McCamy Taylor's Journal
Member since: Tue Nov 9, 2004, 06:05 PM
Number of posts: 13,751
Number of posts: 13,751
Here is my fiction website: http://home.earthlink.net/~mccamytaylor/ My political cartoon site: http://www.grandtheftelectionohio.com/
Damaged Care was the term for the problems that arose from Managed Care, the experiment during the 1990s in which health insurance companies took all comers regardless of pre-existing conditions and then found novel---and sometimes unethical ways---to get the sickest folks off their insurance plans. Their number one way to retroactively cherry pick was to pay doctors to limit care. When the doctors did not limit care enough, the HMOs penalized doctors for prescribing necessary care. They did this in such a way that doctors who cared for the sickest members of our society were forced off the HMOs--taking their costly patients with them. Since poverty and minority status are linked to poor health, the patients affected were often poor, sick minorities and the doctors who served them. Managed Care was a huge disaster---and it fell out of favor. Now, it is just a bad memory for most.
However, in an attempt to control rising Medicare costs, the nation's managed Medicare plans---aka Medicare Advantage plans---and the federal government are embarking upon a "new" payment policy for physicians that is just Damaged Care all over again. In the very near future, if you are on Medicare, your doctor will receive bonus payments if you 1) have well controlled diabetes 2) fill all your medication prescriptions 3) do not have to go back to the hospital soon after being discharged among other things. If you are a patient who can not control your diabetes because you also take steroids for your life threatening asthma, your doctor will face a financial penalty. If you are a patient who can not afford to fill your prescriptions because you are too poor, your doctor will face a financial penalty. If you are a patient with a disease like congestive heart failure, inoperable coronary artery disease, cancer, multiple sclerosis and you are in and out of the hospital, your doctor will....
You get the picture.
Financial incentive and penalty plans like this are only fair if all doctors have the same relative proportion of "well" to "sick" Medicare patients. As a family physician, I can tell you with absolute confidence that each doctor has a different type of practice. The primary care doctor whose patients are wealthy retirees who hang out at the country club stands to make even more money from this system. The family doctor who has a lot of poor, minority and rural patients and the family doctor who specializes in taking care of those with chronic severe illness will find his already low Medicare reimbursements cut.
What does this mean for patients? If you are one of the lucky ones who retires because you can afford to, not because your health gave out, and you live in an affluent part of town and have transportation, you will have no trouble finding a primary care doctor. If you stopped working because of illness, or if you live in a minority or poor or rural community, or if you can not drive and so you have to find a doctor whose office is on the bus line, you will find very few doctors taking new Medicare patients.
"Managed Medicare" is in its embryo stage. It may not turn out as badly as Managed Care (HMOs). The federal government may realize that instead of promoting disease prevention, it encourages family doctors to cherry pick the healthy and turn away the poor and sick. However, the worst care scenario is 1) traditional Medicare drops the bonus/incentive plan while 2) private Medicare keeps the bonus/incentive plan (under guise of encouraging disease prevention). If this happens, all the sickest geriatrics in the country will be on the federally funded program, while the privates will reap a windfall as they collect premiums for folks who don't need care----
And Medicare costs will rise rather than falling.
Posted by McCamy Taylor | Mon Dec 17, 2012, 04:47 PM (0 replies)
Question: Why does the United States spend twice as much per person on health care as any other industrialized nation but achieve results on par with Mexico?
Answer: Because we refuse to invest in disease prevention, aka public health.
So, what do Republicans want to trim from the federal budget? Public health spending. Even though public health dollars pay for themselves many times over in reduced disease, time off work, disability and health care costs. And, if the press is to be believed, the Democrats are willing to negotiate on this part of health care reform in order to insure as many people as possible.
Why the short-sightedness? Votes. The GOP hopes to gather the votes of the already insured who will be happy to vote for the party that "reined in Obama-care." The Democrats hope to gather in the votes of the newly insured.
Part of the problem is folks do not always know what "public health" does for them. Public health keeps your water clean so that you don't have to worry about cholera, a big killer in the old days in urban areas. Public health wiped out small pox and has virtually wiped out polio, rabies, tetanus and a bunch of other old time killers from industrialized nations. When you invest pennies to pay for mosquito curtains to prevent malaria deaths, you are investing in public health. Pap smears have helped doctors reduce the rate of cervical cancer, a big killer in the 19th century. Back in the 19th century, one out of three of us would die of tuberculosis, too. And syphilis was the number one reason people were put into insane asylums.
If you want to know what "public health" is doing for you now, check out any war-torn or natural disaster ravaged country. Want to live like the folks in Haiti post earthquake? Eliminate all public health spending.
Under W. public health took a beating. Dollars that should have been spent on things like raising the levees in New Orleans (flood control is also part of public health) were spent instead getting tiny towns in the middle of no-where ready for an Al Qaeda "dirty bomb" terrorist attack that was never, ever going to come. We have had one Al Qaeda attack on U.S. soil. We have many hurricanes every year in this country. For several years before Katrina, those in the public health profession were talking about the risks of flooding in that city. Did the federal government listen? No.
Certain industries would also prefer that the U.S. reduce its public health spending. The biggest preventable cause of illness and death is tobacco use. Eliminate smoking and the nation's health care spending would fall dramatically. But that would also make R. J. Reynold's profits fall. Overeating is causing an epidemic of obesity, sleep apnea, degenerative arthritis----resulting in massive spending on knee and hip replacements, cardiac surgery, medications and obesity surgery. Simply tackling America's taste for sugary beverages would save a ton of money---and help us live longer, healthier lives. But the fast food industry does not want that.
And, sadly, portions of the medical industrial complex want us to "just say no" to disease prevention. I am referring to drug companies, the manufacturers of prosthetic joints, hospitals with big ICUs and surgical suites. Their ideal economy is one like we have now----lots of disease, lots of insurance to pay for treating that disease.
One of the essential functions of the government is to pool tax dollars and figure out ways to spend them that provide a benefit for everyone at low cost. Money invested in public health helps everyone---the rich have no special immunity to cholera---at pennies to the dollar of the cost of a hospital. Make that pennies to the thousands of dollars of the cost of a hospital.
So, please, don't sacrifice our nature's health and economy for a short term political gain. If we don't do something now to make people healthier, in a few years we will see a small number of healthy young workers supporting a huge number of retired/disabled middle aged and elderly Americans. And that is going to hurt much worse than any vaccine.
Posted by McCamy Taylor | Fri Nov 23, 2012, 01:56 PM (0 replies)
Today we have 20 women coming to the U.S. Senate. We have a female Secretary of State---the third one in this country. There are eight other women in the cabinet including the Secretary of the Department of Homeland Security. There are two women on the Supreme Court. Women have been to space. Women perform cardiothoracic surgery. And yesterday, the Fort Worth Star Telegram had a feature in the Life and Art’s Section asked “Which will be the first lady of fashion?”
Before I comment on the article, a word about “Life” and “Living” sections of local newspapers. When I was a girl back in the 1960’s, these were the “Women’s” sections. Then, someone realized that women do more than cook and buy clothes and change diapers. They invest in the stock market (the business section), they bet on football (the sports section). They even---have mercy!---vote (local and national news). So, newspapers changed their “Women’s” sections to something more gender neutral to reflect changing times. Too bad they did not change the way they look at women.
Dear Mary! Did we learn nothing from Eleanor Roosevelt? Were we asleep during Bill and Hillary? How far have we regressed that we judge the wives of presidential candidates on their ornamental value?
I grumbled over the article then dismissed it. I had more important things to think about, namely the election which would determine the health of my nation. And the patients in my office, who needed diagnoses and prescriptions and referrals. And my latest short story. And bird feeders that needed filling. And cats that needed feeding.
But today, as I was at the gym trying to improve my cardiovascular fitness, I got another look at the way America looks at women. The television in the changing room was tuned to Dr. Phil. He was advocating for a young woman who insisted that she could not be a good mother to her five children without breast implants and a tummy tuck. Her husband disagreed. The husband was shot down. It is, according to Dr. Phil, perfectly normal for an American woman to want to spend tens of thousands of dollars stuffing saline filled sacks under her breasts and having someone chop out a piece of her abdomen so that she can feel good about herself.
Idiocracy is not the future. It is now. And, according to the entertainment media, every woman is still just a piece of Ass (you know, the award winning movie within the movie), no matter how she spends her days.
Posted by McCamy Taylor | Wed Nov 7, 2012, 05:50 PM (6 replies)
Right now Karl Rove is telling his Super Pac Pals that it will all be different in 2014. Without Obama on the ballot, minority turnout will be low and angry white male voter turnout will be through the roof. He is promising them the Senate and maybe even hinting at Brother Jeb in 2016 to turn it all around for the party he crashed.
But we Democrats know better. In 2014, millions of Americans who have been priced out of the health insurance market---or have had the door slammed firmly in their faces due to “pre-existing conditions” or “age”---will be able to afford health insurance. States that have stubbornly refused to create their own pools will find their citizens offered insurance choices by the federal government.
One of these could be Medicaid, which will be expanded. Medicaid may be a good choice for those on fixed incomes, since it typically has no deductibles, low copayments and good (i.e. 100%) drug coverage. Now that Social Security income will no longer be counted towards determining Medicaid eligibility, lots of disabled people who are being nickeled and dimed---or $100ed and $1000ed--- by their Medicare copayments may get relief. Some states have indicated that they will resist the Medicaid expansion. However, this will mean turning away lots of federal money, at a time when many states are strapped for cash. Medicaid pays for such popular items as nursing homes and prenatal care. Does the Tea Party have the guts to paint itself as the enemy of the elderly and pregnant women? I don’t think so. I expect to see the red states hold out their hands and say “Gimme!” the way they always do, since what blue states give in increased productivity and taxes, red stakes taketh.
For those making too much to qualify for Medicaid, there will be private insurance plans which will no longer be able to discriminate against those with risk factors for disease or medical conditions. Why the change of heart at United and BlueCross? The private insurance industry is salivating at the thought of collecting premiums from healthy 20 something men who never get sick. They hope that the tax penalty for those who are uninsured will persuade lots of healthy people to sign up. The Tea Party is hoping that the tax penalty will get the angry white male voting block so riled up that they will turn out in record numbers in 2014. My advice? The IRS should “slow walk” the penalty part of the law. Give folks a two or three year grace period to look around and find the insurance that is right for them. This will force the private insurers to write affordable policies that will attract the cherries they want to pick. This will encourage more folks to become insured. And, it will remove the sting from the law, so that in 2016, Affordable Care will be win/win for the Democrats.
Using its executive powers, the Obama administration and HHS should be able to overcome any GOP roadblock. As a last resort, offer Americans the same insurance that federal employees get. Or, better yet, tackle the health care crisis by announcing open enrollment in Medicare. An “emergency” is anything the administration says it is. And millions of Americans dying needlessly through lack of health insurance is the biggest ongoing crisis we face---much worse in scale than any hurricane or any terrorist attack. It is moral crisis, that tests our nation’s vow to stand together. It is an economic crisis which strains hospital emergency rooms, decimates the work force and increases disability.
The GOP claims that Affordable Care is a job killer, but I think we will see the exact opposite. Folks who used to look for jobs with big companies, because they needed the insurance, will now be able to work for small businesses. Or even start up their own small businesses. Small businesses are the big employers in this nation---and they are unlikely to move to China. Strengthen small businesses and you increase jobs.
Healthcare spending is also a job creator. Not quite the job creator that education spending is, but much, much better than military spending and tax cuts and about equal to infrastructure spending.
This election was a huge crap shoot for the Tea Party and its corporate backers. I have no idea how much money Karl Rove wasted, but I hear that $150 million was spent for Romney in the last three weeks alone, so I am guessing a couple of billion went down the toilet. Why are the Koch Brothers of the world so determined to strike down Affordable Care? Because they get rich by keeping American workers poor, uneducated, sick and desperate. If your choices are Dixie Cup or the poor house, you will, reluctantly, choose Dixie Cup. But who will slave in a Dixie Cup factory when she or he can get a skilled job with better wages and benefits? No one.
Posted by McCamy Taylor | Wed Nov 7, 2012, 01:42 PM (0 replies)
Two years ago, I speculated that Citizens United---the Supreme Court ruling that gave wealthy corporations (foreign as well as domestic) the right to spend unlimited amounts of money to influence U.S. elections---was a conspiracy cooked up by Scalia and Bush officials. If you did not read it in 2010, here is a link.
Karl Rove was obviously part of the plan. Who announced the formation of the very first SuperPac----before the ink was even dry on the SCOTUS's opinions in the case? Turd Blossom, of course. Who held out his hand and told some of the nation's richest men "Give me hundreds of millions and I will make you billions (and quash that federal indictment while I am at it)"? Bush's Brain----
Except, Rove is not as brainy as all those billionaires seemed to believe. If he was, he would have realized what a bad idea Citizens United was for the party he claims to love.
What's not to like about legal steamer trunks full of cash (as opposed to Dick Nixon's secret suitcases full of cash)? Plenty, if you are a Republican. As a Democrat, I found the whole thing amusing---and very predictable. According to the rules laid down by Scalia, Super Pac money could be spent in only one way---on attack ads. You know, those negative TV commercials that drive everyone crazy in battle ground states. And what do Americans hate? Negativity. I thought Nancy Reagan taught the Republican Party that truth back in 1984. I guess Rove was not paying attention to those Morning in America ads. He was probably too busy rereading Pat Buchanan's dirty tricks memo from 1972---the one that sent all those people to jail.
Citizens United was the gift that kept giving---to the Democrats. All that rogue money meant that the party lost the power of the purse strings. Rather than rallying behind the candidate with the most money, Romney, they kept rallying behind whatever candidate was the latest recipient of SuperPac cash. And so, the party faithful fell in love with---and then discarded---Michelle Bachman, Rick Perry, Newt Gingrich, Rick Santorum (!) before finally settling for whatever was left over, namely Mitt Willard Romney, less than affectionately known as Mittens by the Party base. By the time he finally won the nomination, he smelled like week old catfood----and was somewhere to the political right of David Dukes.
And it got better. In the past, candidates had to raise money from lots of folks, meaning that they had to have social skills. After Citizens United, a single wealthy donor could easily bankroll a congressional candidate. As a result, the Republicans were stuck with the kind of greasy little toadies that only a wealthy donor could love. And every time a greasy little toady---like Akins or Mourdouck-- put his foot in his mouth and said something asinine about rape, garnering shit loads of bad press for the party, the wealthy donor would come to the rescue with more steamer trunks full of legal cash....
The obscenely rich love their money more than anything else. I can only imagine what is going through the heads of guys like the Koch Brothers who have handed over millions of dollars for what turned out to be a massive crap shoot. What will they do in 2014 when Rove comes along with his hand out, asking for money again? Will they think to themselves "I should have given more?" and double their investment? Or will they realize that pouring money into SuperPacs is just like flushing it down the toilet?
I think they will double their investment. And I can't wait to see what kind of creepy candidates a handful of wealth megalomaniacs will pick for the GOP next time.
Posted by McCamy Taylor | Wed Nov 7, 2012, 03:13 AM (5 replies)
Anywhere. Even at the polling places, where there are tons of Republican signs, I have not seen a single Romney/Ryan sign. No Romney/Ryan signs in yards. No bumper stickers. If the Republicans in a redder than red state are ashamed of Romney, how can he expect them to turn out in huge numbers on election day to stand in line to vote for him?
I don't know what the press is smoking. Maybe weed wrapped in hundred dollar bills courtesy of Rove's SuperPac. No one likes Romney. He is an ass. The last candidate this unlikable was Dick Nixon, and we all saw how close the race was in 1968 with him running against a VP. How on earth does anyone think that Willard can unseat a popular president except through voter intimidation and election fraud?
Get out and vote and show the press that we do what we want to do, not what they tell us we ought to want to do.
Posted by McCamy Taylor | Sun Nov 4, 2012, 01:36 AM (28 replies)
150,000,000 Google hits describe Romney's lies and 26,000,000 call him an outright liar. That makes him the most truth impaired candidate for president that we have seen since Tricky Dick ran on a campaign of ending the war in Vietnam---while secretly bribing Kissinger to sabotage LBJ's peace talks with North Vietnam. How does Romney sleep with himself at night? Easy. Romney thinks that he is a god-to-be, meaning that he is not running for president, he is running for Caesar or King, positions that are stepping stones on his road to divinity.
All Mormon males in good standing know that once they die, they will become gods with their own planets full of devoted worshipers. And Romney, with his enormous piles of trash is obviously a very, very good Mormon, since the God of the puritans shows His favor by granting material wealth in this world and then spiritual wealth in the next. That makes Romney a demi-god, at the very least. He is running for president in order to increase the number of worshipers he will have in his next life. If the law denies him a harem of wives to wait upon him after death, he will accept a bunch of serfs instead.
Having God as a president should be a good (Godly) thing, right? Depends upon what you think the president's job is. If the Commander-in-Chief exists in order to increase His own glory and reward His faithful and punish His enemies, then Romney is the man for the job. If the president is supposed to serve the people, then maybe Mittens is not such a good choice.
Take Romney's position on FEMA and natural disasters. Of course he would be against federal assistance for storm ravaged states. A storm is an act of God. Helping people who have been punished by God is a sin. If God-President Romney decides to punish you for being an unmarried pregnant woman or a gay male or Black, you had better keep your mouth shut and enjoy it----the way that some Republicans want women to enjoy rape. Indeed, as a god in the making, if Romney screws you over, it won't be figurative rape---it will be what Zeus did to Leda. And Danae. And Io.
The Roman Caesars got away with anything---murder, incest---because they knew that upon their deaths they would become gods, and gods are always right----even retroactively. So, when Romney lies, he does so secure in the knowledge that the truth is what he (God) says it is---and therefore, it is fact checkers like Candy Crowley who are going to Hell.
Now, I would like to suggest a common sense exercise for anyone thinking "Ah, Romney can't be so bad. He was governor of Massachusetts." Think back to the last president who believed that he was the anointed successor. The one who lied and cheated his way into office twice. The one who used his power to enrich his friends and persecute everyone else. The one whose Department of Justice waged war on Black Folks. The one who used the military as mercenaries for the oil industry. The one who used the Constitution as toilet paper, because he answered to a higher law---his own. While Romney may not seem exactly like W. at first glance---he is a bit smarter and a hell of a lot more disagreeable---they are cut from the same cloth. The only difference between Willard and W. is the friends that will be rewarded and the enemies who will be squashed like bugs. So, unless you are Mormon or a hedge fund managers or a banker, you really ought to get out there vote for Obama, the man who looks after his enemies as well as his friends because he knows he was elected to serve them all.
Posted by McCamy Taylor | Thu Nov 1, 2012, 03:56 PM (6 replies)
…..and loves polytheism? Now that Billy Graham has taken down the “Mormonism is a cult” page from his website and Mike Huckabee has told us that we will burn in the fires of Hell if we vote for Obama, I have to assume that Biblical scholars have unearthed some new information. Like a revised Ten Commandments that starts off
“I am the Lord Thy God and I have an infinite number of subGods, and you will bow down to your personal subGod, who will in turn bow down to His subGod and so on until someone finally bows down to Me.”
Because according to Mormons every Mormon male who dies becomes a God with his---sorry, His own planet and His own chosen people, making Mormonism a polytheistic religion much like Hinduism or Voodoo. And I am sure that Mike Huckabee and Billy Graham and all the other Fundamentalists would not make such claims unless they had the Scripture to back them up. Not about something like there being more than one God. I mean, dude! That is the most basic tenet of monotheism, which is what I was always taught Christianity is.
Also, God Prime (aka Elohim) is not from the planet Earth. He is from Kolob. And God did not make us. Some subGod did. The same way that all the subGods to be (like Mitt Romney) are making Their people to populate Their own planets. That's "Their" with a capitol T, because there is more than one of Them. And They don't come from Earth. They come from Kolob. Which I can't find referenced in the Bible. Maybe Rev. Graham or Huckabee can point out that passage for us, just so we are clear about why we are going to Hell is we don't vote for Mittens? I want to make sure Huckabee and Graham did not pick up a copy of a science fiction novel instead a Bible, when they came to their decision. Because I don't think we get do-overs when it comes to Hell.
Posted by McCamy Taylor | Wed Oct 31, 2012, 10:31 PM (16 replies)
You voted for Romney/Ryan in 2012, because you had a vague sense that these two men had more in common with you than then President Obama. Nothing you could put your finger on. There was just something you liked about Romney’s face----
You were 55 when you voted for Romney. You lost your job in banking in 2008, when the economy went Boom under Bush, and it took you four years to find another, halfway decent job, one with benefits. In 2013, you were just starting to pull yourself out of a financial hole when Romney, the president of your choice was sworn in.
You noticed the change right away. The federal government under Romney stopped enforcing key provisions of the Affordable Care Act. Your 22 year old daughter was dropped from your health insurance----while pregnant with her first child. Then, in 2014, your employer stopped offering health insurance. You were given the option of paying out of your own pocket for continued coverage, but there was no way you could pay over a thousand dollars a month plus pay off your debts. Ironically, 2014 was the year you would have been able to purchase your own individual insurance at a reasonable rate, had the federal government not repealed Obama-care. Looking back, you wondered what you were thinking in 2012. Romney’s face did not look so agreeable when you saw him on television, now.
Since you couldn’t afford insurance, you went without. You were worried, but you reminded yourself that you had done it before, between 2008 and 2012 and nothing bad happened….
Three years without health care. In 2017, that pesky “indigestion” you were having for over a year turned out to be a heart attack. A major heart attack. By the time the doctors at the charity hospital released you to return to work, your job was gone. Your employer had hired someone younger. You consulted an attorney but were told that the Super Pac approved judges whom Romney had appointed overwhelming sided with employers in age discrimination lawsuits. So, you found a job at a convenience store and tried to stay afloat while you filed for Social Security disability---
Five years later, you still had not qualified. Social Security said that you were too highly educated. You could work from home, from bed if necessary. Too bad no employer was hiring a 60 something with a bad heart who had to work from bed. Too bad you could no longer retire early.
In 2022, you finally reached the age of 65. That was when you got the bad news. Your Social Security retirement savings---they were gone. Long gone, into some billionaire's Swiss bank account. Romney rewarded his hedge fund manager and banker donors by “privatizing” Social Security---and then, your retirement savings were invested in a bunch of worthless mortgages.
And your Medicare, the insurance that was supposed to take care of you in your retirement years? Gone. Long gone. Instead, the government issued you a voucher. If you could have cashed it in and used the money to pay for food or rent you would have. But the voucher could only be used to buy health insurance. So, you started asking around. And you discovered that because of your age and your heart condition, your voucher would only buy you a high deductible----$5000---policy that only covered your hospital expenses, no outpatient, medication or preventive service coverage at all. The hospital industry was happy. When you finally showed up in an emergency room dying, their bill would be covered. But your Voucher-care was not going to do anything to keep you healthy in the meantime.
Welcome to the first day of you Voucher-care!
Posted by McCamy Taylor | Mon Oct 29, 2012, 01:13 PM (2 replies)
Forty-eight years ago, 2 year old Monique Corzilius aka Daisy was featured in an ad reminding us that life is too precious to waste. Monique Corzilius is now 50 years old. If Romney/Ryan win this election, she will never get Medicare. Instead, when she reaches 65 she will be given a voucher and told to purchase insurance from an industry which refuses to insure the elderly and sick. "Daisy" is in just as much danger now as she was in 1964. Unless Americans read the small print, they may go to the polls convinced that Romney is the same as Obama---except white----not realizing that he, his VP and his party have vowed to eliminate the Medicare program that LBJ built to keep the nation's elderly from sinking into poverty due illness and aging.
If "Daisy" was worth saving in 1964, she is worth saving now.
Watch the original ad here:
"These are the stakes. We must either love each other, or we must die" LBJ
Posted by McCamy Taylor | Mon Oct 29, 2012, 12:16 AM (0 replies)