Doctor says people needing care should 'abandon the island' after Puerto Rico’s medical system crippled by #Maria https://t.co/ArQdxwM9Xy pic.twitter.com/8a1xYEjiTv
— Reuters Top News (@Reuters) September 25, 2017
Roughly half of everyone living in Puerto Rico has health insurance through Medicaid. Medicaid is obligated to pay for medically necessary care in an emergency even if the hospital is not in the provider network. The doctor in this clip is making a recommendation that anyone who needs significant care and whose family can find a way to get them off the island to go to the mainland.
I grew up in Lowell, Massachusetts. There was a large Puerto Rican population there. I would be shocked if some of the kids I grew up with are not talking with their siblings and their cousins about ways to get a family member to Lowell General Hospital for treatment next week. Those same discussions have to be occurring all over America. And these are the discussions that are best for the families involved.
However, it will drain the already inadequate Puerto Rican Medicaid block grant as some of the potential medical evacuees will be insured via Medicaid and when they present their cards to mainland hospitals, the care will be medically necessary and unavailable in Puerto Rico. The prices that will be charged will be far higher than the prices hospitals on the island charge to Medicaid. So each given unit of service will be a more expensive unit of service and a higher proportion of the fixed budget of the Medicaid program.
Block grants don’t work when there is a large shock that needs an immediate response.
ThresherK
Block grants don’t work
when there is a large shock that needs an immediate response.FTFY
rikyrah
Block grants are a scam.
Thanks for proving that once again, Mayhew.
SFAW
So will they become the new Marielitos? Or the new Dunkirk evacuees?
Hmmm, let me see, I wonder how the Maladministration will treat them …
rikyrah
Mayhew,.
You know damn well that Rand Paul can’t be trusted. Please post another Call to Arms post. Our work is not yet done.
SFAW
Lowell? What part?
ETA: I was going to say “Gee, you don’t look Cambodian,” but people who never heard of John Silber would not get the “joke.”
SFAW
@rikyrah:
So are they all, all honorable men.
Glad to see I wasn’t the only one thinking that about Little Lord Randy.
Feathers
@SFAW: I remember John Silber well and I didn’t get that one. One of my few Republican votes was Weld over Silber.
SFAW
@Feathers:
During his campaign against Weld — or perhaps before the campaign — Silber “speculated” that the reason there was such a large Cambodian population in Lowell was because of welfare. Interestingly, he didn’t seem to fling the same accusation towards the large Portuguese-speaking areas of Fall River and New Bedford. I wonder why that was?
I don’t recall — one of the “benefits” of age, I guess — but I’m pretty sure I also voted for Weld. I know I voted for Frank Bellotti in the Dem primary, however. Vote for that arrogant, racist prick Silber? Right.
ETA: Of course, in those days, there wasn’t as much economic anxiety, but Shitgibbon reminded some people of Silber — although Silber had about 50 IQ point on Lying Littledick
Balconesfault
Speaking of things that don’t work … “Tax Reform”.
It’s not a tax CUT, right? It’s all about making the tax code simpler for people and small business to deal with?
Meanwhile, Repubs show why tax simplification always fails as they try to use hurricanes to pass targeted tax cuts.
ThresherK
@SFAW: Mom’s family went thru Worcester to Bridgeport. Dad’s family, New Haven. I’m German and Irish, mostly. As far as I can tell when my Irish forebears immigrated, the children of Ye Auld Sod were considered white in the USA.
Study question: By what year did the New Bedford / Falls River Portuguese community get “upgraded to white”, like the Irish?
Patricia Kayden
Sadly, it looks as if Puerto Ricans are on their own. Ryan has promised federal aid all the way in mid-October.
David Anderson
@SFAW: Centralville…. where are you from?
SFAW
@David Anderson:
I’m not. We lived in Tewksbury for about 15 years, went through Lowell all the time. we almost bought a place there (Belvidere, but not one of the mill owner homes, of course). . Never made it to the (now long-gone) Speare, however.
Frankensteinbeck
@Balconesfault:
It is a giant tax cut for the rich and no one else. I don’t even have to see the details. I guarantee it. Also, it has zero chance of passing unless McConnell nukes the filibuster, which seems unlikely because his caucus is unlikely to support that (they do love their power to grandstand), or through reconciliation.
JaneSays
@rikyrah: Agreed that we still need to get Murkowski as a firm “no”, but apparently Paul’s firm line in the sand is the total elimination of the block grants. He doesn’t want one dime of federal tax dollars going to healthcare, and I don’t think he’s gonna budge on that.
aimai
@SFAW: Perfect comparison.
aimai
@ThresherK: Never?
Amir Khalid
@Patricia Kayden:
Did Ryan say the House would approve emergency aid by mid-October, or that such a bill might be presented in the House by then? Either, he seems not to realise that making Puerto Rico wait at least three weeks is unconscionable.
SFAW
@Amir Khalid:
Only to those brown people, and the alleged “Americans” — those who are not economically anxious, of course — who care about them
David Anderson
@SFAW: Cool, I spent enough time in Tewksbury; one of my first memories as a kid was the weekly? trips down 38 singing to the tune of the Batman theme song: “Na na na na na Heartland, we’re going to Heartland’ for our grocery shopping.
And when I was older, my best friend’s high school girlfriend lived right behind TewMac so we drank heavily in those woods.
SFAW
@David Anderson:
Sorry to inform you that Heartland — we often shopped there — has been gone for 20-plus (I think) years, and Tew-Mac was turned into a golf/country-club-and-housing development something like 15 years ago. The spring water was still available for awhile after Tew-Mac closed, but I have no idea whether it still is. (I lived off of Livingston Street, which is the road that intersects 38 at Tew-Mac.)
As far as I know, Mac’s Dairy Farm is still going strong.
This is so weird. Never thought I’d be talking about Tewksbury on this blog.
the Conster, la Citoyenne
@SFAW:
I got the joke – it’s a good one. If you get it, you’ll also remember Natalie Jacobson’s sit down dinner interview with Silber and his family and how that turned out.
SFAW
@the Conster, la Citoyenne:
Sorry to say, I DON’T remember how it turned out (although I vaguely remember Nat doing some interview with Silber that didn’t turn out particularly well). What happened?
ETA: Never mind, I used Teh Google. I remembered his inner-city comment, but had forgotten about his peevish response to Natalie re: his “weaknesses.” I had also forgotten that he was way ahead of Weld before those two statements.
the Conster, la Citoyenne
@SFAW:
OMG, they’re all at the dinner table having a nice discussion and Nat asks him a typical interview question – what are your strengths, etc. – then she asks what his weaknesses are, and the thin skinned racist bully (sound like someone we know?) starts getting defensive, then switches into accusatory “you media enjoy focusing on my negatives” (sound like someone we know?), raises his voice, starts pointing his good hand at her (emphasizing his disability) and half raises out of his chair as he loses it in front of her and his family. To Natalie, whom everyone in Boston loves. LOL. The next night they broadcast her at Bill Weld’s house doing the same thing, asking the same question. He chuckles and calmly says something like “I’m a bit too detail oriented” or some such anodyne comment. Weld won.
SFAW
@the Conster, la Citoyenne:
Even more ETA: And all that asshole had to say, re: his “weaknesses” was: “Well, some people have told me I’m too humble” or some obvious ironical joke, and then chuckled to let Natalie know he was “joking,” and she would have laughed, and he would have won. But humorless, arrogant, highly-intelligent pricks like that don’t really know how to laugh at themselves. Or, I should say, “it has been my experience.”
ETA: Just saw your response. Yeah, I did not see that when it aired. But you’re absolutely right about Boston loving Natalie; what a fucking moron he was to think that would work. Actually, I doubt he “thought.” But, in fairness, Silber was a shitload smarter than Lying Littledick ever was — even pre-dementia.
FlipYrWhig
@the Conster, la Citoyenne: IANA Massachusettsian but ISTR a Rolling Stone article about Silber where someone said of him that he thinks he’s an intellectual because instead of saying “I went up the stairs” he’ll say “I _ascended_ the stairs.”
the Conster, la Citoyenne
@FlipYrWhig:
Silber was a piece of work. Like cop talk – “the officer engaged in a confrontation with the person of interest and after an escalation of the incident precipitated by the suspect, the officer discharged his service weapon and the individual was apprehended by the officer and other members of the force who arrived to assist”.
SFAW
@FlipYrWhig:
OK, first of all: we’re not “Massachusettsians” — we’re Massholes (except for Anne Laurie, of course) TYVM. But Silber actually was smart. He turned BU into a national name, and without his Daddy’s money, and without defrauding the students. He was still an arrogant, racist prick, and a complete asshole to any faculty who did not bow down to him, but stupidity — except in certain ways (see earlier comments) — was not really one of his traits.
Victor Matheson
@rikyrah: I don’t want to be argumentative just to be a troll, but there is certainly a place for block grants in government in general. For example, the federal government block grants a ton of highway funding to states who in turn may block grant funds to municipalities on the assumption that Washington, DC, and state capitols don’t need to micromanage road repairs in Lowell or Tewksbury.
Pretty obviously the block grant scheme in Graham-Cassidy is a sham for a whole variety of reasons, but block grants aren’t inherently evil. Even the Puerto Rico issue brought up by Mayhew here doesn’t necessarily mean block grants are bad as long as Washington is sufficiently flexible to authorize additional block grant spending in the face of state (or territory) specific public health, natural, or economic disasters. Of course, like Mayhew, I have no reason to believe Graham-Cassidy would be sufficiently flexible in the wake of changing conditions.