Category Archives: Health Care

We’re All In This Together


Harris Rosen is a real person.  He really did give free daycare and college scholarships to all high school graduates in this very poor little neighborhood in Orlando, FL.  It is unclear for how long he did this or if he continues to do this now and the graduation rate statistic is suspect, but it’s still truly inspiring.  What is interesting is how different people find this inspiring.  A conservative friend is the one who posted this on Facebook (Yes this is another Facebook argument.  Yes something is wrong with me.).  My response was this:

Imagine all the money the government is going to save on welfare. Imagine all the extra money the government is going to make in taxes from the increase in income that comes from going to college. Imagine that instead of one neighborhood winning the rich-guy lottery, we all got together and pooled our resources to make this a reality for all. Imagine if everyone in the U.S. had free daycare and college scholarships. Imagine how much better the U.S. and the world would be as a result.

When talking to conservatives, use conservative talking points.  Don’t throw in inflammatory barbs like “Imagine if there were someone running for president right now that has promised to provide these things.  Feel the Bern!”  Though I was sorely tempted, that’s just poking the bear.  His response was:

I get it dude, but forced philanthropy breeds resentment and entitlement. There’s no substitute for a kind heart with a smiling face, proving to a neighborhood that they matter, are not forgotten, and have a gift that requires stewardship.

Which is really along the lines of “That’s all fine and dandy but if you force people to do the things that inspire them they’ll resent you and the people that benefit from it will feel all entitled and stuff.”  It’s such a low view of humanity.  It’s as if benefits don’t count unless you can put a face to the benefactor.  Which is absolutely hilarious when you realize that this seems to be a very popular view in certain Christian circles.  Maybe it has something to do with being told from birth that you’re a dirty sinner and undeserving of anything and thus must work hard from conception to get what you want.  Try to pinpoint exactly who would be resentful and who would feel entitled and you can’t (You know, people.  Not me.  Not my friends.  Those other people.), which was my next point:

 Resentment from whom? Entitlement from whom? Those who would resent this are already resentful. Those who would feel entitled already feel entitled. I think most would feel grateful. Most would feel empowered. Everybody would win; the resentful, the entitled, the rich, the poor. If you’re the one who would feel resentful, fine, conversation over, but if you wouldn’t feel resentful, you are much closer to those that are resentful than I. Change minds. Change spirits.

He “liked” this which is basically a polite way of ending the conversation, but then someone else posted something that I think gets to the heart of why conservatives don’t quite get what the stakes really are even though they should be blindingly obvious:

Let me empty your bank account to pay for my sister’s medical bills and we’ll see who’s resentful.

If you legislate charity, it becomes theft. If you force someone to’s not giving. And if you didn’t make the money, it’s not yours to give.
I’d like a great many things, doesn’t mean I should get them. And just because someone is in unfortunate circumstances, doesn’t mean they should have someone else solve their problems.

I wanted to concentrate on the first sentence only because the rest is just boilerplate libertarian nonsense that people reflexively repeat.  The last sentence is also worth commenting on briefly, though.  This person is obviously Christian and obviously cares about certain things.  These things even correlate very closely with the goal of providing basic childcare to all children.  But she wants to decide exactly whom to help.  She wants to be able to pick a winner and loser.  Take that agency away from her and you suddenly go from an obvious good to grounds for rebellion.  But back to the first sentence:

Um, I am a perfectly healthy male with insurance. I DO pay for your sister’s and hundreds of thousands of other people’s medical bills. Probably not your sister specifically since we are almost assuredly on different health plans, but you get the idea. Plus, we’re kind of switching subjects from education to healthcare, but the whole point of pooling resources is so that any individual DOESN’T get their bank accounts emptied. That was the biggest problem with insurance pre-Obamacare. Have a preexisting condition and you’re uninsurable and you either find a way to pay for your condition or find a magical benefactor or you die. I gladly pay property taxes for the education of children that I won’t have because a better education for all makes us all better. I would gladly pay more in taxes to provide daycare for all because well taken care of children make better prepared children makes us all better. I would gladly pay more in taxes to provide a college scholarship for those that graduate highschool because smarter people get higher paying jobs which allows them to buy more things and provide more things which makes us all better.

I don’t want to live in a world which depends on a magical benefactor who sweeps down on a vanishingly small subset of humanity to provide for a basic need like a child’s education. I want to live in a world where we all recognize that childcare and education are a fundamental necessity for children who had zero choice in to whom they were born and where they were raised. I want us to recognize that this benefits not just the children but all of us. I want to live in a world where the popular belief of “I suffered and so should you” is replaced with “we suffered now let’s try to make things a little better for you”. I am my brother’s keeper. I am my sister’s keeper. My brother is not just Tangelo Park. My sister is not just Orlando, FL. My brother, my sister is the United States of America. Harris Rosen has proven how beneficial childcare is to primary education on a small scale. Let’s make it nationwide and reap the whirlwind of benefits together. No child is not deserving.

It’s a little speechy (I sometimes get like that when I write), but I believe it hammers home my point.  We’re all in this together.  Not a single one of us has the wisdom to decide who is deserving and who is not.  This is true for every single human being, but especially true for children who should be considered deserving by default.  One person proving that providing basic childcare benefits those children immensely is absolutely inspiring.  Learning from that and pooling our resources to make it a reality across the entire United States would be awe inspiring.

She Gonna Catch Up On The Rebound A Da Medicide

Good news, everybody!  Scientists have discovered a new class of antibiotics.  Well, not so much discovered as finally got off their lazy asses and tried doing something other than growing things in a petri dish.  How amazing is this discovery?  Well, it’s been almost 30 years since the last discovery and it’s been getting pretty scary out there in the medicine world as the current batch of antibiotics gets less and less effective.

The new antibiotic, called texiobactin, has been known to scientists, but has been largely ignored because it doesn’t grow well inside a petri dish.  In order to grow texiobactin, scientists had to get a little dirty.  Literally.  Like, in the real use of the word literally, not in the purloined use that actually means figuratively.  Scientists have to get texiobatin from the dirt!  They do this by using an incredibly clever device with an incredibly unclever name called the iChip.  If I understand it correctly, the iChip works kind of like a sorting device.  It lets in only a specific type of bacteria, in the case of texiobactin that would be eleftheria terrae. You put some eleftheria terrae in the chamber of the iChip and then you bury it in soil where the bacteria grows.  The iChip then allows more eleftheria terrae into the chamber as it grows around the device.

So far, scientists have discovered as many as 25 different bacteria that show promise using this method.  Of them, the eleftheria terrae/texiobactin one shows the most promise.  As with most brand new discoveries, there is a bit of hyperbole involved.  People involved are saying that this new antibiotic should stay effective for 30 years or more.  That’s all fine and good, I’m sure, under normal circumstances, but in our over-prescriptive society, I’d give it 10-15 years tops before bacterial immunities to the antibiotic start to appear.  Maybe we’ll have learned our lesson by then and slowed down our antibiotic addiction.

Of course, the usual caveats apply; this is a new discovery, these things take time, sometimes what seems promising turns out to be a dud, blah, blah, blah.  Still, this has the feel of practicality to it so my powers of prognostication give it a 75% chance of coming to fruit.  Let’s hope.

The Greatest Peacetime Challenge The World Has Faced

Those are the words of the World Health Organization (WHO) director as he talks about the Ebola pandemic in West Africa.  A bit hyperbolic, perhaps, but the statistic are shocking: over 6,000 infected and almost 3,000 deaths, across 5 countries.  That may not seem like a lot, but in comparison, all the previous Ebola outbreaks combined do not add up to these totals.  And the scariest thing is this outbreak shows all signs of just getting started.  The WHO predicts over 30,000 confirmed cases by the end of October.  There is also lots of evidence that the number of cases may be underreported by a factor of 2.5 times because of the stigma associated with the disease, among other reasons.  The Center for Disease Control (CDC) says that if this pandemic continues at its current exponential growth, we could be looking at 1.4 million infected by January.

Those are some scary statistics and it’s easy to get worked up in fear over such numbers, but we here in the U.S. are pretty much assured of the outbreak never reaching our shores.  With a modern health care infrastructure, Ebola is fairly easily contained even if a handful of cases do reach us.  That’s been the biggest problem in West Africa this outbreak.  Most Ebola outbreaks were contained in isolated villages, but this one made it into population centers and a combination of slow initial response, poor infrastructure, distrust of Western medicine, and burial rituals which help spread the disease all came together to make this the disaster that it is today.

There is something you can do to help.  I’d recommend donating to Doctors Without Borders.  They do great work in areas that are severely underserved and are doing some top-notch work in this pandemic.

Here Comes The BOOM!, which has been absolutely awesome at projecting Affordable Care Act sign ups, and the Obama administration are showing that over 7 million people have signed up for individual insurance through the exchanges as of the March 31st deadline.  That surpasses the Congressional Budget Office’s original 7 million person projection by a hair or two.  The grand total of private individual insurance sign ups is somewhere between 14.6 M and 22.1 M.

This can not be seen as anything other than an amazing success.  Of course, you have the usual nay-sayers, the same people who kept on insisting that Mitt Romney was going to win the last election despite an overwhelming amount of evidence that he wasn’t, who exclaim very loudly and often that the numbers are all wrong.  To be fair, there are still some legitimate questions, but they are minor and will do nothing to take away from the awesomeness of hitting this milestone.

This must be the worst April Fool’s joke ever for ACA naysayers, those that called it a disaster, that said it would bankrupt the country, those that vigorously attempted to thwart the legislation at every turn.  April 1st, 2014 marks the beginning of tens of millions of Americans having affordable, comprehensive healthcare for the first time ever.  No longer can they be driven to bankruptcy because of an accident or a disease.  No longer will they have to decide between getting the healthcare they desperately need and the food they must eat.  No longer will people be tied down to their jobs because of the health care it provides.  Goodbye and good riddance to those barbarous days and hello to a still flawed but markedly better future.

Take The ACA Quiz Challenge

The Kaiser Family Foundation has a quiz asking ten questions on various parts of the Affordable Care Act, aka Obamacare.  The questions are fairly easy if you’ve been paying attention and have been able to slash your way through the massive misinformation jungle that has surrounded the ACA.  I got 9 out of 10 correct.  I did not know whether or not the ACA raised the Medicare tax on high income earners.

I lost the page that referred me to the quiz, but it was talking about how misinformed even doctors still are about the law.  30% of one specialty got the end-of-life governmental panel question wrong.  Luckily, doctors don’t need to understand the intricacies law in order to provide care.  I’d be interested in a poll to see how many primary care physicians knew which procedures were guaranteed to be covered by insurance without a deductible now because of the ACA.  And by interested, I likely mean horrified.

Corporations Are People, My Friend

That titular comment was made by the silver-spooned Mitt Romney during the run-up to his being trounced by Barack Obama in the 2012 Presidential race.  It, and many other silly comments like it, are a lot of the reason why he lost so handily.  Sadly, in this instance, he was kind of right.  The law of the United States is that any use of the words “person” or “whoever” in laws automatically includes corporations.

Much of the precedent has to do with the equal protection clause of the Fourteenth Amendment.  I don’t mind laws protecting corporations from governmental interference.  A lot of the Fourteenth Amendment arguments make fairly good sense.  Where I draw the line is the Constitutional protections afforded corporations.  I don’t think it should be the Fourteenth Amendment that protects corporations.  I think it should be law.  What I find especially funny is the most vocal proponents of Constitutional protections for corporations tend to be the same people who also advocate Constitutional Originalism.  Corporations existed back in 1776.  It would have been really easy for the founders to include corporations in the Constitution if they thought it should be applied to them, but the Constitution doesn’t mention corporations.  Funny, that.  Of course, I also find Originalism to be an intellectually bankrupt idea and the personhood dichotomy is just one reason why.

We now have another attempt to expand corporate personhood coming up at the Supreme Court.  The case is Sebelius v. Hobby Lobby.  The issue is the Obamacare mandate that requires health insurance policies to cover birth control.  The argument is that the mandate violates Hobby Lobby’s right to religious expression under the Religious Freedom Restoration Act (RFRA).  All because the owners of Hobby Lobby have a misguided bug up their ass about emergency contraception and how it works.  The RFRA was written in response to a Supreme Court decision that ruled the government is able to pass generally acceptable neutral regulatory laws that happened to curtail a person’s religious expression.  And since corporations are people, the RFRA also applies to corporations.

Think about that for a moment.  The argument is that a for-profit entity that only exists as a piece of paper filed in some clerk’s office can now have a religion and must be allowed to freely express that religion.  If this doesn’t show the perversity of corporate personhood, I don’t know what does.

Keep in mind, Hobby Lobby is not being forced to give emergency contraception to its employees, it is just required to provide insurance that makes it available as part of the insurance policy that they offer.  The moral decision to use emergency contraception rests squarely with the employee.  Hobby Lobby is no more culpable morally than they would be if someone stabbed another person with the crafting scissors they bought at Hobby Lobby.  They could easily just hire people who swear they won’t use emergency contraception.

The biggest issue is where does it stop?  Hobby Lobby’s argument is pretty narrow.  They are only against the emergency contraception birth control options.  The Catholic Church’s is not.  They are against ALL birth control.  Should the mandate not apply to companies run by Catholics?  What about those backwards religions that are against all medical care?  Should all of Obamacare not apply to them?  If Hobby Lobby is successful, the answer is almost assuredly yes.

This is one of those cases that is hard to predict given the current makeup of the Supreme Court.  Normally, I’d say this is an easy 9-0 victory for the Obama administration.  There’s no way that happens with this court.  I still think a fairly easy win is inevitable, though.  Your religious expression forbids you from using emergency contraception.  Your religious expression demands you proclaim the evils of emergency contraception.  Your religious expression gives you no rights to prevent others from making up their own minds.

You Get Free Birth Control! You Get Free Birth Control! Everybody Gets Free Birth Control!*

* If you happen to be female.

One of the more controversial provisions of Obamacare is that health insurance plans must cover birth control for women.  Why is it controversial?  Well, because it violates a company’s right to freedom of religion.  That is a silly concept in so many ways that it deserves its own post so I’ll leave it for later.

What I want to spread is some good news.  The birth control mandate took effect at the beginning of 2013.  Prior to 2013, only 15% of women with private insurance were getting free birth control pills.  By the spring of 2013, that number was up to 40%.  The numbers for the ring were even more impressive.  Prior to the mandate, 23% were getting the ring for free.  That jumped to 52% by spring.  This is amazing.

With millions more women currently signing up on the exchanges, that number is likely to skyrocket when the statistics for 2014 come out.  In many cases, these will be women who could not afford birth control previously and now will be able to.  I don’t think it’s going out on a limb to say that this expansion of birth control coverage will lead to a marked decrease in the abortion rate in the United States.  And that’s great news everyone can get behind!

Adventures In Obamacare 6: HealthSherpa To The Rescue!

The biggest problem about is that it is nigh impossible to get to the point where you can actually look at plans and how much they cost.  A trio of young geniuses decided to take it upon themselves to fix this.  The result is  All you need to do is enter in your zip code and age and smoking status of each person to be covered and you are presented with a list of all of the plans available in your area and their cost.  And you can do this for any zip code you want!  You can also enter in your salary and it will figure out your subsidy as well.  Pretty cool.

It is, admittedly, a bit limited, but you can do more on the site than on the government site. It would be nice if they were able to provide more information like deductibles and copays and such, but it’s a great start and it should give individuals a pretty good idea of the range of options available in their area.  This is something that has failed miserably at unless you were lucky enough to get through the cumbersome enrollment process.

Simple.  Efficient.  Robust.  *golf clap*

Adventures In Obamacare 5: Weekend At Eric’s

I am still in the bureaucratic limbo of trying to prove that I am an actual person, but my friend Eric has gotten past that step because he has a perfectly normal name.  He was gracious enough to let me peruse the options that offers for Illinoisans.

The first thing that struck me was how counterintuitive the website was even at this point.  In order to get a list of plans, you had to click this innocent looking green box that simply says “SET”.  That’s all it is is a green box.  There is no indication that you’re supposed to click it to get to the plans.  There’s no cursor change over the box except when you hover over the word “SET” and the cursor changes to the familiar word processor capital ‘I’ cursor.  I would think that there would be bells and whistles and pointers and perhaps a marching band playing informing you to CLICK HERE FOR PLANS!  But no.  I wonder how many people have signed up on the website and think they can’t get to the plans because they don’t know to click the green box.

Once you get to the actual list of plans, things are much nicer.  You can look only at certain levels of plans or view them all.  The layout for each plan takes up a bit more real estate than it should, but each plan has links to the plan’s provider networks and coverage options from the offering company’s website which is really nice.  I didn’t go any further into the process than looking for the plans because Eric would probably be upset if I signed him up for something.

The thing that sticks out the most is how much of a disparity in price there is between the various providers.  When you get to this granular level, it becomes really difficult to actually compare the products to each other.  Two products with the same deductible and copays and coinsurance can be $100/month different and a useful comparison of provider networks is impossible so there is really no meaningful way to judge if that extra $100/month is worth it.

The good news for me is that my current provider, Blue Cross and Blue Shield of Illinois, offers the cheapest plans pretty much across the board.  The strange thing is that the prices quoted on the site are slightly different than the prices quoted on the Blue Cross site.  For instance, Blue Cross quoted me $152.24 for the cheapest plan, but healthcare.gove quotes the same plan at $157.84.  I’m not sure why there’s a discrepancy.  I can only guess that there’s a surcharge that the federal government places on insurance orders placed through  If anyone knows anything about this, I’d be interested in knowing.

Adventures In Obamacare 4: Wrath Against Obama

There has been some somewhat warranted righteous indignation against President Obama for his repeated comments that you will be able to keep your insurance if you like it.  Obama really pulled a Obi Wan Kenobi on this one.  What he said was true from a certain point of view.  Plans were grandfathered in when the Affordable Care Act went live.  All insurance companies had to do was not materially change the coverage during that time.  In the real world, insurance companies materially change their coverage all the time.  People don’t even recognize that this happens.  They get a lengthy legalese notice from the insurance company and quickly check to see if they owe money and then recycle it.

Another part of the story is that insurance companies are just choosing to not continue certain plans even though they are grandfathered in.  There are no statistics that I can find, but I would guess that a majority of the individuals receiving cancellation notices (including myself) fall into this category.  Look at it from the insurance company’s perspective.  They can either choose to keep a plan which they can no longer sign up new customers or they can drop the plan and force customers to choose a new Obamacare approved plan.  Which would you choose if you were an insurance company?

We have to also keep in mind that this is just the individual insurance market we’re talking about here.  And while potentially 15 million individuals (including myself) fall into this pool, it’s still only 5% of the entire population.  We get inundated with horror stories of people’s rates going way up, but they’re all just anecdotes.  Me?  Similar coverage from my cancelled plan to my new plan will actually save me money.  Without a bigger picture, it’s all just rage over nothing.  Not to mention we have no proof that the anecdotes are actually true.  One told of an individual whose rates were going way up and he was saying that he’ll just cancel his insurance and wait to get insurance when he gets sick.  Um, insurance doesn’t work like that.  I certainly hope the reporter told the guy so.

The worst thing is that the information that comes from the insurance companies is basically crap.  My notice doesn’t mention any concrete reasons why my individual policy was being cancelled.  It does make mention of pediatric dental coverage being necessary under Obamacare, but it doesn’t really say that my current plan doesn’t cover it.

This was really a shoot yourself in the foot moment for Obama.  Even though a vast majority of the population is going to be able to keep their insurance, he should have really nuanced his bold claim that you would be able to keep your insurance a lot more than he did.  With all the blanks being fired at Obamacare based on complete unreality, he’s gone and given the crazies actual ammunition.