Democrats’ Aim Should Be Universal Coverage – Improving the ACA is the Right Vehicle

Democrats’ Aim Should Be Universal Coverage – Improving the ACA is the Right Vehicle

I get why the liberal wing of the Democratic Party is obsessed with enacting Medicare-for-All as the vehicle to universal coverage. I do. There’s no question that if we got it right, it would be both far more equitable and cost-effective than the present chaotic patchwork of a “system” that we’re currently lumbered with. I was raised in England and I know what a blessing the National Health Service has been, warts and all, in providing first class health care to everyone and without driving any of anybody into bankruptcy.

I also understand only too well the frustration of forever being told that it simply can’t be done, that the odds are stacked against it. How do we know unless we try, right?

Nevertheless, reality must intrude. First, as we have already seen with the few states that have tried to add a public option to their ACA markets that the health care industry will wage total war on any suggestion of even a modest expansion of of a public health care option. And when I say the health industry, we’re talking the insurance companies, the hospital industry, the pharmaceutical industry and much of the medical profession, particularly specialists, surgeons and the hospitals each of whom gain the most from the present lack of price controls on any but Medicare patients, and who will fight tooth and nail to keep it that way. Added to the health industry’s implacable opposition will be the Republican Party and the entire right-wing universe complete with relentless fear mongering and lies. And they will have a powerful issue that lends itself to demagoguery. Socialized medicine! Egads!! The fact that they’ve called the ACA, modest insurance reform at best, the same thing will of course be lost in the din.

Second, a total reform of the entire US health care system, one that dwarfs the enactment of the ACA, will require the support of most Americans, 180 million of whom currently have employer-provided health insurance which most of them believe is just fine, thank you very much. And Democrats would be asking them to give that up and see their taxes increase to boot – a hard sell even though insurance premiums will go away. All of this on the promise that expanding Medicare to include everybody, entirely rationale but something we’ve never tried before, would be better. And then there’s the seniors who are currently well satisfied with their Medicare and will be scared into believing (by you know who – see above) that somehow they will lose much of what they have if their health care is folded into a national scheme for the whole population.

In short it will not merely be an uphill struggle to enact Medicare-for-all but the policy equivalent of free climbing Half Dome in Yosemite National Park and to believe otherwise is delusional.

But there are other ways to universal coverage. In fact there are many models among developed countries that have achieved and did so with a system that incorporates private insurance albeit heavily regulated. Switzerland is one, for example. Check this link to the non-partisan Commonwealth Fund for a thumbnail sketch of the Swiss system and that of other developed nations from whose systems we can draw lessons .

Which brings us to the Affordable Care Act. Like all compromises on huge and complex pieces of legislation, the ACA is manifestly imperfect and in need of substntial improvement, for example by vastly reducing out-of-pocket expenses and greatly expanding the income cut off to receive premium subsidies. Yet the law has significantly increased the number of people with health insurance whilst proving unexpectedly resilient in surviving GOP efforts to repeal it and the Trump administration’s attempts to weaken it. If Democrats win the White House and Congress in 2020, they have an opportunity to undo all the damage of the Trump era and to make the ACA a far bigger success in providing affordable health coverage to a vulnerable population.

As well, Democrats have other costly priorities to address such as climate change and relieving our kids of the huge debt burden of college loans, to name but two. A full throated battle for a single payer health system will suck all the political oxygen out of the air and leave us with little energy to seriously tackle those issues. And that would be a tragedy.

President Trump Insults Mayor Khan on Day One of London Visit

President Trump Insults Mayor Khan on Day One of London Visit

From the official Twitter account of U.S. President Donald J. Trump:

There so many things wrong with this. Where to begin? The feud with London Mayor Sadiq Khan started in 2016 when Khan, a Muslim, criticized Trump’s Muslim Ban. And Khan wrote a piece for The Guardian just two days prior to Trump’s current London visit that compared him to fascists.

Well that didn’t sit well with our volatile president, so he responded by saying Khan is “nasty” to the visiting POTUS but immediately insults Khan with his own nasty rebuttal. Trump says Khan should focus on crime in London while he sits in a plane pounding out a series of petulant tweets in which he calls Khan a “stone cold loser” and insults him further with a comment about his height by comparing him to the “terrible” but tall NYC Mayor Bill de Blasio. Then he closes with how he looks forward to being “a great friend to the UK”. So presidential!

It’s no wonder that hundreds of thousands of Londoners greeted their “great friend” with protests, like this message mowed on a lawn that could be seen from Air Force One as it descended for landing:

And the now famous Trump Baby Blimp with with its pugnacious face and weaponized cell phone in hand.

Robert Mueller’s Road Map for Impeachment of Trump

Robert Mueller’s Road Map for Impeachment of Trump

I hope all of you took the time to watch Mueller read his statement about the findings of the special investigation and what he could and could not do according to law. The law matters to him – a lot. Not so much to the person at the center of the investigation.

I was working so I could not watch it, but I did read accounts of the reading on a few different news websites.

David Frum’s column gets to the heart of the Muller report and distills it in just a few short paragraphs:

Obstruction of justice, though, need not be clandestine to count as a crime. What matters is intent—and that must be judged by Congress, not a special counsel subordinate to the Department of Justice and bound by its rule that a president cannot be indicted.

The full report is rich with details. But that’s the essence. A foreign power interfered in the U.S. election to help the Trump campaign. The Trump campaign welcomed the help and repeatedly lied about it. The lying successfully obscured some questions the investigation sought to answer; in the end, it found insufficient evidence to charge a broader conspiracy. President Trump, in public and in private, worked to stop the investigation.

Those are the facts. What are the remedies? Mueller underscored at his press statement: He did not exonerate the president. Under the Department of Justice rules he was subject to, he lacked the power to act.

Meanwhile, the Trump administration refuses to take steps to secure the next presidential election against the interference that swayed the last.

I have two questions:

Congress – Will you carry out your duty to oversee the Executive Branch or will you let the president get away with obvious crimes for which only your branch of government can hold him accountable?

Trump – will you do anything about interference in American elections by hostile foreign governments, or will you shrug it off hoping you can benefit from the interference again in 2020?

It’s Alive!

It’s Alive!

Were it not for Robert Mueller reading a summary of his report last Wednesday, this blog would most likely be dead. As you can tell, all of us content providers haven’t been writing anything for quite a while. And, our domain master forgot to renew the domain name. Had I not tried to go to this site on Wednesday, I would not have seen the notice that that the domain name was for sale. I asked Cory about it and said that at least it ought to be worth something – even if it is bastardized English for the Japanese “harakiri“. Well I guess there is some grace period, because Tony was able to get it up and running again. He said it would have been gone for good within three days.

Providence. Thank you Mr. Mueller

So I guess I’ll try and put some stuff up once and a while. Like now.

Seattle air quality index (AQI) like smoking 5 of something that burns per day

Seattle air quality index (AQI) like smoking 5 of something that burns per day

Top 10 comparatively toxic number of things to smoke:

If you sleep with your windows open in Seattle for 24 hours, it’s just like smoking:

  1. 3 New York cockroaches, dried naturally in saltwater from the Great Pacific Garbage patch.
  2. The mystery contents of 5 vegan pill casings found in a small plastic bag lying in the parking space next over from the one you chose so your car wouldn’t get dinged.
  3. 5 cigarettes.
  4. 1 cigarette after accidentally lighting the filter and keeping going till it’s gone.
  5. The “left over” tobacco recovered from select unfinished butts in an outside coffee can ashtray wrapped in a page torn from the Bible. Leviticus or Revelation only, and only because you currently, honestly believe it would be better than nicotine withdrawal.
  6. Water.
  7. 2 packs of 1950’s Marlboros per day for the rest of your life if it never killed you.
  8. One nickel.
  9. Whatever Sarah Huckabee Sanders’s stink-eye is based on.
  10. A 1971 anal thermometer.

5 cigarettes:

Normal, invisible air:

Burma Shave

Burma Shave

“I guess you’d say I’m on my way to Burma-Shave,” sings Tom Waits in the 1977 song “Burma-Shave”. But where is he going with his female friend? Somewhere, but nowhere in particular. They are just going, getting away from trouble with the law, and from a town that doesn’t have the distinction of being a dead end; it’s just “a wide spot in the road”. Burma-Shave isn’t a destination, and it isn’t even a journey, which implies some kind of specificity. Burma-Shave is the anonymous, insignificant, American ubiquity, the inland ocean in which a person could lose themselves. It is the road; or rather, it is the road-side.

There’s something nostalgically current about this story that grabs me. Maybe the viral nature of the campaign that capitalized on the baby-boomers’ generational separation from their parents via the interstate highway system that connected the east coast from the west by 5 days and a now easily-obtainable, used automobile or a ride.

http://nomegallery.com/chapter/burma-shave-by-will-wiles/?exh=1115&order=2

California Smoke Over Western Washington

California Smoke Over Western Washington

Not just Western Washington, which shows in this photo around Mt. Rainier, but this was on my flight back from Salt Lake City, Utah.

Mt. Rainier peeking above the fog of California fire smoke.

 

Returning to Seattle from a short trip to Salt Lake City, I snapped this photo of Mt. Rainier. But while I was in Utah, I was warned repeatedly that the air there was a so bad that emergency care centers were being overwhelmed with patients experiencing urgent respiratory issues.

I’ve never experienced anything like that, no matter the air quality, until this trip. I was explaining to my mom that we couldn’t stay long due to some unforeseen circumstances when suddenly I started into a coughing fit. That has never happened to me. Could be a one-off.

In the above photo, I had to review it several times to be sure it wasn’t a photo of Mt. Rainier with some extreme color-banding in the clouds. This is smoke over the mountains surrounding Mt. Rainier as we approach Seattle to land at SeaTac Airport.

That’s smoke, not clouds, from <~ 30,000 feet.

Obama Fake News PSA by Jordan Peele

Obama Fake News PSA by Jordan Peele

Video technology has progressed to the “Well that’s pretty alarming” level.

I have no doubt that President Trump will soon use this example of believable, but fake video editing to tweet something like “See folks? I told you that wasn’t my voice on the Access Hollywood tape. Totally FAKE! Believe Me!!!” if he hasn’t already.

Of course we all know it was his voice on the tape, because Billy Bush confirmed it.

Anna von Hausswolff gives me chills

Anna von Hausswolff gives me chills

I’ve read reviews of Anna von Hausswolff’s previous albums in print magazines and online, but I had never bought any of her music. Then I read a four-star review of her new album, Dead Magic, in the April issue of MOJO Magazine where James McNair described her vocal performance for the song “The Mysterious Vanishing of Electra” as “…astonishing. With its whoops, shudders and sandpaper-throated expulsions, her singing sounds like an exorcism”. Okay then, tell me more! McNair describes where and how the album was created:

Recorded in nine days, largely using the hulking 20th century pipe-organ at Copenhagen’s Marmorkirken, or Marble Church, …With it’s spidery strings, drones, suspensions and drama-rich support from Hausswolff’s five-piece backing band, Dead Magic comes on like a horror soundtrack-in-waiting, its 47-minute journey bridged by just five songs. Thematically, it’s big on myths, legends and oblivion, and the darker more esoteric kind of magic you wouldn’t likely associate with Ali Bongo.

( I didn’t know who Ali Bongo was either.)

After reading the MOJO review, I searched around and found this article by Laura Snapes in The Guardian.

Never mind other people’s perceptions; she’s more perplexed by her reaction to her own music. “When I start becoming ugly, or raw or unfiltered, that’s also when the most interesting things happen,” she says. “But I feel shame because that’s not how you’re supposed to present yourself as a female. I’m quite a modern girl – and luckily in Sweden we have a very open mind towards women in arts – but I still get that feeling that I’m in a place I shouldn’t be, doing things you really shouldn’t do, like I’m fighting the ideals projected down from our ancestors.”

The paucity of women in extreme music means these stereotypes are even tougher to break: “They have to defend what they’re doing so hard because they’re in a male-dominated genre, so there’s more focus on them being female than on their work. It’s still weird for people to see someone screaming her nuts out, playing loud music. I think, how can it be shocking any more? We still haven’t broken down our idea of how the genders should be.” Old, male pipe organ custodians just about manage to avoid patting her on the head when they show her around their instruments. “Usually I just smile and let the music speak for itself, and then afterwards they’re always shocked and don’t know what to say any more.”

And then I watched this video, and you should too, like right now.

And then I bought the album.

It’s right in my wheelhouse. It’s like P.J. Harvey circa To Bring You My Love melded with Nick Cave’s Let Love In, Richard Wagner’s organ music, and the flying monkeys in The Wizard of Oz. It gave me chills and made the hairs on the back of my neck stand up.

Buy it now and play it LOUD!