Posts Tagged work

it couldn’t hurt .. or could it

I’ve been watching with interest the current Republican party dance around repeal of the Healthcare insurance legislation just passed.  Its a sad bit of badly made political salad with very little for those who need health insurance, a guaranteed business for the insurance companies (universal sign up), guaranteed pharma profits (no pharma negotiation) and extension of the market for about 40% of those who are still uncovered or uninsured.

State legislatures, not to be overlooked are trying their best to carve themselves in our out of the new Heatlhcare bill by blocking advances or by shouting states rights.  With hard economic times, its easy to get voters to hear the shouting but miss the salient points.

We’ve missed the boat, again. Smoke and mirrors and distraction reign supreme. The emperor, or his bill, have no clothes. This does not cover a majority of the uninsured. I’m waiting to see how those who are unemployed, now some approaching the 2 year mark, will pay for this bit of fluff.  The state’s assistance systems were already at a foundering point and shoving the burden to physicians and hospitals for the under and uninsured will only exacerbate the problem.

There’s a bit of shuck and drag going on here. We’re told that we need to work to pass this. We’re told it will bankrupt us. We’re told this is socialism at its worst.  Socialism?

Today one of the walking wounded comes to the clinic. She works 40-50 hours a week, full time  she’s told, at one of the local hospitals. To expedite services the hospital contracts out its housekeeping. The firm, to keep profits ripe,  they don’t pay insurance.  Hmm. Ok. We took what was a paid in-house position, took away the benefits, hired the same folks to do the same job so that the profits would stay as high as maybe ….

I digress. Here’s a full time working person with no insurance.  How is a public option for her, socialism?  From where I sit, we pay into the medicare system.  We pay it in wages and taxes and reap a long term benefit devoid of the need for stockholders to benefit. Although an inconstant fiduciary, generally governments have handled trust funds much better than banks or insurance companies, always looking to the next gaming table, ripening the profits.

If we allow the loud shouts to take back the minimal advances, and I agree its far from perfect, we’ll end up with still more uninsured.  The hidden cost of the ‘uninsured’ long patched over by draining high end payments from private insurers into the unbalanced pot is at an end. The insurance blokes, have cut off that avenue. The uninsured now go to emergency rooms, expensive care, and not much of it.

Emphasis from the Healthcare Plan was on primary care, extending to patients the ability to see and to find competent expert medical care. If we persist at deconstructing the fragile imperfect house, we’ll have but a very expensive house of cards fallen loosely and very expensively apart.  Threats of Medicare cuts are more thunder than substance. We do need government to help us. Watch carefully.

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Its Monday — everybody works on Monday

That line from the movie “Dave” would be poignant if it were not so sad here . Most of the people I see want to work — but there is no work. “Work was something that used to exist” — Jean Sheppard — and he was talking about the ‘Great Depression’. Alas it was neither great nor did we learn from it. But I digress.

Yesterday one of my patients arrived all smiles and cheery… yes.. he just got a job. A real job in a field (food service) he wanted to work in. There’s something radiant about someone who just got a job, a glow and an aura about them. He had been jobless for nearly 1 1/2 years, looking looking but not finding much of anything. A sniff a lead and he was overjoyed.

I hear much talk about how the poor make themselves that way. I see something quite different. I go to the stores in the neighborhood where change is made poorly and incorrectly. At first I thought this an oversight but it happens so frequently that I realized that this is a way of doing business to increase profits, since many don’t check the change. There is loansharking for food, an egregious plot on the poor where 30$ in groceries on Thursday becomes 60$ (or more) on Monday. It doesn’t need much enforcement since there really isn’t much alternative place to go. Additionally the stores carry such small cans of items (2 ravioli in a can), that the prices end up enormous for minimal nutritional value.

Work is hard to find in this poor urban area. Transportation is available but not always convenient. There are dangers, the indolent prey on the poor. There aren’t many but ripoffs and knockdowns occur regularly. Most people travel with one hand free.

My guy. All smiles. He’s looking forward to work. I think most are. Its depressing being marked ‘poor’ and then no places to work. Poor areas become poorer. Business shys away from the area. Poor areas become poorer yet. The spiral continues.

I wish that all the folks here could feel the joy … pleasure … of work, of a job.

Its Monday. Everyone SHOULD work on Monday

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