The Romney Campaign's "Two Words"

 Facts, Fact Checking and Fact Ignoring

No one can be sure about how many of the words relentlessly rolling through a political campaign actually penetrate voters.  Campaigns are a very big business, and they've never been as big of a business as they are in this Citizen United year.  There are "bunkers" filled with opposition researchers, political psychologists, economists, ad men, policy wonks and a dozen other types.

"Boy, that last one you told her was a real whopper!" (image and audio source)

It is also not unusual for campaign rhetoric to be quite a ways off to the side when it comes to actually representing unbiased fact.  The spectrum in this case is between dangerous, destructive, out right lies and other messages which have a sort of foundation in fact but which have been "dragged screaming from their point of birth" to the final form heard in a Super PAC television promo.

None of this is accidental.  Every word folks such as MeanMesa visitors hear has cost someone five digits worth of dollars to vaporize into electromagnetic waves and broadcast.

Another perennial conclusion is that the most recent campaign is, somehow, substantially different than the one just two years prior.  There may be some truth to this old urban legend.  Statistics about campaign costs do, actually, show an unsettling pattern of growth -- especially since the Citizens United ruling.  Happily, this drift may not be permanent.  The outrages which that change brought have probably disgusted enough voters that even the politicians are beginning to notice.

But for the focus of this post we are not lamenting the Citizens United money.

A statistical track of the veracity of campaign rhetoric would help much more here than a simple count of the money flying into Super PACs.  For the first time in American politics, statistics of precisely that feature of the politics have become available even though what we can see at this point is only in the early phases.

The fast technology of our times makes "fact checking" incredibly less tedious than it has ever been before.  The "facts" themselves are so easily available to anyone interested in doing the research that such comparisons are no longer three week vacations spent sitting in a library microfiche viewer.  Most political statements are now videotaped, and most of the substance serving as a topic for those statements is also videotaped, transcribed and catalogued in ways which make it "searchable."

Matching the two in a "fact checking" effort now becomes much more "doable" for the average voter.

However, there remain a couple of parameters in this empirical analysis which still seem a bit "up in the air."

First, how much of research like this is a voter interested in doing?  That interest level will always be commensurate with the value the voter places on the outcome of the election and the estimate of whether or not his vote will actually make a difference.  This is not one of those questions which is simply a conversational, academic imponderable.

"Boiled down to the bones," it is a question about exactly how much a voter cares about what happens to the Republic, to the democracy.  Perhaps more importantly, it is a question of precisely what other issues can outweigh the importance of his civic duties, flooding over decisions directed at his responsibilities as a citizen.

This all becomes gut wrenchingly present when the reason that a voter does not commit the interest and effort required for his responsibilities is because the importance of that act is over shadowed with race bigotry.

Or worse, blind, "fact free" hysteria.

Second, for the citizen who is interested enough to search for such answers, there is always the question of the credibility of the contradictory information he might find.  In the age of video, what a politician might say in a campaign about what someone else has said crashes to Earth almost instantly.  However, if that comparison were to include the task of independently arriving at conclusions about facts, statistics or policy, the credibility issue returns -- now enhanced by a voter's lack of confidence in his own discernment.

It should be no secret now that, crippled with "facts" which cannot bear even casual scrutiny, "attacking the messenger" has also become big business.  Every information source from the Congressional CBO to the Environmental Protection Agency has been riddled with "fly by" attacks, maybe not even countering any specific message, but targeting the previously credentials of institutional credibility in general.

That voter's "lack of confidence" is not an innocent coincidence.  Millions or billions of dollars have been spent to carefully groom this abiding uncertainty in American voters.  Further, we know, without any "uncertainty," the exact origin of this work.  The continuing evidence of it is spewed forth daily.

There is a "Party" and a network which is anxious to invest all of its destiny in precisely this gambit.  "Can we entice voters to 'believe no one.'"  The political "pay off" for all this work in creating a horde of drooling, depressed, amateur nihilists remains to be seen.

The election strategy is clear enough.  There are liabilities which derive from campaign rhetoric filled with out right lies.  Those liabilities can only become attractive when that campaign is convinced that the voters it seeks to influence will never actually research the faulty propositions, or worse, not care even if their efforts were to expose the damning contradictions. 

We haven't gotten to the "two words" yet.  So, why wait?  We had to go through all this ranting and raving so far just to "really get ready for the good stuff."

The Romney Campaign's "Two Words"

We focus here on two words among the many which could have been selected from the glacial supply made available daily.  Nonetheless, this particular choice can be easily validated as one which presents a wonderfully robust example of just exactly what's on our mind.

One is a word which is included relentlessly in the campaign rhetoric, candidates' speeches and cruelly emphasized in the inevitable "objective reporting recaps" of it all.  The other is excluded just as fastidiously.

The respectively repeated use and avoidance of these words present perhaps the ultimate example of word by word content management.  The Romney "think tank" psychologists have revealed the foundation of their tactics if not the sepia tone of their souls.  Although MeanMesa remains unimpressed with the potential effectiveness of the scheme, our hat is off to these adolescent Goebbels "wanna-be's" for eagerly embracing such an outstandingly tedious ploy to rehabilitate the heavily soiled candidates their masters have sent them.

The words themselves mean almost nothing once removed from context, but this is the point.  With the carefully crafted context all around either the presence or the absence of these words, the message and all its implications ring just like a broken bell -- and, needless to say, not a Liberty Bell.

Both words are notable for roughly the same reasons:

1. The use and avoidance of both can be very easily over looked.

2. The inclusion or exclusion of both can be easily attributed to another case of the famous GOP "I mis-spoke" explanation given when any utterance comes too close to the party's platform.

3. Since both are adjectives -- syntactically rendering an associated noun with some sort of limit, modification or condition -- the nouns they modify may, indeed, be "bright shiny objects," but the words [adjectives] both represent important additions to comprehending meaning.

4. Even when the words are present or absent, the casual consumer of the rhetoric which hosts them may "absent mindedly" include or exclude them anyway, that is, automatically.

Income

While Mitt Romney has repeated over and over the supposedly reassuring phrase about the taxes he has paid, he has, just as often, repeatedly omitted the word "income."  He says, "I have paid plenty of taxes."  He does not say "I have paid plenty of income taxes."

However, income taxes, and more broadly, the sources and the disposition of the income itself, are completely the point.  This is exactly the fodder from which the Romney nightmares are hatched.  This is exactly what the little hubris soaked, second string candidate has absolutely denied both his followers and his critics.

Current

In this case is is Romney's "side kick" who is tasked with the heavy lifting. A jewel encrusted, gold plated, absolute treasure of the Romney Ryan rhetoric describes -- notably with the repeated inclusion of the adjective "current" -- that there will be no changes in Medicare benefits to "current" Medicare beneficiaries.

"No changes."  Candidate Ryan's "think tankers" are counting on us old folks to "lock on" to this "no changes part" while overlooking the "current" part.  What Mr. Ryan is dutifully parroting over and over is actually quite a bit more sinister than might be presumed at first blush.

Of course the RRR [Romney-Ryan-Republicans] has to do everything possible on two nearly contradictory courses.  They need the old folks' vote so all possible effort must be directed at scaring the pants off grandma and grandpa.  However, they also need to steal the Medicare Trust in order to pay back the $1 Billion dollars that the oligarchs who own the Republican Party have "contributed" to this train wreck of a campaign so far.

Exactly what Ryan is saying, that is, saying with the word "current" included, is that after this generation dies off, no one else will ever get Medicare benefits like the "current" bunch of old people.   The think tankers assume that old people are just like them, willing to vote to keep benefits for themselves but not caring a whit about what will happen to their grandchildren when they get old.

Conclusion

If, for some strange reason, you are even considering voting for this bag of snakes, pay attention to every word they are telling you -- or, not telling you.

Alan Grayson Interviewed on Medicare and Ryan

MeanMesa received the following transcript of the Grayson interview as an email.  The transcript -- and Grayson -- speak for themselves.

Image from the email

Dear MeanMesa,

Alan Grayson was on national TV on Friday night, attacking the Ryan Plan to end Medicare. The MSNBC host, Cenk Uygur, asked Grayson to explain why every Republican Presidential candidate has lined up in favor of the Ryan Plan. This is what Grayson said:

AG: “Listen, only 4 percent of all Americans ever vote in a Republican primary. That’s 4 percent. The other 96 percent are the normal Americans. The 4 percent are people who must never get sick, because they don't want to have Medicare. Now think about that. Every other industrialized country in the entire world not only provides health care for its seniors, but health care for everyone. And the Republican right wing is trying to tell us that somehow we can't afford health care for our seniors. We’ve got 40,000 Americans under the age of 65 who die every year, because they can't afford to see a doctor when they're sick. And now they want to extend that [tragedy] to the most infirmed, most victimized, sickest part of the population, our senior citizens, so that more will die. I honestly believe that if Rush Limbaugh and Glenn Beck announced one day that they were in favor of the Black Death, you’d see every Republican primary candidate for President go along with it.

CU: (Laughter). You know, it depends. If Obama said, “Hey I’d like to cure the Black Death,” they’d be like, “Oh, I don’t know, the Black Death sounds pretty good.” So, now look, I think they’ve done tremendous damage to themselves. The polls are 70 percent and higher. They’re on your side, Congressman Grayson. They say, “We don’t want you to touch our Medicare.” So what are they doing here? Do they have a plan? You know, is Rush Limbaugh or Fox News, are they doing some sort of strategy that we can't understand? Or are they just plain stupid?

AG: They are tools. It’s that simple. They are tools. You know, George Carlin said it back in 2005, they have made us ignorant, these people who own the country. They have made us ignorant and they have made us poor. And now the next thing they want to do is to take away our Medicare and our Social Security. He said that in 2005, and it's taken six year to make it obvious that that’s true. And God bless them, these Republicans like Ryan, you know, they may be cruel, they may be heartless, but at least they're honest. They’ve told us exactly what they want to do with the power that they have accumulated. They want to take away Social Security and Medicare from our senior citizens.

CU: You know, I think you nailed it. I think what it is, is corporations that have, you know, run amuck. It’s out-of-control greed. Whether it's the banks with all the risks that they're taking, it’s gonna crash our economy again. Whether it's the oil companies at the height of being the most profitable companies in the world, they still want to take billions in subsidies from the American taxpayers. And whether it's these guys trying to cut your Medicare so they can cut taxes for the rich. I think they got the note from the, you know, the richest people in the country, from the corporations who said: “Hit the gas pedal. We don't give a damn. We're going to out-raise these guys. We're gonna get more money, and this is the time to put ‘em away. Just tell ‘em what you’re going to do. It doesn't matter; we're just going to outspend them during the elections.” I think that's what's happening. Now the problem is they are going to outspend the Democrats in elections, so how do you deal with that problem?

AG: Well, it's apparent now that what these owners want is nothing from the rest of us except for cheap labor. And that makes the senior citizens particularly vulnerable to their plans, because the senior citizens don't work. So from the perspective of the owners of this country, they're useless. Their time in the economy is over and therefore they serve no purpose. But senior citizens still do vote and they voted in huge numbers in the last election, because the Republicans lied to them, and they told them that the Democrats wanted to take away their Medicare. Now they see that the Democrats are the only ones protecting their Medicare, and Republicans are out to destroy it. There’s a reason why we call Medicare “an entitlement.” It’s because you're entitled to it. It’s not Medicare any more if you are not entitled to it any more. They want to take away the privilege of Medicare. They want to take away the right to Medicare, and replace it with a piece of paper they know will not be enough to cover the costs of care. And that’s how malevolent they really are. So I will say to senior citizens of this country: “Now you see the truth. You see their true colors. And the only thing you can do about it is turn out and vote for the only people in this country who are actually trying to protect you and your interests: the Democratic Party.”

CU: Alrighty. Former Democratic Congressman from Florida, Alan Grayson, very clear as always. Thank you so much.

AG: Thank you, Cenk.

Alan Grayson, still telling it like it is.

Latest Freedom Works Email -- Oooops.

Naturally, progressives watched in glee as the "conservative base" voters had their "little chat" with GOPCon Congressional throwbacks in last week's townhalls.  The wing nuts were expecting a "hero's welcome" from the locals, but instead, "Medicare killers" like Paul Ryan were lucky to go home after the meeting without nails through their wrists.

After all, it WAS the Easter season.

Courtesy Huffington Post (image source )

Not to ever "take a second seat" to anything, Freedom Works stumbled up to the microphone for yet another tedious "flame session."  Out went the email -- most likely only a few minutes before the "media" got a hold on the town hall videos.

CBS News - Ryan Booed at Townhall Meeting

Attention Freedom Works:

This cow doesn't like it in the barn.

The email:

Demand a Vote on the "Save Our States" Act -- Halt Implementation of ObamaCare!

Dear MeanMesa,

There is legislation in Congress that would kill the ObamaCare health care takeover, but it needs your support NOW to have any chance of passing.

TAKE ACTION!

Senator Kay Bailey Hutchison (R-TX) has introduced the "Save Our States" Act. This bold legislation would completely halt ObamaCare's implementation pending a final ruling on its constitutionality by the courts, effectively stopping the President's socialized health care nightmare dead in its tracks.

This is exactly the reason so many conservative and independent voters flooded into election booths last November. Unfortunately, Senate Democrats under the leadership of Majority Leader Harry Reid (D-NV) are leveraging their now razor-thin majority to prevent even holding a vote on this important reform.

It is critical for grassroots America to create a groundswell of support for hold ing a vote on the Save Our States Act. If we can reinforce how important holding a vote on this legislation is, even amongst conservative and moderate Senators, Reid will have little choice but to give in and at least schedule a vote on it.

This is step one - but an important step towards reviving this debate and putting lawmakers, many of whom will be vulnerable in the coming 2012 elections, on the record on what they really think about ObamaCare.

Click here to use FreedomWorks toll-free online phone tool to be immediately connected with your Senators' offices and deliver this important message: it's time to schedule a vote on Senator Hutchison's Save Our States Act and stop the implementation of ObamaCare!

Sincerely,


Matt Kibbe
President and CEO, FreedomWorks

P.S. Help support FreedomWorks' larger health care reform campaign to stop the ObamaCare health care nightmare with your generous donation - click here! Through the support of members like you we can reach more limited government activists with "calls to action" like this one that will ensure we keep up the grassroots energy against government run health care. Thank you!

What Part of Single Payer Don't You Understand?

Republicans and Medicare: The Final Solution

Now, MeanMesa realizes that there is no shortage of content criticizing the overall make up and performance of Medicare.  Every voice from disgruntled senior to "ideologically paralyzed" neo-con has taken a turn at the wheel when it comes to lambasting the plan.

Although not the case that it couldn't be, this posting isn't simply another one of those rolling "bitch sessions."

Instead, this little article is more of an NPR-style, "flannel shirt," Sunday morning commentary.  MeanMesa had been "putting it off" for long enough.  The more or less complete stack of information required to re-enlist for next year's Medicare plan had been building up in a pile of unopened mail for a couple of weeks, and now it was, grumble, grumble, time to figure out just what was to be done.

However, rather than simply "jumping into the fray, whole hog plus the postage," MeanMesa was suddenly -- and unexpectedly -- cast into an unanticipated reflective moment.  That pile of stuff was, well, one hell of a pile of stuff, indeed!

(image source: MeanMesa )

So, rather than simply demand that MeanMesa visitors just mindlessly subject themselves to yet another gaseous, detail-starved tirade, the idea arose that a  more meticulous account of just what was "on the table" might be in order.  Let's take a look.

137 pages - Medicare and You 2011:  This publication from the US Health and Human Services Department presents a basic outline of the law.  The content has been carefully "dumbed down," making it not only somewhat narcotizing, but, theoretically, intellectually available to geriatrics with early on-set dementia and other Americans who are -- or have become -- educationally challenged as a result of age.

1 page - "Personal" Cover Letter from Presbyterian Senior Care (PSC):  The "letters" must be counted with the total pages because, although form letters, they contain vital information about the rest of the stuff, including a description of exactly what actions will be required from those "served."

40 pages - PSC Summary of Benefits:  This booklet presents the specific parts of Medicare which are provided through the HMO.  Most of this content duplicates what is presented in the US Health and Human Services catalogue, but there are important exceptions.  The implied message is that the additional monthly premium cost of the HMO provides additional services, but "on the ground" experience suggests otherwise. 

The "persuasion" campaign details why the HMO is justified in charging an additional 15% or so above what raw Medicare would charge.  The actual facts suggest that HMO doctors are willing to provide services for the HMO compensation, but that they wouldn't be so agreeable if they received only the Medicare payments.  The argument is a bit "too light on facts" for MeanMesa to totally buy into the idea.

105 pages - PSC Formulary:  This is a reference document which lists which medicine will be covered by the HMO's repackaged version of Medicare Part D.  MeanMesa's experience suggests that most of the HMO doctors have not ever looked at this document.  They seem to have no problem continually prescribing medicine which is not covered in the formulary list.  These prescriptions become impossibly expensive when they are not covered by the insurance.

169 pages - PSC Evidence of Coverage:  This contains primarily a more carefully constructed explanation of exactly why the HMO's policies are legal in the sense that they comply with Medicare laws and regulations.  Although a little more "legalese" than most folks have any appetite for, this booklet more or less represents the actual contract which describes what is insured and what isn't.

The Evidence of Coverage manual is most likely the one which MeanMesa will store away in a safe place for future reference.

8 pages - The PSC Summary of Ratings of Health Plan Quality:  This is a "representative summary" of client opinion polls dealing with satisfaction levels of people using this health plan.  Of course, the questions tend to be a little "leading," and the "results" have a suspicious "cherry picked" quality to them.

9 pages - PSC Annual Notice of Changes:  Digesting this little jewel might produce some fleeting coherency if the reader were intimately informed about  the details in last year's form of the policies which were now being changed.  However, absent that awareness, the document amounts to little more than new policies for coverage which are being instituted for this plan period.

The main reason for such "changes?" 

Limiting payments for previously covered costs and adding to the "non-profit" PSC's revenue stream by cutting liabilities, in other words, "Because we can."

1 page - Cover Letter Invitation to (Annual Notice of Changes) ANOC Explanation Seminars:  At the last ANOC "convention" MeanMesa attended, there were around 1,200 PSC subscribers.  Everyone attending got a Presbyterian Senior Care umbrella, a small bowl of "breakfast fruit," and half a dozen marginally relevant lectures by PSC executives.

The "breakfast fruit" was to encourage better eating habits among those of us still able to digest fresh fruit.   Only about the first 800 got a chance at the free pancakes and sausage.

The "cover letter" includes an RSVP for this year's event.  MeanMesa says, "No thanks."

2 pages - Invitation to join Silver Sneakers:  This is an exercise program offered through a deal with several local fitness centers.  Old people are supposed to attend low impact "arm moving" and "waist turning" groups.  The big attraction?  It's FREE!

1 page - Getting Help with Your Premiums:  This letter details ways for seniors to get discounts or subsidies for their PSC premiums.  The US Health and Human Services booklet describes a Federal program which covers this for straight Medicare recipients, but the Federal program also includes ways to get help paying for services and pharmaceutical co-payments.  This is another case where the extra 15% you pay for the HMO actually provides less benefit than what you would get from straight Medicare.

142 pages - PSC Provider Directory:  This reference book provides lists of the doctors who work with the Presbyterian (PSC) plan.  During the time that MeanMesa has been covered by the plan, approximately one third of the doctors seen have not been listed in this Provider Directory.  This is caused primarily by by high rate of turn-over the plan experiences.  MeanMesa has to assume that this is the result of low payments to plan doctors.

2 pages - Invitation to Join Free Dental Source Plan:  This is the equivalent to a CostCo discount group.  MeanMesa tried this plan a few years ago, but found that most local dentists won't even touch it.  Medicare does not, generally, include dental coverage.  This phony discount scheme is one of the "additional benefits" the HMO uses to justify it's 15% high rates.

This posting is not about whether or not MeanMesa is grateful for Medicare health coverage.  MeanMesa is incredibly grateful!

( image source: MeanMesa )

However, when the sheer volume of the required details is considered, most of which have arisen from irritating little caveats injected into the process by Republicans serving their corporate insurance company sponsors, the single payer idea gains some real traction.  The coverage dollars unavoidably consumed by each claim trying to swim through such an immense bureaucratic swamp tells us that we made the wrong choice when we obliterated the single payer idea.

What Health Care Reform Looks Like From the Ground

A Letter to President Obama from Precinct 384

This quick note is about a serious difficulty we are having with Organizing for America’s (OFA) health care talking points.101

I am an “Obama soldier” from the campaign -- precinct 384, NE Albuquerque, neighborhood team 39. Naturally, I went to the new OFA office this morning after receiving last night’s phone call. I met the all the friendly, bright eyed, eager folks hunched over their laptops and picked up a copy of the canvassing material.

After looking through it, I am concerned that this effort is making the same mistakes that were made in the campaign -- at least, the same mistakes with respect to the precinct 384 “voter universe.” For 30%-40% of the voters in this precinct, the talking points are a “clear miss.” In fact, I suspect that they even go so far “off target” as to be insulting. This is too similar to an unfortunate repeat of what happened in the endless 2007 - 2008 Presidential campaign “slug fest” where the most persuasive campaign issues seemed to simply be “over our heads and over our pay grade.”

I’ll note the exact conflicts the “Three Principles”President Obama’s promotion plan presents in the real life situations of this constituency.

1. Reduce Health Care Costs
This constituency: They usually don’t pay for treatment. They wait until things get really serious, then they go to the ER and apply for “No Pay” treatment. That process is frustrating, uncertain, demeaning and time consuming. They suffer from all the subtle indignities of this process -- especially when they know that other people have actual health plans. They are totally ready to pay more taxes to get dependable care.

The emphasis on “keeping” your doctor means very little to my neighbors. They don’t have a doctor. They have probably never seen the same doctor more than once or twice. They are completely accustomed to taking what they can get. “Go to the Doctor,” to them, means packing up the family and waiting in the ER for 5 or 6 hours, then not having enough money for medicine until payday.

2. Allow Choice of Coverage and Doctor
This constituency: They have never made any choices at all so far. Period. No choices! Coverage to them means the “safety net.” They, frankly, don’t understand what “choosing a coverage” means. They have never had an employer provided insurance plan, although they may know people who have. A 21st Century version of "keep away."

3. Better Quality Health Care
This constituency: They have no way to make an opinion about health care quality aside from their memory of outcomes. They haven’t experienced enough of a variety of health care, that is, the variety that is implied in the talking points, to make a judgment. As for reducing the paperwork, they have never had health care other than the “No Pay” kind which is always chest deep in agonizing, belittling paperwork.

I’m not interested in starting a class war here, but the OFA material seems basically intent on doing just that. Precinct 384 contains an awful lot of voters who are simply put off by choice issues presented to them at this level. The choice the voters in this neighborhood have made is simply one in favor of improved access to health care.

We registered a lot of these people who had never voted before to elect the President. When we talked to them and approached them in a suitable way, they were completely ready to learn about the election politics and VOTE! However, the Presidential campaign had the same “over their heads” direction as this health care thing, and we could have failed to deliver this state if all this population remained “left out” in favor of a campaign targeted at more prosperous urbanites.

Precinct 384 voters have the same worries as most other Americans. They know that, in a well designed response to the grave damage done to the country during the autocracy, major investments in not only health care reform, but also in climate change, energy policy and educational resource allotment, will mean huge spending bills moving through the legislative process. In the past, they have seen every such possibility of actual progress being ruthlessly looted as it is “negotiated” into oatmeal in the Congress. Traditional hillbillies, crooks and neo-con bigots join forces with "bought and sold" Democrats, emerging from their dens to savage any good idea, that is, to extract every possible illegitimate advantage for their friends and campaign contributors.

About 1/3 of New Mexico is watching these health care developments while “looking up” from the very bottom of the heap. We are a poor state with lots of immigration, education and public service issues. Our neighborhood team made our own campaign literature for 2008 for just this reason. And -- this seemed to work well. Both the President and OFA must make more of an effort to include this constituency by focusing on a description the new system and what it will be like for Americans in this very real situation.

I was never much of a John Edwards fan, but he talked about “Two Americas.” He was right. In New Mexico we need “Two Campaigns” and some way to keep them pointed at the right constituencies. The neo-cons are already targeting the new Democratic Congressional delegation from New Mexico. We can’t let this slide back to where we were when the state went for Bush in 2004.

To President Obama: “Remember us! Tell about a plan that relates to our ‘on the ground’ reality. We support you now, and we will continue to support you, but we would like to be included in the debate!”

Healthcare 2009: Medicare Part D on the "Kitchen Table"

Welcome to the E.O.B.

A "real life" example of a health care question. A huge part of health care reform will be the removal of everything which has been added by the special interests who have designed and legislated every part of what we now have. The switch will be legislation which directs health care at health instead of profits.98

A MeanMesa post about healthcare could easily extend to far too many inches -- and even that approach would still omit many important facts! So, in an effort to keep this short, let’s just say that we won’t mince words.

In order to get right to the point, let’s take a look at the illustration included here. This is a monthly report from Presbyterian Senior Care in Albuquerque, New Mexico. A similar form is mailed to the author of this blog every month. ( Just click for an enlarged image.)




When we look very carefully at exactly what this form says, we can get a glimpse of one aspect of the Medicare Part D Pharmaceutical Coverage as it was written by the pharmaceutical lobbyists when it was passed during the Bush Autocracy. Taking a look at the actual results of the program in action can, hopefully, reveal far more than abstract analysis offered by media pundits. What we will examine here is the reality of what Americans using Medicare Part D encounter across our nation.

The cover letter accompanying this little jewel describes it as an: E.O.B.,
an Explanation of Benefits for Your Medicare Prescription Drug Coverage (Part D).
THIS IS NOT A BILL. Keep this notice for your records.

This notice includes:
1. How much you’ve paid so far this year for your prescriptions.
2. Your recent claims for prescriptions.

Now, to the information on the form.

The second row of numbers is high lighted. It is labeled as “Your Current Phase.” Moving across the boxes in Row 2, “Your Current Phase,” we see the following.

The second box shows the maximum allowed drug costs for the period, $2700.

Now, although one might think that this figure of $2700 represents the maximum prescription costs which will be paid by Medicare Part D under this plan, the fact is that this $2700 figure, thanks to the careful way the original legislation was written, actually represents the maximum which will be paid by either the insurance or the individual.

The third box as we move along this row is the amount actually paid by the insurer, in this case, Presbyterian Senior Care, $160.24. This figure represents the cost of my prescriptions paid for by Presbyterian Senior Care, an HMO which handles my Medicare Part D coverage. This $160.24 is the part of the cost of these prescriptions other than the co-payments I made when they were purchased.

The fourth box shows the figure $80.92. This amount is the total of the co-payments.

Now, it gets a little more interesting. The fifth box shows the figure $80.92 again. This time that amount is described as the amount “you/others on your behalf paid that counted toward your out of pocket expenses.” This means that this $80.92, although not paid by the insurer, is still counted toward the $2700 limit of “this phase” of coverage.

Moving along, the sixth box shows the amount of prescription expenses, $0.00, also paid by the individual, which do not count against the $2700 initial coverage limit. Apparently no one receiving these benefits has ever had any amount listed in the sixth box. All the expenses paid by the individual for prescriptions count against the $2700.

To compute the figure in the seventh and final box on the second row, we will add the figure from box three to the figure in box four, that is, $160.24 + $80.92 = $241.16, the total cost of all prescriptions so far this year regardless of who paid for them. To arrive at the total amount of the $2700 initial coverage limit remaining for future payments during this coverage period, Jan. 1, 2009, to Dec. 31, 2009, we subtract that total from the “Initial Coverage Limit,” $2700 - $241.16 = $2458.84.

Our last stop on this interesting form is on Row 3. The second box on row 3 is described as “Maximum you/others on your behalf pay in this period.” The “this period” part of that label refers to what is called “Coverage Gap.” It is, also, lovingly referred to as “The Black Hole” or “The Doughnut Hole” by folks relying on Part D coverage to help pay for their prescriptions. The “Maximum you/others on your behalf pay in this period is: $4350.00." All the figures shown in Row 3 deal with this “Coverage Gap.”

The final box on Row 3, clear at the right on the form, shows a figure for the “Amount left before catastrophic coverage.” That figure is derived by subtracting the total paid for prescriptions by all payers, calculated in Row 2 and amounting to $241.16, from the “Coverage Gap,” that is, $4350.00 - $241.16 = $4269.08.

The “Coverage Gap,” that is, when total prescription costs have reached $2700 (based on the way they calculate this in Row 2) and gone on until they have reached $4350, means that there is no Part D coverage for this “period” or "phase." Part D becomes active again only after prescription costs have passed $4350, and is then called “Catastrophic Coverage.” Row 4 describes the features of this part of the program.

Relax. All the math is finished.

Now, what exactly is the point? To illustrate “the point,” let’s compare it to a different example of common insurance, say, auto insurance.

When we have a car wreck, our insurance company comes to the rescue. Our policy describes precisely what our insurance covers, and also states very clearly that there are limits on various possible costs resulting from a car wreck. For example, even if you were "drunk as a skunk" and collided with a bus full of orphans from a home supported entirely by trial lawyers, your insurance company would not be willing to pay a trillion dollar settlement.

A trillion dollars would be far more than the limit of liability your policy contains for that sort of accident. The idea of clearly stating the “maximum coverage” provided by your auto insurance policy is a completely standard practice of that type of contract. “Maximum coverage” or “liability limit” simply spell out just how much you have contracted your insurance company to pay. If you had wanted them to pay more, you could have purchased a contract with a higher “liability limit” for a higher premium.

However, if we were to insinuate the Medicare Part D coverage structure into this auto policy, we would arrive at a bewildering conundrum. The “liability limit” on such a policy would include not only the total amount the insurance company might possibly have to pay, but it would also include everything you might pay out of your own pocket! This means that if you had to add any of your own money to the amount finally paid to the orphans, your insurance company would consider that to be a part of what they paid!

In this version of auto insurance, anything you paid would count against your “liability limit” in just the same way as if your insurance company had paid it!

If auto insurers could sell this kind of policy, they would love all the extra money they would earn settling such claims! Unhappily for them, no driver in his right mind would ever purchase a contract like this one. If such a policy were ever offered, drivers shopping for insurance would immediately be on the phone to a different company.

However, with the “special attention” the pharmaceutical lobbyists paid to writing the Part D legislation, the equivalent of this “crazy auto insurance company” turns out to be the only insurer in the market for millions of Americans. Aside from passing the thing at 3 o’clock in the morning in the House and aside from the fact that they had to rely on good old Dick Cheney to break the tie in the Senate, this Part D bill was absolutely “chuck full” of legislative “doo-dads” which guaranteed its pharmaceutical sponsors some outrageously huge profits. And, as of now, those PHARMA sponsors have been doing, well, just great!

It was just the end of one of those binge "looting" parties that George Bush liked the very most. If all of his lobbyist friends were “snorting” and “cavorting” when he signed it into law, he figured that he had done his work very well.

Some of those “doo-dads” have already turned into billions of dollars in profit to the pharmaceutical companies and billions of dollars worth of fraudulent extortion costs for Medicare For example, unlike our auto insurance analogy, there is, by law, absolutely no competition or negotiation allowed. The price tag the pharmaceutical companies stick on any prescription is the price which will be paid under Part D. Period. No Americans will be allowed to go to Canada and purchase the same prescription for a lower price because “it simply isn’t safe for our elder citizens.” Right. They need to buy those prescriptions here where the full price can be charged to be safe!

Gotta' take care of the old people -- and, of course, the pharmaceutical corporations.

Under this weird legislation, even if old people did illegally go to Canada and paid for their prescriptions out of their own pockets, Medicare Part D would consider any money they spent this way to count against their “coverage.” It would appear in Row 2 of our form as an addition to the figures in box four and box five.

All of this "special" accounting might be no more than another Federal policy fluke, except...
When neo-cons are busy "proving" that "we can't afford health care reform," they are using a rather deceptive number to calculate that cost! The figures which are derived as the "cost of the program" are NOT BASED on the amounts that Medicare will pay for covered prescriptions. Instead, those numbers include all the amounts that ANYBODY PAYS for prescriptions. They include the amount that Part D will pay, but they also include the part that individuals will pay in co-payments and for drugs not included on the Part D formulary! Or in Canada! They even include the amount of coupons given by drug companies to lower the price of their own prescriptions!

Snakey. But, what did we expect?

The following e-mail arrived in my computer from the “Organizing for America” folks:

We knew healthcare reform would face fierce opposition -- and it's begun. As we speak, the same people behind the notorious "swift boat" ads of 2004 are already pumping millions of dollars into deceptive television ads. Their plan is simple: torpedo healthcare reform before it sees the light of day by scaring the public and distorting the President's approach.

When the swift boaters flood the airwaves with distortions, we'll flood the streets with volunteers armed with facts. When they send lobbyists to tell Congress to back down, we'll send millions of calls, letters, and stories from real Americans asking them to stand up.

At the very bottom, Bottom Line of all this mischief, health care outcomes in the United States, although the most expensive in the world, are some of the worst in modern developed countries. In most European systems, it is illegal for a for-profit health insurer to even insure primary care.

Yuck. These American parasites seem to have a "thousand mouths."

I hope MeanMesa visitors will remember just how crazy this “gang rape” legislation actually is.

They should remember. They are paying for it, like it or not.

For an account of the scandal of the PHARMA Bill's passage:

http://dailypharmacist.com/wordpress/?p=66

and, straight from the Social Security Administration, a compilation of Part D:

http://www.socialsecurity.gov/OP_Home/ssact/title18/1860D-04.htm

Still interested? An earlier post from MeanMesa: "Health Care Without the Lipstick"

http://meanmesa.blogspot.com/2008/10/health-care-without-lipstick.html