Our current health care mess is more a political debacle than a substantial challenge to the intellect when it comes to solvency.
We can do better by providing excellent health care to allAmericans while lowering the overall cost, though it may slightly burden the wealthy and middle-class folks in order to reach the prize of truly affordable health care for all.
In the 90’s I taught at a local community college and one of my students – who was abused as a child and neither fully-supported nor fully-educated – struggled her entire life with health issues, racking up hundreds of thousands of tax-payer-swallowed medical bills over the course of her too-short life.
Multiply this situation by millions – many citizens are now hooked on opiates – and one can see how this particular demographic could force a single-payer Medicare expansion into near-future reality.
While I was researching this article, it was obvious that
the “facts” coming from sites linked – in one way or another – to private insurance companies were quite different from those emanating from neutral sources.
The insurance-linked information sites apprised the cost at $32 trillion while the neutral sites announced it would actually lower costs. The truth often lies at the midpoint, a hefty sum indeed. But our current direction, and the soon-to-be-announced Obamacare Lite are simply untenable.
Limiting Congressional health-care benefits to their own
plan for the rest of us would be a start. But don’t expect a sitting Congressman to write that bill. And now Republicans are replicating the major mistake Obama committed in his first term, which was to push a secret backroom inviable bill into law while briefly holding the majority and babbling they’d better pass it first so “you can see what’s in it” later.
Fast forward to today and it turns out that the ACA is actually a step above what the current Trumpcare plan offers the truly needy, a plan that boils down to “the rich get richer”.
An alternate path – leading away from the debacle of Obamacare/ Trumpcare – is fairly simple and workable: expand Medicare using a single payer plan while dropping Medicaid altogether.
“So what is single-payer health care? Essentially it involves expanding the present Medicare system to cover everyone and eliminating private insurance (with the claimed accompanying savings of hundreds of billions of dollars).
"Additional features would include the absence of means testing, no concern for pre-existing conditions, the restoration of independent doctors and hospitals who negotiate with Medicare and would be chosen freely by consumers and one public agency processing and paying bills.
“Because it would be unneeded with this system in place, the present Medicaid program for the indigent and its associated administrative costs would be eliminated. Proponents suggest that costs could be contained and quality maintained through more efficient review by the single insurer. Costs would be financed through a progressive income tax.”
Sounds good, aye? Well, unless you’re a millionaire and break in to a cold sweat at the clause “costs would be financed through a progressive income tax”.
Like me, you’re probably reading between the lines here.When “eliminating private insurance” pops out, one’s mind – if the slightest bit of pragmatism is embedded there – questions the odds of cash actually drying up in the UnitedHealth, Kaiser, Humana, Aetna, and Cigna Rivers.
“In the 2012 election cycle, the insurance industry contributed a record $58.7 million to federal parties and candidates as well as outside spending groups. Of the nearly $55 million that went to parties and candidates, 68 percent went to Republicans, who have long been the recipients of most of this category's giving.”
Admittedly, private insurance companies may suffer at first with a single-payer plan, but people with cash would buy supplemental insurance beyond Medicare basics and sustain the industry; jobs would shift to government positions aimed at administrating the new system and would therefore mitigate unemployment.
With the GOP in power, we’ll likely get Obamacare Light if they can scrape up the Senate votes, which fattens the coffers of the already-wealthy while neglecting the truly needy.
However, the worm may turn in 2018, and if a new Congress actually functions, we’ll be able to bring down costs and increase quality with a single-payer Medicare expansion while simultaneously closing the income gap.
Logically, one should abstain from indulging in news the first thing in the morning.
Soaking up death, stabbings, arson, child neglect, fracking, meth-lab explosions, sex slavery, environmental disasters, racist cops, neglected infrastructure, enduring slave wages, endless CEO profit raking, idiotic politicians blubbering pie-in-the-sky promises with no intention of following through … mixing all those nauseous facts with prodigious amounts of caffeine … well.
That can’t be good for the psyche.
But the routine never varies.
Out of bed, slurp coffee, devour news, cautiously turn to the obituaries, brace for the blow.
A recent law-school grad with a long history of academic success, a loving family, and a promising future. Twenty-seven-years-old. Here’s a brief paraphrase from the obit:
God protected him many times when his parents were unable. His earthly life ended unexpectedly but his everlasting life has begun.
We’ve watched the font-size of our local print paper decrescendo for thirty years to the point where it’s barely readable.
After all, they have our subscription money, and we’ve read the news on our iPhones and internet feeds, old print news takes up valuable paper and ink, so we’ll minimalize it, shrink it with a pissant font, and look for other revenue streams.
To balance the loss of readership and revenue to online outlets, our local newspaper doubled the size of its obituary text, colorized large head shots of the recently-deceased, and unknowing created a daily parade of local folk now leaving eternal digitized images.
If you plan ahead, love to scribble, and can afford to throw even more cash at a local newspaper publisher, up goes your twin column half page manifesto, a.k.a. bird-cage lining.
Obituaries sell local papers. Furthermore, the family of the deceased wanting to run an obituary is billed up to $600— approximately five times an annual subscription price — to purchase the publication of their loved one’s death notice.
And newsprint corporations will continue to milk grieving readers until obituaries naturally migrate whole herd onto the “everlasting” cloud — which is subject to evaporation any second of any day.
So we slurp coffee, wipe crust from our eyes, and suffer the dark parade of endless young-people obituaries — two or three “mysterious passings” per week — digitized head shots projecting health, vitality, and promise … while the shocking dissconnect of truth and image confounds the thoughtful reader.
Cancer victims either declare outright the nature of their earthly battle, or direct donations toward eradicating the scourge, which indicates the cause of their passing.
But prescription or illegal opioid drug deaths — cloaked in self-painted societal shame — lie hidden between the lines of the family-or-funeral-home-produced death notice.
We’re talking perhaps 2-3 opioid-connected deaths per-week in a region supporting a newspaper circulation of 43,000.
National statistics suggest nearly fifty-two Americans perish every day from prescription opioid overdoses — eighty per day if you figure in heroin— so two-or-three deaths a week in such a tiny demographic seems outrageous.
Heroin deaths are linked to the pill trade because recently skyrocketing street-prices of prescription opioids allow cheap heroin to flourish across the land, hitting rural states and Appalachia especially hard due to decades of high unemployment and a culture slow to raise education standards, though the epidemic appears to cross all lines, racial, religious, geographic, and socio-economic.
Many of our locals succumb to fentanyl, fifty times more potent than typical street heroin. They go to a party, try a little, forget how much they’ve taken, dab a little more, and before the dawn appears …. the sun sets on their precious lives.
Opioid availability first soared (in recent history) after 26 states and D.C. legalized weed in some form and jerked market out from under Mexico, who made up the loss by dumping cheap heroin and opioid-laden chemicals on an already addicted North America poised to dull the pain with ever increasing amounts of opioids, a class of drugs that has debilitated us since the Civil War.
One family, six months ago, actually came clean in the second paragraph of their boy’s obituary, saying that the deceased fell victim to prescription drugs after losing his father two years prior. The son couldn’t bear the loss.
That’s the only self-admission I’d seen in thirty years of obituary reading, though I must confess that for twenty-eight years I only skimmed obits for astounding stories of WWII vets who’d conquered the world and returned home to build new lives.
The truth remains: we all wear a mask.
This concept came home to me thirty years ago when I taught Hawthorne’s The Minister’s Black Veilto a class of honors English students in a suburban Chicago high school.
A small village church must deal with their minister, Mr. Hooper, who takes a notion to don a black veil covering his upper face — much like a widow would wear at an old-fashioned funeral. Everything goes south when he chooses to leave it on.
He becomes a better minister after this decision, ironically, and though his fiancé breaks off their engagement, she watches his entire life and comes to be with him on his death bed, where he admits all of us wear a mask. Upon his death, Mr. Hooper is buried with the veil in place.
Let’s look into the mirror.
When we’re at Sunday school, we wear the Sunday school face. Job interviews conjure a competent strong obedient flexible yes-sir face. Thursday night dollar-draft-beer Raccoon Club meetings at the local sports bar requires a special façade.
And since random acts of unprovoked violence occur in this crazy world — say the unexpected death of a child through accident or SIDs — well, that means perhaps even God wears a mask.
No one is immune from the natural instinct to project a happy face while masking reality through omission.
Facebook is simply a party-line on steroids, a party line with enough bandwidth so a billion users may share photos, text, videos, music, and fake news.
For whatever psychological reason, the vast majority of us prefer to keep the laundry in the closet and to project the shiniest image of ourselves and our loved ones, clean photo-shopped textually-tweaked images of success and prosperity.
Let’s face it, we’re all the billboard producers of our archived lives, turned digital and pulsing across the electronic social universe — Google Plus, LinkedIn, Twitter, Facebook, et al. — social media entwined through massive servers grown muscular through carrying an ever-increasing crescendo of porn to the sex-starved masses. Thirst begets thirst.
Irony. Cleanliness afforded by dirt.
As a result, we can now Photoshop and video-edit our pimples and purple lives while projecting sanitized, filtered, smiling, I’m so happy, self-assured-selfies, eternal masks frozen in digital clouds of memories, gigabytes juggled in “perpetuity” for dollars a month.
Even when people freak out, breech social barriers, and reveal their dark sides on social media, it’s often ignored until the post mortems roll in.
When an individual’s mask slips down, the tribe doesn’t WANT to look, or doesn’t want to acknowledge some of us actually DIDlook and failed to respond.
Which brings us back to the Double-O-Demons.
Jellybeaners is a topical novel about opiates and obituaries, and the fact that shame drives many of our decisions.
And until we supplant shame with grace and help people recover from addiction through counseling, financial incentives, and work opportunities, well.