rambling thoughts of doom nobody is supposed to voice


guitar_caseI am not going —

To self edit here, I am just going to type and you guys can shoot after. This is in part because I just want to get the thought out, and because I know it won’t be pretty, and because my mouse has gone unhinged again so it is a freaking bitch at the moment to edit anyway. So, here goes —

I have an impending sense of doom.

This is not something shared by most of the people I spend time with, pushing for health care reform. Or I do not sense it from them. The presidential address is over. The Republicans made asses of themselves. The President was very presidential. All should be well. The crazies are exposed, the plan moves forward, right?

And I back it. And I stomp liars and crazies.

But. Doom.

A lot of my compatriots do not even know the difference between “Medicare for all” and “single payer plan” and “public option.” They use them interchangeably. Or say things like, “buy into Medicare.” They just do not know what the different things are. This is maybe understandable. They have lived in a system in which you pay for insurance your whole life. The idea of walking into a hospital that does not have a billing department is maybe inconceivable to them. This lack of knowledge or comprehension of the differences in programs, though —

It is problematic when you are on the right side and do not even know what you are talking about or fighting for. That means you, like the crazies on the other side, are espousing dogma without a real understanding of it.

I said something about triggers and some nice girl tried to explain to me that trigger just meant it would take four years to enact insurance reform because that took a while.

I asked her if that was French and she did not talk to me anymore.

Oops. Maybe I should be more patient.

And I think sometimes, WTF have I gotten myself into here?

Especially because, from what I am seeing, it is a bad plan.

That is after hearing the address. I was withholding judgment until after the address. And everyone else seems reassured by it. But I am not. In other words —

I mean it. Bad. You cannot enact this without some incurred cost. But the president is saying he won’t sign anything that contributes one dime to the deficit. Okay, that cannot be done. So. What? He won’t sign anything? You cannot enact this kind of change without a price tag — unless you sell your soul in some way to pull it off. So who’s soul is on the block here? Problem.

Second, engaging in a program that demands people prove income to qualify for different measures is such a morass of paper, it will just be inconceivable. But this is the plan. Figure out what everyone makes and distribute plans that way.

Next, fine people who don’t buy insurance either from insurance companies or a Federal plan. The insurance companies have to be creaming themselves over this concept. They are just licking their lips thinking, Wow, fifty million people who must by law buy insurance.

Meanwhile, there is something unethical about demanding someone buy an insurance policy just because he or she is born. I can see it, with a car. You buy a car and drive a car? Okay, you should be responsible in some way for what you do with it. But just being born and being liable for whatever genetics or accidents of fates befall you? That is not something you chose to take on or should be responsible for. It is not property you took on. It is life and you did not get asked before it happened. But now you have to insure it?


An expansion of Medicare or the single payer scenario is simple. Everyone pays into one big pot, yes, it is taxes, but it is a huge pool and no one is paying for insurance so you have that extra cash anyway and that national pool insures everyone and if someone goes down, well it is covered. And you do not bitch about paying for someone else’s chemo because hello, you are healthy and not on chemo so should just be happy about that because what, you are jealous they get chemo and you do not? No one pays for insurance. No one has to prove they are too poor to pay for it so carry some stigma of poverty or inequality just to get it. No one has to pay a fine because they bought groceries instead of buying health insurance. And. Everyone gets it. And no one buys insurance from an insurance conglomerate or a Federal government program trying to put too much new paperwork into play to replace the old paperwork and —

Let’s just say I see so much wrong with what is going down.

And at the same time, it does have to happen. Something does have to happen. So, I am supporting the lesser of two evils.

Didn’t I just go through a freaking strike just like this? And weren’t the same evil bastards in charge and doing just the same things then? And didn’t, in the end, the good guys lose then too?

I would sure like for a change to support something actually good. Or equitable. Or right. That had a chance in hell of actually “winning” instead of “not losing as badly as doing nothing would mean.”


where the art work comes from :
that is from presti non è qui

23 Responses to rambling thoughts of doom nobody is supposed to voice

  1. remember:

    this is public policy we’re talking about. not the end of the world. the day they can’t “find a better way” after thinking about something for about ten seconds is the day we die.

    what obama is proposing is a good, big first step.

    just as medicare was a big first step.

    if the public option proves out, some genius will propose expanding it. and (if it’s shown to be working) it will expand.

    america’s a big country. there are test markets everywhere. we should propose a single payer test market. trust me. somebody will go for it. and when it works, people will embrace it everywhere.

    rumor has it that california has health insurance problems… and it’s a big enough market to validate the test results…

    just sayin. california loves referenda…

  2. CJ

    And that’s what I’ve been saying.

    I’ve been trying for over a year to come up with a plan that could work. What prompted my research was candidate Hillary Clinton’s health care proposal that had mandated health insurance. That was always a bad idea, and I was eager to find something better.

    Given the historical corruptibility of large systems in the U.S., I’ve found that the only health care change that works — the ONLY one — is not-for-profit, single provider, tax-funded healthcare. Everything else breaks down rather quickly, if not through overt corruption, then by creative accounting (i.e., the numbers people spout just don’t add up).

    The only patch that doesn’t bash the rank-and-file American is documentation reform…and even that fails pretty quickly. Eliminate the myriad insurance company claim forms in favor of one standard form–making the companies adapt to the form, not by making an absurdly complicated form to appease every company’s whims. Streamline the medical forms and data-exchange formats for each medical specialty so that it is the same across the board.

    Trouble is, while this simplifies things for doctors and results in a cost-savings, the greedy bastages at Kaiser, Cigna, et al. will just use those savings to pay themselves bonuses for their brilliant cost-cutting acumen. The public won’t see the benefit other than not having to fill out the same info every time they see a doctor.

  3. max

    John, this is the end of the world for every person who dies in between now and doing it right. And, since this fight has been raging a hundred years, I am thinking that could be a lot of people.

  4. max

    CJ, I am down to the only answer is the first one, a non-profit, national single payer plan payed for with taxes. Essentially, national Medicare. Then you only get screwed if someone pulls the Republican game of borrowing from the insurance pot like they did with social security, then turning around and saying, Gosh, sorry, money all gone.

  5. Don

    As a student of Economics, I attributed similar feelings to my “dismal” nature. I, a casualty of lost manufacturing, of uninsurable family health issues, of a rural locale where the only government aid appears to be that offered to wealthy agribusiness, where folks vote against their own self-interest. I have hoped for change. I have written my anti-representatives, and have alienated myself from my local church and community in defending the president’s policy. After digesting this Joint Session address, it sure feels like I’ve been “sold down the river.” Perhaps all we have left to do is sing, “Swing Low, Sweet Chariot…”

  6. I basically agree with you both, CJ and max. The unfettered for-profit business model simply does not work in the medical insurance arena (if by “work” one means “efficiently provides goods and services to consumers” instead of “efficiently redistributes wealth from the masses to the few”). The number of competitors is far too low, and the time horizons of decision-making for consumers is far too long. And the insulation of corporations from lawsuits when they don’t cover needed care basically gives them a license to kill.

    The long and short of it is, the overwhelming incentive in today’s for-profit medical insurance business model is to not provide care. That’s how you make money: cover only the care you’re more or less compelled to. And that becomes a political question far more than a marketplace question … which is why those corporations are only too happy to fork over millions to lobbyists, because the return on investment from lobbying is huge.

  7. MotherRedDog

    You all mean like ACORN. Thanks but no thanks. Apparently you haven’t lived long enough to understand how bad the government can eff you. You can have all of my medicare money and my mothers, just let us have our private health insurance. At 81 she still pays for hers. The doctors are getting screwed. You need to look somewhere other then under Hillary’s butt for an answer.

  8. You’re so on it! See here: then here: here: and then here:

    The first post listed, really says it all: Health INSURANCE is NOT Health CARE.
    Thanks for this. It’s appreciated.

  9. max

    Well health has a ticking clock attached. You dick someone around long enough, there is no patient to answer to. I wonder if they check those charts for next of kin to see how likely it is they will get sued…they already know your income and how capable you are likely to be of suing most insurance comes through employers.

    Health care cannot be treated as a commodity. That is like treating air as a commodity. [I understand the irony when we already treat water as a commodity, I guess if you can round it up, you can find a way to withhold it and then sell it, too bad they have not figured out how to do that with air yet — delicate cough.]

    Don. I know being a child in a disenfranchised place, and I know the feeling of being sold I have that too now. I do not know losing my community in the process. I am so so sorry.

  10. max

    Red & Wit, thanks for coming by and sharing your thoughts. I dunno, Red, I’ve had a ten grand insurance bill kicked back in my face for pre-existing condition. It wasn’t fun paying that — or all the incidental additional bills that kept coming in behind it. Wit, I will have to read your link. I agree with the sentiment.

  11. i agree with 100%- i’ve said all along, framing this argument in any sort of fiscal/deficit/profit terms is the WRONG argument for healthcare reform. it should seen as a social and human rights issue, much the way the late senator kennedy framed it.much easier to ditch the for profit model if so. it’s also easier to discredit the boors against reform if they are seen as harming the sick amongst us (the *monsters* they really are) and not viewed as fiscal conservatives.

    i am very afraid that as our president proved in the aftermath of the banking debacle he is a man of the corporations, and his plan will do much to ensure corporate profit, while providing the people with only small gains.

    i don’t know if something is better then nothing, actually. without band-aids of reform over the wound of healthcare, it might foment into a true reform movement sooner, and i’m afraid obama’s refroms will only set us back.

    i am *very* conflicted about this…

  12. I’m not ready for doom and/or gloom just yet. I’m not at all comfortable with the ‘deficit neutral’ language, but overall I feel like this thing might actually have a shot. The biggest problem I (from my admittedly limited perspective) saw with the otherwise awesome concept of a single payer system was that if 17% of GNP is going into this system, how can it be dismantled and replaced without destroying our already fragile economy? So, you find a way to leave the system in place and introduce fairness, seems like there were some good ideas about how to do that.

    But, I could certainly be totally wrong about my lack of doom/gloom, dammit Jim I’m a geek, not an doctor. Or an economist. Or even an actuary. Anyway, I’m not here to argue. I am here to ask, politely, if maybe the next time someone says something silly that indicates they don’t know what a trigger option is, and if that person isn’t a complete moron or a raving asshole, if you might consider taking a few minutes to explain the facts? Just a thought, I wouldn’t blame you at all if it seemed way too annoying to actually do.

    The biggest problem we face is a deficit of accurate information.

    Just imagine, if everyone who was capable of having a clear understanding, actually had one. Wouldn’t that rock?

  13. max

    Well, it was on Twitter. How do you explain to someone who is trying to inform you — who is wrong — that that some has no idea what she is talking about and also explain the concept of the insurance company “trigger”which as far as I am concerned was done pulled at least ten years ago and fifteen is a better estimate — all in 140 characters? Also, I do not respond well to being corrected by someone who is clueless. Which is a character flaw. Sigh.

    Cmajor, yeah. I am studying maps and counties in my approximate latitude. [wry smile]

  14. I agree, this whole issue has been handled disastrously.

    Obama decided that single payer was a “non-starter,” eliminating the best plan for controlling health care costs, and (pragmatically speaking) giving away a hell of a bargaining chip; single payer could’ve been sacrificed in order to secure a robust public option, making it the line in the sand of compromise. Instead, we have a weak public option that may not even be kept in the final bill, and progressives are falling all over themselves to secure that meager table scrap when they should be demanding a single payer feast.

    Then there was the “deficit-neutral” fetish; universally expanding Medicare is the ONE thing the American people would support inflating the deficit for, but Obama and the Blue Dogs nixed that.

    Finally, we have the bipartisanship fetish; the Rethugs would be a great excuse for a watered-down reform effort. “Sorry Democratic Party base: We had to get the GOP on board to keep Independent voters happy with us. Plus, we can blame the inevitable failure of our ‘reform’ on the GOP a few years down the line, while keeping Big Insurance and Big Pharma sending campaign donations our way in the meantime.”

    Maybe it’s part of a grand scheme to help the Dems get even larger House and Senate majorities in the future, when single payer will finally be enacted. But I remember my history: When Medicare was passed in the ’60s, it was supposed to be a back door for universal health care. As we all know, things haven’t worked out that way.

  15. max

    Ooh la la. My mystery guy. That scenario is pretty much what I am looking at too though. Bleak.

  16. Yeah, I don’t see how it is not going to cost any money.

    People who can afford health insurance being forced to buy it? It is the only way you can force insurance companies to cover preexisting conditions.
    Think about it, people would only begin to pay into the system (buy insurance) once they got a condition.

    That is one principle behind single payer, everyone (who is able to) pays into the system, healthy as well as the sick, their entire lives via tax.

  17. max

    Anthony Weiner is being a real gentleman about all this. While simultaneously watching the president flush everything that matters. That has got to be killing Weiner.

  18. max

    This is for you DotLizard, a pretty good article on the “trigger”:

    I am twittering that too maybe it will spread. To me, the mythological trigger is sort of like handing arsonists napalm, Here, nice insurance CEO’s, you get to regulate yourselves. That has worked so well for the last fifteen years, waiting on insurance companies to do the right thing. [delicate cough]

  19. You turn anger management into great blog prose!

    Since my next novel (the Lord of the dragon flies) is all about the end of the world, in a way, I find it actually vitalizing to read this.

  20. Thank you :) information is power, at least it oughta be, by golly. I’ve never favored trusting power to behave benevolently, by its very nature it seems to drift towards feudalism (when it’s not zooming towards it, that is).

  21. max

    “You turn anger management into great blog prose!” Funny

  22. Amarone has that effect …

    Talking of funny, there was this big picture in the papers over here with a lot of Republicans trying to hide under their papers in the Senate during Obama’s speech. They looked like some bad kids in school – it really made me laugh. They always proclaim law and order, but aren’t they the ones who give a XXXX about exactly that

  23. max

    Not exactly a dignified proceeding. Though with everyone carrying on about one outburst and crucifying Joe Wilson, as well as going ape over freaky Glenn Beck’s Washington march, the attention is off the White House selling health care out to insurance lobbyists.

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