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McCamy Taylor

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Member since: Tue Nov 9, 2004, 06:05 PM
Number of posts: 15,231

About Me

Here is my fiction website: http://home.earthlink.net/~mccamytaylor/ My political cartoon site: http://www.grandtheftelectionohio.com/

Journal Archives

Democrats OWN the Center: I'm Not Giving It Back Without a Fight

Ok, my two cents worth. Carter did not lose because he moved to the center. Carter lost, because some very bad people made a deal with the Iranians to exchange Hostages for Votes. McGovern lost by a landslide in 1972, because the GOP was able to portray him as the “Abortion, Acid and Amnesty” candidate—he had spent so much time courting the left wing of his own party in the primary, there was really no time for him to move back to the center for the general. And right now, with the Tea Baggers jettisoning their own semi-sane Republican incumbents in a rite of Calvinist slash and burn frenzy that would make the Salem Witch Hunters proud and replacing them with GOP candidates who are so crazy, so extreme, so far out in far out right field that Goldwater of 1964 would have said “What’s up with these guys?”---

Now is the time for the Democratic Party to proclaim “Hey, America, who are you gonna trust? Those crazy extremists who want to take away your Mom’s Medicare and Social Security? The ones who want to arm kindergarten teachers? The ones who want to privatize your fire department? The ones who would rather see your wife die from being pregnant than allow her to get an abortion? The ones who think that Blacks had it better under slavery? The ones who think that children born to undocumented immigrants should be allowed to stay---as indentured servants, not subject to ordinary labor laws? The ones who want to criminalize sex? The ones who want the Bible---their version of the Bible—taught to your kids in school? The ones who want to wage holy war against Muslims? The ones who want to cut taxes on the rich while raising them on the working class? The ones who think you should get your health care in the Emergency Room? The ones who think that corporations are citizens and that the more money a citizen has, the more influence he should have in a democracy?”

Now is the time for Democrats to remind Americans that our party stands for equality for all before the law---a good old fashioned American value, straight out of the Bill of Rights. Democrats stand for freedom of religion. We stand for the right to privacy. We stand for one person, one vote. We stand for marriage---for all. We stand for children---including children’s safety and health. We stand for a country where no child should go to bed hungry at night. We stand for families---and we won’t stand for having families split apart, so that Dad can be sent to fight a war of choice for oil or that Mom can be sent “back” to a country she never knew where she could be killed.

Citizens United gave some rich folks the right to buy a party. They bought the Republican Party. They filled it with a bunch of kooks who are so far right that only a well-paid media whore could love---no, no one can love them---only a well-paid media whore can stomach them. And now, their party full of kooky, crazy Tea Baggers is having a very hard time trying to connect with ordinary Americans, because they say the kinds of things that only 1% of Americans want to hear. Imagine that.

Since this is politics and not a game of golf or darts, there is no reason why the Democrats have to offer to accept a handicap in order to make the upcoming elections more “sporting.” We do not have to say “Oh, you poor Republicans. Your corporate masters have saddled you with a lot of brainless, right wing zombies. Here, we’ll move on over to the far left, so that it will be a better contest.” We would be fools to make such an offer. Since the GOP has abandoned the Center of the Road as if the Center of the Road has a horrible infestation of cooties, I suggest---no, I demand that we stake a claim to the Center of the Road. We are supposed to be the Big Umbrella. We are supposed to be the party that represents as many people as possible. Seems to me that the Big Umbrella will catch more folks in its shade if we set it up right in the middle of the road where all the traffic will be going. And then, if I may stretch the metaphor, maybe we can gently nudge the traffic and get it moving in a direction that will benefit all of us, economically, socially, emotionally, culturally---

The trick will be resisting those within our own party who look at the Tea Baggers way, way off in right field and then look at us in the center of the road and then look at the Tea Baggers, so very, very far away with their "Privatize Medicare Now!" and "No Gay Marriage ever" and then look at us and then look at the Tea Baggers who call children on food stamps "feral" and then look at Hillary Clinton and proclaim "Hillary is the same as Ted Cruz! Eeek!" Just like all those folks back in 2000 who said "Gore is the same as Bush" though they could not have told you a single thing that Bush did as governor of Texas, because if they could, they would have known that Bush was never the same as Gore. They just liked the way that sounded "Gore is the same as Bush. Yeah, that sounds like something a political rebel would say. I'm a rebel. I wear white shoes after Labor Day!"

The Center of the Road is not a bad place. The Center of the Road is where most of the people who need our help---working class Americans of all colors, religions, ethnicities who are struggling to keep their jobs, their homes, their retirement savings---live in a democracy. It is Nancy Reagan's Morning in America, and while her campaign was a bunch of lies, if the Democrats promise the same thing, we can deliver. Oh, and if I remember 1984 (which I do) all of my liberal friends were absolutely delighted with the Democratic ticket--that got trounced by Reagan. Proving that going "center" was not what did us in.

Posted by McCamy Taylor | Sun May 18, 2014, 09:05 PM (11 replies)

U.S. Health Care Spending 17.9% of GNP in 2011...Do You Feel Healthier Yet?

Rhetorical question. Of course you don't. The US spends over twice as much per person per year on health care costs and yet our health indicators would put most second world countries like Mexico and Eastern Europe to shame. Our infant mortality is high. In many rural counties life expectancy for women is going down not up. And yet, we spend money like there is no tomorrow---on end of life care for people who are going to die, so we stick them in an ICU and bill their insurers hundreds of thousands of dollars so that they can die in style. If anyone demands to know why it costs so much to die in this country we are told hospitals fear malpractice suits--but is a grieving family really going to sue because their dying relative did not get an extra machine that goes "ping"? Often, relatives watch in horror as the health care industry takes over what should be a natural part of life---death---and turns it into something macabre. Why?

The rest of the world knows that we are crazy---and they love it. When we tried to control Medicare Part D costs, the British Pharmaceutical industry protested. If they couldn't sell their drugs in the US at inflated costs, how could they give their own countrymen discounts on the same drugs? Think about it. Your mother and father on a fixed income pay more for their medicine so that Brits on National Health can get cheaper government subsidized health. Why?

We have the fast food industry encouraging us to get fat, the petrochemical industry encouraging us NOT to walk and to breathe crappy air, and the government can barely get a word in edgewise with its wimpy, underfunded public health campaigns. We have private insurers that know that the minute we get truly sick we will go on Medicare or Medicaid, so they are not going to waste any money on disease prevention. We have a private pharmaceutical industry which dreams of the day that everyone in this country has to take 10 or 20 pills just to stay alive---they are not pushing for more disease prevention. We have medical schools that keep turning out specialists who want to fix your diseased coronary arteries and replace your diseased hips but very few who want to keep those arteries and hips healthy, because there is no money in that, and without money they can not pay off their enormous education debt....

If a single insurer was going to be responsible for all of your medical bills from the moment you were born to the moment you died, that insurer would have specialists crunching the numbers, analyzing the data, doing research, figuring out the cheapest most effective way to keep us healthiest longest--because that insurer would make a lot of money for doing it. The insurer could Blue Cross. It could be Aetna. It could be Medicare. It could be the governments of France or Canada that spend half as much per person as the US to get excellent health quality results. As long as we hop-scotch from insurance to insurance--and occasionally off insurance--and finally onto government financed insurance, public health and efforts at disease prevention will remain a joke in this country.

If you make a best selling diabetic medication, who is your best friend? Coca-cola and Big Gulp. If you make a best selling COPD medication, you love R.J. Reynolds and car emissions. If you make a killing sell heart medications, you hope that we spend the next fifty years eating at McDonalds. If you make prosthetic knees, you love all of the above.

Face it my friend, to the Medical Industrial Complex, we are rats in a maze being force fed, forced to breathe smoke, confined to small spaces where we can not exercise and then subject to inhuman experiments that are heavily funded for the good of the profits of the Medical Industrial Complex, not the good of the rats in the maze. Pretty soon, the entire world--China, India, everywhere---is going to make its money making the drugs and machines and tubing that we need to continue our pathetic barely human existence---

---unless we decide to take charge and start living like healthy human beings again.

Eat less, exercise more, don't smoke, sign up for ACA, get a check up, insist that your community clean up its air and its water, eat organic, say no to toxic chemicals, say no to Frankenstein foods---if you really want to stick it to 1%, it is a great place to start. They will hate you for it. Hell, they will probably consider you un-American.

Posted by McCamy Taylor | Sat May 17, 2014, 10:56 PM (3 replies)

Let's Be Accurate: The MMR Vaccine is Not Associated With Autism. But Neonatal Hep B in Males...

Here is the link to the study:


Here is the abstract:

There has been enormous debate regarding the possibility of a link between childhood vaccinations and the subsequent development of autism. This has in recent times become a major public health issue with vaccine preventable diseases increasing in the community due to the fear of a 'link' between vaccinations and autism. We performed a meta-analysis to summarise available evidence from case-control and cohort studies on this topic (MEDLINE, PubMed, EMBASE, Google Scholar up to April, 2014). Eligible studies assessed the relationship between vaccine administration and the subsequent development of autism or autism spectrum disorders (ASD). Two reviewers extracted data on study characteristics, methods, and outcomes. Disagreement was resolved by consensus with another author. Five cohort studies involving 1,256,407 children, and five case-control studies involving 9920 children were included in this analysis. The cohort data revealed no relationship between vaccination and autism (OR: 0.99; 95% CI: 0.92 to 1.06) or ASD (OR: 0.91; 95% CI: 0.68 to 1.20), or MMR (OR: 0.84; 95% CI: 0.70 to 1.01), or thimerosal (OR: 1.00; 95% CI: 0.77 to 1.31), or mercury (Hg) (OR: 1.00; 95% CI: 0.93 to 1.07). Similarly the case-control data found no evidence for increased risk of developing autism or ASD following MMR, Hg, or thimerosal exposure when grouped by condition (OR: 0.90, 95% CI: 0.83 to 0.98; p=0.02) or grouped by exposure type (OR: 0.85, 95% CI: 0.76 to 0.95; p=0.01). Findings of this meta-analysis suggest that vaccinations are not associated with the development of autism or autism spectrum disorder. Furthermore, the components of the vaccines (thimerosal or mercury) or multiple vaccines (MMR) are not associated with the development of autism or autism spectrum disorder.

Note that MMR was cleared. MMR was suspected because it is given at around 1 year of life. One year is when children typically walk and talk. If they do not walk and talk, the parents think back to the thing that happened right before they did not walk and talk---and they remember the MMR vaccine. This guilt by association obviously made no sense and it is a good thing that they have finally laid this myth to rest, since folks die of measles.

However, to say that no vaccine has been linked to autism is incorrect. There is one vaccine that is routinely given to newborn infants---infants whose brains and immune systems are so immature that simple viral infections can have devastating consequences. I am referring to the Hepatitis B vaccine. Why is this given to newborn infants? Because decades ago, scientists studied inner city hospitals where a lot of drug addicts gave birth and they discovered that it was cheaper to just immunize all the babies at birth than to test the mothers to see which were infected with Hep B and immunize their babies at birth. Meaning that you---you who are likely not an IV drug addict and who are likely immune to Hep B from the vaccine you received in school---will have a baby who will be given a vaccine shortly after its birth because that was what was best for drug addicts three decades ago.

What could go wrong with giving an extra, unnecessary vaccine to a newborn baby? The only study so far to find any statistical association between a vaccine and autism is one for male infants given the Hep B vaccine at birth.


Universal hepatitis B vaccination was recommended for U.S. newborns in 1991; however, safety findings are mixed. The association between hepatitis B vaccination of male neonates and parental report of autism diagnosis was determined. This cross-sectional study used weighted probability samples obtained from National Health Interview Survey 1997-2002 data sets. Vaccination status was determined from the vaccination record. Logistic regression was used to estimate the odds for autism diagnosis associated with neonatal hepatitis B vaccination among boys age 3-17 years, born before 1999, adjusted for race, maternal education, and two-parent household. Boys vaccinated as neonates had threefold greater odds for autism diagnosis compared to boys never vaccinated or vaccinated after the first month of life. Non-Hispanic white boys were 64% less likely to have autism diagnosis relative to nonwhite boys. Findings suggest that U.S. male neonates vaccinated with the hepatitis B vaccine prior to 1999 (from vaccination record) had a threefold higher risk for parental report of autism diagnosis compared to boys not vaccinated as neonates during that same time period. Nonwhite boys bore a greater risk.

Association does not prove causality. This study does not prove your child's autism was caused by a Hep B vaccine. It suggests that male children who get the vaccine at birth may be more likely to show signs of autism. I just did a Medline search and I can not find any more recent studies to either confirm or refute this study, meaning it is still up in the air. So, you get to decide what you do with the information. But, do not leave DU tonight telling all your friends "Great news. A study has cleared ALL vaccines."

Posted by McCamy Taylor | Thu May 15, 2014, 07:33 PM (76 replies)

Does Gilead Know Someone in the CDC?

Just asking. Two years ago, the CDC recommended that every baby boomer get screened for Hepatitis C, even if they had no risk factors. They made this recommendation one year before Gilead was scheduled to introduce its new, blockbuster, easy to take, tres cher (expensive) Hep C drug which costs $1000 a pill or $84,000 for a course. And now, the CDC has recommended that everyone who uses IV drugs and shares needles, has unprotected gay sex with men, has a partner infected with HIV or has an IV drug using or bisexual partner (or does not know what their partner does in his free time) should be on a $13,000 a year Gilead drug forever to prevent HIV. Note that taking the drug does not guarantee that you will not get HIV and Gilead still recommends that you not share needles and that you not have unprotected sex. So, if you are using only clean needles and you are using condoms (correctly) every single time, do you really want to take a medication that can have some pretty serious side effects? If you partner is HIV positive this is a great medication. Or is you are a professional sex worker, yeah, sure. But risking your liver on the off chance that a condom might break and that the partner you are sleeping with when the condom breaks is HIV positive? Is it really worth it? Since there is no way to know if your partner is bisexual or using IV drugs do you just assume that they are? Should every 16 year old girl go down to Planned Parenthood and say "I want some birth control pills and I want some anti-HIV pills, too?"

Note that the VA, which has not been doing a very good job of getting our Vets timely appointments, has rounded up the funds to get the Hep C drug on its formulary. Is this their way of taking care of our vets or their way of showing thanks to Gilead's old owner, Former Defense Secretary Donald Rumsfeld? The drug to prevent HIV is already covered by many insurers, though I am not certain if they cover as many people as the CDC is now recommending take it---one source says this will increase usage 50 fold.

Which has me wondering: Who will be the first person at the CDC to leave through the revolving door and get a job at Gilead.

Ok, I am ready for the long list of testimonials from all the folks at DU whose 1) Hep C was cured by the drug above 2) HIV was prevented by the durg above or 3) are absolutely pumped knowing that these medications are available and will be covered by their insurer. But if anyone is at all interested in how private industry uses government regulatory bodies in order to increase their profits--and then turns around and hires former US government officials by way of payment (the so called revolving door), I would be happy to hear from you.

In case people think that this stuff doesn't happen here is a link to a link to some old stuff I wrote about Glaxo-Smith Kline and Dan Troy.


Links about Gildead.




PS. Oh, and by all means, buy Gilead stock. If they know someone at the CDC, they are going to make a gazillion dollars. This is meant to be sarcastic in case anyone wonders. I do not bet on stocks or give stock tips. Just thought it was funny that so much medical news pops up in business journals first when you do a google.

Posted by McCamy Taylor | Thu May 15, 2014, 08:17 AM (7 replies)

Ball and Chain: Not Your Usual Mother’s day Thread

There is something visceral about the tie that binds a mother and child. I realized it when I was pregnant. Nothing in the world mattered as much as the child growing inside my womb. Once he was born, the umbilical cord might as well have still been attached. His pain was my pain. His fear was my fear.

Now that my child is grown, the cord has finally been snipped. But during those first eighteen---no, let’s be honest, those first twenty years---one person in my life came first, and it was not me.

But this is not about my son. This is not about me. This about the role women play in capitalist society, and why so many people on the right seem so determined that our daughters will have unprotected underage sex and give birth to children that they are ill equipped to support.

If a young woman has to drop out of school to support a child, she will. She will do anything to take care of her son or daughter. She will drag herself to a dead end, pink collar ghetto job day after day and she will do her boring work with a smile, because she knows that she is doing it for her baby. She will not join a picket line, not when her kids need to eat. She may dream of going back to college to get a degree. But between work and taking care of the children, there will never be enough time. She will always be there for Tyson and for Dixie Cup---Koch owned Dixie Cup. She will always accept a lower wage than male workers, because a man who does not have children to support can walk away, but a mother has to think about her kids first, second and last.

I was lucky. I grew up in the 1960s. I was on birth control before I ever had sex. I was out of medical school, residency and in private practice before I conceived my (planned) son. My mother, from a different generation, was not so lucky. She was also premed. She got married right before she was supposed to go to medical school, the way I did. But birth control in the 1950s wasn't so good. She got pregnant. Having a baby and being forced to get a job put a permanent end to her plans for a career in medicine. Luckily for her and for my sister and me, she majored in math, not English, not Liberal Arts. So, she went on to a career in computer science with NASA and NASA contractors. Not bad. Certainly not the pink collar ghetto, though not the medical career she had wanted. However, the math major was a fluke. She had to pick something, and she was good in math. She liked it. She never thought she would have to make a living from it.

Children are one of the best things in life. The mother-child relationship is something we should celebrate. But the far right has taken something natural and good and perverted it for their own use. They treat pregnancy as a “wage of sin.” They condemn single mothers and their children to poverty under guise of piety—they are serving the will of a deity who demands that women who “fornicate” wear a big scarlet letter. However, they are really serving the will of industry that uses women as a low paid, unskilled compliant workforce to keep down wages for all workers. There are very few unskilled jobs nowadays that cannot be performed by women. Those that absolutely have to be done by men fetch a higher salary. But for how much longer?

And that is why we---all of us, male as well as female--- need pay parity and why we need choice.

Thanks, Mom, for all you did and do! An especially big thank you for raising me with a political conscience. It is so tempting to shelter our children. But if we try too hard to protect them from all the hurt other people are feeling, how can they grow up to be caring adults? I hope I can be half the mother you have been. And thanks for giving me a love of the blues.

Posted by McCamy Taylor | Sun May 11, 2014, 04:31 PM (8 replies)

GOP "Family Values": When Rural Hospitals Close for Lack of Medicaid, Women and Children Die

You should not need a study to prove it, but one was done anyway. In 1991, the Indiana University Department of Family Medicine discovered a statistically significant association between living in a rural county that lacked adequate obstetric coverage and infant mortality. Now, association does not prove causality, but if this is your first baby, and he is coming out breech and gets stuck and there is no one to do a stat c-section, your baby may not survive long. Or, if you go into early labor, and there is no one who knows how to administer the appropriate drugs to stop that labor, you may deliver a baby that is extremely small---with no Neonatal ICU staff around to save its poor little life.


If you read my last journal, you know that Georgia Republican legislators are gleefully forcing “crack addicted” rural hospitals out of business on the grounds that it’s healthier for our country’s economy if we have fewer crack addicted hospitals among us. Unfortunately, it is not healthier for our country’s health. Rural women, in particular, suffer when they are denied access to health care that urban women take for granted.

General health conditions and behavior that U.S. rural women experience at higher rates than their urban counterparts include, self-reported fair or poor health status, unintentional injury and motor vehicle-related deaths, cerebrovascular disease deaths, suicide, cigarette smoking, obesity, difficulty with basic actions or limitation of complex activities (4, 5), and incidence of cervical cancer (6). Other comparisons show that death rates from ischemic heart disease in rural women exceed that for all U.S. women. In some regions of the country, women in nonmetropolitan areas have higher rates of heavy alcohol consumption (4). Proportionately fewer rural women receive recommended preventive screening services for breast and cervical cancer. Rural African American, Hispanic, Asian, and white women are less likely to have cervical cancer screening. African American, Hispanic, and white women are less likely than their urban counterparts to have mammograms (7). Comparisons of female patients in whom invasive breast cancer was diagnosed in Georgia from 2000 to 2009 indicate that women living in small rural and isolated areas were 30% more likely to have surgery and 17% less likely to receive radiotherapy as first-course treatment than their urban counterparts. Also, within these rural areas, African American patients were 57% less likely to have surgery than white patients.


Rural women do not have the “Choices” that urban women have (from the link above):

Local availability of abortion services also is a concern. Eighty-seven percent of U.S. counties, in which 35% of reproductive-aged women lived, had no abortion provider in 2008. Obstetrician–gynecologists with rural mailing addresses were significantly less likely to perform abortions (6.5%) than their urban counterparts (17.0 %) (32). Rural women seeking abortions in 2008 traveled substantially greater distances than nonrural women. Thirty-one percent traveled more than 100 miles and an additional 42.9% traveled between 50 miles and 100 miles, compared with 3.8% and 7%, respectively, for nonrural women (33).

Among the 14 states ranked the highest on percentage of women aged 13–44 years in need of publicly funded contraceptive services and supplies, nine have rural populations exceeding 33% of the state population (20, 34). Only 46% of the agencies providing publicly funded family planning services reported that their clinic sites are located in mostly rural locations, the majority of which are health departments and Federally Qualified Health Centers (35). In Colorado, where almost three-quarters of the counties are considered rural, substantial numbers of reproductive-aged women live in counties where there is no identified pharmacy or health clinic that either prescribes or fills prescriptions for contraceptives (36). Despite concern about access to emergency contraception, data on current over-the-counter availability of emergency contraception in U.S. rural pharmacies are lacking.

And here, I have to wonder, is this all part of some huge Tea Party conspiracy? Deprive rural women of doctors, hospitals, so that they have no access to birth control or abortion? Force them to deliver their babies at home, without anesthesia, so that they can suffer the “wages of sin”? And what about the children who are born early, who die or who suffer the lifelong effects of prematurity? Is this the Religious Right’s way of ensuring that the “sins” of the mother will be passed on to the offspring? Remember, these are the sickos who objected to the HPV vaccine on the ground that cervical cancer is God’s way of punishing women for having sex, and if the state prevents God from punishing women for having sex, then the state is attacking religion.

Just how bad are things for women in rural America? While life expectancy for most people in the industrialized world keeps rising, women living in rural counties in the south and west of the United States have seen an increase in preventable death.

A new study offers more compelling evidence that life expectancy for some U.S. women is actually falling, a disturbing trend that experts can't explain.
The latest research found that women age 75 and younger are dying at higher rates than previous years in nearly half of the nation's counties — many of them rural and in the South and West. Curiously, for men, life expectancy has held steady or improved in nearly all counties.
The study is the latest to spot this pattern, especially among disadvantaged white women. Some leading theories blame higher smoking rates, obesity and less education, but several experts said they simply don't know why.


In Texas last fall, one rural community discovered exactly what can happen when the only hospital in town closes:

On this much, everyone agrees: 18-month-old Edith Gonzalez, who charmed folks in this East Texas town by shaking her pink tambourine in the church choir and pretending to mother her baby sister, shouldn’t have died.
A grape was stuck in her throat. Her family rushed her to nearby Shelby Regional Medical Center. But the hospital was locked and empty.
“I feel in the depth of my soul had a simple ER unit been in the Center area, the child would have survived,” said Charles Bush, a bystander who held her head and prayed as the family waited in vain for help.
The toddler’s Aug. 12 death has starkly exposed the vulnerabilities of a rural community suddenly left without its longtime safety net.


The hospital in question was kept afloat through fraud and mismanagement. It’s pretty difficult to make a profit from a rural hospital, when you are required by law to provide free care to folks that the law does not care to provide health insurance. When the owner was finally turned in, the hospital shut down, leaving the town---and Edith’s parents---with no place to turn in an emergency.

This is what the “best health care in the world” has accomplished---a system in which rural women and their children are treated as disposable. And the self-styled family values Republicans seemed determined to keep the rural women and children of their own states living---and dying---for lack of health care. This truly is America held hostage.

Posted by McCamy Taylor | Sat May 10, 2014, 06:47 PM (5 replies)

“Rural communities… where 39 percent of the folks who have a stroke or have a heart attack die."

I write a lot about health care for the urban poor, because that is what I know. But there is something much worse than being sick and poor and living in a major metropolitan area in the United States. That is being sick and living in the country.

In the past year alone, more rural hospitals closed than in the prior 15 years combined. This is a staggering fact, which is under reported by national media.


You can’t blame the press for ignoring the plight of rural America. The press lives in the Big City. To them, the country is what you travel through to get from one urban area to another. It probably never occurs to them that people live there and work there and go to school. And get sick there.

In the city, there are lots of rich people and lots of insured people who can keep doctors and hospitals in business. In the city, there is a big tax base that can pay for health care for the poor. But, in the country, where there are not so many rich folks and not so many insured folks and not nearly as big a tax base, it may be hard to keep a doctor and a hospital in business. Oh, the local folks can keep the hospital busy. But they may not be able to pay their bills. And if no one else---meaning the state or federal government---is willing to step in, then the doctors and the hospital will leave, and the small town will find itself with no health care at all.

This problem is most acute in the 24 states which have rejected the Medicaid expansion.

Vidant Health, which announced last year that it was closing its hospital in Belhaven, is coming under renewed fire from town officials and the NC NAACP for its decision as the deadline for its closing draws nearer.
The hospital is the only emergency care provider in the rural area and provides services to 25,000 residents of Beaufort and Hyde Counties. The nearest hospital is in Washington, more than 30 miles away.
Vidant, which is affiliated with East Carolina University, has said the state’s refusal to expand Medicaid put it in financial dire straits.
According to the latest census data, 28 percent of Belhaven lives in poverty. The hospital is the only one in the area required by federal law to provide care to all, regardless of insurance status or ability to pay. Vidant has proposed to build an urgent care center in Belhaven that will not be under the same care provision obligations.


Note that Emergency Rooms must treat anyone who shows up at the door regardless of ability to pay. A minor emergency center can turn you away for lack of money. If your town loses its ER and you are broke and uninsured, you could end up dying of a treatable disease, like an infected tooth. And even if you have insurance and/or money, if the closest ER is an hour away, that may be too far if your life is in danger.

Rural hospitals in Red states did not just miss out on extra Medicaid funding. They are being hit with a federal funding cut. Since all 50 states were slated to receive Medicaid money, the federal government predicted that it would not have to subsidize rural hospitals as heavily as it has done in the past.

A rural hospital located in Brownsville, Tennessee is ending its inpatient and emergency services this summer because it can’t afford to keep operating them. Instead, the facility will become an urgent care clinic dealing with minor illnesses. W. Larry Cash, the chief financial officer for the community health group that operates the hospital, told the Tennessean that his state’s refusal to expand Medicaid was a “contributing factor” in the move.
Providers that serve a high number of poor and uninsured Americans, technically called “Disproportionate Share Hospitals,” often operate on a loss because their patients can’t always pay for their care. To compensate, the federal government offers reimbursements for those hospitals — but the Affordable Care Act changes the way the payments are structured. Because the health law intended every state to expand Medicaid, and therefore reduce the number of uninsured people who can’t pay their bills, the reimbursements for DSH hospitals have been reduced.
But if hospitals are located in states that continue to refuse Obamacare’s Medicaid expansion, that puts them in a difficult spot. They’re losing out on some of the federal government’s funding without making up the difference with an influx of insured patients.


Ouch. Some things just aren't fair.

The people who wrote the Affordable Care Act could not have planned for the Supreme Court, which said, in effect, states have a right to deny their poorest citizens health care. And they could not have anticipated the Congressional gridlock that has prevented anyone from amending the ACA. However, people like Texas Governor Rick Perry surely knew that the people they were going to hurt the worst when they said “No” to all that free money were the same salt of the earth rural voters whom they hold up so proudly as their base.

For the fourth time in two years, a rural hospital in Georgia is shuttering its doors over a dearth of patients who can pay for their medical services, the Albany Herald reports. An increasing number of hospitals that serve large numbers of poor and uninsured Americans are being forced to close in states that are refusing the Affordable Care Act’s Medicaid expansion.
The Lower Oconee Community Hospital, a so-called “critical access” hospital in southeastern Georgia with 25 beds, will close down and possibly re-open as an urgent care center that provides services that aren’t quite serious enough to necessitate an emergency room visit. Patients in the Wheeler County region who need more extensive medical care after the hospital closes will need to travel upwards of thirty miles in order to receive it.
Last fall, Bloomberg reported that at least five public hospitals in Georgia, North Carolina, and Virginia — including three in Georgia alone — were cutting staff and services in the wake of their refusal to expand Medicaid. These hospitals are so-called “Disproportionate Share Hospitals” — providers that serve a disproportionate number of poor and uninsured Americans, and as such don’t always receive payments for the care they give patients.
About one in four people in Wheeler County, where the latest hospital is shutting down, is uninsured. About one in ten residents are unemployed and over 40 percent of children live in poverty.


To put the numbers in terms that may be easier to understand:

A young woman in Georgia was immersed in flames after a four-wheeler accident. At one point, there had been a hospital only nine miles from the accident. Due to GA Governor Nathan Deal refusing Medicaid expansion, however, that hospital had been closed down only weeks earlier.
So what happened to this poor young lady, suffering from second- and third-degree burns? It took a full two hours before she was flown to a hospital in Florida.


Why did this young woman have to suffer? Because of people like Jason C. Spencer of Georgia:

“By the way, many hospitals are addicted to the current reimbursement structure in Medicine (the main problem with the healthcare). They are like addicts on crack. They don’t want to give up the money or move to a different solution. They benefit off the current system."


Benefit? That's an interesting way to describe the massive closure of rural hospitals and the genocide being waged against rural citizens of the 24 states which refused the Medicaid expansion. Someone may be benefiting from that decision, but I don't think it is the hospitals or the people they used to serve.
Posted by McCamy Taylor | Sat May 10, 2014, 02:49 AM (1 replies)

The Plight of Red State Public Hospitals and the Patients They Serve

As I wrote a while ago, the Red State public hospital where I work realized that a bunch of our low income patients were being suckered into signing up for useless “bronze” insurance plans. Plans that would cost them pennies a month—making them affordable---but which piled the entire $5000 out of pocket expense up as a deductible and which had very limited provider lists and benefits (such as prescription services etc.) The companies offering these extra cheap insurance plans would receive several thousand dollars from the feds per person for writing polices that would probably never be used. These plans were designed to appeal to 20 something guys who never saw a doctor and only wanted the insurance in case they got run over by a truck and so they could avoid paying the fine. This kind of insurance was absolutely no use for the average public clinic patient—age 50, with diabetes, high blood pressure, high cholesterol, coronary artery disease, asthma, a bad back, depression---you know, the typical working guy that got laid off from his job in 2008 and who now works in fast food . The guy who would be dead if his city did not spend tax dollars paying for a county clinic and hospital to take care of the medical needs of people like him. This guy needed the silver plan. But even making a low wage, his monthly premium for a silver plan would have been a whopping
$100-200---and he did not have the money. Some months, he could not even come up with the $5 for the copayment for his heart medication. So, he signed up for the only one he could afford---the useless one.

When I reported on the plight of people like these---my own patients---I was called a liar. By now, I assume that enough people have talked to enough other people to know that these folks really do exist---because, hey, private insurance companies have absolutely no qualms about collecting several thousand federal dollars per person selling poor saps an insurance plan that they will not be able to afford to use. Hell, that is how they make money. And it isn’t as if anyone in the federal government can do anything to stop them. Congress is tied up in gridlock. No matter what loopholes are uncovered in the ACA, no one will be fixing them anytime soon. So, all you folks who take any criticism of any aspect of the ACA as criticism of the POTUS, please calm down. This is not about Obama. This is about sick folks who are not keeping their appointments for checkups because they think they are going to get stuck with a bill.

Attendance at the family clinic where I work if down. Down, because so many of our patients think that they can’t be seen “for free” now that they have that $5000 deductible. Those that come in anyway look scared. They ask how much it is going to cost. Boy, are they relieved when they find out that it isn’t going to cost them anything. The county isn’t going to abandon them just because some private insurer is ripping them---and Uncle Sam---off.

Q: Can I have an exchange health plan and still be on JPS Connection?
A: Yes, if you meet the income levels, Tarrant County residency requirement, and other requirements. For patients eligible for subsidized insurance on the Marketplace, JPS offers Connection Secondary to Insurance, which may help cover out-of-pocket expenses.

As of October 2013, the federal Affordable Care Act provides health insurance for many people who could not afford it before. But the Affordable Care Act, often called Obamacare, does not cover everyone and many of the new insurance plans have high deductibles and coinsurance costs. If you are eligible to sign up for insurance under the Affordable Care Act (www.HealthCare.gov and www.CuidadoDeSalud.gov,) you should do so. If you are eligible to sign up for insurance, you must do so in order to be eligible for JPS Connection. Once you're signed up, JPS Connection can help with your out-of-pocket expenses, if you qualify and if your care is provided at a JPS facility.

Good news for the folks who thought that their tarnished bronze plans meant no more health care. Possibly not such good news for the private plans which sold the policies hoping that the $5000 deductible would be an insurmountable barrier to health care for most enrollees.

Now, those who wish to complain that this will bankrupt the private insurance industry which carefully prices premiums and deductibles in order to ensure the most profit for the least amount of expenditure---i.e. the least amount of actual health care---go right ahead. I am sure that the private health care industry appreciates your efforts on their behalf. However, before you start complaining about all the “rich” charity hospitals getting fat off the ACA, you might want to read this:

Indigent care facilities in states that opt-out of the Medicaid expansion are at a particular disadvantage relative to other hospital systems. Apart from the Medicaid expansion and the exchanges, the ACA also reduces payments to hospitals that serve needy populations. (Lawmakers reduced these payments on the assumption that all states would expand Medicaid.) Hospitals in non-expansion states that serve needy populations will, therefore, be asked to cope with further reductions in payments.

Posted by McCamy Taylor | Fri May 9, 2014, 11:35 PM (0 replies)

Dear Ted Cruz, My Religion Tells Me You are a Murderer, and Therefore I Must Not Save Your LIfe

Dear Ted Cruz,

As a Buddhist I would never take a life. However, you are an advocate of ritualized murder---also known as the death penalty in the United States. Most civilized countries in the world have outlawed this barbaric practice. It does not deter crime. It does not bring a sense of closure to those who have lost loved ones. All it does is perpetuate the myth that some people are expendable---and if we rid the world of them, the world will be a better place. And, in a country like the United States, where people are taught to be rugged individualists who value their own opinion over that of the government, it is much too easy for people to take the law into their own hands and "execute" the guy who just cut them off in traffic.

As an advocate of ritualized, deliberate murder, you are responsible for scores of deaths everyday. And therefore, my religion---my own personal interpretation of my own religion as I see it at this moment as I am writing this piece using my Constitutionally protected freedoms of speech and religion---my religion tells me that were I to have anything to do with you, I would become an accessory to murder. That means I can not donate money to your campaign. That means I can not sell you a sandwich. That means if I am staffing the Emergency Room where you are brought one night when you have a heart attack, I will have to decline---politely--to do "business" with you, because it would violate my religious beliefs, the way that Obama is attempting to violate the religious beliefs of those poor little nuns by forcing them to offer rape victims the emergency contraception they need to prevent being forcibly impregnated by their rapists.

So sorry I won't be able to help you. And sorry about the firefighter who won't be able to pull you from your burning house, because he is a Quaker and he couldn't answer to his God if aided a murderer. But you said yourself that religious freedom trumps all else. We promise we will never do anything to harm you. And we promise that if you ever come into harms way we will pray to God and Buddha to save you---or at least save your soul before you die and are damned to the Hell of Murderers.


A physician who is just kidding, she will do everything in her power to pull you back from the brink of death if you ever die in her Emergency Room, although, were she to follow your logic, there is absolutely no reason that she should not put you outside on the curb and say "There is a Catholic hospital down the road. Your type isn't welcome here." Be very careful when you start calling health care "business". One day the "business" could be the "business" you or your loved ones need in order to survive.
Posted by McCamy Taylor | Wed May 7, 2014, 07:28 PM (4 replies)

The Inconvenient Poor

Shameful. The House is going to hold a hearing on poverty but they will not let the poor testify. How can you claim to speak for the poor if you will not let the poor speak?

Ask some of the self-styled supporters of the Affordable Care Act who now take any mention of the plight of the uninsured as an act of treason. To hear them talk, there is no longer a health care crisis in this country. No more unemployment either. The administration has taken care of all that. As this fall’s midterm elections near, the sick and poor are told to keep their mouths shut for their own good. If they talk about their misery, this will only help the GOP---and they would not want to do that. Oh, no.

My friend is sorry to be an inconvenience. But he has worked himself half to death. Literally. He used to be a full time school teacher. Now, his heart is so weak that he is on disability and Medicare. But since no one can live on $800 a month, he substitute teaches for just over minimum wage. Twenty hours a week on his feet. His swollen feet. His heart has about one third the pumping power of yours and mine. When he gets home and props up his legs, the swelling goes down. Mostly. But not all the way. Little by little, the fluid accumulates in his legs. And then in his liver. And then in his lungs. And, when he can no longer breathe, it’s back to the hospital to get the fluid out. So he can go home and start the cycle all over again. And he’s one of the lucky ones. He has insurance. He has a job, of sorts. He is not on the street. He is not starving. Good thing, too, because even the Republicans who call food stamp recipients wild animals might shed a tear or too at the thought of the teacher who taught their children being homeless. But being poor and breathless and constantly living under the shadow of death at 60---hey, for a lot of us, that is as much of the American Dream as we are ever going to get----

No moral here. I just wanted you to meet my friend. His story is inconvenient for some folks at the moment, but it is his story and his life. He's a nice man, gentle and patient, even when he is doubled over from lack of oxygen. A good teacher. He does not expect miracles. He is just glad to know that someone cares.

Hmm. Maybe the Senate should hold some hearings on poverty, too. Maybe the Senate could invite my friend and others like him to speak. I am sure that there are plenty of people in America who would like to hear their stories.
Posted by McCamy Taylor | Sun May 4, 2014, 08:19 PM (10 replies)
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