Legalized Theft

When people talk about bringing manufacturing back to the US, they're really talking about health care, whether they realize it or not, whether they care or not. That's just how it is.

And when they debate a "choice" between "Medicare for All" or the "public option," it inevitably comes down to how much it will cost and who will pay for it. All of that avoids the elephant in the room -- how much everything costs. What we laughingly refer to (in Voltaire's "Holy Roman Empire" sense) as the "health care system" is in fact an unholy collusion between HMOs, insurance companies, and pharmaceutical companies, designed explicitly to hoover money out of a captive market, and if need be to hunt down destitute cancer patients and get them on the debt hook of our for-profit carceral state.

With private equity scumbags leading the charge, it's no wonder Wall Street hates Warren and Sanders -- they might actually do something about this evil system. No matter which candidate finally gets the nomination, they'll have their work cut out for them. As I've said for many years now, Wall Street despises Main Street, and this country is literally owned and operated by psychotic billionaires who would rather bankroll Grampa Walnuts another four years to start World War 3, than pay a single percentage point more in taxes -- or hell, even pay the taxes they actually owe right now.

We need another system, not merely a tweak here and there, but a complete rebuild. This doesn't work for most people anymore. It is sadistic, and the playing field is uneven for all but the few who own it. People do not change until they understand that the cost of not changing is greater than the cost of changing, and nowhere is that more true than with the handful of greedy chiselers who own most of everything.

Near as I can tell, there are just two ways to get them to that understanding:  violence, or making them broke. The second option would be preferable for a number of reasons, but may not be feasible since they own all the basic necessities people have to use or obtain, and it is extraordinarily difficult to keep a sufficient number of people attentive and motivated simultaneously.

But that's how it happens, and that's how it changes. No politician, no matter how well-meaning, will ever be able to more than make modest, incremental adjustments to a system that is irretrievably wrong, run by a business model that is literally set up to not provide the service for which it has already been paid, or to finally provide the product at an outrageous markup.

Requiem for a Bush

No doubt we've given Gramma Bush a hard time or two in here at some point, most likely after her Katrina gaffe, but compared to the current group of scumbags within the White House and supporting them in the media, she's a saint. It's not hard to appreciate a tough old bird who knew when to say when, went home on her own terms, and had bourbon at the end.

Having said all that, this classic internets conspiracy theory never fails to make me chuckle.

In Other News

Best wishes to compadre Outis Niemand, as he recuperates from a nasty bout of pancreatitis. These things happen in threes (that just science, folks), so I'll be looking over my shoulder for some time.

Credit Where Due

So after verbally abusing our good friend Poor Ol' Straight Talk the other day, he goes and Does The Right Thing, and even does it in such a way as to screw over his erstwhile compadres. Good for him, and he even gets style points. I'm more than happy to admit when I'm wrong, especially about something that was done with such "fuck you" panache.

I keep saying that this regime is itself an act of defiance, a huge Or what? to all comers, and that the only sensible way to respond is in kind. Well, McCain just proved that theory. What's Yertle gonna do, fire McCain, screw him out of some pork?

McConnell twisted every arm he could, skirted every possible good-faith procedural measure he could, tried to sneak a blank piece of paper through in the middle of the night, and still couldn't get it done. He lost serious juice from this, and so did Clownstick. Nobody respects these mutts -- and worse, nobody fears them. It's too soon to get too optimistic, but this may actually be the beginning of the end already.

Kudos also to Susan Collins and especially to Lisa Murkowski, who has made a point of bucking her party since retaining office as a write-in against a teabagger insurgent in 2012. The Goopers tried to strong-arm Murkowski for her vote on this blank turd of a bill, and she stood up to them. Compare and contrast with the loathsome Huckleberry Closetcase, who made a point of trash-talking the bill before heading in and dutifully eating the shit sandwich.

Like McCain, Graham just got re-elected last year, and therefore has very little risk -- and potentially greater reward -- in sticking to his so-called principles and telling a rapidly imploding clusterfuck of a regime to go fuck themselves in the neck. He's so used to carrying their water [again, that's not water -- Ed.] it's just a habit at this point.

Lucy in the Sky with Footballs

You know, I can admit to a second or two after John McCain's brain cancer diagnosis where it would almost have been tempting to post some nice, ecumenical, utterly meaningless pap about his sacrifice and how we can all come together and hope he "gets well soon" or whatever. And then reality crept back in, and all the memories of McCain's shameless, self-serving opportunism, concealed under the idiotic media-perpetuated rubric of "maverick" came back.

John McCain is a maverick the way Fuckface von Clownstick is a good bidnessman, which is roughly the same extent to which I'm the starting power forward for the Golden State Warriors. I mean, give me a fucking break. McCain's legend, which he ignominiously added to yesterday, is that of the tough "straight talker" tellin' those rascally DC types the hard truths they need to hear.

And again, yesterday was a prime example of this all-talk-no-walk ethos McCain has always embodied in his political career. He had a prime opportunity to walk that talk, once and for all -- fresh into another six-year term, turning 81 in a few weeks, and being diagnosed with an aggressive form of brain cancer, McCain literally had nothing to lose by sticking to his so-called principles. He could quite easily have gone into the Senate chambers, and cornholed that toxic fuckhead McConnell but good, with his non-existent bill. Or he could have just stayed home. Dude has brain cancer and just had eye surgery, and he owes nothing to a guy who taunted his years of torture in Vietnam. The GOP base despises McCain anyway. People would have understood him sitting this one out.

Instead, McCain found a way to be even more cynical than the cynics, pulling some second-rate Aaron Sorkin "bipartisanship" horseshit out of his ass, as if his worthless excuse of a party has ever made an honest effort to work on the ACA, as if the Democrats are just supposed to go along with whatever Princess Snowflake rage-tweets during any given morning dump.

Speaking of which, McCain did essentially the same goddamned thing today, vocally repudiating Snowflake's call to expel transgender military personnel -- except, of course, McCain lobbied forcefully against allowing transgenders into the military in the first place. You can put your next ten paychecks down that should anything on this come up for a Senate vote, McCain will pull yet another hidebound more-in-sorrow-than-anger bromide out of his worthless ass, and then go on ahead and side with his party. Every fucking time. The man is about as rebellious as Pat Boone.

A real rebel would have at least verbally tuned up the vile, hypocritical machinations of the so-called Senate leader, Addison "Mitch the Bitch" McConnell, who has made it a point of pride to devolve into the absolute scummiest operator in the Senate in at least a generation. McCain makes some empty noises and goes along with the party line.

What's even worse, though, is how the legend persists among the putatively liberal media dipshits. Last night on MSNBC (I know, I know) Lawrence O'Donnell and then Brian Williams fell all over themselves with the Poor Ol' Straight Talk encomia, refusing to recognize McCain's usual cynical rhetoric for what it's always been -- a cheap tactic to conceal his routinely party-line actions and votes. McCain has always gotten a break from the media because he's accessible and quick with a funny retort, but when push comes to shove, they never hold him accountable, and never have.

I've seen a lot of folks on the internets wish McCain a swift and painful death lately, things like that. I understand the rage, even if I don't quite agree with it. Seems like it would be a much more fitting punishment for McCain to live another twenty years -- under whatever health-care "plan" he and the rest of the shameless scumbags in his party finally settle on.

The Wrong Question

The health-care racket in this country is of deep and abiding interest to me, primarily in its baroque and blatant superstructure of grift and complicity. It is a scam that barely bothers to disguise itself as such. In fact, I did my master's thesis on health-care incentives in the public and private sectors.

But the reason I don't write much about it in here is because I've said all there is I can muster on the subject. Coming up with new material or observations would be every bit as difficult as trying to come up with more creative reasons why, say, stealing or killing is wrong.

However, as the Democrats continue to muddle through what should be, given its endless ineptitude, a plum opportunity to reframe its message, I offer a couple of suggestions on how to present said message to its putative audience.

The first is simple and gimmicky, but if you think about how you still know what "death panels" are, even as you know they never existed in the first place, you'll be reminded that sometimes cheesy and simple works. The Republican health-care plan, like the Holy Roman Empire, is none of those things, it is merely a massive tax cut with a bit of rouge.

So start branding it as a "wealth-care" plan. Send the minions out to flood the zone with that phrasing, shoehorn it into every possible discussion, tie it into this grasping, pelf-snuffling douchebag currently grifting the country, and ride that fucking pony. The one skill Clownstick has is as a brander, and there's one way to beat him at his own satanic game. Start right now, and by Labor Day, you'll have everyone singing it by heart. Wealth-care plan. Do it, you spineless motherfuckers.

The second suggestion is more difficult, but will help in conceptualizing a better message. The question I keep hearing and reading is this inane debate over whether access to health care is -- or should be -- a "right" or a "privilege." And it's not a useful question, not only because it skirts the issue of who's paying for what, but because it denies the reality of the situation.

Here's the situation in this country:  health care is a product, period. It has producers, distributors, marketers, consumers, and the racket is constructed accordingly. That's not the way it should be, but it is, and has been for a very long time.

Now, the ongoing failure of the Goopers to secure any sort of "victory" in dismantling even the shitty system we have and selling off the parts to the already obscenely wealthy should present an ample opportunity to the, you know, opposition party. Fortunately for them, all they have to do is show some backbone against a cynical, ineptly crafted bill.

But there's an opportunity for more, if we're serious about this "right" vs. "privilege" guff (which we might be, but they are not). It would necessitate the Democrats standing up to their own insurance/pharma/HMO benefactors, which is why it won't happen. But that's where the real debate starts. Everything else is just a bunch of [mimes jerkoff hand motion] bullshit.

The Democrats are in such disarray that less than six months into the worst collection of scumbags to run this country in my half-century of existence, they are actually in dire need of crafting an identity and message that presents a genuine, viable alternative to these soulless cocksuckers. Well, here's a great place to start, especially since constituents have actually been making the effort to show up and be counted -- call it wealth care, and hang it around that fucking turd McConnell's chinless face, and make him dance.

But you also have to describe how, even if the ACA is preserved as is, what steps you take to improve it. It was always understood to be a work in progress, and now is the time to lay out how that progress would take place.

They Ask Questions

I agree with Jim Wright that health care is a right, but people also have the right -- no, the need -- to voice their concerns about being overcharged in the aggregate for said right. But first things first. The sooner everyone starts asking that question of themselves and each other, and comes to the realization that Paul Ryan and his donors are simply trying to ram a tax cut designed as a health care plan not down your throat, but straight up everyone's ass, the sooner we can send the assholes back home and get people in there who might actually say no once in a while to the insurance companies and their goddamned extortion racket.

Man of the People

Goddamn, he's such a fucking child:

Adults understand that while the ACA has its flaws, the intent was to establish a framework that could be tweaked by subsequent sessions of congressional representatives who took their roles seriously. Children, ideologues, and opportunistic assholes say things like Clownstick does in the above tweet. His essential position on this is "rather than work on the flaws and improve the product, let's burn this fucker down and make a new one."

Never mind that the ACA was the culmination of efforts that began in the Truman administration, never mind that their "plan" was a vicious joke, people will die because these fuckers are content to let the ACA twist in the wind and implode. This should clarify to those who might still be wondering whether they are really as horrible as they seem. They're probably worse than you think.

They Ask Questions

Steve asks rhetorically:

Will media dupes ever stop predicting that Trump might govern as a non-conservative?

And of course the answer is no, and of course we all know it. There will always be some professional journamalists out there who need to occupy column inches and/or time in the sainted 24-hour news cycle.

When we plaintively ask what's wrong with the media, this is really the main part of the problem -- the incessant need to fill, constantly, relentlessly, with less and less quality control. The sad and hilarious irony of it all is that the corporate media monkeys keep genuflecting faster and more furiously to the wingnuts douchebags who don't even read them anyway, who show up only to troll and lob impotent threats from the comfort of their couches. Meanwhile, they betray the people who actually do read their reporting and analyses every time they do shit like that.

All real journalism, excepting feel-good kitten-in-a-tree Bart's people type schtick, should boil down to one of two things:

1. Objective reporting of facts and events -- what was done and said, and by whom. Statements that are factually inaccurate should be pointed out; statements that have already been corrected and are still stated as before are called lies.
2. Objective opinions based on facts and evidence at hand, in order to analyze and synthesize the confluence of events and people that occur on a regular basis. There is generally some assumption or expectation of expertise, or at least a higher-than-average level of knowledge about the subject(s) being discussed.

These are modest definitional expectations, and more and more the "media" collectively fail to meet even that bar. Robert Frank's piece that Steve is responding to in the link is basically a textbook version of the "contrarian" clickbait one sees a startling prevalence of these days. Frank seems to be pinning his analysis, such as it is, on past vagaries of Clownstick seeming somewhat "liberal" on some issues (for example, not being a homo-crucifying closet-case fundie, woo-hoo!).

But Clownstick has never indicated any clear opinion on any major national policy issue, if you look back. He feints and bobs and weaves and head-fakes, but aside from wanting to machine-gun the so-called Central Park Five into a mass grave in Central Park and plop a monument to himself over it, he's never really been definitive about much of anything at all. Clownstick's defining characteristic is a sincere belief that he is smarter and better than everyone else, that he's the biggest swinging dick in the room simply because he repeats that he is over and over until the dullards start to believe it. Again, though, no policy opinions or details, on anything, certainly not on the health care system.

As Steve points out, there is absolutely no reason, based on Clownstick's recent history as a campaigner either, and certainly not with his prospective appointments so far, to even speculate that he might be planning to "innovate" the health-care system in any way that would help the most vulnerable. And since it seriously appears that Clownstick does not even read anything that isn't about him, it's entirely likely that he doesn't even know anything about what a clusterfuck of collusion the health-care system is in this country.

And since he's nothing but a cheap two-bit grifter who lives for fleecing suckers and fools, it's pretty much a slam-dunk guarantee that if someone had the time and patience to explain to him how the health-care racket works, Clownstick's only question would be how to get in on some of that for himself.

A Nation of Rackets

Oh look -- in "water is wet" news, costs for simple (yet life-saving) medical devices are usuriously high. SOMEONE SHOULD DO SOMETHING!

EpiPen maker Mylan has become the new boogeyman of the pharmaceutical industry.

Following complaints from consumers that the company had hiked the price of the emergency auto-injector by $100 in recent months for no obvious reason, members of Congress are calling for an investigation. The price has increased 450 percent since 2004, when a dose cost $100 in today's dollars, to its current price of more than $600. Many consumers hadn't noticed the gradual rise in price, however, because the company often only added in 9 to 15 percent each time and insurance companies had made up the difference. But with recent changes in the deductible structure and co-pays for some health plans that have put more of the cost for drugs on consumers, many families have been hit with sticker shock.

So let's see if we have this straight -- a long-standing collusion of profiteering among a triangle of associated industries (pharma, insurance, HMOs) which has any number of congress-critters in their back pockets suddenly has said critters' antennae tingling, even though prices for the Epi-Pen (and any number of devices and medications) have been steadily rising for years.

What You Wish For

The maps and demographics don't lie, and it doesn't matter. Red-state rubes insist on voting against themselves, again and again, and you can never talk them out of it, because rebel-flag-y'all or whatever. So they get what they get, and maybe if enough of them die younger and dumber than they should have, enough of them will be left to finally sit up and take notice.

Or they can go down to the local snake-handler in their state-subsidized Rascals, gobble their gubmint pills, and repeat the chanted mumbo-jumbo. I'll be goddamned if I can find room to care anymore; I am only interested insofar as their pervasive stupidity doesn't infect the rest of the nation.

Cost-Benefit Analysis

The only surprising thing about this story is that AOL is still apparently a going concern. Who knew?

We're going to be seeing more and more stories like this in the years to come, of outsized health care costs being spread around to everyone. This is because the numbers are what they are, politics aside. Five percent of the population accounts for almost half the expenditures, and that's just the start of it. Everything is a hockey stick, as far as tracking proportional usage.

Socializing medicine by definition means that the other ninety-five percent who make up the other half of expenditures are effectively subsidizing those five percent. Meanwhile, the usurious charges and rates have been completely unaffected by the ACA or private insurance plans.

The racket remains intact, and that's the real problem. How does an infant rack up a million-dollar hospital bill? Instead of plugging the book and harping (rightly) on the HIPAA violations, the article practically begs for an itemization of services. Of course, looking at the EOB would also constitute a HIPAA violation. But it would be helpful to all concerned to get a look at how much things cost.

Tim Armstrong may be an overcompensated asshole, and he's almost certainly not taking a hit on his $12m compensation package. No, better to engender resentment among the working dogs by making sure they have a good idea of what's affecting their 401(k) plans. But all that still doesn't mitigate the fact that consumers are getting rooked by the health care industry, that healthy people are being forced to subsidize unhealthy people, that people with coverage are paying ridonkulous costs to cover people who can't pay for their care.

The moral argument is separate from the financial argument; obviously the moral thing to do would be to have -- wait for it -- the single-payer system we were promised before Ted Kennedy died, the Democrats ran a terrible candidate to replace him and lost their supermajority, and Scott Brown fucked everything up. But we got what we got, things cost what they cost, and people who are now having to pay into the kitty are having to adjust their expectations.

There is no solution. Much like being patient with what's left of your political system, hanging your hat on dickless incrementalism and the Lucy's football promise of Real Change, you're going to have to dial down your expectations of just how much socialized medicine will make your life better. Yes, if you need health care but have no coverage and cannot get on a plan through your job, it's great. But the problem has been trying to soft-sell the cold fact to people who do have coverage and don't use it that it's going to come out of their end, instead of making the CEOs and HMOs and the rest of these high-toned assholes share the pain.

(Bearing in mind, of course, that the family in the article had coverage through their employer. That's yet another area where we're getting fucked; I work for the gubmint and I got socked with an additional $200/month taken out of my paycheck for the exact same coverage, that I don't use in the first place. There's my student loan payment.)

In another ten or twenty years, with a little luck and a lot of help, the ACA will be a lot like Social Security is now, almost untouchable by politicians. But its biggest hurdle to overcome, ironically, comes from the fact that you need to convince the people who need it least and are least likely to vote in general -- young people -- to support it. The people who need it and will use it -- old farts and boomers, getting ready to retire and scavenge every fucking dime of Medicare and Social Security they paid in and then some -- are the most likely to vote, and to vote against the ACA, figuring that they already have their fucking ladder, the rest of us can just go find another staircase or something.

It's not a matter of blaming sick people for being or getting sick. Sooner or later, that fate and more awaits us all. It's a matter of who gets stuck paying for it all, and what kind of care they get for their troubles.

Moral Dilemma

Quick question:  is it wrong to secretly hope that the plaintiffs in King v. Burwell -- who, to a person, are just fucking awful excuses for human beings, and are frankly wasting precious oxygen -- die before the rest of us are forced to subsidize their goddamned health care? You want your libertarian paradise, getting out of the system exactly what you paid into it and not a red cent more, here you go.

It's bad enough when you set up a system that forces healthy young people to subsidize the elderly, the infirm, and the shitheads who couldn't be bothered to take care of themselves in the first place. It's even worse when that latter group of doddering oldsters is so fucking ungrateful.

Scott Brown's Legacy

Longtime readers of this here cereal box know that a persistent (if intermittent) theme here, in between all the f-bombs and fat-cat rants, is the idea of possible pasts. Playing the "what if" game is useful as a strategic, speculative pursuit, as it forces us to think about alternative outcomes.

More specifically, it's the notion that fate sometimes turns on a dime, that a seemingly small event can have a catalytic "butterfly" effect on its surroundings. One such example is the death in 2009 of Senator Ted Kennedy, as his passing took place at a critical point in "negotiations" over what would eventually become the Affordable Care Act.

Somehow, the Democrats managed to lose the seat that Kennedy had held for nearly half a century, due to a spectacularly inept and tone-deaf campaign by Martha Coakley. Coakley lost the seat -- and with it, the Democratic supermajority in the Senate to one Scott Brown, a photogenic, amiable doofus that the Republicans seem to grow on trees. Brown proved to be the linchpin in what became the now-standard GOP practice of might be called ABWOW -- Anything But What Obama Wants.

Only in a turgid industry like politics would pure, stupid obstructionism for its own sake be considered a strategy, but that and the constant threat of filibustering is all that has kept the Republicans going since 2009. Brown filled the Senate seat just long enough to force Obama to accept a ham-fisted, loophole-riddled sack of shit whose primary purpose is to hold doors in place on windy days.

Had Kennedy lived even a year longer, chances are that the supermajority could have forced through the public option, the single-payer system that is the standard in every other industrialized nation. Sure, your betters in the corner offices might not get the nine-figure salaries they so richly deserve, but the last five years of impossibly wealthy corporations and owners whinging over every fucking dime would not have happened.

Let's accept as a given that regulatory legislation written primarily by the industry it's designed to regulate is guaranteed to either be useless or more harmful than the situation it's intended to remedy. This was seen as a feature, rather than a flaw, by Brown and his cohort. And now we have what we have, which is another layer of bureaucracy in the IRS, a health-care racket whose pricing structure is exactly as much of a theft mechanism as it ever was, a baroque clusterfuck of industries bloated with lobbyists and marketers, gouging their captive markets and laughing all the way to the bank.

So now this week, we have one of the more bizarre eructations resulting from the ACA. Some dipshit craft store has decided -- based on its own ignorant interpretation of how certain birth-control options actually work -- that it cannot, in good conscience, be party to the IUD holocaust, or whatever it is these overbreeding, Christofascist weirdos call it.

Legalistic and moralistic angels-on-the-head-of-a-pin arguments aside, what sucks about this is that it gives license for any and every business, whether for reasons of mere penny-pinching or for some fanciful interpretation of Bronze Age legends, some bullshit excuse to duck out of something that could and should have been very simple and easy. No, now because someone "believes" something that is empirically not true, they can weasel out of it. Yeah, that's gonna work.

The public option would have worked, and well, because it would have disintermediated all the parasitic middlemen who drive up costs with marketing, admin, and sales. Ask yourself how well your grandmother's cancer was abated by fucking admin.

None of this had to happen. And now Brown is running for Jeanne Shaheen's seat in neighboring New Hampshire, because there is always more damage to do, more precious money to be made. People will die, and other people will go broke, because the health-care system in this country is an abomination, something that should be strapped into an electric chair and fried like an egg.

But as long as Scott Brown and his benefactors continue to make money and make a flawed process even worse, I guess it's okey-doke. I mean, hell, Jeanne Shaheen is just an Obama puppet, and he's evil. Some 80-year-old fart in Nashua said so, so it must be true. Cool, pops, pay for your own fucking bypass, then. Frankly, I have no interest in subsidizing these morons. Talk about doing the impossible for the ungrateful.

Whenever the post-mortem on this country and this species is written, whether it's five or fifty or 500 years from now, the thing our successors will note about us will be exactly what we noted about the previous civilizations we've unearthed, thinking that we've surpassed them with our intellect, might, and technology. That thing is the tendency to be our own worst enemies, to undermine our own rational self-interest for the sake of superficial qualities of glad-handing and smiling contempt. Your mastery of Candy Crush on your smart phone does not make up for not seeing what is right in front of you.

When Mitt Romney smiles, I see nothing but discomfort -- the inner pain of a man who regards the unrich as another species, and does not understand why the customs of this society compel the best and brightest to break bread with such people, to pretend that they like or even comprehend them. For every rich guy with a conscience, there are a hundred Mitt Romneys -- and because they sincerely regard their infestation of the political process as a bulwark against takeover by the rabble, they're the ones that actually run the show.

As always, people who willingly vote for politicians who can barely conceal their contempt get exactly what they deserve.

Cost-Benefit Analysis

Not to read too much into a typical tearjerker type of "news" article, but as we head into the morass of health-care "solutions," you are going to be seeing more and more of these sorts of things, even though they have been there all along.

All the fear-mongering about "death panels" ignores the obvious situation, one that anyone who has had the misfortune of falling into the system knows all too well -- there are already death panels, insofar as there are individuals and groups of people, faceless, distanced from the emotional impact of the situation. They're called insurance companies, HMOs, or in this case, doctors who have to make difficult decisions with scarce resources, and may even be providing less-than-optimal palliative care.

The dirty little secret about health care costs is not really much of a secret at all -- nearly half of all costs are expended on about 5% of the overall population, while half the population use little or no resources of the system at all. (This in itself is something of a potential future problem, as the success or failure of (sigh) health care reform is predicated to a huge extent on what is euphemistically known as "prevention and wellness," part of which is the usual eat-less-exercise-more exhortations, but part of which is getting at least semi-regular checkups. The thing about doctors is that no one visits them until they're already ill.)

Even without knowing all the gnat's-eyebrow statistical specifics, most of us intuitively understand that this is very much an 80-20 deal, that most of the costs and expenditures are being directed at a very small portion of the population. What that hammers out to is that the public ends up subsidizing very expensive procedures for a variety of conditions, some of them catastrophic, some of them chronic, some of them by-products of lifetimes of poor impulse control and decision making.

That is part and parcel of risk-pooling, of the vaunted social compact; we take care of those who need it now, with the understanding that it will eventually be our turn. Of course, as with Social Security, there are groups of people who statistically pay into the system, yet never collect what they put into it -- smokers, drinkers, African-Americans, and other demographics with relatively less-than-average life expectancy. And yet, at some point, somebody -- or somebody else -- has to foot the bill for all these great machines and techniques and doodads and optimized revenue models. We could always look into more efficient systems, but what's the fun in that?

As a kid, I read tons of sci-fi, and watched more than my share of Twilight Zone and such. So I have, let's say, an enhanced appreciation for the somewhat ironic notion that humanity's capacity for technological innovation consistently surpasses its ability to adapt its social systems to accommodate those improvements. We saw this in the recent Iraq War -- wounded military personnel sustained catastrophic injuries that would have killed them instantly even ten years earlier, so they came back to a dead economy with no jobs in the first place, but with the added obstacles of frequently having to relearn how to walk, or use prosthetic limbs, or deal with the psychological trauma of disfigurement, or just being in combat at all.

The comments section in the CNN article is as interesting as it is predictable -- polarized, diametrically opposed camps of "so sorry, gotta let the cripples die" hard-nosed realists and "every life is precious and invaluable" super-idealists. Of course every life has value, of course you want to save everyone. Most importantly, of course we all want to believe that cost is not a consideration, or at best a tertiary consideration. But -- and this seems particularly to be an issue in the organ-transplant arena, where there simply aren't an abundance of suitable matches to be had, thus a scarcity in viable resources -- it is a consideration all the same. If the heart-transplant surgeon has one heart to work with, and two suitable recipients, chances are (all other factors being more or less equal) they'll go with the more viable recipient -- that is, the one that has the best shot at living a longer, more healthy and complete life.

It's easy to slam the "who made these people God" card when it suits them, but when they need someone to remove their kid's brain tumor, that's exactly the sort of person they want nosing around in the hippocampus. In the meantime, these issues of cost and allocation are only going to get more pronounced. Aside from "eat less, exercise more, relieve stress, take up yoga," it's difficult to impart any real advice on how to prepare for it. Don't get sick. Get a better job so you can afford the higher premiums.

If we're not going to address the elephant in the room -- that maybe hosing a captive market with $77 gauze pads and usurious geographically-based pricing models, so that insurance/pharma/HMO CEOs can get the eight-figure salaries they're entitled to, as enshrined in the Bible and ratified in the Constitution, isn't the most efficient way to run a system -- then this is what you get, forever and ever amen. Is anyone surprised by any of this?

Shit Happens

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Unforced Error

Jesus Christ, really? Smooth move, asshole.

Yes, Amanda Carpenter's empty-headed twit-crowing hits the teatard trifecta of being pointless, obnoxious, and inaccurate, but whatever. It's Twitter, home of racists and inbreds. I mean, I should probably start a Twitter account either for this thing or the PTG site, but I'm afraid either one would contract sepsis simply by existing in the same virtual universe as some of these shitbirds. Hell, I'm embarrassed to physically exist on the same landmass as some of these motherless fucks.

But every moment a sociopath like Carpenter spends fucking around on that freak show is a moment where her hand is away from a lever of power, since she's not converting, merely affirming. If she wants to faux-gloat to her choir, great, no need to concern-troll her by literally wishing death upon her children. I mean, I occasionally sweat Donald Trump's insufferable twitardery, and I'm serious when I say he's a douchebag and an asshole, but I don't really care enough to wish harm upon him or his family. Seems like being Donald Trump is probably punishment enough.

It has to be frustrating to be a Democrat at just about any level, with the hyperbole and vitriol at the state and local levels, and the pure, unadulterated scamboogery in the House (which at this point might as well be renamed the Outhouse, because fuck them). But the way to do it -- and still bring Amanda Carpenter's kids into it, if one must -- is to muster some stats, which are in ample supply, and use them in a "more in sorrow than anger" type of screed. Won't fit into 140 measly characters? Even better, make it a multi-post. Done and done.

These are the times that try the patience of sensible people, when serious business is afoot, idiocy runs amok, and the brains of otherwise intelligent folks are left ajar. Fucking get it together already, it's not that complicated. In fact, I stipulate that an effective strategy can be spelled out in three (3) simple points:

1. Health care is a racket that victimizes the poor and enriches insurance companies, HMOs, and Big Pharma.
2. The 20% of GDP we blow on health care is effectively a tax -- and we know how that word gets the teabozos' peckers wagging.
3. There was an election last year -- I fucking swear it happened, it was in all the papers and everything -- and the guy pushing this mess won. When it went the other way under the previous regime, shit went down and people had to just suck it up. That's just how it is in a so-called dumbocracy. Act like it for once, for fuck's sake. Obama needs to just step up and say, "Fuck you, they voted and this is how it shook out. Eat shit and die." What, are they suddenly going to lose respect for him and start obstructing everything and being fucking children? Yeah, wouldn't want that to happen.

I mean, I assume by default that at the federal level, both "parties" are more or less in cahoots, since they have the same donors and are really more alike than different from each other. But at the lower levels, there is actually some daylight between them, and it helps when the minions don't lose their goddamned minds over a smug tweet. Wait and see what kind of legs this thing gets, the CA Dems will have to dump this guy within a week and issue pleas that they didn't really mean it.

America the Lootiful; Or, Detroit Hock City

The estimable Charlie LeDuff has news for all y'alls looking at Detroit's tribulations and having your SMH moment at "those people":

So Detroit files for bankruptcy. What does this mean? Pay close attention because it may be coming to you soon, Los Angeles, Baltimore, Chicago, Philadelphia. In 2011, Moody’s calculated the unfunded liabilities for Illinois’ three largest state-run pension plans to be $133 billion. (It is expected to be even larger this year.) That’s the size of six Detroit bankruptcies — give or take a few hundred million.

Of Detroit’s debt of at least $18 billion, about $7 billion is secured by collateral like casino revenues and utility taxes. That means creditors — big banks — will get paid. Of the remaining $11 billion or so in unsecured debt, about $9 billion is owed to retirees and current municipal workers, people like firefighters and police officers. These debts come in the form of promised pension checks and health care benefits, all backed by a false, unsecured promise. These are the people who are likely to lose out.

And of course, all of these costs are driven by the exorbitant "health" "care" racket. All those public service workers, people who were dumb enough to trust the promises of the system, don't have to be screwed over. But they will. It's just business. And it will be reiterated, many times, many ways, in many cities around the country. Stay tuned, more fun times are ahead.

The Best Health Care System in the World

Congrats to Heath Kufahl, who sunk a basketball from half-court at an OKC Thunder game to win $20K. The catch is that, instead of enjoying the windfall like he should be able to, he gets to spend it instead on what are euphemistically described as his wife's (who has stage 3 colon cancer) "mounting medical bills".

And whatever you do, pay no attention to that doodoohead Steve Brill's plaintive jeremiad on the racket we call our health care system. Why, it can be taken on good authority that the newspaper industry has a higher rate of profitability than the poor ol' country doctor at your local HMO. That must explain why newspapers are doing so well, whilst hospitals are just dying on the fucking vine, everywhere you look.

As I get older and closer to the eventual strike date we all face sooner or later, it gets more and more difficult to be sanguine or find the humor in this sort of obtuse skullfuckery. The facts are these:

• The "health" "care" "system" is a racket, pure and simple. It is and has been a demonstrable collusion of the pharma, insurance, and HMO industries, all of which (especially insurance) are to some degree utilizing a business model which is predicated on not having to provide the services for which they've already been paid.
• U.S. per capita medical spending is twice that of any other OECD country.
• Health care costs are sapping productivity and fucking up the economy.
• The opponents of "Obamacare" are right about one thing -- it changes nothing in terms of what things cost; in fact, it would be no surprise at all to see costs rise for certain procedures and/or demographic groups.

Take admin, marketing, lobbying, and middle-management spreadsheet-optimizers out of the mix, and you'd be surprised at how quickly costs would normalize. No honest observer could scrutinize the tripartite cartel of price-gouging and not come away realizing that a good chunk of health care costs are a complete waste, and that as 20% of the overall US GDP, that, combined with the amount of waste, fraud, and excess we already know is built into the defense procurement and financial services sectors, a substantial portion of the actual economy is just smoke and mirrors.

Churchin' State

Congrats to the Obama administration for once again finding a way to punt on first down in order to placate the usual gabble of intellectually dishonest poltroons. Funny, the Vatican has also consistently decried the US' wars and military actions, yet Catholic tax dollars still go towards blowing up brown people. Also, too, maybe I missed it somewhere along the line, but I don't recall ever hearing about vasectomies being on the, erm, chopping block as far as mandatory coverage is concerned.

Look, when the church demonstrates half the sense of urgency moral dudgeon over its own institutionalized practice of protecting and enabling serial child rapists, as it does over controlling the reproductive rights of its female employees, then we can all be impressed. Till then, this catering to ancient obsessions over ladyparts needs to stop.