Sunday, November 28, 2010

Health Care Nightmare

I received my "2011 Annual Notice of Changes/Evidence of Coverage" for my health insurance the other day.  It is a 247 page document.  Of course, that's only half the book.  The other half is attachments; hundreds of pages of them.  The entire document is written as to be unintelligible.  I would have to pay an attorney to tell me what's in there. 

Can anyone tell me what an "Abdominal Aortic Aneurysm Screening" is?  Am I supposed to know this?  I have no idea what it is.  I guess I'm supposed to understand it because the insurance company tells me to read the book.  But, hardly any of it matters because of the phrase "usual and customary."  If the insurance company doesn't like it, it doesn't matter what it is, they'll refuse to pay for it.  

My doctor doesn't like the health care system any more than I do.  While the insurance company raises my premiums, they lower his payments.  The doctor is forced to accept health insurance company discounts because if he doesn't, he'll go broke treating people who can't pay.  The health insurance industry works best when there are a lot of uninsured people.

To make up for these discounts, my doctor runs more patients through his office per hour than he'd like.  The doctor would like to spend a little time with me, get to know me, but he can't.  The exam rooms must turn over quickly.  You're in and you're out.  Nurses do the actual work so the doctor can meet his quota of patients per hour.  No offense, doc, but isn't there anyone in the office who can draw blood without sticking me eight times? 

For health insurance companies to make windfall profits, they must charge people high premiums, pay doctors low fees and make sure they enroll healthy people who don't need medical care.  They don't insure pre-existing conditions, have long waiting periods to make sure you're healthy, have large deductibles, hefty co-pays, mandatory payment caps and so on.  The health insurance industry is a scam.

To protect themselves, health insurance companies must game the system.  They spend billions of dollars lobbying Congress, giving political contributions, funding political action committees and billions more in advertising, sales and public relations.  Instead of that money going into care, it goes into protecting the jobs of paper pushers who do nothing to treat people.  I knew a guy who was vice president of a large health insurance firm; his kid played on my baseball team.  The family was filthy rich.  Multiply that by all the health insurance executives around the country.  You talk about Wall Street profits?  Health insurance executives are making big bucks.    

The best health care system would be to give every citizen in the United States a single payer Medicare system that covers everyone, cradle to grave.  You and your doctor make the decisions; everything is covered.  The system does not have to make a profit and our elected representatives manage the system.  Citizens pay into the system through taxes, but would pay far less than they do now because the system is not for profit.  

Republicans call this socialism.  But, what the G.O.P. is actually doing is protecting a health insurance industry that pays big bucks to Republican candidates.  I don't care what it's called; call it anything you want.  If we eliminate the for-profit middleman - the health insurance company, with all its inefficiencies and wasteful spending, and replace it with a non-profit Medicare style system, we will get better coverage at lower cost.  

People are a nation's greatest natural resource.  If we are going to invest in anything, it should be ourselves.  We should invest in every single person, not just those who can afford health care.  We should stand up to Republicans who protect the windfall profits of insurance companies, take control of our health care away from insurance companies and put it in the hands of ourselves.

And, that is a view from Missouri.    
      

Thursday, November 18, 2010

Rare Earth Elements

Spending time with my grandparents in southern Missouri as a child in the 1950's, my grandfather often took me in the early morning hours to check his trot line across the Gasconade River.  A trot line is a rope that stretches from one bank to the other, off which fish hooks descend into the water.  The trot line, when baited, sinks into the water so as to be unseen, except for the ends on each bank which are tied to trees.  I was in charge of the linseed cake, which Grandpa used for bait.  "Hand me another linseed cake," he'd say as he worked the boat across the river, lifting the line to take fish caught overnight, then replacing the bait.  It was a simple question posed to my grandfather one morning that made me aware of rare earth elements.

"Grandpa, why are so many of the farms around here vacant," I asked.  "The government is buying up all the land," he said.  Naturally, my next question was, "Why?"  "There's precious metal in these hills and the government wants to control it."  Immediately, I asked him, "Gold?"  "No, something more valuable than gold - uranium.  Now, hand me another linseed cake," he said as he threw a catfish into the bottom of the boat.  I have always remembered that conversation because Grandpa believed uranium had something to do with my future. 

Now, if you can name all of Santa's reindeer really fast, try saying this list: Scandium, Yttrium, Lanthanum, Cerium, Praseodymium, Neodymium, Promethium, Samarium, Europium, Gadolinium, Terbium, Dysprosium, Holmium, Erbium, Thulium, Ytterbium and Lutetium.  These are the names of rare earth elements in the periodic table.  (If the names have a Scandinavian flavor, it is because rare earth elements were first discovered in Sweden.) They exist all over the world, but only in a few places are they in deposits large enough to be extracted from the earth; places such as the Bayan Obo deposit in China, Mountain Pass in California, Thor Lake in Canada and as it turns out, the Pea Ridge area in southeast Missouri.

Why should you care about this?  Well, you're carrying around rare earth elements in your pocket.  Your cellphone uses them.  In fact, rare earth elements today are used in medical imaging technology, solar panels, wind energy systems, battery systems, magnetic industrial applications, lasers, computer chips, cellphones, optical fiber communication systems, flat screen televisions, automobiles, scientific research applications, radar systems, aircraft, in guided missile systems, particle accelerators, on the space shuttle, and in a myriad of other modern electronic applications.  Current technology relies on these elements; you can't build the stuff without them.

China produces nearly 100% of all processed rare earth elements in the world.  Yes, that is correct; China has a monopoly on rare earth element production.  Recently, the Chinese have begun using that monopoly as a political weapon.  That's why you should care.

This fall (September, 2010), China banned exports of rare earth oxides to Japan in retaliation for the detainment of a fishing boat captain by the Japanese Coast Guard.  Earlier, The Economist reported that "China...announced the latest in a series of annual export reductions, this time by 40%."  China hinted strongly that future exports of rare earth elements will be allowed - only - to countries that produce their finished products in China.  According to The Economist, "Slashing their exports of rare-earth metals is all about moving Chinese manufacturers up the supply chain, so they can sell valuable finished goods to the world rather than raw materials."  In other words, China wants to control industries that use rare earth elements by forcing the finished products to be made in China.  It is a blatant power grab.       

Well, the entire Western world is in a panic.  Everywhere, the question is being asked:  What if China completely shuts off supplies?  Meetings, conferences, governmental hearings, appeals to the World Trade Organization to intervene; the world is taking action.

The United States is responding, too, but will it be soon enough to avoid a disruption in supplies of rare earth elements?  We have significant reserves of rare earth elements, roughly 10% of the world's supply.  Molycorp Minerals plans to re-open California's Mountain Pass Mine in 2012.  Wing's Enterprises, in St. Louis, is re-developing the Pea Ridge site here in Missouri to mine not only magnetic iron ore, but rare earth elements as well.  However, it takes years to open mines and build a supply chain.  From the complicated extraction techniques used in the mining of rare earth elements and extensive processing of these minerals to their shipment and use in finished products, China is simply the center of the universe when it comes to rare earth elements.

It should have never come to this.  In the 1980's, under President Reagan, trucks simply backed up to American rare earth processing facilities and entire factories were moved intact to China.  As a result, American mines, such as Molycorp's Mountain Pass Mine (which used to be the world's largest producer of rare earth elements), were forced to shut down and an entire generation of mining and processing expertise was lost to China.. 

When our national security is threatened by China, I expect something more than Republican Senate Minority Leader Mitch McConnell's strategy, "The number one legislative agenda for Republicans will be to make sure President Obama is a one term president."  I expect our political leaders to fight China on trade policy and currency valuation.  I expect our leaders to resurrect the rare earth mining industry and close a national security weakness.  We need Republicans willing to engage the Democrats in a serious discussion of issues instead of pandering to the Tea Party Express and powerful business interests.  Is that too much to ask?  Evidently, it is.

And, that is a view from Missouri.  

Monday, November 15, 2010

Joyce Kaufman and Allen West

Hired as the Chief of Staff to Congressman-elect Allen West (Republican Tea Party candidate elected from Florida's 22nd District), Joyce Kaufman has a long history of incendiary remarks.  A South Florida radio talk show host, Kaufman did not last long as West's Chief of Staff.  She resigned the position within a few days after her show was linked to threats of gun violence against the Broward County School District and government buildings in the county. The threats led to a county-wide school lockdown effecting 300 schools and 230,000 students. 

Among Kaufman's irresponsible remarks are these:  "if ballots don't work, bullets will."  She advocated the formation of militias to take guns and hide in the hills of Kentucky and Vermont to fight an election outcome that didn't please her.  "Some things are worth dying for." she said.

Speaking of illegal immigrants, she said, “If you commit a crime while you’re here, we should hang you and send your body back to where you came from.”

These are just a couple of the frequent rants that come from this sick person who, unfortunately, has made a living broadcasting such nonsense in the South Florida radio market.  How that qualifies her to be the Chief of Staff to a Congressman, I'm not quite sure, but Allen West sure seems enamored with her:  "I was not hiring a talk radio host; I was hiring a very brilliant political mind, someone that has been in South Florida politics for 20 plus years," West said.  He went on to say, "Joyce Kaufman is the most honorable, with the most impeccable integrity and character that I have met in my life"  Kaufman was one of West's most vocal supporters during the campaign.  He appeared as a guest on Kaufman's radio show over 100 times.

Allen West seems to have a couple of screws loose, too.  “You must be well-armed because this government that we have right now is a tyrannical government," West said.  West is "focused that this liberal, progressive, socialist agenda, this left-wing, vile, vicious, despicable machine that's out there is soundly brought to its knees.”  Listen to the way he defended Kaufman, ""I think the American people are sick of the way that they went after Joyce Kaufman."  "The fact that they're attacking a woman like this, that shows me something about sexism and misogynist behavior."  Really, all the media did was dig up video and audio clips of Kaufman and publish them.

Here's the scoop on Allen West:  While serving in Iraq as commander of the 2nd Battalion, 20th Field Artillery Regiment of the U.S. Army, Lieutenant Colonel West helped interrogate an Iraqi civilian.  When interrogators could not ilicit information from the Iraqi, West walked into the room, drew his gun and fired past the Iraqi's head.  The information West received from the Iraqi, after firing his gun close to the detainee's head, turned out to be false.  West said later, "It's possible that I was wrong about the detainee."   West was charged by the U.S. Army with violating articles 128 and 134 of the Uniform Code of Military Justice.  West was found guilty of misconduct and assault and he resigned from the U.S. Army.

Whether West is qualified to serve in Congress or Kaufman was qualified to serve as his Chief of Staff is not for me to say.  If the people of Florida's 22nd District want West to represent them, far be it for me to criticize them.  But, I will say this:  Those Tea Party candidates and their supporters are goofy.  It would be funny, except that it's so frightening. 

And, that is a view from Missouri.

Note:  Sources used for this post were The South Palm Beach Examiner and The Florida Independent.

Monday, November 8, 2010

Texas

If people are interested in knowing what life would be like under the rule of conservative Republicans, they need to look no farther than Texas.  Texas is the largest emitter of greenhouse gases in the country (yes, larger than California) due to oil refineries, coal burning power plants and manufacturing in the state,.  If Texas were its own country, it would be the seventh largest emitter of greenhouse gases in the world.  Yet, State Attorney General Greg Abbot has filed seven lawsuits in the last year alone to block EPA from regulating greenhouse gases in Texas.  Texas is the only state that will refuse to enforce new EPA greenhouse gas emission standards which go into effect after the first of the year. 

Texas Republicans, however, have a different view.  "EPA is cramming this down the throats of citizens and the states," said Howard Feldman, director of regulatory and scientific affairs at the American Petroleum Institute, another plaintiff against the EPA. Republican governor Rick Perry said in his victory speech the other night, "People are tired of the government cooking up new ways to micromanage their lives," he said. "They're tired of the government killing jobs with their do-gooder policies that have nothing to do with science or economics."

On the other hand, public health doesn't seem to be a concern for Texas Republicans.  Texas ranks highest in the number of people without health insurance and ranks 40th lowest in the number of doctors per capita.  A recent proposal by far right Republican lawmakers would drastically worsen public health in Texas: opting out of the federal Medicaid and Chip programs (Children's Health Insurance Program).  Quoting Republican State Representative Warren Chisum, “This system is bankrupting our state,” he said. “We need to get out of it."

The State of Texas has no state income tax, folks - that's why they are having budget problems.  But, instead of paying their fair share in taxes, rich Texas oil barons would rather cure their budget deficit on the backs of the poor.  I suggest a modest state income tax would provide the Texas legislature with all the funding they need to cure a budget deficit. 

At the expense of the environment, and through the suffering of poor children, Texas Republicans will balance their budget.  Let's hope ordinary Texans rise up and take control of their government. 

And, that is a view from Missouri.   

Thursday, November 4, 2010

The Big News on Wednesday, November 3rd

While election results dominated the news yesterday, along with all the analysis of the outcome, equally important was the Federal Reserve's announcement that they intend to interject another 600 billion dollars into the banking system with the purchase of government bonds.  This is in addition to the Fed's continuing purchase of Treasury debt using proceeds from mortgage related holdings that could drive the intervention to somewhere between 800-900 billion dollars by next year.  If the Fed is correct, this intervention will lead to lower corporate and government bond rates, greater corporate investment and help create a jobs recovery.

With this action, the Governing Board of the Federal Reserve has signaled that fiscal stimulus is an important weapon in the fight against recession.  In doing so, however, the Federal Reserve directly opposes the G.O.P. plan for economic recovery.  Mike Pence, a prominent Republican congressman from Indiana put it this way shortly after the announcement was made: “Diluting the value of the dollar by continually increasing the supply of money poses an incalculable risk,” he said. “Instead, Congress needs to embrace pro growth fiscal policies to stimulate our economy rather than masking our fundamental problems by artificially creating inflation.”

What are the pro growth policies that Pence talks about?  The G.O.P. strategy of cutting taxes while cutting spending will not work according to leading economists, the Congressional Budget Office and Obama's bi-partisan Economic Commission.  Cutting spending is a good idea, if accompanied by tax increases to offset, but will only serve to increase the deficit if taxes are cut.  I'm tired of hearing Republicans say they are going to put more money in my pocket.  They intend to cut taxes on corporations and the wealthy.  And the spending cuts?  They won't be in defense; I guarantee that.  They intend to cut social programs that help the poor.     

I've heard the G.O.P. mantra of "get government off the backs of business."  Cutting regulations on business is irresponsible.  I've had enough of oil spills, mining disasters, tainted lettuce, and auto company recalls.  Regulations are in place to protect the consumer.  I'm not worried about government being on my back; I've got representatives in government.  I'm worried about getting business off my back. 

Fiscal stimulus is the weapon of choice by governments fighting a recession.  Quoting Laurence H. Meyer, a former Fed governor. “Bernanke (Federal Reserve Chairman) has said that fiscal stimulus, accommodated by the Fed, is the single most powerful action the government can take for lowering the unemployment rate, when short-term rates are already at zero,” Mr. Meyer said. “He has nearly pleaded with Congress for fiscal stimulus, but he can’t count on it.”  

A further danger is a movement by the G.O.P. is to bring the Federal Reserve, currently independent, under the control of Congress.  Who died and made Republican leader John Boehner an economist?  The Republican Road Map espoused by G.O.P. congressmen is a recipe for the rich to get richer and the poor to get poorer.  We've already witnessed the largest transfer of wealth from the middle class to the rich in the history of our country - enough already!

I'm counting on the Federal Reserve, the Obama Administration and the Democrats in Congress to reject the Republican plan of tax cuts, deregulation and budget cuts that affect the middle class. 

And, that's a view from Missouri. 

Note:  This article used quotes from the New York Times. 

Tuesday, October 12, 2010

Canary in the Coal Mine

Doctors know there is a "herd immunity" in public health.  That is to say, when a critical mass of people are healthy, all are protected.  I read an alarming statistic today: only 56.2 percent of Missouri children are receiving immunizations, down from 80.6 percent in 2006, according to the Centers for Disease Control.  The decrease is due, primarily, to a lack of public health funding.  For instance, here in Kansas City, the Health Department no longer has the funding to search public school records for children who lack immunizations.

For a free enterprise system to work properly, there must be losers; people for whom bad decisions has led to failure.  While free enterprise may work in many economic sectors, it definitely does not work in public health care.  Disease and infection spread without regard to demographics such as income, occupational status and location of residence.  For every child who does not receive immunizations; for every uninsured person who cannot afford a flu shot; for every homeless person who does not receive medication, there is a price to pay far beyond that single act.

If conservative Republicans are to take control of Congress as pollsters are predicting, we should listen closely to their plans for the future.  A rollback of the new health care law, cuts in public health care funding, education and other "human infrastructure" areas will lead to disaster.  That only half of Missouri children are receiving immunizations is a huge sign that trouble is on the way.  The canary just died.

And, that is a view from Missouri.

Saturday, September 25, 2010

Red State Health Care

There is a sign inside the emergency room at the hospital nearest my house, "If you cannot afford to pay, we will stabilize you and send you to another facility."  I interpret this to mean if you can't pay, the hospital will do the minimum necessary to avoid a lawsuit, then shove you out the door and leave you in the back of an ambulance.  It is a for profit hospital, of course.  Immediately upon entry, this hospital tells you that payment for services is equal to the lives of their patients. 

During the health care reform debate this year in Congress, I heard all manner of arguments in favor of a free market system of health care coming from Republicans.  It is an ideological argument that says a free market health care system produces the best health care at the lowest cost.  Death panels, socialized medicine, government control of health care decisions were just a few of the scare tactics that Republicans used to try to block health care reform.  The G.O.P. pushback against a Democratic bill was fierce; nearly all Republicans voted no. 

Republican rhetoric caused me to wonder, what is so good about the current system that convinced Republicans to vote no?  I researched health care in states represented by Republicans in Congress and dominated by the G.O.P. in state government, the so-called Red States, and was struck the low level of medical care, general health of those populations and the high cost associated with that care.

For instance, Mississippi ranks 1st in heart disease among it's population, 3rd in highest number of uninsured as a percent of population, an infant death rate over 50% above the national average, ranks 50th in number of doctors per capita and citizens have a life expectancy rate over four years less than the national average.  Mississippi ranks 1st in the nation in the percentage of people below the poverty line (21.2%), but 48th lowest in Medicaid per capita spending ($8,711).  I doubt you will hear Republican Governor Haley Barbour boasting of those statistics.

Texas ranks 1st in percentage of highest uninsured, but 40th in number of doctors per capita (2.15 per 1,000 people) and 35th in Medicaid spending.  Oklahoma ranks 2nd highest of all states in heart disease, 6th highest in number of uninsured, the life expectancy of it's population is nearly three years below the national average and ranks 50th in Medicaid spending..  Alabama has the 3nd highest rate of heart disease, well above the average in cancer deaths, an infant mortality rate 33% higher than the national average, ranks 43rd in the number of doctors per capita, and ranks last (51 out of 51 including D.C) in Medicaid per capita spending. 

Whether it's South Carolina ranking 11th in most uninsured, above average cancer, heart disease, infant mortality rates and lower life expectancy, or statistics from other red states such as Georgia, Tennessee, Arkansas, Louisiana, red states, especially from the south, have negative health statistics compared to national averages. 

I've not heard Senate Republican Minority Leader Mitch McConnell of Kentucky talk about his state having the highest percentage of cancer deaths in the country, nor that Kentucky ranks 2nd in the nation in percentage of people below the poverty line, but 46th in Medicaid per capita spending.  Yet, McConnell and many of his Republican colleagues complain that universal coverage would not only reduce the quality of care, but make health care more expensive

Statistics, however, show exactly the opposite to be true.  Massachusetts (the only state with a universal health care system) spends an average of 13% of their per capita income on health care, while Kentucky spends an average of 17% (2007 numbers); Alabama spends 19.8%, Oklahoma spends 14.3%. 

To be fair, western Red States fare better in health care statistics, but spend far more in Medicaid dollars to produce them.  Alaska, for example, has outstanding rankings in nearly every health category, but ranks 6th highest in Medicaid spending.  Idaho ranks 11th; Kansas 19th. It is disingenuous for Republican senators in those states to espouse an argument in favor of free market health care when their their states accept higher than average Medicaid payments. 

Republican defense of a free market system of health care is a fraudulent argument and shows a disconnect between Republican senators and the constituents they represent.  The G.O.P. is protecting the business interests of health care at the expense of the citizens they represent.  Ideology stops at the front door of the hospital.  People are the greatest natural resource and we should do everything possible to care for our population.   

To the hospital near my home that refuses to treat patients who cannot afford to pay, I ask why do you use one of Christ's apostles as your name?  You have Medicaid dollars available to you for low income patients and your development department is working full time to garner grants to pay costs.  It is indefensible that you would refuse to care for the poor.

To the Republican senators who voted no to health care reform, shame on you.  To vote no while you, yourselves,  enjoy the superior benefits of a Congressional health plan paid for by tax payers is indefensible.

And, that's a view from Missouri.

Note:  The statistics in this post were obtained from the U.S. Census, the Social Security Administration, Virginia Commonwealth University, StateHealthFacts.org, StateMaster.com  and the Gallup-Healthways Well Being Index 

















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Friday, September 10, 2010

Israeli-Palestinian Peace Negotiations

Charles Krauthammer's excellent article in today's Washington Post, Your move, Mr. Abbas, questions the sincerity of Abbas in the current round of Israeli-Palestinian peace talks.  What Krauthammer leaves out is this:  Abbas doesn't have enough political power to enforce an agreement, if one can be reached. Frankly, I think the time may have passed when any agreement is possible. Hamas and Hezbollah are stronger (thank you George Bush for invading Iraq and taking away Iran's primary enemy), Iran is on the threshold of being a nuclear power, the Saudis and Syrians seem to be sitting on the sidelines, and any lasting peace lies beyond what Palestinian and Israeli negotiations can produce. No one wants to give Hamas and Hezbollah legitimacy by giving them seats at the negotiating table, but facts on the ground make them legitimate power brokers. Unless Hamas and Hezbollah are brought into the negotiations, along with the nations who support them, no lasting peace is possible. George Mitchell and the Obama administration have done a great job of diplomacy in getting Netanyahu and Abbas to the table.  They should take the next step and incorporate side talks with Hamas, Hezbollah and Syria with the goal of establishing a regional solution to the Israeli-Palestinian conflict.  That's a view from Missouri.