theferrett: (Meazel)

When I first read NPR’s “Unfit for Work: the startling rise of disability in America,” it told me something I did not know: we haven’t actually reduced welfare costs in America.

Yes, we’ve managed to give less money via welfare to people who aren’t working… but disability costs have skyrocketed in recent years.  And if you add the two together, it looks like a lot of people who were once on welfare have shifted to disability.  And, so NPR argues, there’s a lot of cahoots among the folks who grant disability payments to only give those payments to the poorest and most deserving.

This fact has, crazily enough, created a backlash among liberals, who are furious that NPR – NPR! – would join the “liberal attacks” on the disabled.  To quote Tiger Beatdown, “…she contributed to familiar hateful rhetoric about disability in the United States, and what it means to be disabled.  Scroungers. Sucking off the government teat. Fakers. Lazy. Slackers.”

But I read that same story a week or two ago, and I saw none of that.  And perhaps that’s because at this point in time, I should be (temporarily) disabled.

For those who are new here, I am a forty-three-old programmer who had a heart attack, and a triple-bypass surgery, about ten weeks back.  Having a triple bypass is tough on the body; they crack your chest open like  crab, breaking every single rib in the process, and then shove your lungs up and around so it takes about six weeks to get your breathing back. Even now, I still have problems lifting heavy objects (lest I strain the still-fragile ribs, which may not fully heal for another three months) and experience chronic exhaustion from the beta blockers.

And when I was in the Cardiac ICU, one of the case workers came up to me and said, “You’re going to need to take three months off from work. File the paperwork now. Get it in before they can deny you.”

Three months? I thought, being a fairly healthy person before that.  What the hell could possibly render me unable to work for three months?  And I trusted my job, who had done right by me for the thirteen (!) years I’d been working for them, and failed to file.

I thought I’d be back working full-time in three weeks.  And while I was working part-time at four weeks, it took me until six weeks out until I’d say I was really back on the clock.

So those foolish, greedy bastards at the hospital just wanted me to suck at the teat of my employer, right?  They were encouraging lazy slackers everywhere!  Forcing my job to subsidize lazy wretches like me!

Wrong.

My job consists of sitting at a keyboard and thinking.  That’s because I was lucky enough to have some connections and some college, and I lucked into a white-collar desk job.  But before that, for a good eight years, my job consisted of working retail – which, inevitably, consists of standing on my feet for eight hours a day and lifting heavy boxes.

I still could not do that.  I’ve recovered astonishingly quickly by heart patient standards, but if my job depended on me heaving around thirty-pound boxes of the latest Tom Clancy hardback?  I’d be fucked.  I’d be lying in front of the television, sweating the countdown, because at this point I’d have two weeks to go and if I couldn’t manage it by then, what the fuck would happen to me?

Now, admittedly, that’s just my temporary sojourn into the Land of the Disabled, and I’m lucky enough to get to walk out after a while.  But that was a constant worry, even when I was young and hale and twenty-five: what if I threw out my back?  Working for Borders, there were a lot of older guys with braces, chewing Advil like it was their last chance, wincing.  And management, who was kind back in those days of well-managed Borders stores, found ways to work the system – shifting these less-physically able folks to slower-paced jobs when they didn’t have to, moving them to the cash register while the rest of us hauled hundreds of pounds of books back and forth.  We all silently agreed we’d pick up the slack, if we could.

If we’d had a dickier management, those guys might have lost their jobs.  I might have.  My family has a history of bad backs.

And so, when NPR pointed out that more people than ever were on disability, that made total sense to me.  In my white-collar phase of employment, a bad back was trivial; my work was all in my head and hands.  But as a blue-collar or lower worker, you’re pretty much judged by your body… and if that can’t function, you can’t get a job.  That bad back may be a permanent lockout from any job available to you, ever.

That’s a problem, because the growing class divide in America means that more people can only get work based on their physical output.  There was a time when Americans could get good, white-collar, office jobs without a college diploma; those days are no more.  There was a time when America’s manufacturing was robust enough to support hierarchies of management, so you might move up from the factory floor; again, that’s mostly dead.

What we as Americans don’t want to face is that our concept that “Anyone can make it in America!” is mostly a lie at this point.  We have all of the social mobility of France or Britain.  And the truth is, if you’re stuck in the lower tier of jobs, your ability to provide for your family is dependent on health.  That flags, and you can’t bus tables for eight hours, mise well pack it in.

So to me, what Tiger Beatdown proclaimed was an article where NPR gave into the welfare-beating hatred of America, I saw as acknowledging a critical reality: we can’t make people work when we, as a society, have quietly engineered it so that the only jobs they can get are physical labor.  Tiger Beatdown makes the grievous error of thinking that stating the fact of “Disability payments on the rise” is the same as “…and that’s a sign that we’re pandering to lazy assholes!”

No.  What I read was an article where judges were desperately trying to be merciful to people in dire circumstances, tacitly acknowledging that there were two levels of existence in America and trying like hell to find the money for these bastards somewhere.  I saw a hellish process that took forever to get onto, the kind of thing you could only get onto if you were both desperate and persistent.  I saw NPR outlining a fiend’s bargain where you agreed to give up the rest of your working potential for a poverty-level $13,000 a year, forever, never getting a raise unless the government unlikely gave you one, forever condemned to living in poverty… and having that be the only sane option because you had some part of your body give out prematurely.

The problem I have with this “liberal attack” is that Tiger Beatdown let it be a liberal attack. I didn’t see slackers, or scroungers, in that article, and I think you’d have to hunt to find them.  What I saw were people getting fucked over by a country that’s slowly grown callous to these folks, and a hard reality that despite years of conservative poor-bashing, there’s a lot of folks who would like to work who utterly cannot, because the system has failed them, and no amount of so-called “fiscal responsibility” can avoid the truth that we have to help them or things are going to get a lot worse.

What I saw was the most stinging indictment of conservative thought I’d seen in a while… And if conservatives saw that evidence as “scroungers,” then I think it’s high time to raise that banner high and say, “No, these people aren’t suckling on your teat, they’re relegated to terror, poverty, and disease because you’ve robbed them of low-cost health care, jobs with benefits, and education.  Now you’re paying the bill, and that payment, as it turns out, cannot be avoided.  So how do we actually fix America and stop demonizing these folks?”

Which is why I’m disappointed. Some people read a pretty goddamned sympathetic article and called them “slackers,” presumably because they had their heads up their asses.  And rather than refuting those points and saying, “No, actually, this is how bad it is for poor folks that these limited options look good to them,” some liberals chose to yell at…. NPR.

I’m in the top 20% of America.  I’ve got a lawyer for my wife and a highly technical job.  And after I post this, I’ll go back to my job, laying on my couch for the next eight hours and refactoring some programs that need reworking.  And I’ll think about how it might be if my wife worked at Denny’s, and my job was the stock room at Target, and shit, how the hell are we going to pay the bills when I’m falling asleep after eight hours of just sitting down?

I wouldn’t be a slacker, then.  I’d be an ailing man in a dire situation.  And by God, I hope someone would devise some better way of helping me than what we have now.

Cross-posted from Ferrett's Real Blog.

theferrett: (Meazel)

If I was a kid listening to the news, I’d think OBAMACARE was some troll that lived under a bridge and ate people’s hearts.  The word gets tossed around like a football – and I mean that literally.  Have the Democrats fumbled OBAMACARE?  No, wait, the Republicans have got their hands on it!  No, wait, the Supreme Court saved OBAMACARE!  Who’s winning in the great OBAMACARE game?

And I’m pissed at Obama, because for a legislative package that’s literally got his name on it, he doesn’t seem to care that anyone understands what it does.

Look, I voted for Obama on the strength of one book: The Audacity of Hope made me think, “Man, this is a guy who knows how to communicate complicated ideas.  This is who I want in office, pushing my Democratic agenda.”

Instead, what I got was a genius politician.  Seriously.  For all of the Republican smear campaigns crying, “Why, he’s as inexperienced as a child!  He’ll paw like a confused kitten at the levers of government if elected!”, they forgot that Obama got his start in backroom-dominated Chicago, and wouldn’t have gotten as far as he had if he didn’t understand the rules of the game.  So he snuck through Obamacare in what was a magnificent act of legislative juggling, making all the right concessions to do something no other President has ever been able to do.

The problem is, he was so busy getting shit done in the halls of Congress that he forgot to speak to the streets.  And FOX News and company dominated the conversation, talking about OBAMACARE as though it was a dirty bomb someone had smuggled into a church.  Did the man on the street know what OBAMACARE did?  Fuck no.  But he DID know that Obama had pulled off kind of a sneaky trick to pass it, and Obama certainly hadn’t stumped for it in the same way he’d run for election, and he decided that OBAMACARE didn’t pass the sniff test.

So America dislikes it.  And they STILL don’t fucking know what it does.  The number of times I saw this “Explain Obamacare to me like I’m five” link passed around Twitter by people expressing surprise (“Oh, it does THAT?”) by progressives was amazing.  Here’s Twitter, where people are usually a little more politically involved, and here’s liberals, who should have a good grasp on the overall picture, and they’re still like, “What?”  To this day, when I’ve seen people polled on the individual things that Obamacare provides, and the results appear to be, “Yeah, I like that.  And I like that.  And that’s good.  But I despise OBAMACARE like it was the love child of Hitler and Sauron!”

I do not think, as many conservatives would have me believe, that the man on the street has done a complex analysis of the many contributing factors of the insurance companies and the overall economic picture and the long-term effects and come on the downside.

I believe, rather, that Obama’s done such an astonishingly shitty job of touting his plan that people don’t actually know what benefits it provides.

So now that it’s officially here to stay, why isn’t Obama taking ads out in every state talking about what OBAMACARE does?  Why aren’t there thirty-second commercials saying, “My child got cancer, and when I switched jobs the insurance company told me they wouldn’t insure him because, well, he had cancer.  Thanks to Obamacare, they can no longer deny children for pre-existing conditions.”  Or “My insurance company turned me down for treatment for my emphysema.  No reason.  They didn’t have to tell me why, and if I didn’t like it all I could do was hire a lawyer.  Now, thanks to Obamacare, there’s an appeals process I can go to without having to spend $2,000 to retain an attorney.”

Why is Obama so concerned with passing laws and so little concerned with changing hearts?  There’s a lot that people like in this bill, and he’s inextricably associated with it.  If people think better of it, they’ll think better of him.  So why is OBAMACARE still treated like a ticking time bomb that Jack Bauer needs to defuse, its innards mysterious?

That’s fucktastic long-term politics.  Yes, Obama, you passed the law and the Supreme Court, by luck more than skill, upheld it.  (I don’t think anyone saw Roberts coming down on your side, son.)  But because America’s still treating OBAMACARE like it’s a tumor in the genitals, but if they understood it, then at least they’d see that there are tradeoffs.

Obama needs to start using some of the Audacity of Hope on America, explaining the healthcare bill’s strengths in a bombardment.  Otherwise, it’ll remain so hated that legislators will have voter support in getting rid of it, without the voters even really understanding what they’re doing.

(And yes, he’ll get pushback from the Republicans on it, but at this point Obama literally can’t talk about pushups without Republicans bitching about it.  Blowback is not an excuse for inaction, because frankly there are enough stupid-crazy conservatives who feel Obama’s doing too much by drawing breath.)

Cross-posted from Ferrett's Real Blog.

theferrett: (Meazel)

I’m feeling random today, so have some random.

Today’s 4/20!
I’ve never really liked marijuana, and as such I can never really find a celebration of it all that entertaining.

I dunno.  Maybe it works for other people, but every time I’ve smoked marijuana I have really stupid thoughts that never seem to produce anything interesting in the light of day, then I eat until I’m sick.  Then the next day I feel tired and unmotivated.  It’s better than cigarettes in that at least I feel a radical initial high (as opposed to just coughing a lot), but the fetishization of pot just always makes me wonder what I’m missing out on.  So much of pot culture seems to idolize sitting around the house watching TV, and that’s mystifying.

I mean, hey, I’m not saying you shouldn’t do it.  Pot should be legal, and I don’t have to get something to say, “Hey, you go ahead and have fun now.”  But in this case the experience of what other people have with pot deviates so much from my own that it’s actively bizarre to me to see people excited to smoke pot, let alone posting excitedly on Twitter going, “It’s 4/20, man, I can’t wait!”

On The Nebulas
Jim Hines said today that everyone nominated for a major award has the “What if I win?!?!” freakout.  I think it says something about me that I have not once ever thought that I’d win, something confirmed by Sauerkraut Station‘s lack of nomination for the Hugos.

Don’t get me wrong, I’m thrilled to have been nominated.  It’s a major honor!  But my brain immediately went, “That’s as far as you’re gonna get, you’re going up against Rachel Swirsky and Geoff Ryman and Charlie Jane Anders, and those three alone would bury you.”  And I’ve gone on happily going, “I’m gonna attend the Nebulas!  As a nominee!” and never once attached the word “winner” to my head.

The things my brain chooses not to freak out about are odd indeed.

On Levon Helm
I think everyone who is lamenting the loss of music great Levon Helm should read Bart Calendar’s essay on his death, and feel shamed.

The short version is that Levon, a rich and successful man, was bankrupted by fifteen years of cancer.  And I think that’s the myth that conservatives are peddling to stupid people: that hey, if you’re smart and rich and have good health care, you’ll be okay.

Except, as anyone who’s ever actually fucking met someone who’s been through a large-scale disease knows, this is not actually true.  You can do everything quote-unquote right and still get fucked by our system.

I’ve talked to idiots who’ve said, “Well, if I get sick and I’m getting substandard treatment, I’ll just switch to a better insurance company,” as if the term “pre-existing condition” didn’t fucking exist.  I’ve talked to morons who’ve thought that if you had really good insurance, you’d be completely safe, and that the insurance would never run out or refuse a claim.

I’ve said it before and I’ll say it again: you don’t know how good your insurance actually is until you get direly ill.  Every insurance company looks good on paper.  But they can screw you bureaucratically in a thousand ways.  And they’re incentivized to, since a for-profit organization loses money every time they pay for a sick person’s treatments.

And yes, I’m sure you’ve had your insurance claims go well for some major illnesses, conservatives.  That’s fine.  I’m glad yours went well.  But you don’t get to use anecdotes about the horrific failures of the European system as evidence that socialized medicine is evil without acknowledging the fact that some pretty damn well-off people have to work through cancer in order to keep their family afloat.  To acknowledge that the idea that “good insurance and wealth is a catch-all” is not a 100% shield against going bankrupt.

(G’wan.  Talk to my wife, the bankruptcy lawyer, about this.  She knows how many bankruptcies come from medical claims.)

In short, if you’re a fan of Levon Helm and against the socialized medicine and Obamacare, then take a look at the hell that you – yes, you – put him through and decide whether you’re really a fan.  Or whether your policies were fair.

Cross-posted from Ferrett's Real Blog.

theferrett: (Meazel)

When I discuss health care, people tell me, “I have good insurance.” I always reply, “Have you gotten seriously sick?  Have you ever had to make a serious claim on your insurance for major surgery or a large-scale illness?”

To which they have until this point inevitably replied, “Why, no, I haven’t.”

You don’t know, then.  So shut the hell up.

The problem I have with a lot of the health care debate is that it frames “health insurance” as some sort of magic shield where everything is covered and you can’t go broke.  But here.  Take a look at Jay Lake, successful fantasy writer and owner of a fully-fledged and well-paying Day Jobbe with what he considers fairly good insurance.  He got cancer, pretty bad cancer that’s required multiple surgeries and chemotherapy.  He’s paying roughly $200 a week in co-payments for his medicine,  and estimates that the cancer is costing him at least $10,000 a year in medical bills alone.  No word on what it costs him in terms of time off from work, his inability to attend writing workshops as an instructor, his lost writing time thanks to cancer-brain, et al. Lord knows what will happen if his Day Jobbe is callous and finds that Jay’s fogged brain is a liability to his productivity, and sorry, time to let you go.

If not Jay, then think of my sister-in-law Kristi, who had health insurance through her husband.  She got a deadly, rare illness – and the insurance company refused to pay for the only known surgery that was known to treat it.  In the meantime, they pulled every bit of bureaucratic bullshit they could get, delaying her payments to the point where she had to keep switching to other pharmacies because it was three months before they paid up, switching representatives whenever she convinced one this surgery was in her favor, denying routine claims on the first couple of tries.  If it wasn’t for our constant advocacy (terminally sick people don’t have the strength to fight bureaucracy) and her family kicking in the money to hire a lawyer, she’d probably be dead.

Insurance doesn’t necessarily save you.  As my wife the bankruptcy lawyer can tell you, over 60% of all bankruptcies in the US are due to medical costs…. And 78% of those people had insurance when they started out.

Here’s the deal: your insurance is always good on paper.  But that’s like assuming all your friends are close, reliable buddies because they hang out at the bar and drink beer with you.  Of course your insurance is awesome now, when all you’re doing is the occasional doctor’s visit for that cold and the Advair you need to keep breathing!  You’re not asking anything of them.

The real test of a friend comes when your partner’s left you, and you have to move out of hir apartment, and there’s a shit-ton of heavy dressers to move while you’re on the verge of crying and your girlfriend’s there and there’s a good chance a new fight’s gonna start up while you decide who gets the Blu-Ray, and your friends know all this is likely to happen and yet they show up anyway.

Every insurance is wonderful until you say, “BTDubs, I’ve got $150,000 in surgery I need.”  Then a lot of them make their excuses at the bar and find somewhere else to be on moving day.

So you know what? Stop talking about “insurance” as though the act of having insurance keeps you safe from any illness.  There are levels of insurance, and levels of disease even within good insurance, that can still leave you utterly untouched or bankrupt should you get the wrong kind of sick.

That’s what the conservatives don’t want to acknowledge: you can do everything right according to the system and still get screwed.  That’s the core problem.  And I don’t mind them exploring other solutions to it aside from Universal Health Care, but I do mind them acting as though “insurance” is a generically wonderful thing that saves everyone equally.

It doesn’t.  Try to face reality when making decisions, folks.

Cross-posted from Ferrett's Real Blog.

theferrett: (Meazel)

…and disagree with my wife.  (Which I do, you know.  On a regular basis.  I assure you, we’re not connected with a web of neural impulses.)

Let’s have Ron Paul, that ever-happy Libertarian who even Fox doesn’t want to acknowledge, talking about what happens when a thirty-year-old man gets sick:

Watching this video-meme spread across my Facebook, what I saw was this:

“The Tea party is okay with the poor dying in the street…”

“He said that the uninsured who get sick should die because they made a choice to be uninsured….”

“Screw ‘em if they’re too poor to have insurance.” (That would be my wife.)

Except, you know, that’s not what he was asked, or even how he responded.  What was asked was this:

“Lemme ask you this hypothetical question: a healthy, thirty-year-old young man has a good job, makes a good living, but decides, ‘You know what? I’m not gonna spend $200 or $300 a month on health insurance cause I’m healthy, I don’t need it.’  But something terrible happens, and all of a sudden, he needs it.”

That is not a poor person.  That’s a person who could clearly afford insurance, and chose to spend his money on something else.  (Before you growl, “He chose to spend his money on peanut butter to feed his starving children!” note the “makes a good living” in the question’s supposition.)  And that’s someone who’s made a dumb fucking decision, and now it’s going to bite him in the ass.

That’s a much tougher judgment call.  I mean, what are we rewarding then?  Yes, it’s compassionate to save this doofus who went, “Well, I’m never gonna die, so I’m not going to bother to plan ahead” – but what about all the other people who actually have put in their insurance to, you know, do the right thing?

You can hate me, but in this tremendously loaded question – which assumes that we know the state of America’s insurance, and that we have a mysteriously well-off man who decides to fritter away his cash on other investments to save money – we should seriously consider letting him die.  Dude, if a guy knows the hammer could fall and lives his life as if everyone around him should catch him when he trips, then why should anyone be responsible?  Why don’t we all just lose our damn minds and pay zero until hey, it’s cancer time?

This isn’t like, say, the housing market, where banks and scummy middle-men lied to poor people and told them that hey, this house will cost you $400 a month forever, don’t read the contract, trust me.  (And don’t fucking tell me that they weren’t lied to; my wife’s a bankruptcy lawyer, cleaning this shit up.  These uneducated people were fed lines of bullshit until their back teeth squeaked.)

This is America, where there isn’t a single person over the age of twenty who doesn’t know how expensive medical bills can get and how badly we fuck over sick, poor people.  You have no excuse.  If you can purchase insurance, and you decide to slide by without, well, maybe letting you collapse into your own stupidity is going to clean up the gene pool a little.

But that question is also bullshit.

Because the healthy thirty-year-old who can but doesn’t is pretty goddamned rare.  This is a softball question, because he should have asked uglier questions like:

  • Let’s say a healthy thirty-year-old guy has cheap insurance at his workplace, and gets dreadfully sick.  The insurance company says his condition is pre-existing, though there’s no real evidence for that, and decides to do the insurance company shuffle of “Let’s deny claims until he dies.”  What laws do you suggest to fix this problem?
  • Let’s say a healthy thirty-year-old woman contracts AIDS through an act of rape.  She now has a pre-existing condition, and no insurance company will cover her, trapping her in a job that can now abuse her as they see fit because her life literally depends on their good will.  What do you suggest she does? No, seriously.
  • Let’s say a healthy thirty-year-old man wants to start up a competitive start-up, but finds that he can’t get good workers because the insurance costs for small businesses are too expensive and don’t cover enough.  Given that this issue is stifling technological innovation, who do you choose to side with – the insurance companies or small business?

The problem, of course, is that if we go with the dreaded S-word and acknowledge that maybe health care should be a fundamental right – not for moral reasons, but because it’s something that’s ultimately good for business, stripping our GNP of this useless health care boondoggle we’ve been sold – then suddenly we have to get honest about “Who should be allowed to die?” and stop pretending that it’s just the unworthy who suffer.

As it is, the Tea Party’s shouting, “YES!” not because they want everyone to die – but because the answer to this narrow, tilted question is self-evident to them. You’ve set it up so that a short-sighted idiot is finally falling to the consequences of his poor decisions.

Ask them better questions – ones more complex, closer to the truth on the ground, a lot harder to answer. The problem with this is not that the Tea Party wants people to die, but rather that we ask questions that makes it seem like the uninsured and the sick are just lazy bums, and we let them get away with this bullshit illusion.

Don’t play to their fantasies.  As a health care professional, Mr. Paul, you should know better.  And I believe you do know better.

Cross-posted from Ferrett's Real Blog.

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