Good news, right-to-lifers. That brain-dead girl from Oakland, Jahi McMath, had surgery the other day to insert a ventilator and feeding tubes at the secret facility where she's been flown (at an estimated cost of $55,000) to get her away from Children's Hospital in Oakland. The heartless doctors at Children's Hospital, if you will recall, didn't want to feed her or keep her hooked up to a ventilator any more simply because she's been brain dead-- with a death certificate from the coroner and everything-- since December 12. But now, thanks to an activist lawyer, and an ethics-less "healthcare" facility, and a clueless, spineless judge, this deceased individual can continue to take up space (at great expense to somebody, probably you and me-- does Obamacare cover "after the end of life care" too?) until she literally rots-- which process, thankfully, seems already to have begun.
Brain-dead is not like a coma, ala Terry Schiavo or Karen Ann Quinlan. It's dead. There isn't going to be a miraculous recovery. A ventilator pumps oxygen into the lungs of the teenage corpse, the chest rises and falls, and in response to the oxygen the heart mechanically beats. Meantime, what's left of the brain gradually liquifies. The "nutrition" that's pumped doesn't get digested. And eventually the erstwhile young person starts to stink.
Meanwhile, in the anti-Darwinian, anti-Jeffersonian, pro-life State of Texas, another dead woman, Marlise Munoz, is on life support. Apparently, the Texas State Legislature has decided that you can't remove life support from anyone who's been diagnosed as "pregnant," even if they're brain dead. So, despite the clear deadness of the individual in question, and the unequivocal instructions from the next of kin to unhook the patient and let her fly up to Heaven to join Karen Ann and the others, another ventilator is pumping, other feeding tubes are dripping, deep in the heart of Texas.
What's wrong with this picture? I've got news for you, folks-- whether one is alive or not is not a matter of opinion. This is not the Dark Ages, and any medical professional knows that when the brain is dead, the person is dead and should be gone. But what difference do science and logic make in the face of political or religious dogmatism?
Because that's the problem at bottom: crazy religious "faith" coupled with abysmal ignorance, craven political cowardice, and a complete lack of ethics-- all laced with a liberal dose of cowardice on the part of those who should know better-- adds up to a travesty. And let's not forget our culture's irrational fear of death.
The teenager's parents say that they believe their dead little girl is alive because it looks like she's breathing and she "still feels warm." They believe that God is going to bring her back to them. How do you deal with an argument like that from uneducated people who never got a degree but do go to church? Well, you could tell them that if God is all-powerful and really wants their little girl to live, he don't need no stinkin' ventilator. You could even tell them that it's blasphemous for them to assume that the ventilator and the feeding tubes are somehow necessary for their dead child's ressurection. Maybe that would work. As for the family of the victim in Texas, you could tell them to stop voting Republican and maybe something like what's happening to the dead woman there won't happen again.
The real problem isn't the "ordinary people" involved in these cases, anyway. It's people like the brain-dead judge who issued injunctions to keep a dead teenager on a ventilator after the coroner had declared her "completely and sincerely dead," which is good enough to end the matter, even in Munchkinland. At best the judge is a coward, and has no business being in his job.
The problem is people like the opportunistic, politically motivated lawyer who took the Oakland teenager's case to start with. Wait, though, I'm not being fair. Apparently he's motivated by money, too, because he's announced plans to sue Children's Hospital for its violation of the "religious freedom" and "privacy rights" of the dead teenager's family. (Apparently, there are no plans for a "wrongful death" lawsuit yet... can you guess why?)
The problem is people like the ones who run the secret, undisclosed location where the little dead girl is currently being stored, and whomever (presumably a doctor, but who knows?) who reportedly performed surgeries to insert a ventilator and feeding tubes into the corpse to keep it "feeling warm" for a while longer.
The problem is the Texas State Legislature, who passed the crazy laws at issue there, and the fundamentalist wackadoos who fund their election and re-election and re-re-election campaigns. The problem is the legislators and school board members around the country who want to purge the history books of inconvenient figures like Thomas Jefferson and cram the science books with crap like "Creation Science," without whom none of the above would have been possible, thank you very much.
And of course the problem is with the hypocritical proponents of medieval religion who can't even get the "omnipotent" thing right. Hey, guys, I read your Book. It says that Jesus can raise the dead, but it says nothing about Him needing ventilators or feeding tubes to do it.
Death happens, and it happens to everybody-- unlike education, which apparently is in short supply. Unless we want to slide back into the Dark Ages, we'd better start confronting this craziness, don't you think?
Wrong on So Many Levels
Thursday, January 9, 2014
Tuesday, December 24, 2013
The Joy of Christmas
It's "that time of the year" again, the time of year that Johnny Mathis tells us is "the most wonderful time of the year," with the principal themes being snow and presents and flying reindeer and Christmas trees and housebreaking elves and joy and oh yeah... there's often something in there about Jesus and shepherds and Heavenly Hosts of angels, too.
With all of that going on, it's easy to see how some people (those who overthink everything, mostly) might become conflicted about "the true meaning of Christmas." That's a no-win question to ask, though, because obviously Christmas (like almost everything else) is in the eye of the beholder. As Lassie's grandfather, Gene Lockhart, pronounces from the bench in the 1947 classic (i.e., the "real") movie "Miracle on 34th Street," when it comes to Santa Claus, at least, "Many people firmly believe in him. Others do not." It should go without saying that the same holds true for Jesus of Nazareth.
Believers of all stripes tend to agree that Christmas is supposed to be a time for fellowship and good cheer and helping the poor. (You should have gotten all the giving of thanks out of the way a few weeks ago, because there's a special holiday just for that, backed up by a Presidential proclamation.) Gift-giving is also very important, and it is the absolute only time you're going to see wonderful holiday treats like egg nog and fruitcake. (Brrr!)
Christmas is a time for family, they say, and that's probably one of the reasons that Christmases all tend to blur together over the years, because families are steeped in crazy traditions. According to my mother, in my birth family we had a tradition of never eating Christmas dinner. For a while I was married, and in my "in-law" family they had a tradition of having two Christmas trees and a six-hour stint of gift exchanges that began at 4 a.m. and involved literally dozens of packages for each person (some of which were "real" presents, and some of which were stuff like tubes of toothpaste and rolls of tape.) And sometimes families vow, for one reason or another, not to decorate, "gift," or celebrate at all and the day winds up as gloomy as almost any other day in houses like that.
We had a thing for a couple of years called "The War on Christmas," and what was up with that? Apparently, some large retailers decided (or were pressured into deciding, depending upon whom you ask) that their sales would improve if they dropped all references to Christmas and just stuck to "Holiday Sales." This was a big mistake, obviously. First of all, those who celebrate Christmas, at least in part, because it is the date appointed as the anniversary of the birth of Jesus H. Christ were mortally offended, and immediately struck back with protests and boycotts. Secondly, sales did not go up because of the misguided effort at "inclusiveness," because people who weren't celebrating "Christmas" weren't planning on buying gifts because of it, and changing to the "Holiday" signage did nothing to change their plans in that respect.
The people who argue that Christmas has morphed into a largely secular holiday have a valid point. It isn't Jesus who's out there peddling all that merchandise, it's Santa. And although Santa is, at least nominally, derived from legends of the Christian St. Nicholas, the character that we worship these days is as Pagan as all get-out, what with his magic arts and flying forest animals and Druid-inspired Christmas trees. Basically, though, the holiday is two holidays, peacefully co-existing for the most part, because the Jesus Nativity story is alive and well and makes everybody feel good, too, albeit in a quieter, less expensive way.
The "holidays," including most especially Christmas, can be tough on people psychologically because sometimes the joy can be hard to come by. If you're sitting in the dark without power or Christmas movies on TV, if your family is far away and there's no one to feast with, or if you've lost your "Christmas Spirit" and are consumed by doubt and despair, you've also got to contend with the inevitable feelings of guilt that arise when you realize that you are miserable at "the most wonderful time of the year." Unless you're one of the lucky ones whom Santa comes bounding down the chimney to take on a life-changing sleigh ride or three ghosts undertake to "scare straight," you might feel a little lost.
But there is a cure for that, if you dare to take it. Struggle into your snow gear, hit the streets and start spreading the cheer yourself. Walk up to the first person that you meet (if they don't look too dangerous) and wish him or her a "Merry Christmas." They'll probably say it right back, if only reflexively, and you'll start to feel good. Repeat as often as necessary as you continue walking to the local liquor store for those Christmas Spirits, and don't spend a lot of time dwelling on the fact that whomever you just "Merry Christmased" might be back there scratching his or her head wondering exactly what you meant by that remark. It's the "Holidays." Chillax.
With all of that going on, it's easy to see how some people (those who overthink everything, mostly) might become conflicted about "the true meaning of Christmas." That's a no-win question to ask, though, because obviously Christmas (like almost everything else) is in the eye of the beholder. As Lassie's grandfather, Gene Lockhart, pronounces from the bench in the 1947 classic (i.e., the "real") movie "Miracle on 34th Street," when it comes to Santa Claus, at least, "Many people firmly believe in him. Others do not." It should go without saying that the same holds true for Jesus of Nazareth.
Believers of all stripes tend to agree that Christmas is supposed to be a time for fellowship and good cheer and helping the poor. (You should have gotten all the giving of thanks out of the way a few weeks ago, because there's a special holiday just for that, backed up by a Presidential proclamation.) Gift-giving is also very important, and it is the absolute only time you're going to see wonderful holiday treats like egg nog and fruitcake. (Brrr!)
Christmas is a time for family, they say, and that's probably one of the reasons that Christmases all tend to blur together over the years, because families are steeped in crazy traditions. According to my mother, in my birth family we had a tradition of never eating Christmas dinner. For a while I was married, and in my "in-law" family they had a tradition of having two Christmas trees and a six-hour stint of gift exchanges that began at 4 a.m. and involved literally dozens of packages for each person (some of which were "real" presents, and some of which were stuff like tubes of toothpaste and rolls of tape.) And sometimes families vow, for one reason or another, not to decorate, "gift," or celebrate at all and the day winds up as gloomy as almost any other day in houses like that.
We had a thing for a couple of years called "The War on Christmas," and what was up with that? Apparently, some large retailers decided (or were pressured into deciding, depending upon whom you ask) that their sales would improve if they dropped all references to Christmas and just stuck to "Holiday Sales." This was a big mistake, obviously. First of all, those who celebrate Christmas, at least in part, because it is the date appointed as the anniversary of the birth of Jesus H. Christ were mortally offended, and immediately struck back with protests and boycotts. Secondly, sales did not go up because of the misguided effort at "inclusiveness," because people who weren't celebrating "Christmas" weren't planning on buying gifts because of it, and changing to the "Holiday" signage did nothing to change their plans in that respect.
The people who argue that Christmas has morphed into a largely secular holiday have a valid point. It isn't Jesus who's out there peddling all that merchandise, it's Santa. And although Santa is, at least nominally, derived from legends of the Christian St. Nicholas, the character that we worship these days is as Pagan as all get-out, what with his magic arts and flying forest animals and Druid-inspired Christmas trees. Basically, though, the holiday is two holidays, peacefully co-existing for the most part, because the Jesus Nativity story is alive and well and makes everybody feel good, too, albeit in a quieter, less expensive way.
The "holidays," including most especially Christmas, can be tough on people psychologically because sometimes the joy can be hard to come by. If you're sitting in the dark without power or Christmas movies on TV, if your family is far away and there's no one to feast with, or if you've lost your "Christmas Spirit" and are consumed by doubt and despair, you've also got to contend with the inevitable feelings of guilt that arise when you realize that you are miserable at "the most wonderful time of the year." Unless you're one of the lucky ones whom Santa comes bounding down the chimney to take on a life-changing sleigh ride or three ghosts undertake to "scare straight," you might feel a little lost.
But there is a cure for that, if you dare to take it. Struggle into your snow gear, hit the streets and start spreading the cheer yourself. Walk up to the first person that you meet (if they don't look too dangerous) and wish him or her a "Merry Christmas." They'll probably say it right back, if only reflexively, and you'll start to feel good. Repeat as often as necessary as you continue walking to the local liquor store for those Christmas Spirits, and don't spend a lot of time dwelling on the fact that whomever you just "Merry Christmased" might be back there scratching his or her head wondering exactly what you meant by that remark. It's the "Holidays." Chillax.
Sunday, December 1, 2013
Friendship
Friendship
is a mysterious thing. Sometimes it just
sneaks up on you. Sometimes it’s born
out of the smoldering fires of antipathy.
And sometimes it just disappears.
We’ve
all had the experience of “like at first sight.” Some people are naturally attractive to us in
the friendship kind of way, as if they were soulmates from some prior bout with
existence, happily rediscovered. (This
theory was really big in the late Nineteenth Century.) But sometimes you really don’t like your friends-to-be at first. In fact, some people who wind up becoming
very good friends start off trying to wring each other’s necks.Of course, just because you like someone doesn’t mean they’re going to turn out to be your friend. Sometimes you encounter someone whom you like immediately, want to spend time with, and are sure would be a great friend. They may even indicate that they feel the same way about you. But it never really happens, because one or the other of you is just visiting, or is about to move away, or is somebody else’s husband or wife and they don’t like you.
Friendships,
like marriages, are often over long before they are ended. People fall out of friendship just like they
fall out of love. Plus, friendships
sometimes wither because of factors beyond the control of the friends
themselves, for example when it is necessary for one friend to relocate
thousands of miles away. Children are
particularly vulnerable to losing friends this way, because they are in the
thrall of adults and don’t usually even get a vote. But it can happen to adults, too, especially
those in the thrall of giant corporations where one must move around to every
obscure city in the Heartland (or, these days, Asia) in order to struggle up the corporate ladder.
Of
course, “friendship” is a term subject to interpretation. Deep down inside, we all know that most of
our “friends” are really just “acquaintances,” people we know situationally, like
“work friends,” or people with whom we hang out through sheer force of habit (like more “old friends” than anyone will ever
admit.) Sometimes “acquaintances” can
evolve into true “friends,” and sadly the reverse is also true: “friends” can devolve into “acquaintances,” or even
simple “pests.”
One can
be extremely social, amass a myriad so-called “friends,” and be the loneliest
person on earth. You can “friend” a lot
of people on Facebook or keep up a busy social calendar, or bounce from one
group activity or social event to the next, without ever spending five minutes
of actual one-on-one conversation with anyone in the crowd. You can be acquainted with someone for years
and years, and yet know almost nothing about them. Mostly, these people, just like you, are only
hanging for the company and the noise that keeps them from having to listen to
the voices in their own heads.
Take a minute
and think about it. Which of your “friends”
are irreplaceable? In fact, aren’t most
of your “friends” already replacements for other now-departed “friends”?
Show
business “celebrities” talk of almost everyone as their “very good
friend.” Well, come on, it’s a tough
business and you never know when you might need somebody’s “friendship.” But could it possibly be true that someone
could have thousands of “really good friends?”
I guess that would depend upon your definition of a “really good
friend.” In Hollywood, the definition
has to be pretty loose. And what about
all those smiling diplomats on the news?
I guess that Sly Stone was right:
“Smilin’ faces sometimes pretend to be your friend.”
Which
brings us to the subject of “frenemies.”
For various reasons, people sometimes choose to hang out with those they
hate. High school and workplace social
hierarchies being what they are, I guess folks sometimes feel they have no
choice. So they paste a shit-eating grin
on their carefully plucked and made-up faces and wait for a chance to watch
from a front-row seat as their “beloved pal” gets what they pray is his or her inevitable comeuppance.
A
somewhat related scenario occurs with romantic breakups, when one or the other
erstwhile partner makes the almost obligatory request to “still be
friends.” Many of these people were
never friends to begin with, of course, and in such scenarios the suggestion is
just a bad joke. And if they were
friends before they became lovers, becoming lovers probably spoiled the
friendship for good. But sometimes
lovers are also friends , and when they are the friendship can sometimes
survive the breakup. This, however, is
very rare and mostly happens when the breakup is for larger-than-life reasons,
e.g., the breaker-upper woke one morning to realize that he or she was gay
all along, or the broken-up-with partner was kidnapped by aliens and presumed
dead after seven years.
But all
of these observations don’t really get us very close to understanding what a
friend is. If you want to understand
that, you have to look at the very rarest category of friend, the “lifelong
friend.” Of course, there are “lifelong
acquaintances,” too, but it’s pretty easy to tell the categories apart. “Lifelong friends” are the ones whom you’re
still glad to see when you run into them.
Over the
course of twenty years or more, probably the minimum threshold for “lifelong
friend” candidacy, people who have been
“friends” all that time will have had their ups and downs, they will have had
fights and disagreements and troubles of various sorts in addition to all the
rollicking good times. And if they have
remained friends through all of that adversity, they’re probably real friends.
A real
friend will lend you money, if you really need it and he or she has got it… at
least until the first time that you don’t pay him or her back as agreed. A real friend will drive you someplace if you
ask them, and will agree to be a godparent to your obnoxious child. A real friend will take your part against the
world… but will also tell you if you’re acting like an asshole. A real friend won’t always tell you the
truth, but will have a plausible reason for lying when he or she does. A real friend will be sorry when you move
away or die.
When all
is said and done, there is still that mystical, mysterious element to “friendship”
for which we really don’t have a good explanation. (I’d say “pheromones,” but that’s already
being used to explain sexual attraction.)
All the above-referenced observations may tell you who is actually your
friend, but are they really sufficient to explain why? Maybe the reincarnation
thing has something to it, and it really does take several lifetimes to work up
a friendship, just like those Victorian romance writers thought. But one thing is sure: if you have identified
a true friend In your life, or maybe even a few of them, you are fortunate and
you should treat the friendship with the respect it deserves.
Sunday, November 10, 2013
Obamacare and More
Well, it looks like another big wave is starting to break. Probably shouldn't have turned our backs on the ocean.
The "Affordable Care Act," aka "Obamacare," is over 900 pages long. Nobody knows all that's in it; nobody knows how all the different sections of the law will interact with each other in practice; nobody knows what the next big surprise headline will be. But we DO know a few things:
1. Obama was genuinely surprised to find out that he'd been lying to people for years when he told them not to worry, because if they already had health care they liked, they could keep it despite the enactment of Obamacare. Not good that the principal architect doesn't know what he's built-- "Frankenstein," anyone?
2. Premiums for individual health insurance policies "in compliance" with Obamacare requirements are going to be at least triple what most people were paying for "non-compliant" individual policies before the enactment of Obamacare, and although there was a lot of talk about some non-compliant plans being "grandfathered in" that won't happen with any plan that's undergone a "major change" since enactment of the law-- i.e., virtually all of them.
3. If you can't afford to pay for a "compliant" individual policy because the premium is too high, people who make very little money will be eligible to have a big chunk of their premium paid for them by the government-- i.e., the taxpayers-- but ONLY if they buy "compliant" insurance available through the exchanges set up by the Federal government or several of the states. (In case you're worried about insurance company profits, don't. They don't care whether they get paid by the individual policyholder or the government, so long as they get paid, and there's no limit as to what they can charge for the insurance they sell.) Bad news: no matter how little money you think you make, you're still likely to be paying more for your insurance when the dust settles... even after factoring in a subsidy, if applicable. But good news: even if you're 80 years old, you'll have maternity coverage.
4. The plans available through the exchanges provide coverage through "narrower" networks of providers, meaning that only a fraction of the doctors in the insurance company's "regular" networks will be accessible by persons insured through the exchanges, and the odds of a particular doctor being accessible are lower across the board. In some cases, it will be very hard indeed to see a doctor with a particular specialty, and long drives and long waits for an appointment are going to be in a lot of futures.
5. Many of the plans offered through the exchanges offer "good quality healthcare at an affordable price" by simply bypassing major medical centers like UCLA or Cedars-Sinai (to name a couple of L.A. favorites.) Where will the "insureds" be going instead?
6. Not to harp on a small point, but so far it doesn't look like the government has the capacity to sign up all of the necessary participants by the deadlines it set for itself (and for the signer-uppers, too, if they want to avoid paying a tax penalty.) The Federal website still doesn't work, and EVERYBODY is keeping a tight lid on how many people have actually managed to sign up so far. This is fairly alarming, given that the sign-up deadlines are fast approaching, and the Feds have mentioned figures like 16 million as the numbers of people they've got to sign up in the first year to make this plan work.
7. The plans won't work anyway unless a lot of young, healthy people, presumably those without insurance from their job or school, sign up and pay those premiums instead of simply skipping it, as most young healthy people with no money have traditionally done. After all, the penalty, at least for the first couple of years, is a small fraction of the premium, even factoring in a subsidy. On the other hand, everybody with a pre-existing health condition who does want insurance is going to sign up for sure, (well, they will if they can get onto the website) and maybe get a subsidy. The math is not looking good.
8. The people who actually manage to sign up for insurance may not understand just how little they are getting. "Bronze" insurance plans available through the exchanges are basically the same as having no insurance at all, except that they come with the privilege of paying hundreds of dollars a month (or for some, helping the government pay hundreds of dollars a month) to insurance companies for the privilege of not receiving benefits. These plans, like most of the others, include high out-of-pocket limits, and pay only 60% of covered medical services. Not a good deal, especially if you're a gambler and understand the odds. Besides, a real gambler would just "go bare," anyway, since the emergency rooms will still have to treat you even if you're non-compliant.
There's more, of course... and we'll continue to have more nasty surprises as the law goes into effect. For example, many or even most small employers (under 50 "full-time" employees as defined by the statute) may bail on providing health insurance benefits once they realize that a) they don't have to; and b) it's O.K. because the government has guaranteed "affordable" health care to their employees who buy individual policies; and c) they don't really have a choice,because it's too complicated and expensive to offer the benefit any more anyway. As for the large employers, who will (eventually) be required to provide coverage for their employees, they too have a choice. They can reduce the size of their workforce to keep the cost down; they can eliminate jobs so as to avoid the requirement; they can provide a really crappy (but cheaper) benefit; or they can pay a fine (which, as with the individual penalty, might actually wind up being cheaper than being compliant.) Employers have to watch out: if they provide an insurance benefit that costs too much, they will wind up paying a penalty, too, which is actually higher than the penalty for not providing the coverage at all.
Over the last couple of weeks, it has become apparent that even the proponents of this crazy 900+ page law-- up to and including the Proponent-in-Chief himself-- have absolutely no idea of what it says in the aggregate or what its pitfalls will ultimately turn out to be. Mr. Obama, for example, "didn't know," (until 2010, anyway) that people would lose their health plans and their doctors because of the provisions of his Brave New Law. The Administration (in particular Kathleen Sebilius) "didn't know" that the government website, which was rushed online without being tested, wouldn't work. And nobody but the health insurance companies seems to have realized that this law does absolutely nothing to "rein in the cost of health care," while at the same time providing a Wall Street Bailout-style windfall of increased (and now mandatory) premium payments for the health insurance companies.
The Tea Party is full of anarchistic, incoherent rabble-rousers, but it's got one thing right. This particular law, ostensibly designed to "fix" the "health care crisis" in America, is actually making it worse. It needs to be scrapped, and a new law written to take its place, one that requires universal healthcare (whoops! Just lost the Tea Party)-- not semi-universal health insurance-- and provides for a single payer (i.e., the U.S. Government. Yes, I'm a Socialist on this one) and if we can't get it together to do that, we should leave it alone. Although the "marketplace" wasn't doing a good job of delivering "quality health care at an affordable price," it was doing better for most people than the Affordable Care Act will do.
The "Affordable Care Act," aka "Obamacare," is over 900 pages long. Nobody knows all that's in it; nobody knows how all the different sections of the law will interact with each other in practice; nobody knows what the next big surprise headline will be. But we DO know a few things:
1. Obama was genuinely surprised to find out that he'd been lying to people for years when he told them not to worry, because if they already had health care they liked, they could keep it despite the enactment of Obamacare. Not good that the principal architect doesn't know what he's built-- "Frankenstein," anyone?
2. Premiums for individual health insurance policies "in compliance" with Obamacare requirements are going to be at least triple what most people were paying for "non-compliant" individual policies before the enactment of Obamacare, and although there was a lot of talk about some non-compliant plans being "grandfathered in" that won't happen with any plan that's undergone a "major change" since enactment of the law-- i.e., virtually all of them.
3. If you can't afford to pay for a "compliant" individual policy because the premium is too high, people who make very little money will be eligible to have a big chunk of their premium paid for them by the government-- i.e., the taxpayers-- but ONLY if they buy "compliant" insurance available through the exchanges set up by the Federal government or several of the states. (In case you're worried about insurance company profits, don't. They don't care whether they get paid by the individual policyholder or the government, so long as they get paid, and there's no limit as to what they can charge for the insurance they sell.) Bad news: no matter how little money you think you make, you're still likely to be paying more for your insurance when the dust settles... even after factoring in a subsidy, if applicable. But good news: even if you're 80 years old, you'll have maternity coverage.
4. The plans available through the exchanges provide coverage through "narrower" networks of providers, meaning that only a fraction of the doctors in the insurance company's "regular" networks will be accessible by persons insured through the exchanges, and the odds of a particular doctor being accessible are lower across the board. In some cases, it will be very hard indeed to see a doctor with a particular specialty, and long drives and long waits for an appointment are going to be in a lot of futures.
5. Many of the plans offered through the exchanges offer "good quality healthcare at an affordable price" by simply bypassing major medical centers like UCLA or Cedars-Sinai (to name a couple of L.A. favorites.) Where will the "insureds" be going instead?
6. Not to harp on a small point, but so far it doesn't look like the government has the capacity to sign up all of the necessary participants by the deadlines it set for itself (and for the signer-uppers, too, if they want to avoid paying a tax penalty.) The Federal website still doesn't work, and EVERYBODY is keeping a tight lid on how many people have actually managed to sign up so far. This is fairly alarming, given that the sign-up deadlines are fast approaching, and the Feds have mentioned figures like 16 million as the numbers of people they've got to sign up in the first year to make this plan work.
7. The plans won't work anyway unless a lot of young, healthy people, presumably those without insurance from their job or school, sign up and pay those premiums instead of simply skipping it, as most young healthy people with no money have traditionally done. After all, the penalty, at least for the first couple of years, is a small fraction of the premium, even factoring in a subsidy. On the other hand, everybody with a pre-existing health condition who does want insurance is going to sign up for sure, (well, they will if they can get onto the website) and maybe get a subsidy. The math is not looking good.
8. The people who actually manage to sign up for insurance may not understand just how little they are getting. "Bronze" insurance plans available through the exchanges are basically the same as having no insurance at all, except that they come with the privilege of paying hundreds of dollars a month (or for some, helping the government pay hundreds of dollars a month) to insurance companies for the privilege of not receiving benefits. These plans, like most of the others, include high out-of-pocket limits, and pay only 60% of covered medical services. Not a good deal, especially if you're a gambler and understand the odds. Besides, a real gambler would just "go bare," anyway, since the emergency rooms will still have to treat you even if you're non-compliant.
There's more, of course... and we'll continue to have more nasty surprises as the law goes into effect. For example, many or even most small employers (under 50 "full-time" employees as defined by the statute) may bail on providing health insurance benefits once they realize that a) they don't have to; and b) it's O.K. because the government has guaranteed "affordable" health care to their employees who buy individual policies; and c) they don't really have a choice,because it's too complicated and expensive to offer the benefit any more anyway. As for the large employers, who will (eventually) be required to provide coverage for their employees, they too have a choice. They can reduce the size of their workforce to keep the cost down; they can eliminate jobs so as to avoid the requirement; they can provide a really crappy (but cheaper) benefit; or they can pay a fine (which, as with the individual penalty, might actually wind up being cheaper than being compliant.) Employers have to watch out: if they provide an insurance benefit that costs too much, they will wind up paying a penalty, too, which is actually higher than the penalty for not providing the coverage at all.
Over the last couple of weeks, it has become apparent that even the proponents of this crazy 900+ page law-- up to and including the Proponent-in-Chief himself-- have absolutely no idea of what it says in the aggregate or what its pitfalls will ultimately turn out to be. Mr. Obama, for example, "didn't know," (until 2010, anyway) that people would lose their health plans and their doctors because of the provisions of his Brave New Law. The Administration (in particular Kathleen Sebilius) "didn't know" that the government website, which was rushed online without being tested, wouldn't work. And nobody but the health insurance companies seems to have realized that this law does absolutely nothing to "rein in the cost of health care," while at the same time providing a Wall Street Bailout-style windfall of increased (and now mandatory) premium payments for the health insurance companies.
The Tea Party is full of anarchistic, incoherent rabble-rousers, but it's got one thing right. This particular law, ostensibly designed to "fix" the "health care crisis" in America, is actually making it worse. It needs to be scrapped, and a new law written to take its place, one that requires universal healthcare (whoops! Just lost the Tea Party)-- not semi-universal health insurance-- and provides for a single payer (i.e., the U.S. Government. Yes, I'm a Socialist on this one) and if we can't get it together to do that, we should leave it alone. Although the "marketplace" wasn't doing a good job of delivering "quality health care at an affordable price," it was doing better for most people than the Affordable Care Act will do.
Tuesday, October 15, 2013
On the Positive Side of the Ledger
Regular readers of this mess will have to acknowledge that
my view of life tends toward the dark side.
War, famine, idiocy, fanaticism, hypocrisy, climate change… you know,
reality. But every once in a while even
I have to acknowledge the beauty that surrounds us in this vale of tears. The other day, for instance, I was up quite
early, as is my wont, and was treated to a most spectacular sunrise. The sky was ablaze with brilliant oranges and
yellows and reds, speckled with dark clouds, and there on the Eastern horizon
was the blazing ball of the Sun peeking up over the hills across the
harbor. The dawn was still, as if the
world was holding its breath to take in the glory of it. And I stood there in the upstairs dining room
of my house, gazing through the arched windows at all of this, seemingly staged
as a private spectacle just for me, and I felt awe, and something like ecstasy
at the wonder of it… and a little guilty because I so rarely, these days, get
past all the crap to take this in.
Then I thought of the beautiful souls with whom I’ve come in
contact over the decades comprised by my life, human and non-human, and the
love I’ve felt and still feel for them, and I heard myself whisper a “Thank You”
to the Universe for the privilege of having known them. I thought of the warmth of the Sun on my
skin, and I understood for a moment how ancient people, so much more in touch
with the rhythms of Nature, had little choice but to decide that the Sun was a
god. I thought of the goodness of
peaches and apples and berries and, of course, wine. I remembered myself as a small child, back
when my Mother and Father were all-powerful and all-good, my ear pressed
against my Father’s hairy bare chest as he quietly rumbled out a lullaby.
I often calm crises at work by reminding the staff that in a
hundred years none of whatever is causing the crisis will matter, and probably
won’t even be remembered at all. But it’s
hard to practice what I preach. I find
myself cursing at the traffic and scrambling to meet “deadlines,” and getting
worked up over the headlines in the Timeses (New York and L.A.). But when I’m standing all alone in the early
morning looking at a dawn like that, or on a hill looking out over the sea with
a storm building up, or at kittens playing in the “Ponytails” in my front yard,
my proper perspective returns, and I forget all about the petty follies that are
perpetuated by our so-called “modern civilization.”
Thousands of years ago, shepherds used to lie around staring
at the stars in the brilliant night sky around the Mediterranean, and they were
able to pick out the images of gods and heroes, great beasts and timeless
beauties. Now, with all of our
much-vaunted technology, we can see a lot more… but in some ways are able to
see a lot less. Ancient people knew that
every rock and tree and spring had its own spirit, and they took pains to
appreciate and propitiate those spirits, because they recognized that they were
an integral part of Nature, just as we humans are. Now, though, it seems that our LED’s and
halogen headlights have blinded us to the presence of the spirits that abound
in Nature, and that our i-Pods and rap music (and let’s not forget “Fox News”)
have drowned out their voices, too. So
it’s only once in a while, such as when we’re all alone in the still of the
dawn, that we’re even aware of the essence of the world.
The old saying is to the effect that one must take time to “stop
and smell the roses.” I recommend that
you try that, and I personally think that early tomorrow morning would be the
perfect time.
Sunday, September 22, 2013
Know Thyself... and Then Quit Whining
“Know Thyself” is one of the Delphic Maxims, inscribed in
the forecourt of the Temple of Apollo at Delphi. Like much of ancient wisdom, the meaning of
this admonition is open to interpretation.
According to the Suda, a 10th Century encyclopedia of ancient
Greek knowledge, “the proverb is applied to those whose boasts exceed what they
are” and is “a warning to pay no
attention to the opinion of the multitude.” I guess that the message is that nobody’s
opinion of you is any good, including your own.
So how do you know who you are?
What’s the song say? “I’d like to get to know you… if I could.” Popular
music can be cryptic, too.
Nelson Mandela once said that “[o]ur deepest fear is not
that we are inadequate. Our deepest fear
is that we are powerful beyond measure.”
Wonder why you get a little chill as those words sink in? Because Nelson Mandela is right. Some people become very uncomfortable around
mirrors, you know. Maybe they don’t
really want to know themselves, because if they did they would have to assume
responsibility for their thoughts, words and deeds.
These days, people seem to spend most of their time coming
up with excuses (or, more euphemistically, “explanations”) as to why their
lives are screwed up. They blame their
parents. They blame the economy. They blame their luck. They blame their “addictions.” Rarely do they blame themselves, because that
would inevitably lead to questions like, “Well, if you think you’re on the
wrong path, why don’t you simply try a different one?” In other words, if you’re fat—lose
weight. If you’re poor—figure out a way
to earn more money. If you’re
unhappy—find something you like to do, and go do it. And so on.
For obvious reasons, people for the most part don’t want to go the “get
a life” route: taking personal responsibility can be a lot of work.
Kids sometimes sit around the house moaning that “there’s
nothing to do.” If it’s a rainy day,
it’s because they can’t go outside. If
it’s a sunny day, it’s because “there’s nobody around.” Adults often spend a
lot of time moaning about all of the things that they “have to do,” including
go to work every day to support those brats sitting around the house. Yet when somebody wins the lottery, and with
it ostensible freedom from the toiling part of their daily lives, like as not
the inevitable “human interest” story about them in the local paper will report
that they slogged back to their job as a toll-taker on the expressway the
Monday after winning and have no plans in the immediate future to quit.
People complain that they are “stuck” in jobs they don’t like,
find excuses to stay married to people they don’t love, go to hear sermons they don’t believe, vote for candidates they
don’t trust, and watch television programs they acknowledge are “dumb.” You’ve got to ask why.
Psychologists tell us that everything we do is the product
of conscious or unconscious choices.
And there’s a logic behind each choice, too, a logic grounded in fear. If the range of possible alternative
realities seems too unpleasant… or too unknown… people have a tendency to stay
put. Yup. The old “fight, flight or freeze” again. So if one is afraid of change, they fight it;
afraid of bad consequences that might result from changes in their life, they
fly away from them; and if they’re generally unhappy because they’re in a
predictable rut, they dig in a little deeper rut and freeze until they’re numb
to the pain.
Now, it goes without saying that one can’t adapt to life in
a prison cell (or a self-dug rut) and retain even a semblance of sanity if one
is going to insist on being hyper-aware of one’s circumstances. Prisoners daydream and fantasize and zone out
a lot to pass the time… except when they’re out in the general population where
they might get killed, of course. Then
the Law of the Jungle kicks in again.
Outside prison walls, the rest of us are able to deny reality with fewer
restrictions—look at those idiots texting as they hurtle down the freeway. People spend a lot of their time imagining
what it would be like if they were fit, or rich, or educated, or married to
someone they actually liked, or divorced from somebody that they actually can’t
stand, or living in the country, or traveling around the world. But very few of them do anything much about
it. And when they do think about their
unsatisfactory situations-- usually because they have to, for some reason—they
will declare either that they’re “grateful” for all the non-crappy parts of
their lives (by implication having concluded that their lives, however crappy,
are as good as they can expect them to get) or that there’s “nothing to be
done” about the crappiness. “No Exit,”
as Jean-Paul Sartre might say.
Existentialists have one thing going for them. Their denial is not complete. They acknowledge the futility and absurdity
of their existence. Heck, they even
revel in it. They have no responsibility
for trying to “improve” their situation, because they believe that their
situation cannot be improved, and they can churn out volumes of well-supported
reasons for this belief.
Another avenue to acceptance of one’s miserable lot is
adherence to a religion, Catholicism and its offshoots being the obvious case
in point. During the Middle Ages, the
lot of the common individual was pretty shitty, indeed. People lived in squalor, misery, ignorance
and filth. They were plagued by wars,
starvation, witches and, yes,
plague. To keep them from going ape and
threatening the (relatively) better situations enjoyed by the “nobility” of
Europe and the clergy, somebody had to come up with a mythology to explain to
the peasants why it was worth enduring all the squalor and misery and filth,
and the theologians came up with a pretty good story. “We’re living in squalor and misery and
filth,” they said, “because Man sinned against God (by being disobedient and
seeking after knowledge) back in the Garden of Eden and so we’ve got to endure
this crap until we die… but it’s only temporary, because if we’ve been really
good while enduring the squalor and misery and filth, then we’ll go to Heaven
and live forever without any squalor or misery or filth.”
That was the “carrot” dangled before the disease-ridden,
oppressed and ignorant populace back then, but the Church concluded (rightly
enough) that it wouldn’t be sufficient by itself to ensure compliance or
complacency. So they added a
“stick”: “Oh, and by the way, if you’re
not good at enduring the squalor and misery and filth, and you don’t ‘render
unto Caesar’ and follow the dictates of the Church, our loving God will cast
your damned soul for eternity into a lake of burning fire, and you’ll be poked
in the ass by devils with pitchforks while you labor in squalor and misery and
filth. Amen.”
They didn’t get 100% compliance, of course, but the one-two
combination of salvation and damnation
worked pretty well. And besides, they
needed some non-compliant people to hang and burn at the stake now and then in
order to maintain the urgency of the message.
Anyway, the fatalism of the Existentialists and the hope of
the Medieval peasantry give you two ways, at least, of rationalizing a
miserable existence until you’re dead.
There’s another way, the concept
of Tao, primarily promoted by Eastern religions such as Confucianism and Zen
Buddhism, which is, conveniently enough, roughly translated as “The Way.” I mention this as sort of an afterthought,
because it’s not really practical for most Twenty-First Century Americans. The object is to harmonize one’s will with Nature
in order to achieve what has been termed “effortless action”. It requires meditation and moral practices
that aren’t really in sync with our smartphone-driven, Nature-bending, “busy”
lives here in the good ol’ USA. So
unless you’re now living on one of the four or five Colorado mountaintops that
isn’t adjacent to a subdivision, or on a private island, or something like
that, the Tao is going to be a tough path for you to conceptualize, much less
follow. More power to you if you decide
to make the attempt, but I’m going to have to turn my attention now back to the mass of un-Enlightened readers.
Here is the step-by-step, color-by-numbers, Rachael Ray
quick, easy way to gain mastery over your life:
1.
Acknowledge that
your life is less than perfect, and that whatever combination of bad
circumstances and bad people brought you to whatever pit you’re residing in
presently, it’s your fault if you stay there.
2.
Acknowledge that you are not as good as you
could be, and that there are any number of things you could do to try to
improve yourself.
3.
Acknowledge that other people, whatever their
circumstances, are plagued with the same doubts, fears and inadequacies that
you are.
4.
Work at improving yourself.
5.
Work at improving your life.
6.
Stop worrying about why you’re here. Go about the above-listed activities serene
in the knowledge that, although you will never achieve perfection, eventually
it will all stop… or change…or something… when you die. And there you have it, How to Live Your Life.
Saturday, September 7, 2013
Speech Codes and Other Obscenities
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