I return to work today after a week recovering from a major procedure. I underwent gastric bypass surgery to treat, among other things, my adult onset type 2 diabetes.
While no surgery occurs without pain, discomfort, disorientation, and some period of recovery, I can say that my experience has been as good as it could have been given the circumstances. My doctors, their staff, the insurance company, and the healthcare provider have all performed professionally and effectively.
That said, as a guy daily occupied with the effect of government upon the human experience, I certainly perceived areas where the healthcare system would undoubtedly improve if less encumbered by government. First, I noted inefficient compartmentalization.
To give you an idea of what I mean, consider the path taken to get this surgery done. First, I needed to see my primary care physician for a referral. Then I needed a consult at a weight loss clinic. Then I spent three months checking off a long list of labs, dietitian visits, psychological evaluation, and preparatory classes and consults. Despite the fact that nearly all this occurred under the umbrella of the same healthcare provider, every single time I saw a different person – even within the same clinic, it was like I was being seen for the very first time. I had to answer the same questions, fill out the same forms, tell the same story, over and over again. I can only imagine how frustrating this is for patients dealing with chronic illness.
To a certain extent, this redundancy can be justified. Some of it no doubt serves patient privacy and security. For instance, asking for my birthdate or address could be a verification check to ensure I am the right patient. However, I have a hard time believing that explains most of the redundancy. Most of it seems to be a product of compartmentalization, a lack of access to information previously disclosed. Other industries model customer service solutions which could easily be applied to healthcare.
When you go to the airport in any major city, you can check in at a kiosk and get your boarding pass without seeing a clerk. You can even check in online ahead of time, from your phone while in transit if necessary. Why can’t we do this in healthcare? I get to an appointment on time, but have to wait ten minutes in line behind other patients with more complex needs, and end up checked in late. There’s no need for that.
My PJ colleague Walter Hudson published a compelling argument regarding physician-assisted suicide in response to the ongoing dialogue surrounding terminal cancer patient Brittany Maynard. His is a well-reasoned argument regarding the intersection of theology and politics, written in response to Matt Walsh’s Blaze piece titled “There is Nothing Brave About Suicide.” Both pieces are a reminder that, in the ongoing debate over whether or not Maynard has the right to schedule her own death, little has been said regarding the role the medical profession plays in the battle to “Die with Dignity.” Walsh argues:
None of us get to die on our own terms, because if we did then I’m sure our terms would be a perfect, happy, and healthy life, where pain and death never enter into the picture at all.
It’s a simplistic comment that ignores a very real medical fact: Death can come on your own terms. And that doesn’t have to mean suicide.
My mother was a nurse for 20 years. During that time she worked in a variety of settings, from hospitals, to private practice, to nursing homes. Much like Jennifer Worth, the nurse and author of the Call the Midwife series, my mother practiced at the end of Victorian bedside nursing and the dawn of Medicare. As a result, the abuses she witnessed in the name of insurance claims were grotesque. For instance, if a patient required one teaspoon of medication, an entire bottle would be poured into the sink and charged to that patient’s insurance company. This was just the tip of the iceberg of unethical practices that would become priority in the name of the almighty “billing schedule.”
Recently, my wife approached me with the unwelcome news that our health insurance plan — which we like — will likely be cancelled next year. Her employer, a healthcare provider, generously provides benefits even for those working part-time. Due to the devastation wrecked upon the industry by Obamacare, they anticipate the need to drop coverage for all employees working less than 60 hours per pay period. My wife works 56. Since my employer’s offering proves virtually worthless, far too expensive for far too little coverage, we will be left effectively uninsured.
We may consider Samaritan Ministries as an alternative to insurance. Resembling the mutual aid societies which were common throughout America before the rise of the welfare state, Samaritan Ministries operates as a “health care sharing” service. Here’s how it works:
Each member commits to sending a set “Share” amount each month. These “Shares” are sent directly through the mail from one household to another, to the members with “Needs”. Samaritan Ministries uses a database that randomly matches Shares to Needs, so that the Sharing is coordinated and Shares go to the appropriate members with Needs.
Born to a world dominated by employee-provided health insurance, we may find the notion of health care sharing bizarre or even suspect. But is it really any more odd than our rapidly corrupting government?
It’s with some irony that a Christian ministry has essentially gone Galt. While Ayn Rand may have balked at the religious context in which Samaritan Ministries operates, she also may have tipped her hat at their defiance of convention.
The service “even satisfies the Federal health care law’s (Affordable Care Act) requirement that you have insurance or pay a penalty-tax (see 26 United States Code Section 5000A, (d), (2), (B)).”
Would you consider a health care sharing service like Samaritan Ministries? How might the business model be applied to other needs?
By now you may have caught the LIBRE Initiative report of President Obama telling a town hall audience to consider cutting personal expenses to afford health insurance under the [Un]affordable Care Act. Here’s the quote:
[Obama] responded to a question received via email, from a consumer who makes $36,000 per year and cannot find insurance for a family of three for less than $315 per month. The President responded that “if you looked at their cable bill, their telephone, their cell phone bill… it may turn out that, it’s just they haven’t prioritized health care.” He added that if a family member gets sick, the father “will wish he had paid that $300 a month.”
Imagine a Republican politician saying the same thing. The leftist media would go apoplectic.
While that may appear to be a partisan double standard, the truth has more to do with ideology than parties. A Republican telling people to prioritize healthcare expenses over their cable or cell phone would likely do so in a free-market context where such priorities would serve the consumer’s individual interest. Obama, by contrast, asks people to sacrifice for the sake of others.
Obamacare depends upon its mandated enrollments to fund its mandated benefits, a process designed to redistribute wealth. Since paying for others is considered morally superior to paying for yourself in Obama’s worldview, he advises cancelling your cable or cell phone to pay for Obamacare. A Republican offering the same advice in a free-market context would be castigated not primarily for the notion of prioritization, but for the notion of self-reliance. Prioritizing to benefit yourself — bad. Prioritizing to benefit others — good.
The philosophical underpinning of Obama’s comment is altruism, the idea that you exist for the sake of others. The countervailing idea, that you exist for your own sake, is egoism. Obama gets away with his comment not because he’s a Democrat so much as because our culture embraces altruism and bristles at egoism.
Critics of the president would do well to focus on that point rather then the “audacity” of suggesting families might need to prioritize one expense over another. Indeed, families will always need to prioritize one expense over another. That’s part of being an adult in the real world. An alternative to Obamacare should not promise a world without prioritization, but a world where the priorities which individuals choose redound to their own benefit.
Every once in a while, I tune into the local lefty talk station to satiate my mild but persistent masochism. I made it through about ten minutes recently, including commercials. Somewhere in the mix I heard mention of a recent study conducted by advocates of a single-payer socialized healthcare system which claims that over 17,000 people will die unless states expand Medicaid.
Forbes does a decent job of debunking the Harvard/CUNY study. But I don’t need Forbes. I don’t even need to look at the study. I know the claim proves false on its face, because it defies objective reality.
Saying people will die unless states expand Medicaid is like saying your neighbor will starve unless you buy his lunch. It proceeds from a worldview which regards people as houseplants, wholly dependent on external care. My neighbor does not need me to feed him. He needs to obtain food to feed himself. Indeed, if my neighbor needs me to feed him, it can be said that I need him to feed me, in which case we’re both right back were we started.
You know who will die unless they are fed? Prisoners.
Prisoners need to be fed, because they lack the freedom to pursue sustenance on their own. Perhaps that lends some credibility to the study’s claim. Since our healthcare system makes it impossible for people to seek care in a market driven by individual judgment, we just might need the slop doled out by the state.
Jay Michaelson’s whining critique of the conservative slam of Pajama Boy is all at once nerdy, narcissistic, and self-defeating, illustrating the dark void that is the nomenklatura Manhattanite liberal Jewish American psyche. (Go on, say it three times fast.) It leads me to ask: Is there anything liberals won’t do to emasculate themselves in deference to Big Government?
Uh-oh, I said “emasculate.” I must be “unconsciously” sexist now.
In defense of his thesis that conservatives are latent antisemites because Pajama Boy looks Jewish (try to choke down your offense at that one), Michaelson cites research done by Daniel Boyarin (an academic who has no qualm comparing the Israeli government to Nazis) and Sander Gilman. Gilman, who has contributed to the catalog of study regarding Jews and race, has also written on Karl Marx’s own antisemitism. And here’s where a 5 minute Google search becomes vastly entertaining: It would appear that Michaelson falls into the very pit of Marxian, Jewish self-hatred about which Gilman has written. In fact, Marx’s obsession with Jewish physiognomy is the same as Michaelson’s fixation with Pajama Boy’s physical appearance, sexuality, and mode of dress down to eye wear, all of which he cites as evidence of “Pajama Boy’s obvious Jewishness”.
As for all of you straight-haired, unquestionably sexual, well-dressed Jewish men with no glasses, you stand as much of a chance at pulling off your Jewishness as Miley does twerking her way into the soul train.
Set aside any feelings of offense at this video for just a moment.
Now imagine with me. Instead of gay men in their underwear, we have the Marlboro Man out on the open prairie. With the Star of Bethlehem twinkling in the night sky, the Marlboro Man passes out cartons of cigarettes to his young cattle hands. In the background we hear a gruff old voice singing, ”Before the doctor brings a lump of coal, get enrolled, get enrolled, get enrolled…”
Then again we could have a chorus line of Biggest Loser contestants all stuffing triple-stacker hamburgers in their faces, dripping catsup down their ugly Christmas sweaters. Everyone juggling and gulping to the chorus of doctors singing, “Pre-existing conditions won’t stop ‘em…whether silver, bronze or gold… get enrolled, get enrolled, get enrolled…”
Or would you prefer prancing women, scantily clad, seducing men while their pimps holds up the mistletoe?
Out2Enroll is stereotyping gay men, stripping them down to nothing more than their sexuality in this video. A promiscuous gay lifestyle can be deadly. Most of us don’t encourage unhealthy behavior in the people we love, whether it’s risky sexual behavior or smoking. Who gives their favorite diabetic aunt a pound of chocolate and coupon for insulin for Christmas?
Then again, that’s exactly what cultural Marxism does; it destroys the very people it claims to help.
I realize that Melissa Harris-Perry’s little stunt on MSNBC, comparing the word “Obamacare” to the “N” word, was just that — a feeble attempt to get anyone with a pulse to watch her network and click on the website. After all, most of the network’s anchors have been banished to broadcast outer darkness for crimes against human decency and the channel’s longstanding tradition of desperation is quickly devolving into pathological, endless mortification.
But I wonder if there isn’t some merit to the point Harris-Perry was making before she launched into a prurient soliloquy on Obama Her Savior. After all, in any honest word-association test, most rational Americans would think first of words like debacle, disaster, and fraud when confronted with the realities of Obamacare. Aside from the failures of the website, it is an attack on 1/6 of the economy, the results of which we have not yet seen, and it is also in the process of destroying and dismantling the best, most innovative healthcare system the world has ever known. Not only that, it has eroded Americans’ faith in government and attacked the fundamental structures of our constitutional republic, destroying religious liberties in the process. Not to mention the coming Medicaid timebomb. As Harris-Perry said, “The Affordable Care Act will loom large in the president’s legacy as the singular accomplishment of his two terms,” adding that he is “playing to win.”
Harris-Perry said the term Obamacare was meant to “shame and divide and demean.” I say that Obamacare itself shames and divides and demeans. And so I call on the FCC to force all broadcasters to bleep the word Obam#!@$e from now on. No one should be permitted to speak this treasonous word on the airwaves from this day forward. The FCC bans “profane” language between the hours of 6 a.m. and 10 p.m., defining profanity as “including language so grossly offensive to members of the public who actually hear it as to amount to a nuisance.” I’d say that “Obamacare” undoubtedly fits within the boundaries of that definition. We should also vow to stop using Obam#!@$e in its original form in print and online media.
If Ohio Governor Kasich could issue a proclamation banning the letter “M” in the state due to the rivalry between the Ohio State University Buckeyes and the Michigan Wolverines — Kasich noted that U.S. Fish and Wildlife is considering adding wolverines to the threatened species list — the FCC ought to be able to ban the word that is threatening our health care and our very liberty, which amount to far more than a “grossly offensive nuisance.”
Here’s the latest chapter in The Vast Right-Wing Conspiracy.
According to Forward Progressives:
There’s a saying that goes, “If you can’t win, cheat like hell” and it’s apparently the motto that the GOP has taken to heart across the country in their latest attempts to sabotage the Affordable Care Act.
What does their newest attempt involve? Creating fake websites with misinformation that look like state insurance exchanges in order to confuse consumers trying to find out what their new insurance options are under Obamacare.
Forward Progressives cites three websites recently shut down by the Kentucky Attorney General’s Office, including kynect101.com, which, according to the Kentucky AG, was “deceptively similar to kynect.ky.gov, Kentucky’s official health insurance exchange website….[S]ome consumers attempting to locate the site through search engines were being deceptively steered to the kynect101.com website instead of kynect.ky.gov, where they were provided false information about their options under the federal Affordable Care Act, including being informed that there were no plans with federal subsidies available to offset a portion of their insurance premiums.”
In a conspiratorial whisper, Forward Progressives blames Republicans. And what passes for proof with this crowd?
“f you were running a sabotage campaign, why not run it in a state with a fully functional health insurance exchange site and (not coincidentally) a GOP Senator who is facing a battle for re-election both from Democrats as well as from within his own party?
So apparently, as this conspiracy theory goes (if I’m following it correctly), because Kentucky is operating one of the only (mostly) functioning state exchanges in the country, Republicans, wishing to protect Senate Minority Leader Mitch McConnell’s immense Power to Control Everything have been running around creating bogus websites that would not only give Kentucky residents misinformation about their insurance options under the exchanges, but would also potentially leave their personal data in the hands of hackers. (Which, thank goodness, is totally unlike the actual Democrat-created marketplace website that gives Americans misinformation about their insurance options and leaves their personal data in the hands of hackers.) And Republicans have been doing this “across the country” according to Forward Progressives.
And you thought Bush Derangement Syndrome was bad? Progressives, usually content to wait a few years to start their revisionist history, are now revising on the fly. In their alternative reality, they’ve found a way to blame Republicans for (arguably) the most epic website failure in the history of the internet.
[Note to Sen. McConnell’s campaign: After the site was banned by the Kentucky AG, http://kynect101.com is once again available on Go Daddy for the low, low price of $69.99 plus commission.]
On Friday, Texas Senator Ted Cruz made his first appearance on the Tonight Show with Jay Leno. Leno, allegedly in his last season as host of the Tonight Show, has not been known as a particularly partisan entertainer, so it was surprising to see him go “Candy Crowley” on Ted Cruz. You may recall that CNN’s Crowley, who moderated a debate between President Obama and Mitt Romney, became part of the debate when she began reciting (false) White House talking points on Benghazi. Some on Twitter compared Leno to a prosecuting attorney as he interrupted Cruz and accused him of everything from shutting down the government to wanting violent psychopaths to have guns.
Cruz, for his part, used the appearance to his advantage, clearly understanding both the venue and the audience. Although Cruz is certainly more than capable of holding his own in a debate with Leno, he chose mostly to keep his powder dry, defying the media-generated image of him as a hostile aggressor. He was relaxed and laid back, despite the tough questioning. It seemed to go over well with the audience, which erupted into cheers after several of Cruz’s points.
It’s interesting to go back and watch Leno’s interview with President Obama from this past August and compare the questions and tone with Leno’s interview with Cruz last night. The most obviously noticeable difference is how often Leno interrupts Cruz compared to Obama. Leno lets the president finish nearly every answer. Even when Obama lapses into “um…uh….uh…,” Leno patiently waits for Obama to continue.
There is a stark contrast in how often Leno uses the pronoun “you” when questioning Cruz. Also, Leno speaks about policies and events as if the president has nothing to do with them.
On the following pages you can read the questions side-by-side. Where a question is preceded by dashes (- – ), it means Leno interrupted the interviewee.
If you own a home, you may be familiar with force-placed homeowners insurance. Basically, in order to protect their interests, your mortgage lender usually has the right to force you to purchase homeowners insurance. That way, if there is a serious loss of property — say the house burns to the ground — the lender does not have to absorb the loss. The insurance company assumes the risk. As a homeowner borrowing money to purchase a home, you are not permitted by your lender to assume the risk yourself — in most cases you are forced to purchase homeowners insurance that meets certain requirements. You’re allowed to purchase insurance on the open market and rates are fairly reasonable — unless you let your policy lapse for some reason. Then the mortgage lender has the right to force-place homeowners insurance on you, and the policy they choose may be a lot more expensive than the policy you chose for yourself. You consented to the possibility of a force-placed policy when you (probably mindlessly) signed the two-inch pile of papers at closing.
This actually happened to our family when we purchased our home. We had shopped around for the best price and best policy to fit our family’s needs and, as we did with our previous home, we planned to pay for it out of an escrow account, so it was combined with our mortgage payment. Somehow, there was a paperwork mix-up and the mortgage company never paid the premium, resulting in cancellation of the policy. A few months after we moved in, we suddenly found that we had been force-placed into a high-cost homeowners insurance policy chosen for us by our mortgage company. It was three times the cost of the policy we had chosen, but because our policy had lapsed, the lender had the right to force-place us into another plan. Eventually, we were able to drop that policy and get back to the one we wanted, but it was not an easy process.
President Obama wants you to understand what he really meant when he said you could keep your health insurance plan under Obamacare. The Washington Post reports:
Fact-checkers and journalists have ruled that Obama wasn’t being truthful when he claimed that people who liked their insurance could keep it. Obama during a speech in Boston sought to cast the issue Wednesday as trying to weed out “bad apple insurers” who don’t provide enough coverage.
“One of the things health reform was designed to do was to help not only the uninsured but also the under-insured,” Obama said. “And there are a number of Americans, fewer than 5 percent of Americans, who’ve got cut-rate plans that don’t offer real financial protection in the event of a serious illness or an accident.
“Remember, before the Affordable Care Act, these bad apple insurers had free rein every single year to limit the care that you received or used minor pre-existing conditions to jack up your premiums or bill you into bankruptcy.”
In other words, if President Obama likes your plan, you can keep it. This slight revision to his previous claim should be embraced on account of it serving your best interests, the president claims. Before Obamacare, those pesky insurance companies were providing you with precisely what you contracted for and not a penny more. Our national savior can’t have that.
It would have been nice if the president had led with this message from the start. Certainly, those of us who understood Obamacare when it was proposed knew that liking our plan would not necessarily mean we could keep it. After all, that’s the whole point of passing a law, interfering in chosen behavior. You don’t need to pass a law to let people keep what they have. You just need to leave them alone.
Canada has death panels – and that’s a good thing. So reads a headline at Slate, where author Adam Goldenberg defends letting a government committee intervene in healthcare to decide who lives and who dies.
The death panel Goldenberg refers to is Ontario’s Consent and Capacity Board, a unique institution among Canada’s jurisdictions which holds the legal authority to supersede healthcare decisions made by next of kin when a patient lays incapacitated.
The Supreme Court of Canada recently ruled in favor of a family seeking to sustain the life of Hassan Rasouli, who fell victim to complications from brain surgery and has remained comatose for three years. Goldenberg writes:
In Canada, with our single-payer health care system, Rasouli’s situation has a very public bottom line: Should taxpayers foot the bill for his family’s indefinite goodbye?
But American critics of Canadian health care will declare that merely asking this question is unacceptable, unethical, even unthinkable—and that it proves that the Canadian system gives doctors a dangerous incentive to kill off their patients as quickly as possible. They are wrong. The Hippocratic Oath’s promise to do no harm still applies. But they are also only wrong in part. When taxpayers provide only a finite number of acute care beds in public hospitals, a patient whose life has all but ended, but whose family insists on keeping her on life support, is occupying precious space that might otherwise house a patient whose best years are still ahead.
The incentives in the American health care system point in the opposite direction. In the United States, keeping an all-but-dead patient alive on life support in a hospital bed generates income for the hospital, for as long as its bills get paid.
Everything wrong with the Left’s view of economics, morality, and healthcare in particular can be observed in that passage. Goldenberg’s analysis ignores any consideration of individual rights.
The Dispatch reported last week:
House Republicans are preparing to potentially sue GOP Gov. John Kasich over taking Medicaid expansion to the state Controlling Board, and they would base their lawsuit on the arguments laid out in a formal protest they filed yesterday. Thirty-nine GOP representatives signed a letter in protest of Kasich’s plan to ask the seven-member legislative-spending oversight panel on Monday to approve $2.56 billion in federal money over two years to cover about 275,000 more poor Ohioans under Medicaid. They said Kasich’s maneuver will circumvent the “clear intent of the General Assembly,” a violation of Ohio law.
Kasich has been obsessive in his desire to use Obamacare funds to expand Medicaid in the state, bringing cheers from the left and infuriating conservatives. The Ohio governor has repeatedly used God as his wingman in his quest to shove the program through the legislature — unsuccessfully. Kasich has (for now) become the darling of the left for his single-minded determination to expand the welfare rolls in Ohio. Many are speculating that Kasich is positioning himself for a presidential run that will focus on independent voters. Others think his shift to the left will appeal to moderates in his re-election bid. Still others say Kasich really believes that God has put him in the position to use the power of the state government to help the poor. It may be all of the above.
“You don’t have to say any more prayers about that. We are going to expand,” Kasich told Medicaid-expansion advocates Friday.
Why is it some people don’t get it?… It’s probably because they don’t understand the problem. … Can you imagine being in a position where you have no health insurance?
With this recent move Kasich has upped the ante, creating a constitutional crisis over the separation of powers. Kasich had originally included the Medicaid expansion in his state budget. The legislature stripped it out and then added language prohibiting the state from expanding Medicaid in the final budget sent to the governor. But Kasich struck that language from the budget with his line-item veto. Remaining in the budget after all the changes is a section authorizing the state Medicaid director to do the expansion. Republican legislators maintain that Kasich must receive the final legislative financial support to fund expansion, but Kasich has asked the seven-member Controlling Board, which usually does little more than transfer funds between accounts, to authorize accepting the federal funds to expand the program — though there are no guarantees that the federal government would continue to fund the program in future years, which means the burden of funding the program could suddenly shift to the state in the years to come.
The seven-member Controlling Board is made up of Democrats and Republicans appointed by House and Senate leadership as well as a Kasich appointee. The two Democrats and the Kasich appointee are thought to be a lock for Kasich, and Rep. Chris Widener is widely thought to be the Republican “yes” vote Kasich needs for a majority.
This week, there are pats on the head for Ted Cruz and Mike Lee as the pundits and their GOP establishment colleagues give them condescending “attaboys” for their courageous (but misguided) attempt to make the government listen to the American people. They’re not all that bright after all, the pundits imply. Not experienced in the entrenched ways of Washington. They need to learn their place — to stay in the shadows until they’ve been in Washington for a dozen or so years and have been inculcated with the proper D.C. values. Observe the masters like John McCain and Mitch McConnell and, in time, perhaps they too can be like the Great Bipartisan Sages of the Senate. The strategists all warn that the Republicans must have a unified message. “Can’t we all just get along?” they ask.
The problem is that you can’t have a unified message when you have two creatures living in one body — either Dr. Jekyll or Mr. Hyde must ultimately prevail. At the end of Robert Louis Stevenson’s The Strange Case of Dr. Jekyll and Mr. Hyde, Jekyll, who can no longer stop himself from turning into the evil Hyde, writes in a letter, ”I bring the life of that unhappy Henry Jekyll to an end.” Is it also time to bring the unhappy life of the Democrat-lite GOP to an end?
Michael Gerson, in his post-mortem of the shutdown debacle, made it clear that he thinks one side of the GOP is sane and reasonable and the other is completely off the rails. The establishment wing of the party, according to Gerson, “believes in building a legislative majority and electing a president to overturn it.” It’s all very civil and collegial. And it involves a lot of waiting around “for the next election” as the consultants and lobbyists line their pockets and the left continues its long, steady march across the Constitution and our individual liberties.
On the dark side, we have the conservatives. Gerson says,
[T]ea party leaders inhabit an alternative political reality — sheltered in safe districts or states, applauded by conservative media, incited (or threatened) by advocacy groups, carried along by a deep current of anger and frustration among activists — they have no incentive to view defeat as defeat. In fact, turning against tactical radicalism would involve serious political risk. So every setback is interpreted as a need for greater purity and commitment.
This is the same old “clinging to their God, guns and religion” tripe we heard from Obama, only cloaked in a stuffy D.C. political analysis, but it shows the divide between the Washington ruling elites and those who believe that not everything can be solved in Washington — that the entrenched ways of Washington are actually the problem.
Michael Bauman recalled this week a pivotal moment in John McCain’s presidential campaign, when he was ahead in the polls and left the campaign trial to rush back to Washington to deal with a financial crisis. Bauman writes:
But just like his Democratic opponents, when things got bad, McCain turned to government and returned to Washington. He could never convince the American voters that Washington is the problem because he didn’t believe it himself. He believed Washington is the solution. He still does. So does the Republican leadership in the Senate and the RNC. Do not expect him or them to beat the Democrats. They share the Democrats’ ideology and solutions. The difference between them and the Democrats is one of degree, not of kind.
So how’s that HealthCare.gov working out for you? To hear Kathleen Sebelius, secretary of Health and Human Services, talk, the website is just humming along and everything is peachy. (I’m sure all Americans breathed a sigh of relief when they found out the Obamacare enrollments would continue unhindered during the Great American Shutdown of 2013.)
Sebelius joined a panel at the Columbus Metropolitan Library this week to discuss Obamacare’s impact in Ohio. She said her trip to the state was part of the “final phase” of implementing the law. I thought the final phase was when you gave your grandma the pain pill instead of letting her have the heart operation, but maybe that’s the final final phase of Obamacare.
Anyway, the HealthCare.gov website has been widely criticized since its October 1st launch with complaints of long wait times, crashes, buggy architecture, and security concerns. Sebelius addressed some of those concerns during the panel in Columbus.
“There is no question the website had a rocky start and I am first to say we wish it could have been a lot smoother from day one,” Sebelius said. “I can tell you it’s a whole lot better today than it was two weeks ago and HealthCare.gov, the website, is up and running. It will get better each and every day.”
Sebelius defended the decision not to delay the launch of the obviously not-ready-for prime-time website. “I think people have waited for decades for affordable health care,” she said. “We had a responsibility to get that product to them as quickly as possible. Waiting for another season would be totally unfair to those who have been desperate for affordable health care.” The subtle message seems to be that it’s better — more fair, even — to have crappy government services that don’t actually work than no services at all. This is the best we can aspire to in America in 2013.
Just when you thought the intentional infliction of public pain during the partial government shutdown could not possibly get any worse, the Obama administration is now threatening dead people:
Each national cemetery will conduct a reduced number of burials each day. This could cause some families to pay for storage of their loved ones’ remains until burials can be scheduled. Although there may be possible delays in scheduling internments [sic], NCA will continue to provide services to our Veterans and their families during their time of need with the utmost dignity, respect and compassion.
The VA says it will run out of money in late October and will begin to implement its “lapse in appropriation shutdown plan,” furloughing up to 1,063 of 1,809 National Cemetery Administration (NCA) employees. A Veterans Field Guide to Government Shutdown, posted on the U.S. Department of Veterans Affairs website, lists interments under “Services to Veterans Impacted by a Lapse in Appropriations,” saying “Interments at National Cemeteries will be conducted on a reduced schedule.” (Incidentally, the “play” and “pause” buttons on the Veterans Field Guide are not operational — has the Canadian programmer group hit again?)
Sean Baumgartner, director of the Ohio Western Reserve National Cemetery in Rittman, said there will be a “reduced interment schedule” at the Ohio cemetery. Ohio Western Reserve Cemetery (where my husband’s grandfather is buried) ordinarily conducts eight or nine burials a day. Last week there were 17 burials on Monday. The NCA will restrict the number of interments to eight per day at mid-level cemeteries if the shutdown drags on beyond the end of October.
Yesterday, on Fox News Sunday, Juan Williams said he thinks he knows how to end the ongoing gridlock over the partial shutdown of the federal government and the debt ceiling. Williams said the business community should get involved, suggesting that strategic campaign donations could persuade moderate Republicans — like Susan Collins and John Boehner — to “be reasonable.”
Republicans are imploding and what they have — and I think is really key — it’s not just the markets, it’s the business community that needs to reassert itself inside the Republican Party, so that people like Susan Collins, people even like potentially John Boehner, could see that there’s some political powers from money that comes forth to Republican moderates in this fight and that people want him to be reasonable and not simply listen to the far right wing that right now is dominating the Republican Party and driving them over the cliff [emphasis added].
So has Williams finally seen the light on the 1st Amendment? Because just a few months ago he was blaming the Supreme Court — and the Citizens United decision — for the IRS targeting of conservative groups. He complained that the court’s decision unleashed unlimited “dark money” contributions to influence elections:
The calculating, big money players have long wanted to keep their donations secret. Citizens United allowed them to give all the money they wanted without having their names attached to it. … They don’t want to deal with the public fall-out of being seen as a puppet master pulling the strings of the politician they helped elect with their contributions. They don’t want to be seen as supporting corporate welfare or the gutting of labor and environmental regulations or any other unpopular causes that will line their corporate coffers.
Are we to believe that Williams now wants corporate “puppet masters” to pull some strings with “dark money” donations to keep the “far right wing” from driving the Republican Party over the cliff — out of the goodness of his heart?
Why, the man is a veritable Karl Rove — get him a white board!
This week, Ohio Governor John Kasich’s administration asked the seven-member Ohio Controlling Board to appropriate federal Obamacare funds for the purpose of Medicaid expansion, bypassing the state legislature.
The Obama administration approved Ohio’s request to amend its Medicaid program so that people making up to 138 percent of the federal poverty level ($32,499 for a household of four) would be covered. The state’s Medicaid director, John McCarthy, submitted the request Sept. 26 with a corresponding request for the Controlling Board to appropriate the federal funds without the approval of the Republican-controlled legislature, which has stalled Kasich’s plans for Medicaid expansion.
The Controlling Board consists of the chairs of the Senate and House Finance Committees (currently Republicans) and a Republican and Democrat from both houses. The director of the OMB (a Kasich appointee) serves as the board’s president. Generally, the board’s duties include transferring funds between line items or fiscal years, allowing for emergency funding, and approving grants and loans made by the Department of Development. There is speculation that the two Democrats and the Kasich appointee would vote for the Medicaid expansion, so Kasich would only need to secure one additional Republican vote to win approval from the board. Senate President Keith Faber, a Republican, said he believes Kasich has the authority to turn the decision over to the Controlling Board. “I’m certainly a defender of legislative rights, and I would think a better solution would be a legislative option, but the governor does have that authority,” he said.
However, questions remain about the authority of the board. The Ohio Revised Code prohibits the Controlling Board from carrying out any action “which does not carry out the legislative intent of the general assembly.” But Kasich spokesman Rob Nichols justified the action, saying, “Only the General Assembly can authorize Medicaid to spend funds in this way, either through a bill or the Controlling Board.” Kasich, vacationing in Europe, was not available for comment, the Dispatch reported.
Ohio Lt. Governor and Insurance Director Mary Taylor told a group of small business owners on Wednesday that the state insurance office struggled to send information about Ohio’s health plans to Washington by computer this summer and they began bracing for problems, the AP reported. “This is what we expected,” she said of the “glitches” with the website for the federal exchanges. Ohio chose not to set up a state exchange, instead directing eligible citizens to the federal exchanges.
Taylor told Ohio members of the National Federation of Independent Business that while exploring the federal health exchange website she experienced the same problems that many consumers have reported. “I’ve been on,” Taylor said. “The note that comes up to be patient, high volume — experiencing high volume of users. You know, it is frustrating.”
Taylor’s office is suggesting that people try the new website during off hours. “Maybe if we all get up at midnight and try to get on the system — well, if we all do, it won’t work,” Taylor quipped to the business owners.
Taylor, a frequent critic of the Affordable Care Act, also said she doesn’t know how many Ohioans have enrolled in the federal exchanges because Washington is running them.
On October 4th, Taylor and Ohio Attorney General Mike DeWine warned of scams associated with the new exchanges.
A Programming Sutra
This is the way I heard it. (That’s the way all sutras start.) Long long ago — about 1997 and I’m not naming names to protect the innocent and because I figure the statute of limitations is up for the guilty, and the company I’m going to talk about has been through bankruptcy and several acquisitions so it’s not the same company anyway — a major toy retailer ToysForKids (TFK) with stores in malls all over America heard about this nifty new thing called “the web.” As I heard the story, two programmers in IT had the idea that TFK should be selling toys on the internet. They got permission to do a sort of side project, semi-bootleg, to build a demonstration e-commerce web site, ToysForKids.com. (By the way, that domain name is now owned by a domain-squatter in Hong Kong called “iGenesis Limited”, but then ToysForKids never existed anyway.)
They built the web site on a desktop server using a scripting language called
tcl, and demonstrated it. It looked so good they got permission to take it live, and they happily started making dozens of sales a day with it. It really was a lovely site, too, won lots of awards.
The CIO was so pleased that he arranged a demo for the CEO. The CEO was so pleased that he arranged a big advertising buy for Thanksgiving Day during the football game — as I recall, $50 million — so that everyone would know about the new ToysForKids.com.
Everyone did. And everyone’s mom, wife, and girlfriend that had a computer went and tried to start their Christmas Shopping sometime in the first quarter.
Now, remember this is 15 years ago. The desktop server they were using wouldn’t make a good iPad now, and the Internet connection, while good for the time, had less capacity than Comcast promises me.
And everyone who was bored with football and had computer access was trying to use it. The site pretty much melted down; it wasn’t long before the programmers had found different jobs, the CIO wanted to spend more time with his family, and the CEO, um, retired.
Having followed the debate over the Affordable Care Act fairly closely over the last few years, I was curious about the insurance plans being offered under the federal exchange in Ohio. Actual hard numbers have been hard to come by; it seems like they’ve been a more closely guarded secret than the codes to launch the nation’s nuclear warheads. I tried to log on to the site on October 1st, the day the “Marketplace” launched, but after several unsuccessful attempts, I gave up. Today I decided to try again.
I went to www.healthcare.gov and chose “Ohio” from the drop-down menu. Just like visiting a government agency in person, I found that I would be required to wait in line — albeit a virtual line. Take a virtual number.
After about 30 minutes, I finally made my way to the front of the line. My number was called and I was invited to create an account — a user name and password. The instructions said that the user name and password were case sensitive. I followed the instructions and checked my email for the link to authenticate the new account and then tried to sign in. The system did not recognize my user name and password. I knew they were correct because I had copied and pasted them into my clipboard so I’d have them handy. I tried a couple more times, but each time I was greeted by a message saying that the information I had entered was invalid.
At least we dodged this bullet. For now.
The entire continuing resolution impasse has been mostly intense and gloomy, so we have to appreciate anything that provides a moment of levity. Two hours before the government shutdown at midnight on October 1st, this cryptic warning appeared on Twitter:
In 2 hours and 20 minutes, American Pants shutdown will begin. #noBudgetNoPants
— MyWhiteNinja™ (@MyWhiteNinja) October 1, 2013
Josh Barro from Business Insider warned about possible unintended consequences.
— Josh Barro (@jbarro) October 1, 2013
We learned about the new disaster management plan:
— Aaron Cynic (@aaroncynic) October 1, 2013
At midnight, the group Anonymous made #NoBudgetNoPants official (and also made it trend on Twitter):
Your government has just shut down. It's time to show them how you feel – and us what you've got! #NoBudgetNoPants
— Anonymous (@YourAnonNews) October 1, 2013
Hang your pants outside your car and house windows. #NoBudgetNoPants
— Anonymous (@YourAnonNews) October 1, 2013
More unintended consequences:
— Arif Baradia (@_sawbones_) October 1, 2013
This guy has a point.
Despite the hype, it was just a normal evening at home for many followers of Anonymous and Occupy:
Now I'm just laying around pantsless watching Netflix. This has gone from "a protest" to "a normal evening." #NoBudgetNoPants
— TheRealestWaldo (@TheRealestWaldo) October 1, 2013
#NoBudgetNoPants — but then, I dont know how thats different from any other day for me.
— Joanna Blackhart (@MsBlackhart) October 1, 2013
Helpful hygiene tip:
— An0n_Z3r0 (@Anon_Z3r0) October 1, 2013
This guy makes a good point:
I hate to be that guy, but the #NoBudgetNoPants hashtag doesn't make any sense. By that logic, we should've been pantsless for years now…
— Josh Hammer (@josh_hammer) October 1, 2013
The other day I tweeted something about Sen. Cruz’s strategy to defund Obamacare and a friend tweeted back, saying that Republicans need to do more than oppose Obamacare — they need to propose alternatives. Of course, this is true, though it’s not a completely fair criticism. It’s not that Republicans haven’t proposed any solutions, rather, they have communicated their ideas poorly. Instead of succinctly communicating the benefits of free-market, consumer driven solutions to the individual and the family, Republicans often focus more on how their ideas will reduce costs or make the market more competitive — as if they are more concerned with helping the market or the national debt than the individual.
One example is the concept of Health Savings Accounts (HSA), which are tax-advantaged savings plans available to individuals enrolled in low-premium, high-deductible health insurance plans. Employers love them because they help to rein in costs and many families find that they cost less than traditional insurance plans.
But they’re hard to explain.
Sometime during the long night of Sen. Ted Cruz’s speechibuster®, Sen. Rand Paul made some remarks (in the form of a question, as required by the Senate rules) about HSAs:
Why are the health savings accounts important? Because you can save money tax-free, you can carry it over from year to year, and then you can buy higher deductibles. So contrary to what people think, it may be counter-intuitive to some people, the way to fix health insurance is to have higher deductibles, because what does that mean? Cheaper insurance. You want cheaper and cheaper insurance. As you have higher deductibles, you have cheaper insurance. When you have cheaper insurance, you have all this extra money that you can use to pay for day-to-day health care. When you do that, what happens? You drive the price of health care down. I know that is exactly right. As you increase deductibles, as you get the consumer involved in health care, your prices go down.
May I suggest that when you’re trying to promote an idea or market a policy, you generally want the reaction to be something along the lines of, “It sounds good on paper, but what’s the catch?” or “That sounds too good to be true!”