Thursday Open Thread

 

"Time Machine" - Have Gun Will Travel

Sorry guys, but it's been busy, busy, busy -- nine hours of driving on Tuesday, a lovely meal and a few cold ones with our friend Joe S. last night, and tonight a fund raiser for the Scott Walker recall election effort at the AFL-CIO.  The feeling within the pro-recall forces is that the election is much closer than the polls are implying -- the internals within their polling show a race well within the margin of error.  It's all going to come down to turn out, particularly among minority voters in Milwaukee.  This election -- and the accompanying senate recall races -- remains hugely significant to my thinking.  Stop Walker and return control of the Wisconsin senate to the Democrats and it sends a hugely powerful message.  On the flip side, should Walker prevail, one of the more impressive grass roots political efforts in recent memory is going to have fallen short, emboldening Republicans in their war on unions.

Seems like it was an eventful day today.

- Really happy about the decision striking down DOMA from the First Circuit Court of Appeals.  I have not read the decision yet, so can't really give any kind of detailed analysis of it, but once again it would seem historical anti-gay prejudices are not proving an adequate rationale in federal courts.

- Heartened to see that the Justice Department is taking steps to stop Rick Scott's outrageous purging of the voter rolls in Florida.

- Glad to see the Edwards jury would not convict him.  I am curious to see if the U.S. Attorney will attempt another trial.  I would certainly hope not, but my sense is that prosecutorial ego will compel another shot at conviction.

- And finally, libertarians really are creepy, defective human beings. 

What's got your attention at the moment?

Comments

[KN]

SC - you seem to have caught your audience off guard.

I am curious about your Edwards POV, so you think he was set up or something?

Anybody paying any attention to the outrageous election theft in Anchorage on April 3rd? Well, expect more of that. A lot more.

WI is a big issue in my mind, if the thugs manage to hang on they will be emboldened. As if they needed any encouragement.

Next week I am going up to Fortaleza to look for some property. Once I own some land I can easily get citizenship here and so I will not have to return to the US in the long term. I will have to settle some affairs there and make some moves, but somehow I just cannot abide living in a country where even a deluded and brainwashed minority can be convinced that a slime ball like Romney is presidential material. Jerry Lewis would beat him hands down.

Brasil is no socialist utopia, and is more dangerous by a long shot, so far, than the US, but they laugh at us for the complete stupidity of our politics.

It is just sad. Such a great country in so many ways, brought low by a cadre of greedy and ignorant oligarchs, intent only on their own delusions.

Maybe I am paying too much attention.

[oddjob]

it would seem historical anti-gay prejudices are not proving an adequate rationale in federal courts

That's because as long as "But it's tradition!" is not an adequate rationale then there is none.

[MR Bill]

Just checking in guys, I'm still alive and lurking..
Have composed a couple of great comments (IMHO) that were eated...
The play ended in March (it was a success: the audiences laughed, we said all the words, and the theater made money off it..) and i would spend the next month driving my friend 'The Artist Harley' (as opposed to the motorcycle, I guess) to Las Vegas (an appalling, fascinating and wholly artificial place) for a gay biker event he had done the artwork (flyers, online stuff, tshirts) for, and treatment at the Las Vegas VA hospital (a wholly different environment than the much abused, and with reason ATL VA Hosp.) I drove his '91 Coupe Deville (he wanted it out there if he had to stay) and was the '300 lb. Samoan lawyer' in this particular iteration of 'Fear and Loathing. What I found interesting was the poor condition of the roads (We were on I-40 most of the way, and Harley, who has some sort of inoperable brain tumor was making it a bucket list tour, we did Graceland and the Oklahoma city memorial and Meteor Crater and the Petrified Forest/Painted desert, Flagstaff and Grand Canyon, as well as visiting his marine buddies). His condition is stable, horrible headaches, and other symptoms, but he's not dying yet, and is back in GA.
When I got back my computer was dead, and I got it replaced in time for the router to die..Finally back in circ..
I was really down over the endless stream of crap coming out of the GA Legislature. Old friends are trying to get me to move to Asheville NC and try out for paying gigs in the community theaters there..
I've got to move in the next few weeks (this place is being sold) so I must decide something..
Thanks for the 'Crooked Timber' post..
For my favorite Republican idiocy of the day, here NC's Republican Legislators telling coastal scientists they have to produce a 'politically correct' assessment of sea level rise.. It's like the historic attempt to round off pi to 3 for ease of calculation. The subtext is, of course, protecting the potential profits of coastal developers.
I was rereading some of Bill H's comments, and like most, am troubled by many of Obama's actions, especially the targeted executions by drone. It has to be noted that since the 'atomic age', we've give the Executive the power to pretty much destroy the world, much less kill a perceived enemy. I suppose we should be glad Obama has had the restraint not to send drones after Mitch Mcconnell, Paul Ryan, and the Koch Bros...
And watching what Republican government is like, hell yes I'll vote for him again, and wish the Local/state Democrats had a clue.

[oddjob]

I know employment figures are often subject to revision, but this is not good news.

[Prup (aka Jim Benton)]

First, my compliments, KN. I think the line "If it was “liberals” pulling these kinds of stunts and blundering everything so badly that an unrehearsed clown act would look like Cirque d’ Soleil by comparison you can bet the soverign citizens, the militias, the secessionists, the survivalists, would be in the streets, with their small arms and body armor, screaming bloody murder." (from a comment on MUDFLATS) is one of the best lines you've written.

For all, I've seen a lot of discussions of 'jobs' in general, of the effect of 'globalization' and technology, but this makes a point that I haven't seen often enough:

Over the past three decades, the United States has seen substantial growth in both high- skill and low-skill jobs, while growth of those in the middle has stagnated. At the same time, a growing gap in wages between jobs that pay the most and those that pay the least has emerged. As we discussed in a previous blog post, this combination of trends is often referred to as job polarization, and it is happening in much of the developed world. In this post, we examine the extent to which job polarization has occurred in upstate New York, downstate New York, and Northern New Jersey. We find that job polarization has been significant in all of these places, contributing to a sharper than average rise in inequality in downstate New York and Northern New Jersey.

Technology and globalization appear to be the driving forces behind job polarization, displacing many jobs involving routine tasks where computers or relatively low-cost labor from other countries can serve as a good substitute. As a result, this displacement has been most pronounced for traditional middle-skill workers. By contrast, these same forces have increased employment opportunities for high-skill workers who create and use technology, while lower-skill service jobs requiring physical proximity or face-to-face contact have largely been insulated.

The source? Liberty Street Economics, the blog of the NY Federal Reserve Bank -- who knew? -- and the whole blog is surprisingly solid and even more surprisingly, some, not all, of the pieces are written for the average reader without too much Bureaucratese or Academic incomprehensibility. (For one that doesn't have that benefit, but which is worth plowing through anyway, click to the home page and read the next piece down, on CDS and the likelihood of their increasing bankruptcies.)

[oddjob]

MR Bill, I have no roots in either state, but at this point if I had to choose between Georgia & North Carolina I'd choose NC.

[low-tech cyclist]

You know what would be nice? If Obama and the Dems reintroduced the American Jobs Act.

One thing the GOP does well politically that the Dems don't is to just keep on pounding on the same thing until the message gets through that this is what they're for (or against, as the case may be). The Dems will try something once, and when it doesn't get through Congress, they let it go until the next Congress (if then).

Repetition is important in communicating with voters who are only paying attention some of the time. If you want the electorate know where you stand on something, you've got to keep coming back, and coming back, and coming back to it. Over and over and over again.

The message has to be that we ought to pass this sucker now, because we need to put people back to work, there's plenty of work that needs doing, and both from a putting-people-back-to-work perspective, AND from a deficit/debt perspective, there's no better time to do it than RIGHT NOW, while Uncle Sam can borrow money at negative real rates.

And if we can't pass it now, then the next best time would be later this year, and the next best time after that would be next January - but we'll need both a Democrat in the White House, AND a Democratic Congress, to do that.

Electing a Democratic Congress as well should be part and parcel of Obama's re-election campaign - but that obviously makes no sense without an AGENDA that he needs a Democratic Congress in order to pass. And we've heard precious little talk about a Democratic agenda.

The American Jobs Act should be the first plank in that agenda.

[Prup (aka Jim Benton)]

Mr BILL: Welcome back, you were missed. Glad to hear the play was a success. The cross-country trip was fascinating as well, the bit about the roads unsurprising -- but it is nice that you got a chance to tie the fuzzy word 'infrastructure' to a real-life experience. Too often we get involved in long discussions about 'concepts' that become more and more abstract, and our discussions become more and more 'logical' rather than 'rational.'

It's always helpful to yell "Stop" and spend a little time transferring the concepts into actual effects they have on actual people. (I'd like to see more business owners asked, when they thunder against 'Government regulation,' how many additional sick days they are willing to tolerate because the food their workers eat is unregulated, and the equipment the firm uses is equally so and thus more likely to result in worker's comp cases.)

As for your planned move, one thing you might consider is checking here and reading as many local newspapers from an area you are considering. They aren't perfect representations, of course, but they give more of a feel for the place and people. (My hunch, btw, from a 'whole-state' scan I did earlier, is that of the Southern States, Alabama might be less obnoxious. They are still conservative, Republican and religious, but they seem to have been the state in the area that has first recovered from the hangover they got from 'too much tea.')

I can't comment on specific factors like cost, climate, or availability of homes, but for a political environment, I'd al least try to find a place where the Democratic Party has not adapted a "if we disguise ourselves as Republicans maybe they won't hate us so much" strategy. (Not KY, NC or WV, for example.)

As for the drone strikes, I am not worried that Obama will misuse them. He seems to understand -- himself -- the power they give and is likely to keep them very limited. What does bother me are two questions:

a) What use whoever succeeds him in 2017 will make of the precedent he has set? and
b)Why he didn't ask himself question a. (Does this man ever think through the long-range consequences of what he does and the way he does it? Ever?)

Still, of course -- and Jayhawk, will you pick a couple of specific areas for us to debate this over? -- there is no argument for voting Republican -- directly or by staying home, which would have the same effect -- given that everything you worry about from Obama is something the Republicans support even more strongly and are more likely to misuse. And that, equally, the things you wish Obama and the Deomcrats would push more effectively (union rights, wall street reregulation) are things Republicans have, almost unanimously, sworn to reverse.

[Prup (aka Jim Benton)]

On a different topic, the announcement that (in Earth-2) Green Lantern is -- and always has been -- gay has been making a surprising number of headlines. So has Marvel's first gay wedding, wisely featuring Northstar, the first out superhero. And both of them were scooped by Archie Comics, who introduced a gay character (ex-military who met his lover while they were serving in Iraq) in 2010, gave him his own book next year -- after he sold out his own mini-series, and who had a widely celebrated issue featuring his own wedding in March. (Which, despite protests, sold out, the usual term has been 'flew off the shelves')

When I point to this, to WHITE COLLAR announcing its own lesbian FBI agent is contemplating marriage, to the number of gay characters on tv, to MODERN FAMILY and GLEE, and to the evaporation of the "Rock Hudson rule" (that 'no one will accept a gay man in the role of a straight romantic lead') with Neal Patrick Harris and Matt Bomer coming out -- it rarely gets commented on. (In person I'd probably have come to recognize a 'here he goes again' look everytime I brought it up.)

And yet, I think this type of thing may be as important as Obama's 'evolution.' We tend to underestimate the positive effects of popular culture -- but we just love to exaggerate supposed negative ones. But it matters as both a reflection of and a leader of public attitudes. (Remember, it was 15 years after Brown and five years after the Civil Rights act was passed before tv dared 'the kiss' -- on STAR TREK between Kirk and Uhura -- and as important as the actual physical contact was, it was shown as Kirk being under mind control and presented almost as a way of 'degrading' and 'embarassing' Kirk.)

One point to think about -- and I wish I had positive evidence for this rather than merely a lack of negative evidence -- there seem to be little difference in ratings/sales/reception for gay-themed pop culture in blue and red states. WHITE COLLAR, GOOD WIFE, GLEE, MODERN FAMILY, I've never read any story showing a difference in their popularity, and I don't think the sell-out of the Archie wedding issue happened because it was only distributed in urban areas -- my hunch is that ARCHIE has always been less popular there than in small cities and towns.

[Sir Charles]

Jim,

I think popular culture has played a huge and very positive role in terms of achieving far greater acceptance of gay people. I think that is true in matters of race as well, although this is obviously a pretty stubborn problem.

The other thing that I think has been particularly helpful in moving the ball forward on gay acceptance has been the widespread practice of people coming out. I think it can't be underestimated how powerful it is to know that a loved one, a friend, or even a neighbor that you like is gay. And people realize that this doesn't change their feelings about such people in any meaningful way.

[oddjob]

I think this type of thing may be as important as Obama's 'evolution.'

I have long felt it was no accident that the approximate generational dividing line between those firmly in favor of marriage equality and those mostly opposed is also approximately the age of fifteen or so when MTV's The Real World premiered. It must be very difficult to credibly maintain an anti-gay attitude while watching years of a show where there's always a gay adolescent and thus repeatedly seeing that despite who turns the gay one on he or she is otherwise just another ordinary young adult in their late teens or early twenties.

And yes Sir C., for decades gay rights advocates have said over and over that the most important single thing any gay American can do is leave the closet, that the collective indifference of straight Americans to the inequality gay Americans suffered was directly tied to how few straight Americans believed they knew anyone who was gay.

[Prup (aka Jim Benton)]

One quick note about how attitudes have changed. The Archie wedding is not just same-sex, but also interracial, Dr. Clay Walker is black, yet that has only been mentioned as background, never seen as significant.

And, while we've never met her -- iirc -- there has been a feel that the potential wife of the Latina FBI agent in WHITE COLLAR is white. (And the various racial and physical interactions involving Kalinda Sharma, the bisexual detective on GOOD WIFE and her partners would make this one of my longer posts.)

[oddjob]

Democrats are lousy storytellers.

[nancy]

Boy, oh, boy, after the stats released today, reintroducing the American Jobs Act. Most definitely, which would solve the Democrats are lousy storytellers problem, at least for the moment. *Lousy* -- that's sure an understatement. None of us like the KISS concept, so automatically we clutter the narrative, losing the audience in the process. Noble, but persistently counterproductive bug is that.

And I had been reading a good piece of reporting in the New Republic on the changing, but hard to read, political lay of the land in Ohio, when I ran into this report in the Columbia Journalism Review which supplies some background and context to the TNR piece. It's part of a series on the swing states. A bit of a read to follow all of the links, but hey...it's the weekend.

[nancy]

Also. re Rick Scott.

What's the matter with Florida?

[janinsanfran]

Re Edwards verdict: this might happen more often if ordinary people could afford to go to trial. Certainly I've gotten off on several civil disobedience type arrests because the cops never bothered to collect any evidence that we did anything and so were helpless at trial. And now in this interesting review, the writer explains: "Ninety-five per cent of all felony convictions now result from a guilty plea. The criminal trial has virtually disappeared. The American defendant’s fate is decided not by a jury of peers, but by powerful officials with virtually unchecked discretion."

I knew a lot were plea-bargained, but not 95 percent. But most people arrested can't afford to rot inside and risk getting hammered, so the prosecutors have their way with them. Not that some of them shouldn't be off the streets ...

[Sir Charles]

jan,

Not to mention that prosecutors punish anyone who has the temerity to go to trial with attempts to get them put away forever regardless of the offense.

[KN]

I guess I should say thanks Prup.

I guess everyone agrees with everything else I say so ther is not much point in saying anthing.

KBO -

[Crissa]

I can't believe Edward's supporters spent a million dollars on a woman and she got little of it and the prosecution's main witness walked away with a half million dollar home.

Bizarre case, if you ask me.

[Crissa]

What bugs me about the whole row over drone killing is that many arguing against it weren't arguing when we blew up the first man in the first truck in (I think) the Sudan. Under W.

This isn't unique or unusual, we've blown up and tried to attack targeted people many times in the past. Closer to home, dozens of people are wrongly killed by police in the US - my father for one.

It just pisses me off.

[Bill H]

"Jayhawk, will you pick a couple of specific areas for us to debate this over?"

Well, it's nice of you to ask. I guess I could get a nice little thing going over there being a difference between private sector unions and public sector unions. I favor private sector unions very strongly, public ones somewhat less so for a couple of reasons.

Liberals have stood by and allowed private sector unions to become totally eviscerated, and now suddenle jump to the defense of public sector unions. Why?

In private sector collective bargaining the negotiation takes place between the workers and the party who is paying the wages. In public sector that is not the case. The negotiating takes place between the workers and elected officials, with taxpayers paying the wages. Elected officials do not always, in fact don't usually, have the best interest of the taxpayer in mind, since public sector unions play a significant role in helping them get elected. Witness the representative of the SIEU in a California city saying to the city council, "We got you elected and we can throw you out."

Private sector unions bargain differently than public sector ones do, because the former have a vested interest in the success of the company for whom they work, while a community or public entity has no yardstick by which that sort of bargaining leverage can be measured. The public union negotiates against the citizenry, raising its own wages at the cost of higher taxes for the citizens.

That's not to say that we should not pay our public service workers a kiving wage, but unions are a method of taking control out of the hands of the taxpayers/voters, and that is seldom a very good idea.

I'm actually not a big fan of unions at all, so much as I am a very strong supporter of collective bargaining; so much so that I think a collective bargaining agreement should be a requirement for incorporation.

The day that unionism evolved to a business such that the bargainers are no longer actually workers in the shops for which they are bargaining, though, was the day that the labor movement began cooperating in its own destruction. Big business and legislation was a larger cause, but labor itself was not guiltless.

The grocery union in southern California just came to an agreement after working without a contract for some six months. Part of the reason they were able to bring that off was that the union officers, doing the negotiating, are actual workers who man the floors of grocery stores and are paid by the union only for the time they spend doing the actual negotiations. Partly too, of course, was the memory of a lengthy strike four years ago, but...

[Prup (aka Jim Benton)]

As always, Jayhawk, your ideas are useful, chalenging, and worth thinking about -- up until they clash with the political reality that exists. (And, again unless you have paid close attention to the states, you may not realize what that reality is.)

On your overall statements, I would argue that, while in some few blue staes like California and New York, and in traditional union states, public employee unions do have some clout, in most states today and for some time the legislators and governors ignore the interests of the citizens abd taxpayers as a whole, and focus in on the narrow financial interests of a narrow group of taxpayers.

I would go even farther and argue they are defending not the actual interests of much of the group, but rather what their ideology tells them those interests should be. In fact, I believe that the majority of corporations who withdrew support from ALEC were telling the truth in saying they had no idea that their money was supporting many of the provisions that ALEC was pushing for and had they known, would have opposed them. (Is there any corporation that benefits from NRA-style anti-gun control laws except Colt, for example? Most business owners would prefer not having their employees shot, their customers threatened, or even their office windows shattered by stray bullets from the next George Zimmerman. Also, most business owners like to know they won't have to pay sick days to employees suffering from tainted, uninspected food, most business owners prefer that their employees are at least moderately educated, and few business owners affected could have celebrated those cases where budget cuts forced states to let paved roads turn back to gravel -- as happened in several states in the last three years.)

But that's arguable. And I wonder if someone like Sir Charles will have a good argument against your point about unions hiring representatives rather than actually having workers represent themselves. (It sounds good in theory, but I can see things wrong with it.)

But none of this, no question of how we see the ideal world, is relevant to the point we are disputing. The question is whether the difference in attitude towards unions is sufficient to argue that -- if your issue is unions and labor relations -- it makes a difference what party you support.

Tomorrow, I'll go into detail as to why it does. A nice starting place would be this article from the LA Times -- I'll have a lot more articles to throw at you in the next posts.

But I have to insist that pointing out the many failures the Democratic Party has shown towards the cause of labor -- and, unlike you I'd argue they have been far too weak in supporting public service unions against the current attack -- that there is a difference between being too weak, too clumsy, too hesitatnt, and frequently too stupid in defending the rights of unions -- and in some cases for some members, even joining in on some attacks -- and being almost universally consistent in attacking those rights.

Again, one last attempt to put it simply before i start drowning you in details. Democrats have done a lousy job in moving the ball in the direction we'd all want to see it go -- and while we'd all spend days arguing the details, i think there is such a general direction. But almost every single attack on unions has been proposed by Republican legislators or Republicans governors, and when such laws have been brought to a vote have been overwhelmingly -- in some legislatures unanimously -- been supported by Republicans and opposed by Democrats.

Just tell me the level of detail you want. I'm the sort of nut that actuall would enjoy going to each state's newspapers and legislative record and checking the parties of the proposers of every one of the 744 anti-union bills mentioned, and totalling the vote for and against by party on all of them, if you need that demonstration as to how one-sided the Republican party is.

Similar bills have been intriduced into Congress as well, despite the fact that they could not be considered in the Democratic Senate and would be vetoed by a Democratic President. Letting the Senate go Republican, leaving the House Republican would give these bills a chance to pass. And nowhere in Romney's flip-flops can you find a statement that could even be twisted into implying he'd veto it, even if he turned back into the 'moderate Mitt' -- that esicted more in legend than in fact.

If trying to destroy unions, cripple collective bargaining, strip employees of pensions, and keep union members from speaking out politically on other than financial issues (school teachers working for better schools, safer and newer buildings, and against political dictation of a right-wing agenda curriculum, for example), if those define 'evil' in the field of labor relations, then voting for a Democratic President (even one as weak as Obama) and a Democratic Congress is needed to 'stave off the triumph of evil.'

More details on this, and maybe something similar on women's issues and women's health issues. But tomorrow. Hope I don;'t fall asleep before the captcha.

[Prup (aka Jim Benton)]

I want to get back to the discussion on health care, and the discussion with Jayhawk on unions, but first:

"We interrupt these proceedings for a personal message:

W*H*E*E*E*E*!!!

As of last night, the Mets had played 8020 regular season games in their history. (I have heard or watched most or all of 6000-6500 of them, and the number would have been higher had I not spent 5 seasons living in Philly, and half of another in Baltimore -- the second half of 1969 of all seasons.)

Despite being a team usually based on strong pitching, they were one of two teams that had never had a no-hitter. The other is the Padres -- and they are seven years younger a franchise.

Thanks to Johann Santana -- okay, and a blown call on Beltran's 'foul' ball -- that is no longer true.

W*H*E*E*E*E*!!!!!

[Bill H]

Yes, thank you for that about the Padres being the only team in major league without a no hitter. I was aware of that, as well as the fact that they currently have the worst record in major league baseball, and I won't even get started on their ownership issues. But thank you for reminding me, nonetheless. I'm trying to determine if this is humility or humiliation.

Yes, I'm aware that Republicans are always the instigators of anti-union legislation. Democrats always sit back and do little or nothing to defeat it. Democrats always play the straight man to Republican thuggery. What's your point?

Unions help elect officials in more than a "few blue states" with campaign contributions and by telling their members how to vote, or they did before they were eviscerated. I was a member of the IBEW in ~1963 after I got out of the Navy and the Teamsters in ~1968 when I went to work in a steel plant. In both cases I was told who the "union candidate" was, and I can assure you that a vast majority of my brethren voted accordingly. Public sector unions hold similar power today, smaller but still powerful, and don't think for one minute that they don't use it.

Yes, elected officials represent the interested of the corporate oligarchy, but at union negotiation time the taxpayers get screwed by negotiation which goes, "I'll agree to higher wages if your union will support me for reelection."

[Bill H]

We also have the San Diego Chargers. Sigh.

You want to talk about "Card Check" maybe? Oh, let's do.

[Prup (aka Jim Benton)]

Now that's out of my system...

Getting back to the discussion on health care above, it shares one fault with most of the similar discussions coming from both sides in the campaigns, totally itgnoring anyone below the 'middle middle class' -- at least economically. The act itself makes provisions that at least begin to help those below this, especially those who, while employed, had no insurance at all, none from their insurer and none they could afford privately, but the discussions tend to skip over that.

(One brief note, mostly for Bill H. We all -- afaik -- support a single-payer system. Almost all of us admit that it would have been a political impossibility to move in that direction. Whether a different type of President -- one who was more of a leader, one who understood the political facts on the ground better, one who could begin his term with a plan and forced the Republicans to attack it, and who could have marshalled the voters in general to line up behind it -- could have pulled it off is an arguable question, but an irrelevant one. I may think a TR, and FDR, an LBJ, even a JFK or a Truman might have done it. But we didn't have them as President, and Obama's unreadiness, his legislative deference, and his attempt -- long after it was obviously an impossibility -- to construct a 'post-partisan' bill made it impossible at least for him to do it.)

But when we have discussed it, and when Obama and his surrogates have discussed it, all the concern goes to the person who might lose his insurance, who might not be able ti afford it because he's just out of college and starting on his career while living at home, and the like.

There's no talk at all aimed at the person who has been working for decades, but not in a job that provides insurance, or a large enough paycheck to afford to purchase private insurance. There's no talk at all of the poor, working or not, who have no chance for any insurance unless their desperation-fueled lottery tickets come in.

No one is talking to them and explaining how the ACA has helped them already, and will help them more and more as other provisions kick in.

(This is not the same as the 'bidding war' that I will also get back to. That is 'prospective,' it is about what Democratic economics will do for them. And that becomes a battle of competing promises -- aimed at people who don't understand economics enough to know which promise is valid, and who, more than likely, already brush off promises as 'nothing more than political posturing from both sides.')

Reading the discussion, I want to ask if any of you have ever spent a substantial period -- at least three to five years -- without insurance or immediate hope of getting any. Have any of you actually experienced making the choices you have to make in a situation like that? Have any of you actually -- not as an 'academic exercise' but because the answer was vital to your well-being -- investigated what the income limits you needed to be below to qualify for Medicaid? Have any of you actually tested -- again, because you had to -- the 'truism' that, 'oh, if you don't have insurance, you can use an emergency room as your PCP.' (We point out that the rest of us pay for that -- not entirely true -- and that it is an inefficient way of providing medical services. But we never discuss how adequate those services are, how true the truism actually is.)

I actually have. I spent not five, but thirty five years without any form of insurance -- except for a couple of brief periods on Medicaid when my income was effectively zero or just from welfare.

I'm going to talk about what that actually feels like, what the pressures are, in the next post. But just to give an idea of just how poor you have to be to qualify for Medicaid, Minimum wage is $7.25 an hour. Here is the total number of hours needed (in NYS one of the more generous of states) -- by all family members combined -- to put you over the monthly limit for 1,2,3, and 4 member households:

1 member - 102 hours
2 members - 127 hours
3 members - 151 hours
4 members - 175 hours.

More later, on what it feels like, not what it looks like from outside, including a discussion of emergency rooms.

[Bill H]

Actually, yes I have spent time without medical insurance, as a self employed person, including three years walking on a leg with a broken fibula which I could not afford to have repaired. It was splintered and refused to heal. It only hurt a little bit walking in a straight line, but turning corners was horrible. The VA finally took me on and put a metal plate on it, even though I was technically over their income limit.

Looking at the subsidies in "health care reform," current insurance rates to the extent that I know about them (which admittedly is not entirely comprehensive), and recalling my income back then, I would still have been without insurance.

[Sir Charles]

KN,

I don't think Edwards was set up. I think he's a foolish, incredibly self-involved individual. I just don't see the need for the criminalization of this kind of fund raising activity. Certainly in light of what else is being permitted in the universe of campaign finance, this seems an odd place to draw the line.

So you are going to stay in Brazil. The country seems to have made some impressive strides over the last decade -- it will be interesting to see if they can sustain it and significantly reduce the number of people living in favelas and reduce the poverty of the northeast.

Crissa,

I think you raise a good point about the drone strikes. American presidents have long had the power of life and death over far flung peoples and most have exercised that power in a way that has been far less directly involved in American interests than has Obama. (The only president over the last hundred years who I cannot recall being involved in some level of killing innocents abroad is Jimmy Carter -- and that just might be a failure of memory on my part.

Sorry to hear about your father. That is a horrible thing to have to live through.

Bill H and Jim,

I think we have to support unions and collective bargaining in both the private and the public sectors. It is important for workers of all stripes to have a voice in their work lives and in their compensation.

That does not mean that each individual union is going to be correct in its demands or always reasonable about what it seeks for its membership. And management legitimately exists to say no where such demands are not realistic.

I don't think that there is much evidence to suggest that elected officials will not say no to public employee demands. By and large politicians would far rather say no to public employees -- even those who back them strongly -- than to seek tax increases to pay unreasonable compensation. Now sometimes politicians will irresponsibly grant benefits to such employees without paying the full freight for it, but that is more the exception than the norm from what I can see.

Most of the unions that I work with elect their leadership right out of the rank and file. But they are full time officer. Having part time union officers who work for employers is not very effective -- either in terms of their ability to get the job done and due to their compromised independence. Indeed, in many of the unions with which I work, if a local union cannot afford a full time officer, it will be merged in with another local that can.

In the industrial and service unions there is a little more history of having officers and high level officials who are not drawn from the rank and file, but even there I think the vast majority are.

On the health care reform front, no I don't believe that any other Democratic president would have necessarily fared any better than Obama. Both FDR and Truman couldn't get national health care done, Kennedy could not get Medicare through, LBJ managed on the strength of a huge majority, much more ideologically fractured parties, and the benefits of having a martyred president to help sell his program. There was no way in the world that Obama was going to get someone like say Joe Lieberman to back single payer -- not given the influence of health insurers in a state like Connecticut.

I don't think the ACA will eliminate all problems with affordability and access to care, but it gets us a long way down the road from the current system. And yes, the notion that emergency rooms function like having health insurance is a ridiculous one.

[Prup (aka Jim Benton)]

[written before I saw any response to my last post. Mare later this afternoon or evening.]

Before I go on, I want to make a point with one of my pop culture references. In one of the Doctor Kildare movies from the late 30s and early 40s -- sorry, not sure which one -- Dr. Gillespie gives a speech about how things won't get better until people realize that health care should be a right, not something that you need to buy.

A few years after that, Harry Truman began trying to change the health care system. Through the years other Democrats tried as well. Medicaid, Medicare, and yes, Medicare Part D, were all substantial improvements, but they left much of the basic structure intact. And fot those who were dependent on private sector insurance, there were the problems we have repeated so many times, 'preexisting condition' exemptions, deductibles, too much money not going to claimants, 'recissions' and panels that actually did make you choose between a life-saving necessary procedure and avoiding bankruptcy, at best.

With all its bllunders, false steps, missteps, and ommissions, the ACA has changed that. The choice is either to accept it -- and support the Party that will protect it -- and may, sooner or later, improve it -- or to scrap it, go back to the old system, and then try again -- from scratch -- to change it. This is what the Republican Party promises to do, destroy it entirely. They clai to have their own fixes -- we've seen them and they don't work -- and once we regained the power to change things, we'd have to overcome the reluctance of those who were burned by the failure of the previous attempt.

Pf coutse, maybe a few years more of the old system will inspire the populace as a whole to rise up and demand single-payer, against the combined weight of the Republican Party determination -- and the Democratic Party timidity.

Bill, really think that'll work this time? Or that it doesn't matter on this topic either?

[beckya57]

Prup--a Mets fan living in Baltimore in 1969??? And you got out alive???

[Bill H]

To correct a misperception on union leadership; the non-working union leaders to which I referred were undoubtedly originally workers on the shop floor, but quit doing that once elected to union leadership. That was a false move. When I was in the Teamsters, union leaders had not worked as teamsters for many years and were totally out of touch with us. They may have been blue collars once, but to us they were "suits" and we despised them. The grocery union in San Diego had negoitators who still wore aprons.

Sometimes, Jim, good is the enemy of better. We take a half measure and settle for it instead of striving to achieve the best that we can achieve. We label it as a "starting point upon which we will build," but that is uncertain and too often does not happen. When I was in the Navy, "the best that I could do" would get you thrown out of Submarine School.

If "health care reform" had not passed, maybe instead of bragging about the half-assed thing we did, the public would be demanding that we do something better. Or maybe we would just continue to have nothing. I don't know the answer to that, but I do know that I am not satisfied with, or proud of, half-assed.

[Joe S]

Bill H, progressives and Democrats have been trying to pass any health care reform since FDR. If you couldn't pass universal healthcare for 80 years, half assed is about the best that could be hoped for (especially when FDR, Truman, Kennedy, Johnson, and Clinton all failed to do it). And "the best that you could do" could be appropriate even in the military. Admirals and other commanders at sea were backed in difficult situations during World War II because uncertainty is a constant in war. Admiral Halsey was never disciplined or demoted in any way after the near disaster at Leyte Gulf (the Battle off Samar). Rather, despite Halsey's mistake, Leyte Gulf was and is painted as one of America's greatest Naval Victory of all time.

[kathy a.]

joe's got a point about how long health care reform has been sought.

prup, we did not have insurance when i was a kid, but could pull it together for the normal things with kids. it caused a lot of financial distress when my baby sister was born prematurely. nothing fancy was available then -- they thought she would die, but popped her in an incubator and she didn't -- but a couple months in the hospital added up even back then.

i'm self-employed, and i would be uninsured now if not for my husband's policy via work.

our son has been uninsured at times when he badly needed care. he has chosen to not go to the ER, because he would then be hounded with costs. by the time we found out, his situation had gotten much worse. we will pay for what is needed, but he is too proud to want much from us. couple of frightening times there, especially when he developed abcesses in his mouth and was very sick.

i cared for my elderly grandmother for the last 6.5 years of her life, when she had alzheimer's, serious complications from a hip fracture, and ended up needing full nursing care, with intermittent hospitalizations and such. so yes, i have dealt intimately with the stuff around medaid, since my grandmother's private money ran out after a year or so.

my grandmother wanted desperately to just come live in our house -- not possible because we had a small house, both worked full time, and had 2 small kids. that also would have crashed her eligibility for medicaid.

i can't tell you how much we depended on the medicaid, medicare and SS to take care of the basics. i could not very well leave her to her own devices -- but personally funding her care was as impossible as personally providing it in my home. THIS is why my head explodes when certain people talk about cutting such programs. wtf do they think families are supposed to do?

[kathy a.]

prup, i agree that these examples are not making decisions when in the gap you describe -- with more "income" than qualifies for medicaid, and struggling with health issues over a long period of time. that is some rung of hell. it's why i hope, eventually, for universal coverage like so many other countries have.

[Bill H]

I'm not saying the "health care reform" should not have been passed or that it was not worth doing. If Democrats had passed it and said, "It's a start, now we have to build on it," I would have been well satisfied with them. But they pass this thing and then engage in chest pounding about "the grestest legislation in generations" and "accomplishing what generations have tried and failed to do," and I say nonsense.

There is a big difference between engaging in naval battles against an unknown enemy who is using unknown tactics with intelligence which was often incomplete and where victory is measured by survival or non-survival, and performing a task that does not meet particularly high standards of excellence and saying that it was "the best that I could do." The military that I served in would never accept that excuse for less than excellent results. In any case, Halsey never offered that as a reason for his actions which did, after all was said and done, destroy the Japanese naval force as a fighting entity. It would have been pretty hard to "discipline or demote" him for doing that.

[low-tech cyclist]

OK, Bill, if the ACA wasn't the greatest legislation in generations, when's the last time such a major and important piece of legislation has been passed? Note that it's been 2 generations since LBJ pushed Medicare, the Civil Rights Act, the Voting Rights Act, etc., etc. through Congress.

And that this did in fact accomplish what generations tried and failed to do, assuming the Supreme Court doesn't undo it, is a fact.

I suppose one alternative is that you accept that it is the most important piece of legislation in generations, but you're calling bullshit on the chest-pounding over that fact.

Sorry, that's just part of politics. If one party accomplishes something significant, they've got to toot their horn about it - the other party isn't going to, after all. And "this is a half-assed improvement, maybe we'll make it better later" is only good PR if you'd prefer to have the other party in power.

One of the real problems for the Dems in the 2010 election was that the Dems were, in fact, largely running away from the ACA as the GOP and allied groups attacked it. You don't win elections that way. And like it or not, doing other good things depends on winning elections.

[Joe S]

Bill H, it was Clifton Sprague and Jesse Ohlendorf that destroyed a big chunk of the Japanese fleet at Leyte Gulf. Halsey wasn't there with his fleet (the most powerful portion of the American Fleet) because he didn't leave a task force to defend the strait off Samar. For that reason, the Northern Group escaped.

Although, I agree it would have been better to just do the ACA early and move on, it is what it is. Politics and coalition building are alot like military campaigns. It's almost impossible to predict all the variables, especially in a coalition like the Democrats where the two wings of the party don't agree on much and don't much like each other.

[kathy a.]

illinois AG is supporting arguments that the state's ban on gay marriage violates equal protection .

here is a roundup of 2011 legislation regarding reproductive rights.

[kathy a.]

oh oh oh -- mormons marching in the SLC gay pride parade! this makes me so happy.

[nancy]

kathy a. -- Wow, I'm forwarding the Tribune article to 11 Mormon BYU step-grandchildren, without comment. It's long past time for them to examine the intolerence and unkindness that their church handed them to pass along. Baby steps, but important.

[kathy a.]

yay, nancy!

[Prup (aka Jim Benton)]

Bill:
Just to finish up your discussion - at least until you respond -- it seems like your main complaint is with the 'breast-beating.' But Bill, you were a small business owner. Did you advertise your company by saying "We do a pretty good job, more or less, most of the time, but we'll be working on getting better?"

I don't think you did. But imagine if, when you were starting out, there was another, well-financed rival, and he was advertising -- and having his friends on local radio -- saying how bad a job you did, that your treatment was poisonous to lawns, that you overcharged, that there had been thefts from houses you had worked on -- all of which was untrue. Would you have any recourse -- other than the law courts and the thicket of 'commercial speech' and delays -- than to do your own breast-beating?

That's what we face with the ACA. A coordinated campaign against it, dedicated to destroying it. We can't be 'modest' in this situation, not when we are battling for 'hearts and minds.'

[KN]

SC, et alia - Yes, I will retain ties with the US but at this point I am too disillusioned with circumstances there, or at least what they appear to be, to give up the state of what we call here tranquilo.

You bring up a couple of interesting points but they are onle two of a multitude of complex issues that this country faces, but at least to a remarkable degree, seems to face from a reality based perspective instead of through the lens of an organized propaganda machine that distorts reality into a grotesque charicature.

Sure there are several million Brasilians living in favelas. But you know what, for the most part they are not *homeless*. They have shelter, they are squatters, they are deeply impoverished. There are many in the US who are arguably worse off if only because they are not allowed to create favelas.

More concerning to me is the fact that in the US the singular thing that seemed to distinguish it so much from places like Lima, Suweto and Monrovia was that there was a modicum of fairness about the system, a modicum of equal rights under the law.

Maybe it is just my outside perspective, seeing it from the point of view of selective information gathering instead of spoon fed pablum on the nightly news, but that sense has been seriously eroded, to the point where it appears to me that there is one law for the 99% and a completely different law for the 1% that is administered and enforced, by the 1%.

To a certain extent it is also more palatable to endure the corruption of government here because it is actually rather above board and simple, but does not have what you might call deep roots. If you expect to be on the good side of the local police, when the police chief pays you a visit you spend a couple of hours with him. Provide him with a few beers or whatever he prefers (Caxiaxia is popular), and talk about his little community, what they need, what they desire. Then after a discrete time, you make a contribution and mizzo meanas have paid your taxes.

I am getting too far off on a tangent that no one there can really appreciate.

I read an interesting we site set up by a California Dr. by the name of Belk that raises the interesting question: in what other kind of transaction for goods or services do we allow a third party to intercede in every single exchange with no transparency? Besides the so-called healthcare insurance industry. Well, admittedly, the mortgage loan bubble kind of encroaches on that realm to the extent that appraisers were routinely complicit in the inflation of the bubble, but trying to stay on topic. It is worth looking up and reading Dr. Belk's web site because he reveals a few inobvious but intuitively true things that will give you pause.

I liked the latest comments by LTC.

Life is a lot more complex that what I can portray here of course, but I think I have gotten the gist of it.

[Prup (aka Jim Benton)]

nancy and kathy:
It's not just Salt Lake City.

From Seattle, Washington, to Washington D.C., New York, Portland, Boise, San Francisco, and Salt Lake City, members of three different Mormon contingents—Mormons Building Bridges, Mormons for Marriage Equality, and Affirmation: Gay and Lesbian Mormons—will walk during the month of June.

The whole article is worth reading, as is almost anything by Joanna Brooks, the 'Mormon specialist' for Religion Dispatches.

Here's one brief quote from the founder of Mormons Building Bridges:

For many years, I felt like there was no other option for gay Mormon people than to discontinue activity in the LDS church. I completely understood why they couldn’t be a part of LDS Church life, and I felt bad about it, but I felt that’s what had to happen.

Then as my children started growing up—my kids are ages 13 to 27—and getting to a point where they decide whether or not to continue LDS Church activity into their own lives, I saw they faced this disconnect: “Gay people can’t be in this Church? What about all the love I’ve been taught my whole life?”

For example, my eighteen-year-old son received a phone call from the bishop for an interview to set him on the road to preparing for his missionary service. So we are in the hall, and I’m telling him, “You need to call the bishop.” My son looks at me and says, “Mom, I can’t do this.” We talked over many things he was concerned about. One of them was that he has an openly gay teacher who, he told me, “is one of the most spiritual people” he knows. “What is this Church if there is no place for him?” my son asked me.

[Prup (aka Jim Benton)]

And I can't help it. The METS ARE IN FIRST PLACE -- okay, 'virtually,' .003 behind Washington.

WOW!!!

[Bill H]

"But Bill, you were a small business owner. Did you advertise your company by saying "We do a pretty good job, more or less, most of the time, but we'll be working on getting better?"

Well, I certainly didn't make claims about my work that were in excess of the actual value of the work. And if my work was substandard and an opponent was lying about my work and claiming that it was even worse than it actually was, I certainly would not use that as justification for exaggerating and claiming that my substandard work was actually brilliant.

Well I guess I would if I was a substandard worker, seriously dishonest, and desparate to get work regardless of the ethics involved, but...

I find it extemely discouraging that the consensus seems to be that our nation is only capable of mediocrity and that each party should pass mediocre legislation and then pass it off to the public as excellence. In other words, lying your way into office is just a normal way of doing politics, and we voters are not bothered by the practice at all.

The alternative is that we have become so jaded that, figuratively speaking, we eat garbage and think it is gourmet food.

[Bill H]

Do we even know what the word "reform" actually means? It means "changing the way things are done." Having people continue to need health insurance, and pay for it, just on a bigger scale is not reform. Having medical care provided by people who are making huge profits and not addressing what that does to the availability of medical care is not reform. Addressing the manner of delivery of health insurance is about health insurance, which may be very worthwhile, but it is not about health care and it is not reform.

All this about the health care clinics and Medicare payments is diversion from the fact that the legislation does not fundamentally do what it was advertised to do. It does do some good things, but health care clinics that provide care for some people but not all people in some towns but not all towns is not a fundamental rsolution to our health care problem, and the Medicare payment decreases existed before this legislation, this bill merely promised to finally quit delaying them.

What this bill does not change is that we have the costliest health care system in the world, and will continue to have that after it is fully implemented, and that we have the poorest access to health care of any industrailized nation in the world, and will continue to have that after the legislation is fully in force. "Reform" would have changed our position in the world on those issues, or at least tried to, and this legistlation did not even try.

[Prup (aka Jim Benton)]

Bill: The trouble with your response is simply that the ACA isn't 'garbage' or 'substandard' or 'mediocre.' It isn't single-payer, true, but while I am probably the only person here who thinks getting single-payer was a theoretical possibility, it would have taken a President with political skills, boldness, firmness, and an ability to communicate with people that the President we actually elected didn't and doesn't have. (One reason I think many of us resent Obama -- maybe sometimes more than he deserves -- is that we had a picture, partially based on the campaign and partially based on our own fooling ourselves, of who he would be, and he's turned out nothing like that.)

Maybe a cross between FDR or LBJ, Truman or Clinton, with Reagan's admitted 'charm' would have been able to do it. Obama has the 'talent' he shares with Woodrow Wilson of making even his good ideas look unpopular.

But the more you force me to look closely at the ACA, the more I find it a valuable first step. No, it doesn't 'fix everything all at once immediately' and certainly there were compromises -- probably, and certainly in some cases, unnecessary ones -- that we wish hadn't been made. On the other hand, even Social Security only got passed because FDR was willing to abandon the (mostly black in the South) agricultural workers and not include them. Should we condemn him for 'bowing to racism' -- which he undoubtedly did -- or should we praise him for making a regrettable but necessary deal that got the idea actually implemented?

But I know of no instance -- maybe you do -- where the ACA made things worse than they would have been without it. The end to 'pre-existing condition exclusions' and 'recissions,' the increase in the age when a stay at home child can be covered under the parents' policy, the setting up of exchanges and mandates that will make it possible for everyone to be covered, which of these are steps backward?

(Please DON'T say 'the mandates.' Not unless you can explain another way to avoid the 'don't sign up until you are already sick' problem. Without that, no company could afford to wrote medical insurance at anything like an affordable rate, and even most 'universal coverage' plans in other countries use a public/private interaction.)

And, finally there is the 'medical-loss ratio.' That got mentioned a little, but then forgotten, but it is 'paying off' right now. That requires insurers who insure individuals or small businesses 'to spend at least 80 percent of premiums on medical care or efforts to improve health-care quality for consumers and small businesses. For large businesses, that threshold increases to 85 percent spent on medical care or health-quality initiatives.'

Sounds like the sort of thing that is great in theory but gets 'loopholed' out of existence, doesn't it? They wouldn't actually give those rebates, would they?

[In just one state, Arizona]Arizona consumers and businesses can expect to collect more than $36 million in refunds this summer from health-insurance companies under new provisions of the nation's health-care law, according to two reports. The reports show consumers who have purchased individual health-insurance plans will get $24.4 million in refund checks or credits to future premiums. Insurers also will refund $9.3 million to employers with small-group plans of fewer than 50 people and an additional $2.9 million to companies with larger plans of more than 50 people, according to reports by Consumers Union and Kaiser Family Foundation.

That's a pretty nice step as well, no?

[Prup (aka Jim Benton)]

Maybe not in this open, but any chance we can get a discussion going on education? Currently Republicns and religious conservatives are attacking education on at least six separate fronts -- a couple of which have superficial plausibility given admitted problems in the system as it currently exists, but which prove to have 'hidden jokers in the deck':

a:) the attack on Public Service Employees, which tends to focus in on teachers and the Teachers' Union;

b:) the continuing push for 'school vouchers' that may -- and usually must -- be used on religious schools ('must' because, despite the selling points, they don't provide enough money to pay for most good secular private schools);

c:) the push for charter schools ('b,' 'c,' and 'd' are all intertwined but they are actually slightly separate) despite the history of lack of achievement and frequent reports of 'manipulating the numbers' to the point of absolute cheating;

d:) the 'privatization push' that even goes beyond charter schools;

e:) the curriculum battles, particularly in Texas -- which is a major factor in shaping most states' textbooks -- and the attempt to introduce creationism and to turn the 'social studies' curriculum into a celebration of Republicanism -- and, in passing, to write civil rights and civil rights leaders out of history.

f:) the religious home schooling phenomena, which is creating a whole generation of fact and evidence averse, isolated, propagandized young people who do not even have the possibility of hearing other viewpoints from students with different backgrounds and interpretations -- because there are no other students or the other students are equally indoctrinated. (Frequently these students don't even have the opportunity to 'find the real world' through television, music, or the Internet because their parents supervise those as well -- and again, there's no 'bad kid in class' to tip the kid off what's out there or to show him the sites his folks don't want him to know about.)

There are other topics as well. If we are going to fight off these challenges, we have to admit and work on the problems schools already face -- money will be a major help in fixing some of them, but others require rethinking and not just more spending. And one side topic we will -- and should -- get to discussing is the question of sexual education. (Not just 'sex eduxation' but including education about LGBT issues, about sexual attitudes that usually get papered over in standard sex ed, etc.)

Again, not here, this has too many running topics already, but maybe in the near future?

[Sir Charles]

Jim,

I just put up a new post and open thread. Feel free to explore the education topics there.

The attacks by the Republicans are in many ways a cynical attempt to de-fund teachers' unions, which have long been a major force in democratic politics. The voucher stuff is a joke. The average secular private school in DC costs in excess of $30,000 a year. There is no way in the world that vouchers will ever cover that cost.

[Prup (aka Jim Benton)]

Sir C: Will do, will copy the piece over. But have to say that you may have it backwards. You see the Republican assault on education as a way of attacking teachers' unions. I see the reverse, that the attack on teachers' unions -- along with being part of the whole attack on government employees and government functions -- is part of an attack on education as a whole.

[Bill H]

The mandate is fine in theory, but is it actually going to work? Doubtful. Anyone with any sense will still not get insurance because the penalty for failing to get insurance is far smaller than the cost of insurance. The smart thing to do is pay the small penalty, wait until you are diagnosed with cancer, and then go to an insurer and say, "I have cancer, I want insurance that will pay for my treatment." The insurer will be required to provide it, and if enough people do it to that insurer he will go broke, quit providing insurance, and we will have to start over.

The "medical loss ratio" is also fine in theory, but what happens to health insurance rates when medical costs rise by 85% or more? Did you notice where the MRI that I had this year cost 85% more than the one I had in 2009? And by cost I am talking about the amount paid by the health insurance company. What part of ACA actually regulates the medical costs upon which health insurance rates are based?

The concept of passing something that can be enhanced is all well and good, and citing Social Security is shaky ground upon which to tread. If it can be enhanced it can also be degraded, and Social Security is proof of that as well. It has already begun to be degraded and is threatened with further degradation, not as a result of cost problems, but due to ideaology using bogus cost numbers as a smoke screen. The program was designed to be something upon which seniors could rely, and the only way that can be true is if it had been created as a solid, tamper-proof program.

Maybe this ACA will be enhanced as everyone hopes, but that is nothing more than hope at this point and rather faint hope at that, and if it is enhanced it almost certainly will follow the example of Social Security and be degraded as well.

[Prup (aka Jim Benton)]

Jayhawk: Your argument is a variant of the 'Emergency Room' fallacy -- and would work no better than someone trying the same ploy when dealing with car insurance. (It also is a prime example of ignoring the simple fact that almost any system can be 'gamed.' Sure, people will 'get away with things' in that system -- as some do now -- but that does not make the system less of an improvement.)

Because I've been wanting to talk about the 'emergency room fallacy' for a while, let me go more into detail than is needed to reply to your comment.

There is a myth that 'the poor don't need insurance, they can always use emergency rooms as their PCPs, and if all else fails, they have Medicaid.' The first is only very partially true, as I will explain, and both work only for someone who not only is poor, but who remains poor.

Medicaid is wonderful, no question about it. When we found we could get on it -- with only a little 'number fiddling' -- it was an incredible relief given our medical problems. But it isn't 'free.' Medicaid has the right -- and exercises it -- to reclaim anything they have spent on you from your estate, if you get on your feet enough to leave one. I believe that they can, as well, seize any money you get from the sale of certain assets. Thus there was no trouble with Em's parents turning over half-ownership of our house to Em, but were we to try and sell it, i believe they could reclaim almost any money we made -- anyone know for certain on that?

And the 'emergency room idea' is even worse. First, emergency rooms give you emergency care -- and that's it. Yes, if that care requires admittance, an operation, whatever as part of it, and it is obvious to the doctors that you do, you'll get it. But any test above the most basic, any follow-up care, any diagnosis beyond triage, any renewal of prescriptions, new prescriptions, etc.? Nope, you have to arrange for that yourself, and pay for it, or attend a clinic at the hospital -- and they are not required to see you if you can't pay.

And emergency room visits are not 'free.' You get charged and billed for them. Okay, they can't send a collection agency after you, they can't refuse you treatment however many unpaid bills you have -- and any use of 'triage' as a way of moving the uninsured and the people who owe money to the end of the line, I'd be shocked, shocked, to hear of such things going on.

BUT, those bills don't go away. Poor people may not need to worry about their credit scores, but people who get 'back on their feet' may find a nasty surprise waiting for them.