A Ben Cohen Ink Comic


By Ben Cohen a “legendary master of the left field.” -BRP!

“Unintentionally misunderstood since 1975.” –Anonymous

“A big f@#k you, to the audience.” -B. Pendarvis

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Sunday, March 21, 2010

Healthcare: Half-Empty, Half-Full

Tonight will be one of those nights where you peak in on your emotional investment only to wish you had buried it in the sand for another long while.  And if, and when it matures you now know you will soon be either satisfied or unsatisfied, but not based on the results, but based on your glass half full, glass half empty persona.

This health care “reform” process has taken liberty with our abilities to proceed on principle.  Everyone involved has sacrificed their moral stance and the results will reflect this.  This battle was honestly waged by some for the greater good.  Nevertheless, with it they have used what ethical fundamentals were left as collateral.  This is not a new feeling.  A crucible of short-term and long-term necessities where used to sacrifice other long-term and short-term necessities.  Just look at our averted total fiscal collapse and how we feel now about it.  It still stinks.  I believe in the buck stopping at the president’s desk.  However, it is hard to blame him for the economic and cultural mess we are in.  No mater which direction he turns he will be blamed.  Therefore, he has done what we do as a nation, thrown it right down the middle and gambled that more people will see the world as half full in the aftermath.

This is a decent bet.  As I have written before we are stable, because of our natural affinity to being middle class in the middle type people.  This cultural and economic reality have played the most significant role in our stability and longevity.  Nevertheless, it has also made us complicit in the manipulations we are subject to and the resulting controlled chaos we are amerced in today.  As “Muse’s” song Uprising has captured our attitude our actions remain far removed from those that birthed this great nation.  In the end, this may prove to be a good thing.  As Joe Scarborough inferred the other day, most of us will wake up when this healthcare bill is passed and still be alive.  However, this attitude may also prove to be our world’s demise, keeping us moderately tuned to our commitments to resolving our issues. 

In the history of the world, we have not been faced with a more dire forecast of our environments future.  The truth is as individuals we can do things to change the environment, but we are either conditioned or in reality we cannot do enough to hold back the tide.  We know that it would require governments big business, and religious leaders to work coordinately with sincerity to accomplish saving us from global warming.  As a consumer and voting mass, we maintain some power in effecting that change.  But the truth is it has been these large entities that have been orchestrating our manipulations.  Apparently for so long that they are unaware of this fact, it has become an instinctual action in the institutions to manipulate our communities away from coordinated efforts to solve world problems in order to further institutional growth.  Communitarians and Individualism will for foreseeable future be at odds, maintaining a moderate existence serving the manipulating unconscious efforts of our institutions hubris, until we adapt or it is to late.  A dire proclamation, considering I am glass half full type.

In Michael Lewis’s “The Big Short” we find high drama in individual stories, but the biggest revelation to me was the reality that the institutions were unaware they were orchestrating their own downfall.  In addition, well all know the government stepped in deeming them to big to fail.  Perhaps saving us, but in such a way that corrupted our ethics and ignited our rhetoric.  A rhetoric that has been easily carried over to healthcare, an issue that if done correctly in the most significant way contribute to lessoning the negative impact of the economic collapse.

Since we are all winning and loosing in this healthcare bill on a most basic level what are the gains and sacrifices?  I am not sure all is know yet.  Much of this is a gamble. 

I would be remiss in stating first that the vast majority of this bill’s ideas on policies original sources are Republican.  Yes over time, Democrats have found it politically exspediant to adopt these ideas as much as Republicans have found it politically beneficial to stonewall policies they came up with.  The process on both sides of the isle have been so toxic, that we may find that subsequent congresses continue to manipulate their rules and the constitution in order to “win.”  Democrats who have been weak and naive in enacting meaningful policy change, have taken this time to adapt ethical standards that mirror their advisories.  The crumbling highroad has been demolished.  This was a congress that set out to bring ethically reform to the institution, but the extreme circumstances, and their own human ethical fallacy proved to strong. Republican’s like the wolf they are found opportunity in obstruction and false characterizations that serve to undermine their own agenda while obstructing “actual” will of the people.  If this year has not been an argument for term limits and actual transparency, what has?  Democrats now get to sate they are as strong (corrupt) as Republicans (at least in carrying our Republican agendas) and Republicans can say they believe in doing nothing.  Not exactly, the deficit reducing small government we all wish was a reality these days.

More people will have healthcare, so at least that goal will be met.  Most of the discriminating polices that contribute to cost cutting or higher profits for Insurance companies, but ultimately contributed to the higher overall healthcare budget.  This increase of coverage will result in less emergency visits for PCP care and increase preventative and conservative treatment of our populace which should result in lowering cost while increasing quality of care.

There is an exchange and some price regulation by the government, so that may prove to provide competition that results in some cost cutting.  Insurance companies gained a lot with the Mandate, but I wonder if they will be forced to lower cost also by the lower of the penalty for not having insurance.

The CBO has projected a substantial deduction of our national debt while only increasing taxes for the wealthy.  Something that is morally appropriate, but still an issue of conflict based on some very principled arguments.  If we can enact a budget that is deficit neutral and a pay-go plan then we may be able to retain sustainability.  One step I would take would be to end our wars and reduce military spending while marinating a strong deterrent and improving our intelligence efficacy in the guidelines set out by the freedoms garneted by the constitution.  This militarily isolationist approach (another truly conservative approach…not a perversion that we see in the Republicans now) could prove to be more effective on the war on terrorism then current policy.  Don’t get me started on the urgency of this threat. I digress.

Medicaid expansion and Medicare fixes are important, but not even close to as effective as had been suggested through the process.  It is watered-down.  Seniors and the needy will see modest but important improvements.

Small and Moderate business employers will see modest improvements, but nothing as good as originally advertised.  It may fall short of improving their ability to survive the current economic conditions.  If the exchanges are effective, it may save the small business however.

The issue of Abortion, I feel as someone who is pro-choice, but concerned about the number of abortions and a practical person, I am concerned about the debate of abortion in this legislation.  What is most alarming is the diverse interpretations of the language and hope this is not representative of the opacity of the overall language in the bill.

Most of what is in the bill will not take effect for 4 years, well after political shift occur.  So who knows what will occur.  This is a purely political reality.  The good news is the discrimination against kids will be immediate.

This patchwork, that the political climate has barely been able to withstand, particularly with the self serving pool of elected officials we have, and the lack of honorable, intelligent and valiant leaders, may still prove to be just enough to accomplish most of what it set out to do in helping reduce cost, and expand coverage and fix ethical issues in our medical system.  However, three huge issues were not addressed.  We did not make coverage universal in quality (perhaps not even in affordability or coverage).  We did not reduce the deficit all the way.  Moreover, the one that drives me crazy the most, because it was hardly addressed and could be the most significant elephant in the room.  We did nothing to change the way in which doctors are paid.  The reason the quality is good in some places and horrid in others.  The reason we have a shortage of medical providers in some fields.  The reason costs are so bloated.  The reason this entire thing is a mess, is because we pay doctors to do procedures, not so solve efficiently and effectively patient problems, while considering the realities of chronic illness and the need for focus on quality of life and patient productivity in these cases.  Until we deal with that, we are just putting a band-aid on it.

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