Tag: health care reform

I hope all of you have been following  the developments on Firedog Lake, especially on the FDL Action Page and FDL News Desk (dday).

I’ve been trying to find a way to summarize the posts, a quote or two that conveys the enormity of the sellout we’re experiencing, but I’m at a loss and perhaps you can help.

Drug Reimportation

Harry Reid, Crook for PhRMA, Tries To Kill Drug Reimportation

By: Jane Hamsher Thursday December 10, 2009 7:21 pm

Reid, White House Trying To Bury Reimportation Amendment

By: David Dayen Friday December 11, 2009 6:00 am

Basically, the deal between the White House and the pharmaceutical industry didn’t allow for any circumstance that would save consumers $106 billion over ten years by being able to purchase cheaper drugs. Some liberals have objected on the grounds that Republicans are making bad-faith arguments about the value of a single negotiator, but as a means to block drug customers from tens of billions in savings annually, it’s a weak argument. And it’s especially weak when the only reason it’s being held up, despite massive support, is that the White House doesn’t want to take a big bite out of Big PhRMa.

My emphasis.

Loophole Adds Annual Limits on Insurance Coverage For High-Cost Illnesses In Senate Bill

By: David Dayen Friday December 11, 2009 8:18 am

Why would this cap on treatments of cancer and other illnesses be instituted? The answer could lie in biologics. Under the current health care bills, drugmakers would be allowed to keep their exclusivity on expensive biologic drugs for at least twelve years and perhaps permanently, thanks to the evergreening clause. These are drugs that cost as much as $80,000 a year annually, and without the prospect of low-cost generic versions, that number will only increase. These drugs offer the hope of treatment for crippling diseases, but the cost is prohibitive to individuals. By preserving the drugmaker’s ability to charge that price, the insurance companies may not want to be stuck with the bill. So a cap on annual spending for the kinds of diseases these drugs treat would pass the costs on to the patient.

Obama and Reid’s War Against Bringing Down Americans’ Health Care Costs

By: Jon Walker Friday December 11, 2009 8:51 am

What is sickening is that Obama campaigned on this rather small, common sense cost controlling idea. Yet Obama traded away drug re-importation to PhRMA in a sweetheart deal. He also traded away direct drug price negotiation in the same deal. Obama and Reid have clearly taken the side of protecting corporate profits instead of bringing down health care costs for regular Americans. I shutter to think of all the other good cost control ideas Obama and Reid were able to more quietly kill as part of some secret industry deal that we still don’t know about. Next time they send Peter Orzsag to pimp all the awesome “bending the cost curve” ideas in the bill, the appropriate response from reporters is to laugh in his face. For the past few days, Obama and Reid have rather publicly fought against bringing down America’s health care costs.

Dorgan Does Right Thing, Holds Up Senate Health Care Debate Until He Gets Reimportation Vote

By: David Dayen Friday December 11, 2009 1:16 pm

The big story here is not that the White House wants to crush Byron Dorgan’s reimportation amendment and hold up their deal with Big PhRMa – that’s been clear for a while. The big news is that Dorgan’s fighting back:

It’s NOT Medicare

I Can Believe It’s Not Medicare: Get Ready For Fake Medicare Buy-In

By: Jon Walker Friday December 11, 2009 7:01 am

This change would result in this fake Medicare program having much higher premiums and a smaller provider network. It would also result in greater administrative overhead. This fake Medicare would lack almost all the benefits of Medicare. A Medicare buy-in program that does not actually allow people to fully buy into real Medicare is a farce. Beware: it looks like we are about to get fake Medicare for Christmas.

Benefit Caps

Harry Reid Slips Lifetime Limit Into Senate Bill

By: Jane Hamsher Friday December 11, 2009 8:34 am

Reid, who is solely responsible for crafting the bill that he introduced in the Senate, decided that there should be a limit on lifetime benefits. So when people get sick and have huge bills for things like biologic drugs that cost $50,000 or $100,000 a year, whose bills could become “unreasonable” because Congress is granting drug manufacturers “indefinite monopolies” (per Henry Waxman) that prevent generics from coming to market to compete with them, Harry Reid thinks they should eventually be cut off:

So Much For Health Care Consumer Protection: Reid Guts Ban On Annual Limits

By: Jon Walker Friday December 11, 2009 9:30 am

For all those apologists who say we should absolutely pass a health care bill, even without a public option, because it still “has so many great consumer protections,” I have a rude awakening for you. The AP is reporting that Harry Reid quietly gutted one of the most important consumer protections in the bill, the ban on annual limits:

HHS Knew About Reid’s "Annual Limit"

By: Jane Hamsher Friday December 11, 2009 12:23 pm

Funny that nobody thought to tell the public.  How many more of these things do we not know about?

You’re Right, Harry Reid, Fake Insurance Is Much "Cheaper" Than Real Insurance

By: Jon Walker Friday December 11, 2009 1:13 pm

The reason Reid dropped the annual limit from the Senate bill was to make his bill appear cheaper in the CBO score, and make insurance premiums appear lower.

No ‘Cost Savings’ in “Compromise”

CMS: Excise Tax On Insurance Will Make Your Insurance Coverage Worse And Cause Almost No Reduction In NHE

By: Jon Walker Friday December 11, 2009 12:31 pm

The new excise tax on employer-provided health insurance will result in most people getting worse health insurance from their employer, insurance that covers less. That is just not my conclusion, it is the conclusion of the CMS.

Highlights Of CMS Analysis Of Senate’s Bill

By: Jon Walker Friday December 11, 2009 3:47 pm

So my summary is this-

Harry Reid, with Barack Obama’s at least tacit complicity, has decided to turn “Health Care Reform” into “Insurance Industry/PhARMA Welfare”.

You will be mandated by the Government to pay at least 20% of your annual income for Health Care because of expensive, crappy insurance that doesn’t cover anything and artificially inflated medical costs.

And it won’t save the taxpayers a dime.

Not to mention taking away a Woman’s Right to Choose.

This is worse than nothing.  Thanks Democrats.

No Public Option, No Mandate.

So says John Aravosis.

Think it could have anything to do with this?

Don’t Be Shocked When The Democratic Base Does Not Turn Out In 2010.

Just two days after announcing the escalation of the war in Afghanistan, President Obama held a jobs summit:

With unemployment levels above 10 percent, Obama said “We cannot hang back and hope for the best.”

But, mindful of growing anxiety about federal deficits, Obama also tempered his upbeat talk with an acknowledgment that government resources could only go so far and that it is primarily up to the private sector to create large numbers of new jobs.

He said while he’s “open to every demonstrably good idea … we also though have to face the fact that our resources are limited.”

Beyond the question of why a Democratic president is giving lip service to deficit hawks at a moment that screams for more Keynesian stimulus, the real question is this: why is it that we have to endure nearly a year of grueling political games just to get a weak, watered down health care bill that we have been told, all along, has to be deficit-neutral, yet no one bats an eye at throwing tens of billions more each year into wars?

A couple weeks ago, CBS News reported:

On this day where the negative news about the War in Afghanistan, fresh doubts about President Obama, and a lack of Democratic unity in the Senate regarding Health Care drives a sourly pessimistic news cycle, now is as good a time as any to push back against the doom and gloom brigade.  It may be time for the Democratic party to begin to reform itself first before it can ever make a solid effort to reform the country.  As much as Republicans have provided a more or less solid base of opposition and obstruction, Democrats have only appeared marginally united and only then for brief periods of time.  While I am aware that this is hardly anything new, disorganization will prove to be our own undoing unless we look inward and take stock of our shortcomings.  Everyone talks about this, of course, but as Mark Twain put it regarding discussions concerning weather, nobody does anything about it.      

The most current gloomy AP story of yesterday was predictably dire,

WASHINGTON – The 60 votes aren’t there any more.

With the Senate set to begin debate Monday on health care overhaul, the all-hands-on-deck Democratic coalition that allowed the bill to advance is fracturing already. Yet majority Democrats will need 60 votes again to finish.

Some Democratic senators say they’ll jump ship from the bill without tighter restrictions on abortion coverage. Others say they’ll go unless a government plan to compete with private insurance companies gets tossed overboard. Such concessions would enrage liberals, the heart and soul of the party.

The first stirrings of a concept known as Intersectionality began to develop in the 1960’s and 1970’s in opposition to the exclusivity, post-modernism influenced arguments of a prior generation of activists and thinkers.  In brief, Intersectionality rightly assumes that taking into account a variety of lenses and perspectives, as well as how they interact with each other is a much better means of attacking a problem.  Instead of taking one or two issues in isolation, viewing the similarities and acknowledging the spot at which all points meet would, as it is proposed, facilitate common purpose much more easily. In that spirit, seeking to address interrelated issues that comprise a complex matter rather than focusing too heavily on quibbling details would do our Senators and Representatives well.  

As the media has presented it, one would assume that the reservations brought up by individual members of Congress while in hot debate over health care have been matters of profound heft.  Certainly the political football of both Stupak and the Public Option are not issues to be taken lightly, but having read many of the published reports regarding day to day conduct in committee, the substantive concerns have often taken a back seat to needless minutia or pointless hair-splitting.  Threats and counter-threats in this laughably extended proceeding have ceased being coercive and might as well be duly noted in the Congressional Record without objection.  The mystical filibuster, for example, once was feared and sparsely used, and now has become part of process wallpaper to such a degree that even the threat of the procedural measure when invoked produces shrugged shoulders more than abject terror.  True filibusters are rare in any case.          

The Democratic party might at least consider the idea of Intersectionality if it is to prevent more than nominal GOP gains in 2010 and if it deigns to rule for an extended period of time.  Having won, it must now find a way to not overstay its welcome in the good graces of the American people.  Democrats know very well what they do not want to be and aren’t so versed on what they think they ought to be.  Many activists believe that a new way of looking at established rules would push every Democratic figure forward rather than being mired in conventional modes of thought that are long past their expiration date.  Many would argue that several of the long term legislators with seniority are long past their expiration date as well.  It is an unfortunate fact that we have been rather frequently and alarmingly prone to factionalism in recent history, which is partially a result of a disturbing lack of more or less uniform direction.  It should be noted that I do not see this as some greater trend along the same lines as peering at an ant farm, whereby what seems from a distance to be chaotic is upon closer inspection merely a method to the madness.  

Seeking to find mutual purpose between individuals and individual organizations alike, rather than pointing out differences and highlighting distinctions could well be our salvation.  What complicates this process, however, are the multitude of non-profits and PACs that dot the landscape, many of which are devoted to a single issue.  Each was founded out of a desire to make sure that the unique concerns of a particular group or cause was not neglected in the legislative process.  They were created based on an inequality or need that cried for alleviation, but with time, however, these groups began to resemble government agencies, whereby bureaus that could have been consolidated with others for the sake of efficiency were allowed to exist alongside similar departments which did more or less identical work.  Networking is still a fairly foreign concept to many of the myriad of entities that compromise the Democratic party and help set its agenda.  How we think influences how we govern and how we seek to influence that which governs.  Though the current model may have had its place once, the time has come to modify our thinking and with it our strategy.  Focusing too heavily on where we are not alike rather than how we are alike is, arguably, what led to the decline of the party post-Carter and contributed to the 1994 election debacle.  

I wrote a post over the weekend which touched some nerves.  In it, I discussed the way our that own fundamental structure as liberals makes getting us on the same page an exercise akin to herding cats.  One of the comments left was something to the effect of “I’m a Progressive and no one tells me what to do.”  Fair enough, except that I wasn’t suggesting that the person in question (or anyone, really) follow blindly behind any cause or personality.  What I was, however, arguing is that we can’t always isolate ourselves in our own identity group and assume that its concerns are of paramount concern to the whole.  Until we identify as Democrats first and other identities later, we’ll always have unintentionally split allegiances.  Any group established for originally altruistic means quickly becomes obsessed with justifying its own existence and in so doing losing sight of the original intent.  A common thread runs through so many organizations and it goes well beyond a simple label of “Progressivism”.  The most successful educational strategies link together a variety of subjects and show students how each is interconnected.  This is where true learning begins and this might also be the point at which true unity is allowed to thrive.    

I don’t believe in groupthink and I certainly don’t believe in playing follow-the-leader, but I do know that it is certainly easier when waste and superfluity is trimmed away.  I do also know that if everyone had been on the same wavelength before Stupak, then women’s rights wouldn’t have been so easily bartered away for the sake of a narrow victory.  If we truly lived our gospel of multiculturalism and plurality, then human rights would mean more than just the latest atrocity perpetrated in a nation far, far away.  If we practiced what we preached, there wouldn’t be a need for the Gay District, since LGBTs would live boringly normal lives right next door to us.  If we took up the cause of intersectionality, there would be no others who are not like us in some way, shape, or fashion.  While I am writing on this particular topic, I am reminded of a woman who is a contributing editor to a Feminist site I regularly visit; she uses this quote as her e-mail signature:

“Engrave this upon your heart: there isn’t anyone you couldn’t love once you heard their story.” –Mary Lou Kownacki    

Decry it as naïve optimism if you wish, but post-partisanship, if we have not thrown it upon the dungheap of history quite yet, begins with this simple statement.  That which separates us is often artifice, over-reaching, or over-compensation.  One President micromanages the Health Care debate, which fails miserably.  Another President puts Congress in control, failing to understand that he is capable of keeping bickering legislators in line without seeming dictatorial.  We are our own worst enemy, far too often.  Arguably we regained both chambers of Congress due to a GOP that had been remarkably good at shooting itself in the foot, if not other members.  One wonders what will be our strategy in 2010 besides praying that the economic data and unemployment numbers improve drastically and that the Health Care reform bill passes.  How will we learn from four years of mixed results?  I can guarantee that the existing framework and system is no viable solution.  We know what we are not, now it’s time to determine that which we are.  

Since I record Dylan Ratigan, for viewing on the week ends, I managed to catch this shocker of an Interview with Howard Dean, a few days ago.

I’m surprised not to have seen it covered much, so here goes …

Full MSNBC Interview

Howard Dean:

“The problem is with this legislation, if one person holds up this Bill, and it passes as a ‘hodge podge of nonsense’, which is what the 4 more conservative Democrats want — basically ‘A Insurance Company Bill’ is what they want — this is a huge problem for the Obama Administration, it is a huge problem for the Democrats in 2010.”

BTW Howard Dean knows a thing or two about winning Elections, nationwide, so Dems would be wise to listen to and think about his blunt warnings.

The AP continues its right-wing propagandistic ways, this time asking one of those “hypothetical” questions that the right wing loves to throw out there, you know, the “Is Obama really a Muslim”, or “Is Bill Clinton guilty of rape?” or whatever, you know the drill, it’s something anyone can do, it’s the classic “when did you stop beating your wife?” technique, but nobody does but the right-wing in this country because, well, nobody owns the media in this countyry except the right wing corporate bastards, and the AP is their clearinghouse for this shit.

So today, thanks to EK’s afternoon news digest here, I am presented with this gem:

Health reform: Is tax on ‘Cadillac’ plans fair?

The MSM has duly taken note that the North Carolina legal firm of Moore & Van Allen is doing work for “AQAH,”  aka  “Americans for Quality Affordable Healthcare,”  which is anything but, as it’s fighting to kill the reform legislation,  but its spokesperson refuses to name the clients who have hired them.  In the ways of the MSM, the search engine is broken… or lacks motivation.  We do have confirmed sightings in NV, ME, and LA.  It was named as Republican astroturf in a front page post at GOS, a start, but didn’t go any further.

It’s going to be the same special interests, just using more identity masks.

Nevada, Maine, Louisiana.    

First thing that makes me think of is the Tea Party Patriots doing their tour bus routine with the Russo Marsh/Move America Forward Republican PR firm, because that PAC did a bunch of anti Harry Reid advertising this summer and toured thru Nevada doing teaparty rallies  (which the FEC is all over their butts for with that filing of Our Country Deserves Better PAC  ). And Prop 8 money from Utah and CA was recently in Maine, letting the 2 moderate lady Republican Senators, Snowe & Collins, know that the Tea Party apparatus was gearing up for Maine 2010.  Louisiana, that’s easy, Sen. Landrieu is on the Republican’s list of mostly likely to be swingable, and she’s also a top recipient of Dem Senate Campaign Committee funding. Louisiana is an oil state.

We’re going to go do some deep sea exploring.  

Much as credit card companies have charged exorbitant interest rates in the period leading up to the passage and enactment of reform, so too have prescription drug companies added more cost to their already prohibitively expensive products.  Afraid that health care regulatory legislation will cut too heavily into their soaring profits, the industry feels no shame, nor any compulsion to give heavily burdened consumers much of a break.  This is a side of the debate that has not gotten the same attention as other areas and one that I have tried to bring to light quite frequently, being that I myself stand to lose quite a bit if out-of-control price increases are not sharply curtailed.  I do not deceive myself into thinking that I am the only one who stands to lose.  Though I do not mind invoking personal experience if it facilitates greater understanding and urgency, I wish it didn’t take the anecdotes of the chronically ill to impress upon a skeptical public the importance of health care reform.          

On the subject of psychotropic medication, something of which I am an amateur expert, I have closely monitored new classes, types, and formulations of prescription drugs in a desire to find the best way possible to treat my condition.  For every new medication that breaks new ground, wins approval by the FDA, and is then prescribed by GPs and psychiatrists across the country, it is a never-ending source of frustration for me to observe the three new offerings which are merely slightly different formulations of existing medications.  This is a covetous process undertaken mainly to reap maximum profit when older scripts are on the verge of losing patent status and thus being offered as generics.  For example, the anti-depressant which is the most recent addition to a family of medications known as SSNRIs has been marketed under the name Pristiq.  Pristiq has a very similar chemical structure and as a result works only slightly differently from an existing drug in the same school, Effexor, that has been around for over ten years.  Sometimes, however, even generics occasionally have limitations.  Though a lower-cost equivalent to Effexor exists, the less-expensive form has been reported to work not nearly as effectively as the name brand formulation.

An article in today’s New York Times reports on Big Pharma’s side of the story.

But drug companies say they are having to raise prices to maintain the profits necessary to invest in research and development of new drugs as the patents on many of their most popular drugs are set to expire over the next few years.

That may be, but before one gets misty-eyed listening to the woe-is-us violin, rest assured that the pharmaceutical industry isn’t exactly hurting for business.  Conveniently they don’t mention the larger picture.  Another example of this kind of infuriating slight-of-hand is the sleep aid Ambien, which has had a sufficient generic alternative for a while.  A relatively new formulation dubbed Ambien CR produces an only a slightly different reaction, mainly by time-releasing the absorption of the drug into the blood stream.  The drug is the same, but the gimmick is different.  Returning to psychiatry, it is either a testament to how little we know about the function of the brain or how unwilling we are to risk radical change that the medications used to treat depression, anxiety, bipolar disorder, and schizophrenia have broken only relatively limited ground in decades.  The best treatment for depression are still a class of powerful anti-depressant known as a MAOI inhibitors, which are close to fifty years old.  They are rarely prescribed, however, because taking them requires strict dietary restrictions that, if not adhered to, can result in serious damage to the body and, in extreme cases, even death.  In treating bipolar disorder, some patients still respond best to Lithium, which has been used in treatment for over a century, but extensively since the Fifties.    

Newer medication often cut down side effects and make the period of adjustment less painful, but do little to increasing the stated objectives of the drug, namely to drag people out of depressive episodes and set them on a course towards health and functionality.  Experimental trials are often plodding affairs proceeding at the pace of a snail, targeting a relatively limited area of the brain, and unwilling to take any unnecessary chances.  Despite this, some medications do pass muster and do end up being taken by who are suffering in the hopes of providing relief.  Even so, the drug makers and those who formulate them sometimes fail to take into account such crucial details as major side effects in a rush to get out the next big thing.  SSNRIs like Effexor, for example, are infamous for producing absolutely awful issues when someone stops taking it.  Though not strictly classified as such, one might even say that such drugs are addictive because the brain acts violently when the medication is discontinued.  These serious matters somehow never find their way onto the commercials on television or the ads inside glossy magazines.  

The difference in cost between name brand and generic drugs is quite vast.  Often it is a matter of several hundred dollars for a one month supply, though it can be as high as a thousand dollars or more.  As one might expect, those with employer-based or individual plans paid for out of pocket have to pay substantially higher co-pays for name brand drugs.  When I had private insurance, the co-pay for generic medications was $10 and for name-brand drugs, it was $60.  Sometimes I had no choice but to take a name-brand medication, which are often treated by insurance companies as something bordering on cosmetic and not essential, when the fact of the matter is that they are highly necessary and highly unavoidable at times.  

Those who don’t have the luxury of private insurance, of course, have it rougher.  Those who have to rely on Medicaid find that they have no choice but to settle for generic medications when a name-brand drug would be a much better fit and work much more effectively.  Medicaid programs vary, but in the state of Alabama, the most expensive medications are only covered if a doctor or specialist one can provide proof that at least two lower-cost alternatives have failed or been insufficient to treat the condition.  Not only must they have failed, one must also work within the confines of a 90 day coverage window.  If a claim to cover a more expensive medication is not filed within 90 days of failing the requisite two medications, then coverage is not granted.  This is ridiculous in lots of ways, mainly that few medications used to treat mental illness work quickly, and many take weeks upon weeks before any psychiatrist or doctor can make a judgment either way.  It’s also ridiculous because it uses a broad brush of convenience, painting all illnesses as basically the same and all treatment regimens as similar.  Some name-brand medications, regardless of the need are not covered at all, since whomever set up the system decided that covering it would unnecessarily drain the General Fund and that it was an unnecessary prescription in the first place.      

Returning to the Times column,

But the drug makers have been proudly citing the agreement they reached with the White House and the Senate Finance Committee chairman to trim $8 billion a year – $80 billion over 10 years – from the nation’s drug bill by giving rebates to older Americans and the government. That provision is likely to be part of the legislation that will reach the Senate floor in coming weeks.

But this year’s price increases would effectively cancel out the savings from at least the first year of the Senate Finance agreement. And some critics say the surge in drug prices could change the dynamics of the entire 10-year deal.

Those who trust Big Pharma do so at their own peril.  

Additionally, The news broke today that, quite unsurprisingly, much misinformation exists surrounding the Public Option™.  As Politico points out,

The debate has placed disproportionate emphasis on the creation of a government insurance plan, raising the expectation that everyone could ditch their employer-provided coverage and enroll in the public option.

But that won’t happen, at least not at the start. The reality is that only about 30 million Americans – 10 percent of the population – would even be eligible.

It could be accessed only through a new insurance marketplace known as an exchange, where consumers would shop for plans. Only certain categories of people could use the exchange: the self-employed, small businesses, lower-income people who qualify for tax credits to purchase insurance and those who are otherwise unable to find affordable private coverage.

This might deflate the hopes of supporters and pacify opponents, but since so much of this debate has been a three-ring-circus based on raw emotion and faulty logic, I sincerely doubt it.  However, as proposed, it is interesting to note that the Public Option™ would be more like Medicaid than anything else.  My hope is that we do not make the same mistakes with the current bill as we do with existing systems it seeks to augment or replace, particularly those in red states who likely would opt-out altogether if provided the opportunity to do so.  Though at least red state residents would presumably have the fall-back of Medicaid, provided they could qualify, the framework is based on ignorance and tunnel-vision of an almost incomprehensible degree.  One cannot simplify the complexities of humanity, nor its diseases, which are as multifarious as its people.  

Returning to the treatment of mental illness, what is often not cited is the disconcerting fact that often African-Americans and Latinos respond much less favorably to medications used to treat the condition.  This is a contentious topic with lots of disagreement, but the argument some advance is that cultural stigma factors in to a very large degree.  If minorities feel shamed or guilty about seeking help for psychiatric needs, they are much less likely to engage in medical research.  Furthermore, many believe that therapy is a more viable option than medication.  Often it is difficult to make any kind of pronouncement when the truth is obscured by so many different interrelated factors.  And though one can easily make a case for mental illness, one could also make a case that minority and low-income residents might be less inclined to visit a doctor for a more run-of-the-mill ailments as well.    

The lifetime prevalence of major depression in the United States is estimated to be 16.2 percent, with considerable social and role impairment evident in the majority of patients. Previous studies found only minor differences in depression rates among African Americans, Latinos and whites. But various studies have found patients from lower social economic groups often have less access to mental health care, are less likely to be prescribed and to fill prescriptions for new antidepressants and are less likely to receive care beyond medications when compared to whites.  

This fear and anxiety so many have that resembles to these eyes a case of St. Vitus Dance may not have any basis in reality.  Doesn’t matter how good the system is if no one uses it.  God forbid everyone in this country have a high standard of living and good health.  As the article points out, minorities and low-income citizens often have the highest need for quality care and are apt to put off seeking help until the pain becomes intolerable.  That these are the people most likely to be eligible for enrollment in the government-run (gasp) option, those now building it from the ground up would do well to consider its target audience.  We speak out of our own privilege when we assume that somehow the Public Option™ will directly affect us for better or for worse, when the poor and less fortunate will be the ones who either reap its rewards or suffer from its limitations.  While it is true that middle class individuals and the reasonably affluent have struggled under the yoke of skyrocketing health care costs, I recall going in that I assumed the changes needed and intended were meant to appeal to our tired, our poor, our huddled masses yearning to breathe free.  Somewhere along the way this became all about us.        

A friend of mine works for a right wing idiot. She sometimes shares with me their political correspondence. His politics usually doesn’t get any more sophisticated than generic right wing talking points. The stupid does, indeed, burn. But one recent exchange really distilled it, for me. I had forwarded her the link to my recent post about people who will die, if health care “reform” doesn’t include a public option. Because even if new laws bar private insurers from excluding people with pre-existing conditions, nothing now and nothing in the current proposals prevents private insurers from denying patients expensive life-saving treatments. The newspaper article on which my diary was based referred specifically to Nataline Sarkisyan, the seventeen-year old who died when her private insurer refused to pay for a needed liver transplant. And my friend forwarded back to me her boss’s response. Which was simply to ask how much a public option would cost, along with his typically mind-numbingly inane parrot-point about “unfunded mandates.” It took about a day for it to sink in. What kind of person, when told about a teenager who died because she couldn’t get life-saving medical care, responds by asking about the cost? What does it say about such a person’s basic human values? It’s hard even to respond to such a sick, soulless attitude. This man has daughters. But I guess if he has enough insurance for them, the rest of the world can go ahead and die. He doesn’t care.