Thursday, March 29, 2012

'Obamacare': Who Does It Scare and Why?
And Who is LYING?
Who is selling you out?

Rick Newman, U.S. News writer for MSN wrote an excellent post recently on the issues of Obamacare, more correctly called the Affordable Healthcare Act.
Before the darned thing passed, I read it, the whole long legislation.
Do I understand it? I think so, reasonably well. 
But I wouldn't consider myself expert, and I think very few people are expert.  What struck me about the Newman article, which I will address here momentarily, is how many other people I have encountered who understand it less than I do, often MUCH less.  Those include the people who believe Sara Palin hysteria about death panels that was a blatant pants on fire lie, a statement at the level of burning stupid, to borrow a pet phrase from a former co-blogger of mine, that I would expect from Palin's paranoia pandering:
Seniors and the disabled "will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care." Sarah Palin on Friday, August 7th, 2009 in a message posted on Facebook
HuffPo quoted her claiming that President Obama and 'Obamacare' would kill her youngest child, afflicted with Down's Syndrome as part of that statement.  That is not true, and it should be too ludicrous for anyone except a rightwinger who has lost their reality grip to believe.
We have others making similar misstatements about health care reform, beginning with the ever factually averse Michele Bachmann who is pretty much incapable of getting a fact correct.  This exchange was about the appointment of the extremely well qualified Donald Berwick to head Medicare and Medicaid Services.  From TPM:
BACHMANN: He’s the one now who will be in charge of implementing full-scale Obamacare and he’ll be in charge of Medicare and Medicaid.
BAKER: Oh boy. That’s why I’m now referring to him as the chairman of the Obamacare death panel.
BACHMANN: That’s right.
BAKER: That’s my title.
BACHMANN: That’s right because this is his quote, and I have it right in front of me. He said, “the decision is not, whether or not we will ration health care. The decision is whether we will ration with our eyes open.” Well, it’s with his eyes open. Because he’s going to be the one who is denying people care.

And of course we have the stupidity from Santorum, who should perhaps be nicknamed 'Insanit-orum', with his weird and fact averse claims about euthanasia in the Netherlands.  No, they don't go around killing all their old people.  They in fact have an excellent form of allowing people to control their very near death and pain so as to die with as much comfort and dignity as possible.  It is closer to hospice care, only slightly more proactive.  An example would be allowing people who are near death without hope of recovery to die at home through having medical staff come to them rather than taking people from what are comfortable and familiar surroundings when they die.  Both the Dutch and the Swiss have very careful provisions in place to use their euthanasia laws to give people the greatest possible control over their lives and death, not take either their control or their lives from them.  We have a version of that already in the U.S. in Oregon, where mass killing of sick and old people has not resulted either, not for convenience, not for cost/benefit reasons.  What is referred to on the right by the likes of stupid candidates like Santorum as 'involuntary euthanasia' would be occurrences like the removal of the life support apparatus, and pain medication as normal death resulted in the case of Terri Schaivo.  This summary of the Terri Schiavo case in the New England Journal of Medicine was compelling, but I will limit myself to these two excerpts:
The right of competent patients to refuse unwanted medical treatment, including artificial hydration and nutrition, is a settled ethical and legal issue in this country — based on the right to bodily integrity. In the Nancy Cruzan case, the Supreme Court affirmed that surrogate decision makers have this right when a patient is incapacitated, but it said that states could set their own standards of evidence about patients' own wishes...
Let us hope that future courts and legislative bodies put aside all the special interests and distractions and listen carefully to the patient's voice as expressed through family members and close friends. This voice is what counts the most, and in the Terri Schiavo case, it was largely drowned out by a very loud, self-interested public debate.
but perhaps the most important quote from the article was this one:
Distortion by interest groups, media hyperbole, and manipulative use of videotape characterized this case and demonstrate what can happen when a patient becomes more a precedent-setting symbol than a unique human being.
Because Terri Schiavo's brain had liquefied.  Every treatment had been tried.  She wasn't coming back, and being a vegetable on expensive life support was something she found grotesque.  That it was also horrendously expensive while grotesque was secondary to human dignity and control of our own destinies in our final days - of determining how we leave this 'mortal coil'.  Republicans made it a hideous circus of distortions, lies, and exploitation that had nothing whatsoever to do with reverence for life.
The Healthcare Reform / Obamcare conflict is about special interests making obscenely large amounts of money off of sick and injured people, leaving others to die who could and should be treated.  They die through the unreasonable costs institutionalized in the system, and through the allowance of denial of insurance to people with preHealthcare reform is about having a more efficient and consistent delivery system of health care in this country, one that IS less expensive, and one that covers more people with better care.
One of the models for that kind of care management came from Minnesota's Mayo Clinic.  I can't believe anyone who is familiar with that institution would EVER claim that they have death panels that determine care, or kill Down's Syndrome babies or elderly people using bureaucrats who make determinations of societal usefulness.  Instead you find the Mayo working with the Obama administration's Department of Health and Human Services  TO LOWER HEALTH CARE COSTS.  From the 2010 MAYO ANNUAL REPORT:
Mayo Clinic in Rochester, Minn., was selected to receive a $12 million Beacon Grant from the U.S. Department of Health and Human Services for a three-year research project in southern Minnesota that will study whether better sharing of patients' health information through electronic medical records will improve treatment of diabetes and childhood asthma. Mayo Clinic was the only rural-area recipient to receive this funding.
 The electronic medical record (EMR) has long been critical to Mayo's ability to deliver health care quality, safety and efficiency while reducing health care costs. Today, Mayo Clinic has one of the largest EMR systems in the world. 
Starting as a pilot program, the southeast Minnesota "Beacon Community" will combine the efforts of public health offices, public schools, medical centers and Mayo Clinic Health System communities to show how electronic exchange of health information can lower health care costs, facilitate care management and improve community health. Everything related to a patient's care — physician notes, laboratory reports, copies of correspondence, appointment schedules, X-rays — will be instantly available to caregivers. 
It is of course NOT true what the right has said about the Healthcare reform.  It is NOT true either what they say about the places in Europe where they have better health care than we do, along similar public regulation to 'Obamacare'. 
So how does the right continue to get away with such extraordinary boldface lying?
That brings us to the recent article by Rick Newman
The real reason Obamacare scares people

Despite the uproar over the individual mandate, the requirement would affect only a tiny portion of the population.

Sometimes the weatherman predicts a big storm that never materializes.
Politicians do the same thing, and right now many of them are warning that President Obama's 2010 healthcare reform law is about to come slamming into the nation like a once-a-century hurricane. Republican presidential front-runner Mitt Romney calls the law "an unfolding disaster for the American economy." His fellow candidate Rick Santorum routinely tells audiences that Obamacare "is the beginning of the end of freedom in America." Board up the windows. Hurry to the basement.
At the eye of this gathering storm is the "individual mandate," a key part of the law that will require most Americans to buy a minimum level of health insurance by 2014, or ask the feds for an exemption. Those in violation will have to pay a penalty fee that could be as high as the annual premium on a basic insurance plan. The mandate, which some people consider highly intrusive, generated court challenges almost as soon as Obama signed the law, with the Supreme Court now due to decide whether it's constitutional.
Many of those people would qualify for subsidies set up under the law, which are meant to encourage people to buy insurance and help them pay for it. Some of them, no doubt, would do what the law says, and buy health insurance. So the number of Americans truly subject to penalties for violating the mandate would be less than 10 percent of the population--perhaps far less. Kaiser notes that in Massachusetts, which enacted a statewide law similar to Obamacare in 2006, about 70 percent of the people without insurance qualify for an exemption, and only 1 percent of the population pays a fine for going without coverage. And there's been little uproar about lost freedoms or a wrecked economy.
Changes are always more intimidating when they're poorly understood, however, and that is certainly one reason that Obamacare is so controversial and highly divisive. Polls show that Americans are about evenly split on their view of the law, with many Republicans strongly opposed to it and many Democrats strongly in favor. At the same time, only about one third of Americans say they feel they understand the law--and their self-assessments may be overly generous.
Complexity, therefore, may be the real reason Obamacare spooks people. For starters, the law could end up remaking the whole healthcare system—which accounts for about one sixth of the U.S. economy—in ways nobody can predict. The U.S. healthcare system was a mess before Obamacare, with soaring costs and millions of families that couldn't afford care.
The 'Obamacare' legislation attempts to make health care more efficient, using as a template something that already works.   It makes it possible for the people who are dying NOW without insurance and without health care, people who wouldn't die at that rate WITH care, to be able to get care and to buy insurance.  And that s a LOT of people.
According to Reuters, someone in that group of uninsured and uncared for dies every 12 minutes (as of 2009 - it may be higher numbers now;).  As health care costs rise, an increasing, not decreasing number of people will lose health care and insurance coverage, and those who DO have it will continue to have declining care.  Why? So that the conservatives can keep enriching their insurance company donors.
They don't give a tinkers damn about people dying or about life; it is just a very effective ploy to deceive the ultra conservative low information voters.  When you have Frank Luntz, famous word master and superlative spinner of terms telling the right they're wrong, you know it's gone beyond the realm of even the tenuous Republican reality.  Even the rational right knows it's wrong.

Current health care and insurance chaos denies health care to millions of people in this country, and we have a lot of avoidable death as a result of our current system, as reported by non-partisan Reuters, providing factual information, not conservative paranoid crap:
(Reuters) - Nearly 45,000 people die in the United States each year -- one every 12 minutes -- in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday.
More than the number of people who die, the number of people who have their lives destroyed, the number of people who are economically severely harmed by our health care system before 'Obamacare' was huge.

From the WaPo back in 2009 when the right wing lies about Obamacare started:

New Study: Bankruptcy Tied To Medical Bills

By Sarah Lovenheim

Sixty-two percent of all bankruptcies filed in 2007 were linked to medical expenses, according to a nationwide study released today by the American Journal of Medicine. That's nearly 20 percentage points higher than that pool of respondents reported were connected to medical costs in 2001.

Of those who filed for bankruptcy in 2007, nearly 80 percent had health insurance. Respondents who reported having insurance indicated average expenses of just under $18,000. Respondents who filed and lacked insurance had average medical bills of nearly $27,000.

Since 2007, the number of Americans without insurance has increased and filing for bankruptcy has become more difficult due to more stringent laws, according to the report..

The authors of the study, David Himmelstein, Deborah Thorne, Elizabeth Warren and Steffie Woolhandler, say their findings "reflect the U.S. health care financing system is broken." Middle class families, they conclude, "frequently collapse under the strain of the health care system that treats physical wounds, but inflicts fiscal ones."

The Republicans have not come up with a single credible alternative to Obamacare, or any proposal that significantly improves the present system that is so clearly broken based on our poor delivery of expensive inferior care, based on the number of people dying without care who shouldn't die, and based on the number of people who are financially ruined and effectively destitute because of the cost of our health care system.  Pretty much every single Republican / Tea Party proposal relating to health care has been nothing but a sham that would benefit special interests and corporations.

Republicans talk about being the party of small government, but they institute the most wide-reaching intrusions between health care providers and patients this country has ever seen.  Republicans talk about being the party of freedom, but they mandate false medical information, medical malpractice style withholding of important information from patients by their doctors, and possibly the most egregious example of the right selling out people to corporations was this:

For Pennsylvania's Doctors, a Gag Order on Fracking Chemicals

By Climate Desk

Mar 27 2012, 9:05 AM ET116

A new provision could forbid the state's doctors from sharing information with patients exposed to toxic—and proprietary—fracking solutions.
Under a new law, doctors in Pennsylvania can access information about chemicals used in natural gas extraction -- but they won't be able to share it with their patients. A provision buried in a law passed last month is drawing scrutiny from the public health and environmental community, who argue that it will "gag" doctors who want to raise concerns related to oil and gas extraction with the people they treat and the general public.
Pennsylvania is at the forefront in the debate over "fracking," the process by which a high-pressure mixture of chemicals, sand, and water are blasted into rock to tap into the gas. Recent discoveries of great reserves in the Marcellus Shale region of the state prompted a rush to development, as have advancements in fracking technologies. But with those changes have come a number of concerns from citizens about potential environmental and health impacts from natural gas drilling.
"People are claiming that animals are dying and people are getting sick in clusters around [drilling wells], but we can't really study it because we can't see what's actually in the product."

There is good reason to be curious about exactly what's in those fluids. A 2010 congressional investigation revealed that Halliburton and other fracking companies had used 32 million gallons of diesel products, which include toxic chemicals like benzene, toluene, ethylbenzene, and xylene, in the fluids they inject into the ground. Low levels of exposure to those chemicals can trigger acute effects like headaches, dizziness, and drowsiness, while higher levels of exposure can cause cancer.

Pennsylvania law states that companies must disclose the identity and amount of any chemicals used in fracking fluids to any health professional that requests that information in order to diagnosis or treat a patient that may have been exposed to a hazardous chemical. But the provision in the new bill requires those health professionals to sign a confidentiality agreement stating that they will not disclose that information to anyone else -- not even the person they're trying to treat.

"The whole goal of medical community is to protect public health," said David Masur, director of PennEnvironment. He worries that the threat of a lawsuit from a big industry player like Halliburton or ExxonMobil for violating a confidentiality agreement could scare doctors away from research on potential impacts in the state. "If anything, we need more concrete information. This just stifles another way the public could have access to information from experts."

The provision was not in the initial versions of the law debated in the state Senate or House in February; it was added in during conference between the two chambers, said State Senator Daylin Leach (D), which meant that many lawmakers did not even notice that this "broad, very troubling provision" had been added. "The importance of keeping it as a proprietary secret seems minimal when compared to letting the public know what chemicals they and their children are being exposed to," Leach told Mother Jones.

The limits on what doctors can say about those chemicals makes it impossible to either assuage or affirm the public's concerns about health impacts. "People are claiming that animals are dying and people are getting sick in clusters around [drilling wells], but we can't really study it because we can't see what's actually in the product," said Leach.

At the federal level, natural gas developers have long been allowed to keep the mixture of chemicals they use in fracking fluid a secret from the general public, protecting it as "proprietary information." The industry is exempt from the Environmental Protection Agency's Toxics Release Inventory -- the program that ensures that communities are given information about what companies are releasing. In 2005 the industry successfully lobbied for an exemption from EPA regulation under the Safe Drinking Water Act as well, in what is often referred to as the "Halliburton Loophole." The Obama EPA has pressed drillers to voluntarily provide more information about fracking fluids, but the industry has largely rebuffed those appeals.

The latest move in Pennsylvania has raised suspicions among the industry's critics once again. As Walter Tsou, president of the Philadelphia chapter of Physicians for Social Responsibility, put it, "What is the big secret here that they're unwilling to tell people, unless they know that if people found out what's really in these chemicals, they would be outraged?"

Yup, those big freedumb-talking right wingers CLAIM to be pro-life, but they sell out people to corporate interests in a heart beat, and too bad if you get sick and die.  You're FREE.  Yup, Free to get sick and die and not know why, in order to protect corporations.  You are free to be denied insurance, you are free to die when you could live, to be sick when you could be well, exclusively to protect corporate greed.  Why anyone would trust the right's position on health care and health care reform is inexplicable.  Such trust is irrational and emphatically ill deserved... emphasis on the ILL.

Want to bet that given the participation by big oil and big fracking interests behind this crony capitalism, that ALEC and especially the Koch Brothers might have a hand in this special interest legislation done in secret?  It sure sounds like their kind of legislative operation.  They can afford the corruption kind; and too many people cannot afford the medical kind.

This is what you get, the corruption you have when public office serves private interests rather than the public interest.

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