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eridani's Journal
Posted by eridani in General Discussion: Presidency
Thu Dec 08th 2011, 04:43 AM
Like public utilities, hospitals have to apply for rate increases. References at the bottom

Advocates of passing some form of the health care “reform” measures on the table as of January 2010 are claiming that a fresh new regulatory regime will control costs to the point where imposing mandates on everyone to buy overpriced underinsurance would be justified. This claim rests mainly on four features—

• An end to refusing policies and price discrimination for people with pre-existing conditions
• An end to recissions of existing policies when people get expensively sick
• Immediate sunshine on price gouging to discourage excessive price increases by insurance companies through review and disclosure of insurance rate increases
• Requiring premium refunds if insurance companies exceed a specified medical loss ratio (MLR)

Unfortunately, none of these proposals, however helpful in and of themselves, will have any effect whatsoever on controlling health care costs.

Ending pre-existing condition discrimination

For one thing, the Senate bill Ensign Amendment1, effectively eliminates this policy by allowing insurance companies to offer discounts for people meeting certain “wellness” goals. Even if that amendment fails to make it into the final bill, there is nothing in the legislation to restrict insurance companies from using this as a justification to jack their premiums sky-high for everybody. For another, all versions of reform retain the policy of charging older people two to five times more, and age certainly has to qualify as a pre-existing condition. Also, there is no mention of what recourse you have should you be turned down for having a bad credit record.

Ending recissions

That would be nice, and I really wish that the legislation as written actually said that. What it does say is that recissions will be eliminated except in the case of fraud. Can somebody please explain why the insurance companies will not be able to drive a whole fleet of very large trucks through that loophole? And there is no mention of what happens when you get dropped because you are unable to afford the premium one month.

A huge problem with the Senate bill is that it leaves regulation to the states, which for all practical purposes is not regulation at all. California has a law against recissions already, but they are not enforcing it at the moment because they can’t afford to.

The sunshine provision

It’s astonishing that anyone could call this regulation and still keep a straight face. What it amounts to is a list of very naughty boys and girls. And they’d better watch out, because if they don’t straighten up and fly right, they’re going to wind up on that very same list again next year.

Medical loss ratio requirements

Unfortunately, 15 states either have these requirements now or have had them in the past2, and they have not had even the slightest effect on escalating health care costs. Of course it’s helpful for some people to get premium rebates, but despite that, the cost of premiums keeps on skyrocketing, 45,000 a year keep dying for lack of the money to pay for health care, and 300,000+ keep going bankrupt due to medical bills (the majority of whom had insurance that was mostly better than the strictly catastrophic underinsurance that will be mandated under “reform”).

Locking the barn door after the horse gets away is not regulation in any sense of the word, as demonstrated by the following real life example.

Dear Mr. and Mrs. Sarkisian:

We were sorry to hear that your daughter Nataline died because CIGNA denied your claim for her liver transplant. However, you will be glad to know that we have analyzed CIGNA’s medical loss ratio and that all of their customers are entitled to premium refunds. Isn’t that wonderful?

Yours truly,
Dr. Pangloss


Another possibility—allowing lawsuits against insurance companies for claims denial

None of the current proposals have any restrictions whatsoever against denials of particular claims, and it is this practice that is a major cause of so many deaths and bankruptcies. People are not allowed to sue companies for denying claims. Representative Jim McDermott (WA-07) is drafting an amendment which would allow such lawsuits. I think it’s a very good idea, but it suffers from the same problem as attempting regulation by mandating specific medical loss ratios—the remedy comes too late to do any good. Mr. and Mrs. Sarkisian would undoubtedly appreciate the money if they sued CIGNA and won, but they would surely prefer that their daughter had gotten the treatment she needed in the first place.

In addition, legal remedies generally increase health care costs. This is already true of medical malpractice lawsuits (even though the cost increases as a cause of our high per capita medical costs are vastly overrated by the tort reform crowd). In no other developed country do people constantly make use of the legal system to get the money needed to pay for the ongoing medical bills necessitated by poor medical outcomes. Note that this motivation to sue is exactly the same regardless of whether or not such outcomes were caused by actual malpractice. The reason for this is that those extra costs are automatically paid by societies which guarantee health care as a right, and therefore there is no need for anyone to initiate a tort lawsuit in order get the money to pay them.

(One of the reasons that we lead the developed world in medical error rates3 is that private employer-based insurers are constantly forcing people to change providers with their endlessly mutating preferred provider lists. Nothing in the proposed legislation deals with this issue.)

Real regulation

Because the largest risk pools will always be the cheapest, health insurance will always trend toward being a monopoly. Wherever natural monopolies exist, society absolutely must regulate them so that citizens do not get ripped off for huge sums of money. We learned this more than a hundred years ago with respect to electrical power grids. At that time, many publicly owned utilities were established and the remainder were put under strict regulation by public utility commissions. When historical amnesia finally set in during the last years of the 20th century, deregulation insured that Enron and Reliant were able to rob energy consumers on the west coast of billions of dollars during a fake “energy crisis”. The corporate-controlled media rarely pointed out that cities with municipally owned utilities didn’t have any brownouts during the “crisis”. All American health insurance companies are Enron. Just as Enron withheld energy from the market to drive up prices and profits, so do insurance companies deny care in order to increase profits.

There is no such thing as health care reform without strict regulation of health care costs. It can be done by outright government ownership of the health care delivery system (Britain, Scandinavia), government monopoly of health insurance (Canada, Taiwan), or strict government regulation of private insurance (the Netherlands, France, Japan). The third method can certainly work as well as the first two in practice—too bad that nothing in current “reform” proposals comes remotely close to that.

Real regulation of mandated private insurance in the Netherlands results in policies that cost 100 euros/month/adult ($95-$145 depending on exchange rates), with no deductibles, no co-pays and no age rating. In addition, many countries regulating private health insurance also directly control provider prices. In 1996, my husband got an emergency root canal in the Netherlands for 100 guilders, or $25 American. In Japan, an overnight hospital stay costs the equivalent of $20. And yes indeed, the number of zeros in those prices are perfectly correct, though they could probably stand to be raised and in fact may have been by now.

Mussolini once said, “Fascism should more properly be called corporatism because it is the merger of state and corporate power.” Without a public option open to anyone and without real regulation, that definition applies to the mandatory purchase of overpriced underinsurance. It’s certainly true that, given the hugely complex nature of the legislation, it does include a number of useful provisions, mostly related to expansion and improvement of Medicare and Medicaid. In my opinion, these useful proposals are analogous to an expensive balsamic vinegar dressing being poured all over a poison ivy salad. Why can’t we just keep the dressing in its bottle and buy it separately?

1 http://www.thenation.com/blogs/notion/5140...
2 http://www.familiesusa.org/assets/pdfs/med...
3 http://www.truthout.org/111908HA
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Posted by eridani in General Discussion
Sat Dec 03rd 2011, 06:58 AM
FOR IMMEDIATE RELEASE
Dec. 1, 2011
Contact:
Steffie Woolhandler, M.D., M.P.H.
Oliver Fein, M.D.
Danny McCormick, M.D., M.P.H.
Mark Almberg, PNHP, (312) 782-6006, mark@pnhp.org

More than 2,400 doctors, nurses and health advocates denounce Institute of Medicine’s health coverage recommendations.

IOM panel ‘riddled with conflicts of nterest’ in violation of agency’s own guidelines, signers of protest letter charge

In a letter (appended below) sent to Secretary of Health and Human Services Kathleen Sebelius and posted on the Internet today, more than 2,400 physicians, nurses and other health advocates condemn the recommendations of an Institute of Medicine (IOM) committee regarding the “essential benefits” to be mandated under the 2010 federal health reform law.

The signers, most of whom are physicians, charge the committee’s recommendations amount to prescribing skimpy coverage that would “sacrifice many lives and cause much suffering,” and urge the Obama administration to reject them.

“The IOM panel endorsed insurance coverage similar to that offered by small employers rather than the more comprehensive coverage offered by large employers,” said Dr. Danny McCormick, an internist, assistant professor at Harvard Medical School and former IOM fellow who helped circulate the letter. “The recommendation was widely viewed as a victory for the health insurance industry, which has long opposed mandating comprehensive benefits.”

The panel also recommended that coverage under the new law be defined by a premium target – an approach often called “defined contribution” – rather than by a list of medically necessary benefits, McCormick said.

The protest letter accuses the IOM panel of being “riddled with conflicts of interest” and notes that many of the panel members have “amassed personal wealth through their involvement with health insurers and other for-profit health care firms” whose businesses would be affected by the panel’s recommendations.

The IOM committee’s members include Sam Ho, executive vice president of UnitedHealthcare; Leonard D. Schaeffer, director of the biotechnology company Amgen and former chairman and CEO of WellPoint (Schaeffer’s family foundation donated $2 million to the IOM in 2010); as well as executives from 3M Health Information Systems, a medical supplier, Milliman Inc., an actuarial consulting firm with close ties to the insurance industry, and The Blackstone Group, a private equity firm with major health care interests.

“Many committee members’ strong ties to the health industry violate the guidance offered in a 2009 report issued by the IOM which recommended that those with industry conflicts of interest should generally be excluded from such panels,” said Dr. Steffie Woolhandler, professor of public health at the City University of New York and visiting professor of medicine at Harvard Medical School, who served as an IOM fellow in 1990-1991. Woolhandler also circulated the letter.

The signers of the protest letter include several prestigious members of the IOM, as well as several former fellows. The letter was first circulated to colleagues by attendees at the IOM’s annual meeting near Washington in October. After learning of the letter, IOM officials instructed security officers to block its distribution at the meeting.

The letter was also circulated by Physicians for a National Health Program, which advocates for a single-payer health system, and by other health professional groups.

Besides being submitted to Secretary Sebelius and other administration officials, the letter has been accepted for publication in the International Journal of Health Services, Woolhandler said.

An Open Letter to Secretary Sebelius and President Obama regarding the Institute of Medicine’s recommendations on the Essential Benefits under the 2010 Health Reform Law

We protest the Institute of Medicine’s (IOM) recommendation that cost rather than medical need be the basis for defining the “essential benefits” that insurance policies must cover when the federal health reform law takes effect in 2014. If adopted by the Department of Health and Human Services, this recommendation will sacrifice many lives and cause much suffering. We call on Secretary Sebelius and President Obama to reject them.

The IOM proposal would base the required coverage on the benefits typical of plans currently offered by small businesses – enshrining these skimpy plans as the new standard. These bare-bones policies come with a long list of uncovered services and saddle enrollees with unaffordable co-payments and deductibles.

Already, millions of underinsured Americans forgo essential care: adults with heart attacks delay seeking emergency care1; children forgo needed primary and specialty care2; patients fail to fill prescriptions for lifesaving medications3; and serious illness often leads to financial catastrophe4.

The inadequate coverage the IOM recommends would shift costs from corporate and government payers onto families already burdened by illness. Yet this strategy will not lower costs. Delaying care often creates even higher costs. Steadily rising co-payments and deductibles over the past two decades have failed to stem skyrocketing medical inflation. And nations that assure comprehensive coverage – with out-of-pocket costs a fraction of those in the United States – have experienced both slower cost growth and greater health gains than our country.

Our patients urgently need what people in these other nations already enjoy: universal and comprehensive coverage in a nonprofit system that prioritizes human need over corporate profit.

The IOM committee was riddled with conflicts of interest, many members having amassed personal wealth through their involvement with health insurers and other for-profit health care firms. Its recommendations were lauded by insurance industry leaders who have sought to undermine real health reform at every turn. As the Lancet noted on its Dec. 5, 2009, cover: “Corporate influence renders the U.S. government incapable of making policy on the basis of evidence and the public interest.”5

Sadly, the committee’s damaging recommendations suggest that this corporate bug has also infected the IOM.

1. Smolderen KG, Spertus JA, Nallamothu BK et al. Health Care Insurance, Financial Concerns in Accessing Care, and Delays to Hospital Presentation in Acute Myocardial Infarction. JAMA 2010;303:1392-1400.

2. Kogan MD, Newacheck PW, Blumberg SJ et al. Underinsurance among Children in the United States. N Engl J Med 2010;363:841-51.

3. Doty MM, Edwards JE, Holmgren AL. Seeing Red: Americans Driven into Debt by Medical Bills. The Commonwealth Fund, August 2005.

4. Himmelstein DU, Thorne D, Warren E, Woolhandler S. Medical Bankruptcy in the United States, 2007: Results of a National Study. Am J Med 2009;122 41-6.

5. Cover. The Lancet: Volume 374, Number 9705, 5 December 2009.


Physicians for a National Health Program (www.pnhp.org ) is an organization of more than 18,000 doctors who support single-payer national health insurance. To speak with a physician/spokesperson in your area, visit www.pnhp.org/stateactions or call (312) 782-6006.






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Posted by eridani in General Discussion
Tue Nov 22nd 2011, 07:39 AM
They are essentially an expensive way to reward affluent and healthy people for remaining so.

http://articles.latimes.com/2011/nov/20/bu...

When the latest statement arrived from my dentist, I cursed my dental plan for paying 100% of his fee.

Whatever could explain this absurd behavior? Simple. Of the $1,800 I placed in my flexible healthcare spending account at the beginning of 2011, I still have $1,000 to spend. Whatever we don't use by Dec. 31, we lose.

Like millions of other Americans, in the late fall of every year I face two annoying conundrums. Somehow I have to forecast my out-of-pocket healthcare costs for the coming 12 months, so I know how much to invest in my flexible account, and I have to root around for qualified medical expenses to rectify any overestimate from the year before.

The flexible spending account is a shining example of a government program conceived as a consumer benefit, then encrusted with so many peculiarities that it crosses the line into insanity. Enacted by Congress in the 1970s, the FSA law allows you to place a certain amount of money annually into an account for spending on healthcare items not covered by your insurance — your deductible, co-pays, drugs, medical equipment, chiropractic, etc.
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Posted by eridani in General Discussion
Sat Nov 19th 2011, 04:16 AM

http://www.capitalnewyork.com/article/cult...

Jonathan Gruber, an M.I.T. professor and a key intellectual architect of President Obama's overhaul of the American health care system, said, "You know, I think basically, what they've constructed, the Affordable Health Act, is the best possible private-sector solution to our problem of the uninsured that we have available, you know, short of single-payer."

"Basically, this is the last hope for a free-market solution for covering the uninsured. If this fails, then you either give up on the uninsured or you go to single-payer. Those are the only two options left. And the Republicans, if they're willing to stand up and say, 'We give up on the uninsured,' then great, let them say that and let the voters come to the polls and decide, but they won't say that."


Comment by Don McCanne of PNHP: "Best possible solution... you know, short of single payer." If the Affordable Care Act fails (which it clearly will because it's only more of the same), then either we "give up," or we "go to single payer." It's too bad that Jonathan Gruber was distracted by concerns about feasibility when he was assisting with the design of the Romney and Obama plans. The only plan that's really feasible is one that works - single payer.

My comment: "Market" health care amounts to mass murder for profit, which unfortunately doesn't bother the 85% of the population that accounts for only 15% of health care costs. Their opinions on how good their insurance is are roughly equivalent to their opinions about how good their fire extinguishers are--that is to say mostly worthless.

Markets are only good for providing more--which is a wonderful thing if you are talking about computer memory or iPod features. Fires, murders, pain and sickness--who the fuck wants more of those things? Market entities, that's who. Can't find it online, but I clipped a brief AP article from the Seattle Times of January 30, 2011

Fewer people suffered from swine flu in 2010 than in 2009, bad news for hospitals. Community Health Systems said admissions fell 3 percent in the third quarter of 2010 from a year earlier, for example. It said 1.2 percentage points of the drop wer due solely to fewer flu and respiratory illness patients. The industry is also getting fewer baby deliveries, as prospective parents wait out a weak economy. Still Oppenheimer is optimistica about hospital stocks, saying a strengthening economy will mean a pick-up in elective surgeries.

What kind of morally deranged sociopathic society thinks that less illness is bad news? One in which health care exists to extract profits from pain, suffering and death, apparently.
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Posted by eridani in General Discussion
Mon Nov 07th 2011, 08:38 PM
Worcester Business Journal
Temperatures Rise Over Costs Of Care
Polls Find Public, Doctors Favor More Government Involvement

http://www.wbjournal.com/news50169.html

Presumably, doctors are more familiar than the general public with the pressures driving up health care costs, and an overwhelming majority of them also say there needs to be some government involvement in the health care system. A survey by the Massachusetts Medical Society this fall found that 41 percent of doctors thought the best option for health care reform in the U.S. would be to adopt a single-payer system like Canada's. That number was up from 34 percent in 2010.

(Another survey by the Blue Cross Blue Shield of Massachusetts Foundation) found that 88 percent of Massachusetts residents think it's important for the state government to take major action on health care costs.


Massachusetts Medical Society
Physician Workforce Study
http://www.massmed.org/AM/Template.cfm?Sec...

A question was added to the Practicing Physician Survey in 2010 to documenthow physicians view upcoming system changes in national health care reform. The following question was asked again this year of each of the respondents:

Which of the following would you choose as the best option for the U.S. health care system?

The percent of practicing physicians choosing each response is outlined below:

1. Both public and private plans with a public buy-in option (allow businesses and individuals to enroll in a public Medicare-like health insurance plan that would compete with private plans) -- 23%

2. Keep the existing mix of public and private plans, but allow insurers to sell plans with limited benefits and high deductibles to keep premiums low. State subsidies would help low-income individuals buy insurance. Individuals could choose to buy a less expensive catastrophic plan, more expensive comprehensive coverage, or no insurance at all -- 15%

3. The recent national plan (Patient Protection and Affordable Care Act) passed by Congress in 2010 (modeled after the Massachusetts health reform law of 2006). This plan includes an individual mandate, expansion of public programs, American Health Benefit Exchanges, changes to private insurance including prohibiting the denial of coverage for preexisting conditions, and employer requirements ?- 17%

4. Single-payer national health care system offering universal health care to all U.S. residents -- 41%

5. Other (please specify) -- 4%

While more physicians prefer single payer as the best option for U.S. heath care reform compared to last year?s survey results (41% in 2011 and 34% in 2010), the majority of physicians prefer other options (59% in 2011 and 66% in 2010).



Comment by Don McCanne of PHNP: Of five options for the U.S. health care system presented to Massachusetts physicians, far more - 41 percent - preferred single payer to any other option. That was almost twice as many as those who preferred the second choice option. The single payer choice jumped from 34 percent last year, likely representing further dissatisfaction with their current system based on a design very similar to that of the Affordable Care Act.

The leadership of the Massachusetts Medical Society is not very supportive of single payer, pointing out in this report that 59 percent of Massachusetts physicians prefer other options to single payer. But if they were more objective, they would have pointed out that when offered a choice of "The recent national plan (Patient Protection and Affordable Care Act) passed by Congress in 2010 (modeled after the Massachusetts health reform law of 2006)," 83 percent of physicians prefer other options.

Presenting the remaining data in the same manner, 85 percent of physicians prefer other options to high deductible plans, 77 percent prefer other options to a "public option," and 96 percent prefer one of the listed options (including single payer) to any other undefined option that they might otherwise prefer.

From this we can conclude that a clear plurality of Massachusetts physicians, who have direct experience with the Affordable Care Act model, would prefer single payer, and that support is increasing. By a large majority, they reject any other option, including their current system based on the model of the Affordable Care Act.
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Posted by eridani in General Discussion
Mon Oct 31st 2011, 05:48 AM
Badshah Khan's followers truly were an army, with everything that characterizes military forces except weapons.

http://www.yesmagazine.org/article.asp?ID=...

On April 23rd, 1930, unarmed crowds gathered in Kissa Khani Bazaar, in what is now Pakistan, in nonviolent protest against the British Raj. When they refused to disperse, British troops began firing on them: “When those in front fell down ... those behind came forward with their breasts bared and exposed themselves to the fire, so much so that some people got as many as 21 bullet wounds in their bodies, and all the people stood their ground without getting into a panic.”

This was the world’s first nonviolent army, called by Abdul Ghaffar (Badshah) Khan, who had joined Gandhi to lead his fellow Muslims in the struggle against British colonialism. His peaceful warriors were revenge- and honor-driven Pathans (or Pashtuns) of Afghanistan, the same tribe that would later dominate the Taliban. Khan won over almost 100,000 of these devout Muslims to a nonviolent movement that played a signal role in India’s freedom struggle.

http://www.progressive.org/0901/pal0202.ht...

Khan believed in equality for women and was emphatic about female education, Asfandiyar says. "If we achieve success and liberate the motherland, we solemnly promise you that you will get your rights," he pledged to women. "In the Holy Koran, you have an equal share with men. You are today oppressed because we men have ignored the commands of God and the Prophet."

The movement encouraged equal participation of women from the start. "Pathan women participating in nonviolent action campaigns would frequently take their stand facing the police or would lie down in orderly lines holding copies of the Koran," Bondurant writes.

<snip>

Nonviolence, religious tolerance, women's rights, and social justice--certainly Khan could have done a lot worse than to spread these ideals. And he did it while deriving his inspiration from a religion some vilify as intrinsically intolerant.

http://www.peacemagazine.org/archive/v04n6...

The Pathan nonviolent resistance movement was created by Badshah Khan, who had previously collided with the British when they opposed his efforts to establish a school for the province. Badshah Khan was an early political ally of Gandhi, attracted by the similarity in their spiritual outlook, despite their often conflicting religious backgrounds.

Although his imprisonment by the British quickly turned him into a national hero, Badshah Khan faced a number of difficulties in creating a nonviolent movement. British policy encouraged infighting among the Pathans, creating a situation where they were "too busy cutting one another's throat to think of anything else." Building on the martial traditions of the Pathans, Badshah Khan developed a disciplined nonviolent way for peace. He worked with a nonviolent army, called the Khudai Khidmatgars -- the "Servants of God" -- that had drills, badges, a tricolor flag, officers, and even a bagpipe corps. Volunteer numbers of this army opened schools, helped on work projects, and prevented violence at public meetings. During the Pathan participation in the Great Congress party salt boycott, British troops killed an estimated 200 to 300 nonviolent protestors. At one point, troops fired on a crowd that had expressed a willingness to disperse if they could remove their dead. Despite the deaths, the Khudai Khidmatgars did not panic and a platoon of British-commanded Indian soldiers refused to fire. The courage of the Khudai Khidmatgars caused their ranks to swell to 80,000 volunteers during the salt boycott.

The British tried bizarre means to goad the Pathans into violence, so that their rebellion could be crushed with familiar military tactics. At one point, understanding the Pathan custom of not removing their trousers as long as they are alive, the British soldiers forcibly stripped Khudai Khidmatgars of their clothing. Cows were shot or bayonetted. Villagers were forced inside their homes. One British commander had Khudai Khidmatgars thrown into cesspools after they were stripped and physically humiliated in public. On other occasions they were thrown into icy streams. Fields were destroyed and oil thrown on them. Despite such provocation, the Pathans did not crack. They understood Badshah Khan's observation that "All the horrors the British perpetuated on the Pathans had only one purpose: to provoke them to violence." Badshah Khan's movement finally succeeded, when the British gave the Pathans an elected civil government having parity with the rest of India.

<snip>

On August 16, 1946, motivated by a desire to control all Muslim cabinet representation in a future Indian government, the Muslim League launched the Day of Direct Action. Where in other parts of India Hindus were beaten or forced to convert to Islam, in the Pathan Northwest Frontier Province, 10,000 Khudai Khidmatgars successfully protected Hindu and Sikh minorities by unarmed patrols.


http://www.monitor.upeace.org/innerpg.cfm?...

Badshah Khan was progressively drawn to involvement in the struggle for independence and sought inspiration from the nonviolent tradition of Islam, which he claimed had been present in that creed but had been forgotten. “There is nothing surprising in a Muslim or Pathan like me subscribing to the creed of nonviolence. It is not a new creed. It was followed fourteen hundred years ago by the Prophet all the time he was in Mecca, and it has since been followed by all those who wanted to throw off the oppressor’s yoke. But we had so far forgotten it that when Ghandhiji placed it before us, we thought he was sponsoring a novel creed.”

Badsha Khan set about setting up his own nonviolent army, Khudai Khidmatgars or “Servants of God” in 1929-30. As with Gandhi, the ”simple life” went hand in hand with nonviolence and anti-imperialism, and non-violence as a method was directed against Pathan violence as much as British violence. When the Pathans wanted weapons he would say “I am going to give you a weapon…It is the weapon of the Prophet…that weapon is patience and righteousness…If you exercise patience, victory will be yours.”

For two years after the formation of the Khudia Khidmtagars, Pathans died without fighting back violently, and Badshah Khan’s movement swelled to eighty thousand, many showing astonishing bravery in the face of British atrocities. He was arrested and then banished. He chose to spend his exile at Gandhi’s ashram and the two men became close. In the end British India did not stay together as we know, and Gandhi died of violence. Badshah Khan lived well into his nineties, dying in 1988, having spent thirty years on and off in prison. He never faltered either in his opposition to foreign rule nor in his resolve of the power of nonviolence
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Posted by eridani in General Discussion
Fri Oct 28th 2011, 03:16 AM
Healthcare reform penalizes married couples
http://thehill.com/homenews/house/190105-h...

The report concludes that fewer than 2 million couples--out of 60 million nationwide--are projected to benefit from the insurance subsidies, while "almost half of the beneficiaries of the tax credit will be unmarried individuals without dependent children."

One reason is that subsidies, which start in 2014, are tied to the federal poverty level, which does not increase proportionally along with household size.

Another problem is a snafu in the law that The Hill first reported back in July.

The law offers insurance subsidies for workers if their employer doesn't provide affordable coverage, but proposed regulations released in August peg that affordability to individual, not family, coverage. As a result, a worker's spouse and children would not have access to subsidies if that worker were offered affordable coverage--even if the worker could not afford the family coverage offered by the employer.

The American Academy of Pediatrics is spearheading a sign-on letter to the Centers for Medicare and Medicaid Services (CMS) that decries a family penalty "that will negatively impact the opportunity to access quality health insurance for significant numbers of children."



Comment by Don McCanne of PNHP: This is yet one more example of the fundamental strategic flaw of trying to design reform to fit a fragmented system of private health plans and public programs. Instead of a complex set of rules which are designed to protect the insurance industry, it would have been so much easier and much more efficient to design reform around the patient instead by simply declaring that everyone is covered by a single comprehensive program that is
equitably funded. We can still do that.
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Posted by eridani in General Discussion
Fri Oct 28th 2011, 03:00 AM
http://www.nytimes.com/2011/10/26/opinion/...

AS an economic historian who has been studying American capitalism for 35 years, I’m going to let you in on the best-kept secret of the last century: private investment — that is, using business profits to increase productivity and output — doesn’t actually drive economic growth. Consumer debt and government spending do. Private investment isn’t even necessary to promote growth.

This is, to put it mildly, a controversial claim. Economists will tell you that private business investment causes growth because it pays for the new plant or equipment that creates jobs, improves labor productivity and increases workers’ incomes. As a result, you’ll hear politicians insisting that more incentives for private investors — lower taxes on corporate profits — will lead to faster and better-balanced growth.

The general public seems to agree. According to a New York Times/CBS News poll in May, a majority of Americans believe that increased corporate taxes “would discourage American companies from creating jobs.”

But history shows that this is wrong.

Between 1900 and 2000, real gross domestic product per capita (the output of goods and services per person) grew more than 600 percent. Meanwhile, net business investment declined 70 percent as a share of G.D.P. What’s more, in 1900 almost all investment came from the private sector — from companies, not from government — whereas in 2000, most investment was either from government spending (out of tax revenues) or “residential investment,” which means consumer spending on housing, rather than business expenditure on plants, equipment and labor.

In other words, over the course of the last century, net business investment atrophied while G.D.P. per capita increased spectacularly. And the source of that growth? Increased consumer spending, coupled with and amplified by government outlay
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Posted by eridani in General Discussion
Fri Oct 14th 2011, 04:04 PM
A recent Quote of the Day message expressed alarm at the fact that the Institute of Medicine is recommending a grossly inadequate, skimpy, spartan standard for the package of benefits to be offered by health plans in the state insurance exchanges being established under the Affordable Care Act:

http://www.pnhp.org/news/2011/october/ioms...

Following is a letter asking the Obama administration to reject this recommendation. Though only selected names will be used in publicizing this letter, we encourage everyone who concurs with the views expressed to sign it, using this link:

http://www.pnhp.org/iom-letter/index.php?U...


President Obama: Reject the Institute of Medicine's skimpy health plan prescription

We protest the Institute of Medicine’s (IOM) recommendation that cost rather than medical need be the basis for defining the “essential benefits” that insurance policies must cover when the federal health reform law takes effect in 2014. If adopted by the Department of Health and Human Services, this recommendation will sacrifice many lives and cause much suffering. We call on Secretary Sebelius and President Obama to reject them.

The IOM proposal would base the required coverage on the benefits typical of plans currently offered by small businesses – enshrining these skimpy plans as the new standard. These bare-bones policies come with a long list of uncovered services and saddle enrollees with unaffordable co-payments and deductibles.

Already, millions of underinsured Americans forgo essential care: adults with heart attacks delay seeking emergency care; children forgo needed primary and specialty care; patients fail to fill prescriptions for lifesaving medications; and serious illness often leads to financial catastrophe.

The inadequate coverage the IOM recommends would shift costs from corporate and government payers onto families already burdened by illness. Yet this strategy will not lower costs. Delaying care frequently creates even higher costs. Steadily rising co-payments and deductibles over the past two decades have failed to stem skyrocketing medical inflation. And nations that assure comprehensive coverage – with out-of-pocket costs a fraction of those in the United States – have experienced both slower cost growth and greater health gains than our country.

Our patients urgently need what people in these other nations already enjoy: universal and comprehensive coverage in a nonprofit system that prioritizes human need over corporate profit.

The IOM committee was riddled with conflicts of interest, many members having amassed personal wealth and career success through their involvement with health insurers and other for-profit health care firms. Its recommendations were lauded by insurance industry leaders who have sought to undermine real health reform at every turn. As the Lancet noted on its Dec. 5, 2009, cover: “Corporate influence renders the U.S. government incapable of making policy on the basis of evidence and the public interest.”

Sadly, the committee’s damaging recommendations suggest that this corporate bug has also infected the IOM.

http://www.pnhp.org/iom-letter/index.php?U...
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Posted by eridani in General Discussion
Fri Oct 14th 2011, 04:38 AM
http://www.thespeciousreport.com/2003_uran...

The alleged communication detailing a uranium deal between Niger and Iraq has been published by a newspaper in Rome.

For more than a week, the Bush administration has been trying to explain how the President could have used the claim, that Saddam Hussein was trying to obtain nuclear material from Africa, as justification for war in his State of the Union speech.

The U.S. government still considers this document to be classified and discussion about it is taking place behind closed doors. But individuals who have seen the document say "anyone with half a brain" would come to the quick conclusion that it is flawed evidence.

The text of the published document is as follows:

To: SaddamHot4U@aol.com
Date: Mon, 14 Jul 1999 18:49:03 -0800
Subject: RE: your order..........qy8xc7kd6fg4

ATTN RESIDENT/CEO

STRICTLY CONFIDENTIAL BUSINESS PROPOSAL

HELLO. MY NAME IS DR. SESE SEKO MOBUTO, DIPLOMATIC ENVOY TO THE PRESIDENT OF NIGER. I AM WRITING TO PROFOUNDLY ASK FOR YOUR GENEROUS HELP. AS YOU MAY KNOW, MY COUNTRY IS RICH IN WEAPONS-GRADE URANIUM. WE HAVE STRONG RELIABLE CONNECTIONS TO OBTAIN US$60,000,000 WORTH OF THIS DESIRABLE COMMODITY. IN ORDER TO OFFICIALLY FORMALIZE THE SALE OF OUR VALUABLE RESOURCE, PLEASE VARIFY YOUR COMPANY'S NAME, ADDRESS, AND FAX ALONG WITH A VALID BANK ACCOUNT NUMBER AT YOUR EARLIEST POSSIBLE CONVENIENCE.

IN ADDITION, MY CLOSE GOVERNMENT CONTACTS HAVE INFORMED ME THAT WE CAN MAKE AVAILABLE TO YOU A REVOLUTIONARY NEW HERBAL VIAGRA SUBSTITUTE, AND THIS TRANSACTION CAN BE KEPT STRICTLY CONFIDENTIAL BECAUSE OF ITS DELICATE NATURE. AT THIS SAME TIME, I AM ABLE TO EXTEND TO YOU THE OPPORTUNITY FOR A PRE-APPROVED NO-CREDIT GOLD VISA CARD. MY ASSOCIATES ALSO HAVE THE ABILITY TO PUT YOUR SEPTIC TANK IN PROPER CHEMICAL BALANCE AND OFFER PRINTER CARTRIDGES AT AN AMAZING 80% DISCOUNT WITH FREE SHIPPING. OR IF YOU PREFER, PLEASE CONSIDER THAT A MINIATURE REMOTE CONTROL CAR MAKES A GREAT GIFT IDEA.

KINDLY REACH ME BY EMAIL FOR MORE DETAILS ON THE LOGISTICS AND MODALITIES IF YOU ARE INTERESTED IN A MUTUAL PARTNERSHIP SO THAT WE CAN ARRANGE A MEETING SOON.

I LOOK FORWARD TO RECEIVING YOUR URGENT RESPONSE,
DR. SESE SEKO MOBUTO
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Posted by eridani in General Discussion
Mon Oct 03rd 2011, 07:02 AM

Health Affairs Blog
http://healthaffairs.org/blog/2011/09/14/c... /
Census Numbers: The Trend Toward Government Coverage Continues

In its yearly survey of health insurance coverage, the U.S. Census Bureau published figures that underscore the trend toward greater dependence on government for coverage.

Those on the right (including myself) who oppose the government-based model see an alternative path toward portability and continuity based on individual ownership and market-based competition. The Heritage Foundation's Saving the American Dream plan empowers individuals and families to own and control their health insurance. It establishes individual tax relief for people to buy coverage in a marketplace where insurers and providers are accountable to meeting consumers? needs of higher quality at lower costs. It also reforms Medicare and Medicaid, putting them on a sustainable path forward.

While discussion of the Census numbers typically focuses on changes affecting the uninsured, the real story is the slow but steady trend away from private coverage and toward government coverage. Recent estimates by the CMS actuaries project that by 2020, government will control 50 percent of all health care spending in the country. Americans should take note that the health care system is moving to the tipping point where it will be more government-run than private.


Response by Don McCanne of PNHP

Why would health care be fiscally unsustainable when it is paid for through a government program, yet sustainable when it is paid for privately?

The fiscally unsustainable argument is based on the assumptions that the government would not introduce adequate cost containment measures, and that the government would not impose adequate taxes or tax equivalents to pay for the system. Based on the experience of other nations, both assumptions should be challenged.

Other nations use either government ownership or robust government regulation to slow the growth in health care costs. They also use government taxing authority or regulatory mandates to ensure that the health system is fiscally sustainable. Directly or indirectly, they function as a public monopsony. Although they may complain about their own rising costs, they certainly spend less money than we do, yet they are able to include essentially everyone in their comprehensive programs.

How would private control of health spending produce a fiscally sustainable system? The answer is that it would be fiscally sustainable only for the government. With a median household income of $49,000 and average health care expenditures of an insured family at $18,000 (Milliman Medical Index), health care costs for individuals and families are already unsustainable. (Median households and families with employer-sponsored plans are not the same, but these numbers still illustrate the enormity of the problem.)

Health consumer empowerment is being achieved by shifting more of the responsibility for payment directly to patients, especially through increased deductibles and other cost sharing. At today's high heath care costs that means that many more patients would be foregoing beneficial health care services, simply because they can't pay for them.

Now Medicare and Medicaid are being threatened with proposed reforms that allegedly would put them on the path of sustainability. Again, that might be sustainable for the government, but the proposed changes would shift more costs to patients, further impairing access because of increasing financial
barriers to care.

Many of us were shocked recently during the Republican candidates' debate when the moderator asked if a thirty year old, critically ill man should be allowed to die because he was uninsured, and members of the audience shouted, "Yes." But that was only a very few voices from an anti-government Tea Party audience. Not only would citizens of other nations emphatically reject this view, it also decidedly violates American values.

Nina Owcharenko offers us the choice between consumer empowerment in which we can reject the health care we need but can't pay for, or our own beneficent government monopsony that would ensure value in our health care purchasing so that all of us could have the health care that we need.

Although her blog entry and this response may appear to be merely a rhetorical game, the choice really is a matter of our nation?s health.

My comment: Word for the day = monosopy. It is like a monopoly, except that in a monopoly the market is dominated by a single seller, and in a monosopy the market is dominated by a single buyer. And you make private health insurance "sustainable" by bankrupting and/or killing the sickest 5% that account for 50% of health care costs.



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Posted by eridani in General Discussion
Fri Sep 16th 2011, 01:50 AM
--was that he would run his administration like he ran his campaign. When it came down to Obama or Clinton, it made no difference to me one way or the other on the issues. Both are confirmed corporatists. Obama was slightly better on the wars, and Clinton slightly better on health care. Both were mostly funded by the same corporate interests.

I made my choice to support Obama strictly on the grounds of his campaign organization. In our caucus state, the Clinton people came in and told local Dems that they'd better get behind the inevitable winner, or those wanting political careers would be made to pay. And she hired worthless pieces of shit like Mark Penn.

Obama, on the other hand, hired experienced organizers and used a lot of his early financial booty to set up software that people could use for self-organization. The paid people came in and mostly approved of what local people were already doing. They contacted local party leaders and PCOs, and listened to what we had to say.

The 2008 general election was THE canonical model for how elections should always be run. In past years, the "coordinated" campaign, supposedly working on state and national candidates concurrently, has always been totally uncoordinated chaos, featuring newbies who blew into town and did their own thing, totally ignoring what local party members were already doing. I don't know how many times I answered calls for door-knocking volunteers and wound up walking a precinct that already had literature hanging from all the doorknobs, put there by a local PCO.

In 2008, the people sent from the national organization immediately connected with the local party people. They asked us for lists of precincts with and without PCOs, and accepted our evaluation of just how likely any given PCO was to actually walk his or her precinct. My legislative district contains parts of 3 congressional districts and 5 cities, so I recommended subdivisions by geography which the coordinators immediately accepted. With a near-perfect blend of the online campaigning pioneered by Dean and tradtional personal outreach, there was this very rewarding sense of being on the same page as everyone else and getting something done right for a change.

Silly me. I expected that to carry over into Obama's administration. When OFA became Organizing for America, all that changed. No one wanted to hear what any of us local people had to say anymore. We were given the word from on high about priorities, and ignored when we wanted to suggest priorities of our own.

I knew that 2010 was going to be a disaster when the OFA people had meetings where they presented charts and graphs and lists of microconstituencies that benefited from particular programs. There was not even a single mention of values or messaging, whereas the 2008 campaign had been heavily values-based. I quit going to those meetings, and did as much canvassing as I had time for on my own, given thatI was also organizing against the Catfood Commission. I got a lot of very good response to mobilizing people against that, from Democrats, Republicans and independents alike. Given that caucus states tend to have much stronger local party organizations, WA State resisted the red tide. Still, I could have done much more without the Obama-imposed distraction of the Catfood Commission.

And here we are at 2012 almost, and not a single word from OFA other than that "we have to educate people about Obama's accomplishments." Actually we shouldn't be doing anything of the sort, despite the fact that much useful stuff has gotten done. Why? BECAUSE THE GENERAL PUBLIC DOES NOT GIVE A BLOODY GODDAM ABOUT LAUNDRY LISTS! They care what is going on in their lives and about values, and no one can tell me what Obama's values are, except they seem to have something to do with government not being able to create jobs, regulations being bad and tax cuts being good.

The economy is still going straight to hell for the majority. This majority would still be strongly behind Obama if they felt he was on their side, no matter how bad things get. I don't feel that at all, and am working hard trying to convince all the 2008 PCO dropouts in my legislative district that we have to get more progressive people in locally and at the state level before we can change anything at the national level in any meaningful way. I'm having some success passing the word on what Republicans plan to do to Social Security and Medicare. I'm into politics for the long haul, but I'm part of a shrinking minority.

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Posted by eridani in General Discussion
Sat Sep 10th 2011, 07:14 AM
http://www.mediatrainingworldwide.com/blog... /

From Media Training Insider, an organization I'd never heard of before, but which seems to offer professional analysis and training for people that speak to the media and public:

"Passion: A+"

"Platform skills: A+."

"Civility and warmth: A+."

"Policy Impact: F-. This president is either unwilling or unable to package his ideas within a greater narrative, story or philosophy. He didn’t explain his vision of how we got into this financial mess and he didn’t explain why his approach is different or better than the Republicans."

"Political Impact: F-. The president failed to make the American people angry with Congress, therefore they won’t be screaming and demanding that Congress make any big changes. Therefore, very little of Obama’s agenda will be enacted."

"Combined Weighted Score: F+"

The House Progressive Caucus is doing what they can to pick up the slack for Obama's shortcomings:
http://cpc.grijalva.house.gov/index.cfm?se... §iontree=5,61&itemid=402
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Posted by eridani in General Discussion
Wed Aug 31st 2011, 09:32 PM
Medicare costs for hospice up 70%
http://yourlife.usatoday.com/health/medica...

Medicare costs for hospice care have increased more than in any other health care sector as for-profit companies continue to gain a larger share of the end-of-life medical market, government records show.

A recent report by the inspector general for Health and Human Services, which oversees Medicare, found for-profit hospices were paid 29% more per beneficiary than non-profit hospices.

At the same time, some of the nation's largest for-profit hospice companies are paying multimillion-dollar settlements for fraud claims and facing multiple investigations from state and federal law enforcement agencies.

Critics say costs have also increased because for-profit organizations have cherry-picked patients who live the longest and require the least amount of care--such as those with dementia or Alzheimer's, rather than those with cancer.

"Certain hospices seem to be seeking out beneficiaries with particular characteristics, and these beneficiaries are often found in nursing facilities," said Jodi Nudelman, a regional inspector general for HHS in a webcast about the report.

In a growing number of cases, hospices are collecting the same daily rate for visiting patients in nursing facilities as other hospice programs that also provide patients' room, board and medical care not related to their terminal illness.

Report of the Inspector General of HHS:
http://oig.hhs.gov/oei/reports/oei-02-10-0...




Comment: PNHP has long advocated removing for-profit corporations, with their passive investors, from the health care equation. This report on hospices from the HHS Inspector General provides more compelling support for this view.

For-profit hospices that provide care to Medicare patients have been ripping off taxpayers by cherry-picking less expensive patients, collecting much larger fees by providing services prematurely, and, worst of all, collecting full fees for merely providing what is not much more than house-call-type services in nursing homes rather than providing the full range of services expected in hospice care. Their multi-million dollar fraud settlements don't seem to deter them.

It is imperative that we remove passive investors and their corporate executive goons from health care.
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Posted by eridani in Religion/Theology
Tue Aug 30th 2011, 08:03 PM
You may ground your ethics in some traditional faith, but if you'll look around you'll see the same ethics shared by people of completely different faiths, or no faith at all. I don't give a rat's posterior if you are against pre-emptive war because Jesus told you to turn the other cheek and blessed peacemakers, because the ancient Jewish prophets told you to beat your swords into plowshares, because the Prophet (PBUH) said that God does not like those who commit aggression, because the Wiccan rede advises you that you may do as you will as long as you don't harm others, because the Buddha told you to be compassionate, or because Confucius said that the superior man should never resort to war as the first alternative. Or maybe nobody told you anything--you figured it out all by yourself that deliberately causing a lot of human suffering sucks. If we all get to that particular ethical place eventually, why does it matter how we got here?
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