Generation Opportunity Prepares College Kids for Future Emergency Room Visits

Posted on November 13, 2013 by wellsdc

"Backyard tailgate party" by tobo [CC BY-SA 2.0], on Flickr

Not pictured: The actual Generation Opportunity tailgate party

I have long suspected that much of the motivation behind opposition to the health insurance mandate aspect of the Affordable Care Act comes from an “It won’t happen to me!“ attitude. I never suspected, however that they would actually go and state it as bluntly as Generation Opportunity did last weekend.

The Koch brothers-funded Generation Opportunity — famous for its series of over-the-top advertisements trying to scare young Americans into not buying health coverage through Obamacare’s insurance marketplaces — took its opposition to health care reform to a whole new level on Saturday. The group threw a tailgate party during the University of Miami-Virginia Tech football that featured flashy cars, drinking games, models, a DJ, and plenty of “educational” material about why young people shouldn’t take advantage of Obamacare.

“We rolled in with a fleet of Hummers, F-150’s and Suburbans, each vehicle equipped with an 8’ high balloon bouquet floating overhead. We hired a popular student DJ from UMiami (DJ Joey), set up OptOut cornhole sets, *beer pong tables, bought 75 pizzas, and hired 8 ‘brand ambassadors’ aka models with bullhorns to help out,” wrote David Pasch, Generation Opportunity’s communication director, in en email to the Tampa Bay Times. “*Student activists independently brought (lots of) beer and liquor for consumption by those 21 and over. Oh yeah, and we educated students about their healthcare options outside the expensive and creepy Obamacare exchanges.”

The line of reasoning, as I understand it, is that college-age people tend to have fewer healthcare needs than older people, and therefore do not need the same level of coverage—therefore, they should not have to have health insurance coverage because Freedom. I suppose one could say my bias is showing, but if even one insurance-eschewing kid at that tailgate had drank too much and, say, gotten alcohol poisoning, fallen and sustained an injury, or crashed a car, our great Socialist state requires emergency rooms to provide them with treatment. Guess who pays for it if the student (or more likely the student’s parent[s]) doesn’t have the cash to cover the tab? I guess it’s our patriotic duty to subsidize liberty-loving college kids’ love of liberty. Or not.

Hell, even insurance-eschewing kids who avoid drinking and all other risky activities could still get hit by a car driven by a less-responsible individual, or even by an entirely-responsible individual who has a car accident for a near-infinite number of reasons. Of course, college-age kids never unexpectedly get sick, or for any other reason find themselves in sudden need of healthcare. Or not.

America: We have raised irresponsibility to an art form.

Photo credit: “Backyard tailgate party” by tobo [CC BY-SA 2.0], on Flickr.

That Other Time the Heritage Foundation Advocated for Affordable Health Care

Posted on October 3, 2013 by wellsdc

The inventory of Creative Commons images in a search for “Heritage Foundation” is rather small, so this is a picture of a jaguar named Khan from the Wildlife Heritage Foundation. How do you not include a picture of a Jaguar named Khan?

The Heritage Foundation, the conservative think tank that has been on the front lines of recent opposition to the Affordable Care Act (a/k/a “Obamacare”). It has not always been so opposed to aspects of the law like the individual insurance mandate, as it rather strongly supported such an idea way back in 1989. As it turns out, its support for various parts of the ACA was in evidence much more recently.

The “universal health care” that many Republicans have recently touted is formally known as the Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986. In short, EMTALA states that hospitals accepting payment from federal programs, including Medicare and Medicaid, cannot deny treatment to a person due to inability to pay or insufficient insurance coverage, if that person is experiencing an acute medical emergency. The government does not directly cover the costs of care required by EMTALA, meaning that the costs either get unloaded as tax write-offs for bad debt, or they are covered by higher hospital costs charged to other patients and private insurers. EMTALA had the best of intentions, but it has had the effect of shifting the costs onto other private actors, not the public. Although the Tea Party has tried, no one has ever seriously argued in recent years that people should not have access to acute care because of a lack of ability to pay. It’s a fundamental human decency thing, at least in my opinion.

The Heritage Foundation generally agreed with these sentiments, i.e. that EMTALA had good intentions but caused many problems, as recently as 2007, and their analysis and recommendations included features now found in the Affordable Care—sorry, Obamacare that they so vehemently oppose all of a sudden. Back in July 2007, John S. O’Shea, M.D., a Health Policy Fellow at The Heritage Foundation’s Center for Health Policy Studies, wrote the following:

The Emergency Medical Treatment and Active Labor Act (EMTALA) is another example of federal legislation that hurts the very people that it was meant to protect: low-income patients in need of emergency medical services. Enacted in 1986, the law is a congressional response to well-publicized cases in which patients were refused immediate medical treatment based on their inability to pay. Continue reading →

Health Insurance is Not Being “Forced on You,” but Your Health Care Might Be Forced on the Rest of Us

Posted on October 3, 2013 by wellsdc

By Thierry Geoffroy (Thierry Geoffroy) [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons The individual insurance mandate originated as a conservative, free-market alternative to the single-payer system, with the significant support of the Heritage Foundation, and it was one of the signature achievements of Romney’s term as MA governor. It acknowledges that health insurance should principally be an individual and family responsibility, not something employers should be required to provide en masse, and it takes into account the fact that a person who declines to obtain health insurance becomes a drain on society when they become sick or injured. Republicans, and conservatives in general, were mostly on board with it until the instant that President Obama supported it.

So please, spare us the “forced upon people” *%#@*!#. People who refuse to obtain health insurance because of liberty, if they are otherwise able to do so, ought to agree in advance to decline all health care that they do not pay for out-of-pocket. Otherwise, they are the drain on society, because many hospital emergency rooms cannot turn them away for inability to pay for services. This means that, if you are in a traumatic accident, have no health insurance, and don’t have enough cash on hand to pay for the emergency room, you agree in advance that you’re probably going to die and the taxpayers are not going to help you. You should probably wear a wristband or something so people will know that you do’t want to participate in the social contract.

Here’s the thing, though. If a person refuses to obtain insurance because they think that the individual mandate infringes upon their freedom to do…..whatever it is they think is being infringed, I would still support them receiving medical care in the emergency room regardless of their ability to pay. I would support this because I am not a monster. I just wish that those people would have the courage of their convictions and agree to risk dying rather than accept the government-mandated healthcare that is (to them) such obvious tyranny.

Photo credit: By Thierry Geoffroy (Thierry Geoffroy) [CC-BY-SA-3.0], via Wikimedia Commons.

That Time the Heritage Foundation Promoted the Individual Mandate, Citing “an Implicit Contract Between Households and Society”

Posted on October 2, 2013 by wellsdc

If you have the means to purchase insurance for yourself, but refuse to do so because freedom, the taxpayers of the U.S. will foot the bill to treat you for catastrophic injuries, because we are fundamentally a decent people. Don’t take my word for it, though. The Heritage Foundation said so back in 1989, when its Director of Domestic Policy Studies, Stuart M. Butler, Ph.D., promoted the idea of an individual health insurance mandate:

Many states now require passengers in automobiles to wear seatbelts for their own protection. Many others require anybody driving a car to have liability insurance. But neither the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement. This mandate is based on two important principles. First, that health care protection is a responsibility of individuals, not businesses. Thus to the extent that anybody should be required to provide coverage to a family, the household mandate assumes that it is the family that carries the first responsibility. Second, it assumes that there is an implicit contract between households and society, based on the notion that health insurance is not like other forms of insurance protection. If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate but society feels no obligation to repair his car. But health care is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services – even if that means more prudent citizens end up paying the tab. A mandate on individuals recognizes this implicit contract. Society does feel a moral obligation to insure that its citizens do not suffer from the unavailability of health care. But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself.

(Emphasis added.)

Here’s a PDF copy of the lecture (source), in case the HTML page goes away.

Photo credit: By Stuart Butler [CC-BY-SA-2.0], via Wikimedia Commons.

There Might Be Beaver Exudate in Your Yogurt

Posted on August 14, 2013 by wellsdc

Via Wikimedia Commons

You’ve probably never heard of castoreum, which Wikipedia defines as:

the exudate from the castor sacs of the mature North American Beaver (Castor canadensis) and the European Beaver (Castor fiber). Within the zoological realm, castoreum is the yellowish secretion of the castor sac in combination with the beaver’s urine, used during scent marking of territory. Both male and female beavers possess a pair of castor sacs and a pair of anal glands located in two cavities under the skin between the pelvis and the base of the tail.

Why do I mention this? Well, according to the natural-products company Conscious Box, castoreum is commonly used as a food flavoring. Continue reading →

Signal Boost: Kurt Eichenwald on “the Murderous Cruelty of Conservatives”

Posted on July 16, 2013 by wellsdc

Vanity Fair published a column yesterday by Kurt Eichenwald entitled “My Family, Our Cancer, and the Murderous Cruelty of Conservatives,” in which he recounts his wife Theresa’s struggle with breast cancer, the top-shelf medical care she received, and the fact that many Americans have no chance at all of receiving remotely similar care. He lays this right where it belongs, at the feet of Republicans (and their occasional blue-dog Democratic allies), who refuse to support health care measures that nearly every nation in the industrialized world now takes for granted, and who refuse to acknowledge the impact their policies have. The whole article is excellent, but here are a few quotes that stuck out for me:

Many Republicans, either out of self-delusion or deceit, deny they are causing any such thing. But there is no question that, in their obsession with zygotes, embryos, and non-viable fetuses as part of their supposed pro-life stance, they are effectively murdering real, walking, talking women—mothers and daughters, grandmothers and sisters, all sacrificed on an altar of Pecksniffian hypocrisy and contemptible disregard by people who have the insurance, connections, and available health care to feel certain their politics won’t kill their loved ones. Perhaps Theresa and I are re-directing our anger from the cancer, but so be it; our rage has focused on the financially comfortable, morally blind, and arrogantly self-righteous who tyrannically conspire to rob poor women of years of life they might otherwise have. It is for this reason that Theresa is willing to disclose her condition, in hopes that, in doing so, we will help highlight how politicians are blithely choosing to kill women who are not as fortunate as she is.

And this:

Like a boy trying to justify what he wants to believe, rather than forming belief around demonstrable facts, the Texas legislators and their mostly G.O.P. counterparts around the country aren’t making arguments. They’re just saying things based on a woeful ignorance of the issues involved.

And this:

Since you don’t understand the issue beyond your desire to limit abortions, Rep. Laubenberg, let me put the meaning of what you have done in clear terms: through your ignorance or incompetence or general lack of interest in the well-being of people who don’t look like you or have your size bank account, you will be responsible for the deaths of untold numbers of Texas women. You, Rep. Laubenberg, will be a murderer, no different than some street punk who shoots up a liquor store. His weapon is a gun; yours, a smug satisfaction with your limited understanding of health policy. If Theresa and I were among the rural poor, she would now almost certainly be one the many people you would kill as a result of her inability to gain access to breast screenings. And for that, you deserve not only our contempt, but the contempt of every decent human being with the humility and intelligence to recognize the impact of the legislation you have “written,” yet aren’t bright enough to understand.

Health, Preventive Surgery, Boobs, and Other Things That Are None of My Dang Beeswax

Posted on May 15, 2013 by wellsdc

Via thesuperficial.com

I gotta run. They’re doing a breast reduction on 3, and I want to get up there to try and stop it. You know what I’m talkin’ about!
Todd, Scrubs season 2 episode 15, “His Story”

So about Angelina Jolie’s preventive double mastectomy. The reaction seems to range from “this is none of my business” to “how very brave of her” to “NOOOOOOOOO, BOOOOOOOOOOOBS!!!!!!!!!” To one degree or another, these are all fair reactions.

None of My Business: This is by far the best reaction, because people’s personal medical decisions should be just that—personal. Still, Angelina Jolie has lived much of her life in the public eye, and whether she likes it or not, people will take notice of her decisions.

Courage: Angelina Jolie is not like most famous people in Hollywood. I’ve never quite been able to put what I mean in words, and I’m not sure anyone else has either. She is beyond doubt a talented actress and an all-around good human being, but she brings something to all of her movies that overpowers everyone and everything else on screen. This manages to make even her not-very-good movies (e.g. Taking Lives) memorable, and makes her the most noticeable part of movies where she plays a bit part (e.g. Sky Captain and the World of Tomorrow.) Even when she’s doing something silly, people take notice en masse. It’s a unique combination of beauty and gravitas, for lack of a better description.

This makes her an ideal spokesperson for various causes, and she can’t seem to help but be a role model. Of course, much of the media attention she has received over the years has focused on her lips and other……attributes. She is and will still be a phenomenally beautiful woman, but there is a bold element to her decision. She may or may not have intended this, but she is basically daring people to assess whether this will affect her entertainment career.

Her mother died of cancer in 2007. She had an eighty-seven percent chance of developing breast cancer, a chance which is now much lower. She has six children, all of whom now have a greater chance of seeing their mother grow old.

Boobs: Let’s just say it. Angelina Jolie had fantastic breasts. I think it is okay to lament the world’s loss, given that it was, is, and will aways be a breast owner’s decision what to do with them. We may think of this as the loss of a great American treasure, but it is not the same as, say, the loss of the Old Man of the Mountain. That was a public trust. These were somebody’s body parts. Let us say no more about them, except to celebrate someone’s courage to take whatever control she could of her own health.

Wait, There’s More! Joe Patrice at Above the Law has a piece on the gene that led to Jolie’s decision, BRCA1. The only test capable of detecting the gene is patented, and therefore very expensive. This means that people like Jolie, who have resources, can get the test, while millions more cannot. Even after the Affordable Care Act takes full effect, “grandfathered” plans may not have to provide coverage for the test. This may change, though, when the U.S. Supreme Court rules on the issue of the patentability of human genes in a few months in Assoc. for Molecular Pathology v. Myriad Genetics, Inc.

And a Little More: It is impossible to Google Angelina Jolie’s name without quickly venturing into NSFW territory. Here’s an NSFW GIF of her taking off her shirt. Thanks for reading my blog.

Depression, in Pictures

Posted on May 14, 2013 by wellsdc

Depression is impossible to describe in words. Any attempt to convey the experience in words ends up sounded clichéd. I have had the opportunity to try to explain my experiences in images in “The Depression Chronicles,” but the best portrayals of life with depression that I have ever seen have come from Allie Brosh, who writes the webcomic Hyberbole and a Half.

In October 2011, she wrote a post called “Adventures in Depression,” in which she described how she fell into a deep period of depression, with the attendant immobility and self-loathing. Her post captured the way someone suffering from depression can recognize the purposelessness of it, while remaining powerless to do anything about it.

She goes on to describe how her depression “got so horrible that it actually broke through to the other side and became a sort of fear-proof exoskeleton.”

Then she basically disappeared from the internet for over a year.

She returned the other day with a follow-up post, “Depression Part Two,” that offers perhaps the best analogy for depression I have ever seen.

I remember being endlessly entertained by the adventures of my toys. Some days they died repeated, violent deaths, other days they traveled to space or discussed my swim lessons and how I absolutely should be allowed in the deep end of the pool, especially since I was such a talented doggy-paddler.

I didn’t understand why it was fun for me, it just was.

But as I grew older, it became harder and harder to access that expansive imaginary space that made my toys fun. I remember looking at them and feeling sort of frustrated and confused that things weren’t the same.

I played out all the same story lines that had been fun before, but the meaning had disappeared. Horse’s Big Space Adventure transformed into holding a plastic horse in the air, hoping it would somehow be enjoyable for me. Prehistoric Crazy-Bus Death Ride was just smashing a toy bus full of dinosaurs into the wall while feeling sort of bored and unfulfilled. I could no longer connect to my toys in a way that allowed me to participate in the experience.

Depression feels almost exactly like that, except about everything.

[Emphasis added, and pictures omitted.] Seriously, go read the whole post. The pictures are the key, but I don’t want to copy too many of them here.

Depression has social stigma, to be sure, but the difficulty goes beyond that. Even if you don’t have a sore throat, or have never had a sore throat somehow, you can probably imagine the difficulties faced by someone with a bad case of strep throat. Everyone has bad moods, or gets in funks, but not everyone (most people, actually) have difficulty relating to a major depressive episode. I doubt that my experiences even remotely compare to those described in Brosh’s posts.

Clark, a blogger at Popehat, calls depression a color most people cannot see:

Depression is hard to talk about. I don’t mean “there’s a social stigma to it”, although that’s true. I don’t mean “modern society calls minor mood swings ‘depression’ and medicates them with lifestyle drugs, so the depths of true depression are hard to convey to someone”, although that’s also true.

I mean that depression is a color, and people who haven’t experienced it are color blind to its hue. There are no words to bridge the gap, to make it clear.

Much like Clark, I cannot add any words of real wisdom to what Allie Brosh has to say about her experiences. She faced the prospect of suicide and, for reasons that may not make sense to many, and that I wish did not make sense to me, is still here. I am very grateful for that.

If you need help, or know someone who does, help is out there: National Suicide Prevention Lifeline, 1-800-273-TALK (8255).

Photo credits: All pictures are by Allie Brosh [CC BY-NC-ND 3.0 US].

In the Battle of States’ Rights Versus Poop, Poop Won

Posted on April 27, 2013 by wellsdc

772355_38434700 Yes, the U.S. Supreme Court once considered the question of whether a state government could prohibit the importation of solid or liquid waste from across state lines, and concluded that no, it cannot. (I may have exaggerated a little in my title when I implied that the case was just about “poop,” but you’re reading now, aren’t you?) I came across this fun decision during a work-related Googling. It is amazing the things you find.

Anyway, Philadelphia v. New Jersey, 437 U.S. 617 (1978), caught my eye, because why would the city of Philadelphia be suing the state of New Jersey? In the 1970’s of all times? It turns out that New Jersey had a law that “prohibit[ed] the importation of most solid of liquid waste which originated or was collected outside the territorial limits of the State…” Id. at 618. Quite a few private landfills in New Jersey and cities outside of New Jersey had business arrangements, in which those cities shipped their trash to New Jersey. I’m lazy, so just make your own New Jersey jokes here. I’ll wait.

Those private landfills and non-Jersey cities were not too happy. The landfills didn’t like losing business, and the cities didn’t like not being able to ship their effluvia to New Jersey (I’m paraphrasing Justice Stewart’s recitation of the facts, but I imagine the mayor of Philadelphia raging about not understanding the point of being so close to New Jersey if you can’t dump your crap there. Al Pacino is playing the role of the mayor in my imagination. It’s some awesome scenery-chewing.) So they sued the state of New Jersey for violating the Commerce Clause of the Constitution.

Typically, when you hear the term “states’ rights,” you either think of segregation or the Tenth Amendment. More jurisprudence related to what states can and cannot do, or what the federal government can or cannot make states do, derives from the Commerce Clause and other provisions nearby. In this situation, rather than a federal government that, depending on how you look at it, was either the source of or the last bastion against tyranny, private businesses were suing their own state, and municipal governments were suing a foreign (i.e. different) state. It doesn’t quite fit the standard “states’ rights” rhetorical model, but it does bring up a good question: does a state government, ostensibly of, by, and for its people, have the right to keep other people’s garbage out?

Short answer, no. If you’ve read this far but would really rather be off elsewhere eating a Hot Pocket, you may go now. Continue reading →

A Black Dog Named Depression

Posted on March 4, 2013 by wellsdc

If you struggle with depression, or if you are struggling to help or understand someone who does, you owe it to yourself to watch this video:

Cryptic Philosopher

Everything on this Site is a Figment of Your Imagination

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