gains taxes whether it’s a loss or gain)

Meanwhile, given the monstrous cost vs. profit imbalance of these Non-profits, TIME puts the kibosh on the widely spread meme that “a cut to the provider, i.e. hospital, must also be a cut to the (Medicare) beneficiary”.

Not with those 11x profits over costs astounding profits it ain’t! Be aware of that, folks, as the sequester heats up and those 2% cuts to Medicare providers are exacted. If you hear or see them crying ‘Foul!” you know they are full of shit.


In the meantime, dear readers, maybe this first blog instalment will have imparted a few important lessons:


1) Make sure all your medical ducks are in a row, say before calling for an ambulance for chest pain.

2) Be sure to find out, if and when you do go to a hospital, whether it uses the infamous ‘charge master’.

3) If you must go the charge master route, demand a 50% or better discount on the test(s), e.g. blood test, or refuse to accept it (after you are informed of the charge master price) in the first place.

4) Push your reps for Medicare to be expanded at least to people younger than the current Medicare eligibility age, say to 64 or 63. Fight like holy hell to prevent the eligibility age being raised to 70!

And stay tuned for more in Part II!