Will That Other David Brooks (and the real one, too) Please Go AWAY!!?

Actually, I really appreciate David, he almost always gets my juices going with all his lies and distortions-- and his self perception as a moderate Republican and humanist.  Today's column  "That Other Obama", is no different, same ol' vile inspiring stuff wrapped in an enigma of "aren't I so dignified?"

In it he attacks the President for his partisanism and "hoary brain dead cliches" attack against the Ryan budget and bemoans --Where is the Moderation?   (Hint DB-- it left with Dwight E.)

Of course it is partisan—you neo-con poop!  (“Sort of a play on words, there.”)  We do not live in a post partisan world—and we all know in his  world of false equivalencies (FE) that Obama is just as much responsible as Limbaugh.

Really “hoary, brain dead cliches” ?   Brooks says  “the Ryan budget has some disturbing weaknesses.” Cliche or in denial-- you choose-- but either way, definitely, brain dead.  It's not weak --it is a full on class warfare assault  and, at last, a rightward moved Democrat is standing up and identifying it as such, in all too mild of terms, but effectively, nonetheless.

He claims the Ryan  budget  “hides” loophole closings. No, it makes allusions to promises that it never intends to keep.  The chasm  which the President only began to illuminate is real.  It is the one that Ryan and his Randian ilk  ( read “Republicans”)  see between themselves as the makers and the rest of us as the takers, when really it is the 1% who have been on the make and take for far too long.

Flying his banner of FE under the banner of Politifact's FE of  a distortion of lie of the year--  now that is quite the image.  Just how is vochureizing and privatizing MediCare  not ending MediCare as we know it?  It is our country’s single payer system for elderly care.  It would become  less care and more profit for  the insurance-pharm industry.  The  prohibitions against  adverse selection and reduced benefits are not worth the vellum  they are printed on.  What is so amazing is not so much that he believes it, but that he expects us to.

That Ryanistas are not recognized as the lunatic fringe is only testimony to how much larger,  if no more lunatic, the Republican fringe has become.  And would the Right stop being wrong and please stop referring to that which we have paid for during our entire working lifetimes as “entitlements?”  

He calls for Obama to lay out a bigger better solution.  I got your  bigger better solution right here, David. The Peoples Budget and Single Payer Health Care—Twice the health care at half the price (REALLY!)

AMERICA IS EUROPE ?

 

According to David Brooks column today the American and European social support 
structure are more or less equally funded. I do not have the numbers directly at my finger
tips—and apparently gauging from the lack of them in his column he didn’t either.
( Or he did, but ignored them because they disproved his thesis)  The absurdity of which
  is to propose that “the U.S. does not have a significantly smaller welfare state than the 
European nations.” (First of all, David,  congratulations on that “welfare state” buzz word 
insertion.)

Some European governments “offer health care directly”, some just pay for it directly and some have a not-for-profit system  with highly regulated structure .  All of them pay a lot less for a lot better care/outcomes.  He  infers is that our health insurance   tax  structure is welfare.  If so it is primarily corporate welfare—for the insurance companies and the employers.  Much better healthcare is available without these direct subsidies to the corporations.  How do we know—because the rest of the developed world has done it!  So subtract those corporate tax breaks from your “welfare” total.

The same is true for the other areas he mentions—childcare,  subsidies to industry.  The point is rather than his  indirect, unfocused tax breaks, mature societies make mature decisions about where to invest and then invest—not “untax” individuals or corporations.

Brooks adds in the money the  government doesn’t collect and calls it spending?  Really!? What world does he live in?  If we collect it and then use it then it is spending.   If we don’t collect it, his  absurdist $10 billion dollar example notwithstanding, then we are not directing its use for the society. 

That is the theory you all want us to buy . The  middle of his column does seem to acknowledge that this is just a sham for redirecting money upward.   But, surprise, somehow he gives it all another mobius twist and ends up calling for LOWER tax rates, without, of course all those bothersome regulations.

Finally, Reagans tax cuts did not produce any benefits – except, again, for those that didn’t need it.  In fact he raised  taxes several times  primarily on the lower and middle classes to make up for the hole his cuts caused in the economy.  His raising of the FICA was  and is the largest tax raise ever foisted on the middle class.  And now they want that money, too.  So much for the right being concerned about true tax reform.

THE FUTURE IS NOW

Francis Fukuyama  argues in the current issue of Foreign Affairs  The Future of History   that"stagnating wages and growing inequality will soon threaten the stability of con­temporary liberal democracies and dethrone democratic ideology as it is now understood. What is needed is a new populist ideology that offers a realistic path to healthy middle-class societies and robust democracies." Almost o.k., as far as it goes, but, actually his main argument is that progressivism has not come up with coherent critique and policy to address the socio-economic and political realities of the time.

There is not so much a dearth of progressive ideas and ideology—but a corporate control 
of policy and minimization of distribution of those ideas.  The little known People's Budget 

of Congress’ Progressive Caucus is an excellent illustration.  It addresses many 
of the concerns raised in this article, yet few have heard of it.  Few, also, know that 
that same Progressive Caucus is the largest such entity in Congress.

In specific, Mr Fukuyama is in error regarding  his statement that  accuses the left of 
“a lack of credibility. (That) Over the past two generations, the mainstream left has 
followed a social democratic program that centers on the state provision of a variety of 
services, such as pensions, health care, and education.”   In fact where the social 
democratic left has been successful it has been in  these very areas.  Especially 
healthcare, where most of the developed world has some form of universal, equitable 
health care-- Always not for profit and often single payer.

Time and space do not allow for  a more  complete response. However, I would posit  
related and relevant points to ponder.  Corporate control of the narrative and  policy 
has curtailed progressive ability to mature the dialog.   That same corporate frame’s  
predominance   has only permitted  the “academic left … postmodernism, multiculturalism, 
feminism, critical theory, and a host of other fragmented intellectual trends that are 
more cultural than economic in focus” to be visible.  This has simultaneously served the right 
as a sop to their consciousness but one they can dismiss for its ephemeralness.   Far 
beyond incoherent scribblings, this progressive economic, social, psychological and 
political philosophy “it's all around if we could but perceive.”   It is in the 
aforementioned People’s Budget, in the writings and critiques of Thom Hartmann, Naomi 
Klein, Jared Bernstein,  Rachel Maddow,  Robert Reich , Paul Krugman and oh so many more. 
 And,  yes, Occupy is one of our distilleries. 

 

WHO LIES

I know I should not be, but I continue to be dumbfounded that the likes of Jay Ambrose still grace the national media. His recent column (1/24) accusing President Obama of lying about the Keystone pipeline is, indeed, full of lies-- Ambrose's.

Time will allow for only a partial review. But first, let us note that this is the same Jay Ambrose who,  in defending obvious lies about WMD's, uranium, et al , said that accusing Bush of lying was "hateful hallucinations that poison political discourse." In the first sentence Ambrose accuses the President of being “weasel-worded”. Does this not “poison political discourse” ? Before he concludes that first sentence he accuses President Obama of betraying his country, lying and welshing. (That latter, though I am sure it is far too “pc” for Mr Ambrose, is an ethnic slur.)

A basis of his argument is the inference that the tar sand oils will be used for domestic energy. This a lie that the supporters promulgate implicitly or explicitly. The whole reason the current pipeline is being added to and extended is to transport the oil to Gulf refineries for export. For the profit of the corporations not for the energy of the nation. We, in fact, are not going to  “use” the oil.

He claims that the environmental complaints are about CO2 content and global warming. True enough, but he ignores other issues such as spills-- of which the current shorter pipeline has had at least 11 in the last year . Certainly a great risk to any surface and ground water exposed-- not, as he claims, “physically impossible tainting.”

Ambrose refers to “some Nebraskans complained.” In fact the UNANIMOUS state legislature passed and the Republican governor signed a bill prohibiting the planned route and voting $2 million to study an alternative route. A process that, in itself, will take us beyond the November elections.

If, as he accuses the president, there is a lie in not being sure the pipeline was safe it is in that we can be sure that the pipeline will not be safe. Yes, there is a risk-benefit analysis to be made, but that analysis must be comprehensive, including the need to move away from increasingly more polluting and expensive non-renewables and to move towards investing in cleaner, renewable energy sources.

Again, there is so much more, but let me end with my outrage that this man who has so defended Bush's lies-- about affairs, domestic and foreign-- that got so many people killed, injured and financially devastated, has the nerve to finish his venomous column with accusing President Obama of leaving “this country wounded and bleeding.”

PRIMING THE PUMP--SINGLE PAYER NOW AND THEN… A brief history.

(Presented to the San Francisco Progressive Democrats of America June 23, 2011)

I’m a member of Physicians for a National Health Program. I am not a physician. I am a Jungian psychotherapist. Martin Luther King, Jr. said that “of all forms of inequality, injustice in healthcare is the most shocking and inhumane.” I’m in this because it is the right thing to do and I want a voice on how it impacts my portion of the health field.

There’s a phrase that I’m sure we all are familiar with—but perhaps not so much aware of its origin. “Priming the Pump.” The old hand pumps for water wells required that you put a little water down the pump in order to create the pressure to start pumping water up. This is priming the pump.

Now, my dad, a good Nixon Republican…. Funny after all these years those two words—“good” and “Nixon” still don’t go together… My dad, used to present me with story questions—
his way of teaching life lessons. In one he would tell me to imagine myself crawling across a desert, dying of thirst and coming upon an old rusty hand pump. Next to the pump was an old bottle of brackish water with a label on it instructing you to use the water to prime the pump and there would be plenty of fresh, clear, cold water. And—to be sure to fill the bottle back up for the next person.

He would ask me would I trust that old pump and the note, or would I just drink the bottle of water. I thought about it and it was pretty clear to me that the bottle certainly wouldn’t keep me alive very long and then there would be none left for the pump or the next person. So, though I didn’t have the words for it at the time, that’s when I realized I was a Progressive Democrat. I would need to trust the pump and leave enough for whoever came after.

Now a Republican would look at that brackish water and that old pump and decide he’d need to drink it for himself. But, don’t worry, he’d give the pump a tax cut and the invisible hand of the market would pump the handle – though it would only spew out dust. Then he’d crawl off and die from the insufficient and tainted water. But, at least , he’d keep it all for himself to the very end.

The health reform, Single Payer movement has been priming the pump for a long time. And we certainly have more to do. There are more successful flows in various places throughout the world-- France, Germany, Taiwan the United Kingdom – but those are subjects of other talks.

Right now, I’ll just present a brief comparative history of Canada and the U.S. In both there is a long history and though Canada is clearly much further along, there are still efforts afoot to reduce the pumps primer.

Many of you might know that Tommy Douglas was the Saskatchewan leader who created Single Payer for that province in 1962. For that and other accomplishments Canadians have voted him the Greatest Canadian of all-time.

But what you might not know is that Universal Healthcare for Canada was proposed as far back as the 1919 Liberal Party national platform. Douglas himself, got universal Hospital coverage in Saskatchewan in 1947. In 1957 the Canadian government began to provide 50% of hospital costs to the Provinces. Priming the Pump.

In 1962 Saskatchewan introduced a province wide universal , publicly funded health coverage. This was greeted by a three week doctors’ strike in an effort to overturn it. The government held strong, established the system. Six years later the Canadian government instituted province based Universal Single Payer Healthcare known as MediCare . Priming the Pump.

Today there surely are things to improve in Canada. Many of the problems have resulted as successive governments have reduced funding . These could largely be addressed by adding another percentage point of GDP into health care, and still leave it at 2/3rds of U.S. costs.

IN THE U.S.

Teddy Roosevelt, promoted universal health care in his unsuccessful effort to return to the Presidency in 1912. Priming the Pump.

FDR initially had universal healthcare as part of the Social Security legislation, but had to drop it in 1935 due to political resistance. Priming the Pump.

Truman’s 1949 Fair Deal included universal coverage, but was defeated. Priming the Pump.

In 1965 LBJ headed a coalition that successfully created universal single payer for people 65 and over—Our MediCare. Many had the intent, thus far unrealized, to reduce the age qualification incrementally over time. Priming the Pump.

Nixon (Nixon!?) proposed a healthcare system in 1974 that while employer based allowed for a sliding scale buy-in to MediCaid for those of low income. Teddy Kennedy thought it was insufficient—he was right. He also thought he could get better—he was wrong. Priming the Pump.

(At about this point a woman in the back of the audience yelled out “Time for a New Pump!”)

Today health reform efforts are active in Congress and something like 19 states are at various stages of development.

Congressionally, as you probably know, Michigan’s John Conyers has introduced a national single payer health bill every year since 2003. HR 676 would create an improved MediCare for all. It would, additionally require for-profit hospitals return to or become non-profit institutions. Vermont’s Senator Bernie Sanders and Washington’s Representative James McDermott have introduced S915 and HR1200. They would create state based single payer programs. Inexplicably, they would exclude “undocumented” residents.

In the states, most significantly we hear about Vermont and California. California has SB 810 in the legislative process into the 2012 session. ( My co-presenter followed me and reviewed 810 )

We’ll come back to Vermont momentarily.

There are formal legislative processes up in running in Oregon, New York, Wisconsin, Pennsylvania, Minnesota, and Maryland. Additionally at least Ohio, Montana and New Mexico have inititiated strong grass roots movements. A lot of pump priming going on.

Labor, of course, would like to stop having to negotiate against itself—healthcare vs. wages/working conditions. They would much prefer to have a national healthcare program take care of one side of that equation.

And, perhaps that is true for big business, too. It would most likely be better for their bottom line and make them more competitive in the international markets. However, never underestimate the class loyalty of big money, nor would they want to give up such a divisive weapon against labor.

In Vermont, where single payer activists were called “bomb-throwers” two years ago the movement has made major strides. The governor and much of the legislature were elected on a single payer platform. Vermont has passed and signed into law what is billed as single payer. However, it is important to realize that at this point the law’s framework would be more accurately described as “fewer payer.”

The regulatory skeleton that has been established may in two to three years time actually produce a single payer system. Unlike California's proposed (and twice passed and vetoed)legislation, Vermont does not incorporate MediCare into their structure. Also stlll “in-play” are our old favorite private for-profit insurance companies, co-pays, deductibles, etc.

And, finally, there is one county in the U.S. that has single payer for everyone. Every resident, even every “former” resident of Lincoln County, Montana is now covered by MediCare for All. Is this some sort of pilot study?, something that will set the stage for universal single payer ? Well maybe the latter. But how did this come about?

You may remember Montana Senator Max Baucus chair of the Finance committee. Single payer activists showed up at his committee chanting, “We need single payer!” He had them thrown out, famously commenting, “We need more police.” Well, Max decided for the good of politics, er, the people of Lincoln County.

The small town of Libby in Lincoln County was the home of a W R Grace vermiculite mining operation that spread asbestos and other pollutants throughout the air, water and ground. Grace has avoided all responsibility and the county has been declared a Public Health Disaster. To cover for his old friends Baucus inserted a MediCare for all -–of Lincoln County-- into the Health Care bill. No age limit, no income limit, no waiting, no exclusion, no buy in just—MEDICARE FOR ALL.

They Are Lying to Us

(Remarks prepared for speaking to the Single Payer Rally Outside of the American Health Insurance Plans convention, June 16, S.F.)

Ronald Reagan is famous for proclaiming as the nine most terrifying words in the English language as, "I'm from the government and I'm here to help."

Well, I have the five Truest words in the English language-- THEY ARE LYING TO US!

When they tell us there is no money for healthcare...
THEY ARE LYING TO US!
When they tell us there is no money for MediCare...
THEY ARE LYING TO US!
When they tell us that Canadians come here for healthcare...
THEY ARE LYING TO US!
When they tell us that insurance companies are better than the government...
THEY ARE LYING TO US!
When they tell us that single payer will not work...
THEY ARE LYING TO US!
When they talk about "entitlements"...
THEY ARE LYING TO US!

You now they talk about it as if we act entitled. When in their usual projective way, living in "opposite world", they are the ones who act entitled.

ENTITLED to their TARPs; ENTITLED to their Bailout;, ENTITLED to their recissions; ENTITLED to their denials; ENTITLED to their obscene profits and salaries; ENTITLED to their low or no taxes;
ENTITLED TO DESTROYING THE MIDDLE CLASS !

We are not ENTITLED! We have WORKED for and EARNED our Social Security;We have WORKED for and EARNED our MediCare; We have WORKED for and EARNED our paycheck; We have WORKED for and EARNED our right to a decent life, a decent standard of living; and we sure as hell are WORKING for and EARNING our SINGLE PAYER HEALTHCARE !

SO REMEMBER NO MATTER WHAT THEY SAY-- THEY ARE LYIN' TO US! LYIN' AS IN RYAN! (GODDESS BLESS YOU WISCONSIN!!)
SO REMEMBER NO MATTER WHAT THEY SAY-- THEY ARE LYING TO US!

/:And what do we say... SINGLE PAYER NOW!:/

Practitioner, Employer, Consumer, I

I want to talk with you about Single Payer Healthcare from the perspectives and concerns of an allied health care, non-medical, private practitioner and public health provider/manager. I’m a Jungian psychotherapist with a Marriage and Family Thearpist license. A short list of my career of over 30 years includes mental health, substance abuse, HIV/AIDS, supportive housing, in home care, non-profit service and executive management, public policy development and advocacy. All these are tremendously impacted by the reimbursement system—private and public.

I’ve been practicing so long that I remember billing insurance companies $120 a session. And you know what they paid me? $120! And that was when $120 was real money. Now-a-days insurance reimburses about $60 a session and severely limits the number of sessions.

Along the way I’ve experienced an unending cascade of crises and catastrophic attempts to control costs of services. Another way of saying that is though services were inadequate to begin with we were asked to to do more and more with less and less and what actually happens is less. Another way of saying that is the less we got the more profit the insurance corporations and administrative structures got to keep.

I’ve seen that fee for service “full reimbursement”  indemnification I mentioned . I’ve also seen and worked with, in no particular order--community rating, experience rating, capitation, case rate, DRGs, HSAs, HMOs, IPAs, FSAs, EMRs, Provider Groups, Consumer Driven, Consolidation, Co-pay, Co-insurance, Deductible, Out of Pocket, Carve Outs, Carve Ins, Authorization, Assertive Community , Targeted Populations, Best Practice… and though the list is far from complete, let me just finish with everyone’s favorite—-PRE EXISTING CONDITION EXCLUSION.


You know what? YES, you KNOW! NONE of them work. None of them deliver adequate services and none of them contain overall cost. This is greed over service. It is, frankly, cruel. As the current GOP/ Ryan Budget has finally exposed.

SO THE QUESTION IS how do we change all this and what do we change it to ?.

UNIVERSAL Coverge is the proven approach used by much of the quote/unquote “developed” world. WHY? Because it works and because they have had the fortitude to focus on solving problems not on , for example, where their head of state was born. It is this kind of diversion tactics that has left us as at #1 in health spending and 37th in health outcomes.

The  equitable and best  path towards universal coverage in the U.S. is Single Payer/Improved Medicare for All. There is so much to say about the superiority of single payer. The one point I want to underscore here is that with single payer you get a system that takes responsibility for overall care including future costs. Unlike the current patchwork system, single payer recognizes that it has to bear the costs now and later. It is incentivized to provide adequate treatment to reduce future costs. Private insurers know that if they deny service now, probably someone else will be faced with the bigger bill later. They are incentivized to kick the can-sumer down the road.

The importance of our work surely stands on its own. But, this bears on us as allied health professionals because it is certainly demonstrable that our services now are important drivers for reduced costs later.

As allied health professionals—mental health, chiropractic, substance abuse, etc. we are included in the single payer coverage. As consumers, we are, of course, covered. And if we are employers we will also be impacted by it.

I am looking forward as a knowledgeable activist consumer to a more complete, humane health care system. However it works out, exactly, it is clear to me that we will get more predictable, less expensive, understandable, comprehensive services . Imagine if you didn’t have to worry about your health care costs, your families, or see your neighbor lose their house because of some catastrophic illness. Over half of the bankruptcies in the US are related to medical costs.

I know as a provider we have a lot of questions as to how this will affect our practices, fees, reimbursement, paper work, etc. Will services be on demand or will they need prior authorizations? Are we looking at a fee-for –service? Will the program essentially be a “consumer-voucher” for service ? Will there be ways to aggregate funds into programming ? Will the regulations and billing processes be as onerous as they currently are for MediCare Mental Health? Will it recognize the need for and efficacy of long-term , depth work? What providers will be included/excluded? Will it be allowed to truly be a “behavioral health” approach and dispense with substance abuse morality issues? Will it help promote service delivery to lower socio-economic groups and efforts against stigma?

Will universal coverage force us to participate in an insurance system that is underpayed and over administered at the same time it dries up our high paying private client pool?

How will it impact us as employers? Probably payroll tax and employee tax will be revenue sources— how will these be structured so that they are more affordable than the current system ?

It won’t come for free—but it will be less expensive and provide better care. How its finances and delivery systems are structured will be best determined by those involved in its creation and maintenance. These issues need to be being addressed in all our policy and advocacy discussions.

I'll be exploring and discussing this as we go along. For now, it is true that I can not give you clear answers on all these questions. Many of them are "in process," depending on how legislation and regulation is developed. That is to say, that the current answer seems to amount to “it will all come out in the wash.” It is imperative that we are involved in this particular laundry.

The current legislative process develops regional councils to design answers to these and other questions. Will this be adequate/will allied health have enough political will and presence to sufficiently address our concerns?

So while you/we are dealing with the usual cascade of crises that seem to make up our lives and work , we really need to attend to this tipping point before we are tipped without being part of the tipping. (To keep up to date and to get involved check out PNHP CA)

IMPROVED MEDICARE FOR ALL!