Cheat Sheets

I'd like to think that actually participating in one of the ACA's already enacted programs -- PCIP -- gifted me with lots of useful info and insight into the health insurance and health care access crisis in this country.  You'll have noticed, Dear Readers, that I mention it often enough.

But my official cheat sheet has often been Shadowfax over at Movin' Meat.  His Blogger "about me" consists of:

I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

I think it's the "progressive politics" that hooked me, along with a healthy respect for an excellent wonk.

Anyway, take a look at two of his latest posts if you are just now starting to give this whole crisis stuff a thought.  Shadowfax is a good place to start, and then to continue, and then to hone your critical thinking skills -- you may have to jump around the blog a bit but that's no waste of time, either.

Here's one:

OBAMACARE DEFEATS TRUMAN

So this is great news and a great day. My quick reactions: 

First of all, CNN & FOX. Once again proving that being first is a higher priority than being right. How embarrassing. At least their soon-to-be-fired producers will be able to get health care coverage. 

Second, Roberts: I have to give him a little credit. I fully anticipated him to be a partisan hack and invalidate the law. Perhaps the burden of history weighed heavily on him, perhaps the delegitimization of the court influenced him, or perhaps the sheer radicalism of Scalia's dissent drove him to uphold the law. Regardless, he got it right. Make no mistake, though, he did what he could to advance his long-term agenda by slowly restricting the reach of the commerce clause. 

While most of the focus centered on the the Heritage-Foundation-developed mandate (aka the greatest threat to liberty ever), it's important to note that the 4 conservatives wanted to invalidate the entire law, and there is far, far more than the mandate in Obamacare. 12 million Americans will get rebates from their insurers this year based on the ACA's insurance regulations. Rescissions of policies is now prohibited. In a couple of years, pre-existing conditions will be covered under the guaranteed issue provisions, and the moribund individual market will be resuscitated by the insurance exchanges. All of these huge reforms survived and will transform healthcare in a good way. 

The mandate itself may work, or people may prefer to pay the "tax" penalty and go without insurance. We will see. If enough people opt out and insurers are experiencing serious adverse selection in a few years, perhaps the partisan rhetoric will have died down enough that Congress can tweak the incentives at bit. One can hope, anyway.  [READ THE REST HERE]

And here's the other:

 Defending the Mandate and its Tax/Penalty

From a contributor at the Daily Dish: 

This. This is exactly the right approach.

I do not understand why Democrats don't embrace the newly defined "tax", saying: you bet we raised taxes, but not on the hard-working, responsible middle class. This is a tax on those deadbeats who don't pay for their own insurance but still expect care when they show up at emergency rooms. It's a tax, all right, and I think we should agree to raise it even higher so they have more of an incentive to buy their own damned insurance and leave the rest of us alone. Let the Republicans protect the rights of deadbeats; Democrats are fighting for people who play by the rules.  [READ THE REST HERE]

As I said, peruse the dood's writings on health care policy, they're instructive, they're even-handed, I agree with them, and so, they are right.  [Hey, I've had a rough day!]  A big "thanks" to Shadowfax for sharing his inside info and his insightful analysis, too, on this... schtuff.

Pure Knack

If you've never read James Thurber, I hope you will real soon.  Maybe you'll have a free moment after you pay the gas bill, lower this month, since you negotiated that new price per therm.  Try to get hold of a copy of The Thurber Carnival and just read straight through.

My favorite introduction to his world is "The Night the Bed Fell," but all most people seem to remember is Walter Mitty.  Ask them about Bach, and to a person they will tell you he was deaf.  Bring up Ronald Reagan to hear about the Jelly Belly Candy Company, even though it wasn't incorporated until 2001.  People are fickle, so just read straight through, though "More Alarms at Night" makes an obvious companion piece to "The Night the Bed Fell."

Here, wet your whistle on the opening paragraphs of the story:

I suppose that the high-water mark of my youth in Columbus, Ohio, was the night the bed fell on my father. It makes a better recitation (unless, as some friends of mine have said, one has heard it five or six times) than it does a piece of writing, for it is almost necessary to throw furniture around, shake doors, and bark like a dog, to lend the proper atmosphere and verisimilitude to what is admittedly a somewhat incredible tale. Still, it did take place.


It happened, then, that my father had decided to sleep in the attic one night, to be away where he could think. My mother opposed the notion strongly because, she said, the old wooden bed up there was unsafe- it was wobbly and the heavy headboard would crash down on father's head in case the bed fell, and kill him. There was no dissuading him, however, and at a quarter past ten he closed the attic door behind him and went up the narrow twisting stairs. We later heard ominous creakings as he crawled into bed. Grandfather, who usually slept in the attic bed when he was with us, had disappeared some days before. (On these occasions he was usually gone six or seven days and returned growling and out of temper, with the news that the federal Union was run by a passel of blockheads and that the Army of the Potomac didn't have any more chance than a fiddler's bitch.)


We had visiting us at this time a nervous first cousin of mine named Briggs Beall, who believed that he was likely to cease breathing when he was asleep. It was his feeling that if he were not awakened every hour during the night, he might die of suffocation. He had been accustomed to setting an alarm clock to ring at intervals until morning, but I persuaded him to abandon this. He slept in my room and I told him that I was such a light sleeper that if anybody quit breathing in the same room with me, I would wake Instantly. He tested me the first night-which I had suspected he would by holding his breath after my regular breathing had convinced him I was asleep. I was not asleep, however, and called to him. This seemed to allay his fears a little, but he took the precaution of putting a class of spirits of camphor on a little table at the head of his bed. In case I didn't arouse him until he was almost gone, he said, he would sniff the camphor, a powerful reviver.


Briggs was not the only member of his family who had his crotchets. Old Aunt Alelissa Beall (who could whistle like a man, with two fingers in her mouth) suffered under the premonition that she was destined to die on South High Street, because she had been born on South High Street and married on South High Street. Then there was Aunt Sarah Shoaf, who never went to bed at night without the fear that a burglar was going to get in and blow chloroform under her door through a tube. To avert this calamity -for she was in greater dread of anesthetics than of losing her household goods-she always piled her money, silverware, and other valuables in a neat stack just outside her bedroom, with a note reading,: "This is all I have. Please take it and do not use your chloroform, as this is all I have." Aunt Gracie Shoaf also had a burglar phobia, but she met it with more fortitude. She was confident that burglars had been getting into her house every night for four years. The fact that she never missed anything was to her no proof to the contrary. She always claimed that she scared them off before they could take anything, by throwing shoes down the hallway. When she went to bed she piled, where she could get at them handily, all the shoes there were about her house. Five minutes after she had turned off the light, she would sit up in bed and say "Hark!" Her husband, who had learned to ignore the whole situation as long ago as 1903, would either be sound asleep or pretend to be sound asleep. In either case he would not respond to her tugging and pulling, so that presently she would arise, tiptoe to the door, open it slightly and heave a shoe down the hall in one direction, and its mate down the hall in the other direction. Some nights she threw them all, some nights only a couple of pair.


But I am straying from the remarkable incidents that took place during the night that the bed fell on father.  [CONTINUE HERE]

Thurber is the source of a particular sort of chuckle -- a complex guffaw / chortle type of thing that can, and will, if the circumstances permit, cause you physical harm. Were you to read him too soon post-appendectomy, for example. Were you to try and read a story aloud and fall out of your chair, for another.

As a teacher, I've always enjoyed "University Days," and still find young Bolenciecwz's dilemma a compelling one.

It's a pleasure to find a true raconteur in the course of a day's rambling.  I've been a fan of Shadowfax and his blog Movin' Meat for a while, and hereby confess that admiration to be based on pure storytelling knack.  One of several hundred bloggers I follow with Google Reader, he hasn't written much of late, so I checked out a new entry this morning with real hope for entertainment.  He did not disappoint.  After you've finished your Thurber refresher, head on over to Movin' Meat and read "He says he's not dead."

Penpals: Write for Health Care Reform

Remember back in February, when the world was new? My favorite health care policy wonk and medical blogger, Shadowfax, was sulking because an old friend from his doubtlessly grungy Chicago days had taken a new job, and -- in his words: "He dropped me like a warm turd."

A word [As in: Psst! Over here! Shhh! Quiet, listen up!] -- I am embarrassed to say that I have long periods of mental idling, much like a coughing old jalopy, and while my opinions about health care reform are incredibly strong, they are not well informed beyond the data of the personal. So I do what I always do when smarty-panted conversants start to leave footprints on the top of my head: I locate those that seem closest to professing my own sentiments, but sanely and clearly, and I read them. Yes, I cut out a huge portion of original and new material that I rightly ought to be processing. But I also benefit from well-appointed points-of-vue, dotdotdot.

In short, I let other people do the work.

I am very fond of Shadowfax's old friend. Our relationship is new, and probably conducted under the observant eyes of his protection detail. I've become an ardent penpal.

Okay, so I have written him once. And I wrote "my story" up for submission to a chatty, lighthearted version of the serious, fer-real working group on health care reform.

I've emailed more regularly, and he tweets me all the live long day.

I haven't quite recovered from my "eureka!" moment (long time fan of Archimedes in the tub...). As I began setting down my story of health care and health insurance difficulties, it became crystal clear that any changes made will come too late to help me.

I am no longer one of those people who might slip through the various and sundry cracks -- I've already fallen through; I've already lost hope.

Given that this places me squarely among the most powerless, I expect my letters and emails to self-destruct within 30 seconds of their being opened.

President Obama needs vibrant, smart, effective people around him. My smart-ass, self-pitying "story"? It doesn't inform, nor does it inspire. It whines.

The NYT tells me this morning that Obama's point man on launching health care reform legislation is Senator Max Baucus of Montana, chair of the Senate Finance Committee -- "a political shape-shifter and crafty deal maker who is not fully trusted by either party."

It sounds, cough, like a match made in heaven.

And so... bleary-eyed and very sick, I resolved to write Shadowfax's good buddy one more time, and to copy that letter to every member of the Senate Finance Committee, which -- imagine the coincidence -- is actually asking for popular feedback.

As I familiarized myself with the Finance Committee's web site, I felt rather stupid for not having known of its existence or importance before today.

Senator Baucus authored a 98-page whitepaper -- Call to Action: Health Reform 2009 -- back on November 12, 2008.

There is access provided, via video and text, to all eight Health Care Reform Hearings held thus far in 2009, and the list of witnesses is impressive.

Most importantly?

To submit comments on the Senate Finance Committee’s Health Reform Policy Options email PDF or Word files to Health_Reform@finance‐dem.senate.gov

You who have not slipped through the cracks, you who remain stolid contributing members of society -- please find the time to put your thoughts on health care reform down in the requisite technical form, and send it off to the politicians.

I've always wanted to use the phrase "It is incumbent upon..."

It is incumbent upon us all -- upon the pity-partying, upon the thriving, upon the vast majority of those who simply and steadily struggle -- to tell our stories, yes, but also to frame those stories with information and suggested guidance.

If you want to give your blogging brain a jumpstart, give some of Shadowfax's opinion pieces a good read.

Oh! Oh, my! What do you mean you don't share my liberal leftwing gay pinko points-of-view? I'm shocked. Share, then, if you will, those policy wonks you'd like to make part of the common information pool. To whom do you give a nod of the head?

*** *** ***

Well, I'm off to make friends and influence people. Maybe feed a few cats, do a little laundry.
Take morning meds (This month's medication cost? $1113.00), recharge the wheelchair, get in bed, elevate the frozen purple legs, the throbbing infected shoulder and arm. Take a few pain pills, decide whether my ballooning face (the left side only) warrants a call to my MDVIP doctor. Ponder where I will come up with the $1,327 for my monthly BCBS health insurance premium. If I get rid of telephone, internet, television, and Netflix -- will I be able to make a payment to the hospital where I am having my 6th major surgery in less than 9 months -- in just 2 weeks? Will the fact that I still owe $900 impact their willingness to accept me, yet again, as a patient? What will happen if I code again? Is it possible some doctor or nurse will decide that I shouldn't be vigorously resuscitated, being such a drain on an active and working society? No wonder I don't sleep.