This study has a good graph showing how people in high deductible health plans forego or delay care. It also notes that the incidence of foregoing and delaying care goes up as the poverty of the individual increases. Conclusion: HDHP’s are making access to care even more challenging for the poor. I would like to see how the Affordable Health Care act plans to remedy this.
Brita Rose at Common Dreams reports on the community response to Hurricane Sandy.
Light After the Storm – Local Churches Partner with Occupy Sandy in Grass Roots Relief Efforts
by Brita Rose
It was a beautiful sight — throngs of volunteers lining up outside a local church on Sunday, Day Five of the local recovery initiative spearheaded by Occupy Sandy. The number of willing helpers had tripled over the last three days alone, a response as dizzying as it was encouraging for the coordinators at the relief hub in St. Jacobi Lutheran Church in Sunset Park, Brooklyn, New York.
Occupy Sandy is an offshoot of the Occupy Movement, which, until now was by some pundits given up for dead. In collaboration with Occupy Sunset Park, 350.org, recovers.org and interoccupy.net, it emerged to meet the essential needs of storm victims while larger charities were already turning away willing volunteers, just a few days after the storm. It began organizing local relief efforts so that supplies could be immediately sent to the most devastated areas — beginning with Red Hook and The Rockaways. To their own surprise the Occupy activists found themselves doing so with an efficiency and speed that was sometimes outpacing government relief organizations. While the latter focused on essential infrastructure — pumping out subway stations and restoring transportation and power — independent groups were able to reach isolated areas by building community solidarity and mutual aid on the local level. Both entities were needed, as was becoming ever more apparent.
Lots of talk about the middle class. Tax cuts for the middle class. Saving the middle class. Doing more for the middle class.
Not one word about poverty.
No mention that nearly 25% of the children in the world's richest nation live in poverty.
Not one word.
That’s a seventy-year-old sidewalk laid down by WPA workers in the Great Depression. Still sound, like a lot of the infrastructure work done then.
The New York Times business section puts in simple terms why stimulus money used wisely on needed repairs is smart policy…
Millions of Americans remain out of work only because employers can already produce more than enough to meet depressed demand. The obvious remedy is to increase total spending. Although economic stimulus has become a controversial topic in the abstract, a few simple observations should persuade every sensible legislator — perhaps even a majority! — to support a specific type of higher spending: accelerated refurbishment of our crumbling infrastructure.
Some in Congress have consistently opposed the president’s infrastructure proposals, citing the huge national debt. But that’s an incoherent objection. If repairs to the Capitol dome or a tattered stretch of interstate highway are postponed, they will just become more costly. Many job seekers have the skills for this work. If we wait, we’ll have to bid them away from other tasks. The required materials are cheaper now than they will ever be. And interest rates are at record lows.
Of course, the debt is an important long-run problem, but deferring infrastructure repairs will only worsen it. Relative to current policy, then, such projects would address multiple pressing problems without distress.
Pumping up consumption while neglecting essentials just means that the car we bought on credit gets dinged in the pothole we didn’t fix.
It’s true, Americans want jobs, but when we get past the desperate stage we want work that matters. The WPA created both jobs and useful work. Why not build on what we learned then at such cost?
When you have a personal relationship with The Omniscient are you ever tempted to ask for an inside stock tip?
From The Guardian UK–
News Corporation made a loss of $1.6bn (£1.2bn) in the last quarter as it absorbed $2.8bn in charges related to a plan to spin off its ailing publishing businesses.
The loss compared with a profit of $683m in the same period a year ago and came as revenues dipped 6.7% to $8.4bn, hit by a slide in audiences for TV shows including American Idol and disappointment at the box office for its Hollywood studio. The results were below analysts’ expectations and the company’s shares fell in after-hours trading.
The fourth-quarter loss was linked “most significantly” to poor performances at News Corp’s Australian publishing assets, the company said.
News Corp announced plans last month to split off its publishing assets including the Wall Street Journal, the Times and the Sun in the UK, and its Australian newspapers from the more lucrative film and television assets including Fox Broadcasting, the Twentieth Century Fox studios and its stake in BSkyB.
The move comes in the wake of the phone-hacking scandal that has led to a sprawling criminal investigation in Britain and has triggered an investigation in the US under the Foreign Corrupt Practices Act.
And this right after the Church sold all its stock in Newscorp. Coincidence? I think not.
Pericles at Daily Kos has an amusing and enlightening history of shaving and capitalism.
So instead, the market has gone two ways. The mass market has kept research labs busy churning out phony “improvements” that generate market-protecting patents and give advertisers something to work with. And vast amounts of money have been spent persuading men (successfully!) that there’s something new worth paying up for and something primitive about the double-edged safety razor.
For men who have caught on to that game, a connoisseur market sells expensive shaving paraphernalia to bolster an overclass identity. So whether you’re a mass-market Gillette-Fusion-type guy or a connoisseur wielding a buffalo-horn-handle Damascus-steel-blade straight razor, you support a market with high profit margins.
What worries me is that I see exactly the same dynamic in the pharmaceutical industry. It takes a huge investment in time, money and expertise– with big risk– to patent a new drug that actually cures something, or even is measurably better than older, cheaper drugs. That’s why you see existing drugs marketed in new forms– gel caps, dissolvable tabs– or new drugs that are almost the same as older ones in the same class.
Letting the free market lead is harmless enough when it produces a ten-blade disposable razor. When it comes to things that really matter, novelty does not reign supreme.
There is a Libertarian argument that the body is a commodity and hey, why not sell a kidney? You do some good and can get access to things that poor people don’t normally deserve, like a college education for their kids.
No surgery, not even a tonsillectomy, is risk-free, as this tragic story shows…
(CNN) — When Manuel Reyna developed a deadly kidney disease, his sister, Florinda Gotcher, didn’t hesitate to give him one of her kidneys. When she found out they were a match, she cried.
“She was so happy,” remembers Gotcher’s daughter, Melinda Williams. “She was overwhelmed that she was able to save her brother’s life.”
Williams said her mother didn’t worry about the risks of surgery. Statistically, kidney donor surgery is considered to be very safe: in 2010, the year before Gotcher’s surgery, 6,276 people donated a kidney, and none of them died within 30 days of the surgery.
Her laparoscopic surgery went well, but about 30 minutes afterwards in the recovery room, she took a mysterious turn for the worse.
Someone raised a question that sent me on a search– what happens to the altruistic kidney donor if they find themselves uninsured and suffering ominous symptoms in the remaining kidney? The answer is disturbing.
There is a large support system for insured people with kidney disease who need a transplant. But for donors who fall out of the social safety net there’s not much out there. The system is set up for people in dire need of transplant or dialysis, but not for prevention of disease in people still healthy. Medicare disability is available for people with end-stage renal disease. The reason that this particular condition is covered is an intersection of science and politics going back a generation…
In the 1960s, in addition to dialysis, kidney transplantation was emerging as a treatment for chronic renal failure. The two therapies interacted in both complementary and competitive ways, each following its own developmental pathway. Though initially greeted with skepticism by many in the medical establishment, these therapies had demonstrated their clinical effectiveness by the mid-1960s.
Clyde Shields, the First Patient with Chronic Kidney Disease to Undergo Dialysis, University of Washington, 1960.
Both lifesaving treatments were costly — beyond the means of most individuals — and not covered by insurance. In Seattle, in response to financial limitations, access to dialysis was restricted through explicit rationing carried out by an anonymous lay committee — an approach that was laid bare for the American public in a Life magazine article in November 1962. Elsewhere, decisions limiting access to dialysis were tacitly incorporated into traditional medical decision making. Dialysis highlighted the tragic choices that had to be made when fundamental societal values encountered problems of scarcity.
Dialysis and transplantation have saved many lives. The lack of investment in prevention, however, has left a huge gap. Diabetes is epidemic, putting thousands on a downward slide to kidney failure. Diabetes can come on gradually, and do a lot of damage before it is diagnosed. The hard-working uninsured American, who is maxed-out on work and family responsibilities is the person who won’t get the inexpensive care to stay healthy. But when they reach end-stage renal failure– Medicare is there.
The funding supports a network of doctors and treatment centers. This is a huge benefit to their patients. Not all kidney disease is preventable, and saving lives is a public good. Universal health care would extend that good to people still healthy and reduce the need for expensive, high-tech treatments like dialysis and transplantation. Keeping a good blood sugar and your own kidneys in working order way beats a transplant.
You would think that a person who donated a kidney would be somehow recognized by a grateful society and not denied medical care. That seems like common decency. But that is not how the free market works. Not only is there no program that guarantees coverage for a donor, they may not even be able to buy insurance. If the Affordable Care Act is struck down by the Supreme Court, insurance companies will once again be able to deny coverage to people with ‘pre-existing conditions’, such having one kidney.
I don’t see a conspiracy here, I see unintended consequences. The system reimburses care for people with end-stage renal disease. These people are deserving, known to their doctors. Every life is precious.
But there are people out there in the community. Maybe they are sweeping the floor, or entering the bills, or caring for patients in the dialysis center. They are on the slide to being a patient there. This can be prevented. Do we have the moral imagination to see public health as a public good? I believe we do, and if the people lead on real health reform, nothing can stop us.
Lauren, at The Fat Lady Sings, has a funny and frightening post about the process of becoming a live kidney donor…
“I don’t even know if I’m a potential donor,” I answered. “I still have to do a kidney scan. If I’m not a donor, there’s no conversation to have. And anyway, I’m only trying to donate one.”
“Why are you being so stubborn about this?” asked Richard. “Most people wouldn’t even think about it.”
I pursed my lips. “Because River needs a kidney,” I said. “I sent the kids to Hebrew school for years so they could learn Torah. Saving a life is the most important mitzvah. What’s the point of talking about all this stuff if you don’t practice it?
“And I’m getting pissed off at hate-mongers and religious hypocrites. Giving somebody a kidney seems like a good way to tell them to go to hell. It makes our blogging community stronger.”
“I’d feel more comfortable with a gift of flowers,” answered Richard. “I understand your reasoning but you mean a lot to us, too. We don’t want anything to happen to you.”
Lauren’s post, incidentally, shows a lot of what is wrong with our health care ‘system’.
Someone close to me was contemplating being a live donor to a co-worker who was very sick. I am greatly relieved that he didn’t. Friends, sign that donor card on your driver’s license. You won’t need them in heaven.
A reader submitted this post:
It tells the now-familiar story of how an unwary person was conned by Michelle Rhee's Students First. The reader was going through her email, and along came a "puppies-and-kittens" petition from Change.org, and "Click!"
Too late: "And suddenly, there it was…the wolf in sheep’s clothing, the Trojan horse of all Trojan horses: Join the Fight to Save Great Teachers…
RI Future reports that the General Assembly voted to increase the minimum wage.
While it’s far short of a living wage– taking into account the high cost of housing just as an example, it’s a good move. For all you out there who sweated at a press all summer for $3.65/hr and met people who worked in the factory for decades– remember that now, as then, some of the most essential work is underpaid. Rhode Island’s industry has moved to China, but we still need workers. You can’t outsource elder care.
If you buy into the myth that ‘job creators’ are financiers and stock traders, you will gripe about the lavish $0.35/hr raise for people doing the toughest jobs. If you value an economy that attracts good workers to the state you will see this as a baby step in the right direction.