The State of Healthcare in America

We all know the healthcare system in the US is a mess. Our federal government is broken. And it seems there is a central character in our numerous problems: money. The privatization of prisons, hospitals, universities. It’s become not about people, but the almighty dollar.  Since when have hospitals been For Profit. I thought they were For Care of the Community. Instead we have board members, rich board members, who are getting paid to be on the board. They have no vested interest in whether people have healthcare. Doctors are overwhelmed by the paperwork required, and the limited time the insurance companies allow them per patient. Talk to your doctor, if you don’t believe me.

Ins No

From an article from the National Economic and Social Rights Initiative (NESRI).

“The market-based health insurance system in the United States has caused a human rights crisis that deprives a large number of people of the health care they need.  The most visible problem is the 32 million people without health insurance; the most distressing is the number of preventable deaths – up to 101,000 people per year – simply due to the way the health care system is organized.”

“Since social determinants, such as race, income and environment, strongly influence who becomes ill and who receives access to quality care, the health care crisis disproportionately affects disadvantaged groups and under-resourced communities, such as people living in poverty, people of color, and immigrants.”

Overall, the “health care crisis is the result of the privatization and commodification of the U.S. health system, which reflects market imperatives and profit interests that devalue human needs, dignity and equality.”

According to the article 45,000 people die each year simply because they have no health insurance.  That’s a lot of voters! Apparently since they are poor, non-white, and often, immigrants, our federal government doesn’t see them as citizens. It seems our government doesn’t see them as human.Some 700,000 families go bankrupt each year trying to pay their medical expenses. Even with insurance, high co-pays and exorbitant hospital costs, it’s not surprising , especially when a catastrophic injury or illness hits.  Yet in 2009 the five largest insurance companies had a combined profit of $12 billion. Some of that money could have been used where needed, not to line the pockets of those who already have enough. (There are no poor people on hospital boards.)We also now have fewer doctors and nurses than other high income countries (WHO 2007).  WHO projects a shortage of 44,000 primary care doctors within the next 15 years (WHO, Health Affairs 2008). Fewer doctors because there is too much paperwork and not enough healing. According to an article from 2016 from Forbes:  One study showed physicians spent 27% of their time in their offices seeing patients and 49.2% of their time doing paperwork. Seems lopsided to me. I can’t blame them when many became a doctor to help people, not do endless reams of paperwork. Nurses are already badly needed, but there are too few nursing programs to put enough nurses to work. According to the Bureau of Labor Statistics’ Employment Projections 2014-2024, Registered Nurse (RN) is listed among the top occupations in terms of job growth through 2024. The workforce is expected to increase, providing 439,300 new nurses. However, the Bureau also projects the need for 649,100 replacement nurses in the workforce bringing the total number of job openings for nurses due to growth and replacements to 1.09 million by 2024.

Meanwhile we have the GOP trying to strip most US citizens from receiving even minimal care. We must stop For Profit from becoming the norm in every conceivable business.  Seems the public schools are about the only thing not privatized (yet).

 

For the want of critical thinking, America has succumbed to tribalism

This says so much of what I’ve been trying to say.

Progressive Culture | Scholars & Rogues

Antarctica is cold. I learned that in grade school. The record is 128.6 degrees Fahrenheit below zero set in 1983. Did you know the southernmost continent is also a desert? I know much of the history of the exploration of the continent — the stories of Roald Amundsen, Ernest Shackleton, James Clark Ross, Caroline Mikkelsen, and others. I know the continent’s 5,400,000 square miles are 98 percent covered with ice (although that’s changing, I suppose, as the climate and sea continue to warm).

p-6421-mfatBut I’ve never been to Antarctica. It’s likely that you haven’t, either. So how do we know so much about the fifth-largest continent?

We read books about it. Teachers taught us about it (usually from textbooks and, if you’re my age, “film strips”). We’ve seen movies and videos about Antarctica. We’ve seen the continent on maps and globes. We’ve watched Emperor penguins on basic cable nature specials.

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On The Realities of Being Poor

I’ve been reading lately:

  • The Heritage Foundation Backgrounder, 19 March 2014 – “Do Federal Social Programs Work?”, by David B. Mulhausen, PhD
  • The Heritage Foundation Backgrounder, 15 September 2015 – “Poverty and the Social Welfare State in the United States and Other Nations,” by Robert Rector
  • Center for American Progress – “The Facts About Americans Who Receive Public Benefits,” by Joy Moses, December 2011.
  • UC Davis Poverty Research Center -“How To Reduce Poverty in the United States”

Poverty, as we all know, is a deep seated problem with no easy answers. The four articles noted above contradict each other on several issues, so it is not surprising that solving the problem is so difficult.

The March 2014 Backgrounder, for example states, “The American Public should have nothing to fear from the elimination of ineffective programs. Now is the time for deep budget cuts in federal social programs.” Some of the programs it suggests terminating include Head Start, which after detailed evaluation found that the program failed to improve the lives of the children, any more than the children who did not attend.  I’d have to agree, the Head Start program may have outlived its usefulness now that nearly all children attend a pre-school for at least a year before starting kindergarten. So, how much is actually spent on Head Start? According to one source: $7 billion.

Other programs the March 2014 article suggests are ineffective are:

  • Food Stamps (SNAP), which “failed to affect earnings and employment outcomes.” Sorry, what? This makes no sense. Were food stamps meant to increase the recipients earnings or employment? Yeah, I didn’t think so. It is a program to ensure better health through nutrition. So I deny that this is a failed or ineffective program based on the faulty testing criteria.
  • Moving to Opportunity (Section 8 housing) was also found to have failed “to produce statistically meaningful results” for the recipients.  This article does not explain the criteria used, but you can go here for more info. I suggest that part of the failure of this program is due to lack of participation of landlords. Applications for the program have actually been suspended for the past 10+ years (at least in Los Angeles), due to the long waiting list and short list of landlords, as well as the limited range; housing is not even offered in most of the surrounding cities. There must be some incentive provided to landlords to participate in the program, and currently there does not appear to be any.
  • The Job Corps program studies show that participants worked fewer hours and received less pay than the control group. I posit this is due to the dearth of opportunities in areas served; i.e., learn all the skills you want, if there is only a job at McDonalds, you will not make more money.  The program isn’t failing, we are. Yes, the program is ineffective, because it doesn’t solve the problem of job availability. Again, we need to provide incentive for businesses to locate in poor communities. Not an easy fix, so I guess it’s easier to just say it doesn’t work and trash it, than say it doesn’t work because it is flawed but could be improved.

The September 2015 Backgrounder discusses the living standards of those people considered poor. The US census (from which most financial data is taken) does not provide an indicator of those who may be using federal aid.  I should think that might skew the numbers, no? One of the criteria for determining poverty (other than income) include whether or not they have air conditioning. Most modern buildings have central heating and cooling.  While I might use my power for heating, I’m less likely to use the A/C because of the cost. So, just because A/C is available to me doesn’t mean I use it. And who says A/C is a luxury? Sure in 1945 it was, but today?

Nearly 75% of those defined as poor have at least one car. Again, who decided that a car was still considered a luxury item. The survey asks “do you have a vehicle.” It does not ask for the age or condition of it.  Two-thirds of the poor have a computer with internet access. Again, not really a luxury item either, now that so much of our lives need that access, especially when it comes to education. They have cable/satellite playing on a wide screen modern TV.  TV is again, not a luxury item. What the survey does not ask is “did you buy the TV or gaming system?” It might be a gift from a friend or relative. All I’m saying is that statistics don’t tell much of the story. Data can be skewed. Information omitted.bad wires

In the end, I know not all our systems work, and some should be dismantled, but others could be streamlined and improved. With each change we make to a system, it is only a patch. Now imagine that as an electrical system? Patch upon patch, always adding a new wire. I’d say it’s a reasonable assumption that this is why our government has become too large, too cumbersome, and too expensive.

And we never really fix the problem because of partisanship. Neither side will let the other side get exactly what they want. When did Party become more important than the People? (Much more on that later.)

Tired of the Hate-filled Rhetoric

I have grown weary of the current rhetoric: me good, them bad.  I’m disgusted with the media as a whole, and after reading this article in Politico, I’m doubly upset.  I think most of us know that the media does not necessarily represent the Average American.  To the contrary, media outlets cater to a particular audience, and that audience thinks like the media.  So, for example, the New Yorker, obviously, has an East Coast philosophy that does not translate well to the West Coast sensibilities.  The Times are each biased by location, and those locations are all large cities (Dallas, Houston, Chicago, Miami, etc.). The rest of the country, apparently, does not really matter.

Some may think that that is just fine. “I live on the West/East Coast, so I’m content,” seems to be the feeling.  The media bubble mentioned in the above article makes complete sense when taken in context with the demise of actual paper news, loss of newspapers. It’s a money game (always follow the money).  Paper publishing costs a lot; paper, ink, printing, journalists, distribution.  The advent of the internet certainly changed all that. Hundreds of thousands of jobs were lost, and with that, coverage of more localized news has nearly vanished.

What does that mean? It means the media is biased to their location and staff, not the people they purport to represent.  We end up with the nonsense of rhetoric, and by virtue of 24 hour news channels, we get sucked up into believing it.  And what is rhetoric? By definition it is: “language designed to have a persuasive or impressive effect on its audience, but often regarded as lacking in sincerity or meaningful content.”   Lack of meaningful content.

We need to start thinking for ourselves, and not let the media play to our fears and biases. Bias/prejudice mean a strong inclination of the mind or a preconceived opinion about something or someone. A bias may be in favor of or against an idea or person or people. Prejudice implies preformed judgment even more unreasonable than bias, and usually implies an unfavorable opinion: prejudice against people of another religion or race. 

Everyone has bias in some form or degree.  It’s only human to base one’s beliefs and morals on one’s own personal experience. However, this leads to prejudice against ideas outside of our personal experience, reality and world. Prejudice that is not easy to shake. Only way to remedy this is to open one’s mind to the infinite possible points of view. The media helped us do that once upon a time. Now it is up to each individual to learn how to open their minds to ideas they might normally be opposed to.  Wouldn’t you like it if the Republicans and Democrats cared more for the country than party?  Personally, I see no reason to have political parties.  I’m a registered Independent for the last 25 years or so, but I still have preconceived ideas and a deep dislike to changing my mind. I also have a deep desire (now) to open my mind more, and possibly even change it.

This is where Free Thinking and/or Critical Thinking comes in.  It helps to take the emotion out of the equation, which where we all go wrong. It’s our emotions that get in the way of critical thinking. Think like a scientist; take a theory and set about to disprove it.

I don’t think using critical thinking will make me change my mind about the fact that Trump doesn’t belong in the White House, but it may help me understand how he came into power, and why the media did not accurately report on what All Americans wanted, just what the Average American wanted.  Not the same thing at all. The average American makes $65,000. I make half that with my and my husband’s income combined. Nothing average here.

So. No more rhetoric for me or from me (I may slip now and then, but I am trying).  Ted Nugent promised that he would no longer engage in such talk. If he can, certainly I can. It hasn’t been a month yet, and since his announcement came only after a Republican senator was shot and nearly killed, I’m having trouble buying it. I checked his FB page and website and don’t see anything hurtful or hateful. But neither do I see his denunciation of hateful rhetoric.  I’d never gone to those sites before so it may be he never posted the rhetoric there. For now I’ll give him benefit of the doubt. I want you to believe the same of me.

I know advice is worth it’s price, but my advice? Stop talking only with the people who already agree with you. Stop using only media sources that favor your preconceived ideas. Expand your media horizons and you may find out some very surprising things. What I’m trying to say is, try to keep an open mind and think for yourself–don’t let the media do it for you.

The Resistance

I have been working with resistance groups for only a few months.  I have learned so much in that short time, met some wonderful, amazing people, and found a sense of purpose.

The drag of this is it looks like the Resistance may not be needed before long, what with Trump being investigated for Obstruction of Justice.  Impeachment papers are being filed, and the White House executives are lawyering up.  I can see this going pretty deep into Trump’s staff: Pence, Bannon, Kuschner, Ivanka, and all the rest of the degenerates and unqualified bozos.  And I celebrate to see this happening.

Even if this all goes down, the Resistance will need to work to repair the damage done in these short six months of Trump’s tyranny.  To that end, it is going to take a lot of work to get people to vote.  Time for the Independents to grow in number and create a strong third party.  We need to ensure that it will be impossible in the future that no single party gains control of the House, Senate and Presidency at one time.  We need to eliminate Gerrymandering, and that will not be easy with a Republican Congress.  We need to eliminate Lobbyists. They’re just glorified beggars, aren’t they?  Disgusting humans.

To make that happen, however, we need to inform people of the importance of voting and when voting, how to do so.  We need to teach our children and immigrants the importance of voting for all elected positions.  Including the School Board.  If more people actually became aware of what their school boards are doing, perhaps we can save education from the greasy talons of Betsy DeVos.

We are the people, remember?  We are the people who create this country and hold onto the values on which it was founded.  That means taking back control of our government at all levels. That means education.  It means hard work.  It needs your time and effort. This is a hard thing to do, for people have families, work (sometimes at two or more jobs).  People have cars that break down.  They get ill, lose jobs, lose insurance, and in the end, lose hope.  It would be good for people to have hope again.

I hope this blog will help educate people on how the government works, where your tax money goes, and the danger of Gerrymandering.  Here is an excellent explanation of Gerrymandering and why it is dangerous.  I didn’t know how bad this was until recently. Gerrymandering lines should be erased–permanently–if we don’t want a single party system.

 

The Growing Poor in America

Our GNP has been growing.  Inflation has been rising since the 70s and cost of living has increased.  Yet wages have stagnated.

wages

Most wage increases over the last 20 years have been less than helpful in keeping up a Middle Class.  You can see by the above chart, the lowest incomes have actually decreased in the last 15 years!  Inflation has continued.  No wonder we no longer have a Middle Class.  I’d say Middle Class has dropped into the following categories: Poverty-Stricken, Poor, Middle Poor, and Barely Squeaking By.

Wages
In 1970, minimum wage was $1.60 an hour. Today, it’s $7.25 an hour. That’s a 353% increase over that period of time, which seems like a fair amount… until you actually start looking at how prices have increased.

What about average wages? I couldn’t find a document that laid out full details on average wages per year, but this document from the Census Bureau, laying out some average wage information, shows that average household income has roughly kept pace with consumer prices.

Consumer Prices
In January 1970, the Consumer Price Index was 37.8. In January 2011, it was 220.223. That’s a 482% increase over the period we’re looking at.

In other words, for every dollar increase in the minimum wage since 1970, the price of an average item has gone up $1.36. Even adjusting for inflation, a dollar today buys less than it once did for low income earners.

So, for a person freshly out of school, the initial income outlook is worsethan a fresh graduate in 1970, but after some career advancement, their salaries end up being comparable given inflation.

Education
In 1970, a year of tuition at a public university cost $1,207. In the most recent year of data available, 2007, a year of tuition at a public university cost $11,034. That represents an annual average increase of 6.2%, which, if you applied it to the 2007 price, gives you an estimated 2010 cost of a year of education as being $13,216. That’s a 994% increase in the cost of a four year degree.

So, let’s say you’re earning minimum wage and trying to make it through college.

In 1970, you could work 755 hours at a minimum wage job over the course of a year to earn enough to pay for a year of schooling at a public institution – about 14 hours per week.

In 2010, you would have to work 1,823 hours at a minimum wage job over the course of a year to earn enough money to pay for a year of schooling at a public institution – about 35 hours per week.

Source: http://www.thesimpledollar.com/a-dose-of-financial-reality/

 

Most people I know are in the Just Barely Squeaking ranks.  They own houses with large mortgages, have car payments, and credit card debt in excess of $10,000, lots of that is student loan debt.  Adult household members work at jobs they probably hate, and don’t pay near enough.  Jobs they have taken mainly for the insurance benefits, which have decreased steadily over the past 15 years.  Ever since the Reagan Era “Trickle Down” theory.

We pay more for homes, cars, and groceries than ever before, and are (for the most part) no better off than their Middle Class upbringing.  Why?

Technology.  It’s expensive.  Lot’s of techies make lots of money, but it doesn’t trickle down very far.  Maybe it trickles to their housekeeper, gardener, grocer.  (All of whom make 1/4 of what the Techie does.)  Technology, that god I heard about ever since I can remember.  That thing that would give workers more leisure time.  That thing that has replaced people with computers and robots.  Remember the old Secretarial Pools?  Large documents would be typed up by a bevy of women with each one typing a section over and over.  It took more people to do the typing because at that time Xeroxing was new, time consuming, messy, and expensive.  Now one person can type entire documents. Granted this didn’t happen over night, but computers have eliminated millions of jobs.

Health Care.  It’s expensive.  Insurance costs for such care is beyond believable when you see hospitals charge $1,000 for Tylenol.  Doctors charge over $300 per 15 minute visit. Luckily most of us can still see a doc for under $50 co-pays, but not all of us.  God forbid you have a serious health problem like cancer, Parkinson’s, Huntington’s, Progressive MS or ALS.

Housing.  It’s expensive.  Greedy people have driven up the cost of homes to unprecedented heights.  New York, Paris, London, Los Angeles; all the major cities are virtually unaffordable for the Barely Squeaking.  In my city the cheapest homes you can buy are $500,000 fixers, for which you need another $200,000 to make repairs or alterations.

Gentrification of Poor Areas.  Rich Man buys apartment building occupied by 20 families each making less than $30,000 per year.  Rich Man evicts all 20 families.  He spends millions to rehab and improve his investment.  Who can blame him? So he puts in expensive carpet, wood floors, guts the bathrooms and kitchens and adds stainless steel appliances, granite counters, fancy pedestal sinks, and low-flush toilets and showers. The evicted families were paying less than $1500 per month for their 2 bedroom 1 bath apartment.  The newly finished building now houses only 10 units, minimum 2 bed/2 bath over 1500 square feet of living space (as opposed to the original 700 sf 2 bed/1 baths).  There is now underground parking, and a concierge.  The units are now to be sold as condos, starting at $750,000.

Improving the poor areas, right?  No.  It’s just relocating the poor by force.  Those 20 families now struggle to find a new apartment that they can afford. Usually they find something farther from their jobs.  Making it more difficult for them to keep those jobs. Likely a job will be lost simply because they can’t make it to the second job on time riding the bus.  Bus service is slow, cabs or Uber are expensive, cars even more so.

Many people with such low income work two part time jobs.  Neither of which will provide health insurance coverage if the worker puts in less than 30 hours.  So mom and dad work two minimum wage jobs without health insurance.  Their only health care provided by ERs across the nation, thousands of which have been systematically closed down by the Board of Directors of hospitals, because the ER is not cost-efficient.  Why? Because 90% of those in an ER have no insurance and no means to pay for their visit. ERs are required to treat a person, regardless of their ability to pay.  It’s no wonder they aren’t cost effective.

That says a lot when discussing a National Healthcare Insurance.  ERs would no longer be crowded with people with ear infections and colds, and could return to the intended use for accident victims.  Thereby decreasing costs simply by eliminating those without means from incurring debt they cannot pay.  It’s not Socialism, at least not in the bad sense of the word, it’s common sense with some compassion tossed in.

Do rich people really think I want to be borderline poor?  What is this lingering hate toward the poor (and the homeless)?  It’s been with us thousands of years, ever since “income” became a necessary part of life.  The poor in this country will continue to fall further behind and end up on Welfare (another GOP-hated social assistance).  The number of homeless will continue to increase.

Don’t those in power and/or with money care at all about us down here on the bottom row of the pyramid?  We built the fucking pyramid, we should not have to be buried by it.

Bipartisanship

As a society we are taught there are three (or four) things that should never be discussed: Sex, Religion, Politics (and money).  I only agree that talking about money is unwise.  But the rest are what we should discuss!  If we were able to teach our children tolerance, compassion, understanding and empathy, it would be quite a different world.  Instead we teach them not to talk to those who are different, or whose opinions are different from our own.  This breeds contempt, misunderstanding, frustrated anger, and festering hate.  Just the things the GOP seems to want people to feel.

Can there ever be such a thing as bipartisanship?  Truly?  What if we could change that? Would you try?  I would and will. Do you believe that nothing should be off limits to public discourse.  A little honesty, buttered with some empathy might go down better than angry rhetoric.  At least that’s my mind.

I don’t want to listen to the other side either, truth be told.  But neither do I want to see my world continue to be blown apart by hatred, anger, misunderstanding, rumor, and lies.  I see no reason that can’t change. If we want it to.  I am now on a search for a means to have real, open dialog with those with views opposing mine.

I wrote a few weeks ago about a lost opportunity to talk to the “other side” of an issue. Not many people want to listen to someone else’s side of an argument.  We merely wait on our side of the conversation for something from the other to tear into and deny. Name calling is easier than holding our tongue.  Spouting the same tired rhetoric is more appealing than using our own minds and hearts to listen.  Hating easier than understanding.  Empathy can’t be taught, apparently.  Nor maybe compassion.  But we can learn to understand one another.  Maybe become more tolerant of our differences. But to do this we need to have real, honest communication with each other.

We know that our rhetoric has become empty phrases devoid of personal meaning.  So let’s quit spouting the same old lines and come up with a new strategy.  I’m thinking radical here, but honesty is definitely something to shoot for.  I know that goes against the grain when talking politics, but honesty in political discourse–wouldn’t that be something?

Restraint will also need to be learned. Drop your preconceived ideas and ideology at the door.  We need to enter into these discussions with an open mind.  A very tough thing to do.  I’ll admit I have a serious bias against the religious.  I didn’t realize how closed minded I was, until fairly recently.  I’m endeavoring to change that personality flaw. Perhaps you don’t fully realize that you are unreasonably closed minded about something or someone?

Brainstormed recently w/a friend about how to accomplish this, we thought the first thing we need to try to do is teach people how to think for themselves.  A thing is no longer taught in US schools, along with civic responsibility (but that’s another blog).  Too many people do not understand the meaning of the phrase “critical thinking.”

So we need some sort of public education format, Meetup groups and the like, to provide a place for people who want to understand, an opportunity to do so.  Who would teach these classes?  Good question.

Forget the GOP.  Ignore the labels of Republican and Democrat.  Understand that liberal and conservative are opposites, not hate groups.  I’d like to see us stop labeling ourselves. African American, Hispanic, male, female, liberal, christian, conservative.  I get that it is instinctual to label and order our worlds in order to understand them.  However, this no longer seems necessary.  Can’t we all just be “people”?

Want to help build bridges to the other side?  Interested in understanding critical thinking?  Want to debate the issues in an educated way?  I want to learn how to do that. I am quite guilty of not wanting to understand opposing views, but I also know that it is unhealthy to do so.  For all of us.   Join us?