Sunday, July 24, 2016

"I Could Shoot Somebody and I Won't Lose Voters."

Today's New York Times Sunday Review (July 24) consists of 19 articles.  Seven of these (37%) deal with Donald Trump.  With publicity like this, who needs advertising?

The Times, and so many of the media, continue to point out the many inconsistencies and lies he has  perpetrated since the start of his successful campaign to win the Republican nomination.  They continue to remind us of all his insinuations and insults on his way to that nomination - "lyin Ted, low-energy Jeb, little Mario, crooked Hillary," to mention a few.  And his lies - thousands of New Jersey Muslims cheering 9/11, thousands of immigrant Mexican are rapists and murderers.  And his innuendo and outlandish statements - Ted Cruz's father was complicit in the Kennedy assassination, Putin got it right, John McCain's no hero because he was captured ("I like people who weren't captured").  And many more.

We all are all too familiar with these atrocious and inciting Trumpian remarks.

What has all this done for Mr. Trump?  Has it hurt him?  Has it stopped him?  In fact it has elevated him to an exalted position.  He has captured a major political party,  and has captured the loyalty of millions of disgruntled Americans who seem to regard him as almost "messianic."  Incredibly,  he has  gone on to become the Republican nominee for President of the United States!

Trumpism demonstrates the desperation of so many American people today.  Desperation exists - whatever the reason.  It exists whether ill-founded (which it is) or not.  And when such feelings enter one's brain and one's "soul" he/she anxiously searches for a "Trump."  Lies, distorted history, or inaccuracies revealed about a demagogue are ignored, or otherwise rationalized as either not true, unimportant, or marked as an attempt to smear.  Irrationality takes hold.

It is not unlike the philosophy behind theodicy - the acceptance of a god despite clear evidence of horrendous evils.

So media, give it up.  As Trump said:  "I could shoot somebody and I wouldn't lose voters."

And the New York Times, as well as many other media outlets, continue to provide this "wonderful father, husband, philanthropic businessman (just listen to his family's platitudes) and human being" the attention he doesn't deserve.

Tuesday, July 19, 2016

Obamacare and Medicare

A recent article in the New York Times (July 19) highlighted some major issues regarding the Affordable Care Act (Obamacare).  The article was provoked by an essay in the Journal of the American Medical Association which emphasized some of the act's weaknesses.

Affordability remains a major problem, according to this discussion.  It was thought that competition would help keep premiums affordable, but this has not been the case.  The government is now considering adding a "Medicare-like public plan" to the mix.  Private companies, however, already unable to sustain Obamacare requirements, would be even more likely to leave the plan with the adoption of a Medicare option which would significantly reduce the private marketshare by virtue of the invocation of a government controlled price option.  Medicare would decrease physician reimbursement as well as hospital reimbursement.

A problem rarely discussed remains the one of physician availability in Medicare plans.  More and more physicians, dismayed by lower reimbursement rates, are opting out of Medicare.  This seems to be particularly true in urban centers.  The Wall Street Journal reported that 9539 physicians opted out of Medicare in 2012 compared with 3700 in 2009.  A recent study (2015) from the Kaiser Family Foundation surveying non-pediatric primary care physicians found that only 72% of the physicians are taking new Medicare patients, whereas 80% are accepting new patients with private insurance.

Medicare, the "safety-net" for senior citizens, is slowly losing physician-subscribers.  This, too, requires addressing.  Lowering reimbursement rates even further to bolster Obamacare will only tend to hasten this physician-departure.