Black Lives Matter - Even Children In Flint Michigan

I have been appalled at the White Nationalists like Rudy Giuliani who think the "Black Lives Matter" movement is aimed only at police.

Today's report of special investigators into the poisoning of Flint, Michigan's water system should disabuse people of that notion. Six more public officials with responsibility for water quality in Flint have been charged with felonies in connection with the poisoned water.

When asked why the officials acted as they did, the prosecutor answered that, to those officials, the people of Flint didn't matter.

The majority of the population in Flint is black.

WHO Says America Has The Best Healthcare System?

Actually WHO doesn't say that. The World Health Organization ranks the health care systems of its members.

WHO's on first?

France.

We're number 37!

Here's the list:

World Health Organization Ranking; The World’s Health Systems

1 France 2 Italy 3 San Marino 4 Andorra 5 Malta 6 Singapore 7 Spain 8 Oman 9 Austria 10 Japan 11 Norway 12 Portugal 13 Monaco 14 Greece 15 Iceland 16 Luxembourg 17 Netherlands 18 United Kingdom 19 Ireland 20 Switzerland 21 Belgium 22 Colombia 23 Sweden 24 Cyprus 25 Germany 26 Saudi Arabia 27 United Arab Emirates 28 Israel 29 Morocco 30 Canada 31 Finland 32 Australia 33 Chile 34 Denmark 35 Dominica 36 Costa Rica 37 USA 38 Slovenia 39 Cuba 40 Brunei 41 New Zealand 42 Bahrain 43 Croatia 44 Qatar 45 Kuwait 46 Barbados 47 Thailand 48 Czech Republic 49 Malaysia 50 Poland 51 Dominican Republic 52 Tunisia 53 Jamaica 54 Venezuela 55 Albania 56 Seychelles 57 Paraguay 58 South Korea 59 Senegal 60 Philippines 61 Mexico 62 Slovakia 63 Egypt 64 Kazakhstan

65 Uruguay 66 Hungary 67 Trinidad and Tobago 68 Saint Lucia 69 Belize 70 Turkey 71 Nicaragua 72 Belarus 73 Lithuania 74 Saint Vincent and the Grenadines 75 Argentina 76 Sri Lanka 77 Estonia 78 Guatemala 79 Ukraine 80 Solomon Islands 81 Algeria 82 Palau 83 Jordan 84 Mauritius 85 Grenada 86 Antigua and Barbuda 87 Libya 88 Bangladesh 89 Macedonia 90 Bosnia-Herzegovina 91 Lebanon 92 Indonesia 93 Iran 94 Bahamas 95 Panama 96 Fiji 97 Benin 98 Nauru 99 Romania 100 Saint Kitts and Nevis 101 Moldova 102 Bulgaria 103 Iraq 104 Armenia 105 Latvia 106 Yugoslavia 107 Cook Islands 108 Syria 109 Azerbaijan 110 Suriname 111 Ecuador 112 India 113 Cape Verde 114 Georgia 115 El Salvador 116 Tonga 117 Uzbekistan 118 Comoros 119 Samoa 120 Yemen 121 Niue 122 Pakistan 123 Micronesia 124 Bhutan 125 Brazil 126 Bolivia 127 Vanuatu

128 Guyana 129 Peru 130 Russia 131 Honduras 132 Burkina Faso 133 Sao Tome and Principe 134 Sudan 135 Ghana 136 Tuvalu 137 Ivory Coast 138 Haiti 139 Gabon 140 Kenya 141 Marshall Islands 142 Kiribati 143 Burundi 144 China 145 Mongolia 146 Gambia 147 Maldives 148 Papua New Guinea 149 Uganda 150 Nepal 151 Kyrgystan 152 Togo 153 Turkmenistan 154 Tajikistan 155 Zimbabwe 156 Tanzania 157 Djibouti 158 Eritrea 159 Madagascar 160 Vietnam 161 Guinea 162 Mauritania 163 Mali 164 Cameroon 165 Laos 166 Congo 167 North Korea 168 Namibia 169 Botswana 170 Niger 171 Equatorial Guinea 172 Rwanda 173 Afghanistan 174 Cambodia 175 South Africa 176 Guinea-Bissau 177 Swaziland 178 Chad 179 Somalia 180 Ethiopia 181 Angola 182 Zambia 183 Lesotho 184 Mozambique 185 Malawi 186 Liberia 187 Nigeria 188 Democratic Republic of the Congo 189 Central African Republic 190 Myanmar

Source: World Health Organization

Affordable Care Act - The Real Story

Two weeks ago we were all watching the Winter Olympics in Sochi (as Putin was plotting the takeover of Crimea), frequently interrupted by a blonde woman whining that "Obamacare doesn't work." She also said she doesn't like political ads, even as she was making one. Her complaint that millions of Americans were losing their health insurance just isn't so.

Anecdotes about losing insurance, when examined closely, mostly relate to insurance policies that don't insure. So-called "catastrophic insurance."

A friend of mine had one of those. It didn't cover preventive care. He couldn't afford regular doctor's visits, but kept enough savings to cover the deductible. In short, he was as responsible as anyone in his economic circumstances could be.

When the catastrophe came, he had stage four colon cancer. Treatment took all of his savings and kept him alive for about a year. As insurance, his policy was all but worthless.

Since the Affordable Care Act, previously uninsured individuals now have insurance. Persons who previously would have been unable to get insurance because of "pre-existing conditions" can now get insurance.

Here is the story of one cancer patient whose life was saved.

Here is an earlier post of mine explaining the Republican scheme to discredit ACA. 

Bradley Flinn, August 4, 1969- December 20, 2013

Last night Bradley Flinn, owner of S/V the Shire, died at Pitt Memorial Hospital.

Those who knew him knew a very nice man. He was a Navy veteran of the Gulf War, who lived on his pink-hulled boat. He was a libertarian, but not as doctrinaire as some. I enjoyed talking to him. He had a wide range of interests. In an earlier age, he might have been called an autodidact. But that could apply to anyone with an inquiring mind.

We knew he had health problems, but didn't know how serious.

Over the years, he had anchored his boat past the bridge over Smith Creek and rowed into Oriental every day. When he developed a rotator cuff injury, he had to move the boat closer to the dinghy dock. He planned to move back up the creek, but for a long time the water level was too high. By the time the level went down, he was unable to make the move for other reasons.

Brad was a bit eccentric. Completely within the normal range for the Town of Oriental.

Rest in Peace.

Affordable Care Act - Medicaid

In a recent New York Times op-ed piece, columnist Timothy Egan describes the refusal to expand Medicaid as the South's new "lost cause." He makes it plain that this is irrational, but he rather dances around the reason motivating southern states to reject an obviously good deal.

Ed Kilgore, writing in the Washington Monthly, is more direct. Calling the decision to reject Medicaid expansion the "pure meanness litmus test," Kilgore explains what this is about: "...states refusing the Medicaid expansion are doing so on grounds that they don’t want their own citizens to benefit from it. And since opposition has centered in the South, there’s not any real doubt a big motive has been a continuation of that region’s longstanding effort to—choose your verb—(a) reduce dependence on government among, or (b) keep down—those people."

In the 1930's, it was the same region, then in thrall to racist democrats (who have since become republicans),  that made sure the new social security program would exclude "agricultural workers."

There will be serious collateral damage inflicted on an already strapped health care system in the South. The health care industry understands this.

Affordable Care Act: What's The Real Problem?

Economist Brad DeLong calls attention to a piece by Jim Tankerslee in Ezra Klein's Blog. Tankerslee explains the problems poor workers in Rome, Georgia have with the ACA as "due to a quirk in the law."

DeLong makes it very plain that it is NOT due to the law. It IS due to a decision by Justice Roberts and his cohorts on the US Supreme Court, coupled with efforts by Republican Governors and State Legislators who intentionally sabotaged the law.

Here is how DeLong explains it:

"The phrases "because of a quirk in the health-care law, and the fact that Georgia declined to expand Medicaid coverage for low-income people like him, Rizer can’t qualify for a subsidy to buy coverage" are not adequate. What Tankersley means is:

1. The ACA provides subsidies for people with incomes more than 1/3 above the poverty level to afford insurance via the exchange-marketplace.
2. The ACA provides coverage for people with lower incomes via the expanded Medicaid program.
3. Chief Justice John Roberts and the other four right-wing justices broke this system by giving individual states the option not to accept the federal money to pay for the expansion of Medicaid.
4. This was a lawless and unforeseen action: no precedent for it in previous court decisions and no warrant for it in the constitution.
5. Because it was a lawless and unforeseen action, it had never struck the minds of anybody drafting the ACA that the John Roberts, C.J., and his Four Horsemen of the Constitution-in-Exile would do such a thing.
6. Thus people with incomes less than 1 1/3 times the poverty level are left high and dry: since they are supposed to be covered by expanded Medicaid, there is no language in the ACA allowing them to claim subsidies.
7. If Roberts, C.J., had been a public-spirited an intelligent man, he would have realized that if he was going to rewrite the ACA to break its Medicaid expansion provision, he also needed to rewrite the exchange subsidy provision to provide people with incomes less than 1 1/3 times the poverty level with access to subsidies.
8. Roberts, C.J., did not do this.
9. Perhaps Roberts simply wanted to harm people with incomes lower than 1 1/3 times poverty who lived in states that would pick up the ball not to expand Medicaid he had given them and run with it, on the theory that creating an aggrieved class for whom the ACA is clearly not working would redound to the political benefit of the Republican Party.
10. Perhaps Roberts did not understand what he was doing.
11. In any event, Roberts rewrote the ACA from the bunch--and so left people with incomes like Donald Rizen's in red states with governors and legislatures who fear the Tea Party out in the cold. All of numbers (1) through (11) are inside Tankersley's "quirk in the health-care law". I know that that is what is inside Tankersley's "quirk in the health-care law". But how many of Tankersley's readers will know that?
12. The state of Georgia did, indeed--in spite of the protests of doctors and hospitals that want Medicaid expansion so they don't have to keep playing the shell-game of cost-shifting in order to raise the resources to cover the treatment of the uninsured--did indeed refuse to expand Medicaid.
13. And that is how the Governor Nathan Deal, the legislature of Georgia, John Roberts, C.J., and the Four Horsemen of the Constitution-in-Exile casually #@#&^ed Donald Rizen, a fifty-something with a bad shoulder, and many other Americans as well. All of numbers (1) through (13) are inside Tankersley's "quirk in the health-care law, and the fact that Georgia declined to expand Medicaid". I know that's what those clauses in Tankersley's article are really saying. But how many of Tankersley's readers will know?
14. And then comes the end of Tankersley's article: "When he visited the federal health insurance exchange Web site, he found the cheapest policy available to him cost $200 a month — one quarter of his current salary. 'Obama', he said, 'he thinks that he’s helping things, but he ain’t'. He fished out a bruised green apple and tossed it aside. Only a few boxes were left." Could there be a crueler irony? The original ACA--the one that Pelosi and Reid passed and that Obama signed--provides Donald Rizen with health-insurance coverage (Medicaid, admittedly, but coverage) for free. It is Republicans John Roberts, Nathan Deal, the legislature, and the Four Horsemen who have casually #@#&^ed him. But who does he blame? He blames Barack Obama."

Make no mistake. That is the Republican scheme.

Effect Of ACA On Different States: Those Expanding Medicaid Do Much Better

Here is an excellent report examining how different states do under the Affordable Care Act. The report has a good summary graph of the difference between states expanding Medicaid and those not expanding Medicaid. If state governments are concerned for the welfare of their citizens, expanding Medicaid is a no-brainer.

NC Health Insurance And Medicaid

Information is accumulating that the McRory Administration war on Medicaid and the General Assembly's refusal to expand Medicaid is fraudulent from beginning to end. And North Carolinians are suffering as a result.

Here is what NC Health News has uncovered. The bottom line is that NC Medicaid has one of the nation's lowest administrative costs instead of being 30% higher than similar states. But the incoming administration suppressed that information. They wanted an excuse to reject Medicaid expansion, which is a central element in keeping overall health care costs down.

Then the General Assembly prohibited the Insurance Commissioner from providing any assistance to Insurance companies interested in taking part in an insurance exchange. The News and Observer explains.

For ideological and partisan reasons, the Republicans in charge of North Carolina have intentionally sabotaged the Affordable Health Care Act and increased profits for Blue Cross/Blue Shield.

Expanding Medicaid would reduce costs and increase competition.

What's The Health Care Fight All About?

"The Republican Party is bending its entire will, staking its very soul, fighting to its last breath, in service of a crusade to....
Make sure that the working poor don't have access to affordable health care."

Kevin Drum

Another way to put it:

When the exchange opens, 1,346,603 uninsured and eligible North Carolinians will have access to affordable care.
Up to 95,000 young adults in North Carolina can now stay on their parent's health insurance until they're 26 years old.
People from North Carolina with Medicare saved nearly $209 million on prescription drugs because of the Affordable Care Act.
Up to 4,099,922 non-elderly North Carolinians with pre-existing conditions, including 539,092 children, can no longer be denied coverage.

And this is what Republicans are trying to take away.

By the way, this is the party that claims to be "Christian" and to reflect "family values."

Someone has to explain that to me.

An Oklahoma City Surgical Hospital Leads In Cost Transparency: Who Knew?

Want to know how hospital costs compare for surgical procedures? You mostly can't find out.

Unless you have the surgery done in Oklahoma City.

Good for them!

Affordable Care Act: How Is It Doing So Far?

Good summary in today's New York Times of the accomplishments to date of the Affordable Care Act. Even though the complete law doesn't go into effect until January 1, 2014, many elements have already taken effect.

What has ACA (aka Obamacare) accomplished to date:

1.  Nearly 7 million children have stayed on their parents' insurance, more than 3 million previously uninsured;
2.  71 million Americans already received free preventive care (no co-pay or deductibles);
3.  34 million additional Americans on Medicare received free preventive care;
4.  17 million children with pre-existing conditions now insured;
5.  107,000 adults with pre-existing conditions now in federal plan;
6.  Community health centers serving 3 million additional Americans;
7.  19 million Americans with reduced premiums or cost sharing;
8.  In 2012 insurers paid $ 1.1 billion in rebates because they didn't spend enough revenue on claims or quality improvements;
9.  Lower rate increases by insurers;
10. $ 6.1 billion saved on prescription drugs;
11. Sharp declines in annual growth in health care spending;
12. Medicare Advantage premiums down 10% and enrollment up by 28%.

That's just the beginning. Readmissions are down and followup care improved. More improvements are in the offing.

Life Expectancy

There are a lot of more or less rational arguments that can be raised in favor of changing some social and economic policies. One that does not withstand close examination is the idea that we should increase retirement age because "we are all living longer."

It turns out that "all" is a bit of an exaggeration.

In fact, it turns out that the life expectancy at age 65 of the lowest quarter (25%) of US males is down close to the life expectancy found in Eastern Europe. Not good.

Here is a link to some interesting graphs.

By the way, life expectancy for white people in America with less than a high school education is declining, as shown here.

To Save A Woman's Life - Or Not

Here's a link to an account of a pregnant woman who was in essence tortured to death in a Galway hospital.

Judging from this Spring's Republican primary election debates, this is the kind of country some Republicans want us to become. Can any of them sense the cruelty of it?

Health Care: More Detail

As experts review the 193-page Supreme Court decision on the Affordable Care Act, some of the consequences of the decision are becoming more clear. The majority ruling on Medicaid, for example, could have some truly bizarre consequences.

Here is an article that spells out some of the detailed results.

Health Care

Today's Supreme Court ruling is good news, not only for those many Americans now uninsured, but also for all Americans who might lose a job and consequently health care insurance in the future. And for those employees who have remained in a job they hate just so they can retain health insurance. You all know someone in those categories. There are so many good aspects to the Affordable Care Act that I think Americans (who have been lied to about it) will eventually fight to keep it.

The big effect: Everyone must now get in the pool. No more insuring healthy people and denying coverage for less healthy people or those who become ill.

Health Care

Whatever the Supreme Court has to say about the Affordable Care Act this morning, my order of preference for a health care system would be:

1. Straight socialized medicine - government delivered health care. Like I had for many years in the military;

2. Medicare for everybody or some other single-payer system;

3. ACA or something like it;

4. Our present hodge podge of employer-provided health insurance, which will drive the country broke to the benefit of insurance company executives.

US Health Care Costs - An Analysis

Why does the US spend more on health care costs than other advanced countries? Another fair question might be, why are our health care outcomes generally worse?

The first question is not of trivial significance. Our health care costs range from 50% to 100% more expensive than other countries offering comparable technological quality of medicine. This is important to current debates on budget priorities, because most of the projected increase in federal budget expenditures over the next few decades results from projected increases in health care costs.

Economist Timothy Taylor has taken a close look at several studies of health care costs here. His conclusion:

"The question of why the U.S. spends more than 50% more per person on health care than the next highest countries (Switzerland and Netherlands), and more than double per person what many other countries spend, may never have a simple answer. Still, the main ingredients of an answer are becoming more clear. The U.S. spends vastly more on hospitalization and acute care, with a substantial share of that going to high-tech procedures like surgery and imaging. The U.S. does a poor job of managing chronic conditions, which then lead to episodes of costly hospitalization. The U.S. also seems to spend vastly more on administration and paperwork, with much of that related to credentialing, documenting, and billing--which is again a particular important issue in hospitals. Any honest effort to come to grips with high and rising U.S. health care costs will have to tackle these factors head-on."

Drug Overdose

Did you know that death from prescription drug overdose now exceeds all other accidental deaths, including automobile accident?

We learned that bit of information at last night's meeting of Pamlico County's Board of Commissioners. Ms. Tanya Roberts of ACT Now NC briefed the commissioners on Project Lazarus, which among other measures, is establishing a safe procedure for citizens to dispose of unneeded or out of date prescription medicine. The Pamlico County Sheriff has agreed to establish a medication drop box in the Sheriff's office.

The box, which will be under 24-hour surveillance, will solve the problem of disposal. The procedure will be described by pharmacists in a notice provided to everyone picking up a prescription.

Social Security

I don't read the obituary pages. But one can't escape the headlines. One message comes through loud and clear:

A lot of people my age are dead.

But a lot of them aren't.

Which brings up today's column by Gail Collins and the forthcoming anniversary of William Henry Harrison's inauguration in 1840.

What does this have to do with Social Security and the current presidential election?

Read Gail Collins' column and find out.

Drug Shortages Kill Americans

I was pleased to learn this morning that the president will issue an executive order to resolve critical shortages of drugs for treating life-threatening illnesses, including cancer.

Shortages kill. To be more precise, the illnesses do the killing, but shortages of drugs and consequent inability to treat the illnesses prevent doctors from prolonging life.

My sister was a victim of shortages. One drug (the most effective in my sister's case) was withdrawn from the market because it didn't prove effective in very many cases. Translation: not enough customers. The next drug selected by the oncologist simply couldn't be located because of shortages.

We will never know how much the shortages curtailed my sister's life. Would she have lived a day longer? A month? A year or more? We have no way of knowing.

Still, we know that shortages have increased greatly in recent years, endangering thousands of lives. This shouldn't happen in America.

It's time to do something about it. If Congress won't act, then the president must.