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Medical, nursing schools need to work together | Healthcare Finance News
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No shit. Ya think?
And it'd be nice to have Nursing's voice taken seriously. Tell the truth- when's the last time (and I love my docs, love love love them) the doctor spent 8 hours at your bedside in ICU, put in your IV in ER, or wiped up your vomit on the med/surg floor? [And if your nurse/nurse's aid DIDN'T, that's not a criticism of nursing. It's a criticism of how thinly stretched nursing is.]
I'm inviting responses, dialogue, criticism, commentary, and your stories. I've got something brewing that can't quite come to a boil, yet, about all this and the health-care/health insurance/public health/personal health debacle/debate that's going on nationally, but I need more points of view, more facets, to properly focus the light so I can see what I'm really looking at.
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At the end of this month HR 646, The Federal Acupuncture Coverage Act of 2009 will be voted upon. This Act will provide for coverage of acupuncture services under Medicare and all Federal Employees' Health Benefits programs.
Passage of HR 646 would mean that 25 million people who could receive acupuncture as a part of their covered health plan.
The best medium with which to write in support of HR646 is an old-fashioned one--handwritten, paper letters. Note that the deadline for letters to be submitted is approaching fast! All letters should be submitted to the AAAOM National Office no later than May 20, 2009.
American Association of
Acupuncture and Oriental Medicine
PO Box 162340
Sacramento, CA 95816
916-443-4766 Fax
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Everybody wants to get into the act:
Harry Potter and the order of the Harman
Published Date: 08 March 2009
By Nicholas Christian
HARRY Potter was looking glum. With a sigh, he picked up his trusty magic wand and muttered: "Magic is one thing, but this will take a miracle."( full article, but go to the site to read the comments because they're snarkily worth it )
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Once upon a time there was a Boy who Wanted a Pony.
He really, really, really wanted a pony.
His neighbor, a curmudgeonly stingy old bastard who had very little good to say about anyone, but who did, once he'd given it, keep his word, overheard the boy talking one day, and said, "Come clean out my barn, and I'll give you a pony."
Well.
Everyone knew this man kept his word. And there were witnesses. So, that weekend, the boy's mother packed him a lunch, and he walked over the fields into the rising sun to the man's barn.
The man greeted him with a shovel, said, "I'll be up to check on you at noon," and opened the barn doors.
This barn. This barn was full of manure.
Side to side. Front to back. Floor to ceiling. Full of manure.
The boy sighed, pushed his hat off his brow, and set to work. The man went back to his house, certain he would get some of his barn cleaned out, and not have to satisfy his end of the bargain.
At noon, he came up with a glass of lemonade (a gift of pity from his wife), and found the boy leaning on his shovel, wiping his face with his kerchief.
Next to the barn was a HUGE pile of manure. HUGE.
"My God, sonny," the man said, handing him the lemonade. "This barn's half empty!"
The boy took the lemonade, saying "Thank you." He took a long, slow drink.
Then, with a straight face, he answered the man. "Well, Mister- With all this shit, there's got to be a pony in there somewhere."
Especially for ![[info]](http://www.insanejournal.com/img/userinfo.gif) thenotorious04, because- well, because there has to be a pony in here somewhere.
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Paul Rodriguez narrates this one hour doc on salt in the water supplies of various parts of California, and how what we do here in the Bay Area affects and is affected by water use elsewhere, statewide water policy, and other things. I had a chance to see it tonight at work. It's well worth seeing.
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An article on the issue of prosecuting members of the Bush administration for war crimes and the possibility of a massive general pardon from Bush. The article is from Salon.
Obama's plans for probing Bush torture
President Bush could pardon officials involved in brutal interrogations -- but he may also face a sweeping investigation under the new president.
By Mark Benjamin
Nov. 13, 2008 |
With growing talk in Washington that President Bush may be considering an unprecedented "blanket pardon" for people involved in his administration's brutal interrogation policies, advisors to Barack Obama are pressing ahead with plans for a nonpartisan commission to investigate alleged abuses under Bush.
The Obama plan, first revealed by Salon in August, would emphasize fact-finding investigation over prosecution. It is gaining currency in Washington as Obama advisors begin to coordinate with Democrats in Congress on the proposal. The plan would not rule out future prosecutions, but would delay a decision on that matter until all essential facts can be unearthed. Between the time necessary for the investigative process and the daunting array of policy problems Obama will face upon taking office, any decision on prosecutions probably would not come until a second Obama presidential term, should there be one.
The proposed commission -- similar in thrust to a Democratic investigation proposal first uncovered by Salon in July -- would examine a broad scope of activities, including detention, torture and extraordinary rendition, the practice of snatching suspected terrorists off the street and whisking them off to a third country for abusive interrogations. The commission might also pry into the claims by the White House -- widely rejected by experienced interrogators -- that abusive interrogations are an effective and necessary intelligence tool.
A common view among those involved with the talks is that any early effort to prosecute Bush administration officials would likely devolve quickly into ugly and fruitless partisan warfare. Second is that even if Obama decided he had the appetite for it, prosecutions in this arena are problematic at best: A series of memos from the Bush Justice Department approved the harsh tactics, and Congress changed the War Crimes Act in 2006, making prosecutions of individuals involved in interrogations more difficult.
Instead, a commission empowered by Congress would have the authority to compel witnesses to testify and even to grant immunity in exchange for information. Should a particularly ugly picture emerge, the option of prosecutions would still theoretically be on the table later, however unlikely.
In Obama's camp, there is a sense among some that such a commission would essentially mean letting Bush get away with crimes. "People have called for criminal investigations," one person familiar with the talks told me this summer as plans got under way. On Wednesday, a person participating in the talks confirmed that some people involved in the planning felt strongly that the commission would amount to "bullshit" and that Bush officials should be prosecuted to the full extent of the law.
But few think prosecutions are realistic, given the formidable legal hurdles and the huge policy problems competing for Obama's attention. Among them is the complicated task of closing down the military prison at Guantánamo Bay, which Obama advisors say is a priority. Some observers outside the Obama camp are also questioning how much Democrats really want exposed with regard to interrogation, since top Democrats in Congress were briefed in secret on some of the harshest tactics used by the CIA and appear to have done little, or perhaps nothing, to stop them.
Further complicating the Obama team's planning is uncertainty about what President Bush might do. On the one hand, a blanket pardon for anyone involved in the interrogations could be viewed by the public as a tacit admission of colossal wrongdoing -- after years of public denial -- which would do nothing to help Bush's tarnished legacy. Yet, if the administration fears an investigation will follow Bush out the door in January, they may not want to leave officials exposed to potentially revealing criminal proceedings. Bush might seek to frame a blanket pardon as a preemptive strike against wrongheaded, partisan retribution.
Constitutional scholars say a pardon of this kind would be an unprecedented move -- the prospective pardon of not just individuals but entire categories of people, perhaps numbering in the thousands, for carrying out the president's orders , which the White House has argued all along were legal.
Those scholars agree, however, that Article II of the Constitution gives Bush much latitude: There is no authority that can stop the president from doing so if he wishes, and there is no outside check or balance to revisit such a decision, however controversial it may be. "The president can do with pardoning power whatever he wants," explained University of Wisconsin Law School professor Stanley Kutler. "It is complete and plenary unto itself."
A blanket pardon from Bush could cover, for example, anyone who participated in, had knowledge of, or received information about Bush's interrogation program during the so-called war on terror. Not only are there potentially too many people to name without risking missing somebody, but some of the names are presumably classified.
"The classic pardon is an identifiable individual; here you are talking about potentially thousands of people involved in illegal activities," explained Jonathan Turley, a professor at George Washington Law School. A blanket pardon of this variety, Turley said, "would allow a president to engage in massive illegality and generally pardon the world for any involvement in unlawful activity."
There are, in fact, some constitutional scholars who believe a pardon might actually facilitate more complete participation in a fact-finding commission, by removing the threat of looming liability. "Holding people accountable is certainly nice, but in terms of healing the country and moving forward, so is actually getting a clear picture of what happened and letting the public make an informed decision," said Kermit Roosevelt at the University of Pennsylvania Law School. "If we had a pardon followed by something like a truth and reconciliation commission, that might not be such a bad outcome." (Roosevelt represents a detainee held at Guantánamo.)
The politics of it would be fraught with danger, however, and could so blemish Bush's legacy that some doubt he would go so far. "A pardon is an admission of guilt," noted Donald Kettl, a political science professor at the University of Pennsylvania. Bush has argued for years that his interrogation program was perfectly legal. With a pardon, Kettl said, Bush is essentially saying, "Gee, maybe we did not do the right thing."
It is not entirely unprecedented for a president to grant a pardon based on a category of behavior, rather than pardoning an individual by name. The day after his inauguration, President Carter pardoned all those who avoided the Vietnam draft by failing to register or by fleeing to Canada. George Washington pardoned participants in the 1794 Whiskey Rebellion. Andrew Johnson pardoned Confederate soldiers in 1865.
But these were pardons designed to foster reconciliation, handed out to categories of individuals who acted on their own conscience, rather than the president's own allegedly illegal orders. "This would be a different deal completely," explained Kettl. "It would be anticipating that people thought the official policy of the administration was wrong."
-- By Mark Benjamin
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http://www.youtube.com/watch?v=W4xfMisqab8
11/6/2008
WASHINGTON – The following is an op-ed from Human Rights Campaign President Joe Solmonese. This editorial is intended as free use and can be quoted or published.
You can't take this away from me: Proposition 8 broke our hearts, but it did not end our fight.
Like many in our movement, I found myself in Southern California last weekend. There, I had the opportunity to speak with a man who said that Proposition 8 completely changed the way he saw his own neighborhood. Every "Yes on 8" sign was a slap. For this man, for me, for the 18,000 couples who married in California, to LGBT people and the people who love us, its passage was worse than a slap in the face. It was nothing short of heartbreaking.
But it is not the end. Fifty-two percent of the voters of California voted to deny us our equality on Tuesday, but they did not vote our families or the power of our love out of existence; they did not vote us away.
As free and equal human beings, we were born with the right to equal families. The courts did not give us this right—they simply recognized it. And although California has ceased to grant us marriage licenses, our rights are not subject to anyone's approval. We will keep fighting for them. They are as real and as enduring as the love that moves us to form families in the first place. There are many roads to marriage equality, and no single roadblock will prevent us from ultimately getting there.
And yet there is no denying, as we pick ourselves up after losing this most recent, hard-fought battle, that we've been injured, many of us by neighbors who claim to respect us. We see them in the supermarkets, on the sidewalk, and think "how could you?"
By the same token, we know that we are moving in the right direction. In 2000, California voters passed Proposition 22 by a margin of 61.4% to 38.6%. On Tuesday, fully 48% of Californians rejected Proposition 8. It wasn't enough, but it was a massive shift. Nationally, although two other anti-marriage ballot measures won, Connecticut defeated an effort to hold a constitutional convention ending marriage, New York's state legislature gained the seats necessary to consider a marriage law, and FMA architect Marilyn Musgrave lost her seat in Congress. We also elected a president who supports protecting the entire community from discrimination and who opposes discriminatory amendments.
Yet on Proposition 8 we lost at the ballot box, and I think that says something about this middle place where we find ourselves at this moment. In 2003, twelve states still had sodomy laws on the books, and only one state had civil unions. Four years ago, marriage was used to rile up a right-wing base, and we were branded as a bigger threat than terrorism. In 2008, most people know that we are not a threat. Proposition 8 did not result from a popular groundswell of opposition to our rights, but was the work of a small core of people who fought to get it on the ballot. The anti-LGBT message didn't rally people to the polls, but unfortunately when people got to the polls, too many of them had no problem with hurting us. Faced with an economy in turmoil and two wars, most Californians didn't choose the culture war. But faced with the question—brought to them by a small cadre of anti-LGBT hardliners – of whether our families should be treated differently from theirs, too many said yes.
But even before we do the hard work of deconstructing this campaign and readying for the future, it's clear to me that our continuing mandate is to show our neighbors who we are.
Justice Lewis Powell was the swing vote in Bowers, the case that upheld Georgia's sodomy law and that was reversed by Lawrence v. Texas five years ago. When Bowers was pending, Powell told one of his clerks "I don't believe I've ever met a homosexual." Ironically, that clerk was gay, and had never come out to the Justice. A decade later, Powell admitted his vote to uphold Georgia's sodomy law was a mistake.
Everything we've learned points to one simple fact: people who know us are more likely to support our equality.
In recent years, I've been delivering this positive message: tell your story. Share who you are. And in fact, as our families become more familiar, support for us increases. But make no mistake: I do not think we have to audition for equality. Rather, I believe that each and every one of us who has been hurt by this hateful ballot measure, and each and every one of us who is still fighting to be equal, has to confront the neighbors who hurt us. We have to say to the man with the Yes on 8 sign—you disrespected my humanity, and I am not giving you a pass. I am not giving you a pass for explaining that you tolerate me, while at the same time denying that my family has a right to exist. I do not give you permission to say you have me as a "gay friend" when you cast a vote against my family, and my rights.
Wherever you are, tell a neighbor what the California Supreme Court so wisely affirmed: that you are equal, you are human, and that being denied equality harms you materially. Although I, like our whole community, am shaken by Prop 8's passage, I am not yet ready to believe that anyone who knows us as human beings and understands what is at stake would consciously vote to harm us.
This is not over. In California, our legal rights have been lost, but our human rights endure, and we will continue to fight for them.
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Open letter to white activists by lj user slit thanks to lj user princessofg who describes it as "Brilliant and timely stuff on coalitions and minority groups...."; in addition it contains excellent thought-provoking writing on "...sex and freedom..." and privilege.
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And how does the government pay for universal tax-payer funded
healthcare and universal tax-payer funded education? You might say it
is only a utopian dream, that it is naïve to ask for the government of
the United States of America to provide free comprehensive healthcare
and education for all of its citizens. I say that it was not dreaming
to expect Barack Obama to become president, and it is not dreaming to
expect the United States of America to behave like a modern, civilised
democracy. Where does the money come from? For one thing, it comes
from not bailing out the privileged few who have, through willful
mismanagement of their financial institutions and through corporate
piracy, raped and pillaged the nation's economy and robbed the U.S.
tax-payer blind with the encouragement of the government officials
whose campaigns they continue to fund. It does not come from
continuing to make a lucrative business of war-profiteering and
military-backed corporate imperialism, from perpetual armed corporate
robbery around the world, largely funded by U.S. taxpayers of today
and tomorrow.
Barack Obama received considerably more campaign funding from "Wall
Street" than John McCain did. Does this mean that he will
automatically bail out the rich who continue to steal from the hardly-
as-rich vast majority of U.S. citizens and their children? Ask him. If
he tells you that it is just too complex an issue, that bailing out
these for-profit failed capitalistic institutions and corporations is
a necessary stop-gap measure to save the economy, I would venture to
say that the answer is "yes". I would venture to say that he is as
bought-and-paid-for as George W. Bush, Bill "Nafta" Clinton, and every
other president in memory. Sadly, this would mean that "Change", that
word Mr. Obama so eloquently used - if often vaguely - as a
rhetorical cudgel to win the presidency and a chance to really make a
difference, is worth nothing more than a handful of pennies to the
economic future of the average citizen and to the hope of a socially-
responsible democracy. If the answer is "yes", then those who have
stolen Big will be richly rewarded and the profitable (for the
privileged, amoral few) military-industrial empire will thrive and
prosper as the noble dream of a just society suffers ever greater set-
backs. Let capitalism function as a responsibly-regulated system, not
as a costly welfare safety-net for billionaires and their capitalist
enterprises. We have a dream. It need not be further compromised by
the next U.S. administration. Sometimes the picture is quite clear.
Take a stand.
Viggo Mortensen
The People Speak
"Democracy is in dissent. Democracy is in resistance. Democracy doesn't come from the top: It comes from the bottom." ~~ Howard Zinn
Please. I know it can come off as ranting. I don't think it is. I think it's an impassioned plea for each of us to own our citizenship, to own the commonwealth that is ours by virtue of our labor, by virtue of our participation, however indirect it may seem to be, in the governance of and economy of our country.
I know it would be a long project, re-making the way we take care of our health as individuals and as a society. I am well aware of the limitations of "Universal health coverage" in Canada, in the UK, in the Scandinavian countries, and I can imagine as well limitations and risks of universal tax-payer funded education. But I like to think these are public conversations, conversations in the national interest as well as in the personal, and I hope that as I pursue my part in it my President-Elect, soon to be President, will be at least willing to listen while I speak.
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Dear President-Elect Obama,
Please do all that you honestly can to bring to justice Dick Cheney, David Addington, John Yoo, William Haynes, George W. Bush, Donald Rumsfeld, Condolezza Rice, Colin Powell, George Tennet, John Ashcroft, Alberto Gonzalez, Karl Rove, and numerous other members of the Bush administration since the start of 2001 who have either been directly responsible for or complicit in the numerous acts of treason, human rights violations and other crimes in the United States of America and abroad, including in but not limited to Haiti, Iraq, Afghanistan, Venezuela, Colombia, Pakistan, Syria, Iran, and Lebanon. There have been many violations of domestic and international law by the Bush/ Cheney regime, but the use of torture by this administration, in blatant disregard of long-accepted international and U.S. standards, is on its own enough to see many U.S. officials prosecuted and jailed. The energetic promotion and white-washing of torture by U.S. interrogators are not only reprehensible and damaging to the reputation of the United States, but have undoubtedly placed all of its citizens - military as well as civilian- in increased danger from reprisals and acts of terrorism for years to come. The war crimes and clearly-impeachable misconduct of the Bush/Cheney administrations cannot go unprosecuted and unpunished if citizens of the United States of America are to move forward with relatively clear consciences and the hoped for restoration of their country's relatively good standing in the community of nations. This is about moral responsibility, common decency, and historical legacy. Thank you in advance, Mr. Obama.
http://www.percevalpress.com
ETAThere are things about this that bother me. Worry me. I agree, emotionally and ethically, that there have been war crimes committed in my name. But I also worry that directing too much energy toward that, right at the beginning of what I fervently hope is, and will work for making be, a huge change in our national bearing, will steal from what needs to be done.
I trust Mr. Obama to do what he honestly can. I think he's well-educated, thoughtful, resourceful, aware.
I just wanted to put this out here, as an articulate presentation of one aspect of the effects of the last 7 years.
ETA2 I should mention, too, that Mr. Mortensen has a double degree, essentially Government or Political Science and Spanish, from St. Lawrence College in New York. I suspect that as angry as he is about this, he's put a fair amount of thought into this post.
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Newswise — Researchers at the Drexel University School of Public Health led by Dr. Dennis Andrulis authored a comprehensive report comparing the two presidential nominees’ health care reform plans in the context of eliminating the nation’s longstanding racial and ethnic disparities in health and health care. The report was released by the Joint Center for Political and Economic Studies.
The report, Health Care Proposals of the 2008 Democratic and Republican Presidential Nominees: Implications for Improving Access, Affordability and Quality for America’s Minorities, was issued by the Joint Center’s Health Policy Institute in partnership with the Center for Health Equality at Drexel University’s School of Public Health and Health Management Associates, a leading health care research and consulting firm. The report was funded by W.K. Kellogg Foundation in support of the Joint Center Health Policy Institute’s National Health Policy Training Alliance.( Read more... )
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In light of the Obama/McCain health care plan differences (well outlined here) I'm posting a couple sites i've found about the history of health insurance in the US (would welcome sites about other countries' insurance/care programmes).
Medical History and Ethics/History of Health Insurance in the US from neurosurgical.com, and from Thomasson encylopedia: US Health Insurance.
It's quite astonishing, actually. I'm in the field, have studied this off and on over the years, and STILL learned a lot, even from two relatively short high-lights only entries.
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Everyone should have health insurance? I say everyone should have health care. I'm not selling insurance.
—Dennis Kucinich (from Perceval Press)
I'm not so inexperienced as to think that it's enough to say "Everyone, keep yourself healthy!" Or so negative as to think that it's someone's fault if I get sick, or so naive as to think that doctors should know everything or so cynical as to think all doctors (hospitals, pharmaceutical companies, nursing agencies) are only in it for the money.
But seriously.
I'm very interested- personally as well as professionally- in how health care reaches people, and what people expect "health care" to be. How do I, a registered nurse, make available my knowledge, skills, and experience, if I'm not going to do it within the confines of a hospital system, the state/federal public health system, or an agency? Can I charge for it? Barter for goods or services? What risk do I assume? What risk does someone I work with assume?
On the larger scale, do we, as health care "consumers", have any obligation to stay as healthy as possible, to reduce the pressure on those who provide us with basic health care? When private industry takes over the municipal water supply or the garbage pick-up, how does a citizen ensure his or her neighborhood, town, city is safe and sanitary?
What is possible, at the overarching level of the State? How feasible is employer-based insurance? Insurance in general? What are the obligations of the individual-in terms of caring for oneself, for one's family, community, the organizations that provide care?
One of the things that came up at dinner tonight was that Kaiser Permanente has figured out that, with only 2 percent of medical students planning to go into primary care, it needs to take care of the primary care MDs it already has, since it "needs to make them last", as my friend put it. She is 63, had, 10 years ago, her own practice, which she had to give up when spiraling costs and sinking reimbursements made it impossible to continue and still pay off her medical school debt as well as care for her family.
You know what I'd like? If you would give me your experiences- good or bad, honest, I'm interested in all sides- with health care, lack of health care, health care access, health insurance (employer or government based, US or in another country)- how it's changed for you over time, or depending on your age, or status (student, military, married or not, employed or not, healthy or not, pre-existing condition or evolving condition). It feels to me like there's something in this- an article, or series of articles, at least, for one of the nursing magazines- and, in some paradise of enough time and energy and focus and luck, a book or two or three (perhaps one for nurses, one for the public, and those children's books I so want to write about being healthy, having a healthy community). But I can't write anything with only my own experience- so if you would be willing to share yours, or even point me in the direction of things you know or have experienced, but anonymously- I would appreciate it tremendously.
Of course, I would keep any confidences. That's my obligation as an RN- but more, it's my obligation to you as a person, one person to another.
And on that note... /ramble.
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have abut 80 pages of Native American Studies reading to finish by next Saturday. Means I must concentrate on this.
Car needs to be smogged (for my EU/UK friends- have its biennial government-mandated check-up and [pray] pass California's emissions standards). This is going to take a bit of finagling of both time (I can't get to work without a car) and money (please, please let it pass without needing major work, or worse).
I really have to not spend too much time with news of politics, the economy, and world events. It's too easy to fall from 'have to get the car taken care of' to 'I'll be homeless living on twigs' if I read from the debates to the bail-out to Zimbabwe. That's false reasoning (or no reasoning, really), doesn't illuminate anything, steals energy I need to do the actual problem-solving required to be a good citizen, and prevents me from having any real understanding of just how dire things are in other places, like Zimbabwe. Not that that couldn't happen here- history proves anything can happen anywhere, as the very good book for Native American Studies is proving (well-researched and well-written, Indians in American History by Hoxie and Iverson). But it's not happening right-this-minute. I do not need to buy up 50 gallons of water and 10 gallons of gasoline (all I have storage for, myself) and curse myself for not drying 100lbs of apples this fall and burying nuts for winter. That's insane.
So, not too much of the 'news' (or as it should be more accurately called, bread and circuses). Concentrate on finishing uni, on staying (getting more) healthy, on saving money for summer.
Back to the book while my girl is still sleeping. She continues to slowly slip; progressive diseases are unforgiving. But her family loves her, and I'm amazed that it's two years I've been working here with them. It's an honor.
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McCain’s Radical Agenda
By BOB HERBERT
Published: September 15, 2008 (thanks to jassyskie for the heads-up)
Talk about a shock to the system. Has anyone bothered to notice the radical changes that John McCain and Sarah Palin are planning for the nation’s health insurance system?
These are changes that will set in motion nothing less than the dismantling of the employer-based coverage that protects most American families.
A study coming out Tuesday from scholars at Columbia, Harvard, Purdue and Michigan projects that 20 million Americans who have employment-based health insurance would lose it under the McCain plan.
There is nothing secret about Senator McCain’s far-reaching proposals, but they haven’t gotten much attention because the chatter in this campaign has mostly been about nonsense — lipstick, celebrities and “Drill, baby, drill!”
For starters, the McCain health plan would treat employer-paid health benefits as income that employees would have to pay taxes on.
“It means your employer is going to have to make an estimate on how much the employer is paying for health insurance on your behalf, and you are going to have to pay taxes on that money,” said Sherry Glied, an economist who chairs the Department of Health Policy and Management at Columbia University’s Mailman School of Public Health.
Ms. Glied is one of the four scholars who have just completed an independent joint study of the plan. Their findings are being published on the Web site of the policy journal, Health Affairs.
According to the study: “The McCain plan will force millions of Americans into the weakest segment of the private insurance system — the nongroup market — where cost-sharing is high, covered services are limited and people will lose access to benefits they have now.”
The net effect of the plan, the study said, “almost certainly will be to increase family costs for medical care.”
Under the McCain plan (now the McCain-Palin plan) employees who continue to receive employer-paid health benefits would look at their pay stubs each week or each month and find that additional money had been withheld to cover the taxes on the value of their benefits.
While there might be less money in the paycheck, that would not be anything to worry about, according to Senator McCain. That’s because the government would be offering all taxpayers a refundable tax credit — $2,500 for a single worker and $5,000 per family — to be used “to help pay for your health care.”
You may think this is a good move or a bad one — but it’s a monumental change in the way health coverage would be provided to scores of millions of Americans. Why not more attention?
The whole idea of the McCain plan is to get families out of employer-paid health coverage and into the health insurance marketplace, where naked competition is supposed to take care of all ills. (We’re seeing in the Bear Stearns, Fannie Mae, Freddie Mac, Lehman Brothers and Merrill Lynch fiascos just how well the unfettered marketplace has been working.)
Taxing employer-paid health benefits is the first step in this transition, the equivalent of injecting poison into the system. It’s the beginning of the end.
When younger, healthier workers start seeing additional taxes taken out of their paychecks, some (perhaps many) will opt out of the employer-based plans — either to buy cheaper insurance on their own or to go without coverage.
That will leave employers with a pool of older, less healthy workers to cover. That coverage will necessarily be more expensive, which will encourage more and more employers to give up on the idea of providing coverage at all.
The upshot is that many more Americans — millions more — will find themselves on their own in the bewildering and often treacherous health insurance marketplace. As Senator McCain has said: “I believe the key to real reform is to restore control over our health care system to the patients themselves.”
Yet another radical element of McCain’s plan is his proposal to undermine state health insurance regulations by allowing consumers to buy insurance from sellers anywhere in the country. So a requirement in one state that insurers cover, for example, vaccinations, or annual physicals, or breast examinations, would essentially be meaningless.
In a refrain we’ve heard many times in recent years, Mr. McCain said he is committed to ridding the market of these “needless and costly” insurance regulations.
This entire McCain health insurance transformation is right out of the right-wing Republicans’ ideological playbook: fewer regulations; let the market decide; and send unsophisticated consumers into the crucible alone.
You would think that with some of the most venerable houses on Wall Street crumbling like sand castles right before our eyes, we’d be a little wary about spreading this toxic formula even further into the health care system.
But we’re not even paying much attention.
Direct link to op-ed piece
Ronald Reagan, in 1967, as Governor of California, dismantled much of the state mental health system. Now, it had its definite problems, and could have used a serious overhaul. But all he did was take it apart, without funding or putting into place the community-based systems that were supposed to take over. Now we have prisons full of people who need mental health care and a huge homeless population of mentally ill, but no community-based mental health care. That same term in office, Reagan said 'If you've seen one redwood, you've seen them all," and opened the door to clear-cutting in the state forests. Trees that were 500, 800, 1200 years old cut down to make picnic tables.
Since those two events I've never really trusted a Republican to understand things at ground level, down here among the people. Now McCain shows that he's just as unaware as Reagan was.
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