Saturday, March 6, 2010

A Comment on Health Care

Every Monday morning J H Kunstler publishes an essay in his blog called Clusterfuck Nation. I recommend it as, whether or not he hits the mark, his writing is always provocative and entertaining. This week he took on health care reform, surprisingly from a very anti-Republican angle. He isn't usually so decisive, even though one would never accuse Kunstler of being Pro-Democrat! Kunstler's world view could be summed up as expecting a decisive economic slide into poverty and limited technological resources for the US and anyone riding on the Empire's coattails. From this week's blog I read this rather cogent comment from someone called Jeff, who offered a personal insight into the US's health insurance mess that resonated with me. This is not a comment by the author of the blog (a link to that is at the end of the page):

I found the summit very useful, not just for exposing transparently obstructionist Republican tactics of the "let's just start over" (repeated ad nauseam) sort but also for laying out some honest-to-goodness policy differences. The mainstream media seemed to willfully ignore those, in favor flogging some personality driven sniping, of which there was actually comparatively little, the better to convey the meeting as some kind of demeaning, reality TV show.

Of the substantive differences, perhaps one of the most telling: Republicans object to the Obama plan in part on grounds of defending Medicare. When you hear a Republican defending Medicare, your bullshit antenna should go up, you should cover your nuts and grab your wallet (not necessarily in that order.) It became apparent that what they really meant is they want to protect Medicare C (aka "Medicare Advantage" plans.) I learned what these things are the hard way recently, by doing bureaucratic battle to get my geriatric father's Medicare advantage coverage accepted by a prominent national cancer center. In a nutshell, these things are private insurance market policies which "replace" the insured's Medicare, plus (in theory) provide a little additional coverage like preventative services, gym memberships, etc., of the sort which are extremely cheap and very infrequently used by senior citizens. For this, the private insurers can charge policy holders additional premium over and above what Medicare would charge, they also get paid an incentive from the government of about 15%, and are permitted to allow doctors and hospitals to whack insured's for an additional chunk of the total bill.

The kicker? Doctors and hospitals are free to accept or reject the coverage on a visit by visit basis. Meaning the policy holder cannot know in advance (as they can with other types of policies which have networks of hospitals and doctors)where they'll be eligible to be treated.

This is what Republicans mean by "market based solutions." The whole experiment has been an unmitigated disaster - - except for the agents and insurers who've reaped huge profits from a previously untapped market. And for Republicans who found a back door way to undercut Medicare, and provide themselves with another example of how "big government" programs don't work. Think Grover Norquist's wet dream of shrinking government down to the size where it can be drowned in the bathtub.

Petronia On The Hill

Some people think it amusing that Key West's highest contour is but 16 feet (4.5 meters) above the sea. Solares Hill makes for a nice spot to take a bicycle if you'd like a stretch of downhill for a change. And though the hill itself is actually located on Angela Street one block over, it's upper slopes reach out to Petronia Street forcing a cyclist to put in some effort to get over the rise:.You can cycle uphill to this spot from over by the Schooner Wharf Bar if you feel like it. Elizabeth starts (or ends) in front of Conch Republic Seafood. Elizabeth Street runs by on a lovely downhill glide all the way to Truman Avenue where cars and motorbikes are all backed up waiting for the light to change so they can spill onto Duval Street. Of course you would be cycling the wrong way on a one way street which could get you pulled over...perhaps you might plead your case for a stern verbal warning. I'd give it a try for the pleasure of the long free wheel down hill.Petronia Street is full of classic Conch touches.And here we have a church that puts me in mind of another island I have long wanted to visit. My wife and I considered a cruise ship ride to Bermuda from Charleston with a two night stopover (and rented scooters of course) on the island. But those were happier economic times and now I content myself with armchair travel. This church, one of the trillion in Key West has the square bell tower of a solid Church of England export built in a bright sunny land, the sort of thing I'd expect to see in Bermuda. Except it's on Petronia street.
I can't keep the names of all these churches straight so from the horse's mouth as it were...A dude next door was frozen in one single posture saying hi to passers by. I returned the salute with a picture.
His home was as trim and neat as he was himself:
As you look through these pictures of various aspects of the historic little homes at the top of the hill you might be struck, as am I by the deep blue sky overhead.
These are the homes that have survived storms and wars and depressions and population growth and bankruptcy.The sun shines, the banana trees grow and give us a splash of green between the white and the blue.
Whitmarsh Lane is open to car traffic believe it or not. You could drive here from Angela Street and the "real" Solares Hill. Notice the downhill slope toward the camera.The unnecessarily tall pillbox on the skyline isn't a defensive measure, it's just a commercial building struggling for a view in a community that is so flat the best you can normally do is see a sea of roof lines.
And palm trees of course.The homes have endured here for decades, some of them, for much longer some others.
And the sun still shines on them on Petronia Street. Banksters be damned.