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This is What Democracy Looks Like

Weekend Madman

Friday-Sunday, February 9-11


I won't be writing anything for Weekend Madman. It will be the first time I haven't published my own thoughts since Madman's inception in November, 2004. Originally I was going to comment on John Edwards health care Plan from his website www.JohnEdwards.com. (To read the plan in its entirety, go to http://johnedwards.com/about/issues/health-care-overview.pdf.) That was before Robert Scardapane forwarded Paul Krugman's New York Times column "Edwards Gets It Right" to me. Krugman, more eloquent than I could ever be gets "It" right as well. You can read his comments below.

It is still my belief that a Single Payer Universal health care Plan comes when our system of legalized bribery - pay-to-play lobbyists - comes to an end. This Edwards Plan deserves consideration and he deserves to be applauded for stating more than "We need to do something about the rising costs of health care in this country."

First, Arthur Cheliotes puts what is wrong with President Bush and the party of his "base" of "haves and have mores" in perspective with a Communications Workers of America article in the lead: "Study: U.S. One of the World's Worst Countries for Family/Medical Leave". Arthur Cheliotes is President of CWA Local 1180.

Closing tonight's issue will be an interesting health care tale from Rhian.

These will be the only three articles tonight.

-Noah Greenberg

Study: U.S. One of the World's Worst Countries for Family/Medical Leave

Just as Big Business is getting revved up to go after Americans' meager Family and Medical Leave benefits, a university study of 173 countries shows that the United States ranks as one of the worst for providing leave for illnesses, new babies and family emergencies.

"When it comes to ensuring decent working conditions for families, U.S. public policies still lag dramatically behind all high-income countries, as well as many middle- and low-income countries," say the authors of "The Work, Family and Equity Index: How Does the United States Measure Up?"

The United States, for instance, is one of only five countries out of the 173 that don't guarantee paid maternity leave. The four other countries that don't are the African nations of Lesotho, Liberia and Swaziland and the Pacific island nation of Papua New Guinea.

The newly released research, from Harvard and McGill universities, also finds that:\
-At least 145 countries require that employers provide paid sick leave, with 127 of them guaranteeing at least a week of sick time.
-Unlike the United States, 137 countries require paid annual leave, with 121 of them guaranteeing at least two weeks.

The study comes as the U.S. Labor Department is wrapping up a comment period that could lead to devastating changes for workers in the 13-year-old Family and Medical Leave Act, the first bill signed by President Bill Clinton.

CWA and other unions are fighting to save the law. FMLA provides only unpaid leave and many employers make it difficult for workers to take any time off. Yet the business lobby and its Republican backers want to make it even harder for workers to use the law.

More than a hundred CWA members responded recently when the union asked who had used the law and how they felt about it, comments that are being included in CWA's response to the Labor Department.

Members pleaded with CWA and the DOL to save the law, saying it had changed — and even saved — their lives, or allowed them to take care of sick or dying family members. One member said FMLA gave her time to see doctors and specialists who ultimately cured her severe migraine and eye problems. "Without FMLA, my life would not be what is today," she wrote.

A telecom member, with an ill son, a dying grandmother and her own health problems said she fears she would be "fired and forced on to the systems of welfare and Social Security" without FMLA protection.

For updates on the FMLA review process and a link to the McGill University report on family leave worldwide, go to www.cwa-union.org.

-Forwarded from the Communications Workers of America by Arthur Cheliotes, President, CWA Local 1180

Edwards Gets It Right

What a difference two years makes! At this point in 2005, the only question seemed to be how much of America’s social insurance system — the triumvirate of Social Security, Medicare and Medicaid — the Bush administration would manage to dismantle. Now almost all prominent Democrats and quite a few Republicans pay at least lip service to calls for a major expansion of social insurance, in the form of universal health care.

But fine words, by themselves, mean nothing. Remember “compassionate conservatism?” I won’t trust presidential candidates on health care unless they provide enough specifics to show both that they understand the issues, and that they’re willing to face up to hard choices when necessary.

And former Senator John Edwards has just set a fine example.

At first glance, the Edwards health care plan looks similar to several other proposals out there, including one recently unveiled by Arnold Schwarzenegger in California. But a closer look reveals extra features in the Edwards plan that take it a lot closer to what the country really needs.

Like Mr. Schwarzenegger, Mr. Edwards sets out to cover the uninsured with a combination of regulation and financial aid. Right now, many people are uninsured because, as the Edwards press release puts it, insurance companies “game the system to cover only healthy people.” So the Edwards plan, like Schwarzenegger’s, imposes “community rating” on insurers, basically requiring them to sell insurance to everyone at the same price.

Many other people are uninsured because they simply can’t afford the cost. So the Edwards plan, again like other proposals, offers financial aid to help lower-income families buy insurance. To pay for this aid, he proposes rolling back tax cuts for households with incomes over $200,000 a year.

Finally, some people try to save money by going without coverage, so if they get sick they end up in emergency rooms at public expense. Like other plans, the Edwards plan would “require all American residents to get insurance,” and would require that all employers either provide insurance to their workers or pay a percentage of their payrolls into a government fund used to buy insurance.

But Mr. Edwards goes two steps further.

People who don’t get insurance from their employers wouldn’t have to deal individually with insurance companies: they’d purchase insurance through “Health Markets”: government-run bodies negotiating with insurance companies on the public’s behalf. People would, in effect, be buying insurance from the government, with only the business of paying medical bills — not the function of granting insurance in the first place — outsourced to private insurers.

Why is this such a good idea? As the Edwards press release points out, marketing and underwriting — the process of screening out high-risk clients — are responsible for two-thirds of insurance companies’ overhead. With insurers selling to government-run Health Markets, not directly to individuals, most of these expenses should go away, making insurance considerably cheaper.

Better still, “Health Markets,” the press release says, “will offer a choice between private insurers and a public insurance plan modeled after Medicare.” This would offer a crucial degree of competition. The public insurance plan would almost certainly be cheaper than anything the private sector offers right now — after all, Medicare has very low overhead. Private insurers would either have to match the public plan’s low premiums, or lose the competition.

And Mr. Edwards is O.K. with that. “Over time,” the press release says, “the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan.”

So this is a smart, serious proposal. It addresses both the problem of the uninsured and the waste and inefficiency of our fragmented insurance system. And every candidate should be pressed to come up with something comparable.

Yes, that includes Barack Obama and Hillary Clinton. So far, all we have from Mr. Obama is inspiring rhetoric about universal care — that’s great, but how do we get there? And how do we know whether Mrs. Clinton, who says that she’s “not ready to be specific,” and that she wants to “build the consensus first,” will really be willing to take on this issue again?

To be fair, these are still early days. But America’s crumbling health care system is our most important domestic issue, and I think we have a right to know what those who would be president propose to do about it.

-Paul Krugman and the New York Times, as forwarded by Robert Scardapane

Will That Be Cash or Charge?

While my two daughters were trying to rescue a cat from their dog, they were both bitten. It was a feral cat, being fed off the deck of a neighbor, along with dozens of other cats, and skunks.

They didn't need stitches, or anything but cleaning of very small wounds, but the doctor at the emergency room advised the rabies series, because once rabies symptoms present, it's too late for treatment and rabies cannot be detected in a blood or urinalyses. I agreed and they each got four shots that day. The other 8 were given over the course of 10 weeks.

The total bill for this, not including the doctors charges, was $28,000. Lab work charges were reasonable.
Hospital charges were reasonable. The charge for the actual serum was close to $1500 per dose.

If this does not speak volumes about the greed of the pharma companies, I don't know what would.
It might be safe to say that they are more corrupt than Exxon, who posted the highest net profit earned by a corporation ever, in 2006.

The doctor never mentioned during his spiel about rabies and potential death from rabies, that I would be facing a bill of this size, nor did he offer to take care of it in his clinic, to save some money. When I called the hospital to see if there was some mistake, the girl on the phone asked casually if I would like to put it on my Visa. (There were supposed to have billed IHS insurance.)

I keep wondering which CEO actually needed $4 million in wages in 2006, and who else got to line his pocket besides me. The greed of the few is staggering.


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-Noah Greenberg