I’m not surprised to find out that former Fox News personality John Kasich, Medicare fraud profiteer Rick Scott and Mitt Romney are planning a celebration if the Supreme Court strikes down Obamacare. I imagine they’ll be a lot of high-fiving and dancing in the aisles on the Right and among current and former media personalities.
Reality keeps intruding on conservative fantasy, though. For the vast majority of us who are not political or media celebrities, we have seen the future of health care without reform and it is Texas:
Last year, Luis Duran drove almost 200 miles to San Antonio to have a colonoscopy because he didn’t want to wait six months for an opening at a county clinic.
A few days later, the doctor in San Antonio – a friend of a friend who had performed the screening for free – called to break the news that Duran, 51, had advanced colon cancer and needed immediate surgery.
“I kind of broke down,” recalled Duran, a machine operator whose employer had terminated his health policy. “I said, ‘Doctor, I don’t have insurance, and I don’t have much money, but I won’t refuse to pay. Please help me.'”
They say everything is bigger in Texas, and the problem of the uninsured is no exception. The Houston metropolitan area has one of the highest rates of uninsured people in America, and a health safety net imploding under the demands of too many people and too few resources. Almost one in three residents – more than a million people — lack health insurance, and about 400 are turned away every day from the county hospital district’s call center because they can’t be accommodated at any of its 23 community or school-based centers.
Those seeking care at the public hospital’s ER, meanwhile, arrive with blankets and coolers full of sandwiches and drinks in anticipation of waits that may go 24 hours or longer.
“If the Affordable Care Act is overturned, the rest of the country should take a good look at the situation in Texas, because this is what happens when you keep Medicaid enrollment as low as possible and don’t undertake insurance reforms,” said Elena M. Marks, a health policy scholar at Rice University’s James Baker Institute for Public Policy and a former city health official.
What do conservatives in Texas offer in response to this public health emergency? A theory. A marketing slogan. A phrase cooked up and refined at a think-tank round table:
Opponents of the federal health care law see the problem of the uninsured very differently. They object not just to the price tag of expanding coverage to millions more people, but to the whole philosophy behind it.
Texans are individualistic and value their freedoms and responsibilities, said Lucy Nashed, spokeswoman for Gov. Rick Perry, who notes Medicaid spending is a big part of Texas’ budget.
“Individual responsibility is about making healthy choices and taking ownership of your lifestyle — not just about buying health insurance,” Nashed said. “And you can’t legislate a healthy lifestyle.”
Thanks for that, Lucy. Good to know.
Meanwhile, back in the real Texas:
At the same time, the proportion of Texas workers with employer-sponsored insurance is almost 10 percentage points lower than the national average of 61 percent, in part because of the state’s high concentration of jobs in the agricultural and service sectors, which often lack benefits.
“Seventy percent of the people we see here are employed,” said Dr. G. Bobby Kapur, associate chief of the emergency room at Ben Taub General Hospital, part of the taxpayer-supported Harris County Hospital District.
“They’re hourly wage earners, nannies, [people] working in lawn care services or dry cleaning or real estate, or people working two part-time jobs and neither will pay for health care,” he said. “Many are small business owners who are well-educated and well-dressed.”
The problem is not too few health care providers –– although there may be a shortage of primary care doctors willing to treat Medicaid patients. Houston’s hospitals are world-renowned, drawing patients from all over the globe for its highly specialized care — primarily to those who can pay.
Take a good look at Texas, because that’s the conservative vision for health care, realized. Those who have insurance will get top-notch care, and those who don’t will get a stern lecture on ‘healthy choices’ along with having to beg for a free diagnosis of advanced colon cancer.
One more thing. The next time you hear a media personality, uninformed babbling pundit or conservative politician repeating the tort reform mantra, you may also point to Texas. Some of the most radical “tort reform” in the country, in place since 2003, and ordinary people benefitted not at all. It was a lie, there have been endless studies proving it’s a lie, yet they all repeat it anyway.
Horrendo Slapp (formerly Jimperson Zibb, Duncan Dönitz, Otto Graf von Pfmidtnöchtler-Pízsmőgy, Mumphrey, et al.)
Great. Now I know what to look forward to.
The Dangerman
That’s not entirely fair; they also want to be able to sell insurance across state lines. Of course, there will be some state that will allow the companies to sell shit insurance, thus ruining it for everyone (feature, not bug).
Cris (without an H)
Dear Luis Duran,
CANCER IS YOUR FAULT, JERK
Sincerely,
Rick Perry
Mnemosyne
My mother had breast cancer before she was 30, and died of it before she was 40. So the healthy lifestyle choice I should make to avoid breast cancer would be, what, choosing to be born to someone else?
My father-in-law has a glioblastoma (brain tumor). There is no known genetic or lifestyle link to his kind of brain tumor. Nonetheless, he gave up smoking 25 years ago, became a vegetarian, and got fit enough to run marathons. So his lifestyle choice should have been … choosing not to get a brain tumor?
a hip hop artist from Idaho (fka Bella Q)
This is who they are. And it is even uglier than we’d imagined.
beltane
It would really make more sense for these high-end, state of the art Houston hospitals to relocate to Dubai for all the good they do working Texans.
A couple of years ago there was a study which showed that insured Texans don’t necessarily receive top-notch care, they just happen to receive A LOT of “care”, as much care as greedy providers can extract from the private insurers.
russell
I don’t want to be in the same country as Texas anymore. Next time they talk about seceding, I say vote them off the f**king island.
Maybe don’t even wait for them to talk about seceding.
Seriously, I can’t think of what I have in common with them from a social, economic, or political point of view.
They weren’t even in this country 20 years before they seceded the first time, to join the Confederacy. What have they ever done but drag the rest of the country down?
No offense to any native Texans, I just don’t see what I have in common with the place. They seem like a bunch of insane yahoos to me.
The Dangerman
There is some truth there; also, you can’t legislate away abortions, only safe abortions.
Raven
Whaddya Have for the Prez at the Greasy V!
BGinCHI
Texas
The
Lone StarFuck You Statekindness
It’s all a big con job. The rich don’t care about anyone but themselves and their families. So what if they have to hire a new pool boy ’cause the old one busted?
russell
There will be several, and one of them will be Texas.
Kay
@Mnemosyne:
She should get fired for that answer.
I can’t imagine her response to an epidemic: “go fuck yourselves, whiners. I’m doing okay”.
The Very Reverend Crimson Fire of compassion
I saw what these people thought about other people’s medical needs during the AIDS epidemic. It forever destroyed my hitherto naive beliefs about who we are as a country. If the Republicans win this war, we will all be “unworthy” of medical care, and they honestly are fine with Americans dying like dogs in the streets. I saw it for myself.
beltane
@russell: If Texas seceded it would only take a few years before it was indistinguishable from Mexico, and all these rich Texans would be flying to the US in their private jets for medical care.
Fezzik
I’m 34, eat well, exercise regularly, and by all accounts I’m actually well ahead of the curve on being fit as a fiddle. I also happen to have been diagnosed this year with multiple sclerosis. I’m kind of curious what my conservative parents will have to say about things if/when I’m denied drugs due to out of pocket costs and/or I’m booted off of my wife’s health insurance.
Whether or not the SCOTUS overturns this, I’m finding myself getting angrier and angrier, and less and less tolerant of conservative assholery. Seriously, if I didn’t have kids I would consider leading an armed insurrection, Che Guevara style.
Shinobi
Have you seen the Texas GOP’s platform for this year? IT includes such noble stances as the opposition of teaching any form of critical thinking.
“Knowledge-Based Education – We oppose the teaching of Higher Order Thinking Skills (HOTS) (values clarification), critical thinking skills and similar programs that are simply a relabeling of Outcome-Based Education (OBE) (mastery learning) which focus on behavior modification and have the purpose of challenging the student’s fixed beliefs and undermining parental authority.”
ericblair
@russell:
Remember what Texas did to your textbooks? Now they get to do that to your insurance.
russell
Fine with me.
Charge them a 500% non-resident surcharge on all medical care, and use the money to fund medical care for the rest of us.
Even better, whatever procedure they come here for, they have to pay for five Americans to have the procedure before they can have it.
Works for me.
Valdivia
Also–the get insurance across state lines bs line makes me so angry because it means we will ALL be Texas if that happens. Lowest common denominator of coverage and regulations. Nightmare.
The Moar You Know
When did Mr. Duran die of his cancer?
slim's tuna provider
@Shinobi: i don’t think they understand what “critical thinking” means….
celticdragonchick
Charles at LGF has front paged the 2012 Texas GOP platform, and it is a vision of
hellthe unfettered wingut mind.Read it and then look at the GOP 1956 platform for an amusing comparison.
This is why my spouse and I are seriously talking about moving to Canada.
beltane
@kindness: My husband went to high school in Venezuela with a lot of rich Venezuelans who cared about nothing but themselves and their families. These people, would only spare a thought for the poor for the purposes of mocking them, are in a state of butthurt over Hugo Chavez. Yeah, Chavez sucks, but it is hard to have sympathy for people who have their heads so far up their asses that they can’t imagine that poor people might despise them every bit as much as they despise poor people.
Shinobi
@slim’s tuna provider: Well they’d learn what it was but then they might start questioning their own beliefs and parental authority.
The Moar You Know
@The Very Reverend Crimson Fire of compassion: This. People said they “couldn’t see this coming.”
Really? Not after Reagan refused to acknowledge that AIDS existed? Not after the GOP went batshit on HillaryCare and took single payer off the table for 20 years?
There’s a word for people that willfully blind: stupid.
BGinCHI
@Shinobi: Just. Fucking. Wow.
Race to the bottom.
beltane
@russell: What rich people won’t pay in taxes they will gladly pay in fees and surcharges if these play to their vanity in any way. It’s too bad the Constitution bans titles of nobility because the sale of such titles would be a dependable source of revenue.
Older_Wiser
This is outrageous. Poor Luis, if only he’s not fired if he gets that operation he probably will make payment arrangements.
Millions of Americans are uninsured–and most don’t even qualify for Medicaid because they work.
The rightwing not only wants us to starve, they want us to die.
Scott S.
@russell: I know it’s popular to say that. But in all seriousness, have you considered exercising your empathy a bit? I mean, the people running Texas are generally assholes. A lot of their supporters are assholes.
And far more people than that are people who, like the linked article said, work one or two jobs that don’t provide insurance and who worry about whether they’ll be able to survive an illness. Can you really not feel empathy for those people?
Because if you can’t, just because they’re from Texas, aren’t you basically an Arizona Republican, just with a different cultural group that you hate for no reason?
All of us need to cultivate our empathy a bit goddamn more. That doesn’t mean caving in to Republican assholes. It means not being assholes to people who need our help.
EDIT: Not picking on russell in particular. It’s a common style of statement that I seem to see everywhere, and it bugs me.
karen
For the whole country to turn into Texas is the goal.
Katrina didn’t kill enough poor people no matter how hard Bush and co. tried by not bringing in the help necessary. Every state becoming Texas will be the way they succeed.
Lurker
@celticdragonchick:
As an American married to a wonderful Canadian, I don’t blame anyone for feeling like that one bit.
However, your move would cost us Americans two more sane and compassionate citizens. I sincerely hope sane folks like you consider staying to offset teh crazy in our nation.
Valdivia
@beltane:
fucking exactly as you said. The Predatory Elite model of how to rule a country. I hate making the Venezuelan comparison in mixed company because then they yell yes Obama is just like Chavez, but the 1% here is learning very much from the Latin American elites. It is very very scary.
Shinobi
@Older_Wiser: “The rightwing not only wants us to starve, they want us to die.”
I don’t think that’s what they really want. They just care more about their ideology of small government, bootstrap, every man for themselves, than they do about actual people actually suffering.
Some of them actually think that if everyone just tried hard enough we could all be Mitt Romney.
gene108
Meh… this is what the folks in Texas want, who am I to stand in their way…
If they didn’t want it, they’d not vote for Republicans, with such
devotionregularity.R. Porrofatto
The GOP in two sentences:
Blitzer: “Are you saying that society should just let him die?”
Audience: Shouts of “yeah!” and loud cheers.
comrade scott's agenda of rage
Always remember how Molly Ivins characterized the state:
Texas: The National Laboratory For Bad Government.
The could secede tomorrow and I’d help em pack…then make visa requirements on par with oh, somebody trying to visit here from Iran.
Lurker
@Fezzik:
First, my condolences.
Second, my feeble advice: as a backup plan, look into qualifying yourself as a “business” in order to be able to purchase guaranteed-issue group health insurance, which cannot discriminate against preexisting conditions.
I am a cancer survivor. I have been rejected three times by three different insurers for private individual coverage. With an insurance broker’s help, I formed a general partnership with my own husband in order to qualify as a “business” here in the state of California. I now pay monthly premiums on a guaranteed-issue group coverage plan.
It’s BS, because if one of us died, the survivor would no longer qualify as a “business” and would lose his or her coverage. However, it’s tiding us over for now until the ACA’s health insurance exchanges come online in 2014.
That said, I sincerely hope the Supreme Court does not overturn the ACA. I know too many people who need it.
gypsy howell
See, now there’s part of your problem right there.
beltane
@Valdivia: I wonder if the U.S. is simply fulfilling it geographical destiny to be like all the other countries in the Western Hemisphere with the exception of Canada. Maybe the legacy of colonial and post-colonial exploitation is too much to ever fully overcome. It is certainly no coincidence that epicenter of the Predatory Elite model in this country lies in the states of the former Confederacy.
Patricia Kayden
So why are Americans so slow that they cannot rally around the Health Care Act and support Obama? Can’t they figure out that if the Supremes overturn it, the Repubs have no incentive to reinstate any of it — even the apparently popularly parts?
kay
@Fezzik:
I’m sorry to hear that, too. Let us know what happens. We can’t insure you, but we can commiserate.
russell
I suggest they emigrate from Texas to the US.
No, there is no imaginable universe in which I am an Arizona Republican. Not least because there is no cultural group that I hate. I’m just sick and tired of trying to fit what I think is good, and what folks in TX think is good, into the same polity.
It ain’t working.
If they want to let their people die because they haven’t exercised sufficient self-responsibility and have therefore contracted colon cancer, there’s is f**k-all that I can do about it. I just don’t want them infecting any body politic I have to live in with their point of view.
Next time they say they want out, I say take them at their word.
beltane
@Shinobi: The wingnuts I’ve spoken to actually take a great deal of pleasure in the suffering of others-it makes them feel all yummy and smug and righteous. These are the types of morally diseased creatures who cannot truly enjoy a good meal unless they know someone is going hungry.
There is nothing to be gained by sugarcoating the basic degeneracy of these people.
Horrendo Slapp (formerly Jimperson Zibb, Duncan Dönitz, Otto Graf von Pfmidtnöchtler-Pízsmőgy, Mumphrey, et al.)
@Shinobi:
I think a lot of them do want people they see as unworthy to die. I think a lot of them get off on the thought that other people are suffering. It isn’t all Republicans at this point, but it’s a shitload of them, and they’re the ones running things.
Scott S.
I suggest they emigrate from Texas to the US.
Spoken like Donald Trump.
Leeds man
Forgive my ignorance, and I know there is a knee-jerk evil right wing component to this, but I thought that insurance companies and Big Pharma were just fine with ACA. Am I wrong?
gogol's wife
Devastating post. I’m so depressed.
Valdivia
@beltane:
I am actually one of those who always thought there was something very different (in a good way) about this country, reason why I moved here and became a citizen. I guess now that I am here they are looking South of the Border for how to deal with pesky poor people and the middle class. I don’t think you are wrong in pointing out the ideas come from certain parts in this country, but also downtown NYC, where the financial elite couldn’t care less about anything but their own money and they would park it in any country.
PeakVT
I’ll never understand why so many states compete to be the worst. But with education like this, Louisiana has a good chance of winning for all time.
Steeplejack
@Raven:
The Varsity! Haven’t eaten there in a while. Good times.
Also the Varsity Jr. in Gwinnett County.
piratedan
today’s GOP – the party of casual cruelty.
beltane
@Valdivia: The financial elite was also fine with slavery. Nothing at all has changed on that front.
scav
In similar news, Taliban leader bans polio vaccinations in protest at drone strikes The Taliban have banned an anti-polio campaign in Pakistan, accusing health workers of spying for the US. This day’s health news brought to you by the brilliant inhabitants of the Letter T.
Seriously, could states insist that TX inhabitants show their papers and proof of vaccination before allowing them in-state? If CA can keep possibly infected fruit out, why not possibly infected TX-fruitcake?
karen
@Patricia Kayden:
Because even if they end up with none of the parts they like of ACA, these same Americans can feel better that undeserving people (usually darker than they are but not always) aren’t getting any of it.
Cris (without an H)
@scav: There they were in a pile. A pile of little arms.
kay
@Leeds man:
I think you’re wrong. The insurance company death spiral without Obamacare theory relies on what I think is a really naive assumption.
The assumption is that things will stay the same for those of us WITH health insurance.
I see absolutely no reason why that has to be so.
Health insurance will simply change, and become less and less comprehensive.
The assumption is “health insurance as we know it”. I have no idea who decided that was a given.
Ruckus
I don’t have to travel at all to see the future. A mirror will do. Your future is my present. It is not pretty. My tips for getting old at the wrong rate/time in US history.
1. Do not get sick or injured.
2. Learn to gum your food.
3. Enjoy being svelte even if you don’t want to be.
4. Kid yourself by thinking you are on vacation. At the cheapest resort on the planet.
5. Yell, scream, argue with any conservative as much as possible. Maybe they will have the heart attack first and get to see our wonderful system at work fucking them in the ass. This one has a downside of course. It could end up being you on the end of that Louima broomstick moment.
Bubblegum Tate
Is there a no-registration-needed version of the tort reform story?
MattR
@scav:
I would call such a suggestion ludicrous except for the fact that we just used health workers to gather intelligence about Bin Laden.
Ruckus
@beltane:
They are fine with slavery because of course it makes them more money.
Bubblegum Tate
@Mnemosyne:
Just as all poor people are poor because they choose to be poor, all sick people are sick because they choose to be sick. Here endeth the conservative lesson.
scav
@MattR: Agreed, but there’s cutting off the suspected health workers and there’s cutting off vaccination for polio. Both T’s seem infected with the large, rather than intelligent, gesture bug. Sort of an auto-immune disease with the T-cells attacking the host in misguided over-reactive protection.
Valdivia
@beltane:
the more things change….
Steeplejack
@kay:
I think company health insurance could wither away in the same way that traditional defined-benefit pensions morphed into “defined-contribution” retirement plans that basically put the onus and the risk on the employee.
mingo
@Leeds man: I suspect they’d be even finer with the boatload of ugliness that would result from repub majorities ‘fixing’ health care.
Steeplejack
@Bubblegum Tate:
Here you go: “Tort Reform Didn’t Cut Health Costs in Texas.”
Spanner McNeil
“Texans are individualistic and value their freedoms and responsibilities…”
And yet somehow they love football and the socialist NFL.
Raven
@Steeplejack: And the big one in Athens!
http://thevarsity.com/index.php
trollhattan
Having read the five selected lowpoints, I decided to read the whole thing. Just. Wow. TPM’s selections don’t do it justice.
http://s3.amazonaws.com/texasgop_pre/assets/original/2012-Platform-Final.pdf
Svensker
@Fezzik:
Best wishes for you. And hugs.
Bulworth
Behold the “prolife” position.
Ruckus
@Steeplejack:
Isn’t that exactly what is happening now?
Last job I worked with health insurance had what would be considered great insurance. The co was told that the insurance co would no longer sell them that level of insurance even if the co wanted to pay for it, which they tried to do. Co-pays instituted, deductibles raised, rates raised, coverage cut. And that was the best they would do.
BGinCHI
For those of you following the UVA President saga, Sullivan was reinstated today. The Board obviously found that it couldn’t get away with a sham process.
http://livewire.talkingpointsmemo.com/entries/former-uva-president-sullivan-reinstated
MikeJ
@Raven: He ordered:
All I can think is, “orange whip? orange whip? Three orange whips.“
Cris (without an H)
Kind of like how Saddam Hussein claimed the weapons inspectors were spying on him. What a paranoid nut.
kay
@Steeplejack:
I think so, too. They could then sell us all a catastrophic-care type policy, across state line, with the least regulated state setting the terms.
There are a lot of ways to make money in insurance. One of them is to cover less, charge less, but sell more policies.
Should be interesting. The big losers in this, in my view, will be providers. They aren’t going to have guaranteed payment on ordinary care. Out of pocket on anything less than 20k? That’s a disaster for them. The providers who fought this are not very bright :)
Raven
@MikeJ: that is pronounced “erng”. He may have gone for a naked dawg walkin too!
gogol's wife
@BGinCHI:
Oh, that’s good. I really don’t understand what happened there. And when someone posted this before, they just said, “Sullivan” and I of course thought it meant Andrew Sullivan. I didn’t know why he needed to be “reinstated,” but I didn’t care. But this is good news.
a hip hop artist from Idaho (fka Bella Q)
@comrade scott’s agenda of rage:
Except, as noted above, let them in for medical tourism at a 500% non resident surcharge. Plus a stiff medical visa fee.
Rafer Janders
Which is why the Texas GOP is also advocating for the repeal of the drug laws. Texans are individualistic, and if they want to snort heroin and toke up, by gawd, no law should be able to stop ’em.
Martin
Yeah, that’s bullshit.
California has the 2nd lowest smoking rate in the nation – entirely driven by legislation. The lowest? Utah, driven by religion.
To a large degree, smoking and obesity overlap quite well. And they overlap most strongly in Republican dominated, small government minded states – like Texas. Coincidence?
Steeplejack
@MattR:
Exactly:
Southern Beale
Wow. And here Boehner told everyone there’d be no “spiking the football.” I guess he was just talking to House members.
Well, between this and that Richard Mourdock pre-taping his responses I have to wonder if these people know something the rest of us do not? I wonder of Virginia Thomas’ Tea Party-affiliated anti-healthcare reform group leaked something? Surely Scalia mentioned something to his hunting buddy Dick Cheney?
They wouldn’t be making all of these plans if they didn’t have an advance heads-up.
Bubblegum Tate
@Steeplejack:
Gracias!
Valdivia
@Steeplejack: @kay:
I know this is getting into theoretical what if but oblige me a second: if they don’t do away with the whole ACA, can the states step up and build their own models of ACA at the state level? I could see Maryland under O’Malley and nyc with Cuomo and other states following through. Could all of it be invalidated by a Republican president by making the sale of insurance across state lines legal?
PurpleGirl
@Leeds man: I think the insurance companies and Big Pharma were fine with the Obama reforms. (And the lead-in time allows them to make some profits and come up with strategies to continue the profit-taking.) I also think we are about to find out just how political the SCOTUS is prepared to be, i.e. vote as body for the good of society/country or vote as ideologically driven individuals with a more or less common agenda of FYIGM.
trollhattan
@gogol’s wife:
You’re not the only one. Since Ed’s long dead, I only come up with Andy when “Sullivan” gets mentioned.
I need to get out more.
Leeds man
@mingo: I suspect they’d be even finer with the boatload of ugliness that would result from repub majorities ‘fixing’ health care.
This is what I will never understand about the corporate mentality; the ugliness which will ensue when people will no longer stand for the abuse will make everything that came before it seem like a picnic. The inability, the lack of desire, to consider consequences is truly, and with no exaggeration whatsoever, sociopathic.
MattR
@Martin: Rick Perry signed into law a $1.00 per pack cigarette tax increase in 2006. Sounds like he thought there might be some ability to legislate a healthy liefstyle at that point.
@Southern Beale: Did you see Colbert’s response to Murdouck?
Lurker
I just thought of all the ways that person was wrong. Government can provide:
– public parks
– sidewalks
– bike lanes
– public pools
– a public playground for children
– calories listed on menus of chain restaurants
– smoking bans
– trans-fat bans
You can’t force people to exercise, quit smoking and eat right, but you can still help.
The ACA even fulfilled one of the things on that list (calories on menus).
PS — thank you, Kay, for everything that you post.
Steeplejack
@Ruckus:
Yeah, it’s already being eroded. I was seconding Kay’s point that if ACA is overturned there is nothing ironclad about the assumption that health insurance will revert to some immutable status quo ante.
kay
@Martin:
Good for you. Public health works. Look at seat belts, or helmet laws or infant seats in cars.
Imagine what infant seats in cars, alone, saved on health care, not to mention anguish and heartbreak.
elmo
@Shinobi:
Truer words never spoken, etc.
Rafer Janders
@Shinobi:
Yes, god forbid you should challenge a student’s fixed beliefs. That’s not what education is for.
Davis X. Machina
You can’t refute a theology.
MattR
@Rafer Janders: Everyone should believe in the Easter Bunny, the Tooth Fairy and Santa Claus for life.
Maude
@gogol’s wife:
I thought the same thing.
OT, but back to kids singing English lyrics. A lot of countries have kids learning English. Not like here, where foreign language is on the back burners.
During the Cold War, you prolly know this, you could learn Russian or Chinese and get paid for it by the Federal Government. Just thought of that today.
Edit: spell fail.
Valdivia
@Lurker:
also too: drinking and driving! that is one health and individual security campaign that got legislated and was greatly successful.
Davis X. Machina
@Valdivia:
Not invalidated, just rendered impractical. State anti-usury laws still exist, and existed, when the business simply all went to Nebraska, South Dakota and Delaware.
Valdivia
@Davis X. Machina:
I guess my question is: Massachusetts has their state health care plan. If they were to make it legal to sell across state lines does that mean that all the residents will lose all their protections?
a hip hop artist from Idaho (fka Bella Q)
@Fezzik: I’m so very sorry. My dx was less than 1 year ago also.
I console myself with the results of my research, which suggest that the very expensive disease modifying drugs I cannot afford don’t actually have very high efficacy rates. And then I do everything I can to keep chronic inflammation down – lots of omega 3s, vitamin D and tons of vegetables.
Shoot me an email addy at the website if you’d like any links. You really have my sympathies.
Davis X. Machina
@Valdivia: It depends on whether the MA bods certify the cross-state plans as adequate to meet their mandate.
Until Congress passes a law — federal pre-emption — saying that Massachusetts can no longer make that call.
States rights, of course, in this case, being meaningless.
russell
Yeah, that’s me to a T. I’m Donald Trump’s psychic body double.
If you don’t like the emigration idea, then I suggest that the people in Texas who aren’t assholes and don’t like the way things are going VOTE FOR PEOPLE WHO AREN’T ASSHOLES.
I can’t do that, because I don’t live there. I have absolutely no control over how TX runs itself.
Jerks hold office because people vote for them. To a non-trivial degree, policies in TX are what they are because a lot of people in TX like it that way.
None of that is my doing, and there is not a freaking thing I can do about it. And when people like me make an effort to establish something more humane at a national level, we are treated to threats of assassination. The good patriots of this nation are going to water the tree of liberty with our blood.
And when I say “make an effort” I mean spend money and time, canvassing and on the phone, advocating for candidates who will hopefully make some good things happen. I’ve done all of those things. I’ve spent money and time on candidates for public office in places I don’t live, candidates who are going to contribute exactly nothing to my personal well being.
Here is the reality:
There are lot of people in TX (and elsewhere) who like things just the way they are there. That, in fact, is why things are they way are there. I can’t do a damned thing about that. Not one thing.
The things I think are good public policy are not the same things that many, many, many other people in this country think are good public policy. I’m not going to change their minds. Trust me, I’m not.
It’s very, very hard for me to find even the most rudimentary areas of common ground with folks like the “assholes who run Texas”. I put that in quotes because they’re not necessarily assholes, and it’s not just the folks who run the place. I have little in common with them, and as a result the nation as a whole can’t get a freaking single constructive thing done.
If they want out, as far as I’m concerned they can go. Having the state of TX remain in the union is not going to make life for the Durans of the world any better, because they’re still going to be in TX. If they want a different life, they need to live someplace else.
That’s got not one damned thing to do with me.
kay
@Lurker:
That’s what drives me crazy. Everything they say falls apart when you think about it for 30 seconds.
Does this moron wear a seatbelt? Does she think that habit and 30 year public safety initiative came from GOD? It was MASSIVE. It took federal law and state law and tickets and a TV campaign.
Ruckus
@Steeplejack:
I figured.
And will say there is no real status quo in the way the term is in current usage. In the insurance industry, government, life or whatever. Things change. They get “better”(cell phones come to mind), they get better(ACA), they get worse(health insurance, conservatives, TX educational system) but things don’t stay the same.
trollhattan
I’m hooked on this thing. So much WIN.
Valdivia
@Davis X. Machina:
so in essence people who live in states with agencies that will rubber stamp the lower common denominator policies are screwed and does that don’t will be ok. what a fucking nightmare.
Culture of Truth
Milk, Mags & Moms
MattR
@trollhattan:
Fixed that for them. I am sure they meant to reserve the right to punish teachers who support evolution or climate change too vigorously.
Ruckus
@Davis X. Machina:
Theology.
Hard to refute an imaginary story. I mean if one can just make up shit in the first place why should studying it be any different?
dmsilev
@BGinCHI:
Even in an era where the non-apology apology is virtually an art form, this is impressive. Emperor Hirohito “The war situation has developed not necessarily to Japan’s advantage” impressive.
dr. bloor
@kay:
I don’t know many providers who don’t take credit cards, and who don’t demand payments for deductibles before they spent minute one with the patient. I’m still a little sloppy about getting payment up front, but I’m getting there. (I’m holding off as long as I can on using collections agencies). I don’t like it, but neither do I feel obligated to run cover for insurance companies and employers who are sticking their employees with shitty policies.
DFH no.6
You see, most of the middling-to-well-off white folk who do most of the voting in Texas have decent health insurance (for now), so there is little to no incentive for them to do anything or even care anything about those who do not.
The opposition by people (not just rightwing politicians, but scores of millions of people) in this country to health care reform like the ACA that primarily addresses lack of coverage to millions of the poorest and most vulnerable of their fellow countrymen is the single greatest example I know of the bedrock conservative principle we here all know and love as “I Got Mine, Fuck You”.
Unfortunately, those who most need the help ACA provides are not a very reliable voting bloc. Those most opposed to ACA are, conversely, the most reliable voting bloc. Where that dichotomy is strongest (like in, say, Texas) we get governance that reflects that.
As kay so perceptively commented at #57, “health care will simply change, and become less and less comprehensive”.
This has been happening for some time, and will continue until a line is crossed and “decent” health care coverage becomes impractical and unaffordable for most who enjoy it now. Without ACA that line approaches quickly.
So maybe things will change for the better when the “I Got Mine” half of the bedrock conservative principle no longer obtains.
I’m skeptical, though.
piratedan
@elmo: can’t miss what you never had
Davis X. Machina
@Valdivia: 50 states, 50 little laboratories for democracy. And Freedom.
It’ll be an uphill pull for all but the very largest states to maintain anything other than an increasingly expensive, increasingly hole-filled health insurance status quo. MA is probably too small — and one of the reasons why MA can do what they do now is federal support.
Martin
@kay: The largest contributor to increased lifespan for under 25 year olds in the US is auto safety. Saved and prolonged more lives than the polio vaccine (yet another legislated measure that saved countless lives). Globally, clean water has saved more lives than any other measure, and is also legislated. Respiratory disease in SoCal is on the decline not just because of the decline in smoking, but also because of the unbelievably large decline in smog. Also legislated.
LA used to have hundreds of Stage 1 smog alerts annually back in the 50s. Over time, due to air quality laws the number declined, and the air quality board even stretched out the definition of the stages – what was deemed a stage 1 alert in the 50s would have triggered a stage 3 alert in the 90. It’s been so successful that the last stage 1 alert was 11 years ago. My kids have no idea what the alerts are – there have been none in my daughter’s lifetime.
Steeplejack
@kay:
That is a great point. And, just in a (ludicrous) “free market” context, it will cut into their business. People will delay or forgo procedures that they can’t afford and that can be put off (whether safely or not). So the providers will “lose business.”
I experienced this myself with skin cancer. I have a history of basal cell carcinoma, and during a down-and-out period I had a small spot on my arm that I couldn’t afford to get treated. I was pretty sure it was basal cell, which is not immediately life-threatening, so I just did nothing until I could finally afford to get it taken care of. And, of course, when it was treated, it was more expensive because the delay had caused some complications.
I shudder to think about how many people are out there with some problem who never get to the point of “affording treatment.”
Jay in Oregon
@Shinobi:
When Gabrielle Giffords was shot, there were people in Arizona openly speculating on whether or not a Republican would get her seat. That was their primary interest.
There are people whose sole concern is tribal identity; the rest of us are non-people to them.
russell
Scott S, if you’re looking for somebody to bitch at, you want to find the folks referred to here as “Audience”. Bitching at me isn’t gonna make a guy like Duran’s life any better.
Go find the folks who cheered for the idea of letting sick people die and change their hearts and minds. Maybe you can get it done, I’m sick of trying to have a conversation about it.
Steeplejack
@Valdivia:
I think Vermont may have a single-payer system now, but I really don’t know how any of this plays out.
Martin
@celticdragonchick:
Last gasp of a dying party. AZ is a little further along the line. CA went through it too back in the Prop 187 days. We’re as blue as our sky today.
As I’ve noted many times before – had Latinos turned at at the same rate as non-Latinos in TX in 2008, Obama would have won the state. Texans know this instinctively. They’re throwing up as many firewalls as possible to hold off the inevitable, but it’s indeed inevitable. TX will become a blue state before long.
kay
@Martin:
That’s a great story.
I encounter a lot of teen parents in my work. It is socially unnacceptable among them to ride around with a baby not in a car seat. Pure public safety success. Repeat, repeat, repeat, and they all get it. They shame each other into it.
They put diet pop in a baby bottle, but no self-respecting teen parent in this town would be seen without a baby seat.
Steeplejack
@dr. bloor:
As I said in my comment to Kay, it’s not going to be (just) a question of your getting paid for services rendered. People are going to self-ration their medical care and delay getting nonessential treatment that they can’t afford. Your business, i.e., “foot traffic,” will decline.
Valdivia
@Steeplejack:
I know that O’Malley got moving right away in planning for the exchanges and they are ready for the full kick in of ACA ahead of time for 2014. My take has been that if the SC invalidates the mandate Dem Governors can step up and pass something that acts as a mandate without calling it that. If this were the case you would have a heighten the contrast between states that do have some form of universal healthcare and those who don’t. But that presumes Obama still being President.
Totally OT–found this in my bookshelves today and thought you would enjoy reading it.
Valdivia
@Davis X. Machina:
It just seems like if ACA goes down, nothing at a national level could be workable that will be anywhere near as good.
Mike in NC
@scav:
I’ve been to Texas and I’ve been to Pakistan. Both were miserably hot, fly-bitten, dusty nightmarish shitholes. To risk a generalization, of course.
Steeplejack
@Valdivia:
I have read a couple of the Pepe Carvalho books, but only in English. And it was a long time ago. I remember being frustrated because I knew there was a long series and so few had been translated. Like you, I like to read in order, and when I like a series I like to zoom through it.
Martin
@Valdivia: California has a single-payer plan ready to go. They’ve been waiting for the budget issues to settle before dropping it, but this might force their hand. The votes are there in the legislature. The governor wants to sign it, but he wants to balance the budget more, but he’ll likely yield if need be.
Fezzik
Thanks everyone for the well wishes and advice. Although looking down the barrel of potential disability sucks, the upside is that I can one day buy a sweet looking sword cane and/or eyepatch. And so on.
But my main point, of course, is that I’m a good example of how the “people should take care of themselves” argument falls flat on its face–as are literally millions of other examples. We need to make conservatives OWN the moral depravity of their own arguments.
GxB
@celticdragonchick: Christ almighty… This thing reads like a manifesto. The clowns are running the circus, the inmates control the asylum, the fox is in the hen house and I’m going to need a lobotomy if only to escape the madness…
New Zealand is looking mighty fine bout now.
dr. bloor
@Steeplejack: Less than you’d think. Recall the rationale for the mandate–everyone becomes a patient sooner or later.
People will be figuring out whether to put me, the new tires for the car or the big screen teevee on the Visa card in any given month. I’ll get chosen at some point.
Valdivia
@Steeplejack:
yes! I have myself a little marathon of a series, reading every book back to back. Then I have to wait patiently for the next one to come out if the author is still alive and updating the series.
This one is a great series, the character is full of contradictions, and interesting in a way that draws you in. I am waiting to see if the series they made of his novels will ever make it here.
speaking of–it seems we are ready to launch with The Moviegoer. Just a matter of coordinating when we are all in the same thread. :)
gogol's wife
@Maude:
My college education was paid for by the National Defense Education Act. So that I could immerse myself in 19th-century Russian literature. But I’m not complaining. I think I’ve done my bit for the national defense.
kay
@dr. bloor:
Oh, I agree. I think everyone should get paid. However you have to work that, you should get paid.
I’m just not sure the providers who were listening to Rand Paul were anticipating fewer and fewer patients with comprehensive policies. I see that as inevitable, w/out reform
I listen to conservatives, and I laugh, because the new line is “employers won’t cut coverage, because they have to compete for employees!”
Ah, the Magical Markets Fall Back argument. Not yet working, because employer-provided coverage goes down every year, but someday it will work!
They know goddamned well what’s coming.
Steeplejack
@Valdivia:
I started rereading The Moviegoer on my Nook last week (in between other stuff).
Valdivia
@Martin:
that is good news. I really do think we are going for a period of Heightening the Contradictions of our current capitalist system, if the mandate falls.
Lurker
@Martin:
As a fellow California resident, I hope you’re right. California’s population is about as big as Canada’s population, and we have the 8th largest economy in the world. I think it could work.
Maude
@gogol’s wife:
That’s the one. That is great that you could take advantage of it.
Valdivia
@Steeplejack:
I started reading it on my iPad too. now we can figure out how to officialize and think of a timeline. :D
ETA: because handsmile and BGinChi are in.
Bubblegum Tate
@trollhattan:
…in theory. In practice, we don’t give a shit about those dirty whores and their welfare babies, we just don’t want the broads to expand their horizons beyond the kitchen and the nursery.
WereBear
@Fezzik: Damn.
There is considerable evidence accumulating that an intensive antibiotic treatment, known as the Vanderbilt protocol, and similar to what the enlightened prescribe for Lyme disease, can help a great deal.
Mr WereBear is in his fourth year, for the auto-immune disease known as CFIDS, and is experiencing improvement in his worst symptoms.
You can reach me through the contact page for my site if you have questions. Offered in case I can be of help.
Davis X. Machina
@gogol’s wife: Making the world safe from Constance Garnett is a noble cause…
Fezzik
@GxB: Only if they manage to oust the National government in the next election before they do too much damage. Those idiots/assholes are using the GOP playbook from about 10 or so years ago and going hog wild–or as much as its parliamentary system allows.
dr. bloor
@kay: I think the patients are the big losers–their policies will growing increasingly suckier, but they’ll have no leverage with either the doctors or with their employers. This is where the whole notion of “competition” in the health insurance market is absurd–the biggest purchasers (i.e. corporations) aren’t actually using the garbage they buy for their employees.
Felinious Wench
Balloon Juice Texans, and I extend that title to Molly Ivins, have been saying this for years. Since W first became a gleam in someone’s eye, we’ve been saying not to allow the rest of the country to become Texas. Don’t elect these dumb-ass Texas Republicans to any kind of office where they have real power in the country. Because Texas is not like the rest of the U.S., and the rest of the U.S. is not like Texas.
Texas is not going to leave the Union. You’re stuck with us, much as all of us are stuck with Oklahoma. But, trust those of us who are watching everything these idiots do…and refusing to leave the state, because it’s our home, and I’ll be damned if I let a long tradition of Texas liberalism/populism be completely lost to them.
I still miss Molly Ivins and Ann Richards.
The Moar You Know
@Mike in NC: I’ve been to Texas and Somalia (seriously). The weather in Texas was somewhat nicer – north Somalia on the Aden Sea is the hottest place in the world. The Somalis, in general, were nicer.
TenguPhule
Untrue, the trick is making sure *every* one of the bastards is burned at the stake. Miss one and you have to start all over again.
AA+ Bonds
What this actually means is that a lot of Texans take a little joy in seeing poor people suffer, because they deserve it
pluege
it’s a lie, yet they all repeat it anyway.
its a safe wager that literally everything out of a republican’s mouth is a lie.
GxB
@Fezzik: I could be misreading you but are you saying the Kiwi’s have these idiots amok too? – GACK! –
kay
@dr. bloor:
Right. I was looking at it from the perspective of those who don’t have health insurance. They don’t lose, really. They didn’t have it and they won’t have it.
I am somewhat angry at the people who opposed this law and have health insurance ( as I do) because I think they believed they would retain the status quo. They won’t. It was naive and delusional for them to think the system would continue to work for them. The point was to save and expand that system. All they heard was “expand”. They could have had “win/win” , maybe, if it worked, admittedly not at all a sure thing. They chose “everyone loses”, they just don’t know it yet.
Scott S.
@Felinious Wench: Hell fucking goddamn yes. Thank you.
Rafer Janders
I have been to Somalia and I have been to Texas, and I strongly, strongly dispute that. Far be it from me to defend Texans, but Somalia is the scariest, most terrifying place I’ve ever been. At least when I went to Texas, I could move about freely and didn’t have to hire a clan of armed gunmen to keep me from getting kidnapped and shot.
(Yes, kidnapped AND shot. They hadn’t yet worked out how that whole thing was supposed to work).
JCT
@kay: As a native Californian of a certain age I remember when these laws being passed and basically thinking there is NO WAY that people will actually follow these rules. Seatbelt laws are one of the unsung heroes of public health in terms of lives saved.
Nice post by the way — the irony of the Houston statistics given the prestige and overall excellence of the Texas Medical Center and MD Anderson is sobering. My husband is a patient at MD Anderson and we went there for his care even though we live 20 minutes from Sloan Kettering in Manhattan.
But we have choices and clearly in Texas many people have nothing. It’s a moral failure. Period.
DougW
@Lurker: Hang in there. I’m crossing my fingers for you and everyone else’s benefit. I’m just as desperate to see the upholding PPACA ruling as everyone else who has any sense.
Felinious Wench
@Scott S.:
It’s funny, because we’ve been saying this for YEARS. Don’t let these idiots out of the state. Don’t elect them to anything. Don’t let Texas policies become national policies. And yet, these people were elected to the Presidency, Tom DeLay was Speaker. WHO ELECTED THEM NATIONALLY, huh? There aren’t enough Texas Republicans to get their people elected, thank God, so who let them in?
Hell, we can do our best to fight them at the state level, and God knows we do, but we can’t do much if the rest of the country votes them in, except say “we warned you not to do this. We warned you not to use us as some kind of example or guidepost. For God’s sake, don’t let them out of Texas. They’re dangerous.”
Texas, thank God, is not the United States. They can’t get into office or get these policies inflicted on everyone else without the help of the rest of the country, folks.
Original Lee
@kay: Of course, Michigan just went and repealed its motorcycle helmet law because Indiana and Ohio don’t have one.
Mr Stagger Lee
Funny I accidentally,hit the tune button and turned to a Catholic radio station, and the host was bitching about the “culture of death” that is infesting the world. I can assure you it wasn’t about the tragedy that has Luis Duran and those he loved. Fuck these Christians and their pro-“life” bullshit with a rusty pitch fork!!!
Fezzik
@GxB: Not as many idiots (DEFINITELY not as many teahadists), but certainly (percentage-wise) as many Galtian overlords who think they know better, and who mix evenly between the evil and the merely incompetent. Aided by a Labour party that seems oddly disinterested in actual labor issues–you know, just like Democrats. Luckily the Green Party is polling well enough to likely decide the next coalition.
karen
@Mr Stagger Lee:
Was that the same host who said that Catholic nuns should be “pistol whipped?”
Steeplejack
I just did a full Danny Thomas spit-take when I saw this ad in the middle of the Angels-Orioles game a few minutes ago. It is an anti-ACA ad from the Concerned Women for America Legislative Action Committee (CWALAC). Unbelievable.
I went to the Facebook page for Dr. Ami Siems, the doctor in the ad, and she is taking a lot of (justified) heat over it.
rikyrah
thank you kay. not a happy story, but one that needs to be told.
Mike Lamb
So why doesn’t NR have the chutzpah to show up on this thread and discuss why he hopes ACA should be repealed?
russell
Yeah, me too. Sadly, they’re gone.
All the millions and millions of Americans who look at Texas and say, “Hell, that looks pretty good”.
The reason things are f**ked up is because a lot of people like it that way. From their point of view, there’s not f**ked up about it. It’s just the way it ought to be.
You can say “Hey, we told you not to let them out of Texas” but the plain fact of the matter is that a lot of the country is just like the folks down in Texas that everyone is calling @ssholes.
A room full of people responded to the question “should we just let them die?” with a vigorous cheer. Those folks weren’t all from Texas. A lot of folks were cheering right along at home while watching the TV.
Think you’re going to change those folks’ point of view? I don’t. I’m not sure where this crap ends, but I don’t think it’s anywhere good.
It will be interesting to see what the SCOTUS coughs up on Thursday morning.
Judas Escargot, Acerbic Prophet of the Mighty Potato God
@Davis X. Machina:
With Scott Brown (R-MA) voting ‘Yea’.
Xenos
@Judas Escargot, Acerbic Prophet of the Mighty Potato God: When I last lived in Massachusetts my insurance company was based in NY. If a state wants to allow an insurance plan from another state to be sold, they can allow this already – there is nothing standing in the way other than the regulatory system and laws of the state in question.
So when conservatives talk about selling insurance across state lines, they really mean federal preemption of state regulations. They mean taking away the states’ police powers, and they mean gutting federalism where it gets in the way of corporate profits.
As Kay put it the other day, it means running our health care financing system like the credit card industry, which was simalarly preempted by federal law when Scalia ruled that the commerce clause was sufficiently powerful that the lack of a federal statute on usury meant that states could not enforce their own usury laws.
They have done this before and they mean to do it again.
The prophet Nostradumbass
@Mike Lamb: Because, on top of being an asshole, he’s also a coward.
fuckwit
Texas is a good stateside example, but I still think Markos correctly identified the ultimate glibertardian paradise as being Somalia.
Want to see what the ideal Rethug future is? Look at Somalia.