Health Care and Personal Responsibility

Free Press columnist Brian Dickerson asked a provocative question in his column today: Do we all have the same right to health care?

What about these men he saw last weekend at the Woodward Dream Cruise?

...a trio of well-fed spectators wedged into identical lawn chairs on the public right-of-way. [...] Each held a beer in one hand and a cigarette in the other, and all three sported pendulous bellies that spilled over their beltlines and glistened in the midday sun."

Why shouldn't those men be entitled to health care? Obesity and obesity related-conditions like hypertension have been blamed for our rising health care costs, but other major factors include spending on prescription drugs and new medical technologies, longer life spans, a greater prevalence of chronic illnesses, an aging population, and high administrative costs. Poverty, stress, air pollution and environmental hazards affect our health too.

And healthy habits do not necessarily translate into lower costs (via Economix blog/NYT).

Vermonters have the healthiest behaviors, including less smoking and more exercise, according to the latest Gallup-Healthways Healthy Behavior Sub-Index numbers. [...]

The states with the unhealthiest behaviors were primarily located in the Midwest and the South; the worst were Kentucky, Arkansas, West Virginia and Indiana.

How do these healthy behaviors factor into health spending in each state? Not a whole lot, or so it appears on its face. ...

The Western states showed both healthy behavior and lower health costs, but the Northeastern states spent a lot per capita on health care despite their relatively healthy habits. Vermont, for example, spent $6,069 per person on health care in 2004, the ninth-highest level out of the 50 states and the District of Columbia.

Dickerson believes everyone should enjoy access to some minimum level of preventative and acute care, but he wants to add stipulations, i.e. "reimbursement for the cost of treating many chronic health problems should depend, at least to some extent, on what steps the patient has taken to avoid them."

I'm in favor of personal responsibility too, although I'm not sure how possible it is to accurately measure a person's efforts. And in the case of drinking, smoking and overeating, there are often underlying emotional and psychological problems that make quitting extremely difficult. Is it fair to penalize them for falling off the wagon?

Fortunately, helping people live healthier lives is being addressed by President Obama whose principles for health reform include prevention and wellness initiatives. They're also included in the Senate HELP Committee and House Tri-Committee plans. (See a side-by-side comparison of all plans here.)

We need to get health care reform passed and make available to Americans the tools and information they need to live healthier lives today. Nitpicking about personal responsibility and unhealthy habits only serves to slow down or sink reform.


(Cross-posted at Blogging for MI.)

Just Say No to DNC Donations

The Democratic National Committee called me this morning and asked if I could contribute $100 dollars to help move the Democratic agenda forward. This was my not too lady-like response:

I will not contribute another dime to Democrats until they get their shit together on passing health care reform that includes a public option.

What is the matter with Democrats? Voters handed them a mandate for change and they're wimping out on us. Quit listening to the teabaggers, deathers, Blue Dogs, and people like Grassley, Betsy McCaughey and Dick Armey and his Freedom Works. They don't represent the majority of Americans who say we should have the option of government-run health insurance.

They don't represent the majority of Americans who took this CNN poll. (Results as of 9:30 a.m. this morning.)



And they don't represent the one in four Americans who now call health care the nation's most important problem - up from 16% a month ago and 6% a year ago.

Consider this tough love, Dems. I can't show my displeasure at the ballot box until next year, but I can - and I will - stop enabling your bad behavior. When you're ready to start talking about public health insurance again, I'll consider making a donation, but until then you're on your own.

Health Care Debate Takes Compassionate Turn

What two words have been missing from the health care debate on the right? Compassion and religion. The party of compassionate conservatism has always been quick to use religion when it served their purpose in the past, but curiously, neither word has been mentioned often in relation to health care reform. There have been a few exceptions though. While conducting a town hall in Lebanon, PA, Sen. Arlen Specter was threatened with God's wrath by one protester.

"One day, God's gonna stand before you," he said. "And he's gonna judge you and the rest of your damn cronies up on the Hill, and then you can get your just desserts."

I wonder if that person was referring to the lies being told by some critics? As Jim Wallis of Sojourners recently said, "one important moral principle for the health-care debate is truth-telling."

The religious right may be keeping quiet about this issue, but a coalition of interfaith religious groups is backing health care reform. They've launched a 40 day campaign targeting 100 member of Congress and they'll participate in a telephone call-in event with President Obama on Aug 19.

Members of the group said Monday that they intend to fight back against what they say are lies being told about health reform.

“All of God’s children [have] got to be covered now,” said Rev. Jim Wallis, the CEO of Sojourners. “This is not a partisan political move. You are going to hear the moral drumbeat throughout this debate.”

The campaign is sponsored and organized by PICO National Network, Faith in Public Life, Faithful America, Sojourners and Catholics in Alliance for the Common Good.

Catholics in Alliance believe "health care is a basic human right, not a privilege," and Faithful America is letting Congress know people of faith support health care reform in a national TV ad.

Christians aren't alone in this effort. The coalition also includes Jewish and Muslim leaders. In fact, the National Democratic Jewish Council launched a "Rabbis for Health Insurance Reform" webpage urging Congress to get legislation passed for "Democrats, Republicans, Christians, Muslims, and Jews."

"Our tradition teaches us to pursue justice," the site reads. "Yet it is not a just society when families are forced to choose between paying their mortgages or paying for prescription drugs. It is not a just society when small businesses must choose between being profitable or providing coverage to their employees. It is not a just society when people are denied health insurance because they have a pre-existing condition for which they need medical care. Equal access to safe and affordable health care is an essential social justice issue of our time.

If ever there was a time to bring religion and compassion into the discussion, this is it. As one Indianapolis pastor who is part of the coalition said, this "effort addresses the suffering parishioners they [clergy] see each week who can’t afford treatments until their ailments reach emergency room levels. ... This is as much a crisis of faith as it is a crisis of health care.”


(Cross-posted at Blogging for MI.)

Reverse the Bush-era Tax Cuts

A group of rich people, who call themselves Wealth for the Common Good, have started a campaign calling for an immediate rollback of President Bush's tax cuts. I can already hear the cries of protest from people like Mitch Albom, Mike Bishop and other defenders of the rich.

The group believes that "Obama’s election demonstrates broad public support, even among the wealthy, for the idea that the wealthiest Americans should pay more. As a presidential candidate, Barack Obama pledged to raise taxes on households with incomes over $250,000 by reversing the 2001 and 2003 Bush tax cuts. A majority of these high-income individuals, 52 percent, still voted for him."

Here's their statement:

Our country is facing the worst economic challenge since the Great Depression and an urgent need to make a long overdue investment in bringing jobs and stability back to our communities. This investment should be paid for, in part, by repealing the Bush-era tax cuts our country cannot afford.

Those of us with taxable incomes over $235,000 benefited from the upside of the economy during the last decade and profited for eight years from a 2001 tax cut. Now is the time to give back.

We would see a minimal tax increase—from 35% to 39.6%, a rate still far lower than the one under President Reagan—but the increased revenue would raise an estimated $43 billion per year. This would affect a very small fraction of U.S. taxpayers—about 2.5 percent.

Let the weeping and gnashing of teeth from defenders of the rich begin.

(Cross-posted at Blogging for Michigan.)

Michigan Highest Ranked State in Cash for Clunker Voucher Requests

Jalopnik reports that domestic car-producing states who have a large stake in the industry are where most Cash for Clunker vouchers are being requested, and Michigan leads the pack.

According to data from the NHTSA, Michigan is the highest-ranked state in terms of spending with $34,420,500 in voucher requests through Monday afternoon. This far outpaces Ohio, which is in second with $29,274,000 in requested vouchers. California is the most populous state in the nation, but is in third with $26,433,000, followed closely by Minnesota with $26,168,000 in requests.

The area with the least number of trades was Washington, DC, where not a single person took advantage of the program.

Jalopnik concluded that Cash for Clunkers appears to be popular across the map, but the highest concentration is in areas where people are concerned with the performance of the Not-So-Big Three (their words, not mine). That makes sense. The trickle down effect from these car sales won't just help our automakers, but Michigan stands to gain in terms of tax revenue and our local communities benefit when salespeople start spending their commissions at stores, restaurants, etc.



These were the ten most purchased cars according to Jalopnik (approximately 47% of the sales are vehicles from the Big-3).

1. Ford Focus
2. Toyota Corolla
3. Honda Civic
4. Toyota Prius
5. Toyota Camry
6. Ford Escape FWD
7. Hyundai Elantra
8. Dodge Caliber
9. Honda Fit
10. Chevrolet Cobalt

Jalopnik theorizes that foreign cars took 6 of the 10 slots because domestic automakers don't have the most fuel efficient vehicle choices on the road. I have to agree. The Big-3 were warned, but they ignored fuel efficiency because they were making tons of money on SUVs and trucks. Better late than never I guess. And, as Jalopnik points out, "the news is still slightly better for them that they're able to keep pace with their foreign competition."

(Cross-posted at Blogging for Michigan.)

The Time for a National Manufacturing Policy was Yesterday

Employees of the Lordstown General Motors plant in Ohio are banking on the Chevy Cruze to keep them working. We should be cheering them on too. Why? Because Lordstown's story is being told in auto communities across the nation.

"The last eight months have been so chaotic," said Lordstown Mayor Michael Chaffee. "We went from the top of the world in August (2008), to treading water and praying in April."

But the Cruze gives Lordstown residents hope their plant will stay open. GM also hopes the smaller, more fuel-efficient vehicle will carry the smaller, more efficient car company through the next century.

Keeping the plant is one thing, but in an area that American industry has been leaving for 30 years, the loss of jobs from the last major manufacturing employer is huge.

Twenty miles from Lordstown is Youngstown, Ohio, a once-booming manufacturing and industrial community that relied on steel mills to sustain its middle class. When the mills downsized or closed beginning in the late 1970s, residents left to seek work elsewhere, and the standard of living declined for those who remained.

Unlike previous decades, when industry left the area for other parts of the nation, companies are now moving out of the country entirely, permanently erasing thousands of jobs. And it's not just the jobs that are fading, but also health care, pensions and other benefits that built the working middle class.

John Russo, co-director for working class studies at Youngstown State University, has been studying this erosion for years and said he finds the push for cheaper U.S. labor depressing.

"We seem to be willing to create jobs for a working people where the wages and benefits cannot support paying their basic bills," Russo said. "So, it seems to me, Youngstown's story, now Lordstown's story, is a part of America's story as we begin this next century."

President Obama believes “The fight for American manufacturing is the fight for America’s future,” yet he hasn't come up with a formal plan to address the decline. Granted, he has a lot on his plate, but maybe he could find a few minutes to share a beer with Ohio Rep. Sherrod Brown who is proposing a a national manufacturing policy that aligns federal actions with the goal of strengthening our manufacturing sector.

These are the five areas Brown believes our country should focus on (click the link to read the details): Innovation, Supply Chains, Skills, Coordination, and Fair Trade.

Fact: The United States now ranks behind every industrial nation except France in the percentage of overall economic activity devoted to manufacturing. Since 2007, we've lost two million manufacturing jobs and more than five million since 2000, but even in its weakened state, manufacturing is still an essential pillar of our economy.

Manufacturing accounts for $1.6 trillion -- nearly 12 percent -- of the U.S. Gross Domestic Product (GDP). It accounts for nearly three-fourths of the nation’s industrial research and development (R&D) -- with four manufacturing industries alone (computers and electronics, chemicals, aerospace, and autos) accounting for 56 percent of private sector R&D. The industry also accounts for 35 percent of value added in world high technology product production.

Jobs in the manufacturing industry pay 20 percent more on average than service jobs. Each manufacturing job supports 4-5 other jobs throughout the U.S. economy. While employment in manufacturing has steadily declined, one in six private sector jobs is still directly or indirectly tied to manufacturing.

Stabilizing and boosting manufacturing would help our economy, put people back to work, and rebuild the middle class. Obama has been saying all the right things, but he's been sending mixed messages about manufacturing's future.

While Obama felt it necessary to distance himself from the “buy America” provisions put in the stimulus bill, China has no such compunctions. As the Times reports, “when China authorized its first solar power plant this spring, it required that at least 80 percent of the equipment be made in China. When the Chinese government took bids this spring for 25 large contracts to supply wind turbines, every contract was won by one of seven domestic companies. All six multinationals that submitted bids were disqualified on various technical grounds, like not providing sufficiently detailed data.”...

China is intent on dominating the new energy markets of the future. If its past practices are any indication, it will subsidize exports, manipulate its currency, buy China at home, force multinationals to transfer technology and partner with Chinese companies, and engage in industrial piracy to make its way.

And China is not alone: Other countries continue to erect barriers to block American goods and mercantilism and subsidies still reign supreme.

Other countries protect their manufacturing. We shouldn't expect any less from the U.S.

Health care reform would help consumers too

Health care reform is about more than helping the uninsured. President Obama is on the road today talking about reform and how it will help consumers. These are the highlights:

No Denials for Pre-Existing Conditions: Insurers would be banned from refusing coverage based on medical history.

No Huge Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurers would be bound by annual caps on charges for out-of-pocket expenses

Preventive Care: Insurers would be required to cover checkups and tests like mammograms or diabetes screenings.

No Drops in Coverage for Major Illnesses: Companies would be barred dropping or diluting coverage for those who become seriously ill.

No Gender Disparities: Companies could not charge differently based on gender.

No Annual or Lifetime Caps on Coverage.

Expanded Coverage for Young Adults: Family plans would cover people through age 26.

Renewal Guarantees: If premiums are paid, policies have to be renewed even if new illnesses emerge.

Obama calls these "health insurance consumer protections to make sure that those who have insurance are treated fairly and insurance companies are held accountable."

In my case, "no denials for pre-existing conditions" hits a nerve. My husband works in the auto industry and his employment is tenuous, along with his health insurance. If he loses that, it's scary to think we might not be able to get new coverage, particularly at our ages. We're too young for Medicare, but old enough that problems like high blood pressure and arthritis are starting to pop up.

Reform can't happen soon enough in my opinion.

Mitch Albom defends the richest 1 percent

Did you catch Mitch Albom's column in the Free Press defending rich people from having to pay more in taxes in order to fund health care reform? Prepare yourself to gag:

In explaining why it was OK to sock a new 5.4% tax on the highest earners in this country — to pay for health care reform — President Obama’s press secretary, Robert Gibbs, said this:

“The president believes that the richest 1% of this country has had a pretty good run of it for many, many, many years.”

Ah. So that’s it. The old “You’ve had it good enough for long enough” policy. That’s why a family earning a million dollars a year should now cough up $54,000 of that — in addition to all the other taxes it pays...

It is not that the rich should not pay fair taxes. They should.

But to justify a grossly overweighted tax by saying “You people have had it good long enough” is to engage in the worst and most destructive form of politics: class warfare.

"Grossly overweighted tax" is not only incorrect (which I'll get to later), but Mitch seems to forget who his target audience is: Poor slobs like me who bought his books and helped make him rich. I won't make that mistake again.

Speaking of his books, David Sirota notes that Albom has "made millions of dollars writing books about sick people and death." He also assumed "that because his writing comes into contact with the most gut-wrenching parts of health care system, and because he portrays himself as a shining beacon of compassion and selflessness, that he is, in fact, a somewhat compassionate human being."

However, after reading Albom's column in what Sirota calls "quite literally the most economically devastated city in the United States," he changed his opinion of him. "Albom is a run-of-the-mill royalist and right-wing psychopath."

And yet, Albom -- the guy who has made his pile by trumpeting his alleged compassion for the plight of the sick and dying -- is spending the most crucial week in the health care debate insisting that the superwealthy pay too much in taxes and never avoid paying what they owe. And more importantly, Albom spends this week insisting the major problem facing America is a "class warfare" that would ask a Goldman Sachs executive making $1 million a year to devote just 9-tenths of one percent more of his taxpayer-subsidized income to a universal health care program. And he's doing all this in the flagship paper of the city that has been most devastated by the economy.

Not only is Albom not compassionate, he's also a fool when it comes to that "grossly overweighted tax" he mentioned. His math is not only wrong, it's considerably off, by a factor of six according to A Tiny Revolution.

Someone making $1,000,000 per year wouldn't pay $54,000 more in taxes under this bill. They'd pay $9,000.

That's because the 5.4% surcharge would only apply to someone's income over $1,000,000. Your tax bill wouldn't suddenly go up by $54,000 if one year you made $1,000,000 instead of $999,999.

Albom writes at a third grade reading level and isn't a tax accountant (he has a degree in journalism from Columbia University plus an MBA from Columbia's Graduate School of Business), but that doesn't justify passing along false information as the truth. Or could it be, as A Tiny Revolution points out, that it's just acceptable practice in his line of work.

"There really is no field but right-wing punditry where you can make these kind of catastrophic errors and keep your job. You can't graduate from Columbia Medical School and become a surgeon if you believe human beings have six spleens, and you can't stay an anesthesiologist if you give someone six times too much Sevoflurane. But as long as your horrifying incompetence serves a right-wing agenda, there will always be a cozy home for you in journalism."

It's too bad Mitch didn't take to heart Morrie's words:

"So many people walk around with a meaningless life. They seem half-asleep, even when they're busy doing things they think are important. This is because they're chasing the wrong things. The way you get meaning into your life is to devote yourself to loving others, devote yourself to your community around you, and devote yourself to creating something that gives you purpose and meaning."


(Cross-posted at Blogging for MI.)

Racial profiling or not, the Cambridge police were wrong

It's probably safe to say President Obama could have been more tactful last night.

"The Cambridge police acted stupidly in arresting somebody [Skip Gates] when there was already proof that they were in their own home."

Tactful or not, police officers are no different from the rest of us - some of them do a good job and some of them don't. (See here, here and here.) In this case, I agree with the president that the police acted stupidly (and unprofessionally).

It should have been handled differently according to this former policeman.

I was an auxiliary police officer for 20 years, 11 in Michigan where a wise chief told us never, under any circumstances, were we to arrest someone for disorderly conduct. He said that if we couldn't find a more serious charge it was up to us to calm the person down. Otherwise he told us that using this charge was just an easy way to end a situation with a disruptive citizen without using the skill we were supposed to have to de-escalate. ...

As far as I'm concerned the police should have used their skills to de-escalate. This is part of their training.

It's possible Skip Gates blew up and got confrontational, but that doesn't justify arresting the man for breaking into his own house. As the president also said, "I think it's fair to say...any of us would be pretty angry." That seems like a reasonable assumption.

I actually have experience with "profiling" and can identify with Gates. Not too many people know this, but I have a disability that limits my walking distance so I use a wheelchair in public. About 15 years ago, while shopping at Lechters Housewares with my then 14-year-old daughter, I noticed that a salesclerk kept following behind us as we moved through the store. (My daughter was pushing me.) I assumed she was waiting to see if we needed any help so I turned around, told her we'd be fine and that she didn't need to wait on us. Her answer? I have orders to follow customers in wheelchairs to make sure they don't shoplift. I was flabbergasted. Had I been standing up, I probably would have fallen over!

Was I angry? You betcha, but I'm the type of person who busts into tears when I get angry. The yelling comes later. Anyway, the clerk took one look at my face and felt compelled to defend management's policy. She explained that disabled people in wheelchairs are a higher security risk because we can hide kitchen gadgets down by our sides or sit on stuff in order to smuggle it out.

Needless to say, I wasn't too pleased that she treated me like a criminal. I left the store and took my business elsewhere. Lechters went out of business in 2001, proving there is cosmic karma!

I don't know if racial profiling was the motivation behind Gate's arrest or not, but I can understand how a black man might feel in a situation like that because of my experience. Trust me. It's not a good feeling.


(Cross-posted at Blogging for MI.)

Americans continue to lose health care

Americans can't afford to wait another year, another month or another day for health care reform. According to Families USA:

With each passing week that meaningful health care reform is not enacted, more families in every state are losing health coverage... Families USA based its state numbers on national estimates published in the peer-reviewed policy journal Health Affairs in May 2009. These estimates project that 6.9 million more Americans, primarily people in working families, will lose health coverage by the end of 2010. [emphasis added]

Their report breaks down the number of people who may lose health coverage between the beginning of 2008 (the period immediately after the last Census Bureau report on the number of uninsured) and the end of 2010 (the close of the current 111th Congress) and it shows a total of 162,100 Michiganders losing coverage during that period. That's 1,040 people per week, 4,500 per month and 54,030 per year.

The clock is ticking. Each week another 44,230 Americans lose their health coverage. Please, call 1-800-828-0498, ask to be connected to your member of Congress, and tell him/her to pass health care reform NOW.




(Cross-posted at Blogging for Michigan.)