Alan Grayson: The Only Democrat with Balls (Aside from Kucinich)

Alan Grayson: “Well, listen, I didn’t call names. What I said is true. The Republicans have even nothing resembling a plan. And when you don’t have a plan, what that means is your plan is ‘Don’t Get Sick.’”

Obama, the Medicare “Doughnut Hole,” and the Working Poor

Last night, on Twitter, I got into a lively exchange relating to last night’s Obama infomercial. I had initially watched ten minutes of this broadcast, and I grew increasingly upset by the manner in which basic realities about health care and the working poor have been severely overlooked in this presidential race. Upon being pressed, I watched the whole thing from the beginning. “Those weren’t the working poor in that video? The 72 year old guy working at WalMart not poor enough?” argued Seth Harwood. While retired railroad man Larry Stewart putting on his Wal-Mart badge and taking out a loan on his house to help his ailing wife is indeed a crushing story (beginning at 7:30 in the Obama video), at least the Stuarts have a house to take a loan on. What of the doughnut hole created by a Republican-led Congress through the Medicare Modernization Act of 2003? What of those trapped in Medicare with chronic conditions who skip out on vital medications because they don’t have the money? The situation is this: Under the Medicare Part D prescription drug program, if a senior has more than $2,250, but less than $5,100 in annual drug costs, the senior is required to pay these costs out of pocket.

Now consider the case of 65-year-old Frances Acanfora. Thanks to the MMA, this retired school lunchroom aide saw her drug costs jump up from $58 to $1,294 courtesy of the doughnut hole. She even had to temporarily stop taking her drugs after talking with her doctor. Did Acanfora have a partner or a home to fall back on? We know that she had a credit card. But is she still alive? One wishes that the Washington Post would conduct a followup story. Meanwhile, other seniors have stopped taking their drugs altogether. They couldn’t afford it.

While it is true that Obama advocates the federal government negotiating with the drug companies to reduce prices under the Medicare Part D drug program (similar to what the Department of Veteran Affairs now gets), permitting citizens to purchase prescription drugs from outside of the United States, and closing the doughnut hole, let’s consider why this policy was effected in the first place. The MMA came into being because of rising costs in prescription drugs and the inability of the federal government to allocate enough funds to pay for it. What we have here is a scenario in which the pharmaceutical companies hold all the cards. The companies set the prices. The generic drugs that were supposed to save people money have proven to be more costly thanks to the MMA. The companies claim that the drug prices are high because the companies need to spend this money on R&D. And, of course, the drug companies have lobbyists.

And if the drug companies hold such power, how can there possibly be negotiation? I can see the conversation going something like this:

Government: We need you to lower the costs of drugs. Now we’ll be happy to take them all off your hands, guaranteeing X number of drugs over the next five years, if you’ll lower the prices.

Drug Companies: You’re already going to be getting X number of drugs over the next five years from us. With all due respect, what’s changing here? We’re your supplier. And wait a minute. I thought we agreed back in 2003 that we wouldn’t be negotiating.

Or as Robert Laszewski put it, “If you go to a car dealer and tell him you’re going to buy his car no matter what, and then try to negotiate, you’re not going to get a very good deal.”

Which puts the government in the awkward position of going overseas to import its drugs for Medicare. But if Medicare’s chief drug source comes from another country, how then can the FDA provide the essential oversight for the drugs? This leaves the government coming back to the pharmaceutical companies with its tail between its legs. I’ve looked around numerous places, but Obama has not specified how he can “negotiate” with these draconian realities in place. But to his credit, he did issue a press release last year condemning the Senate’s failure to consider legislation permitting Medicare negotiation.

Let’s return to the issue of Larry Stewart and Frances Acanfora. The rhetoric in this presidential race has involved speaking to Main Street and the middle-class, who we are told increasingly are having to “tighten their belts” to make ends meet. But what is not really being talked about by either camp are the 29.4 million Americans — up 4.7 million from 2002 to 2006 — living below the national poverty line. Tayari helpfully directed me to this Democracy Now! segment from a few days ago, which goes into this issue at some length. And indeed why should either candidate talk about low-wage workers when Obama leads 2 to 1 over McCain? (Incidentally, a majority of low-wage workers polled in this article indicated that their personal finances were unlikely to change — even with an Obama presidency.)

When you consider Medicare’s reliance upon pharmaceutical companies and this regrettable framing emphasis away from the working poor, what Obama essentially presented to us last night was comfort food for the middle-class. (So flexible is the term “middle-class” that one can make a six figure salary and still remain lodged within an income bracket that likewise includes someone making $20,000 a year.) But none of this takes away from the fact that nearly 30 million Americans are impoverished, and that 47 million Americans are without health care. What this nation needs more than “hope” is a concrete and realistic plan. We need something more than promises to “negotiate” in nonnegotiable situations. Something that returns us to the dialogue kickstarted by John Edwards last year. Something that ensures that the dread P word spelling out our poverty will return to our national dialogue with neither shame nor flash, but with the maturity and grace that Obama has built his campaign image upon.

American Health Care: Grin and Bear It

Freelancers do indeed need health care. Shame on the spineless Democratic presidential candidates for failing to bring this up or call for universal health care, proper. I admit that I say this out of self-interest. Because I am now a freelancer. And I do not have health care. And I play Russian roulette every day hoping that I will not get sick or viciously maimed or otherwise be the target of expensive hospital bills.

“Well, you chose this life,” you might say. “You knew you had it coming.”

Maybe so. And I’m pretty damn committed to it too. That’s what passion will do for you. Because I am, in part, a crazy bastard. But does this mean that I, and other freelancers who are in the same boat, should be denied free or low-cost health care? Is it selfish for freelancers to expect health care as a basic right? Or do we just grin and bear it?

Shortly after moving to Brooklyn, I contracted one of the worst bouts of pneumonia and bronchitis that I have ever experienced in my life. There was no money to see a doctor and, being on deadline all the time and not having nearly the kind of high octane energy that I usually have when I am the pinnacle of health, I foolishly didn’t go to a free clinic. Because I didn’t have the time. I ended up losing my voice for almost a month — and yet I still continued to conduct interviews.

I coughed so hard that I actually threw out my back, and spent two days in more pain than I cared to divulge to my girlfriend, who was absolutely kind to me throughout — just one of the many reasons why I’m exceedingly lucky. But there came a time when I woke up at 3 AM in which the pain was so severe that I hollered at the top of my lungs and tears streamed down my face. If I moved an inch, my entire back would feel as if it had been stabbed repeatedly. I pretended that all was well, and I learned to live with the pain until it went away. And it was all because I was terrified of paying hundreds of dollars just to get some goddam antibiotics that would fix the problem. The pain was an assault to my very being, yet I was determined to carry on, as vigorously as possible, not being a corporate whore.

But I was a whore of an altogether different sort. A whore to patriotism and a severely flawed health care system in which the sick, the ill, and the wounded are expected to carry on with their business as if all is well. Because this is America, an ostensible nation of progress and democracy. And we really should shut up and tough it out. This is the American way.

If I was sick, then I damn well better get well. I damn well better have the constitution to pretend that all is fine when it isn’t. That this bronchitis or pneumonia was just a protracted cold. And how different is that really from the cavalier manner in which we look the other way and accept other problems that we believe will get resolved of their own accord?

My intention in 2008 was to vote for a Democrat. But if the Democrat that becomes a presidential candidate cannot get behind universal health care, s/he won’t have my vote. I’m voting for a candidate who has the conviction to guarantee health care for everyone. It may very well be a wasted vote (or maybe not in this blue state), but if I have to grin and bear it when I get sick, I sure as hell have no intention of grinning and bearing it when it comes to this much larger question. In a just universe, this would be one of the major issues of the 2008 election. But this is a nation that would rather pretend things aren’t as bad as they are.

I could vote for Hillary Clinton, who gives you the illusion of choice, or Barack Obama, who promises that no American will be turned away. (Well, you may not be turned away. But you’ll still foot the bill.) Clinton and Obama are big on “lowering costs,” but they haven’t bothered to toss out any concrete figures. (The only thing we get from Obama is that “the typical consumer would save $2,500 a year.” But that’s more like promising voters that they will continue to carry on the long American tradition of collecting coupons from the Sunday newspaper. Big whoop. I’ll pay $5,000 for open heart surgery instead of $7,500. Thank you for shopping at Target Greatland. (The Edwards plan is more interesting, in that it boldly pits a public health care industry against a private one. But it is likewise reticent about costs.)

But here’s what I want to know. What’s the bottom line? How much will each of these health plans cost me if I want to sign up? And can these plans seriously curtail the crazy costs that come from even an ambulance ride? These are the questions that every uninsured American is asking. These are the questions that keeps someone uninsured. The three major Democratic candidates simply will not, or maybe just cannot, recognize the worries and concerns of working-class America.

So, in the meantime, grin and bear it, America. You may not have health care anytime soon, but this is the greatest country on earth.

edrants