Girlie Men Gone Wild.
The Republicans are really in a box here, aren't they? They keep coming up against this young guy who can string a turn of phrase and a train of thought into this THING that just sort of fills the room, fills all the voids in a massive public debate, leaving very, very little room around the edges. Worse, his opponents are sort of always on stage, without quite realizing what a fishbowl they are in all the time. At the end of the debate over health care reform, if we can call it a debate, we are left with the impression that one side was debating and negotiating, while the other side was having a tantrum. Last night an adult stepped up to set some limits, enforce a curfew and remind us that school is back in session.
We're clearly going to have a health care reform bill soon. It will not be an express ticket to nirvana, but it will be the most substantive step towards solving a festering (often literally) wound in our society. Medical care will never offer the American people the benefits that it should if an average American is always at risk of losing access to or never being able to afford the basic medical care that they need. A tremendous amount of study has gone into developing an optimal regimen of testing and "preventive maintenance" that at its core is rather like making sure that one keeps up with their car's recommended maintenance, keeps their oil topped up and changed regularly. If it works for a car, and I can promise you it does, why wouldn't it work for people? No reason, but instead of making certain that everyone has access to the basics of preventive medical care... we have done something else. That alternative has become an overpriced system of inflated charges and endless bargaining between insurance companies and the health insurance industry. Our youngest son recently needed a surgery, of a type that turned out to be seen as an elective surgery, since the condition does not immediately kill you. Usually. So we had the option of waiting until he had another type of insurance (which may be hard for him to get, since he has this pesky "pre-existing condition" now) or we could be self-pay. We chose Option B and it turned out to be a highly educational experience. I won't bore you with numbers, but the asking price would buy a really nice car. We asked about a discount, since we were self-pay. The process ground its way along, and ground some more, we were told our ideas were unrealistic and it ground on some more, the Doctor told us that we needed to understand that he was running a business here, had pretty high overhead, we had a choice to make, yadda, yadda, yadda. In the end we paid one-sixth of the list price for that medical procedure. That works out for us, but remember that we were not in crisis mode. We could wait, we weren't about to do something totally stupid, so we were in a better negotiating position than most people would be. One staffer commented that we ended up paying "about what an insurance company would have paid". I guess that we were meant to take that as high praise. We had done what can only normally be done by the professional wrestlers of the insurance world. Whoopie. But what it also told me is that the health care "industry" is a world of inflated pricing and endless bargaining, where an average person stands relatively little chance of being able to make sense of it all.
Imagine if colleges were run like that? Students would be told that tuition was $200,000 a year and their families would either need to have "education insurance" or they'd be screwed. That wouldn't make a lot of sense, would it? So if that is so obviously absurd in that situation, how come we see the medical "industry" as a more logical realm for such absurdity? I mean, it's not like it is important to the lives of the American people, our fellow citizens, right? Oh, it really sort of is? Oh yeah, well never mind, let's make up stories and take large donations from the insurance industry so we can stay in office to "serve the American people", you know that marionette theater in Washington where trained performers go out and deliver the talking points provided to them by their financial patrons. Heck, if you have a couple of spare millions you could buy yourself a Senator, too! See, for what they cost they are quite a bargain. And that deal they've made with the Devil? Oh yeah, it's all a bit worrisome, but it's kinda like one of those adjustable rate mortgages. The bad news only comes later. I mean who knows, maybe the Rapture will happen first, so why worry?
The Republicans are really in a box here, aren't they? They keep coming up against this young guy who can string a turn of phrase and a train of thought into this THING that just sort of fills the room, fills all the voids in a massive public debate, leaving very, very little room around the edges. Worse, his opponents are sort of always on stage, without quite realizing what a fishbowl they are in all the time. At the end of the debate over health care reform, if we can call it a debate, we are left with the impression that one side was debating and negotiating, while the other side was having a tantrum. Last night an adult stepped up to set some limits, enforce a curfew and remind us that school is back in session.
We're clearly going to have a health care reform bill soon. It will not be an express ticket to nirvana, but it will be the most substantive step towards solving a festering (often literally) wound in our society. Medical care will never offer the American people the benefits that it should if an average American is always at risk of losing access to or never being able to afford the basic medical care that they need. A tremendous amount of study has gone into developing an optimal regimen of testing and "preventive maintenance" that at its core is rather like making sure that one keeps up with their car's recommended maintenance, keeps their oil topped up and changed regularly. If it works for a car, and I can promise you it does, why wouldn't it work for people? No reason, but instead of making certain that everyone has access to the basics of preventive medical care... we have done something else. That alternative has become an overpriced system of inflated charges and endless bargaining between insurance companies and the health insurance industry. Our youngest son recently needed a surgery, of a type that turned out to be seen as an elective surgery, since the condition does not immediately kill you. Usually. So we had the option of waiting until he had another type of insurance (which may be hard for him to get, since he has this pesky "pre-existing condition" now) or we could be self-pay. We chose Option B and it turned out to be a highly educational experience. I won't bore you with numbers, but the asking price would buy a really nice car. We asked about a discount, since we were self-pay. The process ground its way along, and ground some more, we were told our ideas were unrealistic and it ground on some more, the Doctor told us that we needed to understand that he was running a business here, had pretty high overhead, we had a choice to make, yadda, yadda, yadda. In the end we paid one-sixth of the list price for that medical procedure. That works out for us, but remember that we were not in crisis mode. We could wait, we weren't about to do something totally stupid, so we were in a better negotiating position than most people would be. One staffer commented that we ended up paying "about what an insurance company would have paid". I guess that we were meant to take that as high praise. We had done what can only normally be done by the professional wrestlers of the insurance world. Whoopie. But what it also told me is that the health care "industry" is a world of inflated pricing and endless bargaining, where an average person stands relatively little chance of being able to make sense of it all.
Imagine if colleges were run like that? Students would be told that tuition was $200,000 a year and their families would either need to have "education insurance" or they'd be screwed. That wouldn't make a lot of sense, would it? So if that is so obviously absurd in that situation, how come we see the medical "industry" as a more logical realm for such absurdity? I mean, it's not like it is important to the lives of the American people, our fellow citizens, right? Oh, it really sort of is? Oh yeah, well never mind, let's make up stories and take large donations from the insurance industry so we can stay in office to "serve the American people", you know that marionette theater in Washington where trained performers go out and deliver the talking points provided to them by their financial patrons. Heck, if you have a couple of spare millions you could buy yourself a Senator, too! See, for what they cost they are quite a bargain. And that deal they've made with the Devil? Oh yeah, it's all a bit worrisome, but it's kinda like one of those adjustable rate mortgages. The bad news only comes later. I mean who knows, maybe the Rapture will happen first, so why worry?
Arthur
1 comment:
Eugene Robinson,
"The first came as he was systematically addressing the misrepresentations Republicans have been spreading. When Obama said his planned reforms would not apply to illegal immigrants, a voice on the Republican side of the aisle yelled, “You lie!” The juxtaposition could only benefit Obama: a calm and reasonable president vs. a rabid-sounding critic."
OK, so Wilson breached the social decorum of the sacred chamber. You can Boooo but you can't rant and that's fine and he's an ass. That being said, here's a summation of ABC's Jake Tapper review of what the Congressional Research Service (Google and check wikipedia's site ) has to say about the subject.
"But be that as it may, we decided to take a look at the August 26 Congressional Research Service report "Treatment of Noncitizens in H.R. 3200," the House bill. (You can read a copy HERE.)
The non-partisan analysts conclude that:
* some illegal immigrants -- those who "meet the substantial presence test" -- would be taxed if they don't obtain health insurance that meets the requirements of the law;
* there are no immigration-related restrictions on who can participate President Obama’s proposed health insurance exchanges;
* to qualify for any subsidies for health insurance, "individuals must be lawfully present in a state in the United States." That does not preclude those in this country legally who have illegal immigrants in their family from qualifying for the subsidies.
* how will the government make sure that subsidies don't go to illegal immigrants? The mechanism is left entirely up to the Health Commissioner, who is instructed by law that he or must have some process to establish immigration status before giving subsidies. Sec. 241(b)(1), pg 130 : “the Commissioner shall establish a process whereby, on the basis of information otherwise available, individuals may be deemed to be affordable credit eligible individuals." That “shall” is key.
The one way the H.R. 3200 could end up in more health care being provided to illegal immigrants by taxpayers comes from the expansion of Medicaid.
Illegal immigrants are already eligible for emergency care through the Emergency Medical Treatment and Active Labor Act, signed by President Reagan in 1986. This emergency care is often paid for by Emergency Medicaid, private insurance if the patients have it, out-of-pocket, or it's written off as bad debt or charity care by the hospital.
H.R. 3200 would extend Medicaid coverage up to 133 1/3% of poverty for populations that previously were not covered such as some parents and childless adults.
That expansion could – could -- mean more illegal immigrants would become eligible for Emergency Medicaid."
Now because of Joe the dumbass, Obama is going to have to plug this previously unknown loophole. Eugene "The Clueless Cheerleader" Robinson probably still don't get it.
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