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You are here: Home / Politics / Domestic Politics / Thanksgiving outside the Beltway

Thanksgiving outside the Beltway

by DougJ|  November 26, 200911:49 am| 26 Comments

This post is in: Domestic Politics, Assholes, Good News For Conservatives

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Stories like this never turn up in Kaplan’s anti-health care reform screeds:

Wes and Katie Covington, from Smyrna, Tenn., were already in debt from a round of fertility treatments when complications with her pregnancy and surgery on his knee left them with unmanageable bills. For Christine L. Phillips of Nashville, it was a $10,000 trip to the emergency room after a car wreck, on the heels of costly operations to remove a cyst and repair a damaged nerve.

Jodie and Charlie Mullins of Dickson, Tenn., were making ends meet on his patrolman’s salary until she developed debilitating back pain that required spinal surgery and forced her to quit nursing school. As with many medical bankruptcies, they had health insurance but their policy had a $3,000 deductible and, to their surprise, covered only 80 percent of their costs.

“I always promised myself that if I ever got in trouble, I’d work two jobs to get out of it,” said Mr. Mullins, a 16-year veteran of the Dickson police force. “But it gets to the point where two or three or four jobs wouldn’t take care of it. The bills just were out of sight.”

Although statistics are elusive, there is a general sense among bankruptcy lawyers and court officials, in Nashville as elsewhere, that the share of personal bankruptcies caused by illness is growing.

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26Comments

  1. 1.

    TaosJohn

    November 26, 2009 at 11:55 am

    Only covered 80% They were lucky. What most people don’t realize is that the execrable “reform” the Democrats are pushing will allow insurance companies to only pay SIXTY PERCENT. And of course it will all cost more…

  2. 2.

    BDeevDad

    November 26, 2009 at 12:01 pm

    Kaplan and others probably doesn’t understand that $10k is a lot of money to most folks. They fail to realize that people struggle to pay over years what they pay off monthly on their Visa bills.

  3. 3.

    Elizabelle

    November 26, 2009 at 12:24 pm

    My sister used to work for a bank card (credit card) marketing company. One of the big ones, and one many of you may despise.

    Her company at one point reviewed the records of its “Fallen Angels” — previously ontime paying customers who were falling behind on their credit card balances.

    Surprise surprise. Lots of medical problems/issues that drove solid customers into default and on track for bankruptcy.

    How we have a “Christian” (make that Christianist) country that lets so many people flirt with financial oblivion if health problems occur is beyond me.

    We will never have an honest debate on healthcare reform so long as our public “servants” have a first class policy for themselves and dependents, as do the center-right, careerist “journalists” in the MSM.

    First step should have been kicking their asses into the real world that we inhabit.

    Also: think of the energetic new businesses that might blossom, if entrepreneurs can unshackle themselves from corporate jobs with healthcare.

  4. 4.

    Mark

    November 26, 2009 at 12:28 pm

    TaosJohn – 60% coverage of the first $10k of costs, sure. But even the worst plan in the exchange offers 100% catastrophic coverage, and your annual maximum is a certain percentage of your income.

    I still think the limits are too high, but they’re a hell of a lot lower than they are today.

  5. 5.

    kommrade reproductive vigor

    November 26, 2009 at 12:29 pm

    Oh John, you know good and well that the sick and the poor are being pre-punished by the Baby Jesus.

  6. 6.

    mandarama

    November 26, 2009 at 12:51 pm

    Hey, it’s my town in the NYT! We done made the big time, y’all. I’m not at all surprised by these stories…but TN is a red state through and through except for our little blue enclaves in the cities. Smyrna and Dickson would probably proudly call themselves teabagger territory, sigh. And yet people there are suffering from the system they keep electing. Marsha Blackburn sure knows how to whip up the culture wars–but some of the counties she supposedly represents are experiencing 26% unemployment. What’s helping them? Federal stimulus money, which Marsha totes opposes.

    I guess I should be used to this. I grew up in Mississippi. Great place to watch Republicans run their playbook on keeping the poor on their side through fear and religion.

  7. 7.

    Brachiator

    November 26, 2009 at 12:51 pm

    Wes and Katie Covington, from Smyrna, Tenn., were already in debt from a round of fertility treatments when complications with her pregnancy and surgery on his knee left them with unmanageable bills.

    Oh well. I guess I’ll be the curmudgeon. Fertility treatments are a voluntary course of action. Adoption costs are not as cheap as some might think, but generally cheaper than fertility treatments and pregnancy in difficult cases. Surrogacy is even cheaper (surrogates are selected specifically because they are healthy and stable).

    Do you really expect health care to fund every whim and choice of everybody, and to always make them financially whole again when things get messy and complicated?

    Maybe it’s desirable and doable. I am really intrigued at how the French system kicks in even more when the medical costs escalate.

    Although statistics are elusive, there is a general sense among bankruptcy lawyers and court officials, in Nashville as elsewhere, that the share of personal bankruptcies caused by illness is growing.

    Then don’t write the freakin’ story until you can put things in a firmer financial context. The human interest stories are sad, but when you turn this into public policy decisions, then numbers and costs matter.

  8. 8.

    kay

    November 26, 2009 at 1:00 pm

    I’m not crazy about these break-downs because the real cost of our chaotic and insane health care delivery non-system is difficult to quantify and allocate.
    One of the outcomes of crushing debt loads is divorce. The stress and despair is just overwhelming for people, and they split up, compounding the problem because two households are more expensive to manage than one.
    So, we count divorce as one of the causes of bankruptcy when it may well be a consequence of unmanageable debt.
    People who are in way over their heads are basically emotional wrecks. I have no idea what effect that has on their physical health, but it seems to me that it might contribute to more illness, more debt, and more negative consequences.
    Best Health Care System in the World. Unless you have to actually rely on it.

  9. 9.

    Just Some Fuckhead

    November 26, 2009 at 1:01 pm

    These folks are faking sick so they don’t have to work. Tennesseans are notoriously lazy.

  10. 10.

    kay

    November 26, 2009 at 1:09 pm

    @Brachiator:

    They have trouble parceling it out. They’re putting medical debt on credit cards, for one thing. That’s credit card debt, but it’s a medical cost bankruptcy.
    People allocate. For example, in many places with one provider ( the medical group and hospital are the same entity, and there is just the one entity) they’ll pay the medical bills so they can go back to the doctor, but shift other living expenses onto credit cards. It’s medical debt, but it’s just reallocated.
    They’d rather default on the credit card than default on the medical group, because they need medical care. Shift living costs to the credit card and pay the provider. That’s a credit card bankruptcy, but they got there through medical debt.
    I have had serious discussions with people about whether to make a car payment or a house payment. They need the house, but they can’t get to work without the car. Like that. Decisions, decisions, right?

  11. 11.

    mandarama

    November 26, 2009 at 1:20 pm

    @Just Some Fuckhead:

    Heh. Yeah, it’s tough being a hard-workin’ Real Southerner(TM) up here with all these lazy borderliners.

  12. 12.

    Mnemosyne

    November 26, 2009 at 1:38 pm

    @Brachiator:

    Oh well. I guess I’ll be the curmudgeon. Fertility treatments are a voluntary course of action.

    Oh, geez, is this going to turn into another of those, “Well, you women chose to get pregnant so it shouldn’t be covered by health insurance” arguments? I understand the argument about insurance covering the actual fertility treatments, but it seems silly to decide that only certain pregnancies will be covered by insurance depending on how the conception occurred.

  13. 13.

    Brachiator

    November 26, 2009 at 1:41 pm

    @kay:

    They’d rather default on the credit card than default on the medical group, because they need medical care. Shift living costs to the credit card and pay the provider. That’s a credit card bankruptcy, but they got there through medical debt.

    So again, the question is, what does it cost to make people whole when medical debts mount, and can it be reasonably done for everyone, all the time, for every medical cost, even those that relate to voluntary medical services?

    I have had serious discussions with people about whether to make a car payment or a house payment. They need the house, but they can’t get to work without the car. Like that. Decisions, decisions, right?

    With the money that we shelled out to bail out financial institutions, we probably could have bought a car for every American.

  14. 14.

    Mnemosyne

    November 26, 2009 at 1:52 pm

    @Brachiator:

    So again, the question is, what does it cost to make people whole when medical debts mount, and can it be reasonably done for everyone, all the time, for every medical cost, even those that relate to voluntary medical services?

    I fell off a stepladder at work and tore my ACL (or, as the orthopedist said while showing me the MRI, “See that little ball of goo? That used to be your ACL.”) One of the options that was thrown around was to do only physical therapy to strengthen the muscles in my leg and do without an ACL, but I opted to have surgery and replace it.

    Do you see where I’m going with this?

  15. 15.

    Brachiator

    November 26, 2009 at 2:01 pm

    @Mnemosyne:

    Oh, geez, is this going to turn into another of those, “Well, you women chose to get pregnant so it shouldn’t be covered by health insurance” arguments?

    No. It’s not.

    I understand the argument about insurance covering the actual fertility treatments, but it seems silly to decide that only certain pregnancies will be covered by insurance depending on how the conception occurred.

    It becomes an issue if people deliberately choose a riskier path and then insist that they be made financially whole when things get complicated. I noted that adoption and surrogacy ain’t cheap, but is generally less expensive than fertility treatments and a resulting pregnancy. And here we don’t know as much about the people’s prior health and financial situation, but the fertility biz tends to be an upper middle class game.

    And the anecdote about the woman with pregnancy complications included a husband with medical expenses related to knee surgery which increased the family’s financial burdens, so again the issue is not just which pregnancies you pay for, and certainly not about “women get pregnant, so why insure them” nonsense.

  16. 16.

    Brachiator

    November 26, 2009 at 2:18 pm

    @Mnemosyne:

    Do you see where I’m going with this?

    Nope.

    And work-related accidents and worker’s comp is a whole ‘nuther animal.

    A fellow commuter, a teacher, dropped something heavy on her foot, and ultimately broke some bones, although she didn’t realize it a first, and went home. Her foot swelled, but instead of being able to go to her own doctor, she had to be driven to school the next day, where an ambulance took her to a medical facility that would evaluate her and the subsequent worker comp claim.

    I can’t imagine a stupider way to handle a medical issue.

  17. 17.

    Mnemosyne

    November 26, 2009 at 2:48 pm

    @Brachiator:

    And the anecdote about the woman with pregnancy complications included a husband with medical expenses related to knee surgery which increased the family’s financial burdens, so again the issue is not just which pregnancies you pay for, and certainly not about “women get pregnant, so why insure them” nonsense.

    The woman with pregnancy complications is the same one who had fertility treatments. Are you saying her pregnancy complications shouldn’t be covered because she got that way through fertility treatments? Or are you saying that she should have been psychic and known that her husband was going to have knee surgery while she was pregnant?

    Again, if you’re saying that the fertility treatment itself shouldn’t be covered by insurance, a lot of people agree with you. I’m still on the fence about it myself.

    If you’re saying that a pregnancy that results from fertility treatment shouldn’t be covered by insurance because she chose to get pregnant, that’s just stupid. Will we all have to certify to the insurance company that we got pregnant accidentally because otherwise they can deny us insurance for choosing to get pregnant?

    And work-related accidents and worker’s comp is a whole ‘nuther animal.

    That’s not the point. The point is that I could have done nothing, which would have been cheaper for the insurance company, but instead I voluntarily chose surgery. If we get into the whole “well, you chose to go the more expensive route,” you’re going to have a whole lot of people who end up either having to pay for treatment out their own pockets because they chose it when there was a cheaper alternative or people who go without medical treatment because they can’t afford it. Which puts us right back where we are now.

    An insurance company doesn’t get to refuse to cover a skiier’s knee injury because s/he chose to go skiing.

  18. 18.

    Mnemosyne

    November 26, 2009 at 2:55 pm

    Oh, geez, time to head off to my brother’s for take-out turkey. Happy Thanksgiving, all!

  19. 19.

    Brachiator

    November 26, 2009 at 3:22 pm

    @Mnemosyne:

    Again, if you’re saying that the fertility treatment itself shouldn’t be covered by insurance, a lot of people agree with you. I’m still on the fence about it myself. If you’re saying that a pregnancy that results from fertility treatment shouldn’t be covered by insurance because she chose to get pregnant, that’s just stupid.

    The article noted that the Covingtons were already in debt because of a round of fertility treatments. Presumably, this either wasn’t covered by their insurance, or the insurance coverage still left them with a hefty bill.

    So the question is, should these people be rescued from bankruptcy because subsequent medical costs pushed them over the financial ledge? I’m not saying that her pregnancy costs should not be covered by insurance. However, I do not know that a universal health plan should generously cover fertility treatments and related costs. Off the top of my head, I’d rather see people look for some form of supplemental coverage.

    Will we all have to certify to the insurance company that we got pregnant accidentally because otherwise they can deny us insurance for choosing to get pregnant?

    I don’t think it would be difficult at all to figure out who is getting pregnant as a result of treatments at fertility clinics. Total non-issue.

    RE: And work-related accidents and worker’s comp is a whole ‘nuther animal.

    That’s not the point.

    Yeah, it is.

    Oh, well, time to go eat.

  20. 20.

    Brian J

    November 26, 2009 at 5:07 pm

    Nothing to see here folks. Best healthcare system in the world! Best health care system in the world! Lalalalalalalalalalalalalalala!!!!!!!!

  21. 21.

    mai naem

    November 26, 2009 at 5:41 pm

    @Brachiator:
    Look, I don’t get fertility treatments – to me you can’t have the kid then you move on, but I have a friend and some of the initial treatments treatments are relatively inexpensive . The couple in the story have one kid as a result from the treatments. We aren’t talking octomom here. The complication was sciatica – hardlly something you would predict and actuallly I m not even sure that that was as a result of the pregnancy. It didn’t seem like this couple had spent thousands and thousands of dollars on fertility treatments. But forget that, go read the story and look at the other people they talk about. Does the CBO cost out the decreased cost to the legal system of bankruptcies? I have had two people tell me that they have pretended an injury on the job because they didn’t have insurance and they knew workmens comp would pick it up. Does the CBO cost stuff like decreased workmens comp costs? Does the CBO cost in disabled people who would go out and work because they can get medical care without being on medicaid?
    BTW I would love to know who all the people in the story voted for. I would be willing to bet half of these people still voted against ScaryEducatedBlackMuslimMan. I believe Tenn was one of two states who gave Mccain a higher percentage vote than Bush.

  22. 22.

    Mnemosyne

    November 27, 2009 at 2:23 am

    I don’t think it would be difficult at all to figure out who is getting pregnant as a result of treatments at fertility clinics. Total non-issue.

    So you’re perfectly okay with up to 1.2 million women being denied health coverage for a pregnancy that results from fertility treatment because, hey, they chose to have that baby. What’s next, saying that the resulting baby shouldn’t have health insurance either since it wouldn’t be here without the fertility treatment?

    I think you have absolutely no idea how common fertility treatment is since you’re casually talking about denying prenatal care to over 40,000 pregnant women every year.

  23. 23.

    Mickey

    November 27, 2009 at 9:03 am

    Marsha Blackburn is not a Constitutionalist !
    Economic Stimulus. H.R. 5140, the Economic Stimulus Act of 2008, passed 385-35 on January 29, 2008 (Roll Call 25). It would provide about $150 billion in economic stimulus, including $101.1 billion in direct payments of rebate checks (typically $600) to most taxpayers in 2008 and temporary tax breaks for businesses. Creating money out of thin air and then spending the newly created money cannot improve the economy, at least not in the long term. (If it could, why not create even more money for rebates and make every American a millionaire?) The stimulus has no offset and thus increases the federal deficit by the amount of the stimulus because the government must borrow the rebate money. A realistic long-term stimulus can only be achieved by lowering taxes through less government and by reducing regulatory burdens. Marsha Blackburn voted FOR this bill.(Source: The New American – July 21, 2008)

    Marsha Blackburn is my Congressman.
    She is no conservative.
    See her unconstitutional votes at :
    http://tinyurl.com/qhayna
    Mickey

  24. 24.

    mandarama

    November 27, 2009 at 11:43 am

    @Mickey:

    I perused your website, and I appreciate your reading legislation and actually paying attention to the process of government as opposed to following half-baked TV talking points. Unfortunately, I disagree with you vehemently on almost every point of policy. I would be thrilled at the idea that other constituents here in the 7th are unhappy with Marsha, except that you’d replace her with someone even nuttier given half a chance.

    I’ll be volunteering for Greg Rabidoux next year…see ya out canvassing and at the polls. Marsha will no doubt win out over both our preferred candidates, but that’s the breaks.

  25. 25.

    Mnemosyne

    November 27, 2009 at 12:31 pm

    @Mickey:

    Creating money out of thin air and then spending the newly created money cannot improve the economy, at least not in the long term.

    Isn’t that exactly what companies like AIG and Goldman Sachs have been doing? If you look at their mortgage-backed securities, you have the same mortgage sliced up and each of the pieces sold and re-sold so many times that the buyer ends up paying far more than the actual value of the mortgage, and the only way to make back their money is to find someone who’s an even bigger sucker to pay more than they did.

    Financial companies have spent the last 20 years creating money out of thin air. That’s why we’re in the mess we are today. Regulation and taxes would fix that, but apparently conservatives think that it’s fine for the private sector to create money out of thin air.

  26. 26.

    Brachiator

    November 27, 2009 at 2:02 pm

    @Mnemosyne:

    So you’re perfectly okay with up to 1.2 million women being denied health coverage for a pregnancy that results from fertility treatment because, hey, they chose to have that baby.

    First of all, infertility is an issue concerning couples, and the subsequent treatment might involve the male partner, so no, I am not talking about denying health coverage for women.

    But you seem to imply that a government health plan underwrite every choice that a couple might make. Fertility treatment can be expensive and lengthy, $1,800 per course for intrauterine insemination, $6,200 per course of in vitro fertilization. The success rates aren’t all that great:

    the average percentage of ART cycles that led to a live birth were: 39 percent in women under the age of 35; 30 percent in women aged 35-37; 21 percent in women aged 37-40; 11 percent in women aged 41-42

    What if the couple wanted to choose surrogacy (costing up to $60,000)? Are you up for that, also.

    One question might be whether coverage for assisted reproduction costs are part of any basic plan, or available as a supplement, or of course, pushed to private plans.

    By the way, a potential sticky point related to assisted reproduction might involve this fact: The most common complication of ART is multiple fetuses.

    What would you do if a requirement of a government plan be that all fetuses must be brought to term, with no provision for reduction?

    mai naem — Does the CBO cost stuff like decreased workmens comp costs? Does the CBO cost in disabled people who would go out and work because they can get medical care without being on medicaid?

    Great questions. I don’t know if the CBO analysis looks at the impact of health care reform on worker’s comp and related costs. On the surface, I’d think that in a lot of ways, universal care would be good for workers and for businesses.

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