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View Diary: Maneuvering in the middle on fiscal cliff is still veering too far right (189 comments)

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  •  Yeah, because Medicaid is a death sentence for man (6+ / 0-)

    y. Good luck finding, e.g., a urologist or cardiologist that will even see Medicaid patients.

    And for all the Punditpeople who are so happy about shoving the old and weak worker or fellow American of any sort or personal history into Medicaid "nursing homes," I hope and pray that each and every one of them encounters a life change that puts THEM "on Medicaid," so they can enjoy the kindly attentions that for-profit-drive Sad Sack nurses and aides and CNAs in those hellholes will "afford" them. And of course the "drive-by doctors that specialize in Medicaid "patient care." I'm a nurse, and would be happy to hear other nurses' horror stories of what goes on in the way of "care" in UNsurance-land and state-experiment Medicare.

    And why are so many so happy to be excusing Obama and his hit men in advance for "getting the best deal that was available?" It sure looks like a sellout and a good start on the demolition of the New Deal, which is what the shitheads on the Rich Right have been wanting since they failed to kick FDR out with a coup back in 1933.

    He just signed off on $651 billion for "defense," that enormous fraud, and another half a trillion is out there on off-books fun money for the war-gamers to play with. Focus, please?

    "Is that all there is?" Peggy Lee.

    by jm214 on Tue Dec 11, 2012 at 08:33:49 AM PST

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    •  Couldn't have said it better myself, and I'm real (1+ / 0-)
      Recommended by:

      sure we come from very different angles politically.

      We've been so busy congratulating the administration for getting ACA pass, we've ignored that the real problem is that American health care is rotten (and expensive) to the core.

      That problem wasn't addressed, which is too bad, because there really is no need for Medicare and Medicaid as special programs if health care is made rational.  

      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

      by dinotrac on Tue Dec 11, 2012 at 09:01:37 AM PST

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      •  Gee, and what do you mean by "rational?" Privat- (2+ / 0-)
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        tsk, whaddaya

        ize everything?

        Maybe I should run my tape about how much of my time I spend, every day, trying to get the people I try to provide actual CARE for past the default "deny coverage" phalanx of gate-keepers in the Private Unsurance business? Formulary games, "stepped therapy," a whole range of "prior authorization" tricks and scams? How about the "donut hole?"

        There's no getting any kind of "rational" actual health care, as opposed to just another money-grubbing, regulatory-capturing, fuck-over-the-weak-and-poor business model, if you "trust the dead hand of the market" to "fix things." It's the core sickness of our culture, especially the "business" culture.

        And yes, Medicare is a leaking tanker, with lots of "business" types unlimbering their power drills to make more holes to siphon the General Welfare out of. But as a caregiver and a participant, I KNOW IT WORKS. And you can never kill off all the corruption in our species, but there are lots of relatively straightforward fixes for the bad incentives and loopholes and scam-perations that are currently part of it. Medicare IS NOT THE PROBLEM. Stealing the last bit of security and comfort and mutual care from most people's lives, to fatten the lives of a very tiny few even further than they already are, is not any kind of an answer. It's a "I got mine and most or nearly all of yours too, so FUUUUCCKKKK-YOU!" to the rest of us.

        "Is that all there is?" Peggy Lee.

        by jm214 on Tue Dec 11, 2012 at 09:24:23 AM PST

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        •  By rational I mean a number of things: (1+ / 0-)
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          1. Moved away from employer-based benefits

          2. Move to a more collaborative model similar to what you might see at the Mayo clinic or in the military care system.
          The current insurance-driven "handoff to a specialist" system is terrible medicine and terrible for cost control.

          3.  Probably a deep dive into something resembling socialized medicine or, at the very least, away from pay per procedure model.

          4. As to private/public, I am a great believer in free markets, so wherever that can work, I am happy. We have nothing like that in health care, and I'm not optimistic that we could -- certainly not with so much being driven by insurance companies.  Even little things get in the way of that, however.  How many of us are prepared to make good market decisions when told we have cancer?  Even Steve Jobs, a very smart man with all the money in the world, screwed up on that one.

          LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

          by dinotrac on Tue Dec 11, 2012 at 09:43:42 AM PST

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          •  I'm not sure that's a great example ;) (0+ / 0-)
            Even Steve Jobs, a very smart man with all the money in the world, screwed up on that one.
            The stupid decisions that Jobs made had nothing to do with cost, availability of care (except, perhaps, to use his vast resources to venue shop to increase availability of a last ditch liver transplant), or "markets" so his situation doesn't seem like a very good example.

            His personal, and probably fatal, decisions seem to have been driven by a lack of acceptance of standard medical and scientific methods (this failing was consistent with some of his behaviors well before he was diagnosed with cancer as far as anyone knows).

            I doubt he was reimbursed a penny for his "alternative" care/strategies or that we would implement a system in the US within our lifetimes that would force a mentally competent adult to receive conventional medical care if they refused it.

            •  Point taken, but not so bad if you think about it. (0+ / 0-)

              Market theory presumes rational decision making, but we don't always react well to being told our life is in danger.

              Jobs had the financial resources to do whatever he wanted to, but was unable to make a rational health care decision -- something he admitted near the end of his life.

              How much worse it must be for somebody who's got to rob Peter to pay Paul, or just rob Peter and hope for the best.

              LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

              by dinotrac on Tue Dec 11, 2012 at 10:45:21 AM PST

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              •  Cute Peter-Paulism there. "Market theory" is (0+ / 0-)

                a lot of bullshit, from my perspective as a nurse and as a 66-year-old Vienam vet and father and grandfather who was an attorney for 28 years and has worked in and with a wide variety of businesses and for 14 years in state and federal government.

                It's the narrowest kind of strait-jacketing of the nature of human interactions, removing all the normative and emotional richness of how we really "deal" with each other. But it's a waste of time to argue the point: You have your beliefs, which I think I can fairly infer from your comments, and I have mine. And the Rich Shits who are riding us working folks into the ground are much enamored of "Market Theory" (with the portentous apotheothetic Initial Caps) to justify their own soulless way of life.

                I just got off the phone with a person with a slowly terminal disease, who has worked a long hard prudent life and now has to beg, for all kinds of stuff, while trying to dodge a "Market Theory" Juggernaut called the "donut hole." Cat food, or life-prolonging medicines: That's her "Market Theory" choice.

                Your "Market Theory" ignores, or actually lauds and justifies,  the beatitudinal and horrific realities at the far ends of the power-and-wealth scale, including the continued stripping of the little bits of wealth and security of those in the middle of the scale for the .

                I get VA health care and now qualify for Medicare, and have worked with all kinds of "health insurance" providers to try to obtain "care" for the patients I work with. Your set has nothing but sectarian contempt for "socialized medicine." I have nothing but contempt, and increasingly active hatred, for "libertarians," and Koch-suckers, and that whole bunch who are saddling us with the current load of long- slow- dying. Upward wealth transfer, a grand Henry Potter theft of all that's good, masquerading behind a film of pure fraud.

                "Is that all there is?" Peggy Lee.

                by jm214 on Tue Dec 11, 2012 at 12:28:20 PM PST

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                •  "My set?" (0+ / 0-)

                  Goodness, you haven't been reading my posts very well at all, then, have you?

                  I have said, quite explicitly, that I prefer a kind of health care approach like the one I group up with, which was military medicine, a form of socialized medicine.

                  LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                  by dinotrac on Tue Dec 11, 2012 at 02:28:53 PM PST

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