A CONSTITUTIONAL QUANDARY: AMERICAN HEALTHCARE

I always thought the phrase, “cutting off your nose to spite your face” was rather odd. I’m not the biggest fan of idioms anyway, mostly because it takes me the rest of the conversation to figure out what they mean. I’d much rather people just come out and say what they want to say, please. But “cutting off your nose to spite your face” is really the perfect summation of the healthcare debate.

I was watching the Supreme Court oral arguments for the healthcare mandate on C-Span this morning. Now before you fall asleep, just hear me out. Seriously—stop yawning—I see you out there! More people should supplement their daily Fox News or MSNBC fixes with a side of C-Span. People would be a lot more informed rather than conditioned to think a certain way. Unfortunately, I think most people simply prefer others to do the thinking for them no matter how biased that thinking may be. But I came away with a couple of thoughts in mind. First, Antonin Scalia is so condescending, but rather entertaining. Second, I heart Ruth Bader Ginsburg. And third, that David Verrilli is leaving a lot to be desired in the defense of the healthcare act.

The constitutional point in question with the mandate is whether health insurance falls under the definition of interstate commerce. If the justices determine that it does, than the mandate would be constitutional via the commerce clause (Article 1, Section 8). If health insurance is not interstate commerce, then Congress has no right to legislate it and that part of the law would be negated. Now with that boring little technicality in mind, is this oral argument really necessary? I’m going to go out on a limb here and just predict that this decision is going to be a partisan decision. Roberts, Scalia, Alito, and Thomas will dissent. Bader Ginsburg, Kagan, Sotomayor, and Breyer will decide for the law. Kennedy will be on the fence, but will join the pro side in the end and the healthcare mandate will be upheld. Just a guess, Kennedy could go the other way.

Does anybody really think that health insurance and healthcare isn’t interstate commerce? If I get injured in Idaho, I don’t get choppered back to Maine Med to have my femur fracture repaired so I can bleed out while watching out over the plains of the Midwest. Healthcare is about 17% of our economy. It’s ridiculous to say that healthcare isn’t interstate commerce and just because you don’t like a law doesn’t make it unconstitutional.

Okay, I’m done with the boring constitutionality arguments for healthcare mandates. The Supreme Court will decide and we’ll have to live with their decision. I’d much rather talk about the healthcare debate in general. So here we go…

Let’s first ignore the conservative hypocrisy over the healthcare mandate. The mandate originated with the Heritage Foundation and was pushed for multiple times by multiple Republicans during the 1990’s. Let’s just say, for argument’s sake, that this isn’t about hypocritical partisan posturing in order to take down their enemy, Barack Obama. Let’s just say that the Republican dissent is genuinely based on a concern about government imposition on personal choices—for argument’s sake.

Conservatives are, forgive the idiom, cutting off their noses to spite their faces. They don’t think government should have the power to make them buy insurance and they don’t want to have to pay for someone else’s personal “decision” to remain out of the private insurance market. I put decision in quotations because it’s often not a decision at all. Good luck getting into the private insurance market with diabetes, heart disease, a history of cancer, or any other preexisting condition the market deems too costly for their bottom line. God forbid private insurance companies not be able to pay for their multi-million dollar executive salaries and private jets. Let’s also not forget all of those investigators hired in order to determine (without patient contact, mind you) that your medical procedure was not actually necessary so that they don’t have to make good on the service that their customer has already paid for.  

Well here’s my answer to all those who cringe at the thought of paying for someone who doesn’t have insurance: YOU PAY FOR THEM ANYWAY!! Healthcare cannot be treated like a free market enterprise. People get sick whether they can afford it or not and when the uninsured get sick, we (the insured) pay for it both through government subsidies and through increased private insurance premiums.

Uninsured patients cost hospitals$49 Billion per year. Hospitals have to find some way to recover those costs. How do you think they do that? It’s all cost shifting. We’re paying for these people anyway. The uninsured are charged WAY more for their healthcare, one, in attempt to recoup the costs of those who don’t pay their bills and two, because individuals don’t have the bargaining power that private insurance and the government have. When these people go bankrupt—and many of them will—we now pay this increased cost. At least if they were insured, there could be some caps and control over inflated prices.

We’re a country that values life. I wish the rhetoric of those who say they value life the most lined up more closely with their actions and I wish that someone would remind these same pro-lifers that Jesus preached more against hypocrisy than anything else (Oh, I guess I just did that). But unfortunately, we live in a world full of hypocrites. Because we, as a society, value life we passed EMTALA regulations in 1986 (signed, BTW, by *gasp* the conservative messiah himself, Ronald Reagan). 

 

How many of you against the individual mandate have no idea what EMTALA is? Shame, shame, shame. Well, let me help you. Very generally, EMTALA is the set of laws that require emergency rooms to accept you as a patient regardless of your ability to pay. Despite certain Republican debate audiences, most Americans think it’s a good idea that if uninsured farmer Joe has his arm chopped off in a hay baler that the emergency room can’t turn him away.

           

Sorry Farmer Joe. We’d sew that back on for you, but there’s no way you could afford it. Good luck. I’m sure that massive spurting, arterial bleeding will clot right up.

We passed EMTALA because we believe that even if a person made an irresponsible decision to not buy insurance we don’t want them to needlessly suffer if we have the ability to help them. We value life. When these Farmer Joe situations happen, someone has to pay for it. If we’re lucky, Farmer Joe is independently wealthy and can pay out of pocket. For the rest of the 99% of the country, the likely progression is from sickness to treatment to health to huge bills to being overwhelmed to depleted savings to losing your home and other assets to losing your retirement to claiming bankruptcy and finally to passing the bill off to you and me.

Anybody out there who thinks that the individual mandate is a government overreach must also stand up and fight for the repeal of EMTALA. Anything short is hypocrisy. EMTALA forces a hospital to provide services to customers who cannot and/or will not pay for them. It’s akin to forcing a store owner to sell a plasma TV to a customer who offers nothing but his word that he’ll eventually pay. Are you willing to let Farmer Joe bleed out in his cornfield simply because he couldn’t afford insurance?

Of course, that argument is ridiculous. Healthcare is not a product that follows market rules. It’s not supply and demand. The demand is constant—especially with the American lifestyle. People will always be sick. The real question is what do we value as a society? Should healthcare be a right or should healthcare be reserved only to those who can afford it?

Do I want to pay for somebody who is morbidly obese and refuses to eat anything green unless said food happens to be dyed that color? Do I want to pay for somebody who chooses to smoke two packs a day? Of course I don’t. But, you know what? I pay for them anyway because we, as a society, have decided that even people who make bad choices deserve treatment. You really want to control healthcare costs then you find a way to get preventable disease under control. Unfortunately, the same people who bitch the loudest about individual mandates are the same people who scream and cringe at the idea of putting nutrition facts on restaurant menus, or banning soda in school, or increased cigarette taxes. What do we call that again? Oh yeah, HYPOCRISY! These people don’t care about health, they care about bottom lines and that’s it! Until, of course, they’re the ones lying on the operating table. Everyone else is a freeloader, but when they need help, their claims are legitimate.

Healthcare should not be treated like a free market commodity because the product does not follow the rules of supply and demand. People need healthcare whether they’re rich or poor—whether they have a job or not. When we treat healthcare like a free market enterprise, we get ridiculously high prices for medical procedures, absurdly inflated salaries for insurance company executives who do nothing in terms of actually helping a patient, and a system that focuses on treating sickness rather than preventing the sickness from happening in the first place.

And the thing that hurts our wallets the most is that the sickest in our society are the ones being kept out of the market. Unfortunately, we’re beyond the point of appealing to people’s humanity. Profitability is what matters. Well, I would remind you that when the uninsured get sick, whether it’s a kid who just got off his parent’s insurance and gets into a car accident or a farmer who leaps headlong into a hay baler, you pay for them anyway. So stop cutting off your nose to spite your face! People will always make bad decisions. Most people believe they still deserve to be helped. If you don’t believe that then you need to stand up and start fighting for the repeal of EMTALA. Here’s another idiom for you if you tell your congressman to fight for EMTALA repeal: That’ll go over like a fart in church.

   

LIFE LESSONS FROM LEMON VOLUME 1

Anybody who’s followed my writing probably gets the impression that my life philosophy is sarcasm and curmudgeonly cynicism toward the inanity of our political system and religious institutions. And while those people would be largely correct, I actually have a surprising level of optimism toward human beings as a species. I believe that people are intrinsically good. I think most people’s intentions are upright, even if their actions don’t befit that objective. Though it does exist, true psychopathy is really an anomaly. I believe that the iniquity and venality in society is caused by the groupthink influenced by corrupt institutions, especially religions and political parties.

So essentially, I believe people are ultimately good, but they’re also easily led and, therefore, misled. It doesn't matter what the message is as long as they have someone to follow who at least appears like they know what they're doing. They’re also reticent to be leaders because leaders are required to have their own ideas, which is very scary for people who are afraid of being cast out of the group. Our society is so pariah-phobic that we’ve become inundated with minions who are so paralyzed by their fear of being laughed at that it’s allowed the corrupt few to overtake us and create a population of angry and confused people.  

We’ve been trained to think that the only way to be happy is to fall in line. In the end, that’s what destroys us. We lose ourselves in the quest to be accepted and to not upset the status quo. We’re experts at polishing our façades in order to give people what we think they want and, thus, remain part of the inner circle.

I wish more people would risk being shunned by their respective group because then, just maybe, the groups would dissipate and we could live in an amicable communal society.  

Random thought, yes, but such is my life.

MAKING LEMONADE OUT OF BIGOTED SEXIST IDEOLOGUES

If you’ve been breathing, you’ve probably heard that the issues of birth control and mandatory, state-sanctioned vaginal probes are prominent in the Federal and State governments lately. Yes, that’s right, in the year 2012 we are discussing a woman’s right to have access to and fair funding for birth control and our right to not be subject to state-sanctioned rape. It’s fascinating really in a political sense because Republicans, in the case of birth control, are framing the argument of requiring employers to cover birth control (and I do mean employers and NOT religiously affiliated employers because, if you’ve paid attention, this is no longer about religious institutions but ALL employers) as a government intrusion into personal lives. However, in the case of mandatory trans-vaginal ultrasounds (now whittled down to abdominal ultrasounds because Republicans seem to think another medical procedure forced by the government upon women is somehow more appropriate), they’re making the argument that government is far more equipped to make medical decisions than a woman and her doctor. Do I really need to elucidate the hypocrisy? No? Okay then, let’s move on.

Recently, the House of Representatives held a hearing in which they discussed birth control. They held a hearing on contraception without one single female who was pro-birth control. No women. The one woman that Democrats tried to put on the panel was nixed by Darrell Issa. That’s right. Our House of Representatives convened a hearing about women’s rights, but one thing was conspicuously absent from this hearing—WOMEN!!

What you might not have heard yet is that the woman who Democrats wanted to place on the panel was recently called a slut and insinuated to be a prostitute by the one and only Rush Limbaugh. That’s right, if you’re a woman and you believe that your reproductive health should be covered by your insurance, which by the way you pay for via decreased wages (you don’t honestly think your employer really foots the bill, do you?), then you’re a slut and a prostitute. Hmm…nobody seems to have a problem with the fact that insurance covers Viagra. Let’s see—boners good, contraception bad. I get it now. Rush is a bloviating fool who says things like this purely for ratings and really isn’t worth a response, but in this case I’ll make an exception. I have five words for you Rush, lick me you fat fuck.

Now, that being said, I’m going to try and make some lemonade here out of the fact that women’s rights are being trampled on and we’re being treating like we’re too irresponsible and fatuous to make our own medical decisions without the guiding hand of the government. I’m a feminist, flamboyant and proud of it. I was born late enough to benefit from all the work of the women before me that allowed me to do things like vote (if you’re a woman and you don’t vote, shame on you), work, control when and if I become pregnant, make my own medical decisions, have equal access to education, be able to benefit from athletic competition…shall I go on? I didn’t have to fight for these things because other women cared enough about the future to fight for me. And for that, the least I owe to them is to educate myself about their fight.  

Why now, if we’ve already fought for these things, are we finding ourselves in a position of having to fight for them again? Because we, in so many facets of our lives, refuse to accept the fact that past is prologue. We’ve been complacent. There are young female athletes out there who don’t know what Title IX is. There are women who have never heard of Alice Paul or Elizabeth Cady Stanton. There are women out there who probably think that Griswold v. Connecticut is part of the National Lampoon’s Vacation series. Betty Friedan, Gloria Steinem, Bella Abzug—never heard of ‘em. When we don’t educate ourselves and others about what it took to get to the point we’re at, we’re doomed to repeat the past. And that’s exactly what we’re experiencing now with our government trying ferociously to retract our reproductive health rights.

Here’s the lemonade. I hope the anger we feel toward what Republicans are trying to impose on us, as women and men who support women, incites us to rekindle feminisms fire. We got so far and then got lazy. Women are still locked out of upper management positions in corporations. We still make only about 80% on the dollar of what men make. Medical studies are still largely done on men, so when you’re prescribed that medication it’s pretty much pissing in the wind as to how it’s going to affect you. Athletic programs are trying to undermine Title IX by using it as a scapegoat for problems with men’s sports like wrestling and track and if we get lazy on this, one of the most beneficial pieces of legislation—something I definitely benefitted from—will be gone.

I hope what’s happening today reminds women that there are people out there who believe that you are not equal to them, that you are too dumb to make your own decisions, that you don’t deserve the same opportunities as them, and that you shouldn’t be paid as much as them. I hope this incites women to stand back up and flip the collective middle finger to these sexist bastards with our voices and with our votes. For all of you out there who thought that it was an exaggeration to say that these people exist, I hope what’s happening scares you enough to start caring because if we don’t then we’re going to have to fight all over again for things that were earned long ago.

And for your amusement….

THANK YOU OLYMPIA

I never voted for Olympia Snowe. In 2006 I voted for Jean Hay Bright. I probably would have voted for her in this year’s election, but unfortunately nobody is going to have that option. Imagine that. Me—a registered Independent, but admittedly and proudly liberal in the majority of my stances—voting for the Republican incumbent whose votes largely coincided with her own party (despite what the lunatic tea baggers are feeding you now).

Olympia Snowe represented what is best in our country. She is a woman, a representative of her constituents, who refused to cater to the fringe wing nuts out there who have been allowed to take over Congress because of campaign finance laws and the utterly absurd practice of gerrymandering state congressional districts in order to fix future elections.

I believe it’s the Rockefeller Republicans, so demonized by the right wing, who are actually more in line with most of this country. The vast majority of people in this country are moderates. They don’t want absence of government. They want a government that gets (good) stuff done. They want a government that works in the majority interest and enforces a fair system—one that ensures the needy can subsist and that business people aren’t handcuffed by absurd legislation. The people don’t want to be financially raped by their government in order to serve the interests of mega-corporations or finance big screen TVs for those who refuse to work, nor do they want to be literally raped by their government with mandatory trans-vaginal probes and other intrusions into their private lives. To use the cliché, people want government both out of their wallets AND out of their bedrooms. The majority of Americans don’t hate gays and women and they don’t care if gays get married. You’d just never know that judging by our elected officials. Unfortunately, our current system is set up so inflexible ideologues get elected by a very small minority of Americans who have the ability to finance an entire campaign on their weekend allowance. But I can go on forever about this subject—in fact, I probably will at some point.

Ideologues call Olympia Snowe a RINO basically for a handful of votes—the DADT repeal, a vote for the 2009 stimulus, voting to acquit Clinton, some pro-choice votes, voting for Obama’s supreme court appointees, and voting for stem cell research.

Olympia Snowe didn’t prescribe to the new standard and, as a result, Maine has lost one of its greatest elected officials. I didn’t agree with the majority of her votes, but I never feared that she’d vote against what she felt was best for her state because of partisan bullying. Maybe if more of the country followed the tendencies of our Maine Republican Senators—Snowe, Susan Collins, Margaret Chase Smith, William Cohen—we’d be a better place.

Collins and Snowe both are two of the few Republicans supported by the Human Rights Campaign and both were integral in the repeal of DADT, especially Collins. Both of our current senators are also strong proponents of women’s rights. Apparently supporting equality for all Americans is antithetical to true conservatism.

William Cohen had the guts to break with his party over Nixon’s impeachment and also served under a Democratic President Clinton as Secretary of Defense. But I guess if you’re a true conservative, you’d never serve your country if it meant working with the other team. Ask Jon Huntsman how that works.

Margaret Chase Smith, one of the greatest politicians of all time, in addition to supporting New Deal legislation early in her career, was the first in the Senate to have the guts to stand up against McCarthyism. Every American should read her Declaration of Conscience.

But alas, true conservatism means that you must prescribe to the belief that anyone who disagrees with you is a Commie bastard and should be placed on blacklists, arrested, and subject to public interrogation by Congressmen whose right to throw out fabricated and unsupported accusations toward you is protected.

It makes me sad for our country when people who are willing to work with political opponents are dissuaded from running because we have a Congress that factions itself off like a high school clique.  Our selection of candidates has become so watered down for multiple reasons, not the least of which is because of the lunatics running the asylum in Washington. Representatives are elected to vote in the interest of their constituents, not to cower under the iron fist of their political fraternity. I can only hope that our next senator, like Senator Snowe, won’t cave to the pressures of their party affiliation if it means voting against what they believe is best for the country.  

Senator Snowe, you were one of the few left in Washington with any personal integrity. Thank you for serving our state and representing all of your constituents, whether we voted for you or not.