12/15/24

 Sunday, December 15, 2024

D+40

1939 "Gone With The Wind" premiered in Atlanta (Best Picture 1940, inflation not adjusted highest-grossing film of all time)

1952 Christine Jorgenson was the first known American to undergo a sex-change operation

1973 American Psychiatric Association declared homosexuality is not a mental illness

In bed at 9, awake at 4:15, thinking of Andy, Lilly, my Dad, heartache, up at 4:38.    

Prednisone, day 215, 7.5 mg., day 30.  Prednisone at 4:40.  Missed regular meds,  Empty pill boxes.  

LTMW I see that downy woodpeckers and house finches don't play well together.  A pair of downys are feeding, one on the suet cake and the other on the sunflower tube.  They won't let the finches who are waiting in the nearby bushes and atop the shepherd's crook feed while they are.  I look at all the finches gathered here this morning and remember the finches I fed on the kitchen windowsill of our condo in the Knickerbocker and the trouble I encountered when some feed included corn kernels and attracted pigeons.😱

American Health Care System:  This morning, on Facebook:

You want to hear the craziest thing?  Last year, the United States spent 4.8 TRILLION dollars on health care alone.  That's a tremendous amount.  To put it into perspective, if you took the top ten richest men on the planet and put together all of their net worths, you wouldn't have half of what this country pays for health care in just one year.  Health care spending accounts for something between 15 and 18% of our country's entire GDP, one in every 6 dollars spent in this country is spent on health care.\, far and away more than any other wealthy nation on this planet.  The United States receives the worst health care of any notion on the planet.  In a survey of 10 wealthy nations, the U. S. came in dead last when it came to health outcomes and access to care.second to last when it came to administrative efficiency and equity.  The U. S. came in worst when it came to things like, you know, life expectancy, infant mortality, and diabetes management.  We're spending all this money so where is it going?  It's going to administrative costs.  The U.S. spends more than double the next highest nations in administrative costs.  The money is going to among other devious entities health insurance.  The health insurance industry reported net profits, not gross but net profits of  of 25 BILLION dollars in 2023.  In 2022, while a lot of you were rassling you insulin and your inhalers, CEOs of just 7 health insurers took home 335 MILLION dollars and the health insurance industry has spent 117 MILLLION dollars on lobbying the government to keep the system in place this year alone.  To be clear, they are robbing you, and they are keeping you and the peoole you love the most sick and in pain to do it. 

Annie Lowrey has an essay in the Dececember 14th The Atlantic that is, I guess, supposed to be encouraging though I find it the opposite.  It is entitled "The Health-Care System Isn’t Hopeless."  Excerpts:

The problems are severe, to be clear. Americans spend more on health care than the citizens of any other country, and get less for it. Insurance does not really function as insurance here, in that it fails to shield policyholders from debilitating health-care costs. Premiums are obscene: The average family paid $23,968 for a private, employer-sponsored plan in 2023. So too are out-of-pocket costs. Nine in 10 workers who get health insurance through their job have a deductible, up from six in 10 15 years ago. The average deductible for single coverage is $1,735, meaning that workers need to pay $1,735 of their own bills before insurance kicks in. The government allows family plans to have deductibles as high as $16,100 a year.

As a result of the country’s high out-of-pocket costs and stingy coverage, 41 percent of American adults have medical debt. Hospital bills are a major driver of bankruptcy filings. And many Americans with coverage still skip visits to the doctor and forgo prescription medication because they cannot afford them.

Moreover, the country’s insurers drive up overall health spending, rather than holding it down, as they are meant to. Excess administrative overhead costs the country an estimated $248 billion annually, according to one estimate. The policy analyst Matt Bruenig has noted that in the United States, out of every $100 paid to a private insurance company, just $68 goes to health care. In a single-payer system, such as Britain’s National Health Service, the figure is $87.

The country’s insurers are a major hassle for consumers, as well as employers, hospitals, and doctors. The Kaiser Family Foundation has found that more than half of insured adults experience problems using their coverage every year: having a claim denied, struggling to find an in-network provider, failing to get a timely preauthorization. The sicker a person is, the worse their opinion of their insurance. Insurers also act as a barrier to critical care and necessary medications.

Bernie Sanders and Elizabeth Warren have been championing Medicare-for-All for years with virtually no supporters in our corrupt, best-government-money-can-can-buy government.  It was the principal plank in Sanders' platform when he ran against Hilary Clinton in 2015-2016 and the entire Democratic Party Establishment worked against him.  I was in favor of his proposal then and I am in favor of it now, realizing there would be significant costs to be addressed in abolishing the private health insurance industry.  In any event, Annie Lowrie continued:

There are many beneficial but less disruptive steps for politicians to consider. One would be allowing individuals to buy in to Medicaid, lowering the Medicare eligibility age, or automatically enrolling children in Medicaid, regardless of their parents’ income. Creating a public option, a popular provision struck from the Affordable Care Act, would be another possibility. Millions of Americans prefer Medicare to private insurance: There are out-of-pocket costs and premiums, but they are much lower than in private insurance. And Medicaid, provided to low-income Americans, has extremely limited out-of-pocket spending.

The country could also do what most European countries with private health insurers do: Regulate them much more strictly. Prescribe in greater detail and with greater force what insurers must cover. Set costs and reimbursement rates. Make the insurers compete—really compete—for consumers’ business, with wide provider networks, low overhead, and simple billing programs. Most Americans want to keep the private insurance system; they just want it to work better.

Many Republican health proposals made thus far would do the opposite, and give insurers more power to deny participants’ claims or raise their premiums. But the Trump administration is ideologically heterodox. Elon Musk, perhaps Donald Trump’s most prominent policy adviser, has suggested that the country should make medications like Ozempic widely available at a “super low cost to the public.” Washington could negotiate directly with the drug manufacturers; it could do so for all prescription medications, if Congress wanted it to.

Elected politicians have avoided making any of these changes—because of ideological reasons, fierce lobbying from insurers, or simple inertia. But many of them are popular across the political spectrum. Americans, apparently so fed up with the system that they’re willing to consider vigilante violence an appropriate response, should be calling their reps instead. There are better solutions than a gun, which left one man dead and no sick Americans any better off. 

  

Our Town:  This morning's JSOnline:

A shooting in Milwaukee on Saturday afternoon left one person dead, and a 12-year-old was taken into custody in connection with the incident, according to the Milwaukee Police Department.  At 2:15 p.m., Milwaukee police were dispatched to the 2800 block of N. 51st Street in response to reports of a shooting. The victim, a 32-year-old, was transported to the hospital for treatment but later died from their injuries.  The circumstances leading up to the shooting remain under investigation. Police say the shooting was the result of an argument.  According to Milwaukee Police Department statistics, through Thursday there had been 126 homicides in the City of Milwaukee this year compared to 163 over the same time period in 2023.

The mayor's office and the Police Department will take credit for progress.  

John Updike.  Reflecting the inadequacy of my education, formal and self-directed, and what a poor reader of contemporary (and once contemporary) literature I am, I never knew John Updike was a poet until I came across, and was touched by, his poem Dog's Death in Garrison Keillor's anthology GOOD POEMS.  I brought home the last, indeed posthumous, published collection of his poems appropriately called Endpoint from my visit to the library yesterday.  When Micaela and Dick Kinney visited us the other day, Micaela asked about a book on the table which I said was poems by Edwin Arlington Robinson.  Both she and Dick claimed not to read poetry and I remarked that most of the poetry we see is unintelligible, but there are poems that hit us where we live.  I have copied some of the poems that so hit me in the pages of this journal, Vacillation, Good Bones, Otherwise, Come Up From the Fields, Father, Musee des Beaux Arts, The Second Coming, To a Fieldmouse, Death of a Ball-Turret Gunner, Spring and Fall, and others.  I like what I have read of Updike's poetry.  It is intelligible and thought- and emotion-provoking.  I tried reading one or perhaps two of his "Rabbit" novels years ago but didn't get far.  My Irish Catholic upbringing makes me uncomfortable reading books with so much sex and adultery in them.  You can take the boy out of the Church, etc.  Perhaps I should try again.

  Dog's Death

She must have been kicked unseen or brushed by a car.
Too young to know much , she was beginning to learn
To use the newspapers spread on the kitchen floor
And to win, wetting there, the words, "Good dog! Good dog!"

We thought her shy malaise was a shot reaction.
The autopsy disclosed a rupture in her liver.
As we teased her with play, blood was filling her skin
And her heart was learning to lie down forever.

Monday morning, as the children were noisily fed
And sent to school, she crawled beneath the youngest's bed.
We found her twisted limp but still alive.
In the car to the vet's, on my lap, she tried

To bite my hand and died. I stroked her warm fur
And my wife called in a voice imperious with tears.
Though surrounded by love that would have upheld her,
Nevertheless she sank and, stiffening, disappeared.

Back home, we found that in the night her frame,
Drawing near to dissolution, had endured the shame
Of diarrhoea and had dragged across the floor
To a newspaper carelessly left there. Good dog.