01 Monday May 2017
Posted in Uncategorized
Representative Billy Long (r) [2013 file photo].
A media outlet is reporting that Representative Billy Long (r) is a “no” vote on the Zombie Trumpcare bill:
Scott Wong @scottwongDC
BREAKING: Rep. Billy Long (R-Mo.) tells me he’s a NO on new GOP health bill! Brings to 22 the number of NO votes
[….]
12:40 PM – 1 May 2017
Apparently it’s that bad of a bill.
27 Thursday Apr 2017
Posted in Resist, social media
Tags
#resist, 4th Congressional District, ACA, health care, missouri, prayer, social media, Twitter, Vicky Hartzler
Yesterday, via Twitter, from Representative Vicky Hartzler (r):
Rep. Vicky Hartzler @RepHartzler
2/2 I was blessed to share a prayer for our nation, along with @SpeakerRyan and many more of my colleagues at the event.
[….]
6:29 PM – 26 Apr 2017
Some of the responses:
Did you pray Trump’s tax plan passes so you get a tax cut? Or are thankful for no townhalls?
Quick question – do you support the new @HouseGOP healthcare bill that exempts you and your staff? My folks in #Columbia want to know?
Who are they praying to? The god of money, greed, white supremacy, nationalism …….?
Oh word. An absolutely shining example of the separation of church and state.
Keep religion out of government.
Please pray that we are delivered from greed and malice.
With a psychopath as @POTUS our country needs a prayer.
More than prayer, we need competence, compassion, and courage, all of which are sorely lacking amongst our leadership in the WH and Congress
As a minister, I feel the need to call out your #hypocrisy….
Matthew 6:5-15 (NIV)
so when do we get the same insurance you guy have????
@SpeakerRyan needs to pray as his approval rating is lower than 45. How do you plan to vote on the healthcare/death plan? #PartyofDeath
Your “righteousness ” is appalling
Let’s say a prayer for the Muslims you want to ban, the immigrants you want to deport, and the millions you want to deprive of health care.
You wouldn’t have to pray so much, if you weren’t actively trying to destroy it
Isn’t that precious. Maybe u and the other Mgs need to pray for a little compassion and common sense.
I’m praying for our nation because of the Christian hypocrisy in the government. Shame on you.
Separation of church and State. All republicans think they can just do what they want under the guise of being good Christians. PHONY!!!
A nice christian prayer I assume. Don’t want to upset the fundamentalist base who are supporting a top down theocracy now do we?
Jefferson’s wall. Excellent idea. Look it up.
Do you praying for the Americans who will lose healthcare? Do you even care?
Thanks for screwing us over every single day and then praying for us!!! Bless your hearrrrrrrrrrrrt, hypocrite!
And they did.
20 Monday Mar 2017
Posted in Uncategorized
Tags
2703 Grant Program, ACA, AHCA, Community Health Homes, health care, Medicaid, Mental health care, missouri, Obamacare, SB28, Tom Price, Trumpcare
The Missouri Medicaid environment:
Missouri’s GOP legislature has been adamant that they will never take up the Obamacare offer to provide health care coverage for poor Missourians by expanding Medicaid coverage. In fact, they’re trying to jump the gun on Trumpcare’s not-so-stealthy attack on Medicaid with SB28, which would request “a global waiver from HHS to transform the state’s Medicaid into a block grant program, which would be federally capped and adjusted for inflation, state gross domestic product, population growth and other factors.” This move would , according to health care advocacy groups, “cut necessary funding for healthcare services for Missouri’s most vulnerable citizens.”
The Good News
Given this anti-Medicaid predisposition in the state, it’s all the more surprising to learn that, thanks to Democratic former governor Jay Nixon, Missouri took aggressive advantage of the provision in the Affordable Care Act (ACA) (a.k.a. Obamacare), the 2703 grant program, that allocated funds so that 25 Missouri community medical centers could experiment with providing a wide range of coordinated – mental, physical, dental and counseling – services in a community “health home” environment. The results in Missouri have been wildly successful:
According to a review by the Missouri Department of Mental Health, the results of the 2703 grant program in that state have been impressive. The more than 23,000 Missourians who have received care under the health home initiative met or exceeded six of nine benchmark goals for disease management after the ACA-supported expansion. For patients with diabetes alone (America’s most costly disease, at approximately $332 billion a year), the number with controlled blood glucose levels rose from 18 percent to 61 percent. The percentage of patients with hypertension and cardiovascular disease who controlled their blood pressure went from 24 to 67 percent, and their good cholesterol levels soared from 21 to 56 percent. On the cost side, hospitalizations and emergency room visits for this group dropped 14 percent and 19 percent respectively. This saved the state $31 million just in the first year of the program, and the savings have continued, according to Natalie Fornelli, manager of integrated care at Missouri’s Division of Behavioral Health. In 2015, Missouri’s health home program won the American Psychiatric Association’s Gold Achievement Award for community health services. The program is now considered a national model.
The Bad News:
Under Trumpcare, the funding that supports these programs is likely to disappear:
At the national level, the fate of the 2703 program is also in doubt. It’s possible that, as Republican lawmakers in Washington and the Trump administration wrestle with the complexities of repealing and replacing Obamacare, they’ll conclude that failing to continue the 2703 grants will likely cost more in tax dollars than it saves, even as it would deprive hundreds of thousands of poor, mentally ill Americans the coordinated treatment that can save their lives. But, as Sidney Watson, a professor at the Saint Louis University School of Law and an expert on health care access for the poor, observes, Trump’s new Health and Human Services secretary, Tom Price, “has expressed a lot of skepticism about the Medicare and Medicaid demonstration centers.”
Tom Price? Skepticism? No kidding. They guy believes in freedom. Freedom to die, that is. As Politico notes, Price’s “vision for health reform hinges on eliminating much of the federal government’s role in favor of a free-market framework built on privatization, state flexibility and changes to the tax code.” He’s a member of the Association of American Physicians and Surgeons, a far right fringe medical group that declares Medicare “evil” and “immoral.” You can bet that they and their most prominent member, Tom Price, don’t think much of Medicaid either. The better a federal health program does, the more these fools believe it saps our moral fiber, inculcates dependency and undermines physician freedom – the whole right wing drill, in other words..
Those of you who are calling your representatives and senators and begging them to save our health care, forget about the truly awful AHCA and maybe just fix Obamacare’s relatively minor problems, might also want to bring up the 2703 program and its proven success here in Missouri. Surely the Republicans can’t be so stupid that they’ll argue with success. Or, on second thought, maybe they will.There is that whole Dump and Dupe AHCA effort. If that isn’t arguing with success – Obamacare increased the ranks of the insured by 20 million, after all – then I don’t know what is.
13 Monday Mar 2017
Posted in Uncategorized
I took the graphic below from Talking Points Memo where it is put forward with the following warning: “Please don’t share this image far and wide because then people would know all of President Trump’s broken promises about health insurance for millions of people.” I’m assuming that this is a tongue-in-cheek invitation to share the image far and wide, so I’m taking advantage of TPM’s work to make the point about how dim-witted our truth-challenged President thinks his supporters are. And, sadly, he may be right
What Trump promised:
What Trumpcare delivers:
And this is only a partial catalogue of the potential problems with this dismally amateurish effort at healthcare policy.
So what does Trump – the man who gave us the “bigly health insurance promises” enumerated above – have to say about this plan? He thinks it’s “wonderful.”
Holy Sweet Jesus! This man is our president. For the next four years. Unless he screws up with the corruption and foreign influence scandals to the point that even the GOP congress has to hit the impeachment button. And given how compliant they currently are, that would have to be a whole crap load of corruption.
UPDATE: CBO scoring just released today. lt’s really bad. How bad? Here’s a summary of the numbers from the Washington Post. GOPers reacting with dum-dum denial or slick misdirection – saying things like Trumpcare will increase “access” to healthcare. You can do you know what with “access” to health care coverage I can’t afford to purchase – I need to be covered so I can get “access” to medical care.
19 Tuesday Apr 2016
Posted in Uncategorized
Tags
Alicia Mundy, Claire McCaskill, health care, Koch brothers, The Veteran's Administration, VA hospitals, veterans
An article in the St. Louis Post-Dispatch (4/14) lamented the fact that the local VA hospital was having trouble finding anyone to take the facility’s medical director position. The article cited two main reasons for this situation.
First, was the issue of pay. The Post-Dispatch pointed out that while a similar position in the private sector would pay in the vicinity of $349,000 a year, directors at the the VA have a salary range of $121,956 to $183,300. I don’t know about you, but I’m pretty sure that a salary of about half the going rate isn’t going to get many takers. We all know, too, that those who are willing to work for less might not be quite the very best talent that can be found.
Second, the article pointed out that there has been lots of publicity about shortfalls in VA service over the past couple of years, resulting in lots of heated rhetoric and excessive political meddling in the VA’s management . Nobody wants an underpaid job where oversight means your efforts to succeed will undermined by demogogues and micromanagers who seem to be looking for reasons to cut funding essential VA funding.
It is not really surprising that administrators at the VA are underpaid relative to the market. One need only look at the spending cuts that congressional Republicans wrung out of the Obama administration since 2010 to understand that more than administrative pay may have been compromised by the indiscriminate GOP budget ax – and at a time when the VA system has had to accommodate a large influx of wounded veterans returning from Iraq and Afghanistan. The most recent Republican appropriation was $1.7 billion below the amount requested by the president.
Given the state of VA funding, more is at stake than administrative salaries; a corresponding slippage in service levels would not be surprising. And there have indeed been reports of long delays in receiving service which, if the stories are to be believed have in some cases resulted in the deaths of those on the waiting list.
Nevertheless, despite the prevalence of such horror stories in the media, a large majority of veterans respond positively (pdf) to surveys about their care in VA hospitals (see also here). A report by Alicia Mundy in the Washington Monthly, “The VA is not broken – yet,” quotes from several recent studies that find “the VA still generally outperforms or matches the rest of the health care system on most measures of quality.”
How do we explain the apparent contradiction between surveys that report high levels of patient satisfaction and the widely disseminated stories of VA failures? Is it possible that the VA horror stories might not be true? Mundy tells us unequivocally that this is indeed the case. Kevin Drum succinctly summarizes her findings:
There were some problems in Phoenix, where employees had gamed the system for recording wait times. However, there was no evidence that this problem was widespread; there was no evidence that it caused any deaths; and there was no evidence that care had been compromised.
Mundy assigns blame for the false accusations to free-market Republicans, who abhor the VA as a bastion of socialism, along with health-care businesses that hope to profit if the VA medical system is privatized. In particular, she singles out the Concerned Veterans for America (CVA), a creation of – who else – the Koch brothers, as an important player in the effort to create a false sense of crisis at the VA:
… Seldom, however, has one of their investments paid off so spectacularly well as it has on the issue of veterans’ health care. Working through the CVA, and in partnership with key Republicans and corporate medical interests, the Koch brothers’ web of affiliates has succeeded in manufacturing or vastly exaggerating “scandals” at the VA as part of a larger campaign to delegitimize publicly provided health care.
The CVA smear provides cover for GOP fellow-travelers so that they can face down the numerous veterans groups that have reacted with horror at the suggestion that VA medical services may be privatized. They have also managed to stampede some of the centrist, red or reddish state Democrats – like our own Senator Claire McCaskill – who are perpetually trying to prove to closed-minded conservative constituents that they are open-minded enough to entertain criticisms of liberal institutions. right wing fantasies.
Mcaskill was gung-ho when it came to 2014 legislation to “reform” the VA system which gave us the ill-considered and unsuccessful Choice Card that allows veterans to get private care on the VA dime, as well as setting up a commission to make recommendations about further “reform.” Many of the members of this commission have a partisan bias against the VA; they include members from health care industries that stand to profit from privatization of VA services and the CVA itself. The only groups not represented are veterans organizations that strongly support the VA.
Although McCaskill has been more than ready to endorse the “broken VA” storyline, her actual proposals seem to have been modest and fairly reasonable and, to my knowledge at least, she hasn’t indulged in privatization rhetoric. There’s reason to hope she’ll pick up on the GOP con and will have the courage to resist it even though it seems tailor-made for certain noisy Missouri constituencies. We’ll need her if the VA, one of our government’s success stories, is to survive this most recent, dishonest onslaught. As the saying goes, “if you’re not at the table, you’re on the menu.”
N.B. I would suggest that you read the Mundy Report, and Paul Glastris’ response to conservative criticisms of the Mundy report. They’re all relatively short. If you’re interested in the political process currently underway, this Boston Globe article will be of interest, along with this article from The American Prospect
07 Monday Jul 2014
Posted in Uncategorized
Tags
ACA, ALEC, General Assembly, governor, health care, Jay Nixon, missouri, Obamacare, SB 508, veto
Oopsie.
Governor Jay Nixon vetoed SB 508 today. In his veto message [pdf] he pointedly made reference to a major error in the bill due to its cut and paste origins from a right wingnut American Legislative Exchange Council (ALEC) template:
Governor of Missouri
[….]
July 7, 2014TO THE SECRETARY OF STATE OF THE STATE OF MISSOURI
Herewith I return to you House Committee Substitute for Senate Bill No. 508 entitled:
[….]
I disapprove of House Committee Substitute for Senate Bill No. 508. My reasons for disapproval are as follows:
House Committee Substitute for Senate Bill No. 508 contains a number of worthwhile provisions that can become law with my action on other legislation. However, this legislation does not receive my approval due to a significant drafting error.
House Committee Substitute for Senate Bill No. 508 would impose additional restrictions on the licensure of an individual as a “navigator,” one who provides information or services in connection with eligibility, enrollment, or the program certification of any health benefit exchange operating pursuant to the Affordable care Act. Section 376.2004.6 of the bill would require an applicant for a navigator license to submit two full sets of fingerprints to the Missouri Highway patrol “for the purpose of obtaining a state and federal criminal records check under section 43.540 and Public Law 92-554 [sic].”
The bill’s reference to Public Law 92-554 should be to Public Law 92-544. This mistaken reference to Public Law 92-554, which deals with alcohol abuse and prevention, instead of to Public Law 92-544, which deals with federal criminal records, was included in model legislation developed by the American legislative Exchange Council (ALEC) entitled the “Navigator Background Check Act,”….
[….]
It appears that in copying and pasting from the ALEC model act, the General Assembly failed to correct this incorrect reference to Public Law 92-554.[….] While some may believe that such an error is “close enough” for a model act, it cannot be allowed to become the law of this State. Particularly in an area of the law that is subject of ongoing litigation, a glaring defect such as this cannot simply be ignored. Accordingly, this measure does not receive my approval.
In accordance with the above-stated reasons for disapproval, I am returning House Committee Substitute for Senate Bill No. 508 without my approval.
Respectfully submitted,
s/
Jeremiah W. (Jay) Nixon
Governor
Heh. If they were in junior high school the General Assembly would get an “F” on the assignment. Come to think of it, they are still in junior high school. And they deserve the grade.
30 Monday Jun 2014
Posted in Uncategorized
The Supreme Court decision in Burwell v. Hobby Lobby Stores [pdf] summarized:
Alexandra @aliemalie
Shorter #SCOTUS: Corporations are people, women are not. #HobbyLobby 9:23 AM – 30 Jun 2014
And other commentary:
A. N. Devers @andevers
Women take birth control for medical health reasons, not for religious reasons. They are now imposing other people’s religions on employees. 9:26 AM – 30 Jun 2014
Adam Griffiths @adamgriffiths
It’s probably a good thing that on days like today #SCOTUS has that buffer zone, no? 9:21 AM – 30 Jun 2014
Jessica Podhola @jessicapodhola
I’m incorporating. I’ll have more rights that way. #SCOTUS #waronwomen 9:35 AM – 30 Jun 2014
jess mcintosh @jess_mc
Good thing elections never hinge on the votes of women. 9:31 AM – 30 Jun 2014
Just a bit of sarcasm:
MrJM @MisterJayEm
Great News!!1! The Court’s narrow decisions only affect: 1) working women’s reproductive rights & 2) work traditionally performed by women. 9:36 AM – 30 Jun 2014
Andrew Shaughnessy @andrewshag
Founders would roll over to know that corporations held stronger power than people in the eyes of #SCOTUS 9:27 AM – 30 Jun 2014
Imani ABL @AngryBlackLady
So #SCOTUS refuses to recognize that women’s repro healthcare is actually healthcare. Which is sweet. And by “sweet” I mean “typical.” 9:33 AM – 30 Jun 2014
Top Conservative Cat @TeaPartyCat
Supreme Court rules that corporations have the right to impose a theocracy on their employees, but limited that right to Christian men. 9:47 AM – 30 Jun 2014
David Waldman @KagroX
If you own enough stock, you can write your own exceptions to federal law. That’s pretty cool. 10:00 AM – 30 Jun 2014
Hailey @haileym77
I suppose that my greatest mistake in life was being born as a female rather than as a corporation. #HobbyLobby #SCOTUS 11:03 AM – 30 Jun 2014
Thanks for nothing, Ralph.
13 Sunday Apr 2014
Posted in Uncategorized
Tags
ACA, Affordable Care Act, health care, John Lamping, Kurt Schaefer, Medicaid expansion, missouri, Obamacare, republicans
It looks like one more year will come and go with no Obamacare Medicaid expansion. Why won’t the Republican fools in Jefferson City do what’s right when it comes to Medicaid? Temper tantrums because the GOP doesn’t like the scary black man in the white house and want to scuttle his legacy? Sure. Pandering to special interests who don’t want to pay their fair share? Of course. Efforts to insure failure of government run social programs that would otherwise deflect power from the GOP? That too. And there’s certainly plenty of delusional thinking, not to mention the ugly, retrograde political ideologies that have resurfaced in recent years.
Martin Longman speculates that the tantrum over Obamacare has extended so long and has been played out so passionately and so irrationally that there’s no way now for the committed GOP to retreat:
What’s interesting is that the Republicans’ are so dependent on ObamaCare being unpopular that they have to try to convince people it is failing even though it certainly is not. It’s not enough to point at polls about the law because those polls will change over time. They have to try to keep the polls low any way they can. One way to do that is to keep the myth alive among their base. Another way is to misinform as many people outside their circle as possible. Finally, they can work the refs in the media to the best of their ability, but that isn’t going to work anymore for media that aren’t formally or informally working for the Republican Party.
All undoubtedly true. But what this GOP miscalculation means in practical terms for Missouri is that no matter how empty their opposition is shown to be, the hardcore deadenders that populate many of the GOP seats in the Jefferson City will fight until their last breath against Obamacare, so, since Medicaid expansion under the program would be a big win, it can’t be allowed.
This irrational animus is the sole reason why state Senator John Lamping (R-19), when confronted with efforts from those in his own party to find a way to take a good deal without losing face, insisted no way, “this is done. It’s not happening. Go find something else to do.” It’s why state Senator Kurt Schaefer (R-19) thinks an opportunity to do something to help his constituents is a “problem,” whining about “why is this somehow now our problem, and our immediate problem that has to be solved by us before the end of the session, when we didn’t create this problem?” It’s kind of like having a meltdown when you win the lottery because you’re too stupid to figure out how to claim the prize.
But reality’s a bitch and, as they say, what goes round comes round, so sooner or later reality will catch up with the particular butt-end of the GOP that is now running the Republican show. Small solace though, since meanwhile, Missouri, currently ranked 39th in the nation for health outcomes, will continue to hover around the bottom, and, what’s even worse, people will actually, needlessly, die just so a few Republican diehards can save face and can continue to insist for a few more years that Obamacare really is a harbringer of Armageddon.
07 Friday Feb 2014
Posted in Uncategorized
Tags
ACA, Affordable Care Act, Charlie Christ, health care, Medicaid, missouri, Obamacare, republicans, Rick Scott
Today TPM reports that former Florida govenor Charlie Crist, who is running against Medicare-fraud perpetrator Governor Rick Scott to regain the governorship of that state, spoke some home truths to MSNBC’s Chuck Todd about the consequences of failing to take advantage of Obamacare’s Medicaid expansion provisions:
About a million of my fellow Floridians are not getting health care today, and I am told by friends SEIU (sic), that means six people in Florida die every day as a result of that. Every day,” Crist said.
[…]
It’s not hard to figure that out. It’s common sense. Look at it. If people are sick, and they aren’t getting health care, what happens? They usually get sicker,” Crist said. “Or they die. I mean, those are just the facts, Chuck. That’s what happens. In addition to it, it’s economically stupid. As a result, we’re not getting $51 billion over the next 10 years for the health care institutions in Florida. So the people get better health care, so that kids don’t get sick, that we take care of people. That’s what public servants are supposed to do. That’s why I’m running against Rick Scott, because he’s not a good servant.”
The claim that six people will die daily if Medicaid is not expanded likely comes, as TPM noted, from a joint Harvard University and City University of New York report published last month. You can quibble about the actual number – it’s an estimate after all – but the point is that people will die while ideologues posture and babble incoherently about “government dependency” and the “unsustainable costs” involved in directing federal tax dollars back to the home state.
What does this factoid mean for Missouri? Approximately 2190 yearly deaths that could have been prevented.
But we can take it farther. Most Republicans oppose expanding Medicaid and most Democrats support it. In the Missouri Senate, 24 members are Republicans; in the House, 106 representatives are Republicans, making a total of 130 Republicans running things in Jefferson City. We can do some rough math and conclude that if Medicaid is not expanded, each Republican in the legislature will be responsible for the death of 16.8 Missourians per year, give or take a few.
A crude, tongue-in-cheek exercise perhaps? But no matter, it’s a sure bet that there will be deaths as a result of the action – or rather inaction – of Missouri Republicans. And no matter how you count our dead fellow Missourians, they’ll amount to quite rack of trophies for each Missouri GOPer.
First sentence amended for clarity and a link was added.
02 Thursday Jan 2014
Posted in Uncategorized
Tony Messenger, of the St. Louis Post-Dispatch, via Twitter today:
Tony Messenger @tonymess
About 6 million more Americans have insurance today than they did in 2013. #Obamacare will never, ever be repealed. [….] 11:23 AM – 2 Jan 14
He linked to an article in The Atlantic:
….Only 10,000 people whose individual-market plans have been cancelled or slotted for cancellation under the Affordable Care Act will be unable to get affordable insurance going forward, according to a new report from Democrats on the House Committee on Energy and Commerce. That’s “0.2 percent of the oft-cited 5 million cancellations statistic,” The Plum Line noted. The vast majority should be eligible to stay on their existing plans, thanks to the administration’s last-minute fix to permit this, or get subsidies through the exchanges, according to the report. The rest should be able to obtain affordable catastrophic-care plans, according to the congressional staffers. Still, there are bound to be enough people who previously had something better among the nearly one million people the report says could at least get catastrophic care plans that concerns and objections will continue into the new year. But the specter of a massive increase in uninsurance due to the Affordable Care Act seems unwarranted, the report makes clear, because that projection fails to take into account the variety of insurance options now available.
That upset someone:
Gregg Keller @RGreggKeller
@tonymess Alternate reading: 4M more dependent on govt. 2M enrolled in OCare. 5M forced off their existing coverage. 11:31 AM – 2 Jan 14
Tony Messenger responded:
Tony Messenger @tonymess
@RGreggKeller Alternate reading: Republican consultant machine freaking out because good hair and “repeal Obamacare” is all they’ve got. 11:35 AM – 2 Jan 14
Game. Set. Match. Nothin’ but net.
We couldn’t help ourselves:
Michael Bersin @MBersin
@tonymess Okay, now you’re just toying with them. #battleofwitswithunarmed 11:48 AM – 2 Jan 14