Monday, November 23, 2009

"Medical ghetto"?

Even though I expect this post will set off a firestorm of comments, many or most of which will be very negative, I cannot find the words to properly express just how offensive I find the words of Senator Lamar Alexander (R-TN) during a speech he delivered in the current Senate health care debate.

Give him your attention.



In the first place, Medicaid represents the only health care option available to a portion, and only a portion, of the very poor in America. The major negative associated with Medicaid relates directly to the fact that so few physicians will accept patients covered by the otherwise very good plan.

As a result, my poorest neighbors must wait for care, and not only in long lines or in crowded clinic and ER waiting rooms, but for weeks at a time for scheduled treatment. This would be remedied if we had the benefit of a comprehensive, national health care plan.

But second, and even more offensive, if the good Senator feels that Medicaid is a "health care ghetto." doesn't he have a moral responsibility to improve it? Doesn't he have a fiscal responsibility to the nation to reform it, extend it and promote it? Hasn't he signed on as a national leader with the responsibilities that accompany such a decision? 

Never mind the obvious race baiting here. Let's talk quality, equity and health care justice, not to mention improving the nation's wellness and health outcomes across a broad array of health measures.

Senator, please!

32 comments:

  1. Really hard to believe he said this even if he believes it!

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  2. Are your sensibilities offended by the accuracy or the inaccuracy of the description of a government program?

    WHY do "so few physicians...accept patients covered by the ... very good plan?"

    IF your "poorest neighbors must wait for care, and not only in long lines or in crowded clinic and ER waiting rooms, but for weeks at a time for scheduled treatment" is this a good plan or a bad one?

    Is the ghetto a "ghetto" and do wish to expand it or shrink it?

    P.S. If Alexander's brief comments upset you, don't see the Micheal Oher movie "The Blind Side." It will really set you off.

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  3. I know at least a hundred formerly homeless people at our agency who are thankful they have Medicaid. And we have several doctors/residents committed to working with these neighbors. Without it, there would be no hope for helping them manage their symptoms of mental illness and they'd be knocking down Senator Alexander's door asking for help.

    I also know a family doing mission work in north St. Louis. They've given up the good life and good jobs to serve their neighbors and the church. Thanks to Medicaid, they recently had a baby and have been able to continue doing God's work.

    Unfortunately, Missouri just put a freeze on new admissions to Medicaid, so we're really in a bind on helping many of our neighbors.

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  4. At least Louisiana should be pretty good regarding Medicaid. Mary Landrieu sold her vote for 30 pieces of sil...I mean $300,000,000

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  5. Larry, I have a question because this is the first time have seen this clip. Have you seen his complete statement because this one seemed very edited?

    RC

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  6. RC, no I haven't seen the larger report/clip. If you find a link, please post here for us. I'll look at well.

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  7. Here's a much larger portion of the comments. In my view, nothing in the longer statement helps me in terms of his attitude toward Medicaid. He speaks of humility in his rhetoric, but evidences none whatsoever for the poorest among us. The link: http://videocafe.crooksandliars.com/heather/sen-lamar-alexander-calls-medicaid-medical

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  8. Any liberal, comprehensive national health care plan would not be about health care at all. It is about massive, massive tax increases, income redistribution and restricting your freedom, all in the name of good intentions, compassion and fairness.

    Any health care plan should start with tort reform but liberals don't want to upset trial lawyers who contribute to the Democrat party.

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  9. NPR presented a series on health care for the show "This American Life," with suprizing conclusions from a left leaning organization.
    The team’s correspondents sought out industry professionals, economists, and patients. (They ignored politicians, by and large.) They surveyed the history of the American health-care system and drew some conclusions about why it has so many problems.


    1. Medical-malpractice lawsuits drive up the cost of health care
    2. Insurance companies are not evil
    3. Our reliance on third-party payers is at the heart of the problem
    4. Obamacare won’t fix it

    See more here.
    http://www.thisamericanlife.org/Radio_Episode.aspx?sched=1320

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  10. ok, chand, i dug into the program and i'm not sure you represented the sources correctly. . .a former Bush advisor as "left leaning"?

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  11. NPR leans a little to the left. But I think they have tried to make an honest presentation here with a variaty of input sources.

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  12. Speaking of race baiting....

    "You can't vote against this health care bill and call yourself black." Jessie Jackson

    Since you are against race baiting I assume you will call him out on that?

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  13. chris, while I don't agree with all things Jesse Jackson and while I wouldn't suppose that anyone can direct an entire race of people; I do think that Jackson is making a statement of enlightened self-interest and Alexander is basically admitting that poor folks--and those who are black a much higher % than whites--don't receive nor necessarily deserve a better health outcome, thus his insulting use of the word ghetto. It's just different.

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  14. You sure sound soft on old Jesse. I am from Tennessee and I don't think you have a very good grasp of Alexander. A Republican can say something and it's headlines for liberals. Jesse says stuff and no big deal. I personally think what Jesse said was a much bigger deal that anything than Alexander said. If this health reform gets passed in anywhere near its present form there will be an uprising of the likes few have seen. I think people are just sick of the government trying to take over everything.

    RC

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  15. No doubt this illustrates the different perspectives of regular commenters to this blog.
    On one hand, there are the commenters who perceive residents of "ghettos" to be there because of their own shortcomings and refusal or inability to take advantage of the opportunities that are undoubtedly available equally to all.
    Alternatively, there are the commenters who consider the "ghetto" environment to be the result of intractable systemic injustice that often inhibits a real freedom to choose.
    It's hard though to doubt that every "ghetto" has its slumlords. Those responsible should at least take credit.

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  16. "Enlightened self interest." I don't know what that means but it would probably be an occupational hazard for you to say anything negative about Jessie Jackson, even when he paid off his mistress with profits from his "non-profits."

    Larry, you are so predictable.

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  17. Chris, don't let up on Jesse!!!!!! When I start hearing the heat come down on Jesse and others of his likes then I might listen more. I just get tired of the gross double standard. Alexander is given a lecture, but Rev. Wright is given a pass. That is just the way it comes across to me.

    RC

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  18. rc, do you understand the difference in oppressor and oppressed at all? do you not find the term "medical ghetto" at least unfortunate? can't you see why a person like jackson would call blacks to support health care reform since they are the ones who suffer the most in the current system, along with hispanics? larry's in the middle of it; so he understands. and chris, larry doeen't worry about "occupational hazarads"--he never has, and i've known him a long time. you don't even know the guy.

    rw, dallas

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  19. I think it is time for some genuine honesty. But I doubt that we will see it.

    President Ronald Reagan championed the view that tax cuts, and other policies that would help the wealthiest among us, would lift all boats. The way out of poverty for the many is to give the most help to the few. He assured us that this would be true. He was confident, certain, that the way to help the poor was to help the wealthiest. This would create jobs, spread the wealth around – and help to lift people out of poverty. These were his actual promises.

    Well, we had quite a run for the wealthy. And President George W. Bush provided even greater tax cuts for the wealthiest among us.

    Are the poor better off? Ask Larry James – at CDM, he deals with the fall out, and the fall out now is not just on the poor, but increasingly it is jeopardizing the middle class.

    So -- people like Lamar Alexander, who agreed and supported the approach taken by Reagan and Bush, provided no help for the poor, actually brought harm to the poor, and now refers to a “health care ghetto.” Why not – he has never cared for the people in the ghetto, at least not with his policies.

    It is time to acknowledge the truth: there was no compassion in "compassionate conservatism." The tax cuts for the wealthy did not lift all boats. And now, everyone is feeling the effects.

    People like Chris on this blog need to answer this question – were Reagan and Bush correct? Remember, these were their promises. Did their policies help everyone – from the poor to wealthiest? The answer is clear – it is a resounding no.

    Randy Mayeux
    Dallas

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  20. President Reagan presided over the greatest economic expansion in American history while bringing inflation down to 4.8% from diouble digits. He cut taxes which allowed for growth of millions of jobs. He rejected socialism and communism and ultimately defeated the latter. And if he cut taxes for the rich, well that's the people who pay taxes and create jobs.

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  21. chris, resulting in the widest gap betw rich and poor in Am history, including the infamous Gilded Age!

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  22. Reagan did not "defeat" communism. I am married to a communist. VERY little of the things I was told were correct. The majority of the world has socialist governments. Even the U.S. is socialist - garbage pickup is just one example. People are taught to be afraid, thus making what we have appear to be perfect.

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  23. You could also say Reagan ballooned the National Debt thanks to his poor financial management. Reagan spent way more than he collected in the treasury -- so did Bush Jr. -- moreso than any Democract in the last 50 years. How that aligns with fiscal conservatism I will never know.

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  24. Daniel:

    I don't know where you get you ideas from, but please back up what you say with a little evidence. You were a baby when Reagan was President. He made people like me proud to be an American after the shame of Jimmy Carter. Those of you who want to bash Reagan please back up what you say with facts that people can actually look up. If these are just your opinions like mine are about Carter then say so. There is a difference. I plan to do a little fact checking tonight on Reagan before I post again. I hope some of you will to.

    RC

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  25. Yes, Richard, I was a poor, defenseless toddler when Reagan was president. And that matters, because why?? Last time I checked, one could still interpret factual evidence about a situation regardless of one's state in life at the time said evidence occurred. So let's please drop the ageist remarks.

    Your statement about Carter and mine about the national debt during Reagan's tenure have nothing in common. One is conjecture, the other has underlying data. Look at the historical national debt numbers, specifically as a percentage of GDP (which factors in inflation and economic growth). Those numbers went way up during Reagan and Bush's terms. They had been on the decline ever since WWII. But Bush Jr. might just beat out Reagan.

    After Carter, Reagan became a media darling. He may have done some nice things like lower people's taxes, but he was hardly a fiscal conservative. Drastically cutting taxes and expecting the Laffer curve to fill the treasury back up without making budget cuts was an act of fiscal lunacy.

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  26. Daniel, I like you, but you seriously need to loosen up. You still have not referenced a single reference that can be looked up. You seem to take things way too personal. My only point about your age is that the
    Reagan era was something that you had to experience to fully appreciate, much like WWII. I know more factual information about WWII than any other historical time frame, but my parents lived through it and that gave them a different perspective. That is all I meant. Have a great Thanksgiving and tell you parents hi. You are a good man and I deeply appreciate your passion even if I don't always agree.

    RC

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  27. I have referenced something you can look up... it's a statistic called "national debt as a percentage of GDP" and it's been available since GDP was calculated -- if you google it, there are some nice graphical depictions of the data.

    Thanks for your vote of confidence, but I'm not too worried about being liked.

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  28. RC, I remember the Reagan era so differently, and I believe history backs up my memory. During those tough years, the numbers of poor people coming to my office in Richardson, TX grew to such an extent that we had to craft an entire ministry to help the staff handle the numbers in need. And that city was an affluent N Dallas suburb.

    Then, there was Central America. We worked with refugees from El Salvador and Guatamala and Hondurus who were fleeing the death squads of their national governments, governments that the administration supported and helped to keep in power. I wish you could have heard their stories. Remember the religious workers who were executed on several occasions, including American nuns?

    And, as someone already mentioned, the Reagan rule ushered in the 20th Century version of the Gilded Age during which time the gap between rich and poor grew beyond belief. I would argue that the unrestricted markets that almost brought us down last fall, not unlike 1928-29, began with Reagan. Supply side economics and the trickle down philosophy was once referred to as "voodoo economics" by none other than Pres Bush 41--he was correct.

    Reagan was a media genius and he pumped up the patriotism. So, if that is what makes a President great and effective, I suppose he was at the top of the list.

    I reserve comments on Mr Carter until another time.

    BTW--one last point, and I suppose it depends on where you work and with whom, but Reagan invented the myth of the welfare queen in the pink Cadillac, admittedly a fabrication, but one that got wings in media, a portent of the current web and cable-based lunacy.

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  29. Those who defended Reagan on his thread did not respond to my central point: Reagin promised that his approach would lift all boats, thus reduce the numbers of people in poverty. This did not work, and the numbers in poverty grew through Reagan (and Bush). Their promise did not come true. They were wrong!

    Compare the Reagan approach to the statistics from LBJ's approach -- the actual number of people in poverty declined.

    That was my point.

    Randy Mayeux

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  30. I want to go back to the original question by c hand: Why do "so few physicians...accept patients covered by the ... very good plan?" and why do patients with these plans have to wait for care?

    Medicaid IS a very good plans from the perspective of its benefits, that is, what it will pay for. It is very generous in that respect.

    The reason docs dont "accept patients" (actually it is the insurance that many dont accept...) is that Medicaid's reimbursement does not even cover most docs' costs for the services.

    And if Congress doesnt repeal a Medicare reimbursement cut of 21% that is set for Jan 1st, the same access problems will worsen for the elderly that already happen for the poor.

    The fix is counter-intuitive: increase both the number of people covered and the doc rates for both programs, so that access is easier and happens sooner in the course of a disease, so that the cost of each episode goes way down -- and therefore so does the total cost to taxpayers...

    Unfortunately since it is counter-intuitive, many policymakers have a hard time grasping this reality...

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  31. FYI to readers: Dr Jim Baker is the leader of MetroCare Services here in Dallas, the public provider of mental health serives in the city. He now what he's talking about. I'm thinking of posting his comment on a page of its own!

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