California is getting busy on Health Care

There is a very positive story in today's L.A.Times, California legislators revive plans to expand healthcare insurance.

The bills would require insurers to spend at least 85% of their earnings on patient care; block insurers from canceling policies of patients who need extensive care; and force them to cover more procedures, such as maternity services.

Over the objections of the major doctor and hospital lobbies, the Assembly approved a measure backed by Schwarzenegger that would require medical providers to publicly reveal their costs and medical performance.

With the insurers already spending 22% on administrative cost, a bill that would protect Californians from being dropped will also hinder influence peddling. With hospital books opened and secrets revealed, in addition to pointing out their administrative waste the uninsured will be be given a chance to renegotiate.

On this Super Tuesday with the upcoming unification of the Democrat Party, this story probably won't get much focus but the details are very good.

This bill, one of more than a dozen health bills that are advancing through the California legislature is referred to as a "first step in health care reform."

"In the aggregate, it could be pretty significant," said Sheila Kuehl (D-Santa Monica), chairwoman of the Senate Health Committee, of the legislation. "I think it's just getting to the point where the opposition has just overreached so badly and the insurance companies' actions have been so egregious that both sides of the aisle are getting fed up with them."

States may be limited in the ability to deal with the medical industry and Bush's Supreme Court may stick a meddling hand into cutting into profits but such a positive measures moving forward in California will have some influence on the national debate. Historically states pave many roads to needed changes and this issue is already red hot with voters.

Health care is doing better than Schwarzenegger's unsuccessful proposals to expand medical coverage and being seen in a more positive light because even Republicans who voted against previous efforts are switching sides. The voters are too fed up for excuses and Republicans trying to stay in office have changed colors and showing a willingness to cut into the insurance profits.

Opposition from insurers, however, is not dissuading Republicans -- a traditional ally of the industry -- from supporting some new restrictions. On Thursday, 12 of 32 Assembly Republicans joined Democrats to require insurers to obtain approval from state regulators before canceling coverage for people who have become ill and submitted medical bills.

That bill, by Assemblyman Hector De La Torre (D-South Gate) is one of three measures the Assembly has passed to address that practice, which has prompted state investigations of -- and in some cases led to fines for -- many of the state's biggest insurers. Those companies include Anthem Blue Cross, Blue Shield, Kaiser Permanente, PacifiCare and Health Net.

A bill that hinders insurance providers from canceling out patients who have become ill could make for an inroad to a national bill that ends that heartless practice altogether.

One paragraph was an extremely upsetting example of the state of the health care system in this nation. Not that there is actually anything resembling a system in this free market of death.

Some GOP lawmakers also are agreeing to expand the type of procedures insurers must cover. Twelve of 15 Republicans joined their Democratic colleagues in the Senate and voted to require insurers to pay for surgery to fix cleft palates, a common birth defect that occurs in one of every 790 babies.

Can you believe this nation? I had no idea that insured families were left to deal with a cleft palate on their own. The story also points out that on May 15 a law was passed compelling insurers to provide "for additional charges, coverage to include the purchase of wheelchairs, oxygen tanks and other durable medical equipment." For additional charges?

And how about a bill that compels insurers to reveal how often they rule that procedures are not medically necessary? Does this whole industry gets to operate behind closed doors, messing with American's lives with no oversight whatsoever? Well, at least in California, the times they are a changing.

If you are a Californian a little positive input may prove very helpful to the rest of us Americans who are still waiting. You know where to go. Please contact the California State Senate and the California State Assembly and tell them how strongly you support health care reform.

Do it for the rest of us that live in states where our representatives still have their heads in the sand.

Medical Coverage: What about Americans between 55 and 64?

This may seem like a luxury problem compared with the 47 million walking around like time bombs to financial ruin or much worse. The words of Pete Stark sums up this nation's attitude toward the people;

“Our nation has more people in jail than anywhere else in the world in its effort to combat crime,” Stark said. “Yet, we allow 47 million people to go without health insurance—which translates into going without needed medical care—each year. It’s time to take action and combat the real killer in our country—the lack of universal health care.”

While there are many reasons the U.S. ranks 45th in life expectancy this unseen group of middle aged Americans contribute to that lowered expectation. A study by Families USA ranked lack of insurance as the third leading cause of death for people between 55 and 64 years.

This is no luxury problem. While this has recently become a personal problem for me since I recently become an American who will be forced to work until my sixty-fifth birthday, I'm not writing about just myself. Since many public and private employers are cutting or eliminating early retirees, many near elderly are in the same boat as I am.


Presently Social Security offers early retirement to Americans at age 62 but no assistance with medical coverage until age 65. At one time employers offered a bridge to Medicare, often from an even earlier age. Now the early retiree who has the money to pay 102% of what their former employer paid has only 18 months of COBRA to fall back on.

With the cost of health care coverage even COBRA deters retirement but if forced into the so called free market by attempting to retire sooner than those 18 months prior to Medicare the near elderly become hostages to health care.

People who want to retire before they qualify for Medicare have to find insurers willing to cover them. They have to pay premiums that for a couple ages 60 to 64 average $9,200 a year, according to a study from the insurance industry. They’ll have out-of-pocket costs of close to $1,500 a year, according to the National Institute of Aging.

The numbers form a roadblock. Teachers, administrators, attorneys, maintenance supervisors and nurses who invested wisely and now want to retire are realizing they have no choice but to wait until they’re 65.

Of course those numbers come from the insurance industry and the burden would surly be even greater. During the 10 years before Medicare eligibility kicks in, those near elderly Americans have other means of dying caused by the profit based American health care market. As Americans of all ages have seen medical coverage become a greater percentage of household income and watched the co-pays and deductibles go so high that some don’t even use the coverage when they should, for the near elderly who have reached that stage of life when multiple visits to the doctor become necessary those mounting co-pays often become an even greater hindrance to continued treatment that younger Americans.

For the near elderly who can no longer do their jobs the only other answer is having Medicare awarded based on disability but the Social Security Administration's definition of disability is far different from the worker's. A person must not only be unable to do his or her previous work but cannot engage in any other kind of substantial gainful work.

It is immaterial whether such work exists in the immediate area, or whether a specific job vacancy exists, or whether the worker would be hired if he or she applied for work.

"The worker's impairment or impairment's must be the primary reason for his or her inability to engage in substantial gainful activity, although age, education, and work experience are also taken into consideration in determining the worker's ability to do work other than previous work".

By congressional law age must be taken into consideration but according to one of the many lawyers devoted to the appeal process during the beginning stages of filing a disability claim the SSA denies approximately 91 out of every 100 claims filed. Another claims that SSA denies about 60 percent of the people filing initial applications.

The most common numbers are that two thirds of the workers who file claims are given a final rejection by SSI. Of those denied benefits approximately half hire one of those lawyers and win in a long and exhausting appeal, an average wait of 669 days in some areas.

Of the millions of Americans who fail to receive early disability the choices are very few and none of them are good. Some who are deemed work worthy but incapable of doing the job they have done their entire lives attempt to reenter the workforce. They then find a new form of discrimination, a Catch-22 caused by the medical insurance industry. Since employer provided health care plans are group policies and the younger the group the lower the premiums older qualified workers are passed over for the young and healthy.

Many of them end in jobs with no coverage in lower paying jobs and spend the years waiting for that sixty-fifth birthday dipping into their retirement savings to pay for healthcare out of their own pocket. Some elect to take an early retirement package from their employer without the government safeguard and see their retirement savings rapidly depleted. Both of these groups enter full retirement age with far less money than they planed to have and are forced into an insecure retirement.

At such a late stage in life many who elect to go without coverage almost certainly will join the 700,000 Americans who declare bankruptcy because of medical expenses or the 18,000 adults in the USA who die each year because they are uninsured.

And how’s this for a double kick in the ass from our good government. Both of those groups that are forced to draw funds from their 401k’s and 403b’s in order to pay for medical coverage are forced to pay a 10% penalty to the I.R.S. if the funds are removed prior to turning fifty-nine and a half. The second group who elect for early retirement instead of taking some low paying going nowhere job become ineligible for Social Security early disability the day they elect to take an early pension plan. They have to wait till they turn 65 or become destitute and apply for Medicaid.

While those facts would make a great case for nationalized medicine or at least offering Medicare to people who have struggled and saved for years, no politician has so much as acknowledged this group of struggling Americans since former president Bill Clinton attempted and failed to offer a buy in to Medicare for early retirees and the American news outlets have just stuck their heads in the sand.

The Supreme Court recently giving the employers the green light to drop more workers can only maker matters worse and John McCain's heartless market oriented plan will offer corporate America another opportunity to wash their hands of the medical problems facing Americans;

He wants voters to think he is going after health care cost inflation. In reality, he wants to dismantle the employer-provided system that now covers over 60 percent (or about 158 million) of non-elderly Americans, forcing millions of us who now get fairly decent health insurance on the job to instead buy whatever they can find on the individual market controlled by unregulated and predatory insurance companies. And he would drive health care costs upward, not downward.

And what is the Republican nominee's answer to the million of Americans who are forced to retire early? John McCain wants to raise both the Social Security benefit and the Medicare eligibility age to 67 while Barack Obama is being derided by the media for a "new tax" with his plan of raising the cap on Social Security.

So the near elderly are left in a position where their best case scenario is to have Barack Obama elected. That way they get to be stuck working till only age 65 no matter how much it hurts, have to pay the highest insurance premiums because of their age and do without some medical attention and drugs because of the extremely high co-pays. Wonderful country this America isn’t it?

When you consider those ever increasing insurance premiums, you could call those payments a ‘corruption tax’ because a portion of those fees goes indirectly to your elected officials so they will turn a blind eye to the obvious. There is a very simple reason for the fact that the United States government spends more per capita that other nation while leaving 47 million out in the cold and forcing the middle class to work till they drop. Of course there are other reasons like the highest administrative fees on earth and all of the time and money spent toward removing coverage when a customer most need it but the real reason is lobbyist and payola.

There is a reason that the present day politician seems helpless to address these issues. Our so called health care system has been so corrupted by bribery money that anyone who speaks the truth will be ostracized by everyone else. Consider Dennis Kucinich or John Edwards for that matter. You know John Conyers and the 88 co-sponsors of H.R. 676, has anyone outside of the C-SPAN viewing audience ever heard them say anything about it?

There is a reason that the facts are being ignored by the media and television news is left with no choice as a survival mechanism. Our government redesigned the media to act that way. When the Drug companies got the green light to advertise prescription drugs, those drug companies became the bread and butter of television news. It is no coincidence that most of those drug commercials are aired between news segments. Because of their dependence on pharmaceutical advertisements the news that enters the American living rooms is tainted by that dependence.

A recent look at American Op-Ed pieces in the print media points to Americans reading about a return to “high taxes draining the economy” and “bureaucratic nightmares" caused by the plans of Democratic nominees with elderly Americans taking a backseat to "daunting budget problems." It seems obvious that once Barack Obama is sworn into office the media will create a new generation gap. A division between the working taxpaying young Americans and the elderly who will be cast as the next welfare recipient is sure to come if those newspapers want the medical industrial complex to continue advertising in their papers.


Both of the leading Democratic candidates made many health care promises to larger groups of voters but the American who saved for an early retirement and needs to rest after a long and hard career get little to nothing. A light at the end of the tunnel may have come from Clinton, who while not addressing the the real killer, medicine for profit, would have at least converted medical coverage to a mandatory expense. Americans who can least afford a garnishee on their early retirement checks would have raised one hell of a ruckus and that sort of voter involvement could have brought about real change.

Barack Obama may streamline coverage and do away with the preexisting conditions but there is no mention about the age escalation of coverage. Slightly more affordable premiums, co-pays and deductibles do little for an elderly American trying to live on the fixed income. Under Obama's plan many of the near elderly will just give up medical coverage. They will just die.

Neither Hillary Clinton nor Barack Obama are bad people. They just understand the power and money that would have destroyed their campaigns if they advocated removing the corporate profit from illness or stood up for nationalized medicine. It really is that bad and the medical lobby is that strong. In a nation where the drug companies own the news with commercial income and medical lobbyist own our elected officials with campaign finance it will take a whole lot more that facts to bring about a desperately needed action.

Two months ago when I learned that all of my years of saving for an early retirement had been undermined I placed a desperate comment in WYFP. That hopeless comment ended with my only sign of hope;

I’m actually clinging to one sentence that I heard from Barack Obama in that break out session at Yearly Kos "You know the Canadian plan didn’t happen overnight. It came in stages." That gave me some hope but that’s just denial of the reality of the sort of government we have working for the people. He could devote his whole presidency to nationalized medicine and it would accomplish nothing except the guarantee that there will be another president four years later.

Once Hillary concedes all we have left is some relief to uninsured Americans or at least a means for those considered uninsurable by "death by spreadsheet" hoodlums but there is a question that should be asked about who the real hoodlums are. Is it that insurance person who in order to put food on their table cause endless pain and suffering or is it the elected official who is charged with regulating that industry?

I don’t know how many millions of us there are or if we have a lobbyist group to represent us. What I do know is that if I can find work I will be forced to work full time in a very physical job far longer than I ever expected. What I'm almost certain about is the fact that I will see an early grave compliments of the elected officials that are suppose to represent myself and my peers.

Workers, the backbone of this nation, have been treated like hat in hand beggars for too long. Just compare worker’s compensation and disability to any of the other industrialized nations on this planet. Our lack of a safety net are surely another reason the workers of this nation have a lower life expectancy than the those nations with humane governments.

As an American worker I’m sick and tired of this scumbag government and nothing will ever change until Americans look at this issue for what it really is. Middle class genocide caused by elected officials who are nothing but murderers.

Do you remember "Hey, Hey, LBJ! How Many Kids Did You Kill Today?" Well that may have tainted the presidency of the brilliant politician who signed Medicare into law but isn't it time we ask our elected officials "How many Baby Boomers did you kill today?"

Got a Happy Story? Weekend Edition

I’m on vacation and thoroughly enjoying southern California from my Laguna Beach base. I had so much fun this weekend that I was pleased to see that the infamous May Gray had finally arrived this morning.

My moring beach view included Hollywood and Jared. The two man Beach clean up team that I started off my Laguna Beach Activist diary with;



It was a gray morning but the surfers didn't stay away;



It has already blown off and the sun is shining again but a morning sitting on the lanai in the soft light while going through this weekend’s photos and writing this dairy were therapeutic. I took a few involuntary naps too.

Friday would be the only day this weekend that had anything in common with this mellow Monday. I got in some keyboard time. I had the presence of mind to write Got a Happy Story? California Sunset Edition before I left for vacation but I have a hard time with calling a happy story finished. So I had a beach day with many trips back to my room.

I did get in a few decent photos. Unlike surfing, skimming seems to be exclusively for young men around here and this young beauty was a rare sight. I was not only surprised to see this young lady on a skim board, I also noticed that unlike her male counterparts, there wasn't a scrape or bruise on her perfect figure;



I was also entertained by the supply depot that the Main Beach volley ballers kept on the side. A healthy generation gap can be detected by all of the sun block but besides the fact that D'yer Maker was playing on the iPod, it looked like these young men were giving the ibuprofen a good workout too;



Ah those were the days;




After posting my diary I ran down to the beach for a few sunset photos;









Saturday was very active for me. I got off to a very early start and made a trip to San Diego. On the way down I stopped at all the vistas. I talked someone into modeling for my scrapbook so I could get an image of a squirrel. If these critters ever saw our eastern gray squirrels they might develop an inferiority complex;



But here's one doing an imitation of their eastern cousins;



At the next rest stop I was impressed by this photo that came out a little off focus but is still pleasing to my eye;



Because it seems dangerous I'm trying very hard to give up 80 m.p.h. photography but...



My first destination was to pick up OrangeClouds115 and we drove to the Hotel del Coronado for a day at the beach. The place was so fancy that there was flecks of gold in the ocean water;



As we walked the grounds;



OC being fluent in Chinese came in handy. Her new friends insisted on a photo. Can you guess which two we are? I give you a hint. There aren't too many Obama Girls in China and I'm the sveltely tall one;



Later on we met up with San Diego Dem and made for a La Jolla dinner destination. First we took a walk down at the Cove;



Here's a photo I don't often take. A typical tourist photo but with two wonderful people in the picture;



It was decided to put off dinner for a while so I could get some sunset shots and here are the results;







Sunday was another early day. I was parked at the Santa Monica pier by early morning to pay my respects at Arlington West;



Than an all day walk around Venice Beach. Usually things don't get wild till Venice but even Santa Monica had something to gape at;





Venice offered the usual, flying acrobats, women in money bubbles and throwing knives;







Then there was the Obama Gals really doing their best to get people to place a vote for sanity;







I spent much of the afternoon watching roller skaters;



There was a very friendly group named Vegas Heat and they were not the least bit camera shy;



I have a full series of their show that they drove from Vegas to preform on Venice Beach. It was great an I kept thinking about how much people spent to see Starlight Express while I was out in the sun enjoying a great free show. Here's a sort of roller limbo, the Vegas Bridge;





I also spotted a television star having dinner at an outdoor cafe;



I think the guy may have also been famous because after I walked away from my brief inquiry I got the distinct feeling that he was talking about shooting me for not having recognized him too;



Another trip to the Venice Beach Drum Circle for some shouting screaming and pretending that I know how to dance;




Another sunset, of course;







Followed by a moonlight dinner on the pier;



And I made it home in one piece! Did you have anything happen this weekend that you would like to share? I know I sure did.

Got a Happy Story? California Sunset Edition

I am very happy about the fact that is not quite evening where I am. After a grueling two week work break in New York I’ve returned to the same Pacific view deck in Laguna Beach.



I didn't expect to see many sunsets on this May Gray trip and I don’t have a clue where I'll get the cash to pay for this vacation sequel but I have enough photos from the last trip to make up a diary of Prodigal Sunsets.



Here is a Happy accident. Cameras do funky things all the time when you point them directly at the sun. Do it as often as I do and occasionally the mistake offers a pleasant result;



As many in the Top Comments Crew know I have a little obsession with capturing the perfect sunset. At home I have a view of the Hudson and the Palisades but here on California beaches the sunsets can be so much more interesting. There are rocks and trees for foreground filler;





On April 17, the first night of my last Laguna vacation I ran around trying to capture an interesting photo. The shared emotion at sunset by someone else;



The joy of children in the surf;



Even the fun a wet pup enjoys in that last light;



But what I really love about a Laguna sunset is the action shot. This one just screams California;



I was on Laguna Beach so much at sunset that I caught some real action photos. I didn't know this woman nor did I get permission to take any pictures. She was posing for a professional photographer and I just decided to join in until the told me to get lost. They never did and I enjoyed my introduction to voyeurism. This is the only one I can show from that series or I'll be banned from photobucket;



I also spent a few sunsets at Venice Beach and Santa Monica. A little more voyeurism and warm fuzzies from photographing lovers on the beach. They did give permission and were both Daily Kos fans;




Up in Santa Monica I tried my luck at ripping off an Apple I-Pod graphic;



Here's a happy story within a happy story. I did not see the sunset on my second day in California because I was enjoying a wonderful meal in OrangeClouds115's favorite restaurant Spread with both her and San Diego Dem.

OrangeClouds115 and I met at her place and after lunch on the beach we walked Torrey Pines State Reserve with our nature host (photo below) entertaining us with both identification and interesting stories about the local flora and fauna;



No sunset but here's a photo of the overcast late afternoon sky with both OrangeClouds115 and San Diego Dem wondering why they went hiking with such a slow poke;



On my second day I was a very early riser to go see the Los Angeles Philharmonic at the Disney Concert Hall. After that Saturday matinée I had lunch with Floja Roja at one of my favorite restaurants Barney's Beanery. We drove to the Santa Monica pier and walked around Venice Beach. This was the latest we were there;



I got yet another lesson in the drawbacks of procrastination. Walking through Santa Monica I mentioned to Floja Roja that I always wanted to capture a sunset in the center of the Pacific Wheel. I finally made it there on another day this vacation but a new solar energy panel takes a bit away from the photo. I'm thrilled there is a solar panel on the pier but I should have made it there sooner;



I could offer every sunset I watched from the beach with details about how I spent each day but I don't even think my mother would want all that information. One of the many advantages about being a photo buff is that when I come back I do have a visual diary of each day and it brings back details that are often forgotten.

Here's my favorite from days three and four. The sunset from April 21 is softened by overextending my telephoto as the sun melts into Catalina Island and the sail boat reminds me of Der fliegende Holländer;



One of my favorite sunsets of that two weeks on the beach came on April 22;







The sunset on April 23rd didn't need any help but who you see it with can improve a good sundown;





Besides the ripples in the sky to mimic the Pacific I had very good company to watch me clicking away madly. Trashablanca and Doobie Dog were there. No Doobie is not really interested in photography. That is his "I see another dog" look.



Doobie would have needed a knife if he ran into these two bruisers on the following evening;







On April 25 I missed the sunset again because I was enjoying a good dinner and wonderful company but OrangeClouds115 and I ran into this most happy fella at the San Diego Zoo;



My final night in Laguna was a solo dinner I made myself and enjoyed on my balcony;



On that last day I witnessed people powered politics Laguna Beach style and I was so impressed that I wrote Outstanding in the Field: Laguna Beach Activist before checkout. I was commenting on the 405 as I drove up to Arlington West and met poligirl for the first time. I took so many photos there but I've got to show these two;





That Sunday was a good night for a sunset;








The following sunset was my favorite because it reminded me of something I heard from Jim McKay all through my early years. The Thrill of Victory...



And the agony of defeat...



While I was in Venice Beach I rented a bicycle for four days and did my five piers tour twice always starting at the Santa Monica pier and ending at the Theater of Magic pinball machine in the Redondo Beach arcade. I took this racing for my next to last California sunset;



And this was the last sunset of my last vacation;






Well if every picture tells a story that was the most happy stories you will ever get out of me and I should be all done but I'm back here and it seems that May Gray is canceled for this stay so here is last night's sunset;



How about you, do you have any happy stories?