Monthly Archives: August 2009

Put the oxygen mask on yourself, first

An open letter to people who will show about $150,000 gross or less on their tax form this year.

tombstone: He was a priority for a whileThe present poverty line for a family of four is $21,834, but that doesn’t tell the story anymore. You make a lot more than that. You also have credit card debt and/or equity lines or ARM’s or contracts for services that can’t be canceled. One of you is not making the same as last year. A sane accountant looking at your situation would tell you that you that you no longer have “disposable income.”

Sure, you have a job. Sure, your house is worth more than you can sell it for. Sure, you have assets. You’re vested in your career. But once you pay the what-you-got-to’s, there’s nothing left. You have become the middle class poor. You are the responsible, tax-paying, hardworking, never quit household that is the backbone of our country. You are better off than the unemployed of your same caste, but you are one crisis from being equal to all those other people.

You are going to achieve. Whatever it takes. You pay your bills. You’ve cut back. No more e-bay. Wine at dinner is a memory or an infrequent special occasion. The boutique shopping for the kids has been replaced by trading clothes with friends and family, charity store visits or Walmart. You haven’t been to the dentist in a while and won’t go anytime soon. That 401-k won’t be matched this year. Your hair is longer and a color you haven’t seen since high school. If they say change your oil every 5,000 miles, it’ll probably be okay for 15,000 or so. You are one straw away from total meltdown. You, the admired among the admired, are one late fee and rate change — or, god-forbid, a medical crisis — from the poverty line. Those triple credit score dot com commercials are singing to you in every television break.

This healthcare debate is about you. Forget the poor. Save you.

This debate is framed by spin from all sides, none, not a one, is talking about you. You have healthcare insurance, but please, I beg you God, don’t let me get sick. Don’t make me spend the deductible. I can do a copay today, but a hospital stay? No, save it for the kids. I can’t. There’s a little room on that VISA; what the hey, I can afford to be against healthcare reform. After all, it will bust the budget. Won’t inflation take everything I’ve worked for away?

No. Not like one pain in the abdomen. Or lump in the breast. Or a little blood in your urine. “It won’t happen to me,” you say. “I’m young.” Don’t dance with that devil. He’ll win. It won’t be long before you or yours will hear it. The age of 65 is longer away in medical insurance terms than your mortgage payoff.

Healthcare reform is about you. About that moment, perhaps it is today, when your copay at CVS will mean you don’t have lunch money for the kids. About that moment when you have that follow up appointment you’ve been waiting three months for and your child needs medicine.

Healthcare reform is about what happens to priorities. Your priority list a year ago could go twenty deep. Now it is a list of two. All it takes is a little chest pain to make your priority list a list of one.

You may want to be a bleeding heart: Charity first, save the person on the phone, screw your health, whatever for the other, I’ll make time, I can match that, run for the other and walk for everything important. This is your moment to do something really important for yourself. For your family. For your friends. Because one of you, maybe not today, but certainly a day very soon, will be, for all practical purposes, poor. The working, hard-working, desperate, no place to turn, poor. The I can over achieve because I believe in capitalism and the American way gone wrong, poor. The I haven’t failed, just ran out of money at the wrong time, poor.

This debate, is about you. Your priority needs to be, call your congressperson and senators and light a fire up their asses. Read the bills that are being debated. Decide what makes sense to you for you and tell them. Don’t listen to Fox, CNN, MSNBC or anyone else. They don’t take the crisis calls from your family. Only you can decide. This is your moment.

Money-Driven Medicine

Money Driven MedicineNext week on Bill Moyers Journal, the film Money-Driven Medicine reveals how a profit-hungry medical-industrial complex has turned health care into a system that squanders millions of dollars on unnecessary tests, unproven and sometimes unwanted procedures and overpriced prescription drugs. Based on Maggie Mahar’s book, Money-Driven Medicine.

SYNOPSIS (From the movie website: MoneyDrivenMedicine.org)
Money-Driven Medicine provides the essential introduction Americans need to become knowledgeable participants in healthcare reform, now and in the years ahead. Produced by Academy Award winner Alex Gibney (Taxi to the Dark Side; Enron: The Smartest Guys in the Room) and based on Maggie Mahar’s acclaimed book, Money Driven Medicine: The Real Reason Health Care Costs So Much, the film offers a behind-the-scenes look at how our 2.6 trillion dollar a year healthcare system went so terribly wrong and what it will take to fix it.

The U.S. spends twice as much per person on healthcare as the average developed nation, fully one-sixth of our GDP – yet our outcomes, especially for chronic diseases, are very often worse. What makes us different? The U.S. is the only industrialized nation that has chosen to turn medicine into a largely unregulated, for-profit business.

Effective Care or More Expensive Care?

In Money-Driven Medicine, Dr. Donald Berwick, president of the Institute for Health Care Improvement, explains: “We get more care, but not better care.” Our fee-for-service system channels resources into the high-tech, high-cost “rescue care” patients need after they become critically ill, while it skimps on the preventive primary care which could keep them out of the hospital in the first place. As a consequence, emergency rooms overflow while family practitioners are becoming an endangered species. Medical students explain that these perverse pay incentives drive them away from primary care into higher-paying specialties.

Medical ethicist Larry Churchill doesn’t mince words: “The current medical care system is not designed to meet the health needs of the population. It is designed to protect the interests of insurance companies, pharmaceutical firms, and to a certain extent organized medicine. It is designed to turn a profit. It is designed to meet the needs of the people in power.”

These businesses comprise the “medical-industrial complex” which has wrested power from physicians, turning healthcare into a commodity and patients into profit centers. As the eye-opening ads in Money-Driven Medicine reveal, the more new drugs, surgical procedures, diagnostic devices and hospital beds the health industry can produce, the more they can sell – whether we need them or not. It’s called “supply-driven demand” and it’s possible because a sick person can’t say no.

Although many uninsured and underinsured Americans receive too little care, the well-insured often get unnecessary, even risky care. More than two decades of studies by researchers at Dartmouth reveal that one-third of our healthcare dollars are squandered on useless tests and ineffective or unproven procedures no better than the less-costly ones they replace. The studies demonstrate that evidence-based, accountable care would be both more effective and less expensive.

Taking Back Healthcare

In Money-Driven Medicine frustrated doctors and outraged patients testify to the tragedies which can happen when profit trumps patients’ needs. Veteran physicians stress that reform must begin with a new doctor-patient partnership based on consistent, informed, shared decision-making. “Before patients can reclaim their rightful place at the center of our healthcare system,” Maggie Mahar notes, “we must empower doctors and nurses to practice patient-centered care based, not on corporate imperatives, but on the best scientific research available.”

Money-Driven Medicine will encourage health professionals and patients to work together to take control of American medicine back from the MBAs. The film will alert viewers that universal coverage is just the first step in a long and arduous battle for comprehensive reform continuing well after whatever bill Congress passes this Fall. We have seen that the industry’s lobbyists will resist every measure aimed at cost-containment and results-based care.

Screening Money-Driven Medicine will help viewers distinguish between structural change and sham reform. It will convince them that a sound, sustainable medical infrastructure is crucial not just to their personal futures but to the economy and society as a whole – why curing America’s healthcare crisis could be a matter of national life and death.



Opening Sequence


www.youtube.com/watch?v=oPHYb4g4oT8
Miracles



Now Treating Medicine



Questioning Healthcare



Intensive Care



Not the Best, Only the Most Expensive



Physician Focus



Patients for Sale

 

Editorial Note: This is part of an on-going series of videos shared by LikeTheDew.com readers. If you would like to share a video, send links to: [email protected].

Hurricane Bill & Obama

Hurricane Bill I have been worried all week about President Obama and his family choosing Martha’s Vineyard for their vacation while Hurricane Bill (aka: Tropical Storm Bill) was in the Atlantic. Talk about political risk. Just imagine the photos of the first family being evacuated while the island’s commoners were forced to wait in line for the ferry as the storm was approaching. They’d be shown side-by-side with photos of other Massachusetts’ politicos – Kerry surfing; Kennedy at Chappaquiddick; and Dukakis in the tank.

Just imagine the Weather Channel’s interviews with island folk who dismiss the Cat 2 storm as something they’d been through dozens of times, and how they love to watch others turn tail and run. Imagine the firestorm as pundits exclaim what a wimp Obama is, and how the nation’s enemies would be emboldened. Imagine the comparisons with other presidents who vacationed during a Hurricane – Bush and Katrina would be replayed over and over, finally displacing the grim news repeats covering Michael Jackson’s death.

Fortunately, the storm has veered right and the storm warnings for Massachusetts have been lifted. Too early to tell if this president, who has been compared to the Messiah, and the Anti-Christ had direct involvement – but he did choose to delay their travel until they were cleared by the weather service.

Plan A

elephant-in-the-roomThere’s a cold dark secret inside the White House, your state house and your city hall. You aren’t likely to hear it discussed on talk tv. There are no talking points prepared. Don’t expect mass email blasts raising money for it. No one wants to talk about it. It is the elephant (or donkey depending on your affiliation) in every room.

It explains why healthcare reform will be in name only. Why regulation of banks and Wall Street will be studied in committee well into next year. It is why K Street still has its way on the hill. Why oil prices are going back up although demand isn’t driving it. Why our investments in green are longterm. Why there’s no hurry to get our troops home. Why we can throw money at GM and buy a few extra weapons programs we don’t want and won’t use. Why so much of our stimulus was to help the states who can’t borrow, or was for shovel-ready projects that were just another name for pork. The cold dark secret explains why Republican Bush and Democrat Obama would each bet the house (ours) and ask willing bi-partisan Congresses for blank checks –  all caring less how they are cashed.

This secret is more important than jobs, foreclosures, funding pensions, deficits, global warming, peace, food or clean water. It keeps every sober politician up at night and makes every other drink themselves to sleep. It is the source of their power. This isn’t about mid-term elections. For them, it is all of it. Every last senator, congressperson, governor, mayor and political appointee, regardless of party, has known the crisis was coming, but they had already drank the Kool-Aid. Now, there’s only one way out.

Tax revenues are way down and falling. Their only hope is a Wall Street bubble.

The villains who caused it are now heroes in waiting. “It’s the economy stupid” has been replaced with “it’s the Dow Jones stupid.” The only answer found by our best and brightest is to purposely have history repeat. The speculators are speculating. Our government has provided all the chips and is covering all the bets. They don’t care who gets rich, or how rich. They just know that it is the only way quick enough for enough people to make enough income so enough people pay enough taxes that our great nation of cards won’t fall during their watch. At least not this year.

Our cities and states are suffering. It is way too late to raise taxes and too few are left to pay. Cutting enough spending will just make it worse. Creating jobs is too hard and takes too long. Another housing bubble can’t work until we have finished burping the last. They have never had faith in the middle class and had just as soon be rid of them. Wall Street bubbles are quick, cheap and they’ve done it before. Plus, you can do it with half the country unemployed or paralyzed in debt.

Don’t get your hopes up for anything else. There is no plan B. All the rest is just sport to keep us distracted.

Ready for Sir Paul

SirPaul McCartney's Stage in Piedmont ParkPreparation is just about complete for Saturday night’s (August 15th) Green Concert at Piedmont Park in Atlanta featuring Sir Paul McCartney. Over 30,000 tickets have been sold, but tickets are still available (they are permitted for up to 49,999, but never expected to sell out given the economy) through ticketmaster – $79.50 per person general admission, or $400 for VIP tickets (you’ll be close enough to see him without camping out). You can also hear it for free on DaveFM (92.9) in Atlanta.

 Paul McCartneyThe gates open at 4PM for VIP’s and pre-sale tickets. 5PM for general admission. The music should start about 7PM. Yes, there will be beer (Bud and BudLight) and plenty of other stuff for sale.

After paying Sir Paul, the hundreds constructing the staging and working the event, the 6 foot fences that surround the park, the gigantic stage, lighting and screens, dozens of tents, hundreds of porta-potties, all the clean up, and hundreds more of Atlanta’s finest for shutting down the surrounding the streets, the proceeds will raise money for Piedmont Park’s 53-acre expansion.

Oh yeah, forget about driving and finding a place near the park. Take MARTA.

Fire Jim Dean

Fire-Lou-Dobbs-NoYesterday, I received an email from Jim Dean, Chair of Democracy For America. Frankly, it was a shockingly anti-democracy appeal asking me to contact CNN and demand Lou Dobbs be taken off the air. No. I will, however, contact CNN and demand they protect journalists (in the broadest sense of the word) and free speech.

Quoting the email (links added), “Yesterday, our friends at Media Matters for America, who are dedicated to comprehensively monitoring, analyzing, and correcting conservative misinformation in the U.S. media, caught Lou Dobbs promoting hate and inciting violence towards Governor Howard Dean.

With violence from right-wing extremist groups on the rise and Republican backed mobs hanging cardboard versions of members of congress in effigy, Lou Dobbs’ statement is dangerous. Enough is enough.

It’s time for CNN and the United Stations Radio Network to fire Lou Dobbs.”

The email supplied this link to justify its point. In the audio clip while Dobbs was rambling about the resurgence and resilience of the former Vermont Governor, former Democratic National Committee Chairman, and former family practitioner, Dr. Howard Dean, he said, “He’s a bloodsucking leftist – I mean, he’s a, you gotta put a stake through his heart to stop this guy.” While I disagree with Dobbs’ political stance and his remarks, Dobbs was obviously making a vampire reference. Not a call for violence.

Jim, as you might know, is Howard Dean’s brother and runs the fundraising mailing list that remains from Howard’s unsuccessful presidential campaign. I think it is a wonderful thing for Dr. Dean to help out his brother by creating a job for him. But Jim is doing damage to the cause and maybe it is time for him to go. If he had asked in his email for me to call CNN and tell them what I think about Dobbs’ remarks, that would have been fine. He didn’t.

Time was, and still is, that ratings rule the network decisions on anchors and commentators. Boycott Dobbs and CNN will trade him to Fox where he might fit in better. Ask for him to be fired and you put everyone speaking publicly at risk. Sure, Dobbs long ago crossed the line from a popular, if not respectable, business anchor to promoting his own political agenda. He didn’t just cross the line, among other things, he is a blatant immigration-reform and public option-healthcare opponent. Sure, Dobbs’ “relentless promotion of debunked, racially charged conspiracy theories about President Obama’s birth certificate have already seriously damaged CNN’s credibility” – again, quoting the email. But Jim Dean is advocating a mob-style action to shut down free speech – a similar type of mob-style action that many have accused conservatives for using in the recent town hall meetings – it is reprehensible. It is anti-democratic for America.

Please don’t call or write DemocracyForAmerica.com asking for him to be fired. That, too, would be anti-free speech. But do tell them what you think. Oh, yeah, and boycott Dobbs.

Like the Dew wah diddy

LikeTheDewWahDiddyA couple of months ago, Like-the-Dewer, Terri Evans, read an email requesting entries for Dotster’s Next Big Small Business Contest. The winner would receive a modest cash prize and, more importantly, some promotion. Dotster is

LikeThe.Dew.com’s internet host. Terri spent untold minutes preparing an essay describing LikeTheDew and submitted it.
On July 30th, Dotster announced that LikeTheDew is one of 20 finalists* (we don’t know how many entries they received, but hope it was over 20) and all we had to do in the next step was to create and submit a two minute video about our site (that will teach Terri to read the fine print in the contest rules). The deadline for submission was midnight, Thursday, August 7th – one whole week.

We blew most of the time talking about great video ideas while drinking beer. Most of the rest talking with people who would love to help, but just didn’t have enough time. So we started Wednesday afternoon (the day before the deadline) on our do – it – yourself – whatever – can – be – done – in – one – day – without – spending – a – dime – video. Click here to see it.

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* We had our prize choice for being a finalist of a free webcam or a $50 iTunes. They shipped the webcam before we were able to say we didn’t need another. Anyone want one? Email: [email protected]