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Monday, May 8, 2017

If They Only Had a Heart!

Jimmy Kimmel made a point on his late night show recently that has perhaps gone to the heart of the debate over health care in this country.  That is, when you come right down to the fundamentals, there is no other consideration quite as important as saving a life, extending life, or having the opportunity to savor life.  When your newborn son or daughter faces death because of a heart condition – a pre-existing condition – all the political rhetoric in the world has no meaning.  All that matters is that your child is able to be the recipient of the very best scientific knowledge, equipment, professional experience and expertise, attention and care that will enable him or her to live a full life.  However, no one should have to declare bankruptcy in order to afford those critical and necessary services.
Not only did Kimmel go to the heart of the healthcare matter, his audience agreed with his assessment and went along with him.  And so, perhaps, from the heart of a comedian, we have heard what is missing from most of our politics, our governing and our politicians: a commitment to enhancement of people’s lives.  There is an enormous communal need for this commitment to saving lives; a commitment to putting the needs and priorities of ordinary people at the center of our attempts to bring some societal order out of the randomness and chaos that greets us all as we emerge from the relative safety of a mother’s womb.
[I have no objection to considering the implications of this fundamental principle in relation to the protection of the unborn as well; just not in this piece.  However, you might want to consider some references to that debate in my Post of 04/02/2016]
My focus in this piece is the rather obvious and dubious lack of political attention to the lives of citizens as the top priority for any piece of legislation, executive order, regulation, contract, grant or policy that emanates from our national, state or local governmental entities. We seem so enraptured and captured by the glitter of ideology and pandering rhetoric that we tend to miss the fact that women, children, workers and retirees – among others – are being neglected, ignored and abused every time an economic or political ideology is placed before humaneness as the motive for legislation and judicial decision-making.  It is shameful, for instance, when children are denied programs that provide for nutritious meals at school, or seniors are denied a prepared meal and companionship through Meals on Wheels, or laborers are denied bargaining rights and pensions, or people in dire circumstances are denied healthcare, adequate housing, and a decent minimum wage for their work. 
Have we come to the point where the business and profits of multi-national corporations, drug companies, the nursing home industry, the financial sector, insurance companies, food processing plants and fossil fuel companies are more important than the lives of the one in five children living in poverty?  Is the build-up of weapons of mass destruction more important than the public education of our children?  Is our obsession with tax subsidies for the rich more palatable than our constitutional and societal contract for equal rights, equal justice and equal opportunity?  Do we all as a democratic society have an obligation to care for vulnerable and challenged people, or are we meant to go our separate ways and act as though there is no mutual responsibility for others? 
There is no greater need in our society right now than a return to simple fundamental axioms and truths that made this country great.  To make “America Great Again” has little or nothing to do with austerity budgets, with military build-up, with lower taxes for the rich and higher taxes for the middle class, with trickle-down economics theory, with jingoistic nationalism, or with immigrant-bashing, vulgar speech and hateful attitudes expressed toward racial and ethnic minorities.  “Making America Great Again” is a flawed slogan from its inception because it glorifies “Greatness” above “rightness.”  It touts might above right and rights.  It emanates enmity instead of empathy.  It embraces authoritarian and dictatorial rhetoric and action above democratic values like “one person one vote” or “liberty and justice for all.”   
All this debate about healthcare coverage, benefits, premiums, co-pays, pre-existing conditions, comes down to intention and purpose.   What after all, is the purpose of healthcare legislation?  Is it to provide an opportunity for many more people to be able to afford medical coverage, or is it to inculcate conservative principles into the minds and lives of more citizens?  Are we more concerned with people’s lives and welfare or with political principles and political correctness?  I venture to say that conservative Republicans have built their movement, and their entire agenda on conservative philosophy, not on human rights or human dignity.  in essence, conservative Republicans have taken away a basic commitment to human welfare extending back to Lincoln that somehow got turned around to sound as though people in need, or in dire circumstances or who are somehow different from a white protestant norm are unworthy and undeserving of help.  In fact, a Republican congressman heard recently on TV made it plain that “those people” cannot expect someone else to purchase health insurance for them.
And therein lies the nugget of why the heart has disappeared from that wing of the Grand Old Party.  There is nothing left but a bumper-sticker-mentality that expresses their ideology but has replaced rationality.   A few slogans, using their words, will suffice to show what I mean:
·         Get a job
·         Why should I pay for healthcare for someone else
·         Immigrants are thieves, murderers, drug dealers
·         Repeal and Replace Obamacare
·         Keep people safe -  build the Wall
·         Obamacare is dying on the vine
·         Shutting down government is good
·         States are closer to the people
·         Dictators Deserve Your Love
·         Get Rid of Entitlements
·         Tax cuts for the rich benefit everyone
·         Preemptive bombings show our strength
·         Manufacturing jobs are coming back 

There are just so many....  And every one of them is backed up by stunning bits of rhetoric that often have no place in a democracy.  We have heard too much about the failings, faults and criminality of undocumented Mexicans who come across our southern borders.  We have endured the bashing of Islamic people as though they are all potential or actual terrorists.  We have been subjected to lie after lie about Obamacare – its tax burden, its damage to small business, its rising copays and increase in premiums.  Funny how so many millions are still a part of it and more have joined during the open enrollment periods even as it comes under relentless attack.  Could it possibly have anything to do with the fact that subsidies are still viable and expansion of Medicaid is still in effect? Of course.
 But, Republican conservatives do not want to talk about the underlying importance of subsidies for those who cannot afford the high cost of health insurance because they are too busy trying to defund as many programs as they possibly can that help those with special needs.  Meanwhile, they ignore the enormous amounts of money being extracted from our Tax system to subsidize the rich and the powerful, with absolutely no oversight, regulation or penalties for fraud and waste.    And now, the Donald and his henchmen stand ready to reward these rich welfare kings and queens with further tax breaks that will simply serve to further undermine the middle class tax payer. 
It is perhaps useless to say it, but the bumper sticker mentality of these perpetrators of puerile philosophy and rhetoric is matched only by the Big Lies they use to back up their claims.   Let us stay with the example of their 7-year assault on Obamacare.    In 2012, 2014 and 2016, Republicans used every lie they could manufacture in order to denigrate the ACA, to turn people against it and against Obama and the Democrats, and to win seats in the House, the Senate, and finally in the Oval Office.  They experienced electoral victories that will end up costing us more than can be imagined.  Here are three of the biggest lies about Obamacare that have served Republicans well in their quest for complete control of our governmental apparatus.
1)      Obamacare is collapsing under its own weight – if true:
a.        how come a record number (over 6 million) enrolled during the last enrollment period of  Nov 1, 2016 to Jan. 31, 2017?
b.       how come the House voted to exempt themselves from mandated coverage under the AHCA, leaving them under Obamacare as mandated by that Law?
c.       how come some health insurance companies (Anthem/Cigna and Centeen) are expanding their presence on market exchanges?  Apparently, there is still profit to be made by companies filling the void left by Aetna and HCU.
d.       how come the AMA, the ADA, PNA, and others oppose Trumpcare and the repeal of Obamacare?
e.       How come over 55% of people in Gallup poll (and other polls above 50%) now favor the continuation of Obamacare?
2)      Premiums are rising dramatically   inadequate as a measure of collapse, because:
a.       This isn’t a surprise; it was known from the beginning that it might happen
b.       The original estimates by insurance companies were off in terms of how much their plans would have to charge in order to break even; this involved a miscalculation of how many would be very sick, how many younger healthy people would sign-up and how intensively newly acquired coverage would be utilized.
c.       A back-up mechanism for assisting insurance companies who suffered losses in the beginning was in place until Republicans threw it out in December of 2014.  That action may help explain why premiums had to be raised so drastically, and why some companies have had to withdraw from the market (consult my post of March 7, 2017)
d.    The one item that Republicans refuse to mention is that for those living under poverty guidelines, and others further up the income scale, there are federal subsidies under Obamacare that rise in accordance with the rise in premiums. “87% of people who selected marketplace plans... got financial assistance.  Larry Levitt @larry_levitt Mar 15 On average, ACA marketplace consumers receiving tax credits are literally paying exactly the same this year as last year -- $106 per month   On average, ACA marketplace consumers receiving tax credits are literally paying exactly the same this year as last year -- $106 per month.“ [Larry Levitt, VP of Kaiser Foundation].
3)    States can handle this more effectively than the federal government because they are closer to the people - totally untrue because:
1.    States are struggling just to maintain their own programs because they do not have enough tax revenue.  They may be closer to the people, but they do not have a broad -enough tax base to enable them to spend what is necessary to effectively operate large programs meant to serve all their citizens.  Why is one of the favorite slogans of state governors and legislators “do More with Less”?  Take it from a former 25-year state program director in one of our largest and richest states:  fewer resources leads to one primary result:  doing “Less with Less”!
2.    States are able to function, and to provide services to a relatively large cohort of their citizens primarily because of one thing:  they receive federal money for many of the programs they operate, but state governors and legislators consistently complain that “it is not enough to cover the mandates” of the programs they run on behalf of the federal government. 
Right now, the most vociferous and continuous complaint is in regard to Medicaid, which the states and their sub-divisions (county departments of social services in my state) end up managing.  The states complain they don’t receive enough administrative money to run the mandated Medicaid programs, let alone the ‘waiver’ programs.  Yet the Republicans in Congress want to devolve total responsibility for Medicaid to the states, without adequate money to cover administrative costs that will sky-rocket with such devolvement.  More staff, more local offices, more computers and IT personnel, more field workers, more reports – all of it amounts to one thing:  not enough money allotted to hire enough staff and administrators or to fund enough local social services offices to carry out all the programs and benefits involved.  The result: an inevitable cut in benefits to save money resulting in fewer people covered.  No other result is possible if Trump and the Trumpets in Congress carry forward their proposed cut of almost a trillion dollars ($880 billion) out of Medicaid funds in order to lower the taxes of the richest 1%.  The result:  states will “Do a Lot Less with a Lot Less!”
3.    Federal Subsidies are the key to why Obamacare works for so many millions of uninsured persons. According to, Those subsidies will not be available to enrollees of the ill-conceived Trumpcare.
The poorly-conceived, atrociously-handled and frighteningly-partisan AHCA has done what other actions have not.  People are now seriously taking a look, or asking questions about, how Trumpcare will affect their personal situation.  That is different from a debate about generalized concepts, and introduces an element that cannot be helpful to Republican candidates.  If people perceive that they might be personally harmed by a piece of legislation, they will hold not just their own representative responsible, but blame the Party that is in the majority.  Too bad that very personal evaluative element has so-far failed to enter discussion of other similar kinds of legislation and rule-making.  So let us take a few moments to consider what could be in store, on an individualized-harm basis, in other actions that Trump has in his lethal arsenal.
WAR – no matter how or where you look, Trump has pre-emptive strikes against certain nations on his agenda – in fact, his Secretaries of State and Defense seem to want to remind us that “everything is on the table” – which presumes that nuclear war is not off the table.  Talk about personal harm...!
But even conventional wars bring personal harm to individuals and families – loss of loved ones in battle, the re-instituting of a draft which affects the futures of our young people; prices go up, job growth slows down, wages remain stagnant, and children end up with absent fathers and/or mothers.  And what about outcomes – more suicides of vets, more health issues, more PTSD, more emotional break-downs, more shootings of the innocent by emotionally-disabled people affected by WAR.  Personal consequences of war-mongering are vastly under-estimated.  Get ready to suffer personal hurt and harm...
BUDGET- I’m sorry, but the Trump budget is immoral in its scope of probable harmful outcomes, especially as concerns mothers and children. Here are just a few (for more, consult my Post of 3/21/2017)
·         Denial of funding to Planned Parenthood
·         Loss of Women Infant and Children (WIC) nutrition funds
·         Cut to school brunches and lunches for vulnerable students
·         Loss of Head Start
·         Before and after-school programs cut
·         Interagency Council on Homelessness gone
·         Loss of Foster Grandparent mentoring of children with challenges and special needs 

PUBLIC SCHOOLS- Betsy DeVos is working hard behind the scenes to increase parental choice of school settings.  That’s the line you will regret swallowing.  Secretary DeVos is working to diminish and to destroy public education in this country.  “Choice” is another bumper-sticker slogan standing for something other than what it may imply on the surface.  Choice in radical Republican parlance is a stand-in for private, for-profit education facilities.  DeVos wants to take us back to 18th and 19th century England (and parts of Europe) where private schools run by churches, individual groups representing rich donors, individual former governesses, and families with some educational background, ran schools that charged fees or tuition to their clients.  For any who could not afford to send their children to such private schools, there was a network of charity schools run by benevolent associations, or churches, and finally by the government in 1880.  All of the “leftovers” from society got to “choose” (attend) these “public schools.”
The concept of “greater choice” is a tricky one in Trump-world.  In Trumpcare, it comes down to a choice between choosing to pay for a doctor or medicine or treatment versus buying something to eat or paying the rent.  As to schools and education, it comes down to who you are and what you can afford – a private charter school or “charity” (public) school.    
It is time to begin to judge the efficacy of the Trump administration by a new standard:  how much personal hurt and harm is being caused by their ideology, their policies, their programs, their austerity budgets for 99% of us, their lies, their bumper-sticker mentality, and their attacks on the virtues, values and ideals of democracy, as well as their personal attacks against women and children; AND AGAINST ANYONE WHO DISAGREES WITH THEM?     If they only had a HEART!