Posts Tagged ‘medicaid’
Noted scholar and transcendentalist Ralph Waldo Emerson said, “I hate quotations. Tell me what you know.” So to begin my self-allotted 800 words, what do I do? I quote a smart man explaining his utter disdain for quotes.
True story. I love quotes. Collect them I do. I’m always looking for smart words from those who have journeyed before. Their wisdom is manifest and unmistakable. I find comfort in that.
So this week while thinking about this post, I began looking for a quote about shame. There weren’t that many shame quotes and the few I found were all wrong. They talked about shame as a regulator of behavior – as something to be “ashamed of”. There weren’t any quotes about the lack of shame.
Given the lack of quotes about shamelessness, it might indicate we are regressing along the evolutionary continuum. I imagine shamelessness requires less higher reasoning and a greater reliance on the lower brain stem – which brings me to Supreme Commander Monkey Butt (hereinafter “His Redness” or sometimes “Dolt 45” or “His High Assholiness”).
When I’ve described Dolt 45’s personality traits, I’ve been quite reticent about his mental health. With a high degree of probability I can surmise his behavior patterns, but his mental condition I will leave to others.
This brings me to his shamelessness. The only shame he fears is being labeled a fraud which is his primary and paramount behavioral avoidance priority. For all other types of normal, human shame – he has none. The shame a normal human would suffer does not faze him.
Within the last forty-eight hours, he told Tea Party groups not to worry if the Trump/RyanCare plan failed because he would make sure the ACA failed so he could blame the Democrats. Or telling the same groups he was fine with accelerating the human suffering by speeding up the Medicaid cutbacks by two years if that’s what it takes to win. Sociopathic behavior for sure, but no evidence of shame.
My point is this: While His High Assholiness’ behavior is abhorrent, it is the new Republican Trumpism. He is near the perfect Republican or so says at least 89% of self-described Republicans. Again, my feeble mind is called to a quote from H.L. Mencken:
As democracy is perfected, the office of president represents, more and more closely, the inner soul of the people. On some great and glorious day the plain folks of the land will reach their heart’s desire at last and the White House will be adorned by a downright moron.
The great and glorious day has arrived and the White House is now resplendently adorned by the consummate “downright moron” who happens to be unburdened by shame. He was the apple-eyed desire of the plain folks or at least 70,000 under-educated white men in three states. That desire still burns white-hot in nine out of ten Republican hearts.
These Trumpian sycophants know no shame. Just consider: Passing legislation affecting one-sixth of the economy without a hearing in the dead of night. Or ending life-sustaining medical care for maybe 15,000,000 people. Or ending opioid therapy or mental health treatment for millions. Or ending health clinics and outreach for the poorest and most under-served populations. Or doing all of this without an estimate of the costs.
All of this to give the wealthiest, most secure, and most powerful a massive tax cut. And on top of that giving insurance companies and medical device manufacturers a tax cut. And on top of that making sure the inadequate tax credits are as regressive as possible without regard to need or ability to pay. And on top of that, and this is where the shamelessness is extraordinary, financing the whole damn thing by draconian cuts to Medicaid – cuts to the poorest, weakest, and most vulnerable among us.
This bill isn’t a health care plan, it is a massive tax cut disguised as a political slogan to repeal the ACA. It is a WealthCare plan. It is a risible act of ignominy so outrageous it wouldn’t even make the SNL trashcan.
As discerning Widdershins, you are asking, “Why isn’t he mentioning the hypocrisy?” The answer is simple – without shame there is no hypocrisy. Talking to these people about hypocrisy is like talking to a cobra about venom or a skunk about stink. It is what makes them who they are.
The inimitable Mr. Emerson was a transcendentalist meaning he believed in the inherent goodness of individuals. I want to believe that too since there’s no shame in that – at least not yet.
I’m going to leave you with a musical interlude then I’ll list some links for interesting stories I couldn’t work into my self-indulgent rant/therapy. As always, take the safety off, comment at will, and thanks for listening.
Speaking of clowns, here’s one, and he’s a substitute for the Presidential Daily Briefing:
A wonderfully researched study of 1.25 million stories by the Columbia Journalism Review indicating Breitbart to be the right-wing media anchor hub of a distinct and insulated media system that appears to have set the agenda and overall tone for Hillary’s negative coverage.
An interactive demonstration that the “higher premium” lamentation by the shameless Republicans is, like so many things, made of whole cloth.
The lackadaisical use of military force is troubling and a bad omen of things to come. One week of bombing is equal to one year of missions under Obama.
Watch Paul Ryan’s Adam’s Apple when he’s asked about his “good, best friends” the rich.
Good Wednesday to you Widdershins. I have a couple items here I’ve had bookmarked and thought I’d share with you. One is on Obamacare and a poll that was conducted and the other item is a piece on a new tactic in the fracking wars.
A recent poll showed that two states (and in the South yet!) States that embraced all facets of the healthcare law showed a “significant drop” in the number of uninsured in their state (Okay big duh!), while those that did not, saw less of a change. (Kinda makes sense, right?)
The Gallup-Healthways Well-Being Index found an overall drop of 4 percentage points in the share of uninsured residents for states accepting the law’s core coverage provisions. Those are states that expanded their Medicaid programs and also built or took an active role managing new online insurance markets.
For the states that took neither of those actions, the drop was just 2.2 percent. And the states with the biggest drops were Kentucky and Arkansas!
Leading the nation were two southern states where the law has found political support. Arkansas saw a drop of about 10 percentage points in its share of uninsured residents, from 22.5 percent in 2013, to 12.4 percent by the middle of this year. Kentucky experienced a drop of nearly 9 percentage points, from 20.4 percent of its residents uninsured in 2013, to 11.9 percent.
What was also interesting to see was the contrast between neighboring states that took different approaches to the implementation of obamacare:
— While Arkansas had the 10-point decline in its uninsured rate, the drop in Tennessee was just 2.4 percentage points.
— The uninsured rate in West Virginia fell 5.7 points after the state agreed to Medicaid expansion, but there was no change for neighboring Virginia, where Democratic Gov. Terry McAuliffe has been blocked by a Republican-led legislature.
— Colorado’s uninsured rated dropped 6 percentage points with Medicaid expansion and a state-run exchange, while Utah’s didn’t budge. That state has a federally-run exchange and is still weighing whether to expand Medicaid.
Robert Blendon, a public opinion analyst at the Harvard School of Public Health said it’s still too early to see any big shifts in perceptions of the law. He says that the negative perceptions about the law are driven by folks who already have health insurance and who believe that the expansion of health care coverage will cost them more or affect their quality of care. “Why isn’t the bill more popular?” asked Blendon. “Rightly or wrongly, people who are not directly aided by it are worried.”
Below is a handy-dandy list of the Top Ten states with the largest reduction in uninsureds:
An even clearer number is given here where states expanded Medicaid and state exchange-partnerships and those with only one of the two:
And here’s the thing with this: The more people who get covered by some type of preventative care, the fewer people will be seen in emergent care facilities (emergency rooms). Those folks will be seen in a clinical scenario as opposed to waiting until an illness such as diabetes, hypertension and the like force them to seek care at the e.r.’s. That in turn should drive down costs across the board.
The Frack you say!
Here’s an interesting take on the fracking front: A company in Pennsylvania wants to offer you $50,000 upfront so you won’t sue them.
EQT Corporation is one of the largest producers of natural gas in Pennsylvania. They use hydraulic fracking as the mechanism to get to the gas. And they have been busy around Finleyville they’ve drilled over a dozen wells on one site. It wasn’t long before the residents there started complaining of noise, odors, and general “quality of life” issues with the company. EQT initially offered to do noise studies and even to offer vouchers so folks could stay in a hotel to avoid the noise and fumes. Soooo…EQT got the brilliant idea of offering residents $50k in exchange for not filing any types of lawsuits regarding their fracking operations.
The liability agreements EQT has used in Finleyville — they are often known as nuisance easements — have been used in other circumstances. Residents living close to airports, for instance, are often offered such easements as compensation for having to bear with the noise, vibrations and fumes from air traffic. Property owners close to landfills and wind farms may also sign similar agreements.
release the company from any legal liability, for current operations as well as those to be carried out in the future. It covered potential health problems and property damage, and gave the company blanket protection from any kind of claim over noise, dust, light, smoke, odors, fumes, soot, air pollution or vibrations.
The agreement also defined the company’s operations as not only including drilling activity but the construction of pipelines, power lines, roads, tanks, ponds, pits, compressor stations, houses and buildings.
Doug Clark, a Pennsylvania attorney who specializes in gas leases and mainly represents landowners said:
“The release is so incredibly broad and such a laundry list,”…”You’re releasing for everything including activity that hasn’t even occurred yet. It’s crazy.”
Some folks have taken the money and said that the company has been completely fair with them. Others have considered it an insult.
“I was insulted,” said Gary Baumgardner, who was approached by EQT with the offer in January. “We’re being pushed out of our home and they want to insult us with this offer.”
Baumgardner says he has had to leave his house at least three times so far because the gas fumes from the well site were too much to bear. A local health group has installed air quality monitors in his home and several of his neighbors. Last year when the one of the monitors began flashing red, his daughter, pregnant at the time, fled the house. She has since moved away after her doctor advised her not to live close to a drilling site.
The $50k may sound tempting but I would have to think long and hard over an offer like that. That’s a relatively paltry amount for giving up the quality of your life in your own home.
* lie about health care once again
Lil Bobby Jindal of the gret state of Loozieana, through his Secretary of the Department of Health and Hospitals, Kathy Kleibert, had some good news for poor folks in the Nola area except it wasn’t good news for some of those poor folks. You see, around 60,000 poor folks around Nola have been able to get primary care from a limited expansion to Medicaid in the metro area through the Greater New Orleans Community Health Connection. There has been a waiver in place since 2010 that allowed these folks to have up to 200% of the federal poverty level and still be able to obtain free treatment at the community clinics which are located across the metro area. However, the waiver program comes to an end this year. Lil Bobby has announced though that he happened to find an extra $6.1 million dollars to keep the program going, but with some exceptions. Lots of exceptions. For instance:
- one third of the 60,000 people currently receiving care will no longer be eligible – only those whose incomes fall below 100 percent of the federal poverty level will be able to participate
- health care providers will no longer get any money to help them pay for facilities and equipment needed to serve patients in local neighborhoods
- there will be no supplemental dollars paid to health care providers at the end of the year based on the number of patients they served
- (and the biggie) the rates paid for services provided will drop by 13 percent
Now you might say “Fred that isn’t too bad”. That’s certainly what Kleibert said. And in fact, for those who aren’t going to be eligible for this care any longer, she even had a line of b.s. to dish out. Ms. Kleibert said that for those folks who are over the 100% rate of the federal poverty level, there will be the (taa daaaaa!) Federal health insurance exchange where they can apply for health insurance! Except that’s not true.
You see, the original design for Obamacare was that those who made over the federal poverty rate, but below a certain income would go into the expanded Medicaid portion of Obamacare. We know however that that option disappeared in the decision by the Supremes that let the states opt out of the expanded Medicaid portion. To quote from this excellent article:
The original idea of the Affordable Care Act, known affectionately as Obamacare, was that single adults who have an annual income of less than $15,850 and $32,500 for a family of four, would be covered by Medicaid because they fell below 138% of the poverty level.
Federal subsidies were supposed to be given to those whose income falls in the range of 138% to 400% of the poverty level so that they could afford to buy insurance on the state-based exchanges.
In those 21 states that are not expanding Medicaid, many people will not be eligible for Obamacare or even to claim for subsidies from the government to obtain their medical coverage.
According to the Urban Institute, if these states do not expand their Medicaid, about 4.9 million people will not be insured by 2016 and there is a possibility that the figure may be even higher if the six states that are considering expansion but have not approved it yet decide not to do so.
Benjamin Sommers, assistant professor at the Harvard School of Public Health, said that there will be many low-income adults who will just not be able to get insured because there are no affordable options open to them.
So guess what? Lil Bobby and his Health Secretary flat out lied. Those folks who make more than 100% of the poverty level but less than 138% are just sh*t out of luck. But those of us from the gret state are all too familiar with Bobby and his untruths and half truths.
The Great Polling Debate
(or don’t believe those lying eyes of yours)
Our guv has been in a state of high anxiety and deep depression ever since that poll came out last year that showed his popularity down in the 30s in the state. Well, one way to fix that is to conduct your own poll and skew the questions and the sample to the ones that reflect more favorably on you. Then you can publicly announce that the latest poll shows your popularity or approval rate at higher that fifty percent!
But now we have two separate political polls—both by political conservative organizations—that show vastly different results. One shows his approval rating hovering around 50 percent while the other has him at an abysmal 35 percent—one of the lowest rankings of any governor in the history of Louisiana.
You see, the “good poll” was conducted by OnMessage a company out of Alexandria Va which happened to hire Bobby’s best bud to run a “southern branch” of the company.
OnMessage. Sound familiar? It should. It was OnMessage that hired one Timmy Teepell to head up its Southern operations in Baton Rouge—except there was never a Baton Rouge address or telephone number in Baton Rouge for the company and Teepell’s Jeep has remains parked in the back lot of the State Capitol since his hiring.
Now about the same time Bobby released “his” poll, a PPP poll came out (damned f*cktard LIBERALS!) that showed him with a 28 percent approval rating! And the poll even said he would run behind a (gasp!) Clinton in a presidential race!
Fifty-nine percent of Louisiana voters said they disapprove of the job he is doing. According to PPP, those numbers make Jindal the least popular Republican governor in the country and the second most unpopular governor overall (Democrat Pat Quinn of Illinois is the lowest rated governor in PPP’s polling). At 41 percent, President Barack Obama actually boasts a higher approval rating than Jindal in Louisiana, according to PPP.
PPP’s latest also found Jindal, who’s thought to be considering a 2016 bid, tied for fourth in a hypothetical Republican presidential primary in Louisiana. When PPP tested him against Hillary Clinton in a hypothetical general election matchup, the former secretary of state claimed a 7-point lead among all Louisiana voters.
Well that’s one of those golldarned liberal groups. I mean, certainly a Republican pollster conducting a poll would find a better approval rating for the guv. Except they didn’t.
…on Monday, another poll released by Conservative Intelligence Briefing put Jindal’s approval rating at 35 percent, even lower than SMOR’s numbers from six months ago.
Second-term Republican Gov. Bobby Jindal is occasionally mentioned as a presidential contender in 2016, but he has some work to do back home first. He is deeply unpopular two years after he was re-elected over token opposition. Only 35 percent of respondents view Jindal favorably, versus 51 percent who view him unfavorably. In a hypothetical 2016 presidential matchup, respondents in our poll picked Hillary Clinton over Jindal, 44 to 42 percent.
However, as Clancy Dubos writes, the in-house poll is the one to be believed because all the citizens of the state know that lil Bobby is a “Supreme Leader”.
What’s that, you say? Our Beloved Supreme Leader’s poll was biased, skewed in his favor by under-sampling black voters and over-sampling white Republicans? Only enemies of the Republic would propagate such nonsense.
Yes, it is true that Louisiana’s electorate is 64 percent white and 31 percent black. And it is equally true that the poll, taken by OnMessage, the political consulting group led by Our Beloved Supreme Leader’s right-hand man and home-schooled left-brainer, Timmy Teepell, had a sample that was 67 percent white and merely 22 percent black. But, as Team Jind assures us, black folks don’t vote in proportionate numbers, so why should their opinions count when measuring how beloved is Our Beloved Supreme Leader?
The same principle applies to sampling opinions of Democrats and Republicans. While the “official” voter registration rolls show that 48 percent of our state’s voters are registered Democrat and only 28 percent are registered Republican, the OnMessage sample was more accurately calibrated — to measure the true depth of voters’ passion for Our Beloved Supreme Leader. It thus had a sample that was 41.5 percent Democrat and 40 percent Republican.
See? It makes perfect sense to anyone who is not in league with “rebellious elements.”
You see? Our Beloved Supreme Leader, Jind Il-Sung explains to us why we should not pay any attention to those “other polls” because they “are ‘pure fiction,’ Team Jind says, because they are the work of Democrats, liberals, bloggers and other undesirables.” Ahhhh…when Jind Il-Sung explains it that way we can forget about the
lies uh untruths, uh stories he and his minions have told us about the poorer peoples among us being able to obtain health insurance when the health exchanges open up. Our Supreme Leader was so happy with being able to give health care to the poor (some of them) even though he cut back the number eligible, cut back the reimbursement rate, won’t get any funding for building and equipment…he was so happy with this and for his new-found favorability in his own poll that he even gave himself a round of well deserved applause.
This is an open thread. Oh and yes I know that lil Booby was on MTP yesterday. I was able to avoid that.
I hate to agree with Barack Obama, but when he’s right, he’s right. Health care does generate jobs, and a bad economy inversely kills jobs in health care. The latter statement has been brought home rather painfully to a number of my friends and former colleagues with the financial disaster at Jackson Memorial Hospital. The past week has seen the beginning of many, many layoffs:
The axe has fallen at Jackson Memorial Hospital in Miami where more than forty healthcare providers and nurses have learned that they no longer have jobs.
During a meeting Tuesday morning, Dan Curry with the hospital’s Labor Relations department informed the unions that 20 associate nurse managers and 1 physician would be terminated. Curry informed the union representatives in making the cuts seniority at the hospital was taken into consideration.
More cuts can be anticipated as hospital officials’ deal with a $230 million budget deficit. Currently losing about $15 million a month, if steps are taken quickly many say the hospital will not be able to make payroll by May.
Martha Baker, President of the local Service Employees International Union, said the blame for this starts in the front office with the Jackson’s CEO and President Dr. Eneida Roldan.
“We lost $80 million to $90 million in the ’08/’09 fiscal year, shame on this place. Who’s responsible for this?” said a frustrated Baker. “Shame on them to wait until the 11th hour to say ‘Oh my gosh, we’re hemorrhaging money, let’s layoff the employees and hurt patient care’, no we won’t stand for that.”
Baker, whose union represents 45 hundred employees, said the hospital is already functioning with bare bone staffing and says Tuesday’s cuts, particularly of three nurses at Jackson North’s labor and delivery department could endanger patients.