Available Care Act – Beyond “Coverage”

Much talk about insuring people for healthcare needs.  The giant bedpan in the room is availability.  What good is having Medicare, Medicaid, exchange plans, if you cannot find a doctor for hundreds of miles who will accept your provider’s coverage?  Just look.

The pundits talk about providing millions of people “access” to healthcare; however, they cannot explain why many of the “covered” still do what they did when they had no insurance, go the emergency room of the public hospital known to be the one that cannot turn them down.

Health insurers specify what they will cover and what the insured must pay, in terms of dollars and percentages.  What they do not spell out, is the amounts they are willing to pay the doctors and hospitals for various treatments.  The doctors and hospitals that are willing to accept the insurer’s terms are added to a “network.”  If the insured uses these doctors and hospitals, “in network,” the patient pays less; “out-of-network” providers, the insured pays much more.

Medicare, and the related private insurance plans are shunned by many healthcare providers because of the intense complexity of coding rules, poorer reimbursement rates, and 6-month slow-pay of claims.  I cannot blame them for wanting the easiest, most profitable patients, but look at what that does to retirees:  it shoves them into the offices of the newest, least experienced doctors, who do not have privileges at the best hospitals.

Another specious barrier doctors erect is “not accepting new patients.”  If that is true, why do they prominently promote their doctors, facilities, and services?  Why do they list the insurance plans they accept, on fancy websites?  What do they do when patients get well, move, change, outgrow their need, or die?  Who takes their places?  Are there waiting lists?  This policy seems wildly inconsistent, and dubious to me.

Today’s labyrinth of laws, maze of insurance coverages, intricacies of medical practice, incorporation of hospitals, vast array of medical devices, tests, and procedures, and incomprehensible myriads of drugs and medicines, are the starting point of future choices.  The concept of choosing your doctors, clinics, and hospitals still appeals to me.  If all health insurance policies must meet some minimum standards of coverage, why should health providers exclude any of them?

We have a historic opportunity to put features into the fabric of healthcare; the federal government has more incentives and flexibility to “get it right” as they formulate new laws.  Why not pass a new law called “The Available Care Act?”  If you accept anything except cash for medical services or goods, you accept the coverage of any patient who walks in your door.

 

Left’s War on Winners – Town Hell Meeting = Public Media Pillory

You read it right, “Town Hell Meeting;” the town hall meeting is the latest casualty in the left’s war on winners; turning plowshares into swords.  Politicians and public figures are targets of a recent tactic by their political enemies – “Public Media Pillories.”

Pillories were used to humiliate and torture people who were guilty of malfeasance, breaking taboos, or committing sins.  The pillory was usually a hinged wooden device, attached to a post; it held the head and hands of the subject locked in place.  The pillory was placed in the most public area of a town or village to get maximum exposure.

john_waller_in_pilloryCourtesy of Wikipedia

Once a person was placed in the pillory, they received no food or water; there were no bathroom breaks; the public was free to scorn, humiliate, & pelt them with organic and inorganic matter, sometimes killing them.

Today, vicious partisans employ a new form of pillory – the televised, town-hall ambush. Traditionally, town hall meetings were community gatherings, bringing together all the local citizens to discuss matters of public, common interest.  Yes, people discussed important topics using Robert’s Rules of Order.  http://www.robertsrules.org

The modern version has neither good intentions, decorum, nor civility.  Innocence plays no part in the deployment of this weapon.  Now, it is a form of political ambush.  Only foolish office holders attend public town hall meetings that are “public media pillories” in disguise.

The process goes like this:  Opposition partisans invite public figures saying, “we want to talk to you in an open forum,” when they really mean, “we want you to sponsor a media-covered, public event, where we will hound, berate, criticize, insult, accuse, interrupt, scream invectives, and attack you personally, without allowing you to express ideas, answer questions, or even be heard.”

Only the brave or the foolhardy accept their cleverly encoded, poison-pen invitation.  If you decline, they cast you as non-transparent, and postulate what you could be hiding.  If you accept, you find yourself trapped on a stage, with a microphone.  You are greeted by a standing- room-only crowd.  You are surrounded, not by a cross-section of the community, but by a cohort of angry enemies; some are not even members of the local community.

The hounds are loosed, the cameras capture the mayhem, and the air is filled with posters, chants, rants, and pithy aphorisms.  At some point, you shrug and walk off the stage, having only introduced yourself and thanked the people for “coming out.”

You may think it is over because you survived with all your body parts.  Alas, the torture has just begun; the editing and augmenting begin.

Before and after the meeting, the “reporters” identify photogenic, outraged attendees, recently-ousted office holders, and bussed-in opposition pundits.  They script interviews with everyone and anyone who hates you, and “the horse you rode in on.”  They use snippets and sound bites to punctuate the later broadcasts with righteous indignation, and proud assertions of having done a public good.

The masterful image-smiths design a “storyboard,” and use video tape, & sound bites to fulfill it.  When they are done, the town-hall meeting is a victory of good over evil at Armageddon.  They tailor the context, emphasize “talking points” to meet “breaking news” standards; they include hints that support the opposition, bolster conspiracy theories, and not so subtlety, deride your credibility as a public figure.

If you get invited to lead a “town hall” meeting, think “abattoir,” a spider’s parlor.  This use of the media has eliminated its community value, and weaponized its destructive power.

Democrat in Republican’s Clothing – George W. Bush

George W. Bush supported Hillary Clinton in the 2016 presidential election.  He has become an ersatz Republican elitist, who still thinks he is right to oppose President Trump.  He remains a sore loser, who did not get his way.  He is worse than the Democrats who continue to moan and groan because they lost the election.  George is a Democrat in Republican’s clothing.  It appears that his mission is not yet accomplished.

“Wolf in sheep’s clothing” is a term for something that seems innocent, but is a lethal enemy.  Nothing could be a worse disguised enemy than someone who pretends to be in the same political party, but who attacks the president, being not too careful in hiding his true feelings.

Who would want the return to elite political power more than GWB?  He was born, raised, and steeped in the rarified, upper echelons of the Republican party.

The Associated Press published part of a recent interview, at a book promotion in Simi, CA.  Bush asserted that receding from global interaction creates a vacuum that would be filled with “… people who don’t share the ideology, the same sense of human rights and human dignity and freedom that we do,”

On his assertion of what will fill vacuums:  Just exactly what countries does he mean?  Does he really think we have friends in every nation into which we pour money?  No, they still hate us, but they love our money.  Does he think adversarial ideology will take over Europe, Britain, Mexico, etcetera?  It must be much more complicated than I thought.

Whoever tries to fill the “vacuums” will do so at their financial peril.  Estimated total foreign aid by Russia and China combined was less than half of US expenditures.  If these evil forces had enough money, they would already have forced us to find other places to put our dollars.

What would be lost by focusing on our internal problems?  I read recently that our foreign aid expenditures total about 1% of our budget.  I also read that only 34% of our budget is discretionary.

http://www.politifact.com/truth-o-meter/statements/2015/aug/17/facebook-posts/pie-chart-federal-spending-circulating-internet-mi/

That means 1% is really 3% of our discretionary expenses.  With a total 2016 budget of about $4.15 trillion, $42.4 billion goes to “foreign assistance.”  (And everyone made a big deal about Trump’s proposed $54 billion increase in military spending; just 1.35% of the total budget.;)

In the interview, Bush stated that he, “… didn’t intend to criticize Trump when he said recently that a free press is essential to democracy. Trump has referred to the press as the “enemy of the people.” Bush said at the library, the nation needed an independent press, but added that it needs to be accurate.”

The “independent press” used to be 98% news, and 2% editorials; today, editorials are more like 50 to 100% from many sources on both the left and the right.  That changes the character of the press from providing information, to publishing propaganda.  This is an abuse of the public platform and audiences.  This is a perversion of journalism.

Wikipedia says, ” Journalism is the production and distribution of reports on the interaction of events, facts, ideas, and people that are the “news of the day,” and that informs society to, at least, some degree.”  Note that the word “reports” means relays, or conveys factual information about what happens, without interpretation.  Also note the chagrin of “at least some degree.”

Spin, commentary, opinions, editorials, exaggerations, conflation, are not reports.  Neither are unbalanced, “soft ball” interviews with only strongly opinionated, partisan, advocates or critics, selected to advance an ideological agenda.  (e.g. Fox, MSNBC, CNN) That is propaganda.

The BBC is the best example of journalism today.  They clearly delineate news from opinion, and entertainment.  Walter Cronkite is a shining example of the qualities of journalists, and the journalism of the past.  Persuasion is not the intent of true journalism.

What if a news source is not accurate, on purpose?  What if the “free press” is vicious, verging on hate speech?  What if their articles contain accurate facts, wrapped in overwhelming opinions, “newspeak,” “analysis,” and commentary that is clearly inaccurate, subjective, and savagely slanted in scope and innuendo?  What do you call an organization that is staunchly, and consistently opposed to the elected government of the USA, almost to the point of sedition, subversion, insurgence, even insurrection?  What kind of “free press” pounces on, and amplifies every mistake?  What good is a free press that fearfully, and angrily projects, and postulates every possible, negative, future outcome of executive proposals?  Does a free press overlook, denigrate, and downplay every positive possible scenario to extinction, or discredit?

I appreciate GWB’s talent as a painter; he was president during the most shocking attack on American soil since WW II.  His standard-issue ideas, elitist disloyalty, and blindness to the enemy within is not what we need right now.  We do not need disgruntled words from a veteran patrician.  But I do not mean to criticize him.