Archive for the ‘Healthcare’ Category
No one wants to buy a pig in a poke. Kevin Drum notes in Mother Jones:
Hmmm. Congressional Republicans might have a problem on their hands. Here’s one of the findings of the latest Kaiser Family poll on health care:
That little orange pie slice at the bottom—the one that says 20 percent—represents the number of people who support the idea of repeal and delay. About half the respondents don’t want to repeal Obamacare at all, and another 28 percent, showing the common sense that heartland Americans are famous for, don’t want to buy a pig in a poke. They may not be thrilled with Obamacare, but they sure want to see what’s going to replace it before it’s ripped apart.
This is the mantra Democrats should be hawking every second of every day. We don’t want a white paper, we want to see the real replacement. Does it really protect people with pre-existing conditions? Does it really keep premium costs down? Does it really reduce deductibles? Is it really a better deal for most working-class folks than Obamacare? Does it really keep the Medicaid expansion in place? Does it really guarantee that no one will be worse off than they are under Obamacare? And will it really cost less than Obamacare? . . .
Republicans’ Obamacare repeal plan will add $9 trillion to national debt, but that may not bother them
It is difficult for me to understand the thought processes (if any) of the GOP, but one thing is clear: the GOP is willing to spend handsomely in order to avoid helping the poor and improving the general welfare. We say that in the way many Red states refused to expand Medicaid, even though that refusal cost them money. Not helping the poor was worth it, apparently.
And now the GOP, which has claimed to hate any increase in the national debt, and ready to pile on the debt if it will put a stop to helping the poor get healthcare insurance.
I think you can see why I find that hard to understand. Normally, being able to do something worthwhile and at the same time saving trillions of daollars? That would be what one calls a “no-brainer.” My conclusion: the GOP has, in effect, less than no brain: a negative amount of brains.
Matthew Rozsa writes in Salon:
If Republicans use budget reconciliation to fast-track their repeal of the Affordable Care Act (colloquially known as Obamacare), they will have to accept a $9 trillion increase in the national deficit by 2026. By then, the national debt would reach $29 trillion.
— Steven Dennis (@StevenTDennis) January 4, 2017
Kansas Sen. Rand Paul, a Republican with libertarian leanings, has already vowed to oppose the reconciliation plan on the grounds that the budget resolution will add so much to the deficit.
“It never gets to balance. Not in 10 years, not in 100 years, not in 1,000,” Paul told Bloomberg on Tuesday. “Every Republican that was here voted for a balanced budget amendment to the Constitution that said it should balance in five years, but yet they are putting together a budget that never balances.”
Paul also pointed out that, before Vice President-elect Mike Pence is sworn in and can cast tie-breaking votes in the Senate, a single other Republican voting against the budget resolution would stymie the Republican plan. Reconciliation is a budgetary procedure that, because it cannot be filibustered, could allow the Republicans to repeal a great deal of the Affordable Care Act before Trump is even sworn in on Jan. 20. That said, the process is very complex — a budget resolution must be passed with instructions to committees from both chambers, each chamber must draft its own reconciliation package, both packages are combined into a single bill, and then that bill must pass both chambers. If there are any differences between the bill produced by either chamber, nothing can be passed until they’re resolved. . .
Kevin Drum lays out the way the GOP has boxed itself in. Whatever plan they’ve developed over the past six years must be kept secret from the public because the plan is awful. The GOP wants to repeal Obamacare today and then, a few years down the pike, present their plan when the choice is forced.
It took Democrats about 14 months to develop their plan. The GOP has had years to develop what they say is a better plan. Let’s see it.
Drum’s post is worth reading.
Kevin Drum has an excellent post at Mother Jones refuting a false claim by David French:
Remember when the Democrats passed ObamaCare through reconciliation, using procedural gimmickry to pass major social legislation over the unanimous objection of the majority party? So do congressional Republicans, and it looks like payback might be imminent.
I know this is an easy mistake to make, but I’m pretty sure Obamacare was passed over the unanimous objection of the minority party, the Democrats having won a massive, landslide victory in 2008. They figured this gave them a mandate to carry out the promises made during the campaign—silly, I know, since only Republicans have mandates—and they proceeded to do just that.
Less excusable is French’s contention that Obamacare was passed via reconciliation. It wasn’t. It was passed in the Senate under regular order, by a vote of 60-39 on December 24, 2009. Later, after Democrats lost their supermajority in the Senate, the House passed the Senate bill and then passed a second bill that implemented a few modest increases to subsidy levels and taxes. None of them were critical to the overall bill, but the Senate agreed to support these changes. These small, nonessential adjustments are the only part of Obamacare that was passed via reconciliation.
Everything else—the individual mandate, the pre-existing conditions ban, the subsidies, the Medicaid expansion, the medical loss ratios, the donut hole, the cost improvements, the taxes to pay for it all—in other words, everything that mattered, was passed via regular order.
As for the unanimous opposition of Republicans, that’s perfectly true. Democrats in the Senate tried mightily to put together a plan that might attract some GOP votes, but Republicans were adamantine. They pretended to negotiate, but by October it was clear they were just playing delaying games and had no intention of ever supporting anything that would expand access to health care. This strategy of blind obstruction, which applied to every part of Obama’s agenda, not just Obamacare, is a huge blot not on Democrats, but on the congressional Republicans who decided on it before Obama ever set foot in the Oval Office. It was only in the face of this unconditional obstruction that Democrats went ahead and passed something on their own.
Jennifer Rubin this morning slammed Obama for “not cooperating with Republicans.” She has a short memory. That’s why she’s a conservative.
The Wife has been suffering with some sort of respiratory virus (stuffy nose, cough, weak and tired), and she leaves for Paris in a few days. So I’ve made chicken soup from scratch (this recipe, though next time I’ll make this recipe) and serve her many cups of ginger tea, which I make as follows:
In a 1-qt heatproof measuring cup (e.g., Pyrex, Oxo), put 2-3 tablespoons of freshly grated ginger and juice of two lemons. Pour boiling water over that to the 1-qt mark and let steep 10 minutes. Use a tea strainer to strain it into a cup with ≈ 1/2 tsp Manuka honey. That’s enough for a few cups of tea, but forcing fluids is a good idea, and this fluid is pretty easy to force since it’s tasty.
I’d never previously heard of Manuka honey. It comes in various levels of goodness, with the higher levels costing more. Before, I just used regular honey.
A shot of brandy or bourbon in the cup is not a bad idea: it will make you sleepy, so you can go to be and sleep, which is also good for you.
She does seem to be improving, and I like to believe that the chicken soup and ginger tea (and Manuka honey) are helping, but it may just be the passage of time with the body’s immune system doing the heavy lifting.
From even the planning days, Kevin Drum was pointing out that legislation like Obamacare—complex, with many interconnected organizations and affecting millions of people—generally have start-up problems and hiccoughs, and require some tweaking and “breaking in” and experience before it hits its stride. He blogs today:
Last year, several insurance companies abandoned Obamacare because they were losing money. This year, premiums have spiked 25 percent on the exchanges. As a result, Paul Ryan says insurance markets are “collapsing,” and Republicans are promising to repeal Obamacare practically on Day 1 after Donald Trump takes office.
But a funny thing has happened on the way to the collapse: Obamacare is more popular than ever. Charles Gaba is the go-to guy for Obamacare enrollment data, and the simplified chart on the right is based on his more detailed versions here and here. Last year at this time, a little over 11 million people had signed up on the exchanges. This year, a little over 12 million have signed up. Here’s what this means: . . .
Leonard Jason and Ed Stevens write in the OUP blog:
With rising health care expenses, we are all trying to solve the paradoxical dilemma of finding ways to develop better, more comprehensive health care systems at an affordable cost. To be successful, we need to tackle one of the most expensive health problems we face, alcohol and drug abuse, which costs us approximately $428 billion annually. Comparatively, the expenses of health care services, medications, and lost productivity for heart disease costs $316 billion per year. In addition to economic costs, none of us are spared the ravages of this disease, due to addictions among our friends, family, workers or co-workers. Addictions are the most prevalent mental health disorders, afflicting about 8-9% of the US population. Yet the vast majority—an estimated 90% of those with a substance use disorder—do not receive any formal treatment services. In addition, the majority of those 10% who do receive formal services for substance abuse have been treated previously, and therefore, even those who do get treated for their addiction often do not attain recovery. Something has to change, as our current substance abuse health care system is both expensive and ineffective.
The fact is that millions of Americans are not receiving help for their substance use problems, nor are the current treatment programs consistently producing long term successes. We as a nation need to overcome our denial of our country’s high levels of problematic alcohol and drug use. Simplistic solutions of just saying “no” have been unsuccessful and unwittingly wrecked havoc on our citizens. Rather, we endorse a comprehensive campaign to highlight the extent of our nations’ addiction to mind altering substances, a movement to develop norms that increase an awareness when self-management of occasional use fails, an undertaking to overcome barriers in seeking the help that is needed, and critical efforts to increase the effectiveness of treatment and after-care programs.
Bold new initiatives will be needed to solve these problems on a more systemic and sustainable basis, and below are a few of our thoughts for change.
Aligned with more universal efforts of facilitating self-awareness of problem behaviors, efforts should be made to identify and reduce risks with settings that promote use. This especially includes settings that perpetuate self-defeating and destructive influences on our youth and young adults, for example, college freshman binge drinking.
As a universal prevention effort, all citizens can be responsible for helping those at risk for substance use disorders. The majority of people who use legal substances like alcohol and prescription drugs do so without endangering their health or that of their family members and friends. Early prevention efforts should focus on the trajectory of problematic use and building awareness for self-screening and use management. For some individuals, however, self-management fails, and their alcohol and drug use can become harmful. Collectively, we should promote acting early to prevent addictions, and begin a dialogue with loved ones when such patterns are observed. Family members, friends, and work associates must recognize and change often unconscious subtle actions that unwittingly promote and enable harmful use of substances by their loved ones. Rather than condoning or even encouraging reckless drinking or drugging, and waiting until problems are more entrenched and less resistant to change, loved ones have a responsibility to take action (e.g., changing social activities from bar hopping to art gallery hopping) before a more formal treatment is necessary. Other activities might involve attending self-help groups, making referrals, and searching for appropriate resources in a proactive way.
We all have a role in abolishing barriers for someone seeking help and this includes reducing the stigma of substance use disorder. Taking the first recovery step is emotionally difficult for those troubled with addictions. Often, those who have recognized the need to refrain from patterns of damaging addictive behaviors all too frequently have encountered insurmountable obstacles to obtaining help, such as risk to employment, lack of resources, needs of dependents, etc. We should be promoting personal change rather than erecting barriers, like stigma, against it. Like promoting help-seeking, all of us can help re-integrate those with addictions back into our communities. Rather than stigmatizing those coming out of the criminal justice system or addiction treatment programs, we need to welcome them back into our society following treatment, with needed housing, jobs, supports, and resources.
To achieve lower total costs and greater effectiveness, we as a society are responsible for ensuring adequate funding that provides appropriate and timely access to a choice of addiction treatments. . .
Leonard A. Jason is a professor of clinical and community psychology at DePaul University, director of the Center for Community Research, and the author of Principles of Social Change and co-editor of the Handbook of Methodological Approaches to Community-Based Research: Qualitative, Quantitative, and Mixed Methods.
Ed Stevens is the Project Director of a federally funded social network analysis of Oxford House recovery homes, at the Center for Community Research, and a graduate of the doctoral program in Community Psychology at DePaul University.