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.

The Death of Decency and Morality in the GOP

There are those who wonder how Germany sank to a point under Hitler and the Third Reich that many citizens not only knowingly but willingly closed their eyes to the extermination of Jews and the murder and mistreatment of many other minorities. Under the Nazi regime, through constant lies and propaganda political enemies and disliked minorities were dehumanized to an extent that their murder and torture was deemed morally acceptable by those drinking the Nazi Kool-Aid. Frighteningly, I feel that we are beginning to see a similar process among the Tea Party and GOP base, the vast majority of whom disturbingly claim to be "godly Christians." Twice now during the GOP presidential debates we have witnessed applause at statements that ought to make one cringe. Or at least cringe if one has a shred of decency and gives any credence to the Gospel message. The clip above shows the Tea Party/GOP response to a hypothetical where a 30 year old uninsured individual suffered from a medical catastrophe.

The Washington Post has a column that comments on this chilling episode as well as where the execution of a prisoner - who might have been innocent - came up. It's frightening in that I can see these Tea Party followers/Christianists willingly executing those they dislike, LGBT citizens and non-Christians, of course, topping the list. Here are highlights:

[W]e can now add this debate audience cheering for people dying without health insurance to the last GOP debate audience cheering for executions to our understanding of the current Republican Party.

[T]he GOP keeps spinning farther and farther from the general election median voter every week. And, in many cases, reality — do these folks really believe that the biggest economic problem today is runaway inflation? That Americans are desperate to rid themselves of Social Security? That policies enacted by Barack Obama and the Democrats in 2009 (whatever you think of those policies) caused a recession that began in 2007? That “exceptionalism” is the beginning and end of foreign policy?

Andrew Sullivan is rightfully shocked and appalled. Here are brief highlights from his reaction:

[T]hat cannot excuse the emotional response to the issue in the crowd last night. Maybe a tragedy like the death of a feckless twentysomething is inevitable if we are to restrain healthcare costs. But it is still a tragedy. It is not something a decent person cheers. Similarly the execution of hundreds, while perhaps defensible politically and even morally (although I differ), is nonetheless a brutal, awful business. You don't delight in it. And the same is true of torture. Even if you want to defend its use in limited circumstances, it remains an absolute evil, no humane person would want to do it, and no civilized person would brag of it or dismiss any moral issue with it at all. And yet that is what Dick Cheney and Liz Cheney have repeatedly done. They are positively proud of their torture record. The fish rotted from the head down. Last night, we got a whiff of the smell.

In my view, it is rapidly becoming morally impossible to remain a Republican if one has any moral decency and is a true Christian as opposed to the greed driven, flag and Bible waving modern day Pharisees of the Christian Right and the ranks of the professional Christian set.

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:
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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.
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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.
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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.
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“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.”
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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:
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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.
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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.
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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.
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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.

Gay Marriage Bans Lead to Lack of Health Insurance

A week or so ago I mentioned that Optima Health, one of the large local health insurance carriers, doesn't allow domestic partners to be added to one's coverage under its small business group plans - a category that likely covers thousands of local business - even though Virginia law belatedly now allows such coverage. It's yet another example of this country's f*cked up health care system. It is also another example of the consequences of religious based bigotry against LGBT Americans both by the government and private corporations like Optima Health and its parent company Sentara Health Care Systems. If I had a sham marriage with a woman, I'd have not problem giving her coverage. In the case of a same sex couple, with Optima Health you're SOL. My experience is not unique as demonstrated by a new study of Californians by Lambda Legal and the Department of Health Services at UCLA. Here are highlights of the findings via 365gay.com and Health Affairs:
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Central to the debate on benefit equality are factors affecting who has access to dependent employer-sponsored health insurance. Employees who are legally and heterosexually married have an advantage over those in registered or nonregistered domestic partnerships, in civil unions, or legally married to a same-sex spouse in obtaining insurance from employers that covers dependents. This happens in two ways.
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Advantages For The Legally, Heterosexually Married First, many employers do not offer coverage for an employee’s unmarried domestic partner, civil-union spouse, or legal same-sex spouse, regardless of state laws calling for equal insurance treatment of same-sex partners. And when employers do offer same-sex partner/spousal coverage, there are often unequal eligibility rules, such as requiring cohabitation of varying duration and proof of financial entwinement. Heterosexual married couples do not face such scrutiny and are free to live in separate households should career or other needs require it.
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Second, in contrast to benefits acquired through heterosexual marriage, the federal and most state governments treat dependent benefits for domestic partners, civil-union spouses, and same-sex spouses as taxable earned income. This means that dependent coverage for same-sex partners is not equivalent in price to insurance provided for heterosexual married partners. Even in states with equal marriage laws or civil union/domestic partner protection, the Defense of Marriage Act (DoMA) of 1996 keeps the federal government from recognizing same-sex couples’ marriages. Thus, all same-sex couples face a federal income tax burden on dependent employer-sponsored health coverage, and sometimes a state income tax burden as well, regardless of their marital or partnership status under state law.
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The research shows that the exclusion of same-sex couples from civil marriages and the lack of insurance equity in domestic partnerships “contribute to unequal access to health coverage, with the probable result that more health spending is pushed onto these individuals and onto the public.”
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When an employer’s insurance plan does not cover the employee’s same-sex partner, that partner is often left uninsured. In these cases, the partners are dependent on public insurance options, shifting the cost of their insurance to taxpayers.
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“The data from over 100,000 Californians is the first to quantify dependent coverage disparities by sexual orientation,” said Professor Ninez A. Ponce, the principal UCLA co-author. “By not allowing lesbian and gay couples to marry, and not respecting their status when they are married, government invites the private sector to pass the costs of discrimination onto families and communities.”
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I guess the only silver lining is the fact that the Christianists who oppose same sex marriage are too stupid to figure out that they are unknowingly causing themselves to have to indirectly pay for health care costs of uninsured gays. Obviously, it serves the bastards right.

The Economy's Hidden Unemployed

The New York Times has a timely article that looks at a phenomenon that I suspect is all too prevalent and which causes unemployment figures to understate the extent of the number of workers who are unemployed through no desire of their own. For older workers and laid off professionals the job search becomes most depressing as they are told they are over qualified and many other code words for the fact that in their late 40's or in their 50's they are considered too old. I have had the experience myself with the added down side that I am gay and not closeted professionally. The consequence is that no local larger firm will have an openly gay partner and firms out side the area seek generally attorneys with 3-5 years experience or attorneys with huge amounts of portable business - something not realistic for attorneys in this area where there are few large regional or national clients. Discouragement becomes depression and finally one stops looking. In my case, I opted to stick it out in my own firm and market to niche markets ignored by most of the competition to tide things over until the economy recovers. But I digress. Here are highlights from the New York Times:

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They were left out of the latest unemployment rate, as they are every month: millions of hidden casualties of the Great Recession who are not counted in the rate because they have stopped looking for work. But that does not mean these discouraged Americans do not want to be employed. As interviews with several of them demonstrate, many desperately long for a job, but their inability to find one has made them perhaps the ultimate embodiment of pessimism as this recession wears on.

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The official jobless rate, which garners the bulk of attention from politicians and the public, was reported on Friday to have risen to 9.7 percent in August. But to be included in that measure, which is calculated by the Bureau of Labor Statistics from a monthly nationwide survey, a worker must have actively looked for a job at some point in the preceding four weeks. For an increasing number of people in this country who would prefer to be working, that is not the case.

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In the most direct measure of job market hopelessness, the bureau has a narrow definition of a group it classifies as “discouraged workers.” These are people who have looked for work at some point in the past year but have not looked in the last four weeks because they believe that no jobs are available or that they would not qualify, among other reasons. In August, there were roughly 758,000 discouraged workers nationally. . .

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If the unemployment rate were expanded to include all marginally attached workers, it would have been 11 percent in August. But even this figure is probably an undercount of the extent of the jobless problem in this country. There are about 1.4 million more people who are not in the labor force than when the recession began.

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“There are thousands of people applying for every job I’m looking at, and potential employers won’t even give me the courtesy of acknowledging I applied,” he said. “The entirety of that causes me not to bother. It’s a waste of my time and theirs.”

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Needless to say, many of these unemployed have also joined the ranks of those lacking health insurance and therefore have been hit with a double whammy. I suspect many voted for Obama hoping for change - something he has failed to deliver to date.

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:

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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.

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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.

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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.

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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.
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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.

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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.

Another Sign of a Broken Health Care System

We hear a lot about small businesses being the driving force for job creation. What we do not hear is than many of these small businesses do not provide health care coverage for their employees. Now, with the economy in a free fall many small employers will be pressured to cut health care benefits as they struggle to survive the down turn thereby swelling the number of Americans with no health care coverage. Thus, the national disgrace will be getting worse. The New York Times has a story that chronicles one small business being faced with this hard decision. Here are some highlights:

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When the bottom fell out of the automotive market last year, Amberly Allen’s fast-growing direct-mail firm hit a wall in a hurry. As orders from car dealerships fell by half, Ms. Allen deferred plans to hire more sales representatives. She put off buying the building she now leases in this Houston suburb. And in November, both she and her husband, one of her four employees, stopped drawing salaries.

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Still that may not be enough to keep the four-year-old company afloat. Determined not to lay off any of her tight-knit band of workers, Ms. Allen is now agonizing over an equally unappealing option: whether to terminate the health benefits she provides for her employees and herself.

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Even before the recession, owners of the smallest businesses had struggled to absorb the inexorable annual rise in health premiums. The share of firms with fewer than 10 workers that offer health benefits has declined by 16 percent since 2001, to 49 percent, according to an annual survey by the Kaiser Family Foundation and the Health Research and Educational Trust, while the rate in larger firms essentially stayed flat.

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The economic downturn has only accelerated the pressure on small-business owners to pinch every penny, and many feel they have few options but to go after employee health coverage. Surveys suggest that rising premiums have prompted more than half of small businesses to reduce benefits, raise deductibles or require workers to shoulder a larger share of an ever more expensive pie.

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Workers in firms with fewer than 25 workers are now twice as likely to be uninsured as those in larger firms, according to the Employee Benefits Research Institute. For those small-business employees who do have insurance, the share with high deductibles has more than doubled in the last two years.

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“You can’t cut your rent unless you move, you can’t cut your Internet, you can’t cut your phone — so where do you cut?” Ms. Allen, 28, said. “When you’re not taking a dime out of the company, at some point you have to question whether you’re just working to pay everyone else’s bills.”

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A number of states have started programs to lighten the health care burden on small businesses through tax credits, pooling mechanisms and insurance regulation. President Obama, in his campaign, called for federal tax credits to encourage small businesses to provide coverage but also threatened to tax “all but the smallest businesses” if they did not contribute to their employees’ health care. Mr. Obama has not yet formally proposed a health plan.

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The aid cannot come fast enough for businessmen like Mr. Fritts, of the Illinois sporting goods business. He saw his company’s health costs rise 30 percent last year even as its sales plummeted by nearly 60 percent.

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Republicans may deride "Old Europe," but at least in Old Europe and in Canada citizens are assured some level of health care protection. Here in the USA, unless one becomes destitute, Medicaid provides you with nothing. The state of health care access in this country is a disgrace.