Anthony Weiner on Health Reform

This is a thing of beauty.

Healthcare Crisis Part II: The "Benefits" of Health Insurance

On Thursday, St. Vincent’s who “accepts” both insurances requested Juliette bring the films as soon as possible. Since I work from home I volunteered. The UMDNJ is a typical hospital, white floors, white walls and white ceilings, however friendly medical staff dressed in blue pajamas smile at you and ask, “can I help you find something?” This is the same hospital I attended Physical and Occupational therapy for my hip and elbow. Memories. I picked up Juliette’s films from UMDNJ, paid a bored cashier and waited for the films. Directed to a waiting room, I sat and watched Rachel Ray as she made eggplant balls for Thanksgiving. “Do people actually watch this?” I said out loud. Seven pairs of eyes stared at me as my name was called. Clemency.

I arrived in the city at St. Vincent’s, a beautiful facility on the west side not far from the structure on Seventh Avenue. The first thing I noticed as I walked in was a cappuccino maker, various teas and thousands of magazines. Not bad I thought. I can wait here in peace. The walls were bright, the office neat, it felt like a children’s hospital. A beautiful young looking Chinese American woman, nervous stood before me, Juliette’s age, waiting to speak to a Secretary. We both hemmed and hawed for 10 minutes as they stood just outside our vision talking. Not a good sign, I thought. Though, quickly after we caught their attention, they attended to us and I was on my way back to Jersey City. They gave me a date of November 17^th for an appointment. Everything we could possibly do done, we took a sigh of relief and settled in for the week’s wait.

Juliette and I spoke about the procedure, what this means. Everyone we spoke to seemed to know some relative, aunt, mother, sister who had a similar procedure. “It will be fine” we were told. Except sometimes it wasn’t fine, which scared us a bit and our luck ran with the Irish. Non-existent. We decided to not discuss it and muddle through until the 17th, after all this is something thousands of Americans are experiencing at the same time, right? We need to wait and see and breathe.

On the Saturday before the procedure we received a letter in the mail from St. Vincent’s. “No need to come in for an appointment.” Juliette continued to read. “Wait six months. Probably benign, come back for a new mammogram in six months,” with a bill for $50 tucked in for all the work the medical staff perfromed. “We’re still going to the appointment I announced to Juliette.” “What are you talking about? They just cancelled the appointment!” “They can’t do that” I argued. “Well, they just fucking did!” Juliette said angrily. We pumped ourselves up for the appointment and now it is not to be. “Fuck!” I yelled. “What do we do?” I asked. “Is this reliable? Is this a good thing?”

The fifty dollars was a bill for their services. Juliette called them and said her insurance should cover it. “Well, you didn’t meet your deductible.” “What deductible? I have insurance.” “Right, but this is 'an out of network' claim.” Perplexed Juliette asked them “what the fuck are you talking about. I thought you said you accept healthnet?” “Technically we do “accept” healthnet, but only out of network benefits.” She connivingly said. In "out of network benefits" she explained, “You pay.” So, basically as long as they get their money? No need to tell the patient they will be paying the first $500 or $1000 in deductible instead of simply a “co-pay,” or “in network benefits.” Thank god, we didn't have them perform the procedure, I said.

We weighed our options. Some told us to wait the six months. Juliette would receive another mammogram, and eventually have the biopsy anyway” was the advice. What is the point of that? Juliette asked her personal physician, “what should I do?” “If it were me,” she said. “I just don’t know.” Helpful. Juliette did not want to have her boobs shoved in a machine again, just to be told you need to have a biopsy, “what is the point of that?” she repeated. I agreed and encouraged her to seek a second opinion, though she was not happy about it.

Like controversy was made for us, new mammogram guidelines were released on November 17^th, the day we were supposed to be attending an appointment with St. Vincent’s. These new guidelines sparked immediate controversy. A government advisory board made up of medical professionals said women should not be receiving mammograms until the age of 50. Our eyes perked. The guidelines written by a government panel essentially said that getting screened for breast cancer “so early and so often leads to too many false alarms and unneeded biopsies without substantially improving women's odds of survival.” That sounds about right actually. They sparked outrageous controversy and fear, the media talked about them for a while especially the Rethuglicans who thought it was a good way to derail healthcare reform.

Still, what if? What if Juliette is in that category of women that have no warning signs, could she afford to wait until she was 50? We decided that because she was already screened we would receive a second opinion. We wanted to see what an actual surgeon who examined her would indicate.

We arrived at the doctor’s office at 5:00 PM, right on time. We needed to be buzzed in, "come on this is Hoboken, are we afraid of robberies now?" I said. Not a seat in the house as Juliette checked in with the receptionist. Also, not a white face in the room, all low-income, primarily Latino clientèle. “What is this guy doing,” I thought to myself and intimated to Juliette. "Scheduling everyone he can before healthcare reform passes?" Juliette rolled her eyes with abandon and scoffed the first seat available. After about an hour of waiting and several chapters read in “the Last of her kind” I looked at Juliette and said, “what the fuck?” He comes recommended Juliette said. Dr. B, her personal physician that operates as a community clinic recommended him.

We were called in, he was young, our age actually, he just turned 40. Is that still young? He was Latino, good looking and competent, and calming. He immediately told us “you should have the procedure done.” He explained the procedure and why he thought Juliette might benefit. "Most likely, in six months you will be right back here anyway." he said. "Plus, it is probably benign, but there is no way of telling unless the procedure is actually done." Juliette felt comfortable with him, so we scheduled the procedure for December 23^rd. Done. The scheduler seemed nice, but she told us “I can’t schedule you at Hoboken Medical Center. I am having problems there and the Radiologist there is not on the schedule.” So, she scheduled us for an "ambulatory center" in North Bergen. Only two weeks to wait.

A week flashed by and we still hadn’t heard from the office, she informed us she would call to approve the procedure with Oxford, Juliette’s insurance company and then call us back. We started to worry. Five days before the procedure we started to panic. Juliette called her insurance company. “You are not covered at the ambulatory facility” she was told. "You will pay upwards of 2,000 dollars if the procedure is performed there." "You have not been approved, nor will you be approved.” "No one has called you from Dr. Costa’s office?” Nicole asked. “Nope.” And she intimated, "It sounds like they want you to use "out of network benefits."

Chicken Reform

I said it the other day, and I feel the need to repeat it: the public does not yet understand that the government is about to order people to buy health insurance, with their own money. Yes, the government is about to order people to cough up hundreds of dollars a month each.

When the Republicans start using their toxic message-machine magic on this, and the public starts to understand that they are being ordered by the government to cough up a huge amount of money every month, Democrats had better have good hiding places, because things are going to get really bad out there.

This is the kind of policy that results when "centrist" Democrats give in to to the demands of Republicans and big corporations and the top 1% of the wealthy. Instead of just taxing the wealthy and corporations at reasonable rates and using the money to provide We, the People with health care -- thereby vastly improving the economy for ... the wealthy and big corporations -- they instead come up with a scheme to order regular people to pay for health insurance because they don't already have it because they can't afford it. - Dave Johnson - Open Left

Health Care Bound to Fail

Why is healthcare bound to fail? Because we have representatives that do not represent the public pure and simple. If you want crude analysis on why it is going to fail read Paul Krugman's column on the "centrist" democrats who he blames for the derision. They are certainly to blame, but there seems to be a lot of blame to go around. The Republicans of course flail their hands in the air and scream "Socialized Medicine" the same tactic used since Harry Truman. The Democrats have nothing to add at all. How about that nearly 72% of Americans want a so-called "public option" in their health care (another poll said it was 76%). That doesn't seem to move the elected officials that currently inhabit the most beautiful building in Washington, DC.

It doesn't seem to matter to these sycophants. The entire capitalist system almost falls on its face, we have to prop them up via nationalization and corporate giveaways and still the Republicans and many Democrats cry socialism because we want a health care option that is not the private sector? It is stunning and shocking to me. It is also important to note that the cost that has been so publicly repeated as one trillion dollars could easily be paid by removing the Bush tax cuts, a cost of 1.8 trillion. Iraq? Afghanistan? Shall I go on?

I have no confidence that the public option will be used and be in a final reconciliation bill, my bet is it will be a bunch of nothing, including subsidies and lower costs provisions and we will receive nothing except a temporary measure in deflating healthcare costs and millions still uncovered. Doing it half-assed is not doing it. President Obama campaigned on this, his signature issue besides ending the Iraq war (don't get me started on that one). If he fails and it certainly looks like he will, he may be a one-term President beaten by propaganda and a lack of will on the part of democrats. We are not arguing for Single Payer healthcare here, it is only a request to have competition in the market place, something unfettered capitalism abhors apparently.

It also begs the question of real reform. And I mean campaign finance reform, and I mean publicly financing campaigns completely tearing the money from the system. That is the only way to remove lobbyists and of course our "Public Representatives" out of the public coffers. It is a subject I have been screaming from the roof tops since Bill Clinton's second inauguration, an issue that grows in importance as we see corporations laud more power every year. For a great website discussing Campaign Finance Reform visit the Brennan Center (also a place that wouldn't hire me), tremendous discussions on what is happening around the country. It is not all that hopeless, a groundswell is occurring.

The Trouble with Sanjay Gupta

From Paul Krugman: (I agree wholeheartedly)

So apparently Obama plans to appoint CNN’s Sanjay Gupta as Surgeon General. I don’t have a problem with Gupta’s qualifications. But I do remember his mugging of Michael Moore over Sicko. You don’t have to like Moore or his film; but Gupta specifically claimed that Moore “fudged his facts”, when the truth was that on every one of the allegedly fudged facts, Moore was actually right and CNN was wrong.

What bothered me about the incident was that it was what Digby would call Village behavior: Moore is an outsider, he’s uncouth, so he gets smeared as unreliable even though he actually got it right. It’s sort of a minor-league version of the way people who pointed out in real time that Bush was misleading us into war are to this day considered less “serious” than people who waited until it was fashionable to reach that conclusion. And appointing Gupta now, although it’s a small thing, is just another example of the lack of accountability that always seems to be the rule when you get things wrong in a socially acceptable way.

overdue bill

monthly bill got you down? no not the money type... the pain type! having had a vacation from hell (long story, one of terrible accommodations), i'm in no mood for pain...

i'm always seeking remedies for the monthly cramps (yoga, no caffeine, hot water bottle, herbal belly balm, herbal tea, exercise) but i have yet to find the wonder relief. any readers out there wanna suggest their tried and true healing methods?

as always, here is ideal bite's helpful hints.

"Aching belly got you whimpering like a cocker spaniel?

Stray from regular cramp control methods. Instead, try a holistic approach that includes techniques like massage and natural pain relievers and that isn't so doggone synthetic.


The Benefits

Getting a leash on pain. Alternative medicine practitioners have used these remedies for centuries.

Feeling less shaggy. Natural options such as primrose oil are less likely to cause side effects than your average dose of prescription-only Ponstel.

Not treating the earth like a pooper-scooper. Fewer synthetic pills means less chance of toxic chems ending up in our water supply - and the water supplies of at least 24 major American cities already contain trace amounts of pharmaceuticals.


Wanna Try?

Exercise - it improves blood and oxygen circulation, including through the pelvis, and releases feel-good endorphins.

Get a Massage - massage therapists can target your abdomen to ease the tension.

Avoid Caffeine - it constricts blood vessels and increases tension.

Eat Less Dairy and Meat - antibiotics we add to certain foods may make cramps worse.

Spice with Cayenne - cayenne pepper also improves blood circulation.


Jigsaw Health Activated B - sustained-release B vitamins; Bs may also help with nonmenstrual cramps ($30).

Spectrum Essentials Evening Primrose Oil - widely used in Europe for PMS symptoms, it packs healthy omega fatty acids; so does borage oil ($11-$15).


Aura Cacia Jasmine Massage Oil - jasmine's another PMS symptom-soother; use it to massage your abs ($7)."

The Double Wammy for New Jersey Residents without Health Insurance

A measure sponsored by Senator Loretta Weinberg, which would limit the amount hospitals may charge certain uninsured patients for inpatient and outpatient care was unanimously approved today by the Senate Health, Human Services and Senior Citizens Committee.

Weinberg said she understands hospitals are struggling, but they cannot be allowed to make-up in lost profit on the uninsured, especially she says when these men and women are the least able to pay. Senator Weinberg's bill, S1797, would cap hospital bills for uninsured patients at no more than 15% above the Federal Medicare charge. The bill also calls upon the Department of Health and Human Services to develop a sliding fee scale, based on family income, which would be used to determine reasonable costs for hospital services.

In order to qualify for these set fees, residents' income would have to be less than 500% of the Federal poverty level, which is currently $21,200 for a family of 4 (500% of which is $106,000), said Senator Weinberg.

As someone who has been a victim of this fraud I applaud Senator Weinberg, who has shown herself to be a true blue progressive. Bills are high enough in hospitals when one has insurance, but when you don't the bills pile up at insurmountable proportions. I had surgery after a car accident that was a very serious situation. Within days my bills were passing the $75,000 dollar mark. With no ability to pay (I was in law school) and because I sacrificed my health insurance for food and books I was up the creek. Two years later, poverty stricken throughout law school I finally won a lawsuit to pay the bills.

But, the unfairness in charging someone who does not have health insurance more for their health care shocks the conscience. How many different issues could universal health care actually solve? It would be an interesting list to compile.

Wealthy People Enrolled in New Jersey Health Care Program for the Poor

This could hurt (politically) Vitale's call for universal healthcare in New Jersey. Already some Republicans are calling the state not proficient enough to run a state healthcare insurance program. While, sure fraud exists, I think it is important to note the fraud is from those over qualified from this program, not people who are qualified and are so-called "double dipping." Health Care for all is absolutely essential and because possible fraud is possible is no reason to stop the call for universal healthcare. This is what was found:

Wealthy people are enrolled in a state-run health care program for working poor families and criminal investigators are examining another state health program for the poor, according to new state audits that found shocking displays of wasted money.

An audit found:

• Some beneficiaries failed to report all income on NJ FamilyCare applications. Applicants authorize the program to match applications with their tax return, but the state isn't checking all tax files, allowing people with incomes of $295,000, $186,000 and $177,700 to enroll.

• About 13,000 NJ FamilyCare participants weren't sent renewal applications, though regulations require eligibility be determined annually. The audit found $43.1 million was paid to these participants from July 2005 to September without knowing if they remain eligible.

• The state failed to try to collect $4.6 million owed to NJ FamilyCare by 16,300 people.

• The state paid $2.1 million from July 2005 to December for medical equipment that should have been paid for by nursing facilities.

• The state is failing to monitor medical equipment providers. For example, it found a provider billed the Medicaid program $30,000 for 48,000 adult incontinence briefs, though the audit found only 10,000 briefs were purchased. Auditors said they've referred this and other examples to state criminal investigators.

• The state isn't properly calculating Medicaid reimbursements. For instance, auditors found the state paid $8,181 for a wheelchair that should have cost $5,705.

• The state spent $6.7 million in state and federal money more than was needed to rent oxygen equipment and buy adult incontinence briefs.

• The state, from July 2005 to December, sent as many as three blood pressure monitors to Medicaid patients, even though many come with warranties and are replaced for free by drug store chains. The audit found the state could have saved $100,000 by denying these claims.

Questioning Health Care Mandates

Paul Krugman has been very harsh on Barack Obama on healthcare mandates. I am not going to rehash the arguments fully here. This is a personal piece on how they work. Health care mandates are a "way" of covering universally all the people in our system. Certainly, a lofty goal. Clinton and Edwards have attacked Obama because his plan does not universally cover everyone. Fair criticism in my opinion, but the substance of his argument gets lost I think. Mandates are essentially a pay-off to insurance companies. It is a public - private partnership to have everyone covered and the money goes to who else - insurance companies. Now mandates are better than nothing certainly, but what Obama argues for is lowering health care costs to make it easier on all of us and that when health care costs are lowered those left behind will be able to buy health insurance.

My brother is a single dad with three children. He does not make much money, somewhere in the range of $30,000 per year. He pays child support for 2 children and has custody of one. He was unemployed for a while and his youngest child was covered under SCHIP and he was also covered by the Massachusetts plan. He acquired employment, just enough to pay his bills. Massachusetts summarily cut him and his child off the plan. He lobbied for an exemption for his child and received one, now his child is covered. But, because he now makes too much money ($30,000 for a household of four), he no longer qualifies for the health insurance from the state. He is left to get that insurance from his job at a price of over $200 per pay period (approximately) which he cannot afford. He is in fact, now uninsured and a fine of $500 will be levied against him because he does not have insurance, i.e. the mandate.

Does this sound fair? Krugman argues that the mandate is not the problem & that the Clinton and Edwards plans (unlike Massachusetts) have subsidies to low-income families that will alleviate this problem. Though, I must say he leaves out how that occurs (his criticism of Obama) and how this enables lower income families to afford coverage. For example, why does Massachusetts not do this?

I think the criticism of Obama's plan is a policy debate as he has said and we can discuss that, but criticizing him for not wanting health care for all is really a misnomer and unfair because as is evident above there are problems with mandates, serious problems.

As someone who had a near fatal car accident with no health insurance, I know that tragedy lurks around the corner for all of us without health insurance or what really matters - free and affordable health care. When we are, at the same time, trying to please corporations while providing health care we will inevitably run into trouble. When the priority shifts so that everyone is covered no matter what the circumstance or job, is as large a priority as keeping corporations happy, then we will have a plan that works for all of us.

Mandates are not the end all to be all that we have been told they are by Krugman, by Clinton and by Edwards. On this point I am squarely in the Obama camp.

Socialized Healthcare Please!!

“I shall propose a sweeping new program that will assure comprehensive health-insurance protection to millions of Americans who cannot now obtain it or afford it, with vastly improved protection against catastrophic illnesses,” - Richard Nixon- State of the Union Address 1974.

The Republicans have constantly attacked the Democrats (mostly Hillary Clinton) about their socialist viewpoints on health care, you know like covering the 50 million people that do not have any coverage. Yet, Richard Nixon offered a plan on February 6, 1974 that is very similar to Hillary Clinton's plan. “It was an extremely extensive plan, as I remember, that would have given universal coverage” for health care, recalled Rudolph Penner, a former director of the Congressional Budget Office and economic official in the Ford administration.

Nixon introduced his Comprehensive Health Insurance Act on Feb. 6, 1974, days after he used what would be his final State of the Union address to call for universal access to health insurance. Yet, Republicans continue to talk socialism despite their godfather Richard Nixon offering a similar plan.

A CBS News poll earlier this year found that 64 percent of Americans support federally guaranteed health insurance for all citizens. Clinton’s plan, like Nixon’s, calls for building on the existing private-sector health-care system and using government subsidies and tax credits to get all Americans under an umbrella of health coverage. Like Nixon, Clinton said her plan “is not government-run. There will be no new bureaucracy.”

Let the record show I think John Edwards has the best health care plan yet to be introduced by the candidates, but any plan is better than what we have now. I don't favor the Clinton plan that does curb the corporate profit margin in health care. We should have a government run system like every other western nation. This is not socialism, this is common sense.

Read the article on common dreams.

Bush Vetoes SCHIP Bill for Expanded Health Insurance for Children

Bush sought little fanfare when he vetoed the SCHIP bill. It is only the fourth veto of his Presidency (I have seen all the news reports about this, but give me a break he had a do-nothing, do whatever he wants Congress for six years). Harry Reid said of the veto: "Never has it been clearer how detached President Bush is from the priorities of the American people," Reid said in a statement. "By vetoing a bipartisan bill to renew the successful Children's Health Insurance Program, President Bush is denying health care to millions of low-income kids in America." Democrats may try to override the veto. They have the votes in the Senate, but not the house.

Check out the video above. Does Bush like kids as much as they like him?

New Health Center Opens in New Brunswick

Middlesex County opened a public health clinic in New Brunswick yesterday. It consolidates many services under one roof and people without health insurance (estimates over 1.2 Million in New Jersey) may seek health care. The Center offers space to treat tuberculosis and sexually transmitted diseases, as well as provide childhood immuniza tions, flu shots and education on cancer.

At least 100 people a week are expected to use the new center. There is a bright and spacious waiting room and each of the different clinics operates in well- equipped rooms said the star Ledger. The Director of Nursing, Debbie Gash said the location is one of the center's biggest advantages. The free Hub City Trolley services the center and the Middlesex County Area Transit Jersey Avenue Shuttle also stops at the clinic. The shuttle charges $1 for the general public and 50 cents for seniors and people with disabilities.

More healthcare for the poor can only be a good thing. Good job Middlesex County.

New Rules by the Bush Administration to Hurt Family Care in New Jersey and Elsewhere

The Bush administration adopted new standards to stop states from expanding the Children's Health Insurance Program, commonly known as Chip. A letter was sent to officials in states on Friday evening after hours outlining a plan in essence to stop states from expanding the insurance program beyond those at poverty level.

According to the Star Ledger the new rules would require all states to make families wait a year after they lose coverage before they can apply to the government program, according to the letter. The state would also have to prove that 95 percent of the kids from the lowest income levels were enrolled be fore accepting any child from moderate income brackets.

Ann Clemency Kohler, deputy commissioner of Human Services in New Jersey said the program will cause havoc and jeopardize coverage for thousands of families. What is more the new rules are in the middle of a month long congressional recess.

In New Jersey a family of four with an income of $72,274 may enroll their children in the program. The federal medicaid office has approved these measures because the cost of living in New Jersey is so high. The new regulations simply eliminate New Jersey's generous policies.

The real idea behind the new rules is the Bush administration is concerned with the growing movement for a universal health care plan and sees the policies that seek to grant coverage to moderate income families as a step toward that end. And it seems these policies are directed at states that have become more generous including New Jersey, New York and California.

Sen. Joseph Vitale (D-Middlesex), who sponsored the FamilyCare program legislation and has been a strong advocate for expanding coverage to children and adults says the program is now at risk. Mr. Vitale pointed out the program also covers 89,000 parents and said their status may also be at risk.

The Constitution is in Grave Danger

We are back from vacation and what has happened? The stock Market is about to crash dropping 500 points with more to come some speculate. The Pat Tillman story is in the news again and with vitriol indicating that Pat Tillman may have been killed by his own men for his political views. On Thursday's Countdown Olberman noted that “Corporal Tillman held a number of personal views that were unpopular within the context of the Bush administration, perhaps also within the Army.” Tillman reportedly favored John Kerry in the presidential election, opposed the invasion of Iraq, and had plans to meet with Noam Chomsky. And now Army medical examiners were suspicious of the wounds and wanted the Army medical examiners to investigate whether his death amounted to a crime.

Michael Moore has been subpoenaed by the Bush Administration. By the way I saw the movie on Monday in Portland, Maine. Any of the criticism I read about the film is unwarranted. I believe there are flaws in the film, specifically his inclusion of Guantanamo Bay inmates as getting good health care, which seems to be silly including that in the argument and other arguments about France versus the Americans I felt was simplified and not worth the effort. He makes a strong case, however for single payer health care and we should be thankful to him for his courage.

This press release by the ACLU that the Constitution is in grave danger is perfectly worded and perfectly timed. The ACLU in a statement urged the U.S. Congress to "vote to hold White House officials in contempt for refusing to cooperate with legitimate congressional subpoenas." The ACLU statement said the issue had become "a constitutional crisis that threatens to destroy the separation of powers." "Presidents have tried in the past to overreach in claiming executive privilege," said Caroline Fredrickson, director of the ACLU Washington Legislative Office. "However, Congress has long served as a check to such abuses of power, slapping the president's hand when needed and pursuing contempt or enforcement actions that eventually resulted in the release of crucial information. Today's Congress must do the same if it wishes to remain a meaningful and independent branch of government."

In the wake of the ACLU's press release Patrick Leahy issued a subpoena for the draconian Karl Rove. Leahy issued the subpoenas, one to Rove and one to White House aide Scott Jennings, after consulting with Sen. Arlen Specter (R-Pa.), the committee's ranking member. "The Bush-Cheney White House continues to place great strains on our constitutional system of checks and balances," Leahy added. "Not since the darkest days of the Nixon administration have we seen efforts to corrupt federal law enforcement for partisan political gain and such efforts to avoid accountability."

So, what is it going to be Congress? Are you going to go after these bastards? If Karl Rove does not have to comply then why should Michael Moore. Moore went to Cuba to help 9/11 workers get health care, Rove sought to politicize the justice system. And Robert Mueller's testimony before Congress left no doubt that Gonzalez is a serial perjure. Congress must act and soon if the 110th wants to maintain any credibility with the American people. Waiting on Iraq until September is one thing, but our Constitution hangs in the balance.

A bit of good news for the big box stores though, which I avoid with impunity. Lowe's has dropped its advertising dollars on the O'Reilly Factor. If I had to go somewhere then...Lowe's it is...