PREFACE I was going to write a well-thought-out, sourced piece about healthcare, but I’ve gotten lazy, so it’s just a bunch of related and unrelated points running together. Sometimes I will just keep such posts in eternal draft mode. But since I don’t generally have solid idea pieces on anything, there’s no reason I must start now. Besides, I really like using the Jim Backus image.

The Baucus-led, conservative-leaning Senate Finance Committee voted down two public option amendments today. I wish there would be more headlines about the other bills out of Congress that do have a public option. The great hope now would be that a strong public option winds up in whatever comes from the merger of the Finance bill and the HELP (Health Education Labor Pensions) bill or that it winds up in a ultimate reconciliation between a House bill and a Senate bill. But that so many Democratic senators are reluctant to embrace the public option is very disappointing. Two years ago, we’d always hear from Dem leaders, “But we don’t have 60 votes!” Now, they’ve got 60 votes in the Senate, and it feels as if it doesn’t matter.

Meanwhile, I find Obama’s lack of forcefulness to be mystifying. He’ll tell an audience that he supports a strong public option, but where is the pressure on Arkansas’s Blanche Lincoln and Louisiana’s Mary Landrieu? I feel like Mitch McConnell is right when he claims that Obama will sign anything that says “health care reform”. From everything I’ve read, co-ops, triggers, and even a weak public option plan, when it is not allowed reimbursement rates comparable to Medicare, are b.s. reform.

Meanwhile, where’s the outrage that a sitting member of the House of Representatives has called Obama “an enemy of all mankind?” Not only do the Democrats seem to put up with this type of behavior, but they (particularly the Senate Dems) seem to want to placate the GOP on health care reform, even where there are no votes to be had.

Obama has been in office for eight months now. I’m getting inpatient.

I’ve been going to dialysis for a full month now. I’ve been meaning to write a big post on the details of how these dialysis sessions transpire. I’m still not feeling like doing that, however. Apart from the present moment, I tend not to want to think about dialysis outside of the 27 hours a week that I am forced to contemplate it. (With any good fortune, a lot of those hours are spent asleep). The point is, my dialysis schedule wrecks havoc with my schedule, which is may seem moot given I don’t have any productive activities on my schedule, with the exception of work. The recent move to nocturnal dialysis makes interference with work far less of a problem than what I was starting dialysis at 6AM. If only I could afford to come into work at Noon twice a week, I might keep that 6AM schedule, because, to be blunt, I’m not liking the overnight schedule at all. In a nutshell, six out of seven days a week are directly impacted by dialysis. Either my day ends prematurely by having to head over at 9AM, or my day begins anew in a jarring, undignified way between 5 and 6AM. Sunday is the only unscathed day. To be blunt again, I don’t want to “get used to this”. Anyway, more on the whole shebang of dialysis some other time. Perhaps the only upside to dialysis is that I feel like I have a license to be unhappy. The irony is, my aggregate unhappiness has very little do to with dialysis.

I’ve got to head to nocturnal dialysis shortly, and after my first experience with that Tuesday night, I’m not really looking forward to it. So I’ve been on dialysis for almost a month, and I haven’t really written about what it’s like yet. I’ll have a post on that at some point soon.

For now, here’s more ancient history. Happier times. I think it was around 1982. It’s been all downhill since.

First person to correctly identify me wins…eternal recognition in the big blog cloud in the sky.

This is nursery school, by the way (I guess they call it pre-K these days).I think this is referred to as pre-school.

I’ve got these albums of photos that have never been digitized. No better time like the present to begin this project. (Well, maybe 5 or 10 years ago, but now is better than later).

UPDATE – Apparently, the Lane Robbins pre-school was founded by the man who has “the longest running national talk radio show“. (I’ve never heard of him until now).

This weekend, both a dialysis tech and a 10-year-old girl asked me, “Are you married? Why not?”

I felt like handing them a 50-pound bound version of my memoirs. “Read this; it should become crystal clear”.

I still have a Match.com account. It’s painful. I reason that it’s more painful not to.

I don’t suppose anyone wants to set me up with someone…no?…that’s ok..I’ll manage…

I received a call from Medco, the gigantic prescription drug benefit company. The woman on the other line said she was a pharmacist, and she wanted to review my medications. My ire over the state of healthcare in this country and the ridiculous state of the national debate took over, and I shot back, “I’ve got a major kidney disease, and I’ve got lots of medications that I need to be on, and I’m not going to discuss them with you”. And I hung up.

I found this article online discussing how Medco implemented a “prescription review system” a couple of years ago. The article touts the system as a very beneficial innovation, given that so many patients are harmed each year by medication errors and unintended drug interactions.

Computers flag incoming prescriptions for patients with those conditions – such as diabetes, cancer and infectious diseases – for a specialty pharmacist to review them if necessary. The pharmacists look for dosing errors, interactions with other drugs, whether the patient isn’t refilling prescriptions as directed, or if a new medication would be better.

I have a completely different take, which is that Medco should leave me the hell alone. Given that their bottom-line depends how much money they can save, they are the last people I want to consult about my medications. If I really want to talk to a pharmacist, there are a couple of good ones over at Costco. (Ironic, I know, since both Medco and Costco have similarly evil-sounding names. But I trust Costco).

So I’m thinking that Medco is evil. Am I wrong?

I’ve been seeing a lot of these ads on Facebook for what I presume is some sort of men’s financial empowerment seminar series, because, I suppose, men are one of the main demographics that is hurting in this economy. I don’t know anything about it, honestly. You can google and tell me. I’m busy playing Mafia Wars (which is where I keep seeing the ads).

Anyway, here’s the typical ad I’ve been seeing.

And now here’s another ad for the same event, targeted to the especially classy Duke alumni demographic:

I guess you get to these seminars so you can find out how you can make lots of money so you can give stuff to your “daughter”?

The Baucus bill is a gift to the insurance industry that fails to meet the most basic promise of health care reform: a guarantee that Americans will have good health care that they can afford. The Baucus bill would give a government-subsidized monopoly to the private insurance industry to sell their most profitable plans – high-deductible insurance – without having to face competition from a public health insurer.

Under the Baucus bill, employers would have no responsibility to help pay for their workers’ coverage and would be given incentives to have workers pay more for barebones insurance. Americans who don’t get health benefits through work would still not be able to get good, affordable coverage.

We urge Senators on the Finance Committee to replace the Baucus plan with legislation that will do what the Senate HELP Committee and three House committees have done: guarantee that Americans have good health insurance that they can afford with the choice of a strong national public health insurance option.
- Healthcare for America Now (HCAN) via Jackie Schechner

That’s a tad more articulate than what I tried to summarize yesterday.

By the way, I just caught a minute of one of our local newscasts, and it happened to be the whole minute they devoted to the Baucus plan, which they described as “a plan that’s supposed to bring Democrats and Republicans together”. (Who writes this crap?) There was a ten-second sound clip from Orrin Hatch (R) about it costing too much and then a five-second sound clip from Baucus all proud of himself for steering the debate. No comments from any of the many Democrats who flat out think the bill stinks like rotting roadkill. No wonder most Americans have absolutely no clue what’s going on in Washington and how policy will help or hurt them in actuality.

_{(And, yes, again, I know that’s a picture of Jim Backus and not Max Baucus. I just like the photo now as an icon for health reform).}

1. He short-changed many Democratic Party ideas in order to craft a “bipartisan” bill that, so far, no Republican has said he or she would vote for.

2. There’s no public option, but Americans will be mandated to purchase insurance in what amounts to a boondoggle from Baucus to the insurance industry.

3. The House bill with a public option gets a similar debt-reduction score from the CBO, and it’s widely believed that a mandate will only work if there is a public option to bring costs in line.

4. Baucus’s bill has insurance cooperatives, of which the CBO says, compared to a government-run plan to provide competition to private insurers, would ‘seem unlikely to establish a significant market presence in many areas of the country’.

5. The co-ops would lack the negotiating power of a federal government-run plan.

6. Large businesses couldn’t enroll in the co-ops, thus limiting the size of these state-by-state co-op pools, thus keeping prices up.

7. Subsidies to assist with mandated coverage are not large enough to help families avoid financial ruin in the face of medical crises. Again, in order to carve off billions from what would still be a deficit-neutral bill, one of the key goals of reform is short-changed.

8. The plan taxes businesses for each hiree who qualifies for subsidies. This incentivizes businesses to not hire the poor.

9. The plan will cost $880 billion over 10 years. The Health Committee’s plan under the late Sen. Kennedy and Sen. Harkin has a public option and comes in at just $611 billion. The public option makes reform cheaper!

10. And on a personal note… It does not include an extension of transplant drug coverage. So people will continue to stop taking their anti-rejections drugs and wind up back on dialysis, awaiting a new transplant. Extremely stupid, both fiscally and morally.

Yes, I’ve gleaned some of these ideas from my usual sources.

Overall, I’m annoyed that the media is reporting this Baucus Plan as if it is The Democrats’ Plan. No, it’s this insurance-industry-shill’s plan. A lot of Dems think it is crap.

And, yes, I know that’s a picture of Jim Backus and not Max Baucus. They don’t even have a common surname. But the plan seems to me like something Thurston Howell III would get behind, and I think of Max Baucus as somewhat of a sitcom character.

I happened to come upon the Wikipedia page for wrecking ball. (Why? I was doing some superfluous Mafia Wars research).

Lo and behold, of all the wrecking balls in the world to use an illustration, this page uses a photo of a wrecking ball in Durham, NC.

What an honor for the Bull City!