The health care "repeal and replace" fiasco follows on any number of other failed efforts by the White House and the Trump Regime to force this or that policy or action.
Politifact has been tracking the "progress" of Trump Regime policies and promises, and it's interesting to see what is moving forward -- however haltingly -- and what is stalled or abandoned. Most of Trump's efforts to fulfill campaign promises are effectively non-operative, but some are going forth.
The "Repeal and Replace" debacle is a spectacular failure, but the courts have thwarted the Muslim Ban (for now), the "Deep State" continues to undermine the Regime's authority, the Russia Thing continues to metastasize, the military seems to be going off on its own wreaking havoc in foreign lands without oversight by the White House, and so on. This is only part of what Chaos has wrought, and it is only the first 60 days of the Regime-in-Power.
My sense is that Trump and his boys and girls in the White House were effectively neutered during the last week of February. The courts would not yield to his Authority over the Muslim Ban, the signs were that the Health Care saga would result in defeat or at best a Pyrrhic Victory, the permanent government (the bureaucracy) was in open revolt, the media continued to taunt and in some ways to terrorize (I know, loaded term) the Regime, the polls were going south fast, and for all intents and purposes, Trump was checkmated. What he wanted, he could not have without the cooperation of the governing cliques, the media, the courts and the congress.
All of whom and more he had spent his political capital threatening, alienating, insulting, and denigrating.
This may work in the gangster real estate/casino framework Trump is used to, but it clearly doesn't work in government -- at least not beyond his loyalists in DHS/ICE/CBP. Hm. Who'd a thunk?
The Loyalist faction is interesting, too.
These elements have the potential to operate as a kind of Gestapo serving Trump's -- or someone else's -- interests, and that seems to be what they want to do. Very much so. I'd say their loyalty to Trump is ephemeral, but it is clear that they see their mission as political, forcing compliance with executive command.
What was wrought with the creation of these entities? We're finding out, aren't we? As long as their efforts appear to be focused on foreigners, brown people, non-conformists, what's to worry, right?
Not a wise attitude it seems to me.
Some of their efforts have been thwarted or mitigated by public outrage, but how long that will last is a question. The demonstrations can have an effect, but the returns are diminishing. There's only so much the Rabble in the streets can accomplish. Given our system, there's only so much they are allowed to accomplish, viz: Occupy, Black Lives Matter, NoDAPL, etc.
But something else is going on well outside the purview of the public; Trump is only being allowed so much rope -- apparently to hang himself. And he's doing a bang-up job of it, too.
Under the circumstances, it's looking more and more like he's headed for crash-and-burn defeat, sooner rather than later. Superficially, it may be entertaining as hell, but it's not good for the nation -- for it exposes so many of the weaknesses and worse in our system. We are not prepared to replace it with something better.
Until that time comes, we're in a world of hurt, regardless of who sits in the Big Chair.
What a whirled.
Showing posts with label Health Care Reform. Show all posts
Showing posts with label Health Care Reform. Show all posts
Sunday, March 26, 2017
Wednesday, January 1, 2014
Let Us Reason Together -- New Year Edition (2)
The Obamacare Clusterfuck is perhaps the second most media-watched and driven story of 2013, but the realities of it will only start hitting home this year (Happy New Year!!!), and as they do, the horror of it all is liable to mount exponentially. Which is not to say that things were so much better Before Obamacare. They weren't. For millions, they were worse. Now, for other millions they're getting worse.
First of all, this thing costs a fortune in diamonds, rubies, emeralds and pearls to deliver essentially nothing more than "peace of mind." That is to say, those who get "insurance" through this boondoggle will receive in return the joy of knowing they have "insurance" that pays for approximately nothing until they have already spent every dime they have or are ever likely to have; and the joy of it is that hundreds and hundreds of dollars a month go to the "insurance" companies for each and every one of these essentially worthless policies, month in and month out, year in and year out. It's one of the most astonishing domestic scams ever pulled on the public of this country, and everyone involved in its creation and implementation knew exactly what they were doing.
As Americans recognize just what a scam this is, I wonder what sort of fallout there will be.
By now everyone knows that the correct, final and only real answer to the health care issue in this country is what eventually came to be called "Medicare for All." In other words, everyone qualifies for Medicare the instant they are born, and they never lose it throughout their lives. If they or their parents wish them to have additional coverage, they are free to obtain it on the insurance market, but at the very least they will be covered for most medical expenses from the time they are born until they die. This is not rocket science. It's simple, straightforward, and to the point.
We are told over and over again that such a thing is "politically impossible," but we're never told why. We're just supposed to believe there is no way in hell that We, the Rabble, will ever get out from under the insurance industry yoke, so better just get over it.
Once the full impact -- and expense to the individual -- of Obamacare starts hitting home, I doubt our political class, for once in their useless lives, will be able to resist the backlash, but you never know.
They say that 2014 could well result in a worse "shellacking" for Dems than 2010 did. Could be. On the other hand, the whole political class needs to be shellacked this election year, from top to bottom, red and blue alike, as do their pestiferous funders and owners. We may reach the tipping point.
Happy New Year.
Friday, November 15, 2013
On the Topic of Medicare for All (aka "Single Payer")
Some of what's being spitballed around these days, thanks to the uncertainty of the Health Care Transition mess, is a revival of the notion of Medicare for All, previously known as "Single Payer" (a term only a handful of people ever really understood.)
The objections have been coming thick and fast from plenty of so-called "progressives" who are desperate to make the ACA "work." Ah, willing dupes for the insurance cartel are everywhere, aren't they?
Of course it is asserted that they're all Obots, but that doesn't make sense. I don't know that anyone online who is constantly yowling about "Obots" has ever examined their premise. This being the internet, I suppose questions of that sort aren't asked in polite company, but I don't mind saying there is a distinct whiff of racism in the claim that Obama loyalists are mindless Obots for defending this or that indefensible element of his policy prescriptions and political acumen. Obviously, it was a mistake to give black folk and wimmins the vote, right?
One has to ask "who benefits" from these indefensible policies, and they examine the defenses presented, and all of a sudden, the mindless 'bot argument pretty much falls to pieces. The defenders are, in most cases, those who stand to benefit, and they are not mindless at all; they are engaged in a propaganda campaign to ensure they continue benefiting, and for the most part they aren't black folk at all. Even if they were, it wouldn't matter. The issue is the pitch, what they're selling, and who benefits.
The so-called Obots are those who are benefiting the most from these indefensible policies, such as representatives of the hedge-fund, insurance and banking cartels above all. Mindless? Hardly. They know what they are doing, and they know that way too many so-called "progressives" are too gullible to believe. They are easy marks for con artists.
And many of them will defend the con till their last breath. It's sad.
That said, it's obvious who is benefiting from the cock up of a Health Care Transition that's under way, and it isn't We, the Rabble. It is Our Rulers, in all their glory. They are making money, hand over fist, on the cock up itself and on the really terrifying uncertainty that is being deliberately generated thanks to the cock up. Make no mistake, this was all planned months if not years in advance, and from all appearances, things are going as planned. A lot of people are panicking. Many others have been convinced to blame the victims. The Crisis is building to a crescendo. And you know what the neo-libs say about Crises: never let one go to waste, for they are all opportunities to for ever more creative destruction. Here we go again.
And in the background, some of the hippies who were advocating for single payer/Medicare for All (wonder why it took so long to adopt that slogan; if it had been adopted in the first place, a lot of the confusion about "single payer" could have been avoided. But it wasn't adopted till almost the end of the game....) are raising the issue again.
Of course, it would have been much simpler to go that route, and there has even been some chatter that it might have passed if it had ever been offered on the House and Senate floors. (There are bills, but the measures were never offered for a vote that I know of.)
This really isn't rocket science. The simplest way to do it is to gradually reduce the eligibility age to zero, and when the eligibility age reaches zero, everyone born that year and thereafter is automatically enrolled in a comprehensive health care program -- one like Medicare, but one that provides more and better coverage, rather like the supplements or Medicare Advantage do -- and everyone else is made eligible for expanded Medicare if they want it, which most would, it seems to me.
It could be a two year transition or a ten year one, it hardly matters; what matters is creating a universal health care system that eliminates the insurance cartel's hold on the system. It doesn't mean that private health insurance necessarily goes away -- though it should -- it means that the cartels can no longer control access to and the provisions of the health care system.
If the current mess continues -- and it will continue, guaranteed, as long as important people can make money from it -- the calls for Medicare for All will get louder and louder, and if the revolt against the insurance cartel that's brewing gains steam, we may actually see the insurance cartel throwing in the towel and advocating for Medicare-style universal coverage themselves.
It could get that bad.
We'll see. There are powerful forces intent on ensuring that never happens, but these days you never know. Sometimes Our Betters actually give up on something they thought was going to make them so gosh-darned rich without them doing a thing (such as ACA was intended to do.) Then, when they find it is more trouble than it is worth, they drop kick it into oblivion, and what should have been done in the first place looks like a winner.
We'll see.
The objections have been coming thick and fast from plenty of so-called "progressives" who are desperate to make the ACA "work." Ah, willing dupes for the insurance cartel are everywhere, aren't they?
Of course it is asserted that they're all Obots, but that doesn't make sense. I don't know that anyone online who is constantly yowling about "Obots" has ever examined their premise. This being the internet, I suppose questions of that sort aren't asked in polite company, but I don't mind saying there is a distinct whiff of racism in the claim that Obama loyalists are mindless Obots for defending this or that indefensible element of his policy prescriptions and political acumen. Obviously, it was a mistake to give black folk and wimmins the vote, right?
One has to ask "who benefits" from these indefensible policies, and they examine the defenses presented, and all of a sudden, the mindless 'bot argument pretty much falls to pieces. The defenders are, in most cases, those who stand to benefit, and they are not mindless at all; they are engaged in a propaganda campaign to ensure they continue benefiting, and for the most part they aren't black folk at all. Even if they were, it wouldn't matter. The issue is the pitch, what they're selling, and who benefits.
The so-called Obots are those who are benefiting the most from these indefensible policies, such as representatives of the hedge-fund, insurance and banking cartels above all. Mindless? Hardly. They know what they are doing, and they know that way too many so-called "progressives" are too gullible to believe. They are easy marks for con artists.
And many of them will defend the con till their last breath. It's sad.
That said, it's obvious who is benefiting from the cock up of a Health Care Transition that's under way, and it isn't We, the Rabble. It is Our Rulers, in all their glory. They are making money, hand over fist, on the cock up itself and on the really terrifying uncertainty that is being deliberately generated thanks to the cock up. Make no mistake, this was all planned months if not years in advance, and from all appearances, things are going as planned. A lot of people are panicking. Many others have been convinced to blame the victims. The Crisis is building to a crescendo. And you know what the neo-libs say about Crises: never let one go to waste, for they are all opportunities to for ever more creative destruction. Here we go again.
And in the background, some of the hippies who were advocating for single payer/Medicare for All (wonder why it took so long to adopt that slogan; if it had been adopted in the first place, a lot of the confusion about "single payer" could have been avoided. But it wasn't adopted till almost the end of the game....) are raising the issue again.
Of course, it would have been much simpler to go that route, and there has even been some chatter that it might have passed if it had ever been offered on the House and Senate floors. (There are bills, but the measures were never offered for a vote that I know of.)
This really isn't rocket science. The simplest way to do it is to gradually reduce the eligibility age to zero, and when the eligibility age reaches zero, everyone born that year and thereafter is automatically enrolled in a comprehensive health care program -- one like Medicare, but one that provides more and better coverage, rather like the supplements or Medicare Advantage do -- and everyone else is made eligible for expanded Medicare if they want it, which most would, it seems to me.
It could be a two year transition or a ten year one, it hardly matters; what matters is creating a universal health care system that eliminates the insurance cartel's hold on the system. It doesn't mean that private health insurance necessarily goes away -- though it should -- it means that the cartels can no longer control access to and the provisions of the health care system.
If the current mess continues -- and it will continue, guaranteed, as long as important people can make money from it -- the calls for Medicare for All will get louder and louder, and if the revolt against the insurance cartel that's brewing gains steam, we may actually see the insurance cartel throwing in the towel and advocating for Medicare-style universal coverage themselves.
It could get that bad.
We'll see. There are powerful forces intent on ensuring that never happens, but these days you never know. Sometimes Our Betters actually give up on something they thought was going to make them so gosh-darned rich without them doing a thing (such as ACA was intended to do.) Then, when they find it is more trouble than it is worth, they drop kick it into oblivion, and what should have been done in the first place looks like a winner.
We'll see.
Thursday, November 14, 2013
Circling the Drain Again
I don't pretend to know what's really going on with the various political disasters for the Obama Regime brewing in various corners of the world -- such as the health care thing and the Israel thing and the Iran thing and the TPP thing, but man, it's a super-storm these days. We'll take them one by one, mercifully in separate posts.
Health Care Transition: The launch of the Health Care Transition appears to have been deliberately sabotaged, apparently by the contractors hired to implement it, apparently for more money. But there's more going on as well, much more involving the perfidious insurance cartel directly in what looks for all the world like racketeering right out in the open, something they've been loathe to practice heretofore, though everyone knew it was going on, but now they don't seem to care at all about being found out. I wonder why. Hm. Needless to say, the Rs are taking full political advantage of the mess that's been made of things, but they have no interest in actually destroying the thing. Their political interests are to serve the insurance cartel as certainly as the Dems' interests are. As much as the Rs are accused of the sabotage, they aren't really the ones who did it, nor was it ever in their interests to do it. Their fussbudgeting of it is really minor compared to the rising chorus of complaints from the public -- who are being royally, fiercely screwded.
The only faction of the elites who actually have an interest in said sabotage are those who believe they aren't guaranteed enough money via the ACA/HCR/Obamacare. Given what's been going on, it's fairly easy to figure out who they are, too: the insurance providers, the IT contracting firms, and the various medical industry suppliers. They want more, lots and lots more -- guaranteed -- or they'll keep right on throwing stink bombs.
Health Care Transition: The launch of the Health Care Transition appears to have been deliberately sabotaged, apparently by the contractors hired to implement it, apparently for more money. But there's more going on as well, much more involving the perfidious insurance cartel directly in what looks for all the world like racketeering right out in the open, something they've been loathe to practice heretofore, though everyone knew it was going on, but now they don't seem to care at all about being found out. I wonder why. Hm. Needless to say, the Rs are taking full political advantage of the mess that's been made of things, but they have no interest in actually destroying the thing. Their political interests are to serve the insurance cartel as certainly as the Dems' interests are. As much as the Rs are accused of the sabotage, they aren't really the ones who did it, nor was it ever in their interests to do it. Their fussbudgeting of it is really minor compared to the rising chorus of complaints from the public -- who are being royally, fiercely screwded.
The only faction of the elites who actually have an interest in said sabotage are those who believe they aren't guaranteed enough money via the ACA/HCR/Obamacare. Given what's been going on, it's fairly easy to figure out who they are, too: the insurance providers, the IT contracting firms, and the various medical industry suppliers. They want more, lots and lots more -- guaranteed -- or they'll keep right on throwing stink bombs.
Friday, November 1, 2013
Who Is Really In Charge -- Of What?
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| Uhhh.... guys... |
T've heard rumblings that the "Health Care Rollout Cockup" was an act of sabotage deliberately staged by certain interests -- either in the government or in the contractor sector, or by both working hand in glove -- for some nefarious purpose, testing, perhaps, the levels of anxiety and endurance the public can be subjected to over basic matters like access to something.
In other words, how difficult/impossible can we make something a significant portion of the public will be compelled to do before they snap? I hate to use Nazi allusions, but this is was something the Nazis were masters at in their conquests of Europe. They would institute orders for compelled actions by selected populations that could not be obeyed rationally, but only in a kind of mindless stupor could part of an order be complied with. This had profound psychological effects that helped enable the mass murder to come. People went on command -- and essentially willingly -- into the ghettos, the cattle cars, the camps and the gas chambers, in part because they had been pre-conditioned to do irrational things and to follow irrational orders simply to survive. They believed sincerely that if they didn't do what they were told, or they unimaginably rose up against this madness, they wouldn't/couldn't survive for even a moment longer. At least they had a chance if they complied...
Well, yes, some did survive all of it. A handful.
During Occupy Wall Street actions in New York, I saw (via livestream) people herded onto the Brooklyn Bridge and corralled there, arrested, hundreds of them, maybe more than a thousand, and I saw how they willingly submitted themselves to the authorities who had basically tricked them and trapped them in this pen over the East River, and I was gobsmacked and horrified at what I was witnessing. It wasn't so much what the police had done -- though that was itself horrifying and inexcusable -- it was the immediate and instant compliance of the crowd. Oh. My. God. When I saw a handful of people escaping the trap by climbing up to a higher level of the bridge and slipping away, I was momentarily cheered. Some knew not to comply. But for most? Jesus. They should know deep in their bones where this sort of thing leads.
And thankfully, later, it was clear that many of them did know. And they weren't about to fall into this kind of mental trap and follow these sorts of orders and commands again.
So. Is the Rollout something of the same sort? Perhaps. I don't know. I have some knowledge of relatively huge government projects and how they go "live" and how badly they can be bolloxed initially. If there is sabotage involved, it appears to be the result of contractors (sometimes with the assistance of government functionaries) figuring out how to squeeze as much more money as possible out of the system before it either works or collapses. That's what this cock-up looks like to me from the outside. It wasn't ready, the hundreds of millions poured into it already were not nearly enough to satisfy the contractors who built it -- they want double the money, triple or more -- and so it will be "difficult" for as long as it takes to satisfy them, which could conceivably mean forever.
At least in Iraq they were shipping over pallets of hundred dollar bills, as well as seizing all the hundred dollar bills stashed away in the Republican Palace villas along the Tigris (said to be about a billion and change worth) for the grand par-tays being conducted by the military contractors, some of whom turned around and carried the loot home in sacks and suitcases.
We do these things a little differently in the Homeland, yes?
So from my view, the cockup is deliberate, but it's a money issue, not some nefarious scheme to pre-condition the population to OBEY. On the other hand, we've been immersed in that conditioning for generations, haven't we? We are being conditioned all the time, in addition to being spied on and exploited and everything else.
But then I saw part of the Sebelius hearing on "what went wrong" -- and it was so scripted, I thought, "Wait a minute, this is just for show and sound bites. We are finding out nothing, nothing at all from this hearing. It's just show business."
Oh. So something IS going on. OK. What?
The only thing I could come up with was that the Rollout occurred during the Shutdown, when much of the federal government that the People would ordinarily deal with -- like the parks and such -- was inaccessible (something made plain on the teevee at the monuments in the Mall). The Shutdown was something planned months in advance, a cooperative venture, not spontaneous at all, and I wondered... why?
The Rollout was planned, months (actually years) in advance to occur simultaneously. This was no accident.
It was a coordinated bollox. Was it intentionally planned and coordinated to show the government as useless, incompetent and ultimately "not there" in any case? Had somebody really been thinking things through like this? Oh please.
Who? Who is fucking in charge here, and what exactly are they in charge of?
During the Shutdown and the Rollout, the NSA stories seemed to go on hiatus. But as soon as the government reopened we were told that Glenn had found himself a billionaire and he would be leaving the Guardian to establish a new media venture that he would be in operational and editorial control of, funded by Pierre Omidyar, founder of eBay. Oh. Well. Isn't that special. (My reservations about that are another story altogether...)
After all the hoo-hah in Yurp and particular parts of Latin America over spying on the people and the political leaders, we were treated to the information via the WaPo and a little pencil sketch that the personal/private information held by Google and Yahoo (one assumes others) is accessible by the NSA (one assumes other agencies as well) through various "sekrit" means, and oh, my isn't it a terrible thing, though! And of course Google and the others had no idea, OMG! We are being spied upon!
Jesus. This is such complete bullshit.
The pencil sketch was the tell, if it wasn't for all the other signs that this was yet more "conditioning" to accept the previously unknown/unacceptable.
Please.
I'm sorry, if this is how Our Rulers are conducting their business, on the back of a napkin, then it's a wonder anything works at all, isn't it? Well, isn't it?
Who is in charge of this muddle? What are they really in charge of?
Not only are we pretty fully through the looking glass, we're deep in outer space without a pressure suit.
Wheels within wheels is putting it mildly.
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| Celestial Wheels |
Thursday, October 31, 2013
Outrage Fatigue -- And the Question of Exemptions from Surveillance Returns
I watched a bit of the Sebelius hearing yesterday, and oh, my, weren't the bull-Rs in a high dudgeon, though? Geepers, creepers. Ms Sebelius handled it like a pro, but from what I saw of it, the whole thing was pretty scripted for the cameras, there wasn't really much of anything said that wasn't already on the pre-distributed crib sheets and talking points -- ie: the Propaganda -- from either side, so I got to wondering just what this cock up of a Health Insurance Launch was really all about.
The website is apparently somewhat functional for some people some of the time; there are alternative means of getting coverage, though, so the website issue isn't the biggest deal, certainly not as big a deal as has been made of it since the re-opening of the Government by relenting Rs.
No, the screaming about the website is for show, and it's probably less interesting than the underlying shift that I see going on, the sort of background churning, by which health insurance/health care costs are rising dramatically for many users and customers, while for others costs are being reduced, sometimes significantly. In other words, there is a cost increase and a cost shift going on simultaneously, such that profits will be guaranteed in perpetuity to the carriers and the providers, while costs for users will be distributed "fairly" among the population as a whole.
The website is apparently somewhat functional for some people some of the time; there are alternative means of getting coverage, though, so the website issue isn't the biggest deal, certainly not as big a deal as has been made of it since the re-opening of the Government by relenting Rs.
No, the screaming about the website is for show, and it's probably less interesting than the underlying shift that I see going on, the sort of background churning, by which health insurance/health care costs are rising dramatically for many users and customers, while for others costs are being reduced, sometimes significantly. In other words, there is a cost increase and a cost shift going on simultaneously, such that profits will be guaranteed in perpetuity to the carriers and the providers, while costs for users will be distributed "fairly" among the population as a whole.
Saturday, October 12, 2013
Why Did The Rs Drop the 'Defund Obamacare' Ransom Demand?
No doubt their insurance industry paymasters told them to desist. Or they never intended to follow through on it in any case, it was just red-meat for their ravening base.
Look, Obamacare is practically pure hyper-conservative Heritage Foundation Neo-liberal profit preservation, intended to bulk and perpetuate the profits of the insurance industry, to force purchase of insurance by the multitudes of uninsured, and to place the burden of health care costs squarely on the consumer.
It is neither a universal health care coverage scheme -- there will still be 20-30 million uninsured even with full implementation -- nor is it in any way intended to reduce health care costs or improve health care outcomes.
It is primarily a means of ensuring profits -- forever -- to favored sectors of the industry.
In that, it is perfectly shameful.
But as so many have declared, "It's better than nothing."
Well, maybe. We'll see.
Meanwhile, there could hardly be a more "Republican" version of so-called health care reform, so the whole notion that the Rs would actually repeal it or defund it was absurd. If anything, what they will do -- probably with the connivance of the Dems -- is defund the premium subsidies so that only a very few will qualify. This is not unlike the elimination of community clinics.
The point is to make it slightly less difficult than it was to obtain health insurance -- and to boost the cost to consumers for insurance as far as possible while requiring purchase.
There's an internal logic to the shameful scheme.
But there was never any intention by the Rs to actually interfere with it. No, they just want to ensure that its implementation is as cruel as possible.
It is their way.
Look, Obamacare is practically pure hyper-conservative Heritage Foundation Neo-liberal profit preservation, intended to bulk and perpetuate the profits of the insurance industry, to force purchase of insurance by the multitudes of uninsured, and to place the burden of health care costs squarely on the consumer.
It is neither a universal health care coverage scheme -- there will still be 20-30 million uninsured even with full implementation -- nor is it in any way intended to reduce health care costs or improve health care outcomes.
It is primarily a means of ensuring profits -- forever -- to favored sectors of the industry.
In that, it is perfectly shameful.
But as so many have declared, "It's better than nothing."
Well, maybe. We'll see.
Meanwhile, there could hardly be a more "Republican" version of so-called health care reform, so the whole notion that the Rs would actually repeal it or defund it was absurd. If anything, what they will do -- probably with the connivance of the Dems -- is defund the premium subsidies so that only a very few will qualify. This is not unlike the elimination of community clinics.
The point is to make it slightly less difficult than it was to obtain health insurance -- and to boost the cost to consumers for insurance as far as possible while requiring purchase.
There's an internal logic to the shameful scheme.
But there was never any intention by the Rs to actually interfere with it. No, they just want to ensure that its implementation is as cruel as possible.
It is their way.
Wednesday, October 2, 2013
On the Wreck of the US of A (2013-2014)
The Shutdown is proceeding apace, and it looks fair to be... accommodated, or rather hardly noticed, by the multitudes, much like the Sequester. Ah, glory!
Well, given the fact that the Shutdown was more important than even having another War! we have to give Our Rulers some credit here. If there is a semblance of Peace breaking out in the Middle East (let's not count on it) and for the moment the missiles aren't flying at Damascus from either the Mediterranean Fleet or that nasty little state of Israel, we can ponder the fact that Those In Charge have their Priorities.
First Things First.
And the first thing, right now, is the take down of the Federal Government. One assumes that there will be a subsequent "rebuilding" phase, as there have been some piece by piece restoration bills hammered out between the Congress That Says No and the White House over the last few days.
They say this is all over Obamacare and the necessity to get rid of it. If it were, I'd almost be a happy camper, but it's not. Obamacare is a pig in a poke as those of us in favor of Single Payer/Medicare for All have known since kick-off day to get 'er done back in 2009. Let's not fool ourselves; this semi-universal health insurance program is first and foremost a profit-guarantee for major insurance companies and major health care providers essentially in perpetuity. The radicals in Congress agitating the Shutdown don't want to stop that, not on a bet. What they want to stop is any requirement imposed on Health Care Insurance and the Industry to provide service in exchange for their guaranteed profits and to stop the subsidy payments to the Rabble to help cover the health insurance premiums they are compelled to pay.
That's all.
No, this isn't really about Obamacare at all, it is about gaining full control of the Federal Government and re-making it into what the Radicals think it should be: an invasive and controlling force on behalf of favored segments of the Powers That Be. Nothing more, nothing less.
And they are nearly there.
By taking down the discretionary portion of the Government (some 20% of the budget), then restoring it piece by piece over an extended period, they demonstrate their power as a minority to eventually control everything. That's what the Debt Ceiling battle will be about. The Debt Ceiling battle will involve mandatory spending like Social Security, etc., and it will likely be resolved much the same way: there will be a default on those portions of the debt the Radicals want repudiated, such as the SS Trust Fund, and there will be a restoration, piece by piece, of what they want to preserve.
Of course, it's obvious by now, or at least it should be, that despite all the huffing and puffing and bombast on both sides of the Congressional aisle and at the White House, and despite all the breathless "news" we get through the propaganda media (unfortunately now including almost all the so-called "New Media"), this sequence was laid out long ago, and it became all but inevitable shortly after Obama was re-elected. It has not been a mystery -- except to the Public, of course, who are deliberately kept in the dark about what is really going on and to what object this shit is happening.
Everything's going according to plan.
Evil though it may be...
Well, given the fact that the Shutdown was more important than even having another War! we have to give Our Rulers some credit here. If there is a semblance of Peace breaking out in the Middle East (let's not count on it) and for the moment the missiles aren't flying at Damascus from either the Mediterranean Fleet or that nasty little state of Israel, we can ponder the fact that Those In Charge have their Priorities.
First Things First.
And the first thing, right now, is the take down of the Federal Government. One assumes that there will be a subsequent "rebuilding" phase, as there have been some piece by piece restoration bills hammered out between the Congress That Says No and the White House over the last few days.
They say this is all over Obamacare and the necessity to get rid of it. If it were, I'd almost be a happy camper, but it's not. Obamacare is a pig in a poke as those of us in favor of Single Payer/Medicare for All have known since kick-off day to get 'er done back in 2009. Let's not fool ourselves; this semi-universal health insurance program is first and foremost a profit-guarantee for major insurance companies and major health care providers essentially in perpetuity. The radicals in Congress agitating the Shutdown don't want to stop that, not on a bet. What they want to stop is any requirement imposed on Health Care Insurance and the Industry to provide service in exchange for their guaranteed profits and to stop the subsidy payments to the Rabble to help cover the health insurance premiums they are compelled to pay.
That's all.
No, this isn't really about Obamacare at all, it is about gaining full control of the Federal Government and re-making it into what the Radicals think it should be: an invasive and controlling force on behalf of favored segments of the Powers That Be. Nothing more, nothing less.
And they are nearly there.
By taking down the discretionary portion of the Government (some 20% of the budget), then restoring it piece by piece over an extended period, they demonstrate their power as a minority to eventually control everything. That's what the Debt Ceiling battle will be about. The Debt Ceiling battle will involve mandatory spending like Social Security, etc., and it will likely be resolved much the same way: there will be a default on those portions of the debt the Radicals want repudiated, such as the SS Trust Fund, and there will be a restoration, piece by piece, of what they want to preserve.
Of course, it's obvious by now, or at least it should be, that despite all the huffing and puffing and bombast on both sides of the Congressional aisle and at the White House, and despite all the breathless "news" we get through the propaganda media (unfortunately now including almost all the so-called "New Media"), this sequence was laid out long ago, and it became all but inevitable shortly after Obama was re-elected. It has not been a mystery -- except to the Public, of course, who are deliberately kept in the dark about what is really going on and to what object this shit is happening.
Everything's going according to plan.
Evil though it may be...
Saturday, February 2, 2013
Down At The Clinic
[Note: Been working on this post all week. Taken me much longer than I thought it would. This is a fictionalized account of a recent morning spent at the health care clinic...]
When Americans lose their health care insurance -- or never had it -- as something like 60 million Americans who have no health insurance understand well, we make do with the system of emergency rooms and community clinics (assuming there are any) that passes for universal health care in this country. Or we go without.
The clinics have been a godsend in our experience, but I can't say the same of ERs, where, even if you have insurance, you're likely to be neglected, misdiagnosed and/or mistreated. I think it's time for Americans to understand that medical care is not considered a right, it's not a privilege, it's an opportunity for the practice of medicine. Emphasis on practice. Or not.
At any rate, I shouldn't complain. My life may have been jeopardized from time to time by medical mistakes and/or neglect, but so far, every time it has been jeopardized, my life has been saved in the end by heroic interventions, so what's the beef?
On the other hand, clinic care has been remarkable, especially given that my expectations were so low.
Since moving to New Mexico, we've had to set up a whole new set of clinic relationships as our former health care provider in California -- Kaiser Permanente -- doesn't exist here, and the clinics we were using before we moved don't have reciprocity agreements with the clinics here.
As in California, it took a while to get a new patient appointment (though they say they will take walk ins without appointments), but once the appointment was arranged with the community clinic in town (Albuquerque), things seemed to go well. The place was clean, efficient, seemingly very well operated. I did some research and found out we would be dealing with one of the pioneer urban clinics in the country.
It's hard to imagine what things were like before these clinics sprang up in the 1960's and '70's, but I'm old enough to remember, and it wasn't pretty. If you could not pay for care, they might or might not take you at "County"* depending on factors which you were never made aware of. But generally speaking, you didn't want to go to "County" anyway, because even if they took you, they wouldn't necessarily take care of you. You went to "County" to die, in other words. (*"County" was the county hospital, often out in the country somewhere difficult to reach, or maybe attached to the jail, or by the sewer plant, where indigent patients were sent and treated, either at no charge or very low charge.)
There was very little in the way of public health care, and what there was was focused on specific ailments and infectious diseases -- STDs, TB, polio, that sort of thing -- in need of control/containment/eradication.
For the most part, doctors and hospitals would only see patients who could pay, and ERs were not required to accept patients who could not (ie: they'd be sent to "County" to take their chances.) The fear of "Socialized Medicine" was rampant for some reason. Better you should die a Free Man than be treated for illness or accident a Socialist Slave! America Forever!
The first community clinics I remember were the Free Clinics established in the 1960's by and for the hippies clogging the Bay Area of California and eventually everywhere else. It was recognized that the health care system in place at the time -- private fee-for-service doctors and hospitals that required payment or no care for you, or "County" where you took your chances -- was not working very well for anyone, and not at all for the free spirits of the era who were on the road, traveling, exploring, experimenting with substances and different lifestyles, often living on very little or no money at all, and relying extensively on one another for survival.
There may have been earlier free community clinics, but if there were, I wasn't aware of them. The hippie clinics were staffed by mostly volunteer professionals, med school students and skilled lay people, and they were often supplied by barter, strategy or donations of surplus medical materiel, some of it acquired from the then-bloated military off killing gooks in the rice paddies.
The free clinics would see anyone for anything that ailed them, without restriction, and most would offer their services either free of any charge, or on a sliding scale depending on ability to pay. There was no elaborate bureaucracy, no reams of papers to fill out, or insurance claims to make. It was simple, straightforward, and quite effective.
However, most clinics were not set up to handle serious or chronic illness or injury that required in-patient care. The hospital was the only place that could handle it, and if you couldn't pay, that still meant "County."
But county care was improving as more and more benefits of the free clinics were recognized. Basically, the clinics were taking much of the routine heath care burden off of the "system" -- both the for-profit and the public health system -- which allowed the "system" to focus more on chronic and serious diseases and injuries, and ultimately to do a better job.
Over time, the clinics consolidated, became institutionalized and plugged into the system. There were fewer of them, and for the most part their care was no longer "free," nor were they staffed with volunteers relying on donations of money and materiel. They professionalized. Though most maintained an open door policy, some restricted their acceptance of patients to certain service groups. Their funding sources were primarily from government programs -- Medicare, Medicaid, IHS, and so on -- which meant they had to conform to the operational standards set by their funders. They bureaucratized as they institutionalized. They became essentially indistinguishable from hospital or doctor-provided outpatient care.
Except, of course, that they still tended to serve a poor population rather than one better off.
The urban Indian clinics came a little late to the community clinic field, but they were advanced from the outset compared to some of the others. In most cases, they were immediately funded by government sources, so they could operate at a fairly high level from the get-go. We first encountered the urban Indian clinic in the early 1980's and we stuck with it for quite some time. We found the care to be more than adequate on the one hand, and the spirit of the personnel to be outstanding on the other.
Of course, they were still unable to take on serious injury or disease which required hospitalization. What they could do was make referrals, and usually, because of those referrals, the hospital care provided and any specialist services and follow up were top notch. In other words, you didn't just have to go ER and hope. Wait. Pray. Later on, that would change.
The Indian clinic in Albuquerque is one of the pioneers in the field, and it is very well maintained and operated. It takes a while to get a new patient appointment, but once that's done, it's fairly easy obtain health care service. Indians with "blue card" and CIB receive treatment at no charge, others use Medicare, Medicaid, private insurance, or pay out of pocket on a sliding scale -- which can mean free. No one is turned away because they can't pay. Though busy, it's surprisingly uncrowded. Much less so than some of the ER waiting rooms I've been in. The clientele runs heavily to Indians (shock!) but is by no means exclusively so. Not all are poor, though many clearly are. From what I've seen, the clinic serves a broad cross-section of the population of Albuquerque and the area round about. We come in from the country, after all, a pretty decent drive over the Tijeras Pass. Not something you want to do in a blizzard, though we've done it more than once.
The other day we were at the clinic, and it was clear it was Homeless Outreach Day, for the waiting room was populated by numbers of homeless people trying to navigate the intake paperwork before being seen. Some were understandably having a difficult time of it. One couple in particular was practically in panic over how to fill out the forms.
Every now and then, the Homeless Outreach Coordinator would appear -- a charismatic young Indian of indeterminate tribal affiliation, his lustrous black hair done up in a pert chignon at the nape of his neck, his dark eyes flashing, his smile wide and welcoming. He'd briefly scan the room, talking to some of the clients who said they'd never been there before and didn't know the process. He'd explain that once they turned in their intake paperwork, they'd be seen by one of the doctors to assess their physical condition and then would be put on his list for counseling and referral to the various homeless services available in Albuquerque, and then he would point out that he was really racing from one site to another and he didn't have time to chat.
Off he'd go, sometimes with one of the homeless clients in tow -- "I'll take you right now," he'd say, "so you won't have to wait to get on my list. Did have your vitals taken already? Good!"
It's been a couple of decades since I've dealt with numbers of homeless on a continuing basis, and I can't say that I did it very well. I wasn't particularly prepared for what I would encounter. People are homeless for a variety of reasons, most of them having to do with a chronic inability to function "normally" in the everyday world. Drug use and alcoholism are frequent factors, but in my experience with the homeless, these factors are symptoms rather than primary causes of homelessness. In many cases, addictions and alcoholism preceded homelessness, but in many other cases, they were consequences. On the other hand, those who became homeless were often self-medicating with drugs or alcohol in order -- they thought -- to cope better with normal living. In my often ham-handed way, I would sometimes offer homeless individuals who came to me for help a place to stay, food, or occasionally money (though I rarely had much myself.) But I couldn't deal with underlying causes of homelessness, and so I'm not sure that what little I was able to do was of much help.
Of course, mental illness is a significant contributing factor to homelessness in America. The fact is, there were few mentally ill homeless in the United States prior to the destruction of the residential system for mentally ill individuals beginning in the 1970's. The widespread failure to provide adequate and accessible mental health services, let alone access to residential care, was one of the leading causes of homelessness prior to the onset of the apparently permanent recession. Since the beginning of the recession, homelessness among the economically deprived has increased substantially.
Most of those in the clinic waiting room were able to handle the intake paperwork, though some had a good deal of difficulty and needed help of one sort or another which they typically got from one of the other homeless clients in the waiting room rather than from clinic staff.
The couple (who I'll call Richard and Ann, not their real names) who were having trouble with the forms that I mentioned earlier, however, had a lot of other problems as well, and they attracted the attention of the armed (female) guard who was monitoring the clinic waiting room and was charged with keeping order.
Richard was an Anglo in his early 40's I would guess. He was probably formerly nice looking but now was ravaged and jaundiced, his creeping infirmities taking their toll. His eyes were wide-staring, his body tension-filled. He was acting paranoid. Every now and then, he would get up from his chair and pace, sometimes in the waiting room, sometimes outside.
The younger Anglo woman with him, Ann as I call her, had even more problems. She was constantly trying to help Richard with the intake forms, but every time she would offer a suggestion, he would get upset and tell her to leave him alone. She would then get offended and go sit in another part of the waiting room. She was unsteady on her feet, though, and sometimes seemed to have severe vision problems, as if she couldn't see where she was going.
The guard, who I'll call Julie, took an interest in this couple, especially when Ann would get up and her pants would start to fall down. Ann was not wearing underwear.
At one point, Julie approached Ann and asked if she was all right. Ann replied she was fine, but her speech was slurred and her head was reeling. Julie asked if she'd been drinking, and Ann replied "absolutely not!" but she could barely get the words out and at that point, she couldn't even stand up without a struggle. She said, "I'm not drunk. I'm sick." Richard said, "She's fine." But it was clear Ann was not "fine." Nor, for that matter, was Richard.
Ann was acting drunk, but I wasn't so sure that was her problem. She appeared to me to be having physical as well as mental issues that may have had nothing to do with alcohol. Her problem was that she was trying to be "normal" and failing. Every time she set Richard off, by saying something or doing something that troubled him, she would become morose. My own sense of what was going on was that probably neither of them had eaten for perhaps days, possibly they hadn't slept either. Both lack of food and lack of sleep can have profound psychological effects that can mirror drunkenness and can exacerbate any underlying mental illnesses. That's what I thought was going on based on my observations of their behavior.
At one point, Ann got up from her chair and her pants nearly fell off altogether. Julie, the guard, approached her again and said she would have to leave if she couldn't keep her pants up, that she was in violation of the rules, and she was guilty of indecent exposure. Richard said, "She can wear my belt," which he rummaged around in his backpack to find. It was a very fancy studded belt, something I wouldn't have imagined he'd carry, but you never know. He helped Ann with putting it on, and once it was done, she was quite proud of her new accessory.
Julie, meanwhile, had disappeared into the counseling section of the clinic. She emerged from wherever it was she'd been soon after Ann had been belted up and said to her, "Look, we're going to take you across the street where we'll get you a pair of pants that will fit." Ann's eyes grew huge, "Really!?" she asked. "You'll get some pants, and if you need anything else, we can take care of that, too. Come with me."
Ann was delighted, and eagerly followed Julie out the door. Richard looked worried, but he stayed put. The homeless outreach coordinator (who I'll call Standing Bear) came out and spoke to him briefly, asking if he'd turned in his intake paperwork, and Richard said "Yes," but he had it rolled up in his hand. He'd turned in nothing. "Good," said Standing Bear, "we'll call you in for counseling as soon as your vitals are taken and that shouldn't be long." "What about Ann?" asked Richard. "We'll take care of her, too. Just wait for your names to be called. It shouldn't take long."
Standing Bear disappeared back into his area, while Richard waited for Ann to return -- which she did not too long afterwards, wearing a smart pair of running pants with an elastic waist and carrying her oversized black jeans with Richard's fancy studded belt. She had a huge smile. Julie was with her.
After Ann sat down next to Richard, Julie said, "Look, you're having a real problem here. You're severely dehydrated, your breath smells of alcohol, and you aren't able to function. We're very worried about you, and so we're going to call an ambulance to take you to the hospital for evaluation. You sit here while I go call the ambulance."
Julie walked off, headed to the back of the clinic, while Richard and Ann sat for a moment stunned.
"They're calling an ambulance!" said Ann, as if she was facing the worst fate possible. "What are we going to do?"
Richard said, "We'll have to leave."
He started assembling his things into his backpack, and stuffed Ann's defunct jeans in on top. "We have to go," he said to her. Ann was near tears. "They're going to take me to the hospital? Why?!"
"They think you're sick," said Richard.
"I AM!" she said. "I'm very sick!" But she was terrified of going to the hospital. She was panicking. Richard got his things together, slung his backpack over his shoulder, and said: "Come on, let's go."
Just as they were headed out the door, Standing Bear emerged with a bottle of water saying: "Ann, take this. Drink it. You need to drink it."
She stopped and looked at him, desperation in her eyes, and said, "Thank you! You are a wonderful person." And she and Richard left the building before Julie could come back to announce the immanent arrival of the ambulance -- which so far as I know never came.
So ended a very sad episode at the clinic. It was clear that neither Ann nor Richard could cope with expectations they couldn't meet. There was no real help or hope for them. The only thing the clinic personnel could think to do was get Ann to a hospital for evaluation -- after leveling accusations about her sobriety and inability to function normally. But for Ann, going to the hospital was a terrifying thing. The most terrifying thing she had up to then encountered at the clinic.
I have no doubt that proper protocols were being followed and that Richard and Ann were not being driven out of the clinic deliberately. People having that much difficulty can be liability headaches, however, and without knowing what their underlying problems were, it was hard to serve them appropriately. Getting Ann a full-scale medical evaluation at a hospital was a logical decision, but her panic at the announcement thwarted even the best of intentions. I don't know that the clinic personnel could have handled the situation much better than they did, though it seemed to me that the guard was unnecessarily officious and harsh -- before she realized that Ann was really in bad shape and needed expert help.
Homeless Outreach Day at the clinic I later learned was scheduled the day before the annual Homeless Census. This is a full scale effort to find and count all the homeless throughout the country, and a wide variety of strategies are employed to make sure the count is as thorough and accurate as possible (though I understand some communities actually seek to undercount homeless people so as to make it seem like the problem isn't as bad as it really is.) Asking the homeless to come into a clinic for evaluation and services is one of the strategies employed to ensure a full count. Given the sharp increase in the poverty rate over the last five years, I have no doubt that the homeless number is greater than ever.
For the most part, service at this clinic is remarkable for its warmth and humanity. Patients and clients are not just statistics or symptoms. They are people who are treated with dignity, openness and consideration, much as might be the case in a large, welcoming extended family.
I was sad to see what happened to Richard and Ann, but somehow I have the feeling things will work out for them.
Let's hope.
When Americans lose their health care insurance -- or never had it -- as something like 60 million Americans who have no health insurance understand well, we make do with the system of emergency rooms and community clinics (assuming there are any) that passes for universal health care in this country. Or we go without.
The clinics have been a godsend in our experience, but I can't say the same of ERs, where, even if you have insurance, you're likely to be neglected, misdiagnosed and/or mistreated. I think it's time for Americans to understand that medical care is not considered a right, it's not a privilege, it's an opportunity for the practice of medicine. Emphasis on practice. Or not.
At any rate, I shouldn't complain. My life may have been jeopardized from time to time by medical mistakes and/or neglect, but so far, every time it has been jeopardized, my life has been saved in the end by heroic interventions, so what's the beef?
On the other hand, clinic care has been remarkable, especially given that my expectations were so low.
Since moving to New Mexico, we've had to set up a whole new set of clinic relationships as our former health care provider in California -- Kaiser Permanente -- doesn't exist here, and the clinics we were using before we moved don't have reciprocity agreements with the clinics here.
As in California, it took a while to get a new patient appointment (though they say they will take walk ins without appointments), but once the appointment was arranged with the community clinic in town (Albuquerque), things seemed to go well. The place was clean, efficient, seemingly very well operated. I did some research and found out we would be dealing with one of the pioneer urban clinics in the country.
It's hard to imagine what things were like before these clinics sprang up in the 1960's and '70's, but I'm old enough to remember, and it wasn't pretty. If you could not pay for care, they might or might not take you at "County"* depending on factors which you were never made aware of. But generally speaking, you didn't want to go to "County" anyway, because even if they took you, they wouldn't necessarily take care of you. You went to "County" to die, in other words. (*"County" was the county hospital, often out in the country somewhere difficult to reach, or maybe attached to the jail, or by the sewer plant, where indigent patients were sent and treated, either at no charge or very low charge.)
There was very little in the way of public health care, and what there was was focused on specific ailments and infectious diseases -- STDs, TB, polio, that sort of thing -- in need of control/containment/eradication.
For the most part, doctors and hospitals would only see patients who could pay, and ERs were not required to accept patients who could not (ie: they'd be sent to "County" to take their chances.) The fear of "Socialized Medicine" was rampant for some reason. Better you should die a Free Man than be treated for illness or accident a Socialist Slave! America Forever!
The first community clinics I remember were the Free Clinics established in the 1960's by and for the hippies clogging the Bay Area of California and eventually everywhere else. It was recognized that the health care system in place at the time -- private fee-for-service doctors and hospitals that required payment or no care for you, or "County" where you took your chances -- was not working very well for anyone, and not at all for the free spirits of the era who were on the road, traveling, exploring, experimenting with substances and different lifestyles, often living on very little or no money at all, and relying extensively on one another for survival.
There may have been earlier free community clinics, but if there were, I wasn't aware of them. The hippie clinics were staffed by mostly volunteer professionals, med school students and skilled lay people, and they were often supplied by barter, strategy or donations of surplus medical materiel, some of it acquired from the then-bloated military off killing gooks in the rice paddies.
The free clinics would see anyone for anything that ailed them, without restriction, and most would offer their services either free of any charge, or on a sliding scale depending on ability to pay. There was no elaborate bureaucracy, no reams of papers to fill out, or insurance claims to make. It was simple, straightforward, and quite effective.
However, most clinics were not set up to handle serious or chronic illness or injury that required in-patient care. The hospital was the only place that could handle it, and if you couldn't pay, that still meant "County."
But county care was improving as more and more benefits of the free clinics were recognized. Basically, the clinics were taking much of the routine heath care burden off of the "system" -- both the for-profit and the public health system -- which allowed the "system" to focus more on chronic and serious diseases and injuries, and ultimately to do a better job.
Over time, the clinics consolidated, became institutionalized and plugged into the system. There were fewer of them, and for the most part their care was no longer "free," nor were they staffed with volunteers relying on donations of money and materiel. They professionalized. Though most maintained an open door policy, some restricted their acceptance of patients to certain service groups. Their funding sources were primarily from government programs -- Medicare, Medicaid, IHS, and so on -- which meant they had to conform to the operational standards set by their funders. They bureaucratized as they institutionalized. They became essentially indistinguishable from hospital or doctor-provided outpatient care.
Except, of course, that they still tended to serve a poor population rather than one better off.
The urban Indian clinics came a little late to the community clinic field, but they were advanced from the outset compared to some of the others. In most cases, they were immediately funded by government sources, so they could operate at a fairly high level from the get-go. We first encountered the urban Indian clinic in the early 1980's and we stuck with it for quite some time. We found the care to be more than adequate on the one hand, and the spirit of the personnel to be outstanding on the other.
Of course, they were still unable to take on serious injury or disease which required hospitalization. What they could do was make referrals, and usually, because of those referrals, the hospital care provided and any specialist services and follow up were top notch. In other words, you didn't just have to go ER and hope. Wait. Pray. Later on, that would change.
The Indian clinic in Albuquerque is one of the pioneers in the field, and it is very well maintained and operated. It takes a while to get a new patient appointment, but once that's done, it's fairly easy obtain health care service. Indians with "blue card" and CIB receive treatment at no charge, others use Medicare, Medicaid, private insurance, or pay out of pocket on a sliding scale -- which can mean free. No one is turned away because they can't pay. Though busy, it's surprisingly uncrowded. Much less so than some of the ER waiting rooms I've been in. The clientele runs heavily to Indians (shock!) but is by no means exclusively so. Not all are poor, though many clearly are. From what I've seen, the clinic serves a broad cross-section of the population of Albuquerque and the area round about. We come in from the country, after all, a pretty decent drive over the Tijeras Pass. Not something you want to do in a blizzard, though we've done it more than once.
The other day we were at the clinic, and it was clear it was Homeless Outreach Day, for the waiting room was populated by numbers of homeless people trying to navigate the intake paperwork before being seen. Some were understandably having a difficult time of it. One couple in particular was practically in panic over how to fill out the forms.
Every now and then, the Homeless Outreach Coordinator would appear -- a charismatic young Indian of indeterminate tribal affiliation, his lustrous black hair done up in a pert chignon at the nape of his neck, his dark eyes flashing, his smile wide and welcoming. He'd briefly scan the room, talking to some of the clients who said they'd never been there before and didn't know the process. He'd explain that once they turned in their intake paperwork, they'd be seen by one of the doctors to assess their physical condition and then would be put on his list for counseling and referral to the various homeless services available in Albuquerque, and then he would point out that he was really racing from one site to another and he didn't have time to chat.
Off he'd go, sometimes with one of the homeless clients in tow -- "I'll take you right now," he'd say, "so you won't have to wait to get on my list. Did have your vitals taken already? Good!"
It's been a couple of decades since I've dealt with numbers of homeless on a continuing basis, and I can't say that I did it very well. I wasn't particularly prepared for what I would encounter. People are homeless for a variety of reasons, most of them having to do with a chronic inability to function "normally" in the everyday world. Drug use and alcoholism are frequent factors, but in my experience with the homeless, these factors are symptoms rather than primary causes of homelessness. In many cases, addictions and alcoholism preceded homelessness, but in many other cases, they were consequences. On the other hand, those who became homeless were often self-medicating with drugs or alcohol in order -- they thought -- to cope better with normal living. In my often ham-handed way, I would sometimes offer homeless individuals who came to me for help a place to stay, food, or occasionally money (though I rarely had much myself.) But I couldn't deal with underlying causes of homelessness, and so I'm not sure that what little I was able to do was of much help.
Of course, mental illness is a significant contributing factor to homelessness in America. The fact is, there were few mentally ill homeless in the United States prior to the destruction of the residential system for mentally ill individuals beginning in the 1970's. The widespread failure to provide adequate and accessible mental health services, let alone access to residential care, was one of the leading causes of homelessness prior to the onset of the apparently permanent recession. Since the beginning of the recession, homelessness among the economically deprived has increased substantially.
Most of those in the clinic waiting room were able to handle the intake paperwork, though some had a good deal of difficulty and needed help of one sort or another which they typically got from one of the other homeless clients in the waiting room rather than from clinic staff.
The couple (who I'll call Richard and Ann, not their real names) who were having trouble with the forms that I mentioned earlier, however, had a lot of other problems as well, and they attracted the attention of the armed (female) guard who was monitoring the clinic waiting room and was charged with keeping order.
Richard was an Anglo in his early 40's I would guess. He was probably formerly nice looking but now was ravaged and jaundiced, his creeping infirmities taking their toll. His eyes were wide-staring, his body tension-filled. He was acting paranoid. Every now and then, he would get up from his chair and pace, sometimes in the waiting room, sometimes outside.
The younger Anglo woman with him, Ann as I call her, had even more problems. She was constantly trying to help Richard with the intake forms, but every time she would offer a suggestion, he would get upset and tell her to leave him alone. She would then get offended and go sit in another part of the waiting room. She was unsteady on her feet, though, and sometimes seemed to have severe vision problems, as if she couldn't see where she was going.
The guard, who I'll call Julie, took an interest in this couple, especially when Ann would get up and her pants would start to fall down. Ann was not wearing underwear.
At one point, Julie approached Ann and asked if she was all right. Ann replied she was fine, but her speech was slurred and her head was reeling. Julie asked if she'd been drinking, and Ann replied "absolutely not!" but she could barely get the words out and at that point, she couldn't even stand up without a struggle. She said, "I'm not drunk. I'm sick." Richard said, "She's fine." But it was clear Ann was not "fine." Nor, for that matter, was Richard.
Ann was acting drunk, but I wasn't so sure that was her problem. She appeared to me to be having physical as well as mental issues that may have had nothing to do with alcohol. Her problem was that she was trying to be "normal" and failing. Every time she set Richard off, by saying something or doing something that troubled him, she would become morose. My own sense of what was going on was that probably neither of them had eaten for perhaps days, possibly they hadn't slept either. Both lack of food and lack of sleep can have profound psychological effects that can mirror drunkenness and can exacerbate any underlying mental illnesses. That's what I thought was going on based on my observations of their behavior.
At one point, Ann got up from her chair and her pants nearly fell off altogether. Julie, the guard, approached her again and said she would have to leave if she couldn't keep her pants up, that she was in violation of the rules, and she was guilty of indecent exposure. Richard said, "She can wear my belt," which he rummaged around in his backpack to find. It was a very fancy studded belt, something I wouldn't have imagined he'd carry, but you never know. He helped Ann with putting it on, and once it was done, she was quite proud of her new accessory.
Julie, meanwhile, had disappeared into the counseling section of the clinic. She emerged from wherever it was she'd been soon after Ann had been belted up and said to her, "Look, we're going to take you across the street where we'll get you a pair of pants that will fit." Ann's eyes grew huge, "Really!?" she asked. "You'll get some pants, and if you need anything else, we can take care of that, too. Come with me."
Ann was delighted, and eagerly followed Julie out the door. Richard looked worried, but he stayed put. The homeless outreach coordinator (who I'll call Standing Bear) came out and spoke to him briefly, asking if he'd turned in his intake paperwork, and Richard said "Yes," but he had it rolled up in his hand. He'd turned in nothing. "Good," said Standing Bear, "we'll call you in for counseling as soon as your vitals are taken and that shouldn't be long." "What about Ann?" asked Richard. "We'll take care of her, too. Just wait for your names to be called. It shouldn't take long."
Standing Bear disappeared back into his area, while Richard waited for Ann to return -- which she did not too long afterwards, wearing a smart pair of running pants with an elastic waist and carrying her oversized black jeans with Richard's fancy studded belt. She had a huge smile. Julie was with her.
After Ann sat down next to Richard, Julie said, "Look, you're having a real problem here. You're severely dehydrated, your breath smells of alcohol, and you aren't able to function. We're very worried about you, and so we're going to call an ambulance to take you to the hospital for evaluation. You sit here while I go call the ambulance."
Julie walked off, headed to the back of the clinic, while Richard and Ann sat for a moment stunned.
"They're calling an ambulance!" said Ann, as if she was facing the worst fate possible. "What are we going to do?"
Richard said, "We'll have to leave."
He started assembling his things into his backpack, and stuffed Ann's defunct jeans in on top. "We have to go," he said to her. Ann was near tears. "They're going to take me to the hospital? Why?!"
"They think you're sick," said Richard.
"I AM!" she said. "I'm very sick!" But she was terrified of going to the hospital. She was panicking. Richard got his things together, slung his backpack over his shoulder, and said: "Come on, let's go."
Just as they were headed out the door, Standing Bear emerged with a bottle of water saying: "Ann, take this. Drink it. You need to drink it."
She stopped and looked at him, desperation in her eyes, and said, "Thank you! You are a wonderful person." And she and Richard left the building before Julie could come back to announce the immanent arrival of the ambulance -- which so far as I know never came.
So ended a very sad episode at the clinic. It was clear that neither Ann nor Richard could cope with expectations they couldn't meet. There was no real help or hope for them. The only thing the clinic personnel could think to do was get Ann to a hospital for evaluation -- after leveling accusations about her sobriety and inability to function normally. But for Ann, going to the hospital was a terrifying thing. The most terrifying thing she had up to then encountered at the clinic.
I have no doubt that proper protocols were being followed and that Richard and Ann were not being driven out of the clinic deliberately. People having that much difficulty can be liability headaches, however, and without knowing what their underlying problems were, it was hard to serve them appropriately. Getting Ann a full-scale medical evaluation at a hospital was a logical decision, but her panic at the announcement thwarted even the best of intentions. I don't know that the clinic personnel could have handled the situation much better than they did, though it seemed to me that the guard was unnecessarily officious and harsh -- before she realized that Ann was really in bad shape and needed expert help.
Homeless Outreach Day at the clinic I later learned was scheduled the day before the annual Homeless Census. This is a full scale effort to find and count all the homeless throughout the country, and a wide variety of strategies are employed to make sure the count is as thorough and accurate as possible (though I understand some communities actually seek to undercount homeless people so as to make it seem like the problem isn't as bad as it really is.) Asking the homeless to come into a clinic for evaluation and services is one of the strategies employed to ensure a full count. Given the sharp increase in the poverty rate over the last five years, I have no doubt that the homeless number is greater than ever.
For the most part, service at this clinic is remarkable for its warmth and humanity. Patients and clients are not just statistics or symptoms. They are people who are treated with dignity, openness and consideration, much as might be the case in a large, welcoming extended family.
I was sad to see what happened to Richard and Ann, but somehow I have the feeling things will work out for them.
Let's hope.
Tuesday, January 8, 2013
Note on a Friend
A friend here in New Mexico has been enduring a health crisis for months now. She's been in the hospital with a blood clot that was discovered last Friday during pre-op for a hip replacement. Needless to say, her hip replacement is on hold.
She's on Medicare and has been through the usual series of frustrations, delays, incompetence and lack of communications that have long characterized American health care, and at this point, she's just beat. She's been barely able to walk since Thanksgiving when she was hospitalized the first time with these issues. Complicating the situation with her disintegrated hip joint is sciatica in her other leg, making it almost impossible for her to sit for more than a few minutes, let alone to lie down. She wasn't treated for that until she absolutely demanded that something be done. She's been in pain and misery almost constantly.
She was looking forward to hip replacement as she at least would be able to walk again, but because of the blood clot in her leg, they couldn't do it. She'll need to be on blood thinners for at least a couple of months, then off of them for at least a month before they can do any surgery, and it may well be longer -- much longer. She said that at least in the hospital she could sleep better than she could at home.
It's a sad and aggravating situation -- for our friend most of all, but for her family and friends as well. She's not alone, thank goodness, as she has family in town and friends throughout the area, but she's lived alone and has been independent for most of her adult life, and being dependent on others as she has to be now is driving her nuts. That and the pain and the frustration and being unable to walk more than a few steps at a time.
We're helping out as we can. It isn't all that much, but it's something. We've been through this kind of thing our own selves and taking care of another, so it's not all that unfamiliar. You go into a kind of auto-response of "Oh, this is what you do, this is how you get through it, etc." It's surprising how easy it is to slip back into that routine. Or maybe it's hard-wired.
At any rate, it's taking a good deal of our time, so posting may be light for a while.
Another cliff looms...
She's on Medicare and has been through the usual series of frustrations, delays, incompetence and lack of communications that have long characterized American health care, and at this point, she's just beat. She's been barely able to walk since Thanksgiving when she was hospitalized the first time with these issues. Complicating the situation with her disintegrated hip joint is sciatica in her other leg, making it almost impossible for her to sit for more than a few minutes, let alone to lie down. She wasn't treated for that until she absolutely demanded that something be done. She's been in pain and misery almost constantly.
She was looking forward to hip replacement as she at least would be able to walk again, but because of the blood clot in her leg, they couldn't do it. She'll need to be on blood thinners for at least a couple of months, then off of them for at least a month before they can do any surgery, and it may well be longer -- much longer. She said that at least in the hospital she could sleep better than she could at home.
It's a sad and aggravating situation -- for our friend most of all, but for her family and friends as well. She's not alone, thank goodness, as she has family in town and friends throughout the area, but she's lived alone and has been independent for most of her adult life, and being dependent on others as she has to be now is driving her nuts. That and the pain and the frustration and being unable to walk more than a few steps at a time.
We're helping out as we can. It isn't all that much, but it's something. We've been through this kind of thing our own selves and taking care of another, so it's not all that unfamiliar. You go into a kind of auto-response of "Oh, this is what you do, this is how you get through it, etc." It's surprising how easy it is to slip back into that routine. Or maybe it's hard-wired.
At any rate, it's taking a good deal of our time, so posting may be light for a while.
Another cliff looms...
Friday, June 29, 2012
As For Me
 |
| One Kaiser Plaza, Oakland, CA. Headquarters of Kaiser Permanente. |
I think I posted a while back that today is the last day I will have comprehensive health care coverage. For a little over a year when I am eligible for Medicare, I'll be on my own.
I have been covered through Kaiser Permanente for the last 25 years or so, very rarely using their services but comforted by the knowledge that it was there if I needed it. I didn't realize how costly it had become until the COBRA statement came saying that to maintain the coverage we have would cost close to $3,000 per month. Oh really. Isn't that something. At Kaiser??? Eeek.
Well, after considering the risks/benefits, the costs, and the fact that we would soon not be anywhere near a Kaiser facility, the answer was "No thanks." Other COBRA plans were available at $1,500 a month and up, but they didn't seem worthwhile either -- high deductibles, limited coverage, rather pointless, really.
Thankfully, while I've faced some life-threatening illnesses, I don't have a chronic condition that requires continual treatment and care -- at least not yet. The debilities of age do seem to be creeping up on me, but I've been able to manage them on my own well enough up to this point... let's hope it stays that way.
Interestingly, while medical coverage was hyper-expensive (I have no clue how older workers -- or ex-workers as the case may be -- are supposed to manage such huge COBRA bills to maintain coverage), dental and vision coverage were made available at no cost. So there's that.
I don't know that the ACA would actually have any positive effect on this situation. COBRA would still be available, but it would still be out of reach financially -- at least so far as I've been able to puzzle out the limited information I've seen. If there really is a 6% of gross income limit on health care insurance costs to households, then that actually would make a big difference, but nothing is in stone until it is graven there, and nothing will be graven until after Decision 2012 concludes.
The notion that the First Thing President Romney Will Do is "Repeal Obamacare" is patently absurd, of course. Having seen this man's ways for a while, what he will do First is to sell the rubes on the kabuki that he will be conducting from day one. He has no intention of repealing Obamacare -- it's too lucrative to his owners and sponsors. Besides, despite his August Pretensions, even he doesn't have the power to "repeal" it. Not that he would want to. He might be inclined to suggest changes to the program that increase costs and limits coverage to individuals and households, but otherwise he will leave it pretty much alone. The Industry won't let him muck with it very much.
On the other hand, if Obama receives another term -- which is looking more likely, his political instincts are still astonishing -- he would probably be inclined to tweak it in a similar direction, simply because that's what he does. If an R suggests "improvements" he's right there. So. ACA or nothing, that's what the nation is going to be stuck with.
I've dealt with Medicare and Medicaid on behalf of others in the past, and as long as you can get care, they're fine. The problem is getting care prior to a crisis -- or even in a crisis in some cases. I've spent up to 12 hours in an ER waiting room with a Medicare patient before any sort of treatment at all was offered; and of course once she was seen and treatment was begun, she was in dire shape.
Who would have thought.
There was no cost to the patient for Medicaid treatment, though now there are small co-pays for doctor visits and much higher ones for ER visits (of course, when the doctor refers you to the ER, what are you supposed to do?) Medicare co-pays are still something of a mystery to me. At no time was anything out of pocket demanded, but costs beyond what Medicare reimbursed would be billed to the patient up to certain limits. I still don't quite understand how it worked, though. Nevertheless, I am well aware of all kinds of shady billing practices by providers. Rick Scott is only the tip of the iceberg. It seems like every provider engages in bill-padding at the very least, frequently much worse.
There are nowhere near enough providers and facilities to accommodate a large influx of new patients, and it has long been my impression that the basic idea of the ACA is to get payment now for future medical care -- that quite likely will not be available. It certainly won't be in the short term. This will mean that people will be "covered" for treatment they can't get. Brilliant!
As I understand it, money for more community care clinics is being fervently stripped out of the ACA. These clinics are an important step in expanding access to care, but if the money is being stripped out as we speak, it's patently obvious that expanding access is not on the agenda, not that it truly ever was. If I recall correctly, Bernie Sanders was the one who demanded the clinics, and he was bought off with promises that have been relatively meaningless ever since. If there is little or no access to care due to lack of personnel and facilities, regardless of coverage and subsidies and all the rest of it, then it's pretty obvious that the whole Rube Goldberg contraption of the ACA was never meant to do much more than keep the insurance cartels and the medical industrial complex in profits forever.
Yes, I'm cynical about these things.
From the beginning the correct solution to America's medical care crisis was expanding and improving something like Medicare for All. This is not rocket science, this is obvious, and it was obvious when the correct solution was never on the table let alone considered that the point of the ACA was profit for the medical cartels. Period. If somebody gets medical treatment they otherwise wouldn't, oh well!
The correct solution was to remove the middle-man cost and inconvenience burden of insurance companies, simplify, streamline, make care available, tax to fund it, aggressively expand professional training, and provide an extensive network of primary care facilities. The correct solution was to put all of this in the public sphere, as a public health matter, rather than expanding private, for profit health care.
This has all been known for decades.
And yet the Health Care Reform panels never even heard let alone considered the correct solution.
Ah, but ACA is better than nothing!
The question is for whom?
Tuesday, March 23, 2010
Documenting the Atrocities
Jeebus, the Hysteria.
The stark raving madness surrounding the now-admitted-by-everyone to be a pretty much ideal Republican Health Care Insurance Reform measure so infected the public square and the blogosphere that I just stayed away. The Crazy is catching, and I simply did not want to play.
When you have an amiable drunk like Dick Armey stirring up the masses to Rise and Revolt, and he's the only one doing it, then you know the situation is well out of hand -- and well out of your hands. When Men of Principle like the perpetually peevish Dennis Kucinich can be -- ahem -- persuaded to go along with what is arguably The Best Republican Health Insurance Reform measure evah, then you know the fix is not only in, it has been in for months if not years.
And the hysteria over it just won't quit.
This is politics in America today, and when things get this wild, even though all the Stakeholders are pretty well satisfied, then you know it's all for Show, a Show that is meant to keep the People entertained while their betters abscond with more of their loot.
That nearly the entire blogosphere fell into it and two sites that I frequent -- or used to -- FDL and dKos -- went balls-to-the-wall with rivalry and hysteria, mutual anathema and fury, simply confirmed to me that "Health Care" was being used as a business leader by both of them, with the primary desire and function to increase revenues for their proprietors.
Much as Dick Armey has very successfully done with his "Freedom Works" TeaBagger outfit.
TeaBagging is now the model. First they made it OK to bring up the R-Word, "Revolution". Now they make it OK to be bat-shit insane, and mostly to value myth and falsity over fact to make their point.
The shape and outline of the "Health Care" was set very early on last year, by April or May, and was all but complete by June and July. After that, everything was theatrics piled upon theatrics, and jockeying for attention by all and sundry. It really troubled me that it was being done this way. I still don't know whose bright idea it was to let things devolve into such a continuous goon show, but there you are. "Day of the Locusts" -- and it wouldn't end. It just kept going and going and going...
Couple of things happened, though, that made it almost seem smart (well, that remains to be seen...): 1) the factions pretty much exhausted themselves in virtual combat with one another and with The Powers That Be; 2) the bill that has been (is still in fact being) cobbled together comes across as "Moderate" compared to the foam-flecked fury it has unleashed among the commentariat and the proles. Moderate and wise, considered and responsible, a celebration of the Public Interest, the "Health Care" seems (almost) Just Right. Or something like that.
There is very little energy left to fight the Power, or to fight this fait accompli... or to do much of anything.
Jane posted her Manifesto over the Betrayal, yadda yadda, and something jumped out at me from it: She writes about how exciting and rewarding it was to cover what was going on. As a Journalist. New Media and all that. And then she refers to how difficult it was and frustrating it was to take what she learned as a Journalist and turn it into political action -- ie: to be a Player.
And how the next step has to be this or that to turn political knowledge gained as a Journalist into successful political action as a Player Without Portfolio. Basically to be as influential as any high priced lobbyist on K Street. Or as influential as any other noisy media outfit.
What is the point of Documenting the Atrocities if you can't use them for... good? Well, for what you want.
And this is the core difficulty among political bloggers. They want -- in some cases desperately -- to be Players on the political field, and they want to Win. (cf: Markos, Arianna, Aravosis) They believe that being Journalists is the way to Glory and Winning on the Field. Documenting the Atrocities (in the form of constant Media Criticism) is one of the core functions of the Blogosphere in general, and it is a sure way to -- eventually -- gain Notice. And Notice, somehow, is supposed to translate into Power.
Only it doesn't, not really, when it comes to Blogging. So called Progressives got nothing out of the "Health Care," not even a wink and a nod. At best they got a kick in the nads and a slap in the face, and a demand for their lunch money to boot. And like always, they pay up. It's their role and their function. Surprisingly, Jane has not yet gone into Kali-mode demanding the Heads of all who thwarted her again. Especially the Head of Obama Himself. But one shouldn't be surprised to see her turn when the situation is ripe.
Interestingly, some Republicans are complaining that they got "Nothing." Interesting especially because the measure is for all intents and purposes a Republican measure, barely recognizable as anything but a pay-off to vested interests at the crippling expense of the Public -- the way it is supposed to be in Republican Land.
It's arguably better in that regard than the Republicans on their own could possibly have made it. So what are they crabbing about?
Oh, I see.
They couldn't and didn't do it.
Someone else had to be brought in, Young Mister Obama.
That's the deal.
That's what they're crabbing about. And they will never forgive him for it.
Never.
Note: somebody at the Signing just said, "Thank you. 36 years trying to do this..."
Well, there you are.
Wednesday, February 10, 2010
Dissing His Base
So word gets out that Rahm called MoveOn "fucking retards" for running ads against Blue Dogs who were holding up HCR legislation in the summer of 2009. This gets in the media months later, and Bad Hair Day Sarah throws her hissy fit over the dissing of developmentally disabled people like her new son Trig, and we're all off on another round of "What She Said," and "Ain't Rahm a basterd! Fire his ass!" Sigh. As if we really needed more distractions.
Like the Big Meeting coming up on February 25, the so-called "Health Care Summit" between the White House in one corner, and Those Ornrey Republicans in the other.
Cage match to be televised live from Blair House.
Um-hum. So this is to be another of those heady Bi-Partisan Reach Arounds that the White House has patented thanks to the success of the Obama Presentation at the Republican Circle Jerk in Maryland a few weeks ago.
But wait. Why is Obama continuing to diddle the Rs and to ignore the progressive base that got him the fuck elected in the first place? What is going on here?
11ty dimensional chess again?
Or is it something else?
As far as an observer can tell, at this point, Team Obama sees only the opposition of the Republicans standing in their way. And the only way forward, as far as they can tell, is through the Republican Line, by adopting as many of the Republican "answers" as they can; in other words, by taking the Republicans with them into the Brave New Future World -- and leaving the "retards" behind.
This is what the Plan looks like from the outside, and for once in our lives, let's take things for what they appear to be rather than try to second guess the operation.
The White House and Team Obama is deliberately aligning itself with Rs so as to form a Coalition of Power in opposition to the Democrats' base, which -- apparently -- is to be disposed of in the nearest Dumpster®.
How the Hell did this happen, and what are we going to do about it?
Sunday, February 7, 2010
Delivering the Goods for the Wealthy and Powerful
During the course of the Health Care Debacle ("I'm not dead yet!") we've all been privileged to witness the process of sausage making on behalf of our Betters. Over and over again. It's no secret that the process has been tailor made to serve the interests of the Stakeholders, while specifically, directly and deliberately conceived and convened to exclude the voices and the interests of the People -- except to the extent they are controlled to mirror those of Stakeholders. It's been quite a revolting display, but the only ones actively in revolt are the TeaBaggers and their various sponsors.
Oh, the -tarians and their ilk mouth off all the time, but, apart from the LaRouchians, they don't actually do anything about what's going on. It's all about The Perpetual Argument, you know.
Apparently everyone else is just so grossed out, they have to turn away. Pretend it has nothing to do with them, keep their heads down and their noses clean, and maybe, if they're lucky, this storm too shall pass.
Not on a bet.
Because the Health Care Sausage is stalled in the Senate due to the election of The ItBoy to Ted Kennedy's Seat, there are all these plans afoot to break it into pieces and pass parts of it here and there, thereby letting it "incrementally" grow over time.
The point, as always, is to condition the People to accept delivery of more of the good to the wealthy and powerful rather than to resist.
With the TeaBagging Revolution in the vanguard, success is assured.
Because the TeaBagging Revolution is the only Voice of the People that is being heard by Our Rulers behind their Palace Gates they are content to loot and pillage at will.
Since no one they need pay attention to is objecting, why shouldn't they?
Of course there are objections to specific outrages, but the absence of any comprehensive policy prescription to counter the actions of the Plutocrats, the absence of any "leftish" ideology to counter the wingnuts' "philosophy", and the absence of any political will to do anything but fuss around the margins of what Our Rulers are determined to do (ie: continue the pillage unmolested) is a sad commentary on how far we have fallen.
When most of the so-called "Left" can't even think in terms of Liberal Policy prescriptions to current catastrophe but can only imagine themselves mitigating some of the worst of it, we're all in very deep doo doo indeed.
Saturday, January 2, 2010
Social Democrats vs "Progressives"
Social Democracy functions as a political means to control (we may call it "regulate") otherwise out-of-control and tending-toward-corporate Capitalism. It does not destroy Capitalism or replace Capitalism. Social Democracy curbs the worst tendencies of Capitalism, and it -- generally -- prevents Corporatism from developing and flourishing.
The premise of Social Democracy is that the People are ultimately sovereign over all issues, political, social, and economic, and through their employment of strong Democratic institutions, they are able to set and direct political, social, and economic policies in their mutual interest. Democracy doesn't always get things right, but if properly understood and employed, it can protect the weak from the depredations of the strong, it can mitigate the abuses inherent in unfettered Capitalism, and it can ensure fair and equitable economic and social as well as narrow legal justice.
"Progressives" in this country at least are considered throw-back Conservatives in most of the rest of the world, and what passes for conservatism (which is really straight-out Corporatism) in this country is despised as basic, stripped-down Fascism elsewhere. Our Conservatives are akin to the traditional ruling juntas in Latin America -- a phase of their history that most of Latin America (Honduras excepted) is proud to have put behind them.
"Progressives" in this country are highly influenced by Libertarianism, and many so-called "Progressives" are in fact opportunistic Libertarians. Libertarianism tends to be a fringe right-wing political/social/economic cult rather than a functioning political/social/economic movement. It's at least partially derived from notions of the origins of the United States -- with many diversions over the utility of the Revolution (or was it "really" a Revolution?), arguments over the meaning of the Constitution, sometimes advocacy of a revival of the pre-Constitutional confederacy, etc.
It's been said that Libertarians are Republicans who smoke dope and have lots of sex; "Progressives" could be said to be Libertarians who have a rudimentary social conscience.
Social Democrats are Mutualists (yes, yes, I know, they were "collectivists" back in the day, but those days are gone, and the structure of Marxism as it used to be implemented ain't coming back.) "Progressives," on the other hand, are fierce Individualists, each one an island unto itself. Social Democrats consolidate and agree -- and move forward; "Progressives" split off, atomize, disagree, argue endlessly -- and stand still. Not even incremental progress -- except as individuals accumulating notice, power and treasure unto themselves.
They are not "Leftists." Not even remotely.
We see how anti-Leftist they are in the current antipathy toward the Health Care Reform bills now being finalized. They are, of course, not opposed to Health Care Reform per se, they're just opposed to paying for it, specifically they are opposed to being compelled to pay for insurance they are convinced they will never use, or if they do use it, they won't receive the coverage or treatment they believe is their due. And they are deeply resentful of having to pay anything toward anyone else's health care expenses, such as by being taxed to support the subsidies that are supposed to go to less-well-off Americans to make this "junk insurance" they will be forced to buy "affordable."
They want a Public Option, they say. Something that is never quite defined -- much like "Progressive" itself -- but which is an idea marketed as a government operated alternative to the private insurance market. But what, exactly, that is supposed to be is anybody's guess.
Social Democrats, real Leftists, don't bother with the bullshit of exchanges and markets and options and choices and menus and whatnot when it comes to Health Care Reform. They just go right to the point: what used to be called "Single Payer" (which ultimately was gibberish except to initiates) but is now known as "Medicare for All" -- which people understand.
All the "Progressive" argument over the Public Option is just argument for its own sake. It won't get you where you need to be on the one hand, and it's not going to happen anyway on the other. It never was. It was and is a Chimera.
And yet "Progressives" are obsessed with it.
They drop-kicked any interest in Single Payer/Medicare for All before the contest even began because they were told, and they believed, that there was no way to move a Medicare for All program through the Congress, and the Public Option was the preferred alternative of the Powers That Be. Only it turned out not to be true. The PTB wanted nothing to do with a Public Option -- except, perhaps, as a shiny object to keep the "Progressives" entertained.
Now that the Public Option has failed utterly -- in fact, everything the "Progressives" wanted and advocated for has been stripped from the Senate bill -- some "Progressives" (calling themselves Principled!) are tentatively getting on the Medicare For All bandwagon, saying that's what they always wanted anyway, they did, really, yep.
Meanwhile hurling barrages of insults at all and sundry for questioning their motives and their judgement and hooking up with the most reactionary elements in the political firmament to "resist" whatever is coming out of the Sausage Factory.
OK, then.
Social Democrats have always been fully in favor of a Single Payer/Medicare For All health care reform, modeled on the health care programs in Europe -- where Social Democrats got this thing done ages ago -- and have never wavered, never had any interest in the shiny objects the Corporatists and HCI lobbyists have been tossing out like candy.
It doesn't matter whether you can "move" the legislation to implement it through Congress, at least not in the short term. You start with the principles you believe in and you stick to them, you do not waver or advocate for an alternative (and suppress what you "really" want) in the hopes of getting where you "really" want to be in the bye and bye.
You may have to get where you want to be piecemeal, which is why a Social Democrat may be able to accept what comes out of the Sausage Factory -- without a Public Option, and without supporting the bill.
Why? Simple: as odious as the straight out give aways to the Industry are, Bernie Sanders (a Social Democrat) has managed to put in a provision for the establishment and support of thousands, ultimately more than ten thousand, public health clinics open to all comers, insured or not insured, to provide routine health care to the to those who currently cannot get it.
THAT is a STEP toward correcting the flaws in our health care delivery system, expanding access to CARE -- which is the fundamental problem -- which could lead to the establishment of a rational nationwide health care system serving all Americans.
Hm. What a concept.
The mind boggles.
Yes, the giveaways to Industry are odious. The individual mandate to buy "crap insurance" -- if that's what the mandate actually turns out to be -- may indeed spark legitimate resistance. If the reform that passes causes a sudden widespread reduction of coverage at a significantly higher price to the masses, there will be a strong reaction.
On the other hand, if it provides access to care that was otherwise unavailable, if it provides some mechanism to curb the extraordinary inflation in health care costs (a mechanism not discernible from this vantage point), and if it provides some tangible benefit to substantial numbers of Americans then the reaction won't be any worse than that to Medicare Part D.
Which is what I think our Corporatist-serving government is angling for.
We'll see.
And then we have the whole issue of transforming the Corporatist-serving government into one that serves The People.
A whole nother kettle of fish.
The premise of Social Democracy is that the People are ultimately sovereign over all issues, political, social, and economic, and through their employment of strong Democratic institutions, they are able to set and direct political, social, and economic policies in their mutual interest. Democracy doesn't always get things right, but if properly understood and employed, it can protect the weak from the depredations of the strong, it can mitigate the abuses inherent in unfettered Capitalism, and it can ensure fair and equitable economic and social as well as narrow legal justice.
"Progressives" in this country at least are considered throw-back Conservatives in most of the rest of the world, and what passes for conservatism (which is really straight-out Corporatism) in this country is despised as basic, stripped-down Fascism elsewhere. Our Conservatives are akin to the traditional ruling juntas in Latin America -- a phase of their history that most of Latin America (Honduras excepted) is proud to have put behind them.
"Progressives" in this country are highly influenced by Libertarianism, and many so-called "Progressives" are in fact opportunistic Libertarians. Libertarianism tends to be a fringe right-wing political/social/economic cult rather than a functioning political/social/economic movement. It's at least partially derived from notions of the origins of the United States -- with many diversions over the utility of the Revolution (or was it "really" a Revolution?), arguments over the meaning of the Constitution, sometimes advocacy of a revival of the pre-Constitutional confederacy, etc.
It's been said that Libertarians are Republicans who smoke dope and have lots of sex; "Progressives" could be said to be Libertarians who have a rudimentary social conscience.
Social Democrats are Mutualists (yes, yes, I know, they were "collectivists" back in the day, but those days are gone, and the structure of Marxism as it used to be implemented ain't coming back.) "Progressives," on the other hand, are fierce Individualists, each one an island unto itself. Social Democrats consolidate and agree -- and move forward; "Progressives" split off, atomize, disagree, argue endlessly -- and stand still. Not even incremental progress -- except as individuals accumulating notice, power and treasure unto themselves.
They are not "Leftists." Not even remotely.
We see how anti-Leftist they are in the current antipathy toward the Health Care Reform bills now being finalized. They are, of course, not opposed to Health Care Reform per se, they're just opposed to paying for it, specifically they are opposed to being compelled to pay for insurance they are convinced they will never use, or if they do use it, they won't receive the coverage or treatment they believe is their due. And they are deeply resentful of having to pay anything toward anyone else's health care expenses, such as by being taxed to support the subsidies that are supposed to go to less-well-off Americans to make this "junk insurance" they will be forced to buy "affordable."
They want a Public Option, they say. Something that is never quite defined -- much like "Progressive" itself -- but which is an idea marketed as a government operated alternative to the private insurance market. But what, exactly, that is supposed to be is anybody's guess.
Social Democrats, real Leftists, don't bother with the bullshit of exchanges and markets and options and choices and menus and whatnot when it comes to Health Care Reform. They just go right to the point: what used to be called "Single Payer" (which ultimately was gibberish except to initiates) but is now known as "Medicare for All" -- which people understand.
All the "Progressive" argument over the Public Option is just argument for its own sake. It won't get you where you need to be on the one hand, and it's not going to happen anyway on the other. It never was. It was and is a Chimera.
And yet "Progressives" are obsessed with it.
They drop-kicked any interest in Single Payer/Medicare for All before the contest even began because they were told, and they believed, that there was no way to move a Medicare for All program through the Congress, and the Public Option was the preferred alternative of the Powers That Be. Only it turned out not to be true. The PTB wanted nothing to do with a Public Option -- except, perhaps, as a shiny object to keep the "Progressives" entertained.
Now that the Public Option has failed utterly -- in fact, everything the "Progressives" wanted and advocated for has been stripped from the Senate bill -- some "Progressives" (calling themselves Principled!) are tentatively getting on the Medicare For All bandwagon, saying that's what they always wanted anyway, they did, really, yep.
Meanwhile hurling barrages of insults at all and sundry for questioning their motives and their judgement and hooking up with the most reactionary elements in the political firmament to "resist" whatever is coming out of the Sausage Factory.
OK, then.
Social Democrats have always been fully in favor of a Single Payer/Medicare For All health care reform, modeled on the health care programs in Europe -- where Social Democrats got this thing done ages ago -- and have never wavered, never had any interest in the shiny objects the Corporatists and HCI lobbyists have been tossing out like candy.
It doesn't matter whether you can "move" the legislation to implement it through Congress, at least not in the short term. You start with the principles you believe in and you stick to them, you do not waver or advocate for an alternative (and suppress what you "really" want) in the hopes of getting where you "really" want to be in the bye and bye.
You may have to get where you want to be piecemeal, which is why a Social Democrat may be able to accept what comes out of the Sausage Factory -- without a Public Option, and without supporting the bill.
Why? Simple: as odious as the straight out give aways to the Industry are, Bernie Sanders (a Social Democrat) has managed to put in a provision for the establishment and support of thousands, ultimately more than ten thousand, public health clinics open to all comers, insured or not insured, to provide routine health care to the to those who currently cannot get it.
THAT is a STEP toward correcting the flaws in our health care delivery system, expanding access to CARE -- which is the fundamental problem -- which could lead to the establishment of a rational nationwide health care system serving all Americans.
Hm. What a concept.
The mind boggles.
Yes, the giveaways to Industry are odious. The individual mandate to buy "crap insurance" -- if that's what the mandate actually turns out to be -- may indeed spark legitimate resistance. If the reform that passes causes a sudden widespread reduction of coverage at a significantly higher price to the masses, there will be a strong reaction.
On the other hand, if it provides access to care that was otherwise unavailable, if it provides some mechanism to curb the extraordinary inflation in health care costs (a mechanism not discernible from this vantage point), and if it provides some tangible benefit to substantial numbers of Americans then the reaction won't be any worse than that to Medicare Part D.
Which is what I think our Corporatist-serving government is angling for.
We'll see.
And then we have the whole issue of transforming the Corporatist-serving government into one that serves The People.
A whole nother kettle of fish.
Saturday, December 26, 2009
As I say
See More Dancing With The Stars (game & dance pad) Screenshot at IGN.comThe current crusade by Jane Hamsher and her Toad Prince Grover Norquist to shake up the complacency of the Powerful may or may not lead anywhere. You never know in advance where you'll wind up when you let the Rage get the better of Wisdom.
But.
The shake up is necessary. Regardless of anything else.
The United States has been in an alternating Neo-Con/Neo-Liberal spiral for decades. The People, for the most part, are simply left out of the equation altogether -- except to the extent they can be manipulated by the Professional Persuaders to back one or the other ill-defined set of thieves and mountebanks.
The point is, these are the only choices we are allowed, politically: Neo-Con or Neo-Liberal. Neo-Con governments are suited to smash-and-grab tactics, whether on the economic or the international relations front. Wars, rapine, looting, pillage. That sort of thing. Neo-Liberal governments are suited to the consolidation and institutionalization of the ill-gotten gains of the Neo-Cons. Making permanent, for example, the Imperial Autocracy by which we are ruled -- on behalf of a contracting Plutocracy of inestimable greed and bad intent.
It's a near perfect arrangement. For the Winners.
As I say, the alternation between these two governing philosophies (if you want to call them that) has gone on for decades, and the celebrations of the Peaceful Transitions of Power we've witnessed are celebrations of one faction of the Ruling Class yielding temporarily to the other in a kind of Cosmic Dance. But they are the only two dancers.
You and I aren't even allowed to watch most of what's Really Going On. That's part of why there is such a growing disconnect between the Ruled and their Rulers. "WTF?" is becoming the standard phrase among The People with regard to their Government.
How do you translate that into Action? In fact, what we've witnessed over the years is near total apathy among the public on the one hand and unfocused rage and scapegoating on the other.
Since the collapse of Communism, there really has been no large-scale political/economic force or ideology that can serve as a brake on the worst impulses of a corrupt and nearly unfettered Capitalist/Fascist Globalist Empire.
It's all up to Independent-Minded Individuals.
So, of course, the response of Independent-Minded Individuals to the all-pervading Imperial State is to throw bombs -- or become bombs, whatever. They do it physically or metaphorically, but they do it because it is the only weapon they think they have.
The Star Wars trilogy was all about Independent-Minded Individuals fighting for their "freedom" from the clutches of the Empire...
And of course that's the fundamental mythology of the founding of our own Beloved Country.
Except that it never quite turns out the way the Idealists insist it should.
In our own case, for example, the Intrepid Individualists who founded this country did so on the basis of limited franchise, chattel slavery, genocide, and the extraction of ulimited natural resources. They also did so on the basis of founding a new Empire of their own.
Where we are now is what was built in to the Systems they created.
So it's only natural that people like Ron Paul demand a restart. This is not, at all, the way the Revolution and Founding were marketed. No. No, it isn't. But, anyone who was paying attention back in the day should have been able to see and chart pretty well the course we'd be on.
Jane, et al, are not even at the point of demanding a restart. They don't really know what they want. They have discovered this tool they call "Power" and are eager to try it out on The Devil Himself, Rahm Emanuel.
They have no idea what to do if they "win."
There is no replacement on tap, there is no thought -- at least as far as we can tell -- of an alternate form of government or how it might operate, nor is there any coherent "Progressive" ideology or set of principles by which action and alternatives might be guided.
It's a purely personal endeavor to monkeywrench a governing process they (especially Jane) were not able to affect through advocacy.
See More Dancing With The Stars (game & dance pad) Screenshot at IGN.comAnd it is becoming a cult.
Yes, yes, I know, Obamamania is cultish, too. He's the Good Emperor after all. Dig back in your Roman history, and the notion of the Deified Good Emperor occurs really early in the transformation of Republic into the Empire. And so does the Goddess notion.
While a shakeup in the status quo is necessary, whether these actors can accomplish the deed remains to be seen. So far, the Powers That Be are studiously ignoring the rabble rousers, but then it's a Holiday, and everyone's busy. Snowed in. Whatever.
The notion of Rebellion for its own sake is very appealing to a segment of the population, however -- not just pimple-faced boys, either. And given the success of the Teabagger Rebellion in getting attention, there's now "permission" granted for "Progressives" to give it a shot. The principal first goal being the "attention." For some, I think it's the only goal. But that's my cynical nature kicking in.
As I've said, though, the Rebellion as it stands now is only about the pocketbooks of the bourgeoisie. That's the key to understanding the hookup between Jane and her Toad Prince Grover. They see that the Government is colluding in the private picking of their pockets (Grover has known this for ages of course) and they won't have it!
They're doing it with Health Care (Insurance) Reform, they're doing it with all the financial shenanigans, and they're doing it with Everything.
Yes? And?
Rahm is the Devil.
Yes? And?
HEADS! They demand HEADS!
O. K...
What. Ever.
When these people come up with a coherent "Progressive" philosophy, and reach an agreement widely across the social and some political divides in this country about what "Progressive" means, then I'll perk up.
Until then... Good Luck! Happy New Year!
Just remember. The Dance.
See More Dancing With The Stars (game & dance pad) Screenshot at IGN.com
Friday, December 25, 2009
Kali (Christmas)
Jane Hamsher over at Firedoglake is in full Kali Mode demanding HEADS right and left because she's been thwarted in her unfocused campaign on Health Care Reform.
She started the current phase of her operations with the demand for Hadassah Lieberman's head, and now she's hooked up with the odious right wing toad Grover Norquist to demand Rahm Emanuel's head. She wants Bernie Sanders' head. No doubt she'll go after Barbara Boxer's head. She wants Marcos's head. Arianna better watch her own head. Jane won't be satisfied in her current fury until she has Obama's head as well, you can be sure. And she won't be denied!
The unfocused Health Care Reform campaign turned into an epic "progressive" FAIL. Essentially nothing that "progressives" demanded (even when they could make coherent demands, and the Public Option was not one of them) made it into the Senate bill, and the House bill is so watered down, there's nothing much for "progressives" to crow about in it, either. "Everyone agrees" that the Senate bill, with a few minor tweaks, will be the final bill and Obama will sign it. Yay.
Well.
Jane and others have now shifted their campaign from "Public Option Please!" to "Kill the Bill" to complete and utter, scorched earth destruction.
Their issue is their pocketbooks. They have made very clear, just like Jane's Toad Prince Grover, that they don't want to pay for health care or health insurance if it's going to benefit anyone else. It's about the money. It's about their individualism. It's about themselves.
Jane has thrown a lot of chum in the water to attract Libertarians, and it seems she's done a remarkable job of it. Her site is a free-for-all of Libertarian cant and argumentation. And, oh yes, rebellion. "I won't pay! You can't make me!"
Rebellion. Revolt. Revolution! NOW!
Makes me laugh. When the Busheviks were essentially overthrowing the American Constitutional Republic and replacing it with an Imperial Autocracy, there was plenty of grumbling and argument from the Libertarians over the Bushevik program, but there was nary a hint of Rebellion let alone Revolution. In fact, whenever someone said something about it, the proctors would ritualistically shush any mention of active opposition. Now that the Busheviks are pushed to the side -- make no mistake, they're still around -- Libertarians are free to fantasize about any level of insurgency they choose. And if it directly affects their MONEY, they become the most active Rebels you ever saw. It's funny. In a sad sort of way.
The Busheviks were smart about how to handle this: Overthrow the Republic by all means, institute Imperial Rule, no problem. Make war all over the world. Just be sure you cut the taxes of the Rubes so they won't catch on they're being robbed.
And lookit! It worked.
Obama comes along with his neo-Liberal program and says, "You know, we gotta pay for this somehow, how about on the backs of the middle class?" and all holy hell breaks loose.
Of course I would have preferred the revolt to occur on the basis of principles of social justice and community, the Rule of Law, and the Constitution. You know? All the things that the Busheviks were trashing and trying to destroy? But no. Any hint of Rebellion in those days was rigorously denounced or shouted down. The ONLY way to make serious progress against the March of Empire was Incrementally -- and peacefully.
Now that the Imperium is consolidated and institutionalized, the issue isn't even germane. Few care, and those who do are pissing into the wind if they think they're actually going to make any headway against the Empire by hooking up with Grover. Ain't gonna happen.
But then, that's not the issue. The Rebellion is against mandated health care insurance.
You see. Priorities, people.
You'll shoot your eye out.
Wednesday, December 23, 2009
Incrementalism
The HCR debate has highlighted some real faultlines in American society, politics, and everything, and one of the murkiest faultlines is that between Incrementalism and Bold (sometimes called Revolutionary) Action.
(This oddly mirrors the cleavage between Uniformitarians and Catastrophists in Geology and Planetology back in the day, and we should return to that as a potential model for resolution anon.)
All through the Bush years, Incrementalism was touted on the so-called Progressive Internets as the Only Appropriate Response to Bushevik Radicalism. The very fact that the Busheviks were Radical and (counter)Revolutionary, especially in their foreign policies and their overthrow of the remnants of Constitutional law and so forth, was frequently denied or obscured by prominent Lefty bloggers (I'm looking at a very insouciant picture of Glenn as I write this) so as not to stir up the masses too much about what was going on. Or one supposes the rationale behind the Incrementalist fervor during the Bush years was simple self-protection.
After all, the Stasi was watching, and at any time, so the thinking went, the round ups could begin, starting with anyone and everyone spouting off against the Regime and calling for Revolution Now! There was one incident over at Glenn's that highlighted what THAT was about when Mona freaked over something I said: "Who should be first against the wall when the Revolution comes?"
O. M. G. You'd think the Marxist Cell that is the Greenwaldian patch of the Internets had been discovered. I'd used the quote before (it's from Hitchhiker's Guide to the Galaxy, c. 1972, and it has a long history in geeky comic lit. The quote from Hitchhiker's Guide runs as follows:
The Hitch Hiker's Guide to the Galaxy defines the marketing division of the Sirius Cybernetics Corporation as "a bunch of mindless jerks who'll be the first against the wall when the revolution comes," with a footnote to the effect that the editors would welcome applications from anyone interested in taking over the post of robotics correspondent.
Curiously enough, an edition of the Encyclopaedia Galactica that had the good fortune to fall through a time warp from a thousand years in the future defined the marketing division of the Sirius Cybernetics Corporation as "a bunch of mindless jerks who were the first against the wall when the revolution came."
And this has been making the rounds for decades. Yet both times I used the quote/idea in postings on the internets the proprietors and/or their agents (I've always considered Mona to be Glenn's lawyer -- of course she'd deny it!) have gone ape shit in fear that someone would break down their door at midnight and drag them and their family away to the Konzentrationslager forthwith.
For advocating "Revolution."
Honestly. The mind boggles.
When I explained it as patiently as I could to Mona (who claimed to be familiar with Hitchhiker's Guide, but then she lies), she still didn't get it and was convinced that certain key-words (Revolution, anyone?) would trigger NSA surveillance and shut-down of websites, in this case Glenn's. What was really curious about it to me was that none of these lawyer-types -- including Glenn -- was willing to risk that kind of trouble or oppose the imposition of the National Surveillance State despite their big shows of chest-beating and knuckledragging for blogospheric consumption. When I pointed out that the NSA surveillers were probably laughing their heads off at the stupidity of this exchange and noting well the utter failure of the lawyer-types to stand by the Freedoms they claim are so Important. No, instead, they eagerly serve the State Security and Surveillance Aparat. Ohhhh. Might be a clue there. Well.
At any rate, let's get back to my point, the cleavage between Internet Incrementalists and (What You Call Your) "Revolutionaries."
Nearly all the prominent so-called Progressive bloggers advocate Incrementalism as the only appropriate way to make and hold lasting political or any other change. You do it step-by-baby-step, slowly, bit-by-bit, over however long it takes, and you do not engage in or advocate sudden upheaval revolt or revolution of any kind. It's essentially a moral imperative.
Well. That is until there's Democratic control of Government.
All of a sudden, we have a thoroughgoing incrementalist regime in office, acting incrementally to mitigate the worst abuses of the Bushevik Regime just past, and Internet Progressives are not just dissatisfied, they're openly calling for Revolt -- if not outright Revolution. (Jane has surged to the fore on this front, my goodness she likes the attention almost as much as Holy Joe.)
My goodness. How did that happen?
Such a sudden transformation. Well, certain things are clear: they were literally terrified of crossing unstated boundaries in The Debate during the Bush years. They are fearless now. Apparently they believed there was a Real Threat from the Busheviks to round them all up -- if they said or did anything the State Security Aparat found the least bit threatening to the Program. So they worked overtime not to threaten in any way the Powers That Be, so as to -- one supposes -- preserve their Freedom of Expression. Without, obviously, understanding that their self-censorship put the lie to the whole "Freedom" enterprise.
Now that they believe there is no perceived threat from the State, under the Incrementalist and Mitigationist regime of Obama, they're free to say and advocate whatever they want, including Revolt and Revolution. And so they do. Over something that they fear will impact their pocketbooks negatively -- Health Care Reform legislation.
As one, they cry: "We won't Pay! You can't Make us!"
And Jane, for one, is busy cobbling together Progressive/Teabagger alliances, going on FOX and otherwise sticking hot pokers into the bloated Establishment. Not just shouting from the rooftops but manning the barricades and gathering pitchforks and torches. What a transformation.
When the issue is the pocketbook. And the State Security Apparat is perceived to be weakened.
Good to know.
So all you would-be Revolutionaries out there, strike when the Iron is Hot, bring down the oppressor when the State is weak and Incrementalism reigns on high.
Well, but here's the other thing. This HCR debate -- especially lately -- has brought out the Libertarian troops like I don't think we've seen since the Ron Paul Confederation and Delayed Uprising. They are Everywhere, declaring their fealty to Jane or whomever the Leader of the Moment will be, their adamant opposition to Authority and Convention (only applicable when the Stasi is on hiatus) and so on. It's quite a sight. "We won't Pay! You can't Make us!"
Of course, being Libertarians, they're actually not going to do anything -- except argue themselves to exhaustion, then turn on their putative Revolutionary Leader, whoever it winds up to be, and go back to hibernating or masquerading as Progressives until next they are aroused.
That's what Libertarians DO.
Nevertheless, the current state of Blogospheric hoo-hah does clarify just how deeply interwoven Libertarianism and Libertarians are in the whole so-called Progressive blog matrix. As I say, they are everywhere, asserting wildly and making furious demands, threatening and calling for revolt, resistance, and on the margins Revolution -- because they believe their Sacred Pocketbooks are threatened by Health Care Reform.
And they won't have it.
OK then.
Of course what's happening in the Real World is that the Obama regime is pushing that rock up the hill, step-by-baby-step, just as the the progressives on the net said had to be done for any lasting change to occur, and as flawed and faulty as the whole process is, it is oddly working. Mitigations are occurring. Very gradual Change is taking place. International relations are improving.
And so-called Progressives in the Blogosphere hate it. If they don't, they're obviously paid operatives of the Devil, Rahm Emanuel.
(Note to Rahm: I prefer payment in Gold Bullion. Thanks. You're a mensch.)
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