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Healthcare, Medicare and Socialism

I had conversation recently about “socialized” medicine, specifically Medicare. First off, anytime government is seen meddling in the healthcare system, it’s baaaaad. But Medicare is an exception because we paid into that our whole lives. Secondly, Democrats want to socialize medicine and this is also baaaad. But the proposed alternative, letting people buy policies across state lines, does not lead people to follow that proposal to its logical conclusions. Sure, BCBS might be cheaper in Alabama but if all your doctors are out of network, don’t you end up paying for that? Also, if everyone is buying cheap policies, then the sickest among us will gravitate to them. Pretty soon, the insurance company will need to raise rates to cover all of the sick people and they’re going to raise those rates on everyone. The one thing that could prevent that is cost control by negotiated prices. And that’s Medicare’s big advantage.

It seems that there is a misperception out there that Medicare, which everyone looks forward to, was passed by a Republican Congress and/or signed by a Republican president. Nothing could be further from the truth. Here’s an oldie but goodie post from 2011 that I wrote on the birth of Medicare based on a BBC Witness podcast episode. I relistened to the podcast today and forgot that Ronald Reagan played a role back then by scaring everyone that Medicare was “socialized” medicine that would remove their “choice”. He even hints that most elderly Americans aren’t being honest when they say they can’t afford their healthcare. What he didn’t say but probably thought was that the ones who really were too poor to afford medicine most likely deserved what was coming to them, what with all their profligate spending, bad life choices and not saving for their old age. You know, the same thing David Brooks thinks and writes every day.

Anyway, here is the post from back then in its entirety. The podcast is only 9 minutes long. It shows very conclusively that if you want to make structural changes in healthcare delivery in this country, you have to reduce the number of Republicans in Congress to less than a third of the representatives. We have been kidding ourselves if we think Republicans have only recently become harsher and meaner about healthcare for the poor and elderly. They’ve ALWAYS been like that.

Let’s repeat history and make their votes in Congress irrelevant.

Witness: The Birth of Medicare (BBC)

It’s funny that the BBC frequently does American history better than, well, Americans. Recently, the BBC4 program, Witness, did a podcast on the Great Society and the birth of Medicare. 

What I found interesting is that although LBJ was the president to sign the bill into law, the concept of Medicare was not a new one. It had been introduced into congress years earlier but had to wait until Democrats outnumbered Reoublicans by a ratio of roughly 2:1.

Think about that for a moment. In order to get the kinds of programs that theAmerican middle class actually likes, you have to reduce the number of Republicans in congress substantially. Conversely, when the number of Republicans reaches parity or exceeds it, these programs come under pressure for privatization and elimination. 

This is a concept that escapes most voters who routinely vote for Republicans but who actually like liberal programs like Medicare and social security. 

Check it out here: Witness- the Great Society and the birth of Medicare.

******************************

Personal update:

I am a very lucky person. My “thing” grew very rapidly back in January and was very aggressive. But the weed killer seems to have worked – even better than expected, according to the scans. There was a slight diversion and partial panic with one scan but it turned out to be nothing in the end. The nurse navigators were in awe and almost dancing with glee when they saw the new images. That doesn’t mean that this ordeal is over. It means I have surgery next, but it will most likely be outpatient, followed by some additional treatment. Then, I should be ok. So, keep your fingers crossed that this is the homestretch and I am going to win.

Thanks to all of you for your support.

Damn, I could really use that vacation.

😢😂🤣😭😢🤪

47 Responses

  1. Keeping my fingers crossed…always.

    Since my mastectomy, my daily prayer is:
    My health is my wealth…
    My peace of mind is my happiness…

    • 😘

    • I have eyebrows again! And eyelashes. And fuzz on my head. It’s so cool but at this rate, I’m going to have to give up my porn career soon.

      • I am so glad for you. I had a boss who dealt with cancer and it was, for the most part, simply a manageable illness. Tough, but you’ve got this!

        • Nerd- I agree with you there. Humor does equate with intelligence and, I also believe it equates with humility and humanity, at least some of the time. It is a shame that Inslee left, but that is how this unfolds. Klobuchar and Inslee were/are my favorites.

          I almost forgot about Dixie Lee Ray. I was in Washington during both eruptions of Mt. St. Helens. People were blaming her for the death of some Weyerhaeuser employees that were allowed to stay on the mountain longer than they should, that she was in bed with that huge lumber company (if anyone could tolerate sharing a bed with Dixie Lee Ray).

          • Wow- this thread is kind of messed up- I was responding to Earlynerd below.

          • Lordie (to quote a major T*rump benefactor), she was such a sellout for women. What a thing to have for Washington’s first woman governor!

            As for Inslee, I hope he does get a third term. A double pun, with trees being almost Washington state’s official mascot, sessile or motile, would surely get my vote if I still lived there.

  2. Riverdaughter
    I don’t comment much these days, but always check regularly to see if you are leading the chorus as ever. Happy to hear any good news about the “thing” and keeping my fingers crossed.

  3. Thank you for this update. You have been in my thoughts many times every day since I heard your news. I wish I could do something to help.

  4. Praise Haruhi-kami-sama for Our Dear Leader’s progress! :mrgreen:

    And that includes YOU, cancer!

  5. Off topic:

    For a period in the later ’80s into the ’90s, the Go-Gos went their separate ways, before eventually re-forming. Charlotte Caffey formed a trio with Gia Ciambotti and Meredith Brooks, the latter of whom would later enjoy fleeting fame for the 1997 anthem “Bitch”. They called their band “The Graces”. They recorded one album, Perfect View. Its first single only reached #56.

    I think the single and the album both deserved better. Here’s the first single.

    • Wow, IBW, that’s really good.

      I liked the retro sound of “We’ve Got The Beat”, and Somewhere In Storage I have that album, but they really evolved. It’s too bad the new group didn’t get more attention.

      RD, good to see you’re still kicking the big C’s a$$!

      • Yes, a very good find, and I’m surprised that I have never heard their music. Charlotte Caffey and Jane Wiedlin were the songwriting heart of the Go-Go’s. One of these days I will actually learn how to link a music video onto this page, but until then, I will suggest listening to a superb song called “Things,” which was a collaboration among Wiedlin, Caffey, and the great Penelope Houston, and was released on one of Houston’s albums.

  6. RD, so sorry to hear about your scare but I’m glad everything turned out all right.
    The only thing I have against MFA is the fact that I don’t want Mike Pence managing women’s health. I think the Bismark plan is better and would make it harder for the GOP to mess with healthcare ’cause, you know, at some point they are going to be back in control.

  7. RD, I am glad to see that you are doing better! Hopefully, you are almost to the end of the ordeal, with happier and less stressful days ahead.

  8. I just wrote something which disappeared; sometimes they return, sometimes not. Just in case not, I wanted to say that I am glad that you are doing so well, and that hopefully this whole thing will mostly be over, and you can return to less stressful and difficult daily life!

    • Weird, I just peeped at WordPress and it’s copying every comment three times. Probably a server issue. 🤔

  9. Well, I am glad that it didn’t disappear, so now you have two!

    On the healthcare issue, I am not an expert on this, and should read more. I do think that after fighting so hard to get Obama’s diluted ACA through, and managing to stave off Republican efforts to remove it, running on platforms which call for a completely different plan, which may or may not be achievable or workable, is not a path to winning back the country. Wouldn’t it just be enough to run on improving the ACA, turning back the awful things Trump is doing, rather than coming up with ideas which likely would not be passed in Congress, and which make the party more vulnerable in the crucial election upcoming?

    Now I see that Warren wants to repeal the entire Crime Bill of 1994. She cannot repeal it; she would need a majority of the House (doable), and 60 filibuster-proof votes in the Senate (impossible). So why call for it? Do we have a bunch of political amateurs running? Hillary, who was sometimes attacked for being “too careful,” or being “wonkish,” had these things scrupulously worked out and articulated. She wanted to be transparent, and to lay out programs which were affordable and doable. But no one wanted to read about them, and I now see this absolute jerk Jason Johnson going on TV every day to say how awful a candidate she was, how no one liked her, so that anyone else would do better this time. I find it infuriating, and yet he gets the airtime. Now we’ve mostly got candidates who wildly overpromise, or figure that since no one holds Trump to anything, no one will do so to them, either. Do any of them understand how government works here? Good ambitions are important, and we need major changes, but they have to be reasonably achievable, or people will foolishly vote against them and the candidate. I may be in a minority on this, but I do not like this field; not that there are not some very decent persons in it, but not in terms of laying out understandable and achievable goals, and showing the potential ability to lead the country toward them. Not so far, at least.

    • No, I don’t think the ACA is viable. Certainly not without cost controls. And there are too many moving parts that trying to “fix” it will be very risky, making no one happy.
      Better to scrap it and start over. I’m in favor of letting people buy into Medicare and Medicaid. A true public option might be the competition that is needed to drive down costs.
      Didn’t FDR say something like “try something and see if it works”? It’s very Agile.

      • A simple solution would be to just make insurance companies not for profit. That would eliminate a lot of the costs. There are a lot of ways to get there but so far I’m not sold on MFA. Besides even with MFA it’s likely you’re still going to have to buy private supplemental insurance.

    • Here it is:
      “It is common sense to take a method and try it. If it fails, admit it frankly and try another. But above all, try something.”
      Franklin D. Roosevelt

      We tried ACA. It was marginally better than a sharp stick in the eye. We can do MUCH better and we already have workable options to choose from.
      I think we have to get away from the underlying idea that the public good MUST generate an ungodly profit for shareholders. Let’s scale that back to moderate profit. Or reasonable and customary profit. Or sensible profit.
      I’m not interested in being treated like livestock or an indentured servant.

      • Oh, I agree with your principle here! We have indeed fallen into the trap of accepting that everything is a business and should yield great profits for the people who run it. But of course FDR, my favorite president, did have a different tableau. The country was depressed and desperate. He won a big victory in 1932, and then an immense landslide in 1936, and Democrats controlled House and Senate by large majorities. Once the “Nine Old Men” of the Supreme Court realized they were anachronisms, and started retiring, to be replaced by FDR’s choices (Frankfurter ultimately proving to be a major disappointment over time, but the rest of them not being so), he had an almost unparalleled opportunity to take chances, try things out. He had a great Brain Trust led by Hopkins and Perkins and others. And the people were for this, they loved him for trying to make things better, taking risks.

        Now, however, it is much different. Ninety years of propaganda has convinced many people that liberalism is socialism is communism. The deficits were deliberately run up to enrich the already wealthy, and to make it impossible to spend on social programs. Every slight tax suggested by any Democrat is immediately assailed. And while we share an unimpressed eye toward Obama’s half-loaf efforts, it is clear that the Republicans were not going to do a thing to help him. When Clinton tried to get a slight tax raise for millionaires in his first budget, Republicans proclaimed that it would destroy the economy. Not one single member of that party in either house voted for it, and it barely
        squeaked through, after which the economy soared and we had a surplus, which the Republicans them promptly gave away in tax breaks to the rich.

        So I think that unless we had someone as strong and charismatic as FDR, with the kind of people he had to help him on policy, to make the case we need, most of these ideas will fail as tragically as Bill and Hillary’s effort to give us a better health plan than Obama’s ACA was. $95 million or so spent on those ads with the nice fake couple deciding that we just couldn’t go in that direction. And then even many Democrats bailing out on support. I think that there are many people who would be for major policy initiatives now, but I don’t think that enough of them are in the Senate. And most members of the middle class are virtually programmed to say no to anything which might raise their taxes. It doesn’t mean that we should always compromise, or somehow not even try, but we really do need a frontperson who can sell all of it to a populace which right now seems fairly sanguine about the economy. If people decide that M4A will raise their taxes and/or cost them their current insurance, they will vote against it, and then where are we? There must certainly be arguments that it will be a plus for such people, but can that case be effectively made by one of the candidates who supports it?

        • My French colleague gave me the best reason. She said that Americans are already paying ungodly high taxes because we get very little to show for it. Our taxes don’t pay for healthcare until we are 65. They don’t pay for higher education or childcare or parental leave. Even our unemployment benefits are chintzy.
          M4A *might* mean higher taxes. But it also *might* come with the benefit of not paying a private health insurance company. It *might* mean that hospitals can’t charge wildly different prices for services. It *might* mean pharma has to dial it back.
          I’m not saying M4A is necessarily the right answer. But buying into Medicare and Medicaid *might* be the competition that everyone said would materialize after ACA and didn’t.
          Also, don’t forget about Tricare. My mom opted out of her private insurance plan offered to her after my dad died and chose Tricare because my dad was retired military. She never regretted it and it saved her a ton of money in premiums.
          Then there’s CHIP. Maybe every kid in America should be enrolled in CHIP by default on the day they’re born. Think about how much money would be saved if every asthmatic had access to rescue inhalers, nebulizers and other meds instead of being rushed to the emergency room when they have an attack.
          Prevention will save us a bundle. When people are no longer afraid of the bills, they’ll take better care of themselves.

    • Well, even though Hillary voters were mostly quiet I don’t see the excitement for these candidates that I saw for Hillary. A lot of voters just seem to want to get rid of Trump but none of the current crop compare to Hillary as a candidate.

      • It’s still early. Just wait. I’m actually excited about some of these candidates, though almost all of them would be better than Trump.
        Bernie and Tulsi excluded.

        • Yes, I think a lot of it is because it is early and there are so many candidates. I wish Bernie and Biden were out of it. Biden can’t stop eating his foot and neither can Bernie. Also I think part of Biden’s support is people see him as keeping Bernie away from leading in the polls. Can you imagine how much better it would be without both of them sucking up so much oxygen?

          • Jay Inslee just announced his withdrawal from race, what a shame.He is a good governor, with an absolute focus on the climate issue. I would a thousand times rather have him in this race than Sanders and Gabbard, not to mention some others. It’s always bemusing why some people get more support than others, and it’s very often not for the right reasons.

  10. When a non-elite white American conservative says “socialism”, he or she (usually he) means “anything which benefits Those Other People”.

    They’d rather live (dangerously) without a safety net than share it with Those Other People.

    The Waco Kid was right about them.

  11. FYI RD and anyone who hasn’t visited Uppity Woman in awhile, Upps has ben diagnosed with Stage2B breast cancer (see her Aug 19, 12 PM post). Because of her extraordinary number of other medical issues, she won’t be having chemo or radiation but will require a single mastectomy. She is in good spirits but i am sure she would love to hear that you are doing so well after your treatment and that your prognosis is good. It’s always comforting to know that you are in the thoughts of others when you hit a big bump in the road and that there are other warriors out there who have fought and won.

    • Cats, I am very sorry to hear that news. Uppity is a brave person in many regards, and I hope that she can get through all of this.

      • William, she said that a supervisor once told her she could put her hand in a sewer and pull out a Rolex. She is very hopeful, with an excellent surgeon and oncologist, but her complications are mind boggling. Like RD, If anyone can pull it off, it’s Upps. We can’t afford to lose any of our shining stars in these dark days.

        On a totally unrelated issue, did you hear Sanford (now a primary challenger) say that trump was their Hoover and we cannot risk getting another FDR? Huh? FDR was a BAD prez or just a dastardly Dem? Where do these yahoos come from?

        • These jagoffs never ever should mention Bill Clinton again when running both Trump and Sanford. Of course, we all knew it wasn’t about any of that.

  12. For a bit of a smile this morning, Louise Mensch is now calling the show, “Dancing With the Tsars,” featuring Sean Spicer. A bit more seriously, is everything seen by the media and entertainment, as just another show? Nothing has any serious meaning, other than how it can be turned into viewers and dollars? Just more fun for the masses? Scaramucci becomes a regular on the talk circuit. Huckabee Sanders and her father do a down-home cooking show; Christie does a one-man Broadway performance, “alternately droll and bombastic” The Conways star in a new comedy, “Whose House is This?” Pruitt sells relics on QVC. All the world’s a marketing stage.

    • What do you expect? If we were an honest people, our currency would say “In Mammon We Trust”, because Mammon is, and always has been, the actual god of the United States of America.

  13. Wonderful news that your’e beating the Emperor of all Maladies and in such spectacular fashion.

    • Hi, Sue. Good to see you, I hope you are doing reasonably well, in the midst of things.

  14. RD, it is heartening that you are doing well. I love, love, love this blog and appreciate your willingness to spend time and effort in putting into excellent words all that we are experiencing, together.

    Re: M4A
    I would prefer that Dems adopt one of Hillary’s positions, from way back in 2008…we should all receive the same health care coverage that Congress people and their dependents receive. Let’s take a look at their benefits and see if that template can be applied to the general citizenry.

    After all, we are paying for it, anyway. Without getting the benefit later in life, which we get with Medicare.

    Also, standardize the costs of medical care, once and for all. Medicare is somewhat generous in reimbursement (used to be more so), so if that’s the gold standard, so be it.

    Inpatient admissions, various surgeries, OT/PT interventions, medical imaging, fees for medical materials, consults of different specialties, use of medical equipment (ventilators, post op applications, etc) should be the same across the board.

    If a health care delivery entity deigns to pay its medical/nursing providers more or less, that is up to them, but everything else should be the same.

    And, drug prices, well, we all have heard about this, ad nauseum, but there is NO reason that long time, effective medications should be held hostage to rich assholes who just want to milk the system.

    Medical insurance companies: remove shareholders, first and foremost. “For profit” medical insurance equals no care. Not for profits are marginally better but still have tremendous amounts of money going to “fluff”.

    Legislation which locks in insurance carriers to a 2-3% revenue gain annually might help. You can make a bit of profit, but nothing beyond a small percentage. If there are no shareholders driving mega profits, it won’t be difficult for most insurance carriers to adhere to this requirement. (whether they agree to it, well, I can dream can’t I?)

    In addition, let’s legislate a specific percentage that goes directly into front line care of patients. Even 30-35% would be more than most carriers commit to, at the moment.

    I guess you can tell I have a couple of thoughts about this. 🙂

  15. William, on August 21, 2019 at 9:15 pm:

    Too many nested comments to post in the appropriate place, but I have to say that Wa. State’s come a long way since Dixie Lee Ray:

    I think you’ll like my new stump speech. https://t.co/PgDktxu4pi— Jay Inslee (@JayInslee) August 22, 2019

    I may be biased, but I think a great sense of humor is a sure sign of intelligence.

    • Earlynerd, I wrote a long reply, but it seems to have dissipated; maybe it will be found again. I agree with you on Inslee, he is a good man who cares more about the world than his own ambition.

      I don’t like the metrics used for debate qualification. In a 20-person field, polling on “who is your top choice?” is not reflective. “Who are your top five choices?” would be more so. Candidates like Inslee or Bennett or perhaps soon Klobuchar, who are sane and stable and policy-oriented, but simply do not make the “first choice” numbers, get eliminated. Meanwhile, billionaire candidates like Steyer and Yang have enough of a small following to get picked as top choice by the small percentage needed. And Gabbard has her cult following of Russians and Republicans, so she gets to possibly stay in more debates, while the more sober candidates cannot, so must drop out. Gabbard is also getting donations from American Nazis, who are proud of this. I think that we would much more benefit from having the larger debate field including Inslee, than having a smaller field which has three fringe candidates with very small but devoted coteries of supporters, and then the “major candidates” whose positions we are already well aware of.

    • I responded to you, nerd, but it appeared randomly above.

  16. Some jerk who was an Elector from Colorado in the last presidential election, didn’t want to cast his electoral vote for Hillary Clinton. He wanted to cast if for John Kasich, because of course this Elector is such an important and deserving person, that he gets to decide who the president is, no matter how everyone else voted in his state. Just like the idiots in Washington who would not vote for Hillary, and who voted for Sanders or some Native American. Anyway, Colorado threw out the Elector’s vote, and this upset him so much, that he filed a lawsuit. And some judges in federal court decided that a state could not force their Electors to vote for the winner of the popular vote in their state.

    This will be appealed, but who knows what Kavanaugh and Company would do? What fun! All the Republicans have to do is to buy some Electors in various states, as an insurance policy. Switch ten or so votes away from the Democrat who won those states, and you greatly raise Republican chances of winning. Switch 30 so or so, and you may already have won before Election Day. Or they can wait to see where the best use of their bribery money is. Or maybe they won’t even have to bribe, just make sure that a few stealth Electors are chosen in each Blue state, to undo the work of millions of voters, and insure that Republicans never lose a Presidential election. Because we know that the Democrats would never do such a thing.

    And we know that many of the media will call it “smart politics,” and “Democrats in disarray after 35 Electors from states in which they got the majority of the popular vote,,vote for the Republican, to give him the White House.” And maybe they would not need 35, maybe one would do. This is pretty much what happened in 1876, giving Rutherford B. Hayes the presidency over Bill Tilden. I think the deal was that if the Congressional delegation from Louisiana voted for Hayes, he would pull all of the Federal troops out of the South. That of course led to Jim Crow laws as soon as the Federal presence had gone. The next time somebody tells you about “The Party of Lincoln,” you might remind him of the deal made in 1876. “Anything to win,” that has always been the Republicans’ motto. And now apparently the votes of the American people do not count at all, at least if it would mean that the Republicans would not win the election. And now this absolute jerk in Colorado, who despised Hillary Clinton so much that he could not just cast his one Electoral vote and go home; and then some awful judges, who decided that any Elector may just vote for whomever he or she pleases, irrespective of state law, may have put the final nail in the coffin of the democracy.

  17. On a completely different (well, perhaps not that much) subject, it is almost certain that Trump and his buddies are manipulating the stock market. The big drops and then the big gains in the market based on his tweets have happened much to much for them to be happenstance. He knows what effect these comments have. What a fortune can be made if you know that Trump is going to say something which will drop markets 500 points or more,and if you know that he will soon retract it, or say something positive. Trump probably owns stock, and he certainly has billionaire friends who do. If he were hurting himself or them by the tweets which drop the market, he would not do them. But he does. And I don’t think it’s that he cant’ help himself, it’s because he wants it to happen.

  18. Wow. I wrote a short (but thoughtful!) reply to William and it’s disappeared, but my reply to Lililam re: Dixie Lee didn’t.

    Okay, Boris, Vlad or Natasha come out from behind that WP curtain.

    • This thread is going whacko – I am getting notifications and never asked for them. Never saw your reply to William and I specifically nested under your comment and it went elsewhere. Oh well!

      • Yep, it feels like WordPress is working on a release and there are a few kinks that need to be worked out. Let me guess, the dev ops admins are all on vacation.

    • Like a Nicholas Roeg movie!

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