7.1 Million Sign-ups Don’t Say Nothing

Unlike most folk of my ilk (poverty stricken African Americans), I find it troubling that we have given our Federal government the ability to make us buy a flawed product, or any product regardless if we want to or not. But putting that aside, I want to briefly discuss How I view the metrics of the Affordable Care Act or what is frequently called Obamacare (actual law in picture).

It seems as if many of its supporters are hooping and a hollering that the program has proven to be a success just because it had 7 million plus sign up. I on the other hand, can’t even understand how anyone can use this as an indication of success. Personally, to use this number I would have to know how many who signed up actually had insurance before but lost it due to the law itself. Next, I would have to know how many of those that signed up actually will be receiving Medicare. For example, currently, more than half the states and the District of Columbia are proceeding with a Medicaid expansion which allows them to extend medical coverage to single and childless adults, of which has encouraged jail operators in many of those states to use this criteria to enroll and provide coverage to inmates under ACA.

Last, I won’t be able to see the law in action until all the exemptions and waivers the President unilaterally awarded to businesses and other entities go into effect. Just looking at Maryland for example, we know that only 60,000 people have signed up for Obamacare through the state’s exchange although more than 70,000 in the state lost their health insurance. Is this a marker of success (I know more than 250,000 in total but I am not including Medicare).  But I digress.

Yet still, even without such, that I can see where the Affordable Care Act is going and all I have to do is look at the only other major health delivery operation the government runs is functioning, and that is the Veterans Administration Hospitals.

Everywhere you look the VA is having problems, both with patient enrollment and service delivery. In South Carolina recently, it was noted that problems at the Department of Veterans Affairs hospital in Columbia covered everything but the kitchen sink including but not limited to problems with surgical procedures, operating rooms not always being stocked with backup surgical instruments and equipment and not monitoring patient care close enough. More importantly, problems associated with infection control and rarely following up to ensure problems are solved adequately. And this is after reports of six deaths due to delayed screenings for colorectal cancer at the Hospital.

At the Buffalo Veterans Administration, New York, more than 700 patients at the Center may have been exposed to HIV, hepatitis B or hepatitis C because of accidental reuse of insulin pens, between Oct. 19, 2010 and November 2012.  Then there are the, three deaths that occurred at the Memphis VA, of which one of the deaths occurred because the patient was given a drug despite a documented allergy to that medication and another due to receiving a lethal dose of a painkiller. The last because VA staff did not give the patient the proper medication.

A drug abuse rehabilitation program at Miami’s Veterans Affairs hospital failed to monitor patients, provide sufficient staff, control access to the facility or even curb illicit drug use among patients because Staff members were frequently absent or in a back room instead of monitoring patients in the drug abuse rehabilitation unit. As expected numerous deaths have resulted as a consequence, specifically due to cocaine and heroin overdoses. The Miami VA is part of a network which also saw five cancer patients die because of long waits and delayed care. Not to mention that in 2009, the Miami VA revealed that nearly 2,500 veterans might have been exposed to HIV and other illnesses during colonoscopies performed with improperly cleaned equipment. In 2010, the St. Louis VA hospital may have exposed more than 1,800 patients to HIV and hepatitis in 2010 as a result of contaminated dental equipment. At the West Los Angeles VA Medical Center a 47-year-old Air Force veteran had the wrongtesticle removed during surgically which left him without any functioning testes.

I could go on and on but the fact remains that what we see with the government run VA is what we can expect from the government run Affordable Care Act. The delays that new veterans facebefore receiving disability compensation and other benefits often is way way longer than the private sector, with an average wait time of 273 days. Even worse are those veterans who served in Iraq and Afghanistan filing their first claim, wait nearly two months longer.  And don’t live in New York, Los Angeles or Chicago because that time is doubled.

Across the VA system we observe benefits claims taking longer than ever to process according to a recent report by the Center for Investigative Reporting. Before 2009, the number of veterans waiting more than a year for their benefits was 11,000. Since 2009 that figure grew to 245,000. And all the Federal Government does is asking for and gives more money as if that is the solution.  It is not. The problem with the VA, which is indicative of how the federal government manages health systems. It is one of management, administration, lack of understanding about health care delivery and oversight.  And this is the case for other VA hospitals around the nation in places like Dayton, Atlanta, Pittsburgh and Jackson,Mississippi.

All of the aforementioned is happening even after five years ago the president made a pledge to repair the VA bureaucracy. There should be no way in the world that a dysfunctional systemlike the VA top brass keep getting millions and gain capacity in only by underserving the millions veterans. Yet VA network directors get tens of thousands of bonuses every year on top of six figure salaries.
Rica Lewis-Payton, the network director of the South Central Health Care Network, which includes Jackson, got almost $36,000 in bonuses last year: Washington, D.C., Diana Rubens, the VA executive in charge of the nearly 60 offices that process disability benefits compensation claims, collected almost $60,000 in bonuses. Rima Ann Nelson, the former director of the St. Louis VA (where HIV and hepatitis exposure is believed to have occurred),  had received close to $25,000 in bonuses since 2009; At the  Atlanta VA Medical Center, three of which VA’s inspector general linked to widespread mismanagement, former director James Clark received $65,000 in bonuses over four years.

Again, the issue is management. If we do take the 7.1 or 10 million as a metric of success, we must acknowledge that less than a million of that number did not have insurance, meaning folks who had private insurance were forced to purchase government insurance, allowing the federal government to run and control 16 percent of the U.S. economy. If this isn’t a corporate takeover or monopoly, nothing is.  Second, the ACA to reduce the cost of CARE and or better management. Insurance is based on math and the actuarial sciences. 

Fact is that comparatively speaking, young men use very little health care when compared to young women use more than young men. No way in the world would folk stand for young men saying they should pay the same rates of women, when the fact is that young men driving habits dictate they should pay more than young women.

But like I said, numbers won’t tell the story, but if you look at how the government currently runs health care from filing claims to service delivery, we need only look at the VA and the disproportionately negative health outcomes occurring compared to the private sector. And if Obamacare is managed in the same inept manner, as long as hospitals and insurance companies raking in the loot, money will go to huge profits before health care is provided. And as a result, all the regular folk gonna see is higher co-pay, higher deductibles, higher premiums, folk losing their doctors, not having access to the hospitals in their community and the same old federal mismanagement practices. I mean, is it feasible to expect that people who never read the ACA prior to voting to pass it as law, actually know what it does to manage it even modestly? The real issue is not having coverage but lowering cost and improving service delivery. Unfortunately politicians have people equating health insurance to improved health care or even just health care when it is not. Having health insurance makes you no healthier than having auto insurance makes you a safer driver.

Ryan and The GOP: Just another 80s Boy Band to Me

Ok, I hate to say (really I don’t) but I was pro-phetic like pro football regarding my reference to Obama as being the New Tricky Dick in My post this past Tuesday. Yep like Jimmy “Super-Fly” Snuka, he dropped kicked Paul Ryan and the Republicans. I could not write this on Wednesday, since I wanted to re-read the Ryan budget again to make sure gloating was appropriate. But like I said, I was prophetic.

In Memphis there is one colloquialism that aptly describe what the President did. 1] He pulled his player card.

Now trying to keep it simple, after reading House Budget Committee Chairman Ryan’s budget, what sticks out is that the GOP's cuts come from overturning Obama Care, which would save $725 billion by repealing the subsidies folk would have get to help buy health insurance. In addition, Ryan would drastically change Medicare. Instead of the government reimbursing doctors and hospitals for certain medical services, seniors would purchase a private health care plan and the Feds would then pay the private insurer up to a specified amount. The so-called "Path to Prosperity" would also lower the highest individual and corporate tax rates from 35 percent to 25 percent but neglects to outline which specific tax credits would be eliminated (maybe this is why he was a couple-a-few hundred billion off in his math concerning both cost of interest and Medicare on speculative budget reduction.

Now I can’t be mad at the last one because Obama has not mentioned any specifics either, but he does note the logic in the necessity of taxes, especially for the big Whigs inclusive of individual CEO’s, corporations and their owners. Thus the player card was pulled since Ryan and the GOP (sounds like a 1980s boy band) plainly just wants to use the deficit as an excuse to cut taxes for the rich.

Obama really rocked them with the player card (prescription drug cost reductions in Medicare Part D - ingenious I must admit. This is a real saving compared to Ryan’s proposal which only obtains such from budget cuts. I mean, in my family, I can stop spending as much on going out, but if I have to use it to deal with increasing gas and food prices, what do I actually save? Nothing. The boy band I referenced earlier must think I (representative of Americans, especially the under employed) am stupid. More than 60 percent of Ryan’s cuts come from programs that serve the needy, minorities and the poor specifically.

This is the first time Obama has really impressed me as well as show that he does have gonads. Truth is that Ryan’s plan won’t control costs but rather shift them to the poor and elderly folk who need the most with respect to medical care for example for the latter. Not to mention he states his plan would reduce unemployment to 4 percent in 2015 and 2.8 percent in 2021, figures that America has not experienced since the 1950s

For as Obama stated in his speech: “Around two-thirds of our budget is spent on Medicare, Medicaid, Social Security, and national security. Programs like unemployment insurance, student loans, veterans' benefits, and tax credits for working families take up another 20%. What's left, after interest on the debt, is just 12 percent for everything else. That's 12 percent for all of our other national priorities like education and clean energy; medical research and transportation; food safety and keeping our air and water clean.”

The Ryan budget shows me that as a nation, we need to invest more in education, especially basic math.

Once upon an Oligarchy

Point of order: Been jamming that Hill St. (saint) Soul, love that cut Pieces, check it, cop that.

As many of you know, i'm forever calling folks out, even myself. I often use terms of endearment such as fk boy, or bitch azz to suppurate these thoughts into manageable constructs. Today I will use another term that I was familiarized with while growing up in Memphis – weak azz bitch. Now before I start, I want to say that this direct objectified gerund is neither race nor gender specific, and tends to be best exemplifying of collective acts that can be perpetrated by individulas or groups, for example the congress - especially the democratic members.

I have always been curious how folks can always say one thing and do another. Like the child that says they don’t want to go outside, but cries when you don’t let them out, or the woman that says she doesn’t want to be with a certain man, but wants him after he has removed himself from her life, or as I have mentioned in the prior paragraph, a congress person who says they disagree with a certain policy yet supports it via vote.

Although unlike most of us, who just get a day off for the fourth of July weekend the Senate went home yesterday for the Fourth of July holiday without doing jack to deal with the pressing economic conundrums facing regular folk like us. All though the folk on both side of the aisle say they gone handle theirs, from my vantage point, they appear to act more like a gaggle of weak azz bitches.

Not only did the housing rescue bill could not proffer any love via a test vote, they also could not approve an electronic surveillance legislation to prevent physicians who accept Medicare (H.R. 6331: Medicare Improvements for Patients and Providers Act of 2008) from getting hit with a large percent pay cut. I mean it was passed in the house but filibustered in the Senate.

The only thing that these folks were able to do, I mean by a skunk measure (zero opposition votes) was the passing of a bill to fund the wars in Iraq and Afghanistan that also increases benefits for veterans.

I think the last measure was a good thing. However, it just strikes me as strange that all these democrats voted for this bill, but will likely go back home on the stump, to their districts and talk about how much money we wasting on this war effort. Talking about being two faced and slimy. I mean, it would be disingenuous for me, if I was a poly (many) trickster to say I disagree with all the loot going for the war effort as well as how it is being spent, but yet at the same time vote for the measure. The legislation, passed by a vote of 268-155, with Democrats logging 80 votes with republicans. I won’t call any name this time, but you can find who voted for what here. But that’s why I feel that this republic, for which it stands, seems to be more like an oligarchy each day – u know, “a government in which a small group exercises control especially for corrupt and selfish purposes” – namely staying in office and getting paid.

ps: good look SkoolBoi and Gemni girl for stopping by the shop this weekend. Also Ensayn Reality and marcelle ward for the shout outs.