Playing at the Town Hall

One thing you can say about our own Lindsey Graham is that he is having a good ole time.  I watched all I could tolerate of his performance at his town hall on April 1, about a half hour.  Of the two of us, he was the only one really enjoying himself.

He knew he was being televised, and he had a full house, in a way a captive audience at his mercy.  Which I must say was a pretty clever turnaround after all the legislators who have been caught as though running red-handed from a crime scene.  Which they pretty much were, given the horrendous acts they had committed on their constituents over the past years.

Anyway, the thing about Lindsey is that he does a smooth transition, back and forth, from a level headed, rational person to a rabid right wingnut.  Likewise, his strut across the stage and his ready laugh go from charming to a bit maniacal.

What he did on Saturday was maintain control even in the face of a furious, fed up audience.  They were actually constituents, but he sure made it feel like they were an audience.

He started off with Russia.  Russia was easy.  I could tell he knew he nailed it with the audience, because we all know that Russia is the bad guy.  Trump was another easy one, because by now we all have shorthand for what we think of him, and we knew he agreed.  And that even though he hoped the Senate could do a sound investigation, the most important thing was not to get in the way of the FBI.

Once he got us all warmed up he tossed the bucket of cold water at us.  Gorsuch.  He’s been playing that tune since the nomination.  Lindsey Graham LOVES Neil Gorsuch.  How could he not?  Gorsuch is as slick as they come – as I learned to say in the South, he cleans up real good.  But underneath that well-dressed white haired dignified suit of armor is an angry, mean control freak.  Gorsuch is going to act out every damn thing Graham can only dream of.  He will consistently rule for corporations, which I don’t even think is the most important issue for Graham.  More important, he will take down women, dashing any hope for reproductive rights, worker rights, and basically, self-determination here in the 21^st century.

Because Lindsey truly has a thing about women.  He could be reasonable about Obama, but when it comes to Hillary, his hatred is visceral.  And lately, you can see it in his eyes when he talks about Susan Rice.  Women in power.  Competent women.

So when those types of issues come up, that’s when we see crazy Lindsey.  That’s when facts fly out the window.  I believe this is why his defense of Gorsuch on Saturday was so shrill.  As though he had no idea that the nominee was even more right-wing than Scalia, he told the group that if they couldn’t see how qualified Gorsuch is then “you are blinded by your own partisanship.”  And that our problem with Gorsuch was entirely to do with Trump (and not Merrick Garland):  “You want to set the election aside because you can’t accept the results – that’s your problem,” adding, inevitably, that Trump is being investigated by the FBI, big deal, “so was Hillary Clinton.”  And of course, bringing up the made-up “Biden rule,” as though he has so much respect for Biden’s philosophy that he would follow him anywhere.

After that things went downhill.

There was the usual “Obamacare is failing,” followed by the very strange accusation that the ACA “was not designed to get us health care but to get single payer through the back door.”  A truly through-the-looking-glass moment as I recalled progressives’ anger at Obama, who had not just omitted the possibility of single-payer altogether, but also did away with a “public option” at the polite request of the insurance industry.

When that idiocy brought about some loud boos, he laughed and said, “Good fun!  This is better than going to the Flower Show.”  And proceeded to tell folks that if they like single payer, well, Canada has it.  And if we want his insurance we can join the military, apparently believing that his stint in the military is what makes him deserving of government health care, and not just being an American.  Adding that the VA system is a failure not because it does not have the funding to streamline and have more doctors, but because it is a monopoly.  Ending with a fantastical suggestion for improving health care with a combination of managed care for people of high risk (anybody remember the abomination known as managed care?), tax credits, and allowing sales across state lines.  Done and done.  Everybody insured.

About Betsy DeVos:  “She has spent most of her life working on alternatives to failing schools.”  The alternative being taking money out of public schools to profit private schools.

Around about that time, Graham had a brief attack of sanity.  Regarding social security and medicare, he offered that those with high incomes, like himself, should pay more, take less.  But then came the trade-off:  We should all be willing to raise the retirement and Medicare ages.

Now this has been a bee in Lindsey's bonnet for a very long time.  Way back in 2011, I made an ad for the Progressive Change Campaign Committee pleading with Lindsey not to change the social security retirement age.  It was actually featured on Keith Olbermann's Countdown; it was my fifteen minutes of fame and a truly proud moment.

Point being, that Lindsey is so out of touch with his constituents that he has no clue how many of us finally retire with aches and pains and actual disabilities at age 62, or force ourselves to work to age 66.  He has dismissed us whiners by saying we can just apply for disability, as though his gang of criminals has made it real easy for people who are hurting to cash in.  He has no idea how, thanks to folks on his side of the aisle, Medicare has been chipped and hacked at until it requires costly private supplements, another boon for the insurance industry.  I don't know how people survived before the pharmaceutical boondoggle known as Medicare Part D, but the way it stands now, with the drug plan, we are all in a position where cutting meds in half or living without them -- or not -- is a real option.

And then there is Planned Parenthood, where Lindsey has his final split from reality.  Again, a woman thing.  He doesn't much care about facts at this point, saying that the debate about funding "is about providing abortion services."

Lindsey is not an idiot.  He knows the government does not pay for abortion services -- although they damn well should -- yet he contends that this is the crux of the issue.  And this sometimes rational legislator is willing to not just vote for, but support cutting a truly essential source of women's reproductive health care because they also do abortions.  Like his blind spot with Hillary, the thought of women making their own choices about their bodies brings him to near Trump-level irrationality.

And I am just sick to death of having these unmarried old white guys obsessing over control of women's bodies.

But we are indeed left with crazy Uncle Lindsey.  He might toss you a quarter, but then you have to listen to him rant about Hillary and abortion if you want to keep it.  Unlike the other unmarried right wingnut who "represents" South Carolina in the Senate, at least Lindsey's head clears every once in awhile.  Is it good enough?

Graham has fought off challenges from the right.  He has lately blown away what the state Democratic Party seemed to think was its best chance, a challenger with the all the right stands on the issues, but one who was outmatched in the ability to take center stage.

Invincible?  I'm afraid it would take lots of money and a candidate brimming with personality and chutzpah, who could talk to the folks as though they were having barbecue and beer, and damned, knew what they were going through with that dad-gum gub'mint and was shore gonna fix it.  Somebody who could make even a thick-headed southerner admit that they didn't want their nutty next-door neighbor carrying a gun, or their teenage daughter having to have a baby when that nasty boy she was with got her knocked up.

That would surely do it.  And there's somebody out there just dying to step up. 

Why I Talk about Money

A few days ago, I wrote a blog post about my frustrating efforts to get information in anticipation of my upcoming switch to Medicare.  In that post I talked dollars and cents regarding the costs of Medicare Part B, and specifically the way our Congress has increased the cost to new recipients, while avoiding the shitstorm they might have had if people already enrolled could see how much the premium and deductible had gone up.

My purpose in writing the blog was not just to describe how difficult it is to maneuver the complexities of Medicare, or even to expose all the unconscionable costs that seniors are now expected to pay for health insurance.  I really wanted to leave readers with the awareness that this is very likely to be the future of Obamacare, which is currently affordable and comprehensive.

Since I wrote the blog, I have had a number of conversations with people where we have actually talked in dollars and cents.  It is amazing how many intelligent and aware people do not know or understand all the various components of their health insurance, who just pay what they are billed and are thankful that they are covered.  Which is just the way Congress and the health care industry want it.

I have found, in my life, that we are more comfortable talking about our sex lives than about money.  I was told when I was in my twenties, by a far more sophisticated friend, that it is impolite to talk about money.  We don't want to brag and we sure don't want to beg.  We don't want sympathy, and we don't want scorn.

So we don't talk about our income.  If we were more comfortable sharing information about money, Lilly Ledbetter might not have been in the dark about being subject to wage discrimination.  We might all learn about bad financial deals and all those scams like car buying and loans.  We might exchange good information about tax breaks and government programs to which we are entitled.  We would be far more aware of how the republican right has worked with corporations and billionaires to manipulate our incomes and expenses.

Actually, not talking about money makes about as much sense to me as not talking about age.  It makes a big secret out of something that should be merely a sharing of information.  Really, who cares that I am 64?  It doesn't mean I'm going to die sooner, or look younger.  I believe people will judge me on far more than my age, and knowing how old I am is just a small piece of information that I provide.

Talking about costs is important to me, not because I need for people to know how much I personally live on, but because we all need to know more about how we all survive in this really bad plutocracy.  Absence of information makes us all vulnerable.  That is why corporations fight so hard to hide financial data; that is also why they are working so hard to collect data from all of us.

Here is another thing.  Since the Post and Courier published an article about serious problems with well water on Wadmalaw Island, a number of concerned people asked me how I was faring.  Fact is, I live in a relatively new development, the well is only about 25 years old, and there are people living with wells that were drilled in the 60's and 70's.  But, I add, there is a low income grant that qualifies me for a new well, so I am fortunate on that account as well.

Most people, I think, are uncomfortable learning that I qualify for a new well based on my income.  None of us really want to know that our friends are struggling financially, do we?  And then there are probably those who get their backs up just a bit over their tax dollars paying for my well.  If I end up with a new well and I am not obviously struggling, isn't that wrong?  After all, it wasn't long ago that the right-wingnuts in Congress were saying that you weren't poor if you had a refrigerator.

It's okay for tax dollars to pay for Boeing's success, and it's okay for corporate farms and pharmaceuticals to get huge subsidies from the government.  I recently heard a building contractor, when asked what he thought about Trump, reply, "If he becomes president, I'll be right there putting in a bid to build that wall."  There are acceptable ways to take government money and having a low income just isn't one of them.

I wrestled with agreeing to have that new well built.  I knew there were people far worse off than me.  But I was also told that if something happened to my current system, it would cost $6,000 to drill that new well.  So I agreed.

A businessman getting offered a good deal by the government would hardly turn it down.  But we individuals are made to feel like beggars and sponges if we accept a good deal.  Many, many people do not apply for financial assistance or food stamps because of the stigma, which our right-wing government is all too happy to magnify, by adding regulations from more frequent income checks to required proof of job-seeking to drug tests.

When the housing market collapsed not too long ago, hard working middle class people who believed in our capitalist system were thrown out on the street.  Congress fought over whether people who were unsuccessful looking for jobs should have their unemployment benefits extended.

There is an enormous myth that persists that if you work hard you will not need to turn to the government for help.  And yet those who are in government and trying to cut the benefits we deserve and depend upon are all to happy to take what the government gives them.  Our right-wing majority in Congress, and in too many of our statehouses, insist that people should work two jobs, mothers should work rather than stay home with children.  Meanwhile, members of the US House of Representatives, with full pay and benefits, are scheduled to work 111 days this year.

So let's not be polite about money.  We may think we don't know anyone who is struggling, or we may just think we don't know anyone who is struggling as much as we are.  Fact is, too many of us are in that same shaky boat, while the Koch brothers are in the yacht that is making all the waves. 

Keep an Eye on Obamacare

When my husband died a year and a few months ago, I was surprised and relieved to find that the health insurance of the Affordable Care Act really was affordable.  I figured I might just keep it as my private insurance when I became eligible for Medicare.

Wrong.

When you become age-eligible for Medicare, I have since found out, you cannot keep your Obamacare.  Your options become dizzying, and not in a good way.

I turn 65 in July, so for the past few months I have poured over Medicare books and stared at my computer screen for hours before becoming discouraged and just quitting for the day.  When I take it up again, the bad news starts to sink in, but it doesn't get any better.

But I am not here to whine.  I am here to bitch about the politics of health care for seniors.

I have had a hard time finding out what was available even a few years ago before Part D -- the prescription drug plan -- was enacted into law, so I can't tell you how much better Medicare was in years past.  But my guess is that the republicans -- with some Democratic compliance -- have been chipping away at Medicare for decades now.  Their preference, of course, is to privatize it entirely, but they are content -- as much as such a bunch of malcontents can be -- with destroying it one step at a time.

Let's start with the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.  It may be that there was no drug coverage before 2003 (I can't even get that info on Wikipedia, so if any of you out there can enlighten us as to what people did for prescription drugs before W came into town and got his hands all over it I would be very appreciative.).  From 2003, the drug component -- Part D -- of Medicare proved to be a real boon -- for the pharmaceutical companies.  And there was a sadistic element to the bill that one has to admire.

First of all, it is purchased from private pharmaceutical companies, with the government subsidizing some of the cost.  But you are not required to buy this coverage.  HOWEVER, each year that you do not buy Part D coverage, your cost for when you do decide you need it goes up.  Each year.  It is called a "late enrollment penalty," and this is the way Medicare explains it:

 Medicare calculates the penalty by multiplying 1% of the "national base beneficiary premium" ($34.10 in 2016) times the number of full, uncovered months you didn't have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.

I imagine the drug companies were tickled at those terms.  But wait!  There's more.

You may have heard of the "donut hole," which Medicare more civilly refers to as "the coverage gap."  Not civil either way you look at it.  This bizarre rule means that -- while you continue to pay your monthly premiums, and after your deductible and copays -- if your pharmaceutical needs are so great that your drug cost reaches $3,310 in 2016, your coverage stops  Then you pay out-of-pocket until you have paid $4,850, when your "catastrophic coverage" kicks in.  By that time, your life if not your health can truly be considered catastrophic, so at least that is aptly named.

I still have to stop and let my mouth drop open when I consider those two key provisions of this totally shitful law.

 After you have contemplated Medicare Part D for a few minutes, we can move on to the truly brilliant way the republican Congress has managed to screw up Medicare with barely a ripple of outrage.

Effective for new Medicare recipients, beginning this year, the monthly premium has gone up from $104.90 per month to the astounding $121.80.  And the deductible has gone up for new recipients from $147 to $166.  This is despite the fact that in 2016 there was no corresponding cost-of-living adjustment to social security benefits.  And there was no COLA because Congress determined that the cost of living had not gone up because gas prices went down.  And then proceeded to raise the cost of living by significantly raising Medicare costs.

Slipping this change in for new enrollees means that most of us just pay what we are told, without realizing just how much the cost has gone up.  By not requiring people already enrolled to pay the increase they manage to stem what would probably have been a shitstorm.

Here's something else to consider.  Our less-than-esteemed members of Congress don't have to deal with this at all.  In one of a very few exceptions, they are allowed to keep their government subsidized health care after they retire.  Pretty cool, isn't it?  As Fred Astaire said, "Nice work if you can get it."

I could go on about Medicare, but I really want to end with some thoughts about Obamacare.

I imagine that we are not allowed to keep Obamacare after we hit 65 because it is, so far, a truly affordable and comprehensive health insurance program.  The government pays steeply for this, but the savings are also tremendous and -- hey -- it actually keeps more people healthy.

Those republicans, fat and happy and with their own pretty damned good government health insurance, will lose sleep over the fact that the government is paying for other people to get good, affordable health care.  They will not rest until they have chipped away at Obamacare the way they have done with Medicare.  Over the years to come, as long as we let them, they will increase out of pocket costs and cut the government subsidy until, just as with Medicare, those who are living on a tight budget, will just have to go without needed health care while they pay mandated costs.

And even at that point our elected officials will resent the fact that we are at all able to continue to breathe their air.

So, forewarned, keep an eye on our Obamacare, and let's not let the right wingnuts put this over on us.  Again.

What's In It for Me?

Corporations and their right-wing patsies have figured out that the way to win is to make it all about us, even though it's really not.  They make all their pitches about what we have to gain, and more important, what we have to lose, if we don't vote for them.  Those of us who don't vote often believe that it won't make a difference, that both parties are the same, that nobody represents them.  When we Democrats fail, it is often because we waffle about our principles so that we don't offend anyone, or we talk about them too broadly so they become meaningless to people who are struggling with day to day problems.

There are a lot of differences between the parties and the candidates, and they are not abstract.  They reflect the issues we are struggling with every day.  Who gets elected in November is going to determine in very real terms whether our lives will get better or we will just get by.  This election affects dramatically every person of every age.

So here it is, the pitch:

College graduates:  Republicans are opposed to allowing the refinancing of student loans, forcing graduates to carry high-interest rate loans for years.  This means being strapped with debt before they have even been able to make their way in the workforce.  The high interest loans involved are either owned or guaranteed by the federal government, so this is money that our government is making from what should be an investment in a student's future.  Debt from everything from mortgages to credit cards can be refinanced.  Big banks are allowed to borrow at 0 percent from the government.  Why are students forced to pay exorbitant rates on their loans?  Because the Republicans do not want to increase taxes on the millionaires and billionaires that fund their campaigns.

Women:  Oh, so many issues are so critical for the well-being of women in South Carolina.  Our state and federal legislators continue to force votes that would prevent women from accessing affordable birth control.  Preventing women from having family planning will result in not just unplanned pregnancies, but the stress involved with not being able to control decisions about college, jobs and marriage.  It will result in job insecurity.  Men should be outraged that legislators would remove from the family decisions that so directly effect emotional and financial well-being.

Parents:  School choice is the pseudonym for privatizing.  Basically all the many schemes offered provide inadequate financial allotments to most while the wealthy can continue to send their children to the expensive private schools. This false promise also drains money from a public school system that has never been funded adequately here in South Carolina.

Seniors:  Republican fear mongering about Social Security and Medicare is also all about privatization.  Back in the '80's, social security cuts were enabled by the promise of IRA's, which were supposed to herald in a future of wealth and prosperity, but actually just made us all vulnerable to the greed and speculation of Wall Street.  This false promise also allowed corporations to bargain away our pensions.  Cuts to Medicare have and will continue to damage a system that was once a great safety net, forcing seniors to spend more on health care at a time when they should not have to worry about whether they will be able to pay to survive.

So many issues:

Food Stamps:  Too many people are working and not earning a living wage.  Food stamps not only feeds the poor, but keeps dollars flowing in our communities.

Medicaid:  Not wanting everyone to have health insurance is just plain cruel.  But it is also stupid.  Even without the panic over Ebola, the inability to treat a medical problem before a contagion spreads, or a treatable illness becomes terminal, is costly as well as inhumane.  And again, providing health care also provides jobs to our communities.

Minimum Wage:  All the arguments against raising the minimum wage are really about not wanting to raise the wages of those who are making more than minimum.  Because Republicans really do know that a rising tide lifts all boats.  What they really don't want to see is all wages rise in response to the raise in the minimum wage.  Greedy and stupid?  Sure, but these are the politics we have been suffering under since the 80's.  If you are not working for minimum wage, and you're still struggling, you should be fighting -- and voting -- for raising the minimum wage.  And again, raising the minimum wage puts more dollars into the pockets of those who will spend it in their communities.  So if you are a business person, you too should be wanting everyone in your community to be making a living wage.

Voting Rights:  We all know people who won't be voting because they are afraid they will be confronted (and embarrassed) at the polls.  Let's get out there and vote to protect everybody's rights and elect people who will not need to use intimidation to win.

Gun Control:  Those who are most vulnerable in general tend to live in areas where there is more danger of gun violence.  The Second Amendment argument is pure nonsense.  But the mostly republican lawmakers who refuse to make the streets safe for all our citizens need to be voted out of office.  Our police officers should be voting for legislators who support reasonable gun controls; their lives are on the line as well.  And with shootings by officers in the news, we know that the more guns on the streets, the more stressful the job, and the more likely they will have to live (or die) based on a split second decision.

I could go on and on.  There are so many issues that really do affect us every single day.  I urge our candidates to talk to people not about issues that don't seem relevant to them, but to relate the legislation they would pursue to what it means for each of us, every day.  And when we talk to others about the upcoming election, if we talk about how each issue ripples out to affect us all, we might just motivate people to get out and vote.

Obamacare -- Good News and Lies

Horrors!  The Congressional Budget Office report states that people are leaving their jobs because of Obamacare.  The champagne was overflowing yesterday as the republicans celebrated the proof of just how we lazy Americans would quickly begin to suck on the government teat when given cheap -- read "affordable" -- health insurance.

While employers have been twirling their mustaches and  threatening to let workers go if Obamacare was put into place, only some of us were aware of just how many of us have been stuck in jobs just so we could get health insurance.  And if our employer wasn't providing health insurance, we were stuck in badly paying jobs -- often more than one -- with horrendous hours and no benefits in an attempt to keep our heads above water without health insurance.

Well, fact is, now we have some options.  Some of us can quit our job to go back to school or train for better jobs.  Some of us can stay home to take care of our children or parents.  And some of us can quit jobs that were physically hurting us, many older people who were trapped until age 65 when they could be insured under Medicare.

All of the above absolutely infuriates those who have kept wages low because they always had a line of applicants willing to do anything to make ends meet.  Just listen to the whining from those who will now have to raise their standards if they want a work force.

Of course, it is a different story that is being put forth by the right wing, those corporate patsies who themselves have never had to worry about medical bills since they are graced with taxpayer covered insurance plans.  According to them, we suddenly have no work force.  People are bailing out so they can watch TV and drink margaritas, I guess.

In actual fact, the result of people choosing to leave their jobs is that jobs will be created for those who have been seeking employment.  We seem to be looking at a reduction in unemployment (and payment of unemployment benefits), a healthier and younger work force, and maybe even healthier retirees.

This is exactly why the right wing has been doing everything in its power to kill Obamacare before it could take a breath.  That is, because it works.  Suddenly the power base has somewhat shifted, and there is fear and loathing in corporate America.

But just as every progressive movement, from raising the minimum wage to the implementation of Social Security, has begun with wails and accusations of anti-Americanism, fist thumping and threats, this tantrum too shall pass.  As more people successfully enroll in health insurance, its opponents will search for other misinformation and attempts to scare us.  When it becomes apparent that in fact Americans are not quitting their jobs to live off the government, the muttering will turn to something else.

But the fact is that as more people are able to afford to be insured, more people are free to leave work for better jobs or to live healthier lives, fewer people will be on unemployment rolls, and employers will have to offer better wages, benefits and work conditions in order to staff their businesses.

And that's what is called a good start.

The GOP Search for a Normal Woman

It came as no surprise to me to hear that the GOP had chosen Cathy McMorris Rodgers of Washington State to rebut President Obama's State of the Union.  They have made it clear that they are sincere about proving to women that, well, there are Republican women.  It also came as no surprise that they had chosen a women that pretty much nobody had heard of.  After all, this is the bunch that delivered us Sarah Palin in 2008, and we are all appreciative of that choice.  The GOP could have had another comedic coup had they chosen Michele Bachmann in 2011, but they went and let her represent the Tea Party rebuttal:

Sadly, we all were so focused on the fact that her eyes were trained, in the distance, on those aliens that only she can see that we missed her sincerely spoken words of Tea Party misinformation.  I can only imagine whoever was running the GOP into the ground back then sighing with relief that instead they had gone with male robot Paul Ryan.

But the election of 2012 caused the Republican party leadership to reconsider.  With the words of Todd Aiken and his subsequent loss still stinging, leaders like Bobby Jindal of Louisiana urged his fellow republicans to stop being "the stupid party."  By this he meant, of course, that they should stop letting the American people know what they really think.  As we have seen since then, those old white men continue to loudly fault the poor for their poverty, the undereducated for their lack of success, and women for their menstrual cycles.

What to do, what to do?  The problem being that since nothing is going to convince these guys that they might be wrong, they have apparently come to the conclusion that if women were to hear one of their own speak nonsense, they might not notice that it's nonsense.

So, just as in the not-too-distance past, the GOP found Marco Rubio to talk trash about immigration and Tim Scott to defend the denial of voting rights protections, they hunted and found a woman little known nationally to speak for them.

Cathy McMorris Rodgers has a voting record any Tea Partier would be proud of.  She is a strong supporter of all those rich white men, against not just the Affordable Care Act, but Medicare and Medicaid, prefers subsidies to the rich to subsidies to the poor, and opposes women's rights to medical privacy -- by which I mean abortion and contraception services.  Like her brothers-in-arms, she opposes equal rights and protections for LGBT, undocumented workers, American Indians, and, let me say it again, women.

I am looking forward to hearing what Rodgers has to say tonight, although to be honest I might not be able to get through it.  I am confident though that in Rodgers the GOP has found exactly what they are looking for:  someone to represent the men of today's republican party.

Obamacare and the Rose-Colored Glasses

It's time to pause in my cheerleading for Obamacare and entertain a little reality check.  Yes, Obamacare is better than nothing, but is it right that here in 2013 that should continue to be the mantra of the U.S. healthcare movement?

Once upon a time, on Long Island, I was a psychologist.  As has been my pattern in my life, I was in the right place at the wrong time.  The year I began my private practice, managed care was threatening to take over, promising false promises of great savings in healthcare costs and improved treatment.  Psychology stood in the front lines of the managed care firing squad.  By the time they were done with me, I had decided the only moral choice for me was to quit the couple of remaining groups I was in and just accept sliding fee scale payments.  After that disastrous cut in income, I could afford to retire my practice and move south, and with relief left the field I once loved behind.

What I learned was that the insurance industry would always find a way.  The government was always too many steps behind, and had too many naifs on one side and too many corrupt on the other.  Medicare eventually was plundered to the point where there are now premiums, co-pays and in the end requires supplemental private insurance, a sweet deal for private insurers.  Doctors and hospitals did not sit innocently by back in the Medicare heyday.  If they could raise costs and collect more from Uncle Sam, they quickly did.

Medicaid has never, not ever, been more than a band-aid, and one that doesn't quite cover the wound.  Back in my psychologist days, when private practitioners were charging up to $100 per 45 minute hour, Medicaid was paying out $20 and requiring a full 60-minute session.  Along with the time it took to do bookkeeping and note-taking, and resubmitting all the claims that they had screwed up, lost, or otherwise refused to pay out.  The end result of that, for me, was that I had my pick of patients, because no one else could be bothered.  Hard work for little pay, just like Walmart and McDonald's.

So when President Obama and I insist that we must expand Medicaid, at least one of us knows that this is an insufficient solution to providing health care to Americans.  And when we all scream about protecting our Medicare, our backsides are still unprotected from the insurance industry that has made additional coverage necessary.

As long as we in this country are unwilling to agree that health care is not a for-profit enterprise, we will continue to have inadequate, too expensive protection.  And even when the government pays out, our tax dollars are going toward the fat and inefficient health care machine.

Do doctors make enough money?  I don't know.  I do know that on my insurance claim statement, the same Blue Cross that Congress has access to, the amount billed is considered the fantasy charge.  Since the days of managed care, the insurance industry has been free to invent its own "customary charge" which sometimes reflects a more realistic amount, and sometimes is taken from billing structures from ancient history.

Do hospitals charge too much?  It seems to me that a well run hospital is going to cost a lot of money, but what we have today is hospitals that cost a lot of money to run with inadequate staff on one side and ridiculous waste on the other.

The only reason that medical tests, medical instruments and pharmaceuticals cost as much as they do is because they can.  Our government watches helplessly, when they are not colluding with all kinds of medical corporate interests, as industry gouges doctors, hospitals and consumers.  They parrot lame excuses about the cost of research that don't seem to apply to most other consumer products, where research and competition go hand in hand.  Our government resists providing much needed oversight and regulation for the same lame reasons.

So where does that leave us?  With too many uninsured and the hope that we can at least let them have a band-aid for their troubles.

What should we do?  Strong and common sense federal regulation has to happen for costs to go down.  We have to get private industry out of health care.  I believe that health care will work best on the state level, where there is real concern for the health and well-being of its citizens.

Vermont is taking the challenge.  They have approved a single payer plan to be fully operational by 2017.  Everyone covered, no premiums, co-pays or deductibles.  A slight rise in taxes.

Cynical as I tend to be, I am feeling hopeful about this solution.  This small state has its heart in the right place.  They have Independent Bernie Sanders in the US Senate, and he is as progressive, outspoken, and uncorruptible as they come.  When that works, I know that other states will be quick to come on board.  Not my state, but still, it's a start.

Conundrums

It's true; the republicans are speaking in riddles, and if we don't figure out the right answer we'll be paying for sure.

When they say, "We will work to create jobs," they have actually left out a couple of steps.  What they really mean is, "We plan on giving lots and lots of money back to the really, really wealthy, and we are absolutely sure that eventually they will create jobs with that money.  But not necessarily in America, because, well, that wouldn't be good for corporate America, and they are, after all, the job creators."

When they say, "We want to protect your Social Security and Medicare," they don't add, "for now," but that's what they mean.  In a great moment of honesty, they have begun to add that Social Security and Medicare are safe for those of us over 55.  Then they tap dance around what's going to happen to those of us under 55.  It's kind of bizarre, that they are reassuring some of us that we'll be okay, and not realizing that the end of that thought is that the rest of us are screwed.

When they say, "We are determined to improve the lives of our children," well, they really mean that.  They want to improve the lives of their children.  Not yours or mine.  And how will they do this?  They will make sure that every penny that they own (whether earned by them or not) passes down to their heirs, never being sullied by taxation or obligation.

So listen carefully, folks.  The riddle is in the promise.

PS:  Well, I had drafted this piece before I went on vacation, and came home to find out that Mitt had been caught being honest.  We can all be thankful that he is really a terrible politician.  While they are regrouping, let us all enjoy that brief respite from the Orwellian campaign machine.