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Tag Archives: health care

Catching up

So, I’ve been in Miami the past few days. I generally like TDYs, but not to Miami, because it’s a) hot, b) humid c) filled with the kind of annoying drunken coeds on spring break that make you want to climb a tower and start picking them off with a high-powered rifle.

Also, whenever I go to Florida, I invariably wind up with a three-day headache. This trip was no exception, so it made the numerous meetings I had to attend that much more miserable.

That said, we did have some excellent food, saw some very cool art in the Winwood district between meetings, and I got to talk to a class full of high school students about careers. Yeah, I know. Someone allowed me to speak to kids. I actually corrupted young minds. You can blame my buddy Tim, who is a high school teacher, and somehow thought it was a cool idea to expose his students to my special brand of crazy. I did not drop the F-bomb during my speech. I did, however, drop one several times as we walked outside. In front of kids. Apparently, that’s a no-no or something… as if they never heard the word, “fuck” before.

Le Sigh.

I did take some very cool photos in Winwood with my phone, and they have this awesome taco joint, where we got to sit outside, eat amazing food, and get glared at by feral kittens.

Because kittens.

So what happened while I was gone?

Apparently, someone leaked 45’s tax returns from 2005. After getting her acolytes in a frothing frenzy about the shock and awe contained in those documents, Rachel Maddow broadcast on her show that…

…Trump paid his taxes.

At a higher rate than Romney, Obama, and Bernie Sanders.

Wow… well, that was a letdown, eh unhinged leftists?

And guess what! I know you’ll be shocked at this, but not only did he pay his taxes in 2005, he’s still President!

I’ll let you take a woosah moment.

What else happened?

I was watching the news this morning at my hotel room, when they decided that this was somehow newsworthy.

Mom jeans. With plastic panels, so when you wear these monstrosities, everyone can see your knees. Because what you need more than anything in the world is plastic panels that make your skin exude oodles of moisture to sweat up these clear panels on a warm day. Because, see, plastic doesn’t exactly allow for air circulation.

Literally, WTF?

Is there anyone in the entire universe who would pay $95 and actually wear these things? They’re like chaps for your knees.

Perhaps Nordstrom needs to fire a buyer or two.

Next up is the fiasco of a health care bill the GOP decided to excrete out of its wrecked anus. Rob blogged about this dumpster fire, previously, as did our buddy Jason Pye at FreedomWorks. The Congressional Budget Office savaged the bill, and some Republicans are now running from it like a BLM protester after breaking the window of a convenience store.

Here’s a clue, GOP. You don’t take a horrible law, and make it worse by adding your own even more horrible law on top of it, and then expect everyone to do a happy dance, because “Oh, look! We did something!”

It’s time Republicans stopped being stupid, but I guess that’s too much to ask for.

Oh, it snowed in DC. From the looks of it, we got maybe an inch or two, but that apparently didn’t stop the panicked doofi from stampeding grocery stores like so much rabid cattle. It was in the 70s in Miami, and today was a positively frosty 60 degrees. Yes, be jealous.

Also, apparently, Amy Schumer had a comedy tragedy special on Netflix recently. Let’s put aside the fact that she really does remind me of a potato, and apparently has the IQ of one. She was apparently so unfunny and terrible, that the makers of “Ishtar” are breathing a sigh of relief, because their unwatchable dreck is no longer at the bottom of the cinematographic heap.

IMDB reviews were brutal.

This was painful to watch. Save yourself the time and don’t bother watching this train wreck (that lame pun was better than anything in this special). I have never been a big fan of Amy but she was better when she was stealing other people’s jokes. Maybe she search some old comedy tapes for new material. 1 star is generous for this slop.

If this show was a smell, it would smell of fermented beans and disease.

Mercifully it ended but I’ll never be able to get those wasted hours back. Amy if you ever read any of these reviews I have a special message for you: suicide is still an option.

On my flight back to DC, I finally got a chance to watch “Fantastic Beasts and Where to Find Them.” I loved it! Not because I’m a Harry Potter fan… well… not only because I’m a Harry Potter fan. I thought the design was stunning, Eddie Redmayne is a phenomenally talented actor, and he was at the same time shy, innocent, and a brilliant badass, Colin Farrell was just right for the role of the ultimate bad buy pre-Voldemort, and JOHNNY DEPP!

And finally, I’m excited, because Wonder Woman is finally coming out this June! As a kid, I watched Lynda Carter transform into Wonder Woman on TV every day, and I wanted to be her so badly! That series resulted in my wearing “bracelets” made of tin foil on my wrists and a desire to change my name to “Diana.” And now, Gal Gadot will bring one of my favorite superheroes to the big screen! And it looks terrific, so I’m more than excited!

And yes, now that I’m back from TDY, I will blog more regularly. Thanks for caring.

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This is how the debates SHOULD have been

I spent very little time watching the Presidential debates last year. What little I did watch infuriated me so much, I felt like throwing heavy objects at my TV. I even came up with a list that would make the debates imminently more watchable and fun! The list included rabid badgers and tequila, which gives you an idea about just how irritating I found the entire thing.

Last night, however, I did watch the CNN debate between Bernie Sanders and Ted Cruz, and I have to say I was impressed. First of all, they actually discussed the issue: health care. The moderators – Jake Tapper and Dana Bash – were balanced, and the audience was allowed to ask questions that concerned them as constituents and taxpayers. Bash and Tapper did not argue or fact check the participants. They simply guided the discussion and made sure both got a turn to speak. Good job, guys!

Then there were the participants themselves. They were congenial. They rarely interrupted one another. They were relaxed. They chatted not only to one another, but to the audience. They didn’t threaten one another. They found points on which they could agree and collaborate – right there on stage. There was a little friendly ribbing, but nothing resembling the shit shows of last year, in which threats, accusations, references to sexual plumbing, and name-calling replaced actual issues and substantive discussion.

Shamelessly stolen from FreedomWorks, who grabbed it from some guy on Twitter.

Shamelessly stolen from FreedomWorks, who grabbed it from some dude on Twitter.

That said… Sorry Bernie, but emotionalist hyperventilation does not replace facts in a debate.

Allowing people to keep the money they earned ≠ transferring wealth.

If you agree government corruption is a problem, WHY IN BLEEDING FUCK WOULD YOU WANT MOAR GOVERNMENT INVOLVEMENT IN HEALTH CARE?

If you claim insurance companies that are committing the egregious sin of wanting to profit off misfortune that befalls sick people, WHY IN DOG’S HAIRY HELL DID YOU ALLOW THEM SUCH A HEAVY HAND IN WRITING THE LEGISLATION TO BEGIN WITH?

Telling business owners “too fucking bad; do it anyway” when they ask how they’re supposed to provide health care coverage for 50+ employees without raising prices on goods and services, when they can’t even afford health care coverage themselves, is not moral, ethical, or compassionate, as you claim to be.

“Let me give you an answer you will not be happy with,” Sanders replied. “I think that businesses that employ 50 people or more… I’m sorry, I think that in America today, everybody should have health care. And if you have more than 50 people, you know what, I’m afraid to tell you, I think you will have to provide health insurance.”

The business owner quickly shot back:

“So my question is how do I do that without raising my prices to my customers or lowing the wages to my employees?”

Sanders went on to argue that it’s “unfair” that there might be “somebody else in Fort Worth who is providing decent health insurance to their employees,” but they have to compete with her business that doesn’t provide an employer-based health care plan.

“I think you’ll find the profit margin in my entire industry about the same,” the business owner replied.

What Bernie needs to do is to look up the definition of “right,” and the definition of “rationing.” He kept repeating the same tired leftist tropes about health care being a human right, which Cruz should have hammered him on, given that one cannot have the right to a good or a service, because someone always has to produce said good or service. No one has the right to the fruit of another person’s labor unless you’re into slavery, which is something we abolished a while ago. If your “right” steals the production of another human being via government force, it’s not a right, and you’re a thief – even if indirectly. Period.  I don’t know why politicians are so afraid to say it. Health care is not a right.

“Women are considered a pre-existing condition,” screeched Bernie during the debate. Uh… wat? No, pregnancy is considered a pre-existing condition. Women who aren’t pregnant can get insurance just fine. And frankly, mandating that everyone gets pregnancy coverage whether they need it or not (no, a 70 year old woman or a 25 year old man do not need pregnancy coverage, which makes Cruz’s assertion that allowing people to choose specific services a la carte make all the more sense).

And no, we are not the only developed country that does not guarantee health care as a “right.” As PolitiFact points out, “Among the countries that belong to the Organization for Economic Cooperation and Development, the United States is the only one that lacks universal coverage. But that’s not the same thing as a guaranteed right to health care, which some developed countries lack.”

Yes, we’re relatively high in infant mortality rates, as Bernie claims, but the reasons are a bit more nuanced than that.

The first nuance is one of definition. Infant mortality is defined as the death of babies under the age of one year, but some of the differences between countries can be explained by a difference in how we count. Is a baby born weighing less than a pound and after only 21 weeks’ gestation actually “born?” In some countries, the answer is no, and those births would be counted as stillbirths. In the United States, on the other hand, despite these premature babies’ relatively low odds of survival, they would be considered born — thus counting toward the country’s infant mortality rates.

These premature births are the biggest factor in explaining the United States’ high infant mortality rate. [emphasis mine] Pre-term births can have many different maternal causes, many of which — such as high blood pressure, diabetes, Zika and other infections and age — are not entirely within an expectant mother’s control. Other factors, such as stress level, might be able to be managed, but are not entirely controllable. On the other hand, some controllable risk factors include the use of tobacco, alcohol, cocaine and other drugs. The major issue of the lack of universal access to quality prenatal care should also be considered in any discussion of preterm births and infant mortality. Also, because about 50 percent of pregnancies in the United States are unplanned, some women might not be aware they are pregnant in time to get early prenatal care, and this may be part of the reason for premature births in this country.

And while estimates vary about how many Americans have lost coverage as the result of ObamaCare, and PolitiFact claims that it was “only” 2.6 million, vice the 6 million Cruz claimed on the debate stage last night, does that include those who voluntarily eschew coverage and choose instead to pay the IRS penalty? Does it incorporate the number of insurers that have left the market place thanks to cost increase? And have the cancellations run their course, given the fact that several of the mandates have been postponed until this year? If we take NBC News reporting at its face when it reported that between 50 and 75 percent of the 14 million Americans who buy individual health insurance would likely receive a cancellation notice over 2014 because their plans did not meet the requirements of the ACA, that’s between 7 and 10.5 million people! Because the mandate was delayed twice, these cancellations probably haven’t reached that level… yet. Will these people wind up without coverage? Will they opt to pay the IRS penalty? What will happen if they genuinely get in trouble and need health care? Will they be penalized on top of having to pay exorbitant prices for medical care?

screen_shot_2017-02-07_at_9-13-29_pmCruz whipped out a bunch of statistics and made a good case. Bernie derped a lot and when in trouble, fell back on the old strategy of vilifying the rich and telling people that Republicans want old people to die and while said super rich get tax breaks. The transcript is here, if you missed the debate last night.

Fact is it should never be the function of the government to decide who makes “too much.”

Fact is it should never be the function of the government to tell the individual consumer what kind of health care policy they must purchase and what it should include.

Fact is it should never be the function of the government to control something as personal as individual health care and impose a one-size fits all standard on Americans.

Fact is “rationing” happens every time a government takes over health care and reduces the availability and quality of care for everyone, and contrary to Bernie’s claim, “rationing” does not mean “not having health insurance.”

Fact is health care is not “free” in Scandinavian countries. It is paid for by astronomical tax rates, and by their own accounts, it sucks, and I agree with Ted Cruz – I’d rather live in America.

And props to Ted Cruz for TAANSTAFL!

 

 

 

Government health insurance: the ultimate sickness

Sometimes I forget how lucky I am. I have a wonderful job I love that pays me well and keeps me intellectually stimulated. I have health insurance paid, in part, by my employer. It isn’t fabulous, but it gets the job done, and I’m sure that if I ever wound up deathly ill, my family wouldn’t be financially broken.

Sometimes I forget to be grateful.

A friend of mine is an incredible intellect, who unfortunately lost his full-time job last year, and with it his health insurance coverage. The following is his account of his experience with healthcare.gov.

The website seized up four times, but finally we were able to make our application. We never got to the marketplace, because my salary as a part time adjunct was so low, we automatically qualified for Medicaid.

I want to stress this point. We never got to the marketplace because the system automatically booted us into the Medicaid application for our state. I will come back to this later.

So we got covered. Our kids got covered under Medicaid, and we got covered under Primary Care Network, which is Utah’s iteration of Medicaid.

And, it’s great! As good a coverage as I’ve ever had, low copays, no complaints.

Welcome to ObamaCare. Have a great trip!

Fast-forward to today. We get our 1095 form. It shows that our kids have been covered under Medicaid, which qualifies as full coverage under the ACA, but my wife and I, who have PCN, do not. PCN is apparently only a “limited” plan and does not qualify as full coverage under the ACA. We are now on the hook for penalties going back four months for not having adequate care under the ACA. And the enrollment period ended on Jan 31st, so we will be on the hook for the next year as well. We are talking thousands of dollars here.

This, understandably, sent my wife into a panic and tears. It’s money we don’t have.

I want to re-iterate: we went to the government website, which funneled us to a state website, where we got coverage, and NO ONE informed us that this did not comply with the law or that the coverage for us was not enough under the standards of the law. My wife and I are not dumb bunnies. This wasn’t an oversight. There was simply no way we could have known.

The website was worthless – an endless maze – so we worked the phones. We sat on hold for over an hour, but finally got a hold of a person, who admittedly, was very nice and helpful. We told her our situation, told her we acted in good faith, and wound up here anyway. She told us that since we make so little, we may qualify for an exemption. She gave us the info on how to apply for this exemption through the IRS, what forms to use etc. Part of this application for an exemption requires that we go to Healthcare.gov and look up and submit what the lowest bronze plan would have cost us.

But now you are probably seeing the first paradox: our income is so low, that the website automatically sent us to the Medicaid site without ever taking us to the exchanges. How do we get there to know what we didn’t know? She doesn’t have an answer.

Now comes the second paradox. Even if we get this exemption, how will we make sure we get adequate coverage in the future? My employment situation is unlikely to change in that time. How can we even get to the exchanges to get a plan we are REQUIRED to have when the website immediately redirects us back to the Medicaid application? Where do we go to buy into a plan we can’t even see because the application process won’t let us see it?

Again, she was very nice, but she didn’t have an answer. She thinks there might be a “tool” to help us on healthcare.gov. She suggests that we go to Healthcare.gov and search for “exemptions.” A search for “exemptions” on Healthcare.gov produces 50 hits, by the way.

Finally she suggested we talk to the local Medicaid office in Utah. Perhaps they can help. Maybe Utah offers a Medicaid benefit plan that has full coverage and qualifies under the ACA. So we do. The person at the Utah Medicaid office is very nice, but told us that there is only one full coverage Medicaid plan and it is basically only offered to invalids. PCN, which is, frankly, very generous (thank you, Utah taxpayers!) is what they offer to most of their clients.

It seems crazy that PCN somehow does not qualify under ACA, but here’s where the story gets surreal.

The person tells us that they have never been told whether or not PCN qualifies under ACA!

Let that sink in for a moment.

The ACA has been law since January, 2010 and been implemented since 2013. Six years in, and the state government Medicaid office STILL does not know if their main Medicaid program complies with the law. They still don’t understand the ACA. This is obviously the root of the confusion.

Is everyone on Medicaid in Utah in violation of the law? Are they all paying penalties or forced to go through the exemption process? Do they even know? The person, who again, is very nice, has no answers. Who does know? Again, no answers.

All of this happened this morning. We have been delivered into a system that is completely opaque, with a curtain of websites and applications processes that are nearly impenetrable, and been left at the mercy of bureaucrats who do not even know the full meaning of the law they expect us to live under.

This simply cannot stand.

insuranceI was speechless when I read this, and I asked if I could blog about it. The above is my friend’s post, unedited, other than small stylistic and grammar changes.

This appalling web of bureaucratic lunacy is brought to you courtesy of the Affordable Care Act. A man and his wife, whose takehome pay is so low right now, they qualify for Medicaid, are now being forced to pay thousands of dollars in penalties they cannot afford for turning to the government to get coverage that is now required by law.

The absurdity would be hilarious if a family’s livelihood wasn’t at stake!

And my friend’s story isn’t the only nightmare Americans have been experiencing. A Facebook page dedicated to ACA horror stories has been created, and the stories are heartbreaking.

FreedomWorks last year did an article of its own, detailing top ObamaCare horror stories, including that of a pastor diagnosed with stage three cancer of the esophagus who was told – just minutes before getting chemotherapy – that his treatment would not be covered.

Meanwhile, the left’s smarmy, arrogant, lying, biased, craptastic excuse for an economist Paul Krugman last year claimed the ObamaCare horror stories were “imaginary” – concocted by those who obviously just are too ignorant to know how FAAAAABULOUS ObamaCare and too stupid to know what’s good for them.

These are real people with real life problems, betrayed by politicians and pundits who couldn’t even begin to understand what it’s like to not know how your next grocery bill will be paid, or what it’s like to lose sleep, because the IRS says you owe them money you don’t have.

My friend’s dilemma is real. Imagine you’re so poor, you automatically qualified for Medicaid, but the state doesn’t offer a plan that meets ACA requirements, except to a few really sick individuals, so you have to buy more insurance… again… because you’re poor. And if you didn’t know you had to buy more insurance, you have to pay again. Because you’re poor.

File this under: Things politicians and the “Elite” couldn’t possibly comprehend.

“Health Professional” bloviates about guns, paints himself to be a doofus

I apologize – I should have blogged about this earlier, but between my business trips and jetlag, I have dropped the ball. A week ago, a fellow Johns Hopkins alum and public heath professional Vik Khanna penned an essay that gave some doctors and other health professionals a bit of heartburn, because unlike many health professionals, Vik actually understands and appreciates firearms and the right to keep and bear arms.

In his essay, Vik addressed the so-called “gun problem” from a health care perspective, advocating for public education, training, and giving gun owners the benefit of the doubt that they are, for the most part, responsible, peaceable citizens. He was respectful, and he linked to credible studies and statistics to bolster his view.

Interestingly, and perhaps unintentionally, Vik also predicted pretty accurately what the response from the medical community would be to his essay.

Ironically, public health academics happily assert that there is a clear Constitutional right to privacy, even as they vilify a right that is actually expressed in the document, and they merrily condescend to its adherents, whom they regard as pathetic rubes.

Enter this arrogant, fat fuck.

Art-Caplan-2

Meet Art Caplan, MD. Art heads the bioethics program at the University of Pennsylvania, but judging from his snide, sarcastic, arrogant writing, he doesn’t know a whole lot about actual ethics, human interaction, or effective, respectful communication.

Instead of refuting any actual facts in Vik’s essay, Art simply proceeded to sneer out a “you’re a paranoid gun nut” reply, and in the process showed his absolute ignorance not just about firearms, but about current technologies, training opportunities, and laws.

Vik, buddy, no one and especially the roughly 28 folks in public health not completely distracted by their lack of funding and inability to secure tenure is capable of doing anything that will pry your gun from your warm-blooded grip. There is no political movement to take away anyone’s guns. The NRA is the mightiest lobbying outfit in these United States and the best Mike Bloomberg or Bill Gates are going to be able to do is to get the anti-gun lobby a few more op-eds and soundbites.

See that? No one wants to take your guns away. You’re paranoid. And by the way, GIVE US MORE MONEY!

My reply to Art’s patronizing gibberish is below. I also posted it in the comments section. The bolded text is my additional comments added in this blog post. I wonder how long it will last before it’s deleted…

Wow… condescending jerk much?

Someone offers an alternative view to your “kale crunching, fitbit wearing hordes of public health types” who cannot help but hysterically ascribe human traits to an inanimate object, and you have to come back with snide derision?

To be sure, Art, “buddy,” no you are not capable of prying anyone’s guns from their warm blooded grip. But make no mistake – when you “public health types” parade your medical authority as credibility on the gun issue, people who genuflect at the altar of your so-called “eruditeness,” will cite you as authorities on the issue.

So, to refute some of your histrionics…

1) Carnage is not CAUSED by guns. We analysts understand that using the passive voice in this manner serves those with an agenda well to obfuscate the problem. If you can’t determine the culprit, you will focus on the tool. The carnage is caused by criminals, and those who are ignorant and irresponsible on the proper handling of firearms.

2) “There is no political movement to take away anyone’s guns.” – Actually, you’re wrong there. There was a federal assault weapons BAN, which, even by the New York Times’ own admission, served merely to ban cosmetic features that had nothing to do with actual fatality rates. Until very recently guns were BANNED in certain cities such as Washington DC, and in many other locales, you have to ask permission from sometimes unwilling government authorities to exercise your basic right to keep and bear arms.

3) “Do public health folks have anything to offer that might reduce the mayhem while letting you hunt deer or shoot partridge or blast targets or whatever it is you and your son like to do with your guns?” — The Second Amendment is not about hunting, Art, “Buddy.” If you have any doubt about this, you should read the documents written by the men who founded this nation. (I would refer Art to Federalist 28, and this passage in particular: If the representatives of the people betray their constituents, there is then no resource left but in the exertion of that original right of self-defense which is paramount to all positive forms of government, and which against the usurpations of the national rulers, may be exerted with infinitely better prospect of success than against those of the rulers of an individual state. In a single state, if the persons intrusted with supreme power become usurpers, the different parcels, subdivisions, or districts of which it consists, having no distinct government in each, can take no regular measures for defense. The citizens must rush tumultuously to arms, without concert, without system, without resource; except in their courage and despair.)

4) “How about encouraging doctors, ministers, sporting goods salespeople and other community leaders to learn about and then talk about gun safety?” — The key here is LEARN about gun safety. Most doctors and other public health professionals with whom I have spoken don’t know which way the business end of a rifle points. When you learn the intricacies of using these tools, I might give some credibility to you when you discuss them. Otherwise, it’s much like turning to your plumber for a vasectomy. It might be cheaper, but I don’t recommend it.

5) “How about greater efforts to get gun owners to lock up their guns and ammo properly.” — Do tell me about proper storage for a tool of self defense, Art “Buddy.” Tell me how long it takes to unlock your pistol and load it during a home invasion. Have you ever experienced such an event in your safe, lily-white community? Didn’t think so.

6) “How’s about getting hunters to wear the right high-visibility gear.” — I’m all for it, but much like with seat belts, there are some folks who just don’t wear it, and won’t. You going to fine them? Throw them in jail for violation of safety rules?

7) “Is there any merit to making guns safer including ‘smart’ guns?” — The fact that you even ask that question shows your ignorance on the issue. There has been plenty of discussion on the topic, and there are some serious safety concerns with your “smart guns.” Until you get properly educated and informed on the topic, you have no credibility to speak on the matter, and yet here you are, hiding behind your “medical professional” shield and bloviating about things you obviously know nothing about. (There’s a good article in Forbes magazine on smart gun technology you should probably read, if you haven’t already)

8) “Can we teach people to call the cops when they know there is a gun in the house of someone who is mentally ill or under a restraining order?” Oh, so everyone is now a mental health professional? Everyone knows who is under an RO, or are we relying on ESP to tell us when is a good time to report your neighbor? 

9) “A little training for kids about what to do if they find a gun?” – It’s called Eddie the Eagle. Look it up, “buddy.”

In other words, Art. You obviously have no credibility on this issue, and your little sneering note toward Mr. Khanna shows you to be a supercilious, arrogant wad.

Have a nice day.

Hey, I didn’t even curse. Are you proud of me?

VA fires officials for Phoenix fraud

Word is that there have been some consequences from the recent story about the VA’s obscene secret waiting list that resulted in veterans waiting months for appointments and dying in the process. Commenter Ole’Wolf has more:

Ms. Nicki -word just came down that the Quadrad was fired at the Phoenix VA Medical Center. Washington VA Central Office terminated the Director, Associate Director, Chief of Staff (senior Doctor), and the Associate Director for Nursing Services (senior Nurse) as the facility leaders. Good news, they’re gone. Better news, termination means no more Gubmint jobs for these career bureaucrats…bad news, I doubt seriously anything more will come of it. Families have started suing the VA but no word on direct lawsuits aimed at any of the key morons…

I sincerely hope that the director, associate director and anyone else responsible for this travesty see direct repercussions from this. I hope there’s jail time involved for all. Fraud is not a laughing matter. Fraud that results in the deaths of veterans to whom care was due is an abomination.

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