This is interesting. Dr. Peter Beilenson (former health officer in Baltimore City and Howard County) and others starting an innovative health cooperative in Maryland. Beilenson was interviewed briefly by Dan Rodricks today on WYPR.
UNIVERSAL HEALTH CARE – Possible or impossible? It’s already happening, to a limited extent. Where I live, in a remote corner of Maryland, the hospital has been providing free flu-shot clinics on multiple dates and locations throughout the county, every fall for several years. Highly efficient, low-cost, preventive health care. Are you for it or against it?
Is the present generation willing to accept the simple responsibility of paying its bills?
Or will we refuse to pay? That’s what it all comes down to, isn’t it?
The Roberts decision upholding the Affordable Care Act turned the spotlight on RESPONSIBILITY. The effect of the High Court decision is to require that people of means take responsibility for buying their own health insurance. Some view that as an unreasonable request.
The decision also leaves a central question open to debate. Will society accept responsibility for the health care costs of the poor? The High Court’s position on Medicaid essentially requires each state to decide whether it will accept responsibility for its poor citizens. (A related question is: Can individuals act responsibly to preserve their own health?)
On the world economic stage, the crisis in Europe also spotlights responsibility.
Fascinating complexity in the decision written by Chief Justice John Roberts upholding the Affordable Care Act!
President George W. Bush, a Republican, announces his nomination of John Roberts to be Chief Justice of the U.S. Supreme Court (Photo credit: Wikipedia)
First of all, Justice Roberts, a conservative Republican appointee, voted with the High Court’s “liberal” justices to create the 5-4 majority upholding the law. Republicans and conservatives across the U.S. hysterically called him a “traitor.” Wait. Isn’t a patriot’s first loyalty to the United States of America, not to any political party?
The frightening possibility is that some partisans no longer see loyalty to the U.S. as a patriot’s first loyalty. It’s possible that some of the more extreme Tea Party loyalists have already seceded from the United States in their own troubled minds.
“I will find a way or make one.” — Admiral Robert E. Peary, American explorer
“As between two possible interpretations of a statute, by one of which it would be unconstitutional and by the other valid, our plain duty is to adopt that which will save the act.” – Justice Oliver Wendell Holmes
By all accounts, Chief Justice John Roberts believes that the Supreme Court of the U.S. should try to find a way to uphold a law enacted by Congress, rather than declare it unconstitutional. In other words, declare a Congressional act unconstitutional only if it really is unconstitutional.
Official 2005 photo of Chief Justice John G. Roberts (Photo credit: Wikipedia)
The Supreme Court decision today on the Affordable Care Act, AKA “Obamacare,” shocked my system. It was the first jolt of optimism about the future of America that I’d felt in months. And I hadn’t expected to have any reaction at all.
Chief Justice John Roberts is the man of the hour. With one stroke he won for himself a place in American history.
I can’t claim full understanding of the High Court’s ruling upholding the Affordable Care Act. My gut reaction is it changes everything. It goes far beyond the legal issues at hand. This ruling might be the turning point that saves the American system.
HOUSE REPUBLICAN LEADERS. AP photo, 02-09-11
REP. PAUL RYAN. AP photo by J. Scott Applewhite
This morning, Rep. Paul Ryan, chairman of the House Budget Committee, presented the Republican budget for 2012. Joining him were a TV screen full of his Republican colleagues on the House Budget Committee. Everyone present, from what I could see on TV, was a white man. With a few exceptions, they are from the Red States, the heartland of America.
Not to put too fine a point on it, but the Republican budget would cut government spending by $6.2 trillion over a decade, and sharply cut taxes for the wealthy. The top income tax rate would be reduced from 35 percent to 25 percent. Is the U.S. really broke, or is the U.S. wealthy? You decide.
Here is a list of Republican members of the House Budget Committee. White men in suits from the heartland. Only one female name is on the list.
Many believe the Republican budget is so draconian that it's dead on arrival. I hope so, but the hard line on Medicare, especially, is ominous.
NOT TO IGNORE THE REPUBLICANS IN THE SENATE. Roger L. Wollenberg photo, 03-31-11
Umm, the photos above, of Republican leaders in the House and Senate, and the list of Republicans on the House Budget Committee . . . Is this what democracy looks like in America, in 2011? (Disclaimer: Many of my friends and relatives are white men. Come to think of it, I am a white man. Hey, I even own two winter suits AND two summer suits, so I am prepared to attend weddings, funerals, and job interviews in all seasons.)
The name of the Republican budget is “Path to Prosperity.” Rep. Ryan says these words, “Path to Prosperity,” with a straight face, without a hint of irony.
Here’s an early analysis of the Republican budget numbers, from the Huffington Post.
Here’s another analysis by Ezra Klein in the Washington Post.
The “Path to Prosperity” runs right over Medicare and Medicaid. At this moment, it appears to me that the Path to Prosperity would effectively destroy Medicare and Medicaid. Maybe that is a good thing. Sometimes, I think, the only way to reform a program or a bureaucracy is to destroy it and start over. But I don’t think that’s what Republicans have in mind. I think Republicans intend to privatize health care for the elderly and the poor. In the name of paying off the debt. (For an earlier post on Republican strategy regarding Social Security, see “Divide and Conquer.”)
Also on the Republican chopping block: education, from Head Start to Pell Grants.
I think Republicans are focused entirely on two things: paying off the public debt, and reducing taxes. Two contradictory goals, but possibly both can be accomplished at the same time, by grinding the middle class and the poor — and the elderly — into the dirt. (Go ahead, accuse me of class warfare. Doesn’t this look like a scorched-earth policy to benefit wealthy America and corporate America?)
Rep. Paul Ryan says the Republican budget will “create jobs.”
SHOW ME THE JOBS. How exactly do you create jobs by slashing spending to the bone, on everything except the Department of Defense?
How do you create jobs when Toyota is shutting down 13 factories in the U.S., and food and gasoline inflation is vacuuming up every spare dollar of discretionary spending? AND the U.S. is fighting three wars in the Middle East.
Oh, yeah. And to show their power, or something, Republicans intend to shut down the U.S. government at the end of the week. Will that create jobs?
– John Hayden
Image by Bill Gracey via Flickr
News organizations are reporting this evening that at least two patients have died in Arizona because the state has decided it can no longer afford to pay for organ transplants for low-income patients.
The organ transplants can cost from $200,000 to more than $1 million, according to NPR. A list of 98 patients are potentially impacted in Arizona. NPR provided this explanation of the Arizona budget decision in November:
“In Arizona, 98 low-income patients approved for organ transplants have been told they are no longer getting them because of state budget cuts.
The patients receive medical coverage through the Arizona Health Care Cost Containment System (AHCCCS), the state’s version of Medicaid.” – National Public Radio
WTF? How can a state justify refusing organ transplants to low-income patients, particularly in cases where the refusal amounts to a death sentence without a trial?
But there’s another question that’s even more compelling:
What prevents a doctor or hospital from providing free life-saving treatment? DO THE SURGERY FOR FREE! Would that be un-American?
Am I missing something here? Would a surgeon or hospital spokesperson care to comment? Is there not a single, altruistic transplant surgeon in America? Is there not a single hospital affiliated with a religion that would be willing to provide free surgery as an act of charity, for God’s sake?
What? Would it set a bad precedent, or something?
– John Hayden
Being over 60 means getting a colonoscopy. Truth to tell, I had one about 10 years ago, not long after turning 50. It’s a rite of passage at the end of the middle years. We’re entering new territory, and by now we understand the value of health. The colonoscopy is a symbol of our new watchfulness in a dangerous world.
My second colonoscopy was today, at age 61. Any day that starts with a colonoscopy can only get better. Assuming, of course, that they don’t discover some dread disease that begins with “C.”
Everyone says the day of preparation before the procedure is the hard part. This time, the prep day didn’t seem so bad. Two bottles of salty stuff to drink, four little pills to swallow. Just follow the instructions. They let me drink water up until five hours before the procedure.
I drive to a nice modern facility at 8:30 a.m. Lots of friendly and professional staff. They give me a hospital gown, and a robe to put over my shoulders like a cape. The volunteer says I can keep my socks on, because it’s cold in there. He leads me to a reclining chair, and puts a blanket over my lap and legs. A pre-warmed blanket! First class all the way.
There’s the usual blood pressure and temperature routine, an IV is started, people keep asking my name and date of birth, to make sure I haven’t forgotten. At least four different people ask if I’m allergic to anything. They all seem genuinely happy to be doing their jobs. I sign a few papers, talk to the anesthesiologist. The nurse says there’ll be a short wait. I relax and read my book.
After a while the doc comes and chats, and says we’ll get started in a few minutes. I walk into the next room and lie down on my side, as directed. The chief nurse announces the procedure. At least six health-care folks are in the room, and we don’t want anyone thinking this is an amputation.
The doctor asks, “Do you mind if the student nurse observes?” Of course he can observe! He might learn something. Sell tickets, for all I care. I’m going to be knocked out. Put it on YouTube, if you want. Just make sure to get my good side.
The anesthesiologist is fiddling with his stuff, and a nurse comments on the mystery I was reading. She has the same book. It’s about a dog and a private eye, as told by the dog. We’re all laughing about the dog, or so it seemed to me, and that’s the last thing I remember.
I woke up in a fog, still lying on my side. As a nurse had warned, I felt cramps from pockets of air in my gut. They put air into the colon as part of the procedure, and try to get most of it out when they’re done. But they never get it all, so you have these pockets of air inside. You have to relax and allow the air to escape by the usual exit.
I do not remember this air cramping after the colonoscopy 10 years ago, but I honestly have to say it was the only bad part today. When I became fully awake, the air cramps felt painful. Not terrible, but definitely not pleasant. A guy next to me was having the same problem. Minutes went by, and the air pockets were slow to disperse. I finally got the last of the air out in the privacy of a restroom. It seemed like enough air to inflate a truck tire.
Eventually I got dressed and a nurse took me to a chair, sat me down, and gave me a cup of water. They had said the procedure would begin at 9:30 a.m., and I could go home by 10:30 or 11 a.m. It seemed like a lot of time had passed, but now that I had my watch and glasses back, I could see it was only 10:50.
The doc stopped by and told me everything was fine. He had pictures! He found one polyp and zapped it. No possibility that it was the bad kind, he assured me. Score: Doctors 1, Polyps, 0. Game over.
You may remember that I drove myself to the medical building. But you probably know that they don’t let you drive yourself home. Fortunately, my neighbor was kind enough to come and drive me home. I had something to eat and took a nap. I’ll go back and retrieve my car tomorrow.
One thing more: I decided to have the colonoscopy now, because in two months, I probably won’t have health insurance. – John Hayden
Let me humbly acknowledge: I have been shamefully neglecting “Life After 60,” the blog. This is because I’m too busy LIVING life after 60, the life.
Here are a few of the things I’ve been busy with:
Most recently, visited the Christmas Bazaar at my church, near the end of the second day of the event. They had marked everything down to half price. I bought two ancient commemorative tin wall hangings, one with a picture of JFK, the other with a picture of Jackie. They still have the original Hecht Co. price tags. Hecht Co. sold the plates for $1 each in 1977. I bought the pair for $1 at the church bazaar. What do you suppose they would fetch on eBay? (They’re not for sale at any price.)
Jack and Jackie and Hecht Co. have all passed on to their rewards. I am delighted to be living life, with my memory and my health still in good working order.
– John Hayden
The American cable news channels are in full parallel-universe mode today, Saturday.
MSNBC had President Barack Obama, campaigning for health care reform in Minnesota. MSNBC televised the president’s speech in its entirety to a crowd of thousands. MSNBC’s cameras showed wide-angle views of the packed arena, people cheering wildly.
When the president explained the problems facing health care in America, someone in the audience shouted, “We’ve got to do something!” Mr. Obama agreed, ”We’ve got to do something.” It was a long way from Washington, where a congressman shouted at the president this week, “You lie.”
President Obama said he’s not going to waste any more time with cynical politicians who are clearly committed to defeating health care and destroying his presidency.
The crowd in Minnesota was “Fired up!” and “Ready to go!”
Meanwhile, over at FOX News, they were covering an anti-health care rally on the Mall back in Washington. The FOX News camera focused in tightly on a knot of demonstrators (two dozen? a hundred?) and one unknown speaker ranting about the First Amendment and “uniform taxation.” One thing you have to give the health-care opponents, they’re not a single-interest group. No indeed, they’ve got a gunny sack full of gripes. (Correction: Later in the day I learned that there were a lot more than a hundred demonstrators in Washington. There were thousands and thousands. See note from Lizzi in Comments below.)
FOX was in Texas, too, providing air time to some Texan who was complaining about health care for everyone. What an un-American concept! Health care for all, even the unemployed, even the poor, even people with pre-existing conditions.
The Texan said the government ought to stay out of health care, because the government has no experience running such a program. Umm . . . What about Medicare? Senior citizens seem quite fond of Medicare. Who do you think runs Medicare? What about Social Security, which has one-percent administrative costs? Who do you think runs Social Security?
And so it goes. MSNBC and FOX News, two professional cable news channels, reporting live from parallel universes.
When it comes to government and bureaucracy, most of us simply want to be left alone and allowed to live as we please. Don’t we have enough demanding voices telling us what to do in our families, our personal relationships, our religion, our jobs? Enough! We don’t need any more demands from government! All we want is some freedom, some independence, some space. And while we’re at it, some respect. “Is that too much to ask?” We shake our fist at big-brother government: “What part of that don’t you understand?”
Paradoxically, we want our needs to be taken care of. We’d like to be protected from the vagaries of life, please. (Vagary comes from the Latin, “to wander.”) We wander through a world of troubles — failures and successes — broken relationships, financial hardships, illnesses. The fears are not so clear when we are young and invincible; it all becomes more obvious as we get older. We want to be protected at least from the most fundamental brutalities, i.e., hunger, pain, violence, and failing health. At rock bottom, we’d really like to be protected from death.
Once in a while, democracy lays bare the paradox, confronting an issue that speaks to our innermost needs to be left alone and at the same time to be taken care of. A life-and-death issue, you might say. No wonder we are angry, divided, frightened and perplexed about health care.
Surfing back and forth between the cable news channels, FOX News and MSNBC, before President Barack Obama’s address to Congress on health care reform, a visitor from Mars would likely conclude that the Fox pundits and the MSNBC pundits reside in parallel universes, or perhaps on different planets.
No surprise if it sometimes seems that people are brain-washed by either the conservative pundits at FOX or the liberals at MSNBC.
The president attempted Wednesday evening to speak over the heads of FOX and MSNBC, to speak directly to the American people.
President Obama made his intentions and his resolve clear from the start of his address: “I am not the first president to take up this cause, but I am determined to be the last.”
The president refused to parrot the pundits on either political extreme. He attempted to position himself squarely in the center, saying he prefers “to build on what works and fix what doesn’t, rather than try to build an entirely new system from scratch.”
Congress has been pecking at health care for months, in the unlikely hope of achieving a bipartisan agreement. Wednesday, the president finally made clear his own proposal.
President Obama proposed a “new insurance exchange” from which citizens could select and pay for the health insurance plan of their choice. He proposed that the insurance exchange “take effect in four years, which will give us time to get it right.”
Ending weeks of speculation, the president came down solidly for a “not-for-profit public option” to be available along with private health insurance choices in the insurance exchange.
To those who fear losing their present health insurance, the president said: “Nothing in our plan requires you to change what you have,” and he declared, “I will protect Medicare.”
And to those who urged him to fight for health care reform, President Obama said, ”I will not back down on the basic principle that if Americans cannot find affordable coverage, we will provide you with a choice.”
He declared that the principles of social justice and the character of America are at stake in the health care decision.
Let’s not let cable news channels trivialize the issues.
– John Hayden
All the good intentions of those two dreamers — President Barack Obama and Sen. Ted Kennedy — and their hopes that health care might be available to ALL Americans, have run into a wall of mindless self-interest.
It turns out that Medicare-eligible senior citizens are the new privileged class. People over 65 are the haves; people under 65 are the have-nots.
The virtue of generosity once again is no match for the power of fear and selfishness.
Senior citizens to America: “We’ve got our Medicare; the rest of you can go to hell.”
I never believed the prediction that American democracy would disintegrate into inter-generational warfare over Social Security and Medicare. I was under the naive delusion that America’s elders would teach wisdom and generosity.
Never mind. It turns out that as a group, senior citizens appear to be as callow as a gang of teenagers; as greedy as a roomfull of CEOs; as indifferent to the poor as a convention of Wall Street bankers.
If President Barack Obama’s goal of health care reform fails, it will fail because complacent senior citizens decide to make their children and grandchildren America’s health care have-nots.
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