Posts Tagged ‘health care’

Gorilla Returns

Wednesday, November 11th, 2009

Gorilla apologizes to readers for the lengthy delay in resuming his blog. He enjoyed his time Down Under and decided to take another week to readjust to whatever time zone he’s now in.

Here’s a summary of what Gorilla thought about events of the last 3 weeks:

Health Care Reform: A bill passed the House which does very little about health care reform, as Gorilla predicted some time ago. Action is now awaited from the Senate, and it’s still an open question whether any bill will pass at all. Once that’s not accomplished, it’s on to the conference committee, where everyone will declare victory. The basic problems remain: the stupid tie between health care and employment, the lack of efficiency studies of medical treatments, the failure to insure everyone, the continued hostility towards women, and the inability to gore the major oxen of the medical-industrial complex. The easiest solution, single payer via Medicare, was never on the table. Gorilla thinks: “When disfunctionality is disguised as progress, there’s nothing much to look forward to!”

Shooters and Snipers: Fort Hood gets shot up and the Beltway Sniper gets it in the arm. There remains no serious discussion about gun control in the United States so these sorts of incidents, entirely preventable, will continue. The Fort Hood massacre revealed yet again just how much racism and religious hatred lies beneath the surface of the American Way. Gorilla suggests: “It’s a god and guns thing, cling and bring!”

US Economy: Unemployment tops 10%. There’s a huge need for more stimulus and a national jobs program, and absolutely no chance of either. Democrats are likely to pay the price for their timidity in 2010. There’s little evidence that genuine, non-subsidized, non-inventory oriented economic growth will resume anytime soon. It may take a decade to restore the unemployment rate to a merely exasperating level. Once again, there’s no leadership and no appetite for shared sacrifice. Gorilla asks: “Senator, can you spare a yuan?”

Afghanistan: It’s clear the Administration intends to increase troop numbers. There’s still no exit strategy, just a holding action that could last longer than the Korean War. What remains astonishing is the ability of a few thousand fifth-rate terrorists to keep a superpower cowering for years on end. Gorilla concludes: “We bin Laden in the bushes far too long!”

Pakistan/China/Korea/Iraq/Honduras/Russia: Plus ca change, or as Gorilla would have it: “The mem I chose remains the same!”

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TGIF And Predictions

Friday, October 16th, 2009

This was what mattered most in Gorilla’s world this week:

*The march for LGBT equality continues. Equal justice under the law may take another decade, but it’s clear this will not go away. Gorilla thinks we’ll start with Don’t Ask, Don’t Tell, get rid of DOMA, and get a civil rights bill through Congress by 2020.

*Bilateral negotiations with Iran seem inevitable. After Hillary Clinton’s trip to Russia, it’s clear that the ball’s now in our court; there’s no support for further sanctions short of an Iranian refusal to negotiate. Gorilla thinks Hillary will be landing in Tehran by the end of 2010.

*Health care reform made it out of the Finance Committee and should be passed by the Senate soon. The Senate bills are all woefully inadequate, and there’s no guarantee that the public option will survive. Gorilla believes you could see this as a down payment on further reform, but he’s more convinced there’s no real momentum to avoid the bigger balloon payment before 2015-2020.

*America’s educational system continues to fail its students. The mathematics test scores were appalling and inexcusable. Gorilla has little confidence things will improve soon, for the same reason he has little faith in health care reform: goring vested interest oxen is not a pleasant occupation for any politician.

*The world grows hungrier. Gorilla doesn’t see much solution to this until we, the Japanese, and the EU are willing to give up our amoral and unnecessary farm subsidies. More Doha and less dough will make America more of a beacon to the poor and hungry.

*Afghanistan looks ever more like a quagmire. The fraudulent election produced the result we wanted, but not in the way we wanted. It appears the President will throw in more troops, with no clear strategy. Pakistan, where the threat of extremism is far greater than in Kabul, is descending into chaos at nearly as fast a rate, but we can’t do anything much about it. Gorilla still believes we’ll be on our way out by the end of 2010.

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Taxing The Cadillac

Tuesday, October 13th, 2009

Health care reform? Surely you jest!

This week’s snafu is about taxing so-called Cadillac plans, that is those that cost families and/or employers more than $20,000/year.

It’s a good way to raise money to pay for reform, and it’s a good way to discourage insurance companies from offering expensive plans.

But it’s not popular with labor unions, Know Nothing anti-taxers, and some House Democrats.

What this shows, yet again, is the stupidity of the link between employment and health insurance. Employers get big tax breaks for offering the insurance, while employees are shielded from the true cost of health care.

Rather than simply provide insurance to all, regardless of employment status, via Medicare, a far more cost effective solution, the “debate” at present is essentially about how much profit and how much cherry picking the insurance companies can get away with. It’s certainly not reform.

Gorilla says: “We taxpayers already own Cadillac, so why not take ownership of health insurance plans as well?”

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TGIF And Predictions

Friday, October 9th, 2009

These were the events of importance in Gorilla’s world this week:

*The rethink about Afghanistan goes on. The Administration is caught between a rock (Afghanistan is sinking back into civil war) and a hard place (the terrorists we want to stop aren’t in Afghanistan, they’re in Pakistan and we can’t just go get ‘em). Gorilla believes there will be a few more troops announced, so as to quiet the Know Nothing Party, but that we’ll be on the road to withdrawl by the end of 2010.

*The US economy remains stalled. Many believe the bottom has been hit, but unemployment remains high (and will likely rise), the housing crash goes on (a wave of foreclosures in both residential and CRE is coming), and the need for lots more stimulus, particularly an extension of benefits and aid to the states, remains acute. Gorilla thinks our leaders are pissing into the wind, but eventually they’ll get around to doing something useful in terms of direct stimulus (and wasteful in terms of more tax cuts) before the year is out.

*The UN’s climate change talks are stalled. The US is not really serious about climate change. Beyond the rhetoric, there just aren’t the votes in Congress for a carbon tax, which would be the quickest way to reduce global warming and encourage alternative technologies. This also benefits our fellow polluters in China and the EU, since they don’t have to do anything serious until we do. Gorilla suggests that even cap and trade is a political non-starter and nothing much will be done on the issue over the next 12-18 months.

*Health care reform moves slowly but surely to the end game. The newest gimmick, an opt-out for states from a national public insurance option, may finally get something passed, but the fact remains that these plans do not cover all Americans and do nothing very much about containing the power and expense of insurance companies, doctors, and Big Pharma. Gorilla says there’ll be a bill, with some kind of phony public option, and we’ll really get around to doing something more serious about health care in 2015-20.

*Barack Obama won the Nobel Peace Prize. It’s a good thing for America, although the Know Nothing Party will no doubt experience apoplexy. Gorilla believes the neocon era of unilateralism, fear and greed is drawing to a close, but is not certain that peace per se will be the replacement; it’s a complicated world.

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Only 25 Million To Go

Thursday, October 8th, 2009

Huzzah, the Senate Finance health care reform bill gets a good score from CBO

And 25 million Americans would remain uninsured.

And there’s no public insurance option.

And it keeps the stupid link between employment and health insurance.

And it doesn’t require all businesses to participate.

And it doesn’t include higher payments to doctors under Medicare, or a trigger that would stop a 15% reduction down the road in government funding to insure the poor.

In other words, it’s not reform, it’s not health care for all, it’s what happens when an amoral Congress congratulates itself for keeping 25 million Americans uninsured and costs down over the next 10 years by spending the equivalent of 18 months of the Pentagon’s current budget.

Gorilla says: “You can call it sausage making, better hope you don’t get trichinosis!”

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The Trip To Woeful

Monday, October 5th, 2009

Paul Krugman provides a good excerpt about how the stimulus package was crafted, taken from the recent New Yorker article about Larry Summers.

As pretty much anyone with a brain and a smattering of economics 101 could have told you, the stimulus package was way too small and contained too many stupid, ineffective tax cuts.

Prognosticating White House geniuses like Summers once again missed the boat: the economy’s doing far worse than they thought it would.

Practically speaking, the Administration negotiated with itself, put in an opening bid that was far too low, and got less than half of what was needed from the Congress.

This woefully inadequate stimulus will be mostly spent out by the end of next year, and the Administration will be blamed when unemployment remains high and the economy remains stuck in neutral. A few hundred billion is small beer when the output gap is on the order of $4 trillion.

The same thing happened with respect to health care.

The simplest, most sensible solution, bringing everyone into Medicare and getting some control at last over things like the insurance companies, absurd patent protections for Big Pharma, and ridiculously high salaries for a closed shop union of doctors, was seen as too radical and discarded before the first bill was even drafted. What’s coming to pass from the Congressional sausage machine is very much nothing.

The time to be bold was in the first 2 months of the Administration. Obama will never again be as popular as he was then, nor will America be as hungry for decisive leadership after 8 years of total failure.

But the President decided to be cautious and inclusive, got absolutely nothing for it, and appears at present to be little better than a more eloquent version of Jimmy Carter.

One hopes that Movingforwardville will wake up, get serious and lead, but the overwhelming evidence is that Goingbackwardville still rules the roost when it comes to actual policies, from state secrets to Wall Street non-regulation to kicking the can down the road.

Gorilla observes: “The tragedy is that the stakes are very high, but the gamblers are very small!”

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Too Many Peanuts For The Elephant

Monday, October 5th, 2009

Getting more people into Medicaid may cost the states $30 billion in the next 10 years!

Heavens, more poor people getting benefits from a government program, you just know the Republicans won’t like it!!!

Sounds terrible, until you recall that the states themselves will be spending nearly $30 trillion over the next 10 years, making the additional cost of Medicaid roughly 0.1% of their budget outlays.

Incidentally, or perhaps coincidentally, another GOP favorite bugaboo, the cost of medical malpractice insurance, amounts to less than 0.5% of American health care costs. Total cost of malpractice in the US amounts to 2 percent of annual health care spending.

Gorilla thinks: “It’s hard to know which elephant will choke first on these peanuts: the one who hates the poor or the one who loves the rich!”

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TGIF And Predictions

Friday, October 2nd, 2009

These were the events that mattered in Gorilla’s world this week:

*Health care reform went nowhere in the US Senate. There’ll be a bill of some kind passed, but it won’t be much more than window dressing. Most people will continue being satisfied with their health insurance until they lose their jobs or get sick. Gorilla thinks a golden opportunity has been blown, but remains confident we’ll eventually do something serious when the bill really comes due in 10-15 years.

*The US economy remains dead in the water. In Goingbackwardville, the banks still haven’t come clean and unemployment is approaching 10%. The stimulus is the only thing keeping Movingforwardville slightly upright. There’s a desperate need for more stimulus, but there’s also a total lack of political leadership. Short of the unemployed retraining to become Olympic athletes or bank regulators, Gorilla believes the economy will not begin to come off a non-inventory building bottom until 2011 or 2012. Unemployment will stay high for a decade.

*A new fossil was found that pushes human evolution even further back than originally thought. Gorilla suggests that the evolution away from religion may take a bit longer.

*The US and Iran finally engaged in bilateral negotiations. President Obama played his hand very well. Gorilla thinks the deals will be coming thick and fast over the next 12-18 months, and foresees a time when we will treat the Middle East filling station like we now treat Africa.

*The Chinese celebrated 60 years of the East being Red. Gorilla doubts there will be such a ceremony in 2049.

*Honduras continues the dance of the idiot politicians. These were joined on Friday by a delegation of our idiot politicians, who seem to think that military coups and the suspension of civil liberties are ok. Gorilla believes this will be resolved at the next election, when Honduras will choose a new idiot and Senator DeMint will remain an old idiot.

*General McChrystal submitted his new plan for Afghanistan, which is essentially the old plan with a few more troops and trainers. Gorilla believes we’ll be on the way out within 12 months.

*The Irish voted on the EU Treaty and the 2016 Olympics were awarded to Brazil. Gorilla thinks this would not make any more difference if it was the other way round.

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Swiss Cheese

Thursday, October 1st, 2009

Yet another comparison to foreign health care systems, all of which are cheaper, all of which provide universal coverage, and all of which have better health care outcomes.

These comparisons are useful, but they consistently ignore American political reality: the insurance companies, like the rest of the medical-industrial complex, own the Congress and are not about to give up the profits that come with cherry picking the healthy and avoiding the sick.

The New York Times suggests that the Swiss approach to health care might be a good model for America.

But there’s a problem:

The basic universal coverage offered to all Swiss citizens must be on a nonprofit basis. Insurance companies can make profit only on supplemental plans that provide more services and choices to patients.

Oh, and the patients pay for their coverage. 100% of the premium.

So, what are the chances that Americans would agree to shoulder all of the costs of their health insurance?

Or that American insurance companies would agree to forgo all profits on basic universal coverage?

Gorilla says: “About as likely as the Swiss abandoning the watch business!”

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Insuring Women Remain Second Class Citizens

Tuesday, September 29th, 2009

Although they are in the majority, women remain second-class citizens when it comes to exercising their legal right to abortion.

The desire of men to control women and their bodies is as old as the hills, and it remains deeply stupid, deeply depraved, and deeply troubling.

The latest round of abortion absurdity comes over health care reform.

No public funds shall be used to subsidize insurance policies that might lead to policyholders getting an abortion!

Much better that women have no freedom of choice whenever they decide to die painfully!!!

Gorilla says: “Misogyny loves company!”

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