GOP Senate Bill Expected To Make Massive Cuts to Medicaid

The elderly and children - main targets of GOP healthcare cuts

While much secrecy continues to surround the "healthcare reform" bill being drafted by Senate Republicans, some of the information that has leaked so far indicate that it will make massive cuts to Medicaid - the life line for millions of children, elderly, pregnant mothers and those with physical and intellectual disabilities.  Sadly, it is part and parcel with the GOP agenda of taking from the poor and middle class and giving to the very wealthy.  It is also in keeping with the GOP hypocrisy drenched claims that it is the party of Christian values even as it adopts policies that are the absolute opposite of the Gospel's social agenda.  And make no mistake, if enacted the GOP bill will harm the lives of millions of Americans, both young and old. A piece in the New York Times looks at the leaked details to date.  When you see your Republican friends, ask them if they support ending medical care for children or throwing elderly patients out of nursing homes.  When they say they do not, throw it in their faces that, yes the do if the voted for Trump/the GOP candidates last November.  Here are article highlights:

Tucked inside the Republican bill to replace Obamacare is a plan to impose a radical diet on a 52-year-old program that insures nearly one in five Americans.

The bill, of course, would modify changes to the health system brought by the Affordable Care Act. But it would also permanently restructure Medicaid, which covers tens of millions of poor or disabled Americans, including millions who are living in nursing homes with conditions like Alzheimer’s or the aftereffects of a stroke.

The results, according to independent analyses, would be major reductions in federal spending on Medicaid over time. States would be left deciding whether to raise more money to make up the difference, or to cut back on medical coverage for people using the program. The Congressional Budget Office estimates that the changes would lead to a reduction in spending on Medicaid of more than $800 billion over a decade. (That figure also includes additional cuts to the Obamacare Medicaid expansion.)

About half of all births in the country are covered by Medicaid, and nearly 40 percent of children are covered through the program. Medicaid covers the long-term care costs of two-thirds of Americans living in nursing homes, many of them middle-class Americans who spent all of their savings on care before becoming eligible.

It covers children and adults with disabilities who require services that most commercial health insurance doesn’t include. It covers poor women who are pregnant or raising young children. Those populations were all included in the program before Obamacare became law.

It also provides insurance for poor adult Americans, and recent evidence shows that its expansion under Obamacare has given more poor people access to health care services and reduced their exposure to financial shocks.

“While details remain elusive, this is shaping up to be the largest intergovernmental transfer of financial risk in our country’s history,” said Matt Salo, the executive director of the National Association of Medicaid Directors, in an email. Mr. Salo said that some of his directors would welcome caps if they came with more program flexibility, but said the current approach amounted to a funding cut.

Most researchers who study the program closely say that it is already quite lean. Major savings, they say, will be hard to achieve without reducing medical benefits or cutting higher-cost patients from the program.

Trump administration officials and Republican members of Congress have argued that the Medicaid changes won’t cause anyone to lose insurance coverage directly. That statement is true in only the narrowest sense.

Because the funding cuts would fall to states, it is state officials who would decide whether to save money by raising taxes, reducing payments to nursing homes oreliminating benefits like home-based care for disabled beneficiaries, a few available options under the law.

The Congressional Budget Office estimates that enrollment in Medicaid would decline substantially over a decade, as states pursued a variety of strategies to save money, some of which would push people out of the program.

Several Republican senators have expressed concerns about changes to Obamacare’s Medicaid expansion, which broadened the program to include more low-income adults in 31 states.

Others worry about changes to private insurance subsidies that would make insurance less affordable to older, middle-class Americans. Fewer have spoken out about the cuts to Medicaid’s legacy beneficiaries. That means that, as the Senate works out final details, the forced diet for Medicaid is likely to stay in the bill.

The GOP's War on Poor Children

In the warped Republican world of "family values," some families and some children simply do not matter.  Obviously, families headed by same sex couples do not matter as evidenced by the GOP's opposition to marriage equality which would provide increases security to thousands of children.  Nor seemingly do poor families and poor children matter.  That's the only conclusion that can be reached from a GOP effort to take away health insurance coverage for over a million children.  A New York Times editorial looks at the GOP's sick version of "family values."  Here are excerpts:

Senior Republicans in Congress are seeking major changes to the Children’s Health Insurance Program when the program’s money runs out in September.

Their proposal, labeled a “discussion draft” for legislation yet to be written, could deprive more than a million children of insurance or force their families to pay higher out-of-pocket costs for their coverage. It also would shift costs to states, which would be left holding the bag to pay for the children’s insurance or for the care of the children as uninsured patients.

The draft is being circulated by Senator Orrin Hatch of Utah, chairman of the Senate Finance Committee; Representative Fred Upton of Michigan, chairman of the House Energy and Commerce Committee; and Representative Joe Pitts of Pennsylvania, chairman of the health subcommittee. It threatens to undermine the progress made in reducing the number of uninsured children, gains that came from enrolling more children in Medicaid and in CHIP, which covers children whose families earn too much to qualify for Medicaid.

The Republican proposal would eliminate the Affordable Care Act’s requirement that states keep the family-income eligibility levels stable until 2019, and it could make it harder for families to prove their eligibility. Faced with a loss of federal funds for CHIP, as suggested in the Republican proposal, many states would probably shrink their CHIP programs and reduce their own financial contributions. A result would be fewer children enrolled in the program. 

And the proposal would allow states to impose a 12-month waiting period (up from the current 90 days) before children who lose coverage from a parent’s insurance plan can be enrolled in CHIP. That is a very long time for a youngster to go without insurance and the regular care it provides. Many families in that situation will not be able to afford coverage on the new health care exchanges.

The Republican proposal is billed as a way to let states make “common-sense changes” to their Medicaid and CHIP programs. But instead of helping the states, it could end up costing them a lot of money.

By contrast, bills introduced in the House and Senate by Democrats would extend federal CHIP financing for the next four years and largely continue the program along current lines. That is the better approach. Governors should lean on Congress to extend this valuable children’s program without major changes.

Lynchburg News Advance: Virginia Needs to Expand Medicare

At the moment Virginia finds itself in a deadlock over the expansion of Medicaid.  On one side are Gov. McAuliffe, the Virginia Senate and most of the business community not to mention the state's hospital associations.  On the other is the GOP controlled House of Delegates which in its quest to pander to the racists in the party base continues to say "No" to anything tied to America's first black president.  The estimated 400,000 Virginians who would benefit from Medicaid expansion, including many poor children, simply do not matter to these extremists in the Virginia GOP who are so stupid that they refuse to grasp that all of us are already paying for the uninsured but in the least cost effective manner possible.  A main editorial in Lynchburg's News Advance makes the case as to why Medicaid must be expanded.  Here are excerpts:

The Republican House of Delegates and Gov. Terry McAuliffe and the Democratic Virginia Senate continue their standoff over the budget and Medicaid expansion. Stuck in the middle are thousands of state employees, local governments, public school systems, public colleges and universities and 8 million Virginians.

Ladies and gentlemen in Richmond, it’s time to negotiate, craft a compromise and get the commonwealth out of the Medicaid corner it’s been painted into.
 

When President Obama and Congress crafted the Affordable Care Act, a.k.a. Obamacare, in 2009 and 2010, a key element was reform of Medicaid and Medicare reimbursement rates for the nation’s hospitals. Gone was the old system of pay-for-services, replaced with incentives for the system to keep would-be patients healthy and out of the acute care system. As an industry, hospitals signed on to the changes because part of the bargain was that more people would be covered, especially through Medicaid, leaving hospitals harm-free in the final analysis.

Many states have taken advantage of the tax dollars Washington is directing back to them to expand Medicaid, but many others — primarily those controlled by Republicans — have not.

Virginia falls into the latter category, and thus the current stalemate we find ourselves in.

The Democratic Virginia Senate, working with Democratic Gov. McAuliffe, has approved a state budget that expands Medicaid but by working through private insurance providers. The Republican House simply says no to Medicaid expansion, period.

The money for Medicaid expansion is tax money Virginians are already sending to Washington ... if Virginia doesn’t accept it, it simply goes to states that already expanded Medicaid. In Virginia, we’re talking about $2 billion per year.

The federal government would pay 100 percent of the costs of expansion through 2016, slowly dropping over the next decade to no less than 90 percent of the costs.

It’s the hit to hospitals across Virginia that has people worried though. The University of Virginia Medical Center and the Virginia Commonwealth University Medical Center will see roughly $500 million sliced from their budgets. Here in Lynchburg, Centra officials estimate they’ll lose roughly $17.3 million. Smaller hospitals could simply be forced to close their doors.

Caught in the crosshairs in this budget/Medicaid fight are real people who could be harmed by the actions — or inactions — of ideologically driven politicians. They deserve better.

On their behalf, we repeat our original exhortation to our legislators: Negotiate, craft a compromise and get the commonwealth out of the corner you’ve painted it into.

The GOP- Rooting for Failure and Against Families and Children

I do not adhere to many Democrat positions, yet given the ugliness of today's Republican Party - a sickening mix of greed, racism, homophobia, religious extremism and open hatred toward those deemed to be "other" - I often find that I have no choice but to back Democrat candidates.  A perfect example is the just past Virginia elections where the Christofascist controlled Virginia GOP nominated truly insane and vicious candidates for all three statewide offices.  Another example is the GOP's efforts to sabotage the Affordable Health Care Act yet offer nothing to replace it other than a return to system that is not only the the most costly in the world and but also the least efficient .  And what about the millions of uninsured?  They are to be left to simply sicken and die.  Even as the GOP base congratulates itself on its adherence to Christian values and the mantra of personal responsibility.  A column in the New York Times looks at this sabotage effort.  Here are excerpts:

I just spent 15 minutes on my local health care exchange and realized that I could save a couple hundred dollars a month on my family’s insurance. Of course, I live in Washington State, which has a very competitive market, a superbly functioning website and no Koch-brothers-sponsored saboteurs trying to discourage people from getting health care.

California is just as good. It’s enrolling more than 2,000 people a day. New York is humming as well. And Kentucky, it’s the gold standard now: More than 56,000 people have signed up for new health care coverage — enough to fill a stadium in Louisville. 

This is terrible news [for the GOP], and cannot be allowed to continue. If there’s even a small chance that, say, half of the 50 million or so Americans currently without heath care might get the same thing that every other advanced country offers its citizens, that would be a disaster [for the GOP]. 

But not to worry. The failure movement is active and very well funded. . . . . The Republican Party started a failure campaign earlier this year, but then the strategy got sidetracked in a coercive government shutdown that cost us all $24 billion or so. With the disastrous rollout of the federal exchange, Republicans now smell blood. A recent memo outlined a far-reaching, multilevel assault on the Affordable Care Act. 

It’s hard to remember a time when a major political party and its media arm were so actively rooting for fellow Americans to lose. When the first attempt by the United States to launch a satellite into orbit, in 1957, ended in disaster, did Democrats start to cheer, and unify to stop a space program in its infancy? Or, when Medicare got off to a confusing start, did Republicans of the mid-1960s wrap their entire political future around a campaign to deny government-run health care to the elderly? 

Of course not. But for the entirety of the Obama era, Republicans have consistently been cheerleaders for failure. They rooted for the economic recovery to sputter, for gas prices to spike, the job market to crater, the rescue of the American automobile industry to fall apart.

This organized schadenfreude goes back to the dawn of Obama’s presidency, when Rush Limbaugh, later joined by Senator Mitch McConnell, said their No. 1 goal was for the president to fail.

Does this mean we throw in the towel, and return to a status quo in which insurance companies routinely cancel policies, deny health care to people with pre-existing conditions and have their own death panel treatment for patients who reach a cap in medical benefits? 

The Republican plan would do just that, because they have no plan but to crush the nation’s fledgling experiment. 

Where was the media attention when thousands of people were routinely dumped once they got sick? When did Republicans in Congress hold an oversight hearing on the leading cause of personal bankruptcy — medical debt? All of that is what we had before. And all of that is what we will return to if some version of the Affordable Care Act is not made workable.  

Not too sound too dramatic, but I increasingly do not understand how decent, moral people can support today's GOP.  Of my friends that remain Republicans, sadly most are motivated by greed.  They care nothing for the less fortunate and focus solely on paying less in taxes being to short sighted to understand we all pay when millions of Americans - many of them children - go without health care coverage.

Christofascists and Conservatives - Where Is the Love?

Click image to enlarge

This blog is extremely critical of the hypocrisy of the Christofascists and other self-professed conservatives, especially those within the GOP, who blather incessantly about upholding Christian values yet act in ways that make per-revelation Ebenezer Scrooge look like the world's greatest philanthropist.  These "godly Christians" and their political whores within the GOP are ugly, nasty people and ought to be excoriated by the media.  Sadly, usually, much of the media is afraid or too lazy to expose this rampant hypocrisy.  Interestingly, Nicholas Kristof has put out op-eds in the New York Times on Republican/conservative efforts to demolish America's social safety net.  In a column today, he looks at the attacks he has received and the callousness of these self-centered modern day Pharisees.  Here are excerpts:

When I’ve written recently about food stamp recipients, the uninsured and prison inmates, I’ve had plenty of pushback from readers. 

A reader named Keith reflected a coruscating chorus when he protested: “If kids are going hungry, it is because of the parents not upholding their responsibilities.” 

A reader in Washington bluntly suggested taking children from parents and putting them in orphanages. 

Jim asked: “Why should I have to subsidize someone else’s child? How about personal responsibility? If you procreate, you provide.” 

After a recent column about an uninsured man who delayed seeing a doctor about a condition that turned out to be colon cancer, many readers noted that he is a lifelong smoker and said he had it coming.

Such scorn seems widespread, based on the comments I get on my blog and Facebook page — as well as on polling and on government policy. At root, these attitudes reflect a profound lack of empathy. 

A Princeton University psychology professor, Susan Fiske, has found that when research subjects hooked up to neuro-imaging machines look at photos of the poor and homeless, their brains often react as if they are seeing things, not people. Her analysis suggests that Americans sometimes react to poverty not with sympathy but with revulsion. 

So, on Thanksgiving, maybe we need a conversation about empathy for fellow humans in distress.

[M]any of today’s poor are small children who have done nothing wrong. Some 45 percent of food stamp recipients are children, for example. Do we really think that kids should go hungry if they have criminal parents? Should a little boy not get a curved spine treated properly because his dad is a deadbeat? Should a girl not be able to go to preschool because her mom is an alcoholic?

As Warren Buffett puts it, our life outcomes often depend on the “ovarian lottery.” Sure, some people transcend their circumstances, but it’s callous for those born on second or third base to denounce the poor for failing to hit home runs. 

John Rawls, the brilliant 20th-century philosopher, argued for a society that seems fair if we consider it from behind a “veil of ignorance” — meaning we don’t know whether we’ll be born to an investment banker or a teenage mom  . . . . That’s a shrewd analytical tool — and who among us would argue for food stamp cuts if we thought we might be among the hungry children? 

As we celebrate Thanksgiving, let’s remember that the difference between being surrounded by a loving family or being homeless on the street is determined not just by our own level of virtue or self-discipline, but also by an inextricable mix of luck, biography, brain chemistry and genetics. 

Low-income Americans, who actually encounter the needy in daily life, understand this complexity and respond with empathy. Researchers say that’s why the poorest 20 percent of Americans donate more to charity, as a fraction of their incomes, than the richest 20 percent. Meet those who need help, especially children, and you become less judgmental and more compassionate. 

And compassion isn’t a sign of weakness, but a mark of civilization.

Kudos to Kristof for calling these scrooges out.

America's Highly Inefficient Health Care System

Click image to enlarge

As longer term readers know, I am a proponent of a single payer health care system for America.  A new Bloomberg study confirms that Americans pay for - much more in many cases - for a far less efficient health care system than the majority of modern nations.  Admittedly, my view is soured by my time doing legal work for a health care system and seeing almost daily how providing quality health care was a low priority compared to playing monopoly wars with other health care providers and devising ways to bind doctors to particular hospitals for patient referral purposes.  The map above compares different nations on the level of efficiency of their health care systems.   Here are highlights from a Huffington Post story:

As supporters and opponents of the Affordable Care Act debate the best way to overhaul a clearly broken healthcare system, it's perhaps helpful to put American medicine in a global perspective.

The infographic [above] is based on a recent Bloomberg ranking of the most efficient countries for healthcare, and highlights enormous gap between the soaring cost of treatment in the U.S. and its quality and effectiveness. 

It's remarkable how low America places in healthcare efficiency: among the 48 countries included in the Bloomberg study, the U.S. ranks 46th, outpacing just Serbia and Brazil. Once that sinks in, try this one on for size: the U.S. ranks worse than China, Algeria, and Iran.

But the sheer numbers are really what's humbling about this list: the U.S. ranks second in healthcare cost per capita ($8,608), only to be outspent by Switzerland ($9,121) -- which, for the record, boasts a top-10 healthcare system in terms of efficiency. Furthermore, the U.S. is tops in terms of healthcare cost relative to GDP, with 17.2 percent of the country's wealth spent on medical care for every American.

In other words, the world's richest country spends more of its money on healthcare while getting less than almost every other nation in return.

The systems that rank highly on Bloomberg's list are as diverse as the nations to which they belong. The unifying factor seems to be tight government control over a universal system, which may take many shapes and forms -- a fact evident in the top-three most efficient healthcare systems in the world: Hong Kong, Singapore, and Japan.

Ranking third on Bloomberg's list, the Japanese system involves universal healthcare with mandatory participation funded by payroll taxes paid by both employer and employee, or income-based premiums by the self-employed. Long-term care insurance is also required for those older than 40. As Dr. John W. Traphagan notes in The Diplomat, Japan controls costs by setting flat rates for everything from medications to procedures, thus eliminating competition among insurance providers. While most of the country's hospitals are privately owned and operated, the government implements smart regulations to ensure that the system remains universal and egalitarian.

Meanwhile, Singapore's healthcare system is largely funded by individual contributions, and is often hailed by conservatives as a beacon of personal responsibility. But as conservative David Frum notes, the system is actually fueled by the invisible hand of the public sector: individuals are required to contribute a percentage of their monthly salary based on age to a personal fund to pay for treatments and hospital expenditures. In addition, the government provides a safety net to cover expenses for which these personal savings are inadequate. Private healthcare still plays a role in Singapore's system, but takes a backseat to public offerings, which boast the majority of doctors, nurses, and procedures performed.

The truth is, America's system is seriously  broken yet the GOP seeks to destroy Obamacare and in the process throw millions of Americans to the wolves.  The hypocrisy is off the charts because meanwhile, the GOP base claims to be worship the Gospel message.

Click image to enlarge

NYT: Romney Is Twisting the Facts About Healthcare

As longer term readers of this blog know, I have long been an advocate of sweeping health care reform.  In fact, I believe that a nationalized program akin to that of France or Canada  is the only real solution for most Americans.  Why do I feel this way?  First, having had a child who was stricken with a horrific illness, I know first hand how families with supposedly good or even excellent insurance coverage can still be wiped out financially.  Second, some years back, I worked for a law firm that represented a healthcare/hospital entity and I was appalled that delivering top level heath care was way down the priority list.  Instead, building monopolies and tying doctor groups to hospitals were the real priority.  And as for keeping costs down for patients, the concept never ever crept into the conversation.  The health care industry will not voluntarily reform itself and while doctors constantly plead poverty, they make more than just about any other segment of the population.  How does this figure into the presidential elections?  Because Mitt Romney and Paul Ryan basically want to dismantle protections for the majority and allow the healthcare industry to run amok The New York Times looks at the Romney/Ryan myths and would be plans for health care.  It ought to scare the daylights out of anyone not sitting on vast amounts of family wealth. Here are excerpts:

The outcome of the presidential election will determine which of two opposing paths the nation will follow on health care for all Americans. If voters re-elect President Obama, he will protect the health care reforms that are his signature domestic achievement. If they elect Mitt Romney, they will be choosing a man who has pledged to repeal the reform law and replace it with — who knows what?  .  .  .  . Almost nothing the Republican candidates say on these or other health care issues can be taken at face value. Here are some of their bigger evasions: 

REPLACING OBAMACARE Although Mr. Romney has said he wants to “repeal and replace” the Affordable Care Act, he has provided few details on what he would replace it with. When challenged to do so at the first presidential debate, Mr. Romney never quite answered and made some egregious misstatements along the way, some of which were repeated by Mr. Ryan in the vice-presidential debate.  .  .  .  He continues to assert that his plan would cover people with pre-existing conditions when it clearly would not.

A major goal of the law was to cover some 30 million more people by expanding Medicaid and subsidizing coverage for middle-income people. That goal would be lost if the law was repealed. The Republicans, of course, have no plans for covering the uninsured beyond assuming they can use emergency rooms, leaving the problem to the states. 

MEDICARE Mr. Romney has misrepresented what would happen to both current beneficiaries and future generations under his proposals. He says his plans would have no effect on people now on Medicare or nearing eligibility. But if he succeeded in repealing the reform law, which has many provisions that hold down costs for Medicare enrollees, most beneficiaries would see their annual premiums and cost-sharing go up. The average beneficiary in traditional Medicare would pay about $5,000 more through 2022, and heavy users of prescription drugs about $18,000 more over the same period, if the act is repealed, according to the Department of Health and Human Services. Department of Health and Human Services.

For future generations, the Romney-Ryan ticket would turn Medicare into a premium-support — or voucher — program in which the federal government provides a fixed amount of money to beneficiaries each year and allows it to grow by a small amount annually, which may not keep pace with medical costs. The whole point of turning to vouchers is to reduce federal spending on Medicare, so it seems likely that many beneficiaries would end up worse off than now. 

Mr. Romney and Mr. Ryan insist that the magic of competition among health insurers — both private plans and a public option like Medicare — will bring down premiums. But if competition fails to do that, beneficiaries would almost certainly get socked with added payments or fewer benefits. 

MEDICAID The Republicans want to repeal the reform law’s expansion of Medicaid to cover millions of low- and middle-income people and instead shrink federal funding by turning Medicaid into a block grant. States would be given a fixed amount of money equal to what they had been getting in federal payments for Medicaid, and that grant would then grow at a rate tied to inflation. If those increases failed to keep up with medical costs, states — faced with the necessity of balancing their budgets every year — would probably have to cut enrollments or benefits or payments to providers. That could include cuts to coverage for long-term and nursing home care that millions depend on.

Of course, it one is from a family of wealth and privilege like Messrs. Romney and Ryan, none of this is a concern since one can merely fall back on family money to secure needed health care.  Most of us are not that lucky and could easily find ourselves having to chose between eating and having a roof over our heads or receiving needed treatments and prescriptions.  Truth be told, Romney and Ryan do not give a flying f*ck about most Americans.  We heard it from Romney's own lips when he condemned 47% as moochers and parasites.

Romney Still Clueless: "No One Dies Because They Don't Have Insurance"

One of the biggest failings of healthcare in America is the huge number of Americans who do not receive preventive medical care.  As a result, medical treatment is not sought all too often until the situation becomes serious and as a consequence the medical costs of treatment too late are not only catastrophic but often the patient dies from the illness that might have been curable/treatable if addressed earlier.  The other consequence is that because hospitals have to treat so many uninsured patients, the costs for everyone else skyrocket and vastly exceed the cost of similar treatment in virtually every other advanced industrialized nation.  Sadly, through his latest statements it is evident that Mitt Romney - who has never in his life had to forgo medical treatment because of cost worries - does not understand the reality that most Americans face daily.  Even with decent health care insurance many still think twice about seeking preventive or early diagnostic testing because of deductibles and/or copays.  Likewise, he doesn't grasp that its the millions of uninsured who do precisely what Romney describes that cause our medical cost to be so exorbitant.  Think Progress looks at Romney's utterly out of touch  statements as he talks about repealing "Obamacare."  Here are excerpts:

Mitt Romney doubled down on his suggestion that uninsured Americans can find the care they need in emergency rooms, telling The Dispatch that people will always receive the treatment they need, and do not die or suffer because they can not pay for care. He pointed to federal law that requires hospitals to admit emergency patients, repeating his advice that patients rely on the most expensive form of care reserved strictly for emergencies. Romney told the Columbus Dispatch:

“We don’t have a setting across this country where if you don’t have insurance, we just say to you, ‘Tough luck, you’re going to die when you have your heart attack,’  ” he said as he offered more hints as to what he would put in place of “Obamacare,” which he has pledged to repeal.

“No, you go to the hospital, you get treated, you get care, and it’s paid for, either by charity, the government or by the hospital. We don’t have people that become ill, who die in their apartment because they don’t have insurance.”

He pointed out that federal law requires hospitals to treat those without health insurance — although hospital officials frequently say that drives up health-care costs.

Emergency rooms serve as a place of last resort, but 45,000 Americans still die every year because they lack health insurance, or one every 12 minutes. Uninsured adults under age 65 are also at a 40 percent higher death risk. Hospitals may treat patients for emergency medical conditions regardless of legal status or ability to pay, but patients with chronic conditions that don’t require emergency interference are often unable to access needed care.

Romney’s health care proposal would leave 72 million Americans without health insurance and wouldn’t provide all uninsured Americans with a stable source of insurance.

Romney is not only a shameless liar but totally out of touch with the reality that most Americans face ever day of their lives.  Those born to wealth like Romney AND Paul Ryan simply have no clue because neither they nor their families have ever had to worry about how necessary medical care will be paid for.

 

GOP to the Uninsured: Drop Dead, Don't Use Contraception

To listen to Mitt Romney's campaign ads, one would think that the Republican Party was actually concerned about the nation's economy.  But the actions of Republicans in the House of Representatives reveal the GOP's real agenda: keeping millions of Americans without health care coverage and controlling a woman's vagina and uterus.  And as for the economy, the only real focus is to destroy it in the hopes of destroying Barack Obama.  The collateral damage done to countless lives and families doesn't matter.  It's not even on the GOP's radar screen.  First a column in the Washington Post looks at the continued quest to kill health care reform and the promise of health care coverage to some 30 million Americans, many of whom are children.  Here are excerpts:

The House is voting (again) to repeal the Affordable Care Act on Wednesday.  Meanwhile, six Republican governors (so far) say they won’t go along with the law’s planned Medicaid expansion for 4 million uninsured people in their states, even though the feds would pick up nearly all the tab.

Republican message to uninsured Americans in the wake of the Supreme Court’s recent ruling couldn’t be clearer: You’re on your own. 

The party may not have officially adopted the “let ’em die” policy of right-wing hecklers at that CNN primary debate, when Ron Paul was asked what should be done when uninsured folks show up at the hospital. But as a practical matter, Republicans are in pretty unsavory territory. What other conclusion can we draw when Rick Perry, who presides over a state where fully one in four people lack health coverage, makes swaggering indifference to these Texans’ plight a point of sovereign pride? 

In America — alone among wealthy nations — everyone is a pink slip or job change or new illness away from finding they’ve lost coverage or are uninsurable.  This is the shameful reality behind the GOP’s rhetoric on health care. Republicans don’t want to spend a penny to insure the uninsured.

As the ranks of the uninsured have soared, the size of Republican compassion has shriveled. Why?

Daniel Patrick Moynihan gave me the most convincing explanation not long before he died in 2003. “Those folks never vote for us,” he told me, summing up the Republican mind on the issue, “and we have our priorities for the money.”  Like trillions more in tax cuts for the best-off Americans over the next decade. 

Here’s what you should do, Mr. President. In the debates this fall, pull out a small laminated card you’ve had made as a prop for this purpose. Then remind Mitt Romney that the ranks of the uninsured today are equal to the combined populations of Oklahoma, Connecticut, Iowa, Mississippi, Kansas, Kentucky, Arkansas, Utah, Oregon, Nevada, New Mexico, West Virginia, Nebraska, Idaho, Maine, New Hampshire, Hawaii, Rhode Island, Montana, Delaware, North Dakota, South Dakota, Alaska, Vermont and Wyoming. Read that list slowly, Mr. President. Then ask your opponent: Would America turn its back on the citizens of these 25 states if everyone there lacked basic health coverage? That’s what we’ve been doing for decades.

What strikes me is the callousness and utter lack of compassion for other living, breathing human beings demonstrated by the GOP.  The hypocrisy is even more stomach wrenching as Republican elected officials and candidates profess their Christian beliefs and stick their noses so far up the ass of the Christian Right that it's a wonder they don't suffocate.  And then there's the GOP obsession with controlling sexual practices of women.  As The Hill reports, another effort is underway to kill the contraception mandate under the health care reform package of the Obama administration:

A new Republican bill would remove the teeth from a contentious Obama administration health mandate by barring the federal government from penalizing employers that do not comply.

The measure was written in response to the Affordable Care Act, which requires that most employers cover birth control without a co-pay for employees. Under the GOP bill, employers that object to birth control for religious reasons can refuse to cover it without facing financial penalties from the government. 

Sensenbrenner's bill would erase the taxes faced by employers who choose not to cover certain healthcare benefits "by reason of adherence to a religious belief or moral conviction." 

The GOP "moral conviction" is to increase unwanted pregnancies and once those babies are born to kick them to the curb and leave them uninsured.   Once a baby exits its mothers womb, in the world of the GOP it's on its own. The Party's moral bankruptcy is nearly complete.

Mitch McConnell: Covering 30 Million Uninsured is "Not the Issue"

Yesterday Mitch McConnell pretty much exposed the lie that the GOP is the party of "family values."  The same goes for the GOP's supporters amongst the modern day Pharisee set generally labeled as "conservative Christians."   During an appearance on Fox News Sunday McConnell basically admitted that the GOP had no plan as to how to assure health care coverage to the 30 million who will gain coverage under the Affordable Healthcare Act.  Worse yet, he stated that covering such individual - which includes families and children - isn't an issue.  Sadly, McConnell and his party are more concerned about protecting pharmaceutical companies and the health care industry than needy Americans.  The later, in the GOP's eyes are disposable trash.  Here are highlights from a Washington Post column:

Mitch McConnell’s appearance today on Fox News Sunday was remarkably revealing — it showed as clearly as you could want that the Supreme Court decision is finally forcing Republicans to declare what, exactly, they would replace Obamacare with if they realize their goal of repealing it entirely.

Pressed by Chris Wallace to say what he would do to insure the 30 million people who will get insurance under Obamacare, McConnell at first dodged the question, instead launching into a litany of complaints about the law.  .  .  .  Asked the question again by Wallace, McConnell actually laughed, and said he’d “get to it in a minute,” before claiming the best thing we can do for the health system overall is to get rid of the law and all of its “cuts” to health providers. He labeled Obamacare a “monstrosity” and vowed that there would not be a “2,700 page” Republican reform bill.

Asked a third time how Republicans would insure those 30 million people, McConnell said: “That is not the issue. The question is how you can go step by step to improve the American health care system.”

[E]ven Wallace saw McConnell’s quote in far less charitable terms:

WALLACE: You don’t think the 30 million people who are uninsured is an issue?

MCCONNELL: Let me tell you what we’re not going to do. We’re not going to turn the American health care system into a western European system.

It’s worth pointing out that this is basically Mitt Romney’s position, too. The Romney campaign has acknowledged that he would not replace Obamacare with across-the-board protections for people with preexisting conditions. And the New York Times recently took a look at the alternatives Romney has proposed, and concluded that they would deemphasize the goal of “reducing the ranks of the uninsured.”

As the conversation turns to the specifics in the law, and to the fact that Republicans wouldn’t replace them with anything, Republicans’ best hope will be that the law’s generalized unpopularity will enable them to persuade the American people that the question of whose policies would actually cover the uninsured is “not the issue.”

The growing moral bankruptcy of the GOP will soon be challenging that of the Catholic Church hierarchy and the Vatican.

Second Guessing the Supreme Court on the Health Care Ruling

I've mad it pretty clear that I favor a continuation of what the GOP likes to deride as "Obamacare."  In fact, I'd go even further and state that we need a single payer nationalized system along the lines of France and some other European countries that pay far less over all for health care, have quality health care delivery and provide preventive care.  Nothing less will force the medical professions, hospital systems that play monopoly like games with hospitals and referring physicians to stop raping those with health insurance to make up for the millions of Americans who have no health care coverage.  Andrew Sullivan looks at what some of the predictions on tomorrow's Supreme Court ruling will look like. 

SCOTUSBlog's Tom Goldstein bets the mandate will survive:

I believe the mandate will not be invalidated tomorrow. Far less important, I expect the principal opinion will be written by the Chief Justice; a majority of the Court will find it has jurisdiction; and the challenge to the Medicaid expansion will be rejected.

Tomasky differs:

This is easy. I take the darkest and most cynical possible view of the conservative majority; I believe, as I've written, that they are politicians in robes (with the partial exception of Kennedy); as such, I believe that they will behave here like politicians, and they will render the decision that will inflict the maximum possible political damage on Obama and the Democrats. That means overturning the mandate 5-4.

Walter Dellinger bets they'll split the baby:

[A] compulsory mandate would be unconstitutional but a financial incentive that leaves the choice to the individual would be OK. The practical effect would be to uphold all the operative provisions of the Affordable Care Act, while firmly planting a liberty flag that would limit future Congresses.

Andrew's own prediction:   It will strike down the mandate alone.

I don't presume to know, especially given the partisanship behavior of Roberts, Scalia, Alito and Thomas.   Personally, I simply know that what we had before the AHA was totally inefficient cost wise and broken and not working for many millions of Americans. If AHA is struck down, something needs to be done to deal with the broken health care system.  It's unfortunate that many voters cannot grasp that we are already paying for the uninsured through hospital bills that are sky high compared to the rest of the world and a system that ignores preventive care and puts off treatment until hugely expensive catastrophic illness has developed. For the same over all expenditure we could have a system that doesn't treat far too many citizens as disposable garbage and could rein in costs for those with health care coverage.

The USA's Medical Crisis and Stalled Life Expectancy Increases

Click image to enlarge

In my view, for millions of Americans the USA's medical system is the equivalent of a car owner who continually defers routine and preventive maintenance until suddenly faced with a catastrophic and hugely expense problem that sets off a financial crisis. Millions of citizens have no access to regular preventive medical care. Their only viable options are visits to non-profit hospitals and/or Medicaid coverage. The result is that problems that could have been detected and either cured or managed go unaddressed until a major illness and grossly expensive procedures are required. Meanwhile, the rest of us are paying for this ass backwards approach through higher medical charges as hospitals pass along their unreimbursed costs for treating the uninsured and taxes that support. Now, with Medicaid funding dropping even as demand is soaring as reported by the New York Times, the problem will only get worse. One side effect is that the increase in the life expectancy for Americans is slowing and in some regions - typically so-called Red States - almost stagnated with the result that some third world nations score better. A new report by the Institute for Health Metrics and Evaluation has the details (see the map above too). First, this from the Times story:
*
WASHINGTON — The Obama administration injected billions of dollars into Medicaid, the nation’s low-income health program, as the recession deepened two years ago. The money runs out at the end of this month, and benefits are being cut for millions of people, even though unemployment has increased.
*
From New Jersey to California, state officials are bracing for the end to more than $90 billion in federal largess specifically designated for Medicaid. To hold down costs, states are cutting Medicaid payments to doctors and hospitals, limiting benefits for Medicaid recipients, reducing the scope of covered services, requiring beneficiaries to pay larger co-payments and expanding the use of managed care.
*
As a result, costs can be expected to rise in other parts of the health care system. Cuts in Medicaid payments to doctors, for example, make it less likely that they will accept Medicaid patients and more likely that people will turn to hospital emergency rooms for care. Hospitals and other health care providers often try to make up for the loss of Medicaid revenue by increasing charges to other patients, including those with private insurance, experts say.
*
“Medicaid is very much on the chopping block,” said Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate Finance Subcommittee on Health Care. “Seniors vote. But if you are poor and disabled, you might not vote, and if you are a child, you do not vote — that’s a lot of Medicaid’s population. They don’t have money to do lobbying.”
*
Yet despite this nightmare reality, members of the GOP oppose "Obamacare" and make the claim that the USA has the best healthcare system in the world. Talk about denying objective reality. As for the life expectacy issue, here are these highlights from the new report:
*
June 15, 2011 - While people in Japan, Canada, and other nations are enjoying significant gains in life expectancy every year, most counties within the United States are falling behind, according to a new study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
*
When compared to the international frontier for life expectancy, US counties range from being 16 calendar years ahead to more than 50 behind for women. For men, the range is from 15 calendar years ahead to more than 50 calendar years behind. This means that some counties have a life expectancy today that nations with the best health outcomes had in 1957.
*
The researchers suggest that the relatively low life expectancies in the US cannot be explained by the size of the nation, racial diversity, or economics. Instead, the authors point to high rates of obesity, tobacco use, and other preventable risk factors for an early death as the leading drivers of the gap between the US and other nations.
*
Five counties in Mississippi have the lowest life expectancies for women, all below 74.5 years, putting them behind nations such as Honduras, El Salvador, and Peru. Four of those counties, along with Humphreys County, MS, have the lowest life expectancies for men, all below 67 years, meaning they are behind Brazil, Latvia, and the Philippines.

Will The GOP Succeed in Killing Medicare?

Under the guise of reducing the federal budget deficit, Congressional Republicans and their like minded cronies in various state houses are out to return the USA to the worse excesses of the so-called "Gilded Age" when the robber barons and incredibly wealthy had the good life and everyone else was pretty much left to their own devices and all too often poverty and early deaths. Unfortunately, too many in the voting public are ignoring the details of what the GOP agenda truly entails and some - such as those who continue to fall for the GOP "family values" bullshit - may well vote against their own self-interest and the interests of all but the obscenely wealthy. The GOP's plan to destroy Medicare is a prime example. Yesterday's New York Times takes a good look at the GOP plan versus the Democrat plan - it should be required reading for all seniors and their families. Here are some highlights:
*
We know it is not how most people want to spend their time, but Americans need to give a close reading to the Democrats’ and Republicans’ plans for Medicare reform. There are stark differences that will profoundly affect all of our lives — and clear political choices to come.
*
During last year’s Congressional campaign, Republican leaders claimed to be Medicare’s stalwart defenders — conveniently ignoring their historical animosity toward the program. Older voters overlooked that history and flocked to the party in large numbers. Now the Republicans have embraced many of reform’s changes for Medicare — without, of course, advertising their flip-flop.
*
One of the biggest differences, under both parties’ plans, would be a large reduction of unjustified subsidies to private Medicare Advantage plans that serve 11 million of Medicare’s 46 million enrollees. Last year, those plans were paid 9 percent more per enrollee, on average, for coverage comparable to what traditional Medicare would provide. By eliminating most of the subsidies, the Democrats hope to save $136 billion over 10 years. The Republicans plan to cut only $10 billion less.
*
House Republicans would make another deep cut — definitely not in the Democrats’ plan — that would hit many current and future Medicare users hard. The reform law provides subsidies to help close a gap in prescription drug coverage, known as the doughnut hole, that poses a hardship for millions of patients who need lots of medicine and often cannot afford to pay for it. The Republicans would repeal that subsidy.
*
The differences get even bigger over time. President Obama wants to retain Medicare as an entitlement in which the federal government pays for a defined set of medical services. The Ryan proposal would give those turning age 65 in 2022 “premium support” payments to help them buy private policies. There is little doubt that the Republican proposal would sharply reduce federal spending on Medicare by capping what the government would pay at very low levels. But it could cause great hardship by shifting a lot of the burden to beneficiaries. The Congressional Budget Office estimates that by 2022 new enrollees would have to pay at least $6,400 more out of pocket to buy coverage comparable to traditional Medicare.
*
We were skeptical when the Republicans suddenly claimed to be Medicare’s great defenders. We are even more skeptical now that we have read their plan. We are also certain that repealing reform — the Republicans’ No. 1 goal — would do enormous damage to all Americans and make it even harder to wrestle down health care costs, the best way to deal with the country’s long-term fiscal crisis.

Big Pharma's Wasteful Advertising

Just watching the NBC Evening News a few minutes ago I was yet again struck by the amount of needless, wasteful spending by the big pharmaceutical companies. In the half-hour broadcast there were five (5) ads - all for prescription drugs that no consumer can purchase on their own. Only doctors and physician assistants can write the required prescriptions, yet here we are with countless millions of dollars spent nationwide daily to market to viewers who cannot make the decision to prescribe the drugs pushed in the ads. Meanwhile, of course, the drug company reps are likewise spending lavishly entertaining doctors and physician assistants pushing the same drugs. My sister - a physician assistant - says that the drug reps she interfaces with market to her and others on the medical staff only at the very, very best [and most expensive] restaurants in town.

*

With all the discussion of health care reform and the insane cost of many prescription drugs, I am baffled why no one has argued for the immediate cessation of such wasteful advertising spending by pharmaceutical companies with the savings passed on to the consumer. This kind of advertising makes no practical sense, particularly in a nation where over 47 million citizens have no health insurance coverage.

*

Another wasteful example of a broken health care system is the monopoly games played by many non-profit hospital systems that place little focus on the provision of health care but great effort into wiping out competition. Tied this insanity is advertising by non-profit hospital systems that already have a near market monopoly. Locally, Sentara Health Systems is a case in point. Sentara controls five of the seven local hospitals in south Hampton Roads and has much more state of the art facilities than its competitors - two hospitals owned by the sisters of Bon Secours - yet Sentara continues massive television and print advertising campaigns. Why? And why can't this wasteful spending be eliminated so that savings could be passed along to consumers?

*

One last question is this: why can't Barack Obama and Congressional Democrats ask these same questions?

Why Are Republicans - And Conservative Christians in Particular - Against Health Care Reform?

The New York Times has a main editorial today that looks at the consequences of millions of Americans not having health insurance coverage. Among them ar 18,000 needlessdeaths each year, inefficient and costly use of emergency rooms in lieu primary care givers, and late diagnosis of problems that could have been addressed earlier thereby saving huge costs later. As I have said before, the irony is that the principal opponents of a public option are conservative Republians - who constantly proclaim that they are pro-life and Christian - and their evangelical Christian base. 18,000 needless deaths and the sick going untreated certainly do not strike me as something that Christ would have approved of based on the Gospels which so many of these opponents of health care reform claim are inerrant. The hypocrisy of it all is most telling and further demonstrates that fundamentalism is turing the Christian message into something truly evil. As for the GOP elected officials, they obviously honor the money they receive from drug companies and the insurance industry more than the Gospel message. I wish the MSM would challenge these hypocrites on this issue. Here are some highlights from the editorial:

*

No matter how you slice the numbers, there are tens of millions of people without insurance, often for extended periods, and there is good evidence that lack of insurance is harmful to their health. Scores of well-designed studies have shown that uninsured people are more likely than insured people to die prematurely, to have their cancers diagnosed too late, or to die from heart failure, a heart attack, a stroke or a severe injury. The Institute of Medicine estimated in 2004 that perhaps 18,000 deaths a year among adults could be attributed to lack of insurance.

*
The oft-voiced suggestion that the uninsured can always go to an emergency room also badly misunderstands what is happening. By the time they do go, many of these people are much sicker than they would have been had insurance given them access to routine and preventive care. Emergency rooms are costly, and if uninsured patients cannot pay for their care, the hospital or the government ends up footing the bill.

*

The Agency for Healthcare Research and Quality in the Department of Health and Human Services estimates that 28 million people were uninsured for all of 2005 and 2006 and that 18.5 million of them were uninsured for at least four straight years. That does not sound like a “temporary” problem, and the picture today is almost certainly bleaker.

*
THE WORKING POOR The Kaiser Family Foundation estimates that about two-thirds of the uninsured — 30 million people — earn less than twice the poverty level, or about $44,000 for a family of four. It also estimates that more than 80 percent of the uninsured come from families with full-time or part-time workers. They often cannot get coverage at work or find it too expensive to buy. They surely deserve a helping hand.
*

THE UNDERINSURED The Commonwealth Fund estimates that 25 million Americans who had health insurance in 2007 had woefully inadequate policies with high deductibles and restrictions that stuck them with large amounts of uncovered expenses. Many postponed needed treatments or went into debt to pay medical bills.

*

If nothing is done to slow current trends, the number of people in this country without insurance or with inadequate coverage will continue to spiral upward. That would be a personal tragedy for many and a moral disgrace for the nation. It is also by no means cost-free. Any nation as rich as ours ought to guarantee health coverage for all of its residents.

Bob McDonnell is Wrong for Virginia

The ad set out below is an excellent example of why Virginia cannot afford to have Bob "Taliban Bob" McDonnell elected Governor in the November 2009 elections. Bob and his Christianist puppet masters would rather see families lose their homes instead of departing from their selfish no tax mantra. It's amazing to me that it is always the self-congratulatory Christian set that opposes government spending that would aid children and families. Yet another example of their perverted "family values." Common Sense Virginia is doing a good job of education Virginians about the real Bob McDonnell.

House Republicans uphold Bush's veto of SCHIP, vote to deny health coverage to millions of American kids

The GOP continues to kiss the Chimperator's ass. Who cares about poor children and other children lacking health care. After all, they and their parents don't make big campaign contributions, so they are off the GOP's radar screen. Hopefully, this brazen indifference to the neediest of American citizens will bite the GOP in the ass next year's elections. I love the GOP excuse: it is too expensive. Never mind that the Iraq War is a financial black hole and that outfits like Halliberton and Blackwater are raking in billions in taxpayer funds. Here are some highlights from CNN (http://www.cnn.com/2007/POLITICS/10/18/schip/index.html):

WASHINGTON (CNN) -- House Democrats on Thursday failed to override President Bush's veto of a children's health insurance bill that opponents said was too expensive. By a vote of 273 to 156, the measure fell 13 votes short of the two-thirds majority needed for an override. Forty-four Republicans voted for the override.
Democrats, sensing earlier that they didn't have the votes, vowed to continue the fight, despite a defeat. The issue has ignited an intense two-week struggle on Capitol Hill after Bush vetoed the proposed five-year expansion and $35 billion spending increase. Bush proposes increasing the program by $5 billion. Before the vote, House Speaker Nancy Pelosi spoke of a middle-class family caring for a child with a birth defect, asking lawmakers: "So when the president wants to have 4 or $5 billion for children in this initiative, is he the one, the decider, who wants to go to that family and say, 'Your child is out'?" "We're lobbying for all of the children," said the California Democrat.

Chimperator Bush Vetoes Child Health Plan

Isn't it nice that the Chimperator cares nothing about poor children who are American citizens, but has no qaulms spending three times the 5 year cost estimate in the Iraq War rat hole? The man is simply unbelieveable. I think he loses touch with reality a little bit more with each passing day. Here are the Washington Post highlights (http://www.washingtonpost.com/wp-dyn/content/article/2007/10/03/AR2007100300116.html?hpid=topnews):

WASHINGTON -- President Bush, in a sharp confrontation with Congress, on Wednesday vetoed a bipartisan bill that would have dramatically expanded children's health insurance. It was only the fourth veto of Bush's presidency, and one that some Republicans feared could carry steep risks for their party in next year's elections. The Senate approved the bill with enough votes to override the veto, but the margin in the House fell short of the required number.

Senate Majority Leader Harry Reid, D-Nev., decried Bush's action as a "heartless veto." "Never has it been clearer how detached President Bush is from the priorities of the American people," Reid said in a statement. "By vetoing a bipartisan bill to renew the successful Children's Health Insurance Program, President Bush is denying health care to millions of low-income kids in America."

The State Children's Health Insurance Program is a joint state-federal effort that subsidizes health coverage for 6.6 million people, mostly children, from families that earn too much to qualify for Medicaid but not enough to afford their own private coverage.

The Democrats who control Congress, with significant support from Republicans, passed the legislation to add $35 billion over five years to allow an additional 4 million children into the program. It would be funded by raising the federal cigarette tax by 61 cents to $1 per pack.