Jeb Bush Is Flirting With Disaster: Why His Latest Anti-Medicare Fearmongering Could Sink His Campaign

Much of the GOP base loves medicare. Bush should tread lightly.

By Heather Digby Parton / Salon

 

It’s been a good week for economic reports. For example, we heard that the jobless claims for June were lower than they’ve been in 40 years. Take it from someone who remembers 1975 — it was a long time ago. The job market is finally looking up. And we also found out that Medicare is on stronger footing than anyone could have imagined just a few years ago. Kevin Drum at Mother Jones wrote it up:

Ten years ago, Medicare was a runaway freight train. Spending was projected to increase indefinitely, rising to 13 percent of GDP by 2080. This year, spending is projected to slow down around 2040, and reaches only 6 percent of GDP by 2090.

Six percent! That’s half what we thought a mere decade ago. If that isn’t spectacular, I don’t know what is.

Drum points out that this is largely being driven by the fact that medical costs overall have slowed dramatically. This is due to a number of factors, but one of the most significant has to be the Affordable Care Act’s cuts to provider payments, which you will certainly recall had the Republicans whirling like tops with claims that President Obama was planning to turn the elderly into Soylent Green — or submit them to ghoulish “death panels” at the very least. It was one of the primary motivating factors that drove the white elderly Republican base to invade town hall meetings by the hundreds and storm the voting booths in November of 2010 to decimate the Democratic congressional majority.

Ads like these ran all over the nation:

Republicans have run similar ads in every election since. Indeed, it’s their most potent argument against Obamacare. And there’s been every reason to believe that the Republicans would use this message again in 2016. After all, the Medicare constituency is their bread and butter, and they are, quite reasonably, protective of the program. They may selfishly not want anyone else to have health care but they damned sure want to make sure that seniors have the program. In case anyone hasn’t noticed, the elderly have a lot of health problems. It has always made perfect sense for the GOP to demagogue any and all changes to the program.

This represented a very dramatic change in the demographic make-up of the two parties. Since their inception in the New Deal and Great Societies, Social Security and Medicare had made loyal Democratic voters out of the elderly. They were fiercely protective of the programs and the Republicans were caught by the trap their ideology forced them into. Ronald Reagan’s GOP may have looked congenial to many older people — but they knew that he wanted to end the programs that made it possible for them to live with dignity in their old age. So when they heard his famous recording railing against Medicare — in which he said,”one of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project, most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it” — it sounded abstract and irrelevant to their very practical needs. (Not to mention obtuse; a medical program is a humanitarian project.) It’s likely that many of them were just as staunchly anti-communist and anti-statist as Reagan, but few were willing to die prematurely to make that particular political point.

In the late 1980's, when a virulent strain of deficit fever invaded the swamps around the nation’s capital, the government raised premiums on Medicare to provide some new coverage that many people didn’t need and which didn’t cover the one thing they need need, long term care. Seniors rebelled and they rebelled vociferously:

This summer’s bitter struggle over the Medicare Catastrophic Coverage Act of 1988 has damaged the credibility of one of the nation`s largest lobbies, both in Congress and among the 28 million members of the American Association of Retired Persons.
From his retirement home in Las Vegas, Daniel Hawley, a 64-year-old former airline pilot, has helped organize the stunning grass-roots protest that has shaken AARP and pushed this largest expansion of Medicare benefits to the brink of congressional repeal.
“They thought retired people were sitting around doing their ceramics and their little aerobics classes in senior centers and wouldn’t give any fight,” said Hawley. “Well, they found out differently.”

Indeed they did. This infamous (and hilarious) video of seniors chasing the powerful chairman of the House Ways and Means committee perfectly captures the power the medicare constituency has over the U.S. Government:

They repealed the law in November 1989.

For a lot of reasons, older people began to vote for Republicans over the ensuing couple of decades. But the “Mediscare” campaigns continued to have potency for the Democrats. It wasn’t until they came up with the Obamacare scare ads that the Republicans were able to turn the argument back on the Democrats. And it worked beautifully. It was a strong motivation for seniors to turn out in both recent mid-term elections, and while it wasn’t enough to offset the Obama coalition’s turn out in presidential years, it undoubtedly helped keep elderly white people in the Republican column. It’s a darned good strategy.

So, what in the world is Jeb Bush up to? Has he been asleep for the past three election cycles? Did somebody forget to tell him that old white people are the GOP’s most loyal voters and the new scheme is to say you’re saving Medicare? He must not have gotten the memo because he’s just spent the last couple of days telling audiences that Medicare is on its last legs and will have to be killed in favor of some new program, which will probably be along the lines of Paul Ryan’s “shop for health care ’til you drop” voucher proposal.

Get a load of this commentary he made at a Koch Brothers sponsored Americans for Prosperity event on Wednesday:

“The left needs to join the conversation, but they haven’t. I mean, when [Rep. Paul Ryan] came up with, one of his proposals as it relates to Medicare, the first thing I saw was a TV ad of a guy that looked just like Paul Ryan … that was pushing an elderly person off the cliff in a wheelchair. That’s their response.

“And I think we need to be vigilant about this and persuade people that our, when your volunteers go door to door, and they talk to people, people understand this. They know, and I think a lot of people recognize that we need to make sure we fulfill the commitment to people that have already received the benefits, that are receiving the benefits. But that we need to figure out a way to phase out this program for others and move to a new system that allows them to have something – because they’re not going to have anything.”

That’s the kind of braindead doofus “policy” talk you might expect from Donald Trump, not one of the front-runners for the Republican presidential nomination. Sure, he uses some weasel words about fulfilling the commitment to people “who’ve already received benefits, are receiving the benefits,” but he apparently didn’t get the other memo that says seniors don’t buy that line when Republicans say it about Social Security, and they aren’t going to buy it when they say it about Medicare.

The idea of telling anyone that the program “must be phased out” for something “new” because they’re not going to have anything is just daft. Even Paul Ryan’s privatization plans never said that he planned to phase out the most popular health care program in America (even though he did plan exactly that). Even more daft is the idea that Bush would say this at a time when the projections for Medicare solvency are, as Kevin Drum said, “spectacular.”

But Jeb didn’t misspeak. He meant it.  He actually doubled down on that claim in New Hampshire yesterday, saying “we have a Medicare program that’s not going to be around 30 years from now in form that is.” Apparently, the last time he looked at the numbers was back when  he was stumping for his brother in 2004. Somebody needs to fill him in on what’s been happening in the last decade.

Once again, you see the Republicans stuck in their ideological corner. Medicare costs are leveling out and there is no crisis in funding it. The people who have Medicare love it. In fact, they love it so much that they irrationally oppose anyone else having something like it to prevent their beloved program from somehow being diluted. Republicans have struggled with this problem for a long time: They just do not believe in government health care, no matter how well it works.

But they had, for a time, found a way to finesse that by saying the Democrats were threatening their program by giving similar health care to other people. It was a sweet obfuscation that played into everyone’s worst instincts. It was conservative perfection. Jeb, however, seems to be stuck in 2005, when George W. made his kamikaze attempt to destroy Social Security. And we know what happened in 2006. 

Has anyone told Jeb that when he left office his brother had a 25 percent approval rating?  It’s probably not a great idea to remind people of why that happened.

Heather Digby Parton, also known as "Digby," is a contributing writer to Salon. She was the winner of the 2014 Hillman Prize for Opinion and Analysis Journalism.

Bernie Sanders, Health Clinics and GOP Hypocrisy

By Lee Fang

The conventional wisdom on Senator Bernie Sanders of Vermont is that he’s a charming if impractical dreamer, a pie-in-the-sky socialist who’s good at inspiring young people and aging hippies, but hopeless at the knife fighting that real-life politics requires.

Despite the inherent limitations of a self-described democratic socialist who eschews the norms of Beltway fundraising, the Democratic presidential candidate from Vermont has won legislative victory after victory on an issue that has been dear to him since his days as Burlington’s mayor.

That issue is the simultaneously benign and revolutionary expansion of federally qualified community health clinics.

Over the years, Sanders has tucked away funding for health centers in appropriation bills signed by George W. Bush, into Barack Obama’s stimulus program, and through the earmarking process. But his biggest achievement came in 2010 through the Affordable Care Act. In a series of high-stakes legislative maneuvers, Sanders struck a deal to include $11 billion for health clinics in the law.

The result has made an indelible mark on American health care, extending the number of people served by clinics from 18 million before the ACA to an expected 28 million next year.

As one would expect, the program was largely met with plaudits from patients and public health experts, but it has also won praise from even the biggest Obamacare critics on Capitol Hill. In letters I obtained through multiple record requests, dozens of Republican lawmakers, including members of the House and Senate leadership, have privately praised the ACA clinic funding, calling health centers a vital provider in both rural and urban communities.

To Sanders, the clinics have served as an alternative to his preferred single-payer system. Community health centers accept anyone regardless of health, insurance status or ability to pay. They are founded and managed by a board composed of patients and local residents, so each center is customized to fit the needs of a community. No two health centers are alike.

In rural North Carolina, ACA-backed health centers now provide dental and nutrition services, while in San Francisco, the clinics provide translation services and outreach for immigrant families. In other areas, they provide mental health counseling, low-cost prescription drugs, and serve as the primary care doctors for entire counties. They have also served as a platform for innovation, introducing electronic medical record systems and paving the way with new methods for tracking those most susceptible for heart disease and diabetes.

Author John Dittmer, in The Good Doctors, traces the history of the modern health center to the civil rights activists who ventured into the South during the early 1960s. The activists were seen as outside agitators, and local doctors refused to treat them. As a solution, volunteer bands of physicians were organized by a group called the Medical Committee for Human Rights.

Beyond treating the civil rights workers, the MCHR physicians were struck by the stark disparity in health services, encountering many African-Americans who had never seen a doctor before in their lives. The activist physicians returned to the South after the “Freedom Rides” to found a small clinic in Mound Bayou, Mississippi, in the heart of the Mississippi Delta, and by doing so, began a movement to launch health clinics across the country in underserved areas. Winning support from President Lyndon Johnson’s Office of Economic Opportunity, the clinics became part of Johnson’s “War on Poverty.”

Over the years, health centers have gained support on a bipartisan basis. Health centers secured critical funding from the efforts of the late Sen. Ted Kennedy, D-Mass., and both George W. Bush and John McCain campaigned on pledges to expand them.

Sanders’s place in health clinic history will be remembered for his forceful role in the winter of the health reform debate. In December 2009, tensions ran high as Congress inched closer to a final health reform deal. Sen. Harry Reid, D-Nev., tapped Sanders to help win support from liberals who thought the bill was too weak as well as from Democrats from rural states who were facing mounting pressure. More funding for community health centers, Sanders argued, was a win-win solution for both camps, since the program would ensure access to health care for even the most remote areas of the country while also helping those without insurance. Sen. Ben Nelson, D-Neb., among others, held out to the very last moment.

Two days before the Senate voted to break a Republican filibuster of the bill, Reid called on Sanders to make his case on the Senate floor. Sanders, in typical fashion, said the legislation was far from perfect, but thundered about the common-sense need for health centers, citing the acute demand for more primary care doctors, the cost-savings from patients who would otherwise use the emergency room for the common cold, the patient-centered model of clinics, and so on. Senate Democrats rallied and overcame the Republican filibuster.

Bernie Sanders on community health centers in the ACA from The Intercept on Vimeo.

Another turning point came several weeks later, when Massachusetts Republican Scott Brown won a special election in an upset victory, ending the Democrats’ filibuster-proof majority. Brown’s election brought Democrats close to despair, because lawmakers could only use a procedure called reconciliation to pass the law. Such a move would keep chances for passage alive while foreclosing any chance of enacting the much stronger legislation that originated in the House of Representatives through a conference committee. For progressives, it was a painful blow that not only sealed the defeat of the Public Option insurance program but also removed many robust provisions they had worked hard to include. Again called upon to work out a solution with House liberals, with whom Sanders enjoys a strong working relationship, the Vermont senator forged a deal to build support for the bill by focusing on health clinics.

Daniel Hawkins, vice president of the National Association of Community Health Centers, recalls that in the end Sanders was able to negotiate with Rep. Jim Clyburn, D-S.C., to increase health clinic funding through a special technical amendment that could modify the reconciliation Senate bill through a simple majority vote. The technical amendment passed, with $9.5 billion targeted for health center operations and $1.5 billion for construction and renovation projects. The House passed the final Senate bill, and President Obama signed the legislation with $11 billion in health clinic funding into law on March 23, 2010.

“There was no one who played a more important role than Senator Sanders,” Hawkins says, remembering Sanders’s constant lobbying of other lawmakers to support the funding.

Although the health reform has transformed the funding of local health clinics, few patients even realize that the changes have occurred as a result of the law, because few aspects of the health reform are explicitly branded as being part of the ACA.

That relative invisibility has shielded health clinic funding from the hyper-partisan attacks faced by other provisions of the law. But it has also allowed Republican opponents of Obamacare to play a two-faced game. Every single congressional Republican has voted to repeal the entire bill, health center funding included. But many have taken credit for popular local health clinic programs funded by the ACA, without disclosing the source of the funds. Others have written letters expressing their support for the money.

As I reported previously for The Nation, Rep. Paul Ryan, R-Wis., among other Republicans, authored letters to the Obama administration to recommend ACA funding for local health clinics. Now, a new batch of letters, obtained through a Freedom of Information Act request, shows other requests by GOP leaders.

Rep. Steve Scalise, R-La., the House Republican whip, for instance, signed onto a letter with other members of the Louisiana congressional delegation to ask the Obama administration for health center funding in New Orleans. The proposed clinic, the letter noted, would build a graduate medical training program, a proposal that “will attract not only more citizens back to our community but provide critical training opportunities for our region’s future healthcare workforce.”

Sen. John Cornyn, R-Texas, the number two leader in the Senate, wrote at least 17 letters to the administration asking for funding, in cities such as Lubbock and Houston, for a wide range of programs, including clinics devoted to low-income rural residents and Asian-Americans in Texas. Senators Mark Kirk, R-Ill., Kelly Ayotte, R-N.H., David Vitter, R-La., Rob Portman, R-Ohio, and Pat Toomey, R-Pa., made similar requests.

It’s no wonder that politicians from rural states such as Texas would seek community health centers to better serve their constituents. A recent report from the Texas A&M School of Public Health found that only 9 percent of physicians practice in rural areas. Many rural Texans live in areas that are more than 30 minutes from the nearest hospital, which dramatically raises mortality rates in cases of medical emergencies.

Still, press releases from GOP officials have lashed out at the Affordable Care Act’s health center funding as some sort of “slush fund.”

Regardless of the politics, the success of health centers has been particularly satisfying for Sanders, who can simply point to his own state as a reminder of its impact. One in four Vermonters are now served by more than 50 health centers throughout the state, according to the senator’s office. Just last month, a new federally qualified health clinic opened in Shoreham, Vermont, to provide dental care, physicals and medication for common diseases.

Though his own role in securing the funds for the ACA is barely mentioned on his Senate website, the image gallery is adorned with pictures of Sanders beaming a smile as he breaks ground and cuts ribbons for various health clinic openings in Vermont.

Photo: Bernie Sanders, during a news conference on June 25, 2015. (Bill Clark/CQ Roll Call/AP)

Chris Hayes Beats Down Ex-Senator's ACA Lies With Facts

By Karoli

I've handed Chris Hayes a lot of grief on this site for interviews where he gets filibustered by right-wing screechers, but he did it exactly right on his show tonight.

Former Senator and Governor Judd Gregg was the guest. The topic was the Affordable Care Act, and Judd Gregg was serving up the usual nonsensical talking points in a particularly vitriolic way. From his claim that the ACA was a mess that helped no one, to his mockery of Hayes' claim that the ACA has gotten health coverage to millions, Gregg was mean, nasty, and rude.

Hayes was having none of it, and he used that good old fashioned fallback to debunk Gregg: Facts, with a touch of math for good measure.

Gregg scoffed at Hayes' use of the word "plummeted" to describe the uninsured rate in this country. But in fact, it has plummeted.

Chris Hayes uses math to rebut incorrect statements of former Senator Judd Gregg on #inners http://t.co/xJ5EqwwYf7

— All In w/Chris Hayes (@allinwithchris) June 16, 2015

I was taken aback by the nastiness and disrespect Gregg showed Chris Hayes, but Hayes persisted in simply using facts and math to contradict his claims.

Watch it, because a transcript won't do it justice.



Aside to Chris Hayes: This is one that your colleagues (particularly Chuck Todd), should study to understand how to use facts to stop these talking points dead in their tracks. It's what we expect from our so-called liberal media, and you delivered.

The other thing you'll notice is that Gregg never answered the question.

Terrified ‘Tea Party Patriot’ Realizes He Could Lose Healthcare If GOP Wins in 2016

"The Republican Party, they haven’t done nothing for me, man. Nothing."

By Dave Edwards 

A conservative video blogger with over a million views on YouTube said this week that he would likely vote for Democratic presidential candidate Hillary Clinton because he was terrified that a Republican president would take away his affordable health insurance.

James Webb, a 51-year-old YouTube celebrity who devotes his “Hot Lead” channel to topics like his love of guns and ranting about gay men kissing on The Walking Dead, may have shocked his viewers on Monday when he revealed that he was torn over which party to vote for in the 2016 election.

“And I’m serious because I asked myself, ‘Which party has helped me out the most in the last, I don’t know, 15 years, 20?’ And it was the Democrat [SIC] Party,” Webb lamented. “If it wasn’t for Obama and that Obamacare, I would still be working.”

“With Obamacare, I got to retire at age 50 because if it wasn’t for Obamacare, I would have had to work until I was 65 and get on Medicare because health insurance is expensive when you’ve got medical problems,” he continued.

Webb said that he hoped to lose some weight and get in shape by taking advantage of a gym membership that was covered by his health insurance.

“But you know, the Republican Party, they haven’t done nothing for me, man. Nothing,” he remarked. “So, I’m leaning toward voting for Hillary unless something major comes up. I don’t trust the Republicans anymore because they’re wanting to repeal the Obamacare. And I don’t want them to do that, man, because then I’ll have to go to work again. My life’s already planned out.”

“Just a tough decision,” Webb sighed. “I voted for Republicans for 32 years, I’m a charter member of my Tea Party Patriots chapter. I’m also a veteran of the U.S. Army under Reagan, when Reagan was in. That was great when Reagan was in there.”

“Things have changed. So unless the Republicans change with it, I’m probably going to have to swing my vote over toward Hillary.”

Watch the video below from the Hot Lead YouTube channel.

How Privatization Rips Us All Off

Average Americans are the products, and few of us see any profits.

By Paul Buchheit

The Project on Government Oversight found that in 33 of 35 cases the federal government spent more on private contractors than on public employees for the same services. The authors of the report summarized, "Our findings were shocking."

Yet our elected leaders persist in their belief that free-market capitalism works best. Here are a few fact-based examples that say otherwise.

Health Care: Markups of 100%....1,000%....100,000%

Broadcast Journalist Edward R. Murrow in 1955: Who owns the patent on this vaccine?
Polio Researcher Jonas Salk: Well, the people, I would say. There is no patent. Could you patent the sun?

We don't hear much of that anymore. The public-minded sentiment of the 1950's, with the sense of wartime cooperation still in the minds of researchers and innovators, has yielded to the neoliberal winner-take-all business model.

In his most recent exposé of the health care industry in the U.S., Steve Brill notes that it's "the only industry in which technological advances have increased costs instead of lowering them." An investigation of fourteen private hospitals by National Nurses United found that they realized a 1,000% markup on their total costs, four times that of public hospitals. Other sources have found that private health insurance administrative costs are 5 to 6 times higher than Medicare administrative costs.

Markup reached 100,000% for the pharmaceutical company Gilead Sciences, which grabbed a patent for a new hepatitis drug and set the pricing to take whatever they could get from desperate American patients.

Housing: Big Profits, Once the Minorities Are Squeezed Out

A report by a coalition of housing rights groups concluded that "public housing is a vital national resource that provides decent and affordable homes to over a million families across the country."

But, according to the report, a privatization program started during the Clinton administration resulted in "the wholesale destruction of communities" and "the displacement of very large numbers of low-income households of color."

It's gotten even worse since then, as Blackstone and Goldman Sachs have figured out how to take money from former homeowners, with three deviously effective strategies:

1. Buy houses and hold them to force prices up
2. Meanwhile, charge high rents (with little or no maintenance)
3. Package the deals as rental-backed securities with artificially high-grade ratings

Private Banks: Giving Them Half Our Retirement Money

The public bank of North Dakota had an equity return of 23.4% before the state's oil boom. The normally privatization-minded Wall Street Journal admits that "The BND's costs are extremely low: no exorbitantly-paid executives; no bonuses, fees, or commissions; only one branch office; very low borrowing costs.."

But thanks to private banks, interest claims one out of every three dollars that we spend, and by the time we retire with a 401(k), over half of our money is lost to the banks.

Internet: The Fastest Download in the U.S. (is on a Public Network)

That's in Chattanooga, a rapidly growing city, named by Nerdwallet as one of the "most improved cities since the recession," and offering its residents Internet speeds 50 times faster than the American average.

Elsewhere, 61 percent of Americans are left with a single private company, often Comcast or Time Warner, to provide cable service. Now those two companies, both high on the most hated list, are trying to merge into one.

The Post Office: Private Companies Depend on it to Handle the Unprofitable Routes

It costs less than 50 cents to send a letter to any remote location in the United States. For an envelope with a two-day guarantee, this is how the U.S. Postal Service recently matched up against competitors:

• U.S. Post Office 2-Day $5.68
• Federal Express 2-Day $19.28
• United Parcel Service 2 Day $24.09

USPS is so inexpensive, in fact, that Fedex actually uses the U.S. Post Office for about 30 percent of its ground shipments. As Ralph Nader notes, the USPS has not taken any taxpayer money since 1971, and if it weren't required by an inexplicable requirement to pre-fund employee benefits for 75 years, it would be making a profit. Instead, this national institution has been forced to cut jobs and routes and mailing centers.

Paul Buchheit teaches economic inequality at DePaul University. He is the founder and developer of the Web sites UsAgainstGreed.org, PayUpNow.org and RappingHistory.org, and the editor and main author of "American Wars: Illusions and Realities" (Clarity Press). He can be reached at paul@UsAgainstGreed.org.

Why the Right’s Free-Market Health Philosophy Is Ludicrous

 They claim that the SSDI program is rife with fraud and that far too many people just refuse to work.

 

By Heather Digby Parton / Salon

 

It was startling to see physician and Senator Rand Paul claim the other day that people on disability were faking bad backs and anxiety to get on the dole and cheat the taxpayers. These are real ailments, sometimes totally debilitating,  as anyone who has suffered from either can tell you. Severe back pain can make it impossible to work at any job, even those which only require sitting. Anxiety disorder is a terrible condition that can even make some people unable to even leave their house. What kind of medical doctor would deny such a thing? (If you answered, “one who will willingly trade his professional integrity for political points” you’d be right.)

But this is actually part of the GOP’s ongoing quest to degrade “entitlements” and make America’s health care system the worst in the world for anyone who isn’t wealthy. Their ongoing attack on The Affordable Health Care Act opened up a window to their underlying philosophy about affordable health care.  (They’re not for it.)

And now they are taking legislative aim at the Supplemental Security Income portion of the Social Security System. This is the program that makes it possible for people with disabilities to live without begging on the streets.   Despite the fact that the congress has always routinely pushed money back and forth between the retirement and disability portions of the program as the need occurred, the Republicans in congress have decided that they no longer support doing such a thing. The result, if they have their way, would be to cut the meager stipends of millions of disable Americans within the next year.

They claim that the program is rife with fraud and that far too many people are able bodied and just refuse to work. (They haven’t used the term “disability queen”  in public yet, but you can be sure they’ve thought it.) Representative Tom Price, another erstwhile medical professional committed to proving that trusting a Republican doctor to treat you is like asking a convicted robber to house sit, said:

“There are a number of studies that demonstrate that a lot of people who are on the program are no longer eligible. People get well, people do other things and other opportunities become available from a medical standpoint to treating whatever disability they have to make it so that they can contribute to a greater degree.”

That’s a convenient story but it’s just not true:

About 8.9 million people receive disability benefits from the fund and its eligibility guidelines are stringent. Beneficiaries must have worked at least one-quarter of their adult life and five of the last 10 years. They must be unable to work because of a severe medical issue that has lasted five months and is expected to last at least another year.

Roughly a quarter of recipients have a mental impairment, some have muscular or skeletal problems and others have diseases like diabetes, Lou Gehrig’s disease, congestive heart failure and cancer. A majority of them are 55 or older and many die within a few years of first receiving the insurance, according to CBPP.

Think Progress noted that the reports of disability fraud are actually extremely low and noted:

The severity of the disabilities of those who get benefits is underscored by the fact that one in five men and nearly one in six women die within five years of being approved.

Once on the rolls, payments are far from cushy: they average $1,130 a month, just over the federal poverty line for a single person, and usually replace less than half of someone’s previous earnings. Very few beneficiaries are able to work and supplement that income: less than 17 percent worked at some point during the year in 2007, but less than 3 percent of those people made more than $10,000 annually.

Apparently, even that’s too much. The government needs to crack down on these lazy moochers and put them to work. Back in the day they used to sell pencils and apples on street corners, amirite? And in third world countries you see plenty of horrifically disabled people making a tidy living by begging. They show the kind of gumption we are denying our paraplegics and mentally ill by molly coddling them with a poverty level stipend.

These Republican officials are not alone in holding this philosophy. Recall this confrontation between a Tea Partyer and a disabled citizen during the health reform debate:

A man with a sign saying he has Parkinson’s disease and needs help sat down in front of the reform opponents. Several protesters mocked the man, calling him a “communist,” with one derisively “throwing money at him.” “If you’re looking for a handout you’re in the wrong end of town,” another man said.

He added, “nothing for free, over here you have to work for everything you get.” The lovely gentleman who threw a dollar in his face put the begging principle in stark terms yelling “I’ll decide when to give money!”

The immediate future of the health care reforms will be decided this June by the Supreme Court as they take up King vs Burwell (also known as the “Typo Of Death” case.) In the meantime, as that argument is on hold the right is moving against the safety net from this other direction. Basically, they are challenging the the definition of modern medicine itself:

Fox News Radio host Tom Sullivan told a caller who said she suffered from bipolar disorder that her illness is “something made up by the mental health business” and just “the latest fad.” When the caller told Sullivan that she “would not be alive today” if she hadn’t received mental health treatment, Sullivan wondered if “maybe somebody’s talked you into feeling and thinking this way.”

Sullivan, who is also a frequent Fox Business contributor and guest anchor, began his January 28 program by complaining that people with mental illness have figured how to “game the system” by receiving disability benefits. “They’re mostly government employees and they know how to do it,” he added. Sullivan also defended Sen. Rand Paul’s (R-KY) controversial and false statement that “Over half the people on disability are either anxious or their back hurts.”

Obviously, that is nonsense. But it’s becoming quite common on the right to suggest that illnesses are not real, that people are faking them anyway and that those who are sick are lazy parasites who should find some way to make a living. We have Republicans, some of them medical doctors, publicly declaring that fellow citizens who have been unlucky enough to have an accident or contract a debilitating illness need to be harshly scrutinized by the government to ensure they aren’t stealing that generous $1,000 a month.

I think we probably need to consider the alarming idea that this is going to be the right’s overall approach to dealing with health care. They have no real ideas for how to deliver affordable health care to every citizen and they have no methods for controlling the spiraling costs of the former system. In order to maintain their “free-market” health care philosophy they are going to have to make it clear that you must get rich if you expect to live through catastrophic illness or accidents. If you are sick, it’s up to you to figure out how to pay for your care and shelter. That’s the only solution available to them.

As a libertarian theorist posited in the Washington Post last week,”people could die and that’s ok”:

[It] is an acceptable price to pay for certain goals — including more cash for other programs, such as those that help the poor; less government coercion and more individual liberty; more health-care choice for consumers, allowing them to find plans that better fit their needs; more money for taxpayers to spend themselves; and less federal health-care spending.

I’m going to guess that more money to help the poor is an unlikely “choice” that people who want less government coercion and more individual liberty are going to make. But the rest of that sounds like it’s right in the current Republican wheelhouse. If you get sick and can’t make enough money by begging, well, you can console yourself with the knowledge that other people have more freedom, less government, and more money to spend on themselves. And that’s what life, liberty and the pursuit of happiness are all about. Well, maybe not life.  But two out of three ain’t bad.

Here's What No One Is Telling You About Ebola

I'm a Hazmat-Trained Hospital Worker: Here's what everyone is failing to report.

By Abby Norman

Ebola is brilliant.

It is a superior virus that has evolved and fine-tuned its mechanism of transmission to be near-perfect. That's why we're all so terrified. We know we can't destroy it. All we can do is try to divert it, outrun it.

I've worked in health care for a few years now. One of the first things I took advantage of was training to become FEMA-certified for hazmat ops in a hospital setting. My rationale for this was that, in my home state of Maine, natural disasters are almost a given. We're also, though you may not know it, a state that has many major ports that receive hazardous liquids from ships and transport them inland. In the back of my mind, of course, I was aware that any hospital in the world could potentially find itself at the epicenter of a scene from The Hot Zone. That was several years ago.

Today I'm thinking, by God, I might actually have to use this training. Mostly, though, I'm aware of just that -- that I did receive training. Lots of it. Because you can't just expect any nurse or any doctor or any health care worker or layperson to understand the deconning procedures by way of some kind of pamphlet or 10-minute training video. Not only is it mentally rigorous, but it's physically exhausting.

PPE, or, personal protective equipment, is sort of a catch-all phrase for the suits, booties, gloves, hoods and in many cases respirators worn by individuals who are entering a hot zone. These suits are incredibly difficult to move in. You are wearing several layers of gloves, which limits your dexterity to basically nil, the hoods limit the scope of your vision -- especially your peripheral vision, which all but disappears. The suits are hot -- almost unbearably so. The respirator gives you clean air, but not cool air. These suits are for protection, not comfort. Before you even suit up, your vitals need to be taken. You can't perform in the suit for more than about a half hour at a time -- if you make it that long. Heat stroke is almost a given at that point. You have to be fully hydrated and calm before you even step into the suit. By the time you come out of it, and your vitals are taken again, you're likely to be feeling the impact -- you may not have taken more than a few steps in the suit, but you'll feel like you've run a marathon on a 90-degree day.

Getting the suit on is easy enough, but it requires team work. Your gloves, all layers of them, are taped to your suit. This provides an extra layer of protection and also limits your movement. There is a very specific way to tape all the way around so that there are no gaps or "tenting" of the tape. If you don't do this properly, there ends up being more than enough open pockets for contamination to seep in.

If you're wearing a respirator, it needs to be tested prior to donning to make sure it is in good condition and that the filter has been changed recently, so that it will do its job. Ebola is not airborne. It is not like influenza, which spreads on particles that you sneeze or cough. However, Ebola lives in vomit, diarrhea and saliva  -- and these avenues for infection can travel. Projectile vomiting is called so for a reason. Particles that are in vomit may aerosolize at the moment the patient vomits. This is why if the nurses in Dallas were in the room when the first patient, Thomas Duncan, was actively vomiting, it would be fairly easy for them to become infected. Especially if they were not utilizing their PPE correctly. 

The other consideration is this: The "doffing" procedure, that is, the removal of PPE, is the most crucial part. It is also the point at which the majority of mistakes are made, and my guess is that this is what happened in Dallas.

The PPE, if worn correctly, does an excellent job of protecting you while you are wearing it. But eventually you'll need to take it off. Before you begin, you need to decon the outside of the PPE. That's the first thing. This is often done in the field with hoses or mobile showers/tents. Once this crucial step has occurred, the removal of PPE needs to be done in pairs. You cannot safely remove it by yourself. One reason you are wearing several sets of gloves is so that you have sterile gloves beneath your exterior gloves that will help you to get out of your suit. The procedure for this is taught in FEMA courses, and you run drills with a buddy over and over again until you get it right. You remove the tape and discard it. You throw it away from you. You step out of your boots  --  careful not to let your body touch the sides. Your partner helps you to slither out of the suit, again, not touching the outside of it. This is difficult, and it cannot be rushed. The respirators need to be deconned, batteries changed, filters changed. The hoods, once deconnned, need to be stored properly. If the suits are disposable, they need to be disposed of properly. If not, they need to be thoroughly deconned and stored safely. And they always need to be checked for rips, tears, holes, punctures or any other even tiny, practically invisible openings that could make the suit vulnerable.

Can anyone tell me if this happened in Dallas?

We run at least an annual drill at my hospital each year. We are a small hospital and thus are a small emergency response team. But because we make a point to review our protocols, train our staff (actually practice donning/doffing gear), I realized this week that this puts us ahead at some much larger and more notable hospitals in the United States. Every hospital should be running these types of emergency response drills yearly, at least.

To hear that the nurses in Dallas reported that there were no protocols at their hospital broke my heart. Their health care system failed them. In the United States we always talk about how the health care system is failing patients, but the truth is, it has failed its employees too. Not just doctors and nurses, but allied health professionals as well. The presence of Ebola on American soil has drawn out the true vulnerabilities in the health care system, and they are not fiscally based. We spend trillions of dollars on health care in this country -- yet the allocation of those funds are grossly disproportionate to how other countries spend their health care expenditures. We aren't focused on population health.

Now, with Ebola threatening our population, the truth is out.

The truth is, in terms of virology, Ebola should not be a threat to American citizens. We have clean water. We have information. We have the means to educate ourselves, practice proper hand-washing procedures, protect ourselves with hazmat suits. The CDC Disease Detectives were dispatched to Dallas almost immediately to work on the front lines to identify those who might be at risk, who could have been exposed. We have the technology, and we certainly have the money to keep Ebola at bay. What we don't have is communication.

What we don't have is a health care system that values preventative care. What we don't have is an equal playing field between nurses and physicians and allied health professionals and patients. What we don't have is a culture of health where we work symbiotically with one another and with the technology that was created specifically to bridge communication gaps, but has in so many ways failed. What we don't have is the social culture of transparency, what we don't have is a stopgap against mounting hysteria and hypochondria, what we don't have is nation of health literate individuals. We don't even have health-literate professionals.

Most doctors are specialists and are well versed only in their field. Ask your orthopedist a general question about your health -- see if they can comfortably answer it.

Health care operates in silos -- we can't properly isolate our patients, but we sure as hell can isolate ourselves as health care workers.

As we slide into flu season, a time of year when we are normally braced for winter diseases, colds, flus, sick days and canceled plans, the American people have been exposed to another disease entirely: the excruciating truth about our healthcare system's dysfunction -- and the prognosis doesn't look good.

Note: In response to some comments, I would like to clarify that I am FEMA-trained in level 3 hazmat in a hospital setting. I am a student, health guide and writer, but I am not a nurse.

Year of Republican failure on health care

October 1st marks the day the Republicans shut down the government, and initial roll out of the now very successful Affordable Health Care Act sign ups. Ed Schultz, Wendell Potter and Leo Gerard discuss.

Liberians Explain Why the Ebola Crisis Is Way Worse Than You Think

By Alex Park

Health workers in Liberia haul away the body of a person suspected of dying of Ebola Abbas Dulleh/AP

As of this week, the Ebola outbreak in West Africa is known to have infected more than 5,700 people and taken more than 2,700 lives. Yet those figures could be dwarfed in the coming months if the virus is left unchecked. On Tuesday, the Centers for Disease Control and Prevention reported that the total number of infections could reach 1.4 million in Liberia and Sierra Leone by January 2015. Though cases have been reported in five countries, nowhere has been harder hit than Liberia, where more than half of the Ebola-related deaths have occurred.

More MoJo coverage of the Ebola crisis.

• These Maps Show How Ebola Spread In Liberia
• Even Liberia's Legislature Can't Escape the Ravages of Ebola
• Listen to Some of Liberia's Top Artists Sing about Ebola
• Why the World Health Organization Doesn't Have Enough Funds to Fight Ebola
• New Drugs and Vaccines Can't Stop This Ebola Outbreak
• We Are Making Ebola Outbreaks Worse by Cutting Down Forests

The outbreak has crippled Liberia's economy. Its neighbors have sealed their borders and shipping has all but ceased, causing food and gas prices to skyrocket. Schools and businesses have closed down, and the country's already meager health care system has been taxed to the breaking point.

Meanwhile, as panic grips the country, crime has risen steadily and some reports suggest that Liberia's security forces are among the perpetrators. To get a picture of how dire the situation is on the ground, we got in touch with Abel Welwean, a journalist and researcher who lives outside of Monrovia. He conducted a handful of interviews with Liberians in his neighborhood in the second week of September and also provided his own harrowing story of what life is like in the country.

The outbreak has forced many Liberians to stay indoors and avoid interacting with other people. Since the virus can be caught merely by touching the sweat of an infected person, once-common forms of physical contact, like handshakes, have become rarer.

Frances (a university student): Football has been suspended in our country. We are sitting at home just doing nothing—all in the name of protecting ourselves. It is hurting us, but we have to play the safe rules, because we value our own lives.

Abel: I don't wear short sleeve shirts to step outside my house. I keep my children in my yard throughout the day. I make sure we wash our hands periodically. We do not shake hands with anybody outside of our house. We do not entertain visitors in our house… These behaviors are very strange amongst Liberians… Shaking hands is our one of the cultural values that we have. Liberia may be poor and not willing to be developed, but we are friendly people who believe in shaking hands in a special way, and eating together from the same bowl.

Frances: Schools are closed for time indefinite. We don't know when schools will open. We are sitting at home, watching and praying that school will open sooner. Rumors are coming that schools will open next year— we don't know. What I think the youth can do now is to get on our feet and educate the common man, those that are still in the denial stage, to sensitize them, give them the actual information about this Ebola virus, let the youth get on their feet from house to house, door to door, and try to inform the populace about the deadly Ebola virus, and how it can be prevented.

Abel: I worry a lot about the future of our children's education. I was at the verge of paying my children's tuition when the government announced the closure of all schools in the country. For now, I am my children's tutor at home.

 

"We are urging the international community to come to our rescue, for the downtrodden, because pretty soon there will be another war, and that will be the hunger war."

When the epidemic struck Liberia, a number of hospitals closed, often because their staffs had fled in fear. Adding to the problem, Ebola's symptoms mimic other, still common diseases, but treating anything that resembles Ebola necessitates protective gear that's not always available outside the quarantine centers. That means that many people who are suffering non-Ebola illnesses are going untreated.

Esther (a nurse and midwife): Before, August, September were months we had diarrhea cases in Liberia. But right now, the symptoms of Ebola and malaria are all the same. It's very, very difficult to know an Ebola patient from malaria, so it's very, very difficult to treat any patient in that direction.

Frances: Many were afraid that if you have malaria, you have common cold, you have fever, you go to the hospital, they would diagnose you as an Ebola patient... I even got sick during the outbreak. I was afraid to go to the hospital. I had to do my own medication, but God looked out for me. I'm well. But these were the messages that were going around, that once you have this, they will confine you to a place, they will quarantine you for 21 days, they will inject you. So many Liberians were afraid to go to hospitals. But now the message has spread out. We now know people are surviving of Ebola. Even if it is not Ebola, you just have malaria, you go there, you are treated. They get you tested; they release you on time.

Brooks (an American who was working at the Accountability Lab, an anti-corruption NGO, in Monrovia and has since left the country): Even in July, you heard stories of pregnant women going into labor, bleeding profusely, and not being tended do because people were afraid of Ebola.

Esther: As a midwife, most of the time I have to do deliveries. But right now, as we sit here, this clinic is closed. These are cases that could be treated, but since we don't have the proper equipment, the proper outfits to wear and treat our patients and do tests [for Ebola], we decided to stay away from treating patients, because you don't know who you are touching. Obviously, it's a kind of embarrassment, but we have to go through with it for now.

Before it spread to Monrovia, Ebola struck in Lofa County, Liberia's rice-producing center. Many farmers avoided their fields, severely hurting domestic food production. Food imports (the country imports about two-thirds of its grain supply) have also been hampered because of the crisis. Borders with neighboring countries have been closed, and shipping companies have avoided the nation's ports. All of that has led to the biggest increases in food prices since the nation's civil war, which ended in 2003. In a country where 84 percent of everyone lived on less than $1.25 per day in 2011, this shock has become its own crisis.

Esther: There were times, we were paying, for a 25-kilo [55 pound] bag of rice, we were paying something like 1,150-1,250 [Liberian dollars, or $14 to $15], but right now it's like 1,500 [$18].

John (a Liberian employee of the International Committee of the Red Cross): I see so many people, sometimes they are walking to town [about six miles]. Even if they have money, they prefer walking a distance and saving the money to buy food so they will eat for the day. We tend to be afraid to assist someone from the vehicle, even to tell them the distance they are going, because we don't know who is carrying the virus.

Lawrence (the Liberia country director for Accountability Lab): Hunger is really hitting the country… If the ships are not coming, [farmers] are not making rice, the stockpiles are depleted…the animals are eating the crops, what happens then? The production will decrease, the price will increase, and if you don't have money, what is going to happen? Hunger is going to strike… This is a serious war, without bullets.

It's not just a rise in food prices that Liberians are struggling with; transit costs have increased as well, partly because the government has forbidden commercial vehicles from carrying large numbers of people. Markets have been shut down; NGOs and companies are asking employees to stay at home; schools are closed so teachers are not working. On September 17, the World Bank warned that Ebola could cut Liberia's GDP by 3.4 percentage points, costing $228 million by 2015.

Esther: In my own clinic, I have a staff of twelve. But right now, everybody has to be home until otherwise. Since we don't have protective gear, we don't have anything to work with, we cannot risk our own lives, because if you are not able to protect yourself, you will not able to work with other people. It will be difficult for their families.

Frances: It is better for us to stay at home, but we need, also, to have our daily bread. The international community, international donors, need to come to our rescue, because hunger is taking over Liberia, gradually.

Abel: I have gone out of job because of the Ebola outbreak. Before the outbreak, I had contracts with Princeton, PBS Frontline, Nursing For All, and the Gender Ministry. All of my contracts are on hold until the crisis is over.

The statistics are unreliable, but many report that violent crime is rising since the outbreak began. Even more troubling: some of these crimes have reportedly been at the hands of police and soldiers in uniform. Some Liberian's blame the government's curfew for the problem.

John: Armed robbery is increasing because the government placed this curfew from 9 [p.m.] to 6 AM. Before, there used to be community watch teams. At that time, there was no curfew.

Abel: Our lives were relatively peaceful before the deadly outbreak of the Ebola virus. We could go out any hour and return any hour. There were robberies once in a while, but not compared to the recent ones… I do not know if the proliferation of robberies was political or some criminals just decided to take advantage of the situation.

There have been numerous cases of armed robberies since the curfew was announced… There was one in my community and my neighbors were badly affected. I was really afraid that night when I heard the bullet sound. At that time my family and I were watching movie in the living room. We got scared so much that we couldn't continue the movie. We turned the video off, turned all the lights in the rooms off and went to bed. Fortunately for me, those police officers that came to rescue my neighbors were my friends. They came to my house that night to see how my family and I were doing. [Later, I learned] the robbers wore police uniforms and were fully armed.

Esther: I was a victim about four days ago. I just left my back door open to hang clothes in the front. By the time I was back in, someone had snuck in and took the two phones I had charging. Because the children are not in school, most of the young ones are turning to crime—and not just the young ones, even people who were working and they are not able to work now, some of them are thinking, how do they maintain their families? They are collaborating with some of these criminals to get their way through.

Frances: Liberia is declining, the economy is declining, and things are just getting difficult on a daily basis. We are not free to move around, we are not free in our own country because of this deadly Ebola virus. We are urging the international community to come to our rescue, for the downtrodden, because pretty soon there will be another war, and that will be the hunger war.

GOP running out of arguments against the ACA

Rep. Emanuel Cleaver and MSNBC’s Melissa Harris Perry join Rev. Al Sharpton to talk about a new report that’s poking holes in GOP arguments against the Affordable Care Act.

Mitch McConnell’s ACA problem

The Affordable Care Act is working in Kentucky, but Mitch McConell is vehemently opposed to it. So, how to campaign on a losing battle?

Desperate Liar Mitch McConnell Gets Caught In His Own Health Care Trap

By Sarah Jones

Upon Senator Mitch McConnell’s (R-KY) primary victory promise to repeal Obamacare, I mused who would ask him about kicking the 413,000 Kentuckians who were on Kynect off of it. Your mainstream media did just that, and the Kentucky Senator told a bold faced lie. A lie so disingenuous and so important policy wise that it can’t be overstated.

The man who is hoping to be Majority Leader of the Senate and who promised to repeal Obamacare if he makes it claimed that the Kentucky state exchange is not connected to Obamacare. But of course, it is. It is Obamacare, under a different name.

ABC reported:

But the veteran senator won’t say what would happen to the 413,000 Kentuckians who have health insurance through the state’s health care exchange.

McConnell told reporters Friday that the fate of the state exchange is unconnected to the federal health care law. Yet the exchange would not exist, if not for the law that created it.

Kynect is the state exchange version of the Affordable Care Act, aka, Obamacare. It’s a marketplace run by the state as the drafters of the ACA intended all marketplaces to be (before Republicans sabotaged the online marketplace by refusing to build the state markets).

A plurality of Kentuckians like their Obamacare, so long as it’s called Kynect, so it’s no wonder that McConnell is trying to dodge his way around kicking them all off of their health insurance.

According to Kynect statistics as of 4/21/14, 413,410 Kentuckians are enrolled in new health coverage, including Medicaid and private insurance.

Per the Kynect website, “Calling it ‘the single-most important decision in our lifetime for improving the health of Kentuckians,’ Gov. Steve Beshear announced in May 2013 the inclusion of 308,000 more Kentuckians in the federal Medicaid health insurance program.

Read slowly in honor of Mitch McConnell:

The expansion – made in accordance with the federal Affordable Care Act (ACA) – will help hundreds of thousands of Kentucky families, dramatically improve the state’s health, create nearly 17,000 new jobs and have a $15.6 billion positive economic impact on the state between its beginning in Fiscal Year 2014 and full implementation in Fiscal Year 2021.

Kentuckians deserve to know what Mitch McConnell plans to do with all of the folks who signed up for insurance under Kynect or got onto Medicaid when he repeals Obamacare, as he has promised to try to do.

It looks like McConnell is caught in his own Obamacare trap. Too bad he and his party never tried to do anything to solve the healthcare crisis in this country — and have staked their entire party upon the public buying their smears about Obamacare — instead of realizing that once it was implemented, they would be running on kicking people off of insurance and that’s not as easy as telling Obamascare lies.

Kynect is Obamacare, and Senator McConnell knows it. This is one of the most brazen, outrageous lies told in the last few years, and I’m ranking it above even Mitt Romney’s Jeep lies, because it is meant to fool innocent Kentuckians who have no clue that Kynect is Obamacare. There aren’t words for this kind of cruel hypocrisy.

Politics is full of spin, but this goes beyond spin. This is a matter of people’s lives.

Desperate Liar Mitch McConnell Gets Caught In His Own Obamacare Trap was written by Sarah Jones for PoliticusUSA.

McDonald’s Manager To Sick Employee: ‘Just Put A Bullet In Your Head’

By Rika Christensen

A manager at a Chicago McDonald’s told an employee to just put a bullet in her head after she asked to go home following a diabetic episode on the job. Image: 28704869

A manager of a Chicago McDonald’s told employee Carmen Navarrette to put a bullet in her head for being sick. Navarrette is diabetic, and had asked to go home after having a severe diabetic episode.

Navarrette, who’s been an employee at that McDonald’s for nine years, went to the Workers Organizing Committee of Chicago with the incident.

She also told her story to the Organizing Committee for Chicago Women Caucus, where there were similar stories from other people. That’s prompted a rally on Saturday, where workers were demanding an end to verbal abuse and respect from their managers. Several Chicago aldermen attended the rally as well.

So far, McDonald’s corporate hasn’t commented on the matter. Last year, they began cracking down on staff and managers for poor customer service. One in five customer complaints has to do with not receiving friendly or speedy service, according to an article in the Wall Street Journal. As yet, though, there’s little evidence that they’ve been pressing their franchisees to train managers to treat employees better.

Disrespect isn’t unique to this particular McDonald’s.

Another Chicago McDonald’s is under fire for poor employee treatment, age discrimination, unsanitary conditions, and failure to provide proper safety equipment. Centro De Trabajadores Unidos (CTU) Immigrant Worker Project says that several women at the McDonald’s at 92^nd and Commercial Avenue, on Chicago’s south side, frequently deal with verbal abuse, along with stress so bad it affects their health outside of work.

In 2013, CTU was pressuring that McDonald’s restaurant to sit down with them and work something out so that workers would receive better treatment. At the time of their posting, the restaurant had not responded to their letters.

McDonald’s might benefit more from treating their workers with some decency.

Perhaps the problem is deeper than just rude workers. It can be very hard to put a smile on your face when not only does your boss treat you like you’re nothing, but customers do also. Business Insider has a list of McDonald’s horror stories from 2012, and most of them have to do with customers.

There are a few that have to do with bad working conditions.

Perhaps the problem is, at least in part, our society’s disdain for fast-food workers. You see it all over the place, especially when talking about raising the minimum wage.

These jobs are low-skill, requiring minimal training, and for some reason we associate that with a person’s worth as a human being. If they were better people, they’d have better jobs. Since they don’t, there must be something wrong with them that just makes them “beneath” the rest of us.

It’s not just customers who think it’s their right to step all over a fast-food worker like they aren’t human. As Navarrette’s story shows, the managers and franchisees do it, too.

The Wall Street Journal article discusses how trying to raise the level of customer service across the board has had limited success. One McDonald’s franchisee said, “I think it’s an ongoing problem, and always will be.”

The question there is, why? The franchisees are addressing the issue by increasing staffing and introducing new order systems to speed things up. Why doesn’t employee treatment factor into this at all?

Employee engagement and well-being brings in a higher profit margin.

Organizations that actively participate in employee well-being and engagement, and invest time and energy in providing good working environments, tend to see greater returns and greater profits than companies who treat their employees like mere cogs in a machine. This isn’t something that only applies to certain industries; it’s true across all industries. It isn’t necessarily about wages, either.

Treating employees with respect, and letting them know their value to the organization as a whole, can go a very long way towards how well they perform.

But even if the returns were small, treating your employees with disrespect is just bad management.

Anybody who’s so disrespectful that they would tell an employee to put a bullet in their head because they’re sick shouldn’t be a manager to begin with.

This McDonald’s manager really should just be fired for that.

There’s no information available as to how often Navarrette was absent from work due to her diabetes. If it was quite frequent, then frustration on the part of her manager is to be expected.

However, that absolutely does not give him the right to tell her she should kill herself. If her health is causing that much of a problem with her attendance or performance on the job, then he needs to schedule a meeting with her to discuss her options (including things like light duty, and possibly disability).

If, however, her diabetes is not causing problems with her attendance and on-the-job performance, then his behavior is even worse because that level of frustration is entirely unwarranted. But regardless, no manager, no matter how frustrated they are, has the right tell anyone to just put a bullet in their heads.

Navarrette has a petition on Moveon.org regarding her situation, and the situation of all McDonald’s workers who’ve had to endure abuse from their managers. If McDonald’s is serious about improving their customer service, technology is only one step. They need to better train their franchisees to ensure store managers are leaders, and not just overseers.

The California GOP's fake health care website

Posted by Jim Hightower

Listen to this Commentary

In this wicked world of woe, there are hucksters, flim flammers, plain ol' crooks… and Republican members of the California Assembly.

This last bunch of scoundrels went out of their way to monkey wrench the rollout of President Obama's new health care law. Obama's computer geniuses were making a hash of the initial rollout in October, but the sign-up was finally smoothing out – and with any Obama success, GOP lawmakers automatically start tossing monkeywrenches.

This time, the tool they tossed is a fake website created by California Republican legislators in August to look like the state's official health exchange site, where people can sign up to get coverage under the Affordable Care Act. When things finally got worked out on the national health care exchange in November, the Repubs mailed a pamphlet to their constituents, directing them to the decoy site, calling it a "resource guide" to "help" them navigate the ACA sign up process.

Far from help, however, the faux site is a trap. It's filled with boilerplate Republican propaganda against the law, gimmicks to discourage viewers from even applying for the health care they need, and a rash of distortions and outright lies. There's so much bunkum on the site that its fine print includes a disclaimer saying they don't vouch for "the quality, content, accuracy, or completeness of the information" it provides.

The silliest thing about the lawmakers' blatantly political ploy is that even if it convinces some people to forgo the ACA's benefits, who does that hurt? Not Obama – but their own constituents! I know there's no IQ requirement to be a state legislator, but what were they thinking?

We can laugh at their low comedy, but if you're a California taxpayer, congratulations: You paid for the GOP's bogus website and mailings.

"A bogus Health care website, courtesy of the GOP," www.msnbc, December 4, 2013.

"California Republicans Defend Fake Obamacare Site," www.abcnews.com, December 3, 2013.

"California GOP creates fake health care website to discourage constituents from obtaining insurance," www.dailykos.com, December 2, 2013.

"Email from Ed H." December 16, 2013.

Need for healthcare hits close to home

Ed Schultz shares his wife’s very personal experience with ovarian cancer & the need for all Americans to have high-end health insurance. Rep. Schakowsky joins.

Statewide healthcare success sways the public

Right wing smear machine begs to stay relevant, as public opinion shifts to favor the Affordable Health Care Act with success in KY. Rep. Yarmuth and Rep. Connolly join Ed Schultz.

McDonald's advises hungry, sick employees to get welfare benefits

McDonald’s “help?” It’s just so outrageous

Look, by now, everyone knows that McDonald’s doesn’t pay their employees enough to make ends meet. See what happens when Nancy, a Chicagoland McDonald’s employee, calls the McResources “help” line.

And spread the word about the hidden costs of the fast food industry after you have.

Jon Stewart Takes Aim At Health Care Fiasco

All that stands in the way of Democratic electoral success is a mildly competent implementation of the health care policy they battled so hard to keep.

The Daily Show
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No, You Can’t Just Go to the Emergency Room—Unless You Want to Go Broke

By Tim Murphy

About three weeks ago I was walking home from the grocery store when a group of teenagers demanded my wallet, cellphone, and—for reasons I can't fully explain—gallon of whole milk. Although I made no effort to resist, I ended up with a laceration on my lip that required stitches, fairly intense swelling on both sides of my head that required X-rays, and a bruised rib. And I was down a gallon of milk and a dozen eggs. It sucked.

On Tuesday, though, I got some good news—a billing statement from George Washington University Hospital, where I got my stitches, CAT scan, painkillers, and a tetanus shot. Thanks to my employer-provided insurance company, Carefirst Blue Cross Blue Shield, I ended up paying about $50. But if I didn't have insurance, like 47 million working-age adults nationally and approximately 23 percent of 18-to-25-year-olds, it would have increased the bill by a factor of more than a hundred. The sutures alone were $1,400, and another $300 to have them taken out four days later. I'm a young journalist at a nonprofit magazine. I do my best to budget responsibly. But I don't have $5,000 of disposable income just lying around. My unfortunate encounter with typically wayward millennials could have left me broke.

I mention this because conservative lawmakers have spent much of the last four years—and the three weeks since the Affordable Care Act's exchanges opened on October 1—arguing that emergency rooms are a suitable replacement for having health insurance.

"We do provide care for people who don't have insurance," Mitt Romney explained during his 2012 presidential campaign. "If someone has a heart attack, they don't sit in their apartment and die."

During last year's campaign, now-Sen. Ted Cruz (R-Texas) took heat from doctors groups when he argued against all evidence that it would be cheaper for the state to keep sending the 6.1 million Texans who lack health insurance to emergency rooms than it would to expand Medicaid. And in 2011, then-Mississippi Gov. Haley Barbour (R) explained that he was rejecting the Affordable Care Act's Medicaid expansion in the nation's poorest and unhealthiest state because "there's nobody in Mississippi who does not have access to health care." After all, his office explained, there was always the emergency room.

But by the time the uninsured get to the emergency room, the damage has already been done.

According to a study from Harvard Medical School, someone dies as a consequence of not having health insurance about once every 12 minutes in the United States, because they aren't able to seek basic primary care treatment that can prevent more serious problems. (About 9,000 Texans will die each year as a result of Gov. Rick Perry's rejection of the Medicaid expansion, according to an analysis by the Institute for Medical Humanities at the University of Texas Medical Branch in Galveston.)

But Barbour and his colleagues missed the broader economic point: Someone has to pay for emergency room visits. Emergency care can help literally stop the bleeding—it did in my case. But it's expensive, and it's not a substitute for regular primary care or health insurance.

In recent months, conservative groups like FreedomWorks and the Koch Brothers-backed Generation Opportunity have sought to dissuade young Americans from purchasing health insurance, arguing that millennials are being forced to pay disproportionately high prices for something they're disproportionately less likely to need. But random crime can happen to anyone—and young people are disproportionately unlikely to be able to pay out of pocket.

If you get mugged in Washington, DC, and you're uninsured, you have some help. As the detective assigned to my case helpfully informed me, the District covers up to $25,000 in medical expenses for victims of violent crime. But there are plenty of other ways to mess up your face that don't involve felonies, and plenty of violent crimes that will send your bill sailing far north of $25,000. (Just consider the case of Salon reporter Brian Beutler.)

The numbers back this up: A 2012 study from the Commonwealth Fund found that 51 percent of uninsured young adults—the healthiest age group in the United States—had trouble paying medical bills.

So if you're uninsured and can afford a basic plan, you should get insured—because while your odds of going to the emergency room on any given day are statistically low, your odds of being financially ruined if you do are quite high. Otherwise, it just might cost you the arm and a leg you were trying to save.

Tim Murphy

Reporter

Tim Murphy is a reporter at Mother Jones. Email him with tips and insights at tmurphy [at] motherjones [dot] com. RSS | Twitter