Archive for the ‘Obamacare’ Category

Annals of Unemployment, Part 5: Kafka’s Castle

June 6, 2014

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Last November I went to the Covered California website to look for health insurance on the exchange. I was told that I qualify for Medi-Cal, California’s version of Medicaid, under the new rules. I filled out the application on the website and submitted it. I was told that my application would be forwarded to the Department of Social Services. I waited a few weeks without hearing anything. I called my caseworker at DPSS and asked her about it. She said that the new rules didn’t go into effect until January 1, and I wouldn’t hear anything until then. So I waited. January 1 came and went. In the middle of January, I called my caseworker. She told me that they were still waiting for instructions from the federal government. Until then, they couldn’t do anything. I would just have to wait until I heard from them.

I waited a few weeks. I called my caseworker again, and she told me the same thing. In late February, I looked at the Covered California site again. It did not say that my application had been approved. I called my caseworker, but she was out of the office. So, I called the DPSS’s information line. I gave the operator my case number. He said that they had never received my Medi-Cal application. I told him that I had applied through the CC website. He told me I should try calling them. So I called Covered California. The person there told me that my application had been forwarded to the DPSS.

So I downloaded another application, printed it out, and filled it out by hand. I then put it in an envelope and wrote my case number and my caseworker’s name on the outside. I then went to my local DPSS office and put it in the mail slot. Several days later, I received a letter from my caseworker saying that she needed proof that I was receiving unemployment benefits, as well as a copy of my driver’s license. So I sent those to her. I waited a while, and then I called her. She said that my application was “pending” and that they would contact me when it was approved. I waited a couple of weeks and called her again. She said that my application was still pending. This went on through March, April, and most of May. A couple of weeks ago, I called my caseworker. A different woman answered the phone. She told me there was something in the computer system that was blocking my application from going through and that they were working on it. After I hung up, she called me back and said that she needed proof that I was receiving unemployment benefits. She gave me a fax number. I had already given this information, but I decided not to argue with her, so I faxed it to her. The next day she called and said that my application had been approved. She said that I would receive my Medi-Cal card within a week.

A week later I received a plastic card in the mail. On it was printed, “State of California Benefits Identification Card”. On the back, it said, “This card is for identification ONLY. It does not guarantee eligibility.” This didn’t sound encouraging to me. I called my caseworker. The woman I had talked to the week before answered the phone. When I asked her about the card I had received, she said that was my Medi-Cal card. When I asked her when would I receive instructions on how to use it, she said that I didn’t need instructions, I just had to show the card to my medical provider. When I asked her if I could get a list of physicians who accept Medi-Cal, she told me I would have to “research” that myself. She said they would eventually send me a list, but they couldn’t do it now.

Today, out of curiosity, I looked at my account on the DPSS website. It said that my Medi-Cal application had been DENIED. What the hell??? I immediately called my caseworker. This time, a third woman answered the phone. When I told her my case number, she said that my Medi-Cal application was still pending! When I asked why the website said that my application had been denied, she said she didn’t know. She said that my regular caseworker will be in tomorrow, and she will have her call me.

It is now June and I still don’t have the coverage that I was supposed to receive back in January. If I had become seriously ill during this time, I would have been screwed.

Yeah, Obamacare is a huge success, ain’t it?

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Obamcare’s Tiny Dent

April 10, 2014

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President Obama and his supporters are crowing about how 7 million people have signed up for health insurance since Obamacare inched rolled out. This number sounds impressive, until one thinks about what it actually means. Writing in Firedoglake, Jon Walker tells us:

    Not all 7 million who have selected a plan on the exchange will actually get coverage because they won’t follow through with paying their premiums. Sebelius said about 80-90% of people who have signed up so far have actually paid their first premium. If we assume roughly 15% of people won’t fully complete the process the roughly 7 million signups should translates to about 6 million people actually being covered by exchange policies this year.

The Los Angeles Times, on the other hand, tells us that 8 million people have “gained coverage” since last September. For the sake of argument, let’s take the Time‘s more optimistic figure of 8 million. (It’s not clear whether all of these people were uninsured before. For the sake of argument, let’s assume they were.) According to all the sources I’ve consulted, the number of Americans without health insurance before Obamacare seeped rolled out was around 44 million. That would mean that there are still about 36 million uninsured Americans. So, even when we make the most optimistic assumptions, it is still clear that Obamacare has been a failure.

Ah, but we live in the Age of Public Relations, in which every failure can be presented as a success. So we are told, for example, that the Iraq War was a success, even though, by every objective standard, it was a failure.

Single payer is the only way to solve the health care crisis in this country.

Obamacare Walks Among Us

March 27, 2014

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Last November, I applied for Obamacare using the Covered California website. I was told that I qualified for Medicaid under the new rules of the Affordable Care Act (ACA). Medicaid is a federal program. However, in keeping with our nation’s passion for inefficiency, it is administered through the states. In California, it’s called Medi-Cal. Every time I call the Los Angeles County Department of Social Services about my application, they tell me that my Medi-Cal is “pending”. They say this is because they are still waiting for instructions from the federal government. The new Medicaid rules became effective on January 1st of this year. It’s nearly the end of March, and the federal government still hasn’t told the states how to proceed with this.

Part of me is hoping that the federal government never does tell them what to do. What many people don’t know is that the state governments have the right to demand that people reimburse them for medical treatment that was paid for by Medicaid. The state can actually seize a person’s assets to do this. Cute, huh? And you thought that Medicaid was a social safety net.

I’ve been told that in California, where I currently live, the state waits until after somebody dies before seizing any of his assets. (Sort of like having your pockets picked by an undertaker.) Apparently, in some states they don’t necessarily wait until you’re dead before they seize your assets. The sign-up site for Medicaid in New York contains this clause:

    I understand that once I get Medicaid coverage, if I am over 55 or if I am in a medical institution and not expected to return home, the Medicaid program may do the following in order to pay for my medical care:
    Take money I already have or that is owned [sic] to me.
    Take money that was made from selling certain things I own
    Take money from people who were legally responsible for me when
    I got benefits.

Nice, huh? Things may be different here in the Golden State, but who knows, our notoriously cash-strapped state government may decide to change the rules at some point.

Because I qualify for Medicaid, I am automatically blocked from applying for subsidized insurance on the exchange. I have been told, however, that I can purchase private insurance at full price. (If I could afford to do that, I wouldn’t have qualified for Medicaid, would I?) Now, here’s a really fun fact for you. Almost half the states have refused to accept the ACA’s expansion of Medicaid. If you qualify for Medicaid and you happen to live in one of these states, you are doubly screwed: not only do you not get Medicaid, but you can’t purchase subsidized insurance precisely because you qualify for the Medicaid that you can’t get. What a brilliant piece of legislation the ACA is! At this point, one has to wonder whether the ACA will significantly reduce the number of uninsured people in this country.

Single Payer is the only rational and humane solution to our country’s health care problems. It is time for us all to admit this.

Obamacare Rolls Out

November 21, 2013

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After hearing all the horror stories about HealthCare.gov, I decided to use California’s exchange site, CoveredCa.com. I must say, it worked well, although it had an annoying habit of asking certain questions over and over again. (I’ve had this problem with websites before. Somebody needs to explain to web designers that it’s only necessary to ask a question once.) Within a matter of minutes I had applied for coverage. Not bad.

So how is it that the State of California, which has its own proud history of corruption and incompetence, was able to do a better job of the roll-out than the federal government was? The Obama Administration had over two years to prepare for this, and they did a lousy job. Perhaps this is a sign that Obama has never really cared about the health care crisis in this country. When he ran for president, he was pressured to come up with a health care proposal, so he opted for an idea that the Republicans came up with to try to derail calls for single payer. No doubt he decided it wasn’t worth the trouble to call for Medicare for All, and besides, that wasn’t what the insurance industry wanted.

Dennis Miller: Human Slime

October 21, 2013

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It would be hard to imagine a more repulsive human being than Dennis Miller. For those of you who don’t know who he is, Miller was a popular stand-up comedian and talk show host back in the 1990’s. (Before most of you were born.) His persona was that of a hip, iconoclastic liberal. In the wake of the 9/11 attacks, however, he opportunistically reinvented himself as a right-wing twit, an advocate of racism, militarism, and imperialism. (Miller was like Christopher Hitchens on steroids.) This worked well for Miller for a time, but then the public soured on the Iraq War, and his career went south. He is now condemned to the purgatory of right-wing talk radio. On a recent episode of his talk show, he gave a small business owner some advice on what to do about Obamacare:

    If for your purposes you have to let some people go, kind of get the office wrangle of who’s an Obama supporter, who’s an Affordable Care Act – and do the right thing. You can’t go on seniority anymore, there’s some people who think this is crap. Fire a believer, they’ll understand. Just say “we’re all in this together, this is what you wanted, I have to let you go. But at least you’ll have health care in the single payer.

Miller then offered advice on how a boss should determine his employees’ views on Obamacare:

    Go out, into the parking lot, if somebody has to be cut to 29 hours, if somebody has to be fired, you know how proud they are, the Obama-Biden bumper stickers in their original permutation they’re still on five years down the road. Clock who they are, as you have to fire people, call those people into the office. Not somebody who doesn’t believe in it, that’s been there two days less than them, that’s the past, that’s silly. You’re doing the right thing, you’re not being mean. Look them in the eyes and say, “You know,this is your thing. I can’t afford you anymore. So at least you know I’m doing the right thing.

(It’s perhaps an indication of how out-of-touch Miller is that he doesn’t mention Facebook here.)

Miller calls himself a “libertarian”. Miller apparently thinks that “liberty” means tailoring your beliefs to keep your asshole boss happy.

Obama Agonistes

July 4, 2013

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Barack Obama and a liberal.

Liberals who talk about what a brilliant political strategist President Obama is are on a par with conservatives who talk about what a great war leader George W. Bush was. Consider the recent incident in which the plane carrying Bolivian president Evo Morales was diverted and forced to land, supposedly because somebody thought Edward Snowden might be on it. What did Obama hope to gain by doing this? (And it’s pretty clear that Obama must have been behind this.) Did he wish to show the whole world that he is willing to trample on international law just to punish a whistleblower? He just made himself look petty and ridiculous.

Or consider Obama’s recent decision to delay until 2015 implementing the requirement of the Affordable Care Act that companies with 50 or more employees supply them with health insurance. One website has hailed this as a brilliant tactical move that will rob the Republicans of a talking point during the 2014 congressional elections. In fact, the decision makes Obama appear weak. Also, it suggests that he lacks confidence in his own much ballyhooed health care bill. And then there’s the obvious fact that this decision is a betrayal of all those people who thought they were going to get employee health insurance in 2014. (I guess they will just have to cross their fingers and hope that they don’t get sick for another year.)

The sequester that Obama foolishly agreed to will likely kill off the weak economic recovery. The president and his party will be blamed for this, and the result will be Republican victories in congressional and local elections. That means more Republican officeholders with their reactionary social views and their anti-labor legislation.

Ah, but nothing can shake the admiration that some liberals have for Obama. Decades from now, liberal historians will be talking about the strategic brilliance of a president who accomplished virtually nothing.

The Health Care Feeding Frenzy

February 24, 2013

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The most recent issue of Time magazine features an article by Steven Brill which deals with the question of why health care costs are so much higher in the U.S. than they are in other countries. Brill shows that it basically comes down to greed: hospitals charge high fees simply because they can get away with it. The logic of the “free market” doesn’t apply to health care. If, for example, you’re in a car accident and your leg gets crushed, you don’t have a choice of whether or not to get medical attention. And you don’t have the luxury of being able to shop around for which emergency room has the lowest prices. (This is an argument that we on the Left have been making for decades. It is satisfying to see a mainstream media outlet finally admit that we are right.)

Brill describes how “non-profit” hospitals rake in enormous profits, so much so that their top administrators can receive multi-million dollar salaries. Medicare, Medicaid, and private insurers use their influence to try to keep costs down, but their efforts don’t apply to the millions of Americans who don’t have coverage. What we’re seeing is a sophisticated form of bottom-feeding: hospitals are gouging the most vulnerable members of our society. Brill is also critical of the pharmaceutical industry. He demolishes their claims that research and development justify the high prices they charge.

Brill gives a spirited defense of Medicare. He shows that it is actually run in an efficient manner. (Hospitals are reimbursed more quickly by Medicare than they are by private insurers.) He is, on the other hand, critical of Obamacare. Among other things, he points out that it will likely lead to higher insurance premiums.

Brill suggests expanding Medicare so that it applies to everyone. This strikes me as the most rational solution to our health care problems.

This article on Obamacare by Doug Henwood is also worth reading.