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Member since: 2001
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Why I DO want "medicare for all" and DON'T want "Medicare for all"

"WTF, Bright, you gone schizo all of a sudden?" Bet that popped into the head of many DU peeps who clicked on this post.

But a subset of DUers already suspect (accurately) that capitalizing "Medicare" in the second citation means I'm differentiating between "medicare for all" as a shorthand for "publicly funded and administered primary health insurance" and "Medicare for all" as the precise term for the current Medicare program.

And it matters.

And not making it clear *exactly* what we mean when we're talking about "M/medicare for all" produces a lot of heat and not much light.

The easy one: I do NOT want "Medicare for all" because, frankly, as wonderful as the Medicare program is, and as grateful as I am for it, it would simply not meet the needs of most Americans. It's designed very specifically for elderly Americans. Coverage for pediatric medicine, obstetrics, and other services used by non-elderly people might be quite problematic.

In addition to that, while over the past few years the darling esposo and myself have learned, with professional help, to navigate the various plan offerings at annual renewal, it DID take professional help to sort out which of many options is best for us.

A system that requires professional help to navigate the choices is more in the "part of the problem" territory than in the "solutions" box.

So, grateful as I am for "Medicare", I don't believe "Medicare for all" is a viable solution to America's health care crisis.

On the other hand, I am absolutely gung-ho about "medicare for all"!

That is, a system that provides universal access to a fairly comprehensive array of commonly-needed and cost-effective health, dental, etc., services for Americans of all ages, funded through taxes and administered by a central agency with the multi-faceted mandate of:

a) assuring everyone is signed up and understands how to use the program and get good health care;

b) assuring covered services are accessible to everyone;

c) monitoring the quality of services and ensuring they are safe and effective;

d) identifying and addressing 'high cost' areas (such as emergency-room use, over-testing, price gouging by drug and device makers, etc., etc.,) devising and implementing cost control strategies that don't shut people out of needed care; and

e) working constructively with private insurers and health care professionals who provide supplementary insurance and additional private-pay care (just, for example, as Medicare now works with private-insurer providers of Part C coverage).

I suspect, given their existing experience with case management and administration, such an agency would end up being a combination of the existing Medicare administration and the existing Medicaid administration, with the Feds taking on certain parts of the mandate and State-based branches doing the actual customer service.

And since back in 1986 the Community Action Agency I worked for was part of an administrative cost analysis survey that found private insurance costs between 13 and 28 cents of every health care dollar to administer, 'HMO' type insurers cost between 15 and 21 cents, Medicare (at the time) costed about 6 cents per dollar, and Medicaid costed THREE OR FOUR CENTS of every dollar to administer, we would see pretty substantial savings just from that. I'd bet that even if those numbers have changed in the last forty-some years, the proportions remain similar.

Yes, it's complicated. Yes, I'm oversimplifying a bit.

But not all THAT much. This is not make-a-successful-moonshot-with-1960s-tech or devise-a-superweapon-with-1940s-tech complicated. We have all the elements we need to make such a system work, and work well.

What's lacking is political will.

And we won't overcome the problem of too many elected officials being in the pockets of profit-greedy health care ghouls until we have some consensus about what we want and how to express it in simple terms.

If that's "medicare for all" then fine. If not, someone come up with a better, clearer, more pithy and descriptive term. I'm happy to accommodate.


My profound gratitude to America's military leadership.

I cannot describe how heartsick I was at the initial claims that America's long Independence Day tradition of community-based celebration was going to be desecrated by a bombastic show of military hardware, apparently only to bolster the Commander-in-Chief's microscopic and delicate ego.

The Constitution you and all those who serve gave oath to defend is a document of law and equity, a blueprint for building opportunity and promoting a more perfect Union of the diverse people who believe in our promises. Yes, our military is the world's most impressive armed force.

The awesome power invested in our military has its own gravitational pull and its own corrupting temptations, and our history is not without sorrowful evidence of leaders who have succumbed. But it is also bright with evidence of the highest ideals and standards upheld against those pressures.

As you have provided us this Independence Day.

It cannot have been either easy or simple to determine exactly how to uphold the traditions of discipline and the inherent respect required for a Commander-in-Chief, even one as manifestly unfit as the current holder of that rank, while maintaining fidelity to your service oath and Constitution of our civil state. I can't imagine all the possible avenues of negative consequence and possible backlash you face in walking that delicate line. Careers, ethics, the duties owed to advance the well-being of your troops, the eyes of the world, diplomatic and military operations and objectives at stake, intraservice pressures, and (I'm sure) dozens more a civilian can't even imagine.

So now we're down to a couple of Abrams tanks sitting on flatbeds.

There they are. Military might.

Sitting on flatbeds, dusty and worn. A symbol of what we can and have deployed in the service of the Constitution and the advancement of freedom and democracy, safely at rest on their transports. Not rolling threateningly down civilian streets, just quietly sidelined, as military force always should be in times of peace and celebration.

Present, per orders.

But present as a veteran who wears a uniform to a parade and stands on the sidelines, enjoying the day with their fellow-citizens, proud of their role in maintaining or restoring the peace that allows the celebration.

Bless you.

I hadn't realized how deep my trust in our military as an institution went, until I felt the jolt of horror at the thought it would be betrayed.

And you have not betrayed it.

Thank you.


Impeachment: Like Thanksgiving Dinner, it's all about TIMING.

What is the Democratic Party most worried about right now?

That the 2020 election will, because of the various election-tainting strategies perpetrated and enabled by the GOP, be close enough to steal (again) and/or precipitate sufficient violence to enable some kind of "martial law" move by President Windrip.

Democratic Party officials always knew there would be insufficient time, and insufficient leverage, between a massive takeover of ONE BRANCH of Congress and the next general election, to monkeywrench the election-tainting.

Insufficient time/leverage to deal with gerrymandering.

Insufficient time/leverage to deal with voter suppression and disenfranchisement.

Insufficient time/leverage to deal with vote hackability.

Insufficient time/leverage to deal with Russian interference.

Their ONLY viable strategy, with the Supreme Court in Russian-controlled hands, is to deliver an electoral victory large enough to relegate any kind of contest to the obvious "sour grapes" column into which it naturally falls anyway.

In other words, to deliver a MASSIVE electoral majority to the Democratic candidate, in as many states as possible, including the states most complicit in election-tainting.

Anyone who's ever tried to put an elaborate, traditional Thanksgiving meal on the table all at once, at a specific time on Thanksgiving Day, knows about timing.

Think about a Thanksgiving dinner for a moment: Multiple dishes. Multiple TYPES of dishes. Variable cooking times, variable cooking methods. A large array of ingredients, many of which are not part of the day-to-day meal preparation routine. For the dinner to be successful, hot stuff needs to land on the table still hot. Cold stuff cold. Early stuff- carrot sticks, appetizers, whatever- shouldn't destroy the appetite for the main course. There needs to be options- for vegetarians, for gluten-avoiders, etc.

It's not just "Hurry up and carve the turkey!!"

Even the turkey itself, needs lengthy preparation- to brine or not to brine? Deep-fry, or roast? Stuff or unstuffed? Can you keep the white meat moist while ensuring the dark meat is cooked through safely? Even serving required multiple presentations and formats: Giblets in the gravy for the giblet-gravy eaters, giblet-free gravy for those who can't stand giblets. White meat and dark meat. Are there enough drumsticks to go around? How do you share them creatively among more than two drumstick aficionados?

(This, by the way, is why Thanksgiving Dinner when our household hosts it consists of reservations to a really nice Thanksgiving Dinner buffet at a very warm and inviting local hotel. They are EXPERTS. With lots of practice. I'm not.)

To deliver that massive electoral victory on November 3rd, 2020, Speaker Pelosi and the Democratic Party leadership are already doing the ingredient prep and planning the cooking of the most complicated and consequential "Thanksgiving dinner" political event ever in my lifetime.

If you've ever walked into the kitchen of a competent Thanksgiving Dinner chef anytime from several days prior to five minutes before the actual sit-down-and-eat time, you might recoil in horror. What? You haven't even STARTED mixing the dressing? Aren't you going to brine the bird? Are those whole pumpkins table decorations or future pies? Where are the cranberries? Haven't the rolls even gone into the oven yet? Isn't the red wine open to breathe? WTF??

I suspect Speaker Pelosi has delivered more than a few Thanksgiving dinners to the table. Both literally and in the political metaphor sense.

Me, I'm staying out of the kitchen.

But watching what's going in there... the shopping bags full of ingredients, the big ol' roasting pan coming up from the cellar, the tablecloth being transferred from the washer to the dryer...

I'm planning on showing up for dinner.

And I suspect it'll be a dilly.


No, Ben Carson ISN'T "stupid"... it's worse than that:

So the late-night comedians and the media are having all kinds of fun with Ben's shambling incoherency at the Congressional hearings the other day-- Responding "Amway?" when asked about the OMWI program, and "Oreo?" for REO.

The implication (and outright assumption) being, "What a dummy! Doesn't even know critical aspects of HIS OWN job! Stuff he's been asked about before, sent enquiries in writing, etc.! How stupid can you get!?"

He's not stupid.

He may not be the smartest brain surgeon on the planet but he did manage to qualify as one. I suspect his IQ is in the high normal range, at least.

The problem isn't stupidity.

It's that he honestly believes he doesn't HAVE to know about that stuff. That stuff is for underlings. How stupid are these Congresscritters to be asking him stuff that he very rightly (in his own mindset) leaves to "his people", who are supposed to take care of that kind of thing.

What do they think he is, some mid-level civil servant program manager? Idiots! THEY'RE the stupid ones.

Secretary Carson is a reflection of his boss's own philosophy of leadership:

You don't need to know anything about anything. You just have to have the authority to tell other people what to do.

This isn't just President Windrip's approach, by the way. It seems to have become the default for the entire GOP. NONE of them appear to believe they need to have any skills or knowledge to serve the public. Just authority, to tell other people to deliver on their campaign promises for them, whether the requirements of doing so are Constitutional or not.

It's why they get all self-righteous with fury when those underlings don't "do their jobs" and make the "leaders" look bad.

And here's what's even worse:

Their followers believe this, too. They're not upset that the ignorant, uncaring incompetents they've elected can't perform the functions of legislation or executive management. They're upset that the underlings aren't "making it so" and/or that pesky Constitution and those eeee-vile libruls are interfering with it being made so.

And all the while, we're thinking, "Finally, they'll see how incompetent these doofuses are, and come around to realize we need to elect people who understand the job and have the skills to do it."

We're the stupid ones.

And we are SO screwn...


A Modest Proposal: Can We Compromise With the Forced-Birthers?

Hear (well, read) me out, now... I know how dizzyingly rageful the latest round of forced-birth legislation has made everyone who mistakes women for human beings. And when the rage is that overwhelming, the very word "compromise" can be like a red flag before a bull. I get that.

But look at the playing field, particularly the Supreme Court. Not to mention all those other Federal Courts the forced-birthers are busily packing. We're in a real pickle, here.

Maybe it's time to negotiate.

I had an idea that will reduce the number of forced births women are subjected to by up to FIFTY PERCENT.

Yes, yes, I know... NO forced births is the morally, ethically, and humanly correct number, but we're a very long way from that now.

Fortunately, technology has stepped in with a potential partial solution (no, I didn't say "partial birth", put away that brick of C-4, dudes.)

See, now with modern medicine, we can tell the gender of a fetus at about nine to ten weeks with a simple NIPT screen. A few more weeks, and we can use ultrasound as well. This is critical, because it enables us to identify the VALUABLE fetuses. The ones who are fully human and can be accorded full rights as human when they're born.

Thus, we can also identify the second-class fetuses, the ones that are not quite fully human and thus can be legally treated like an advanced form of livestock.

So how about this: We allow the uterine hosts to abort ONLY THE LESS VALUABLE fetuses, and force them to carry only the valuable ones to term?

This will reduce the number of forced births by, well, maybe not a full fifty percent, since some uterine hosts may decide to go ahead and replicate another uterine host, but it will drastically cut down on the total number of forced births.

We only send them to jail for 99 years or whatever, if we find they've accidentally-or-on-purpose aborted one of those valuable, fully human fetuses.

We cool with this? I think it could work...


P.S. I suppose I should add the smiley here... there's always someone who needs it.

Quit calling it "Anti-abortion". Or "Pro-Life". It's the FORCED-BIRTH movement.

It's not about "saving babies" when you're talking about a fetus so impaired it will die within a few minutes of birth anyway-- AFTER killing the mother.

It's not about the "innocent unborn" when the conceptus was forced on a newly-fertile 11-year-old by an adult subhuman rapist.

It's not about "life" when you're requiring a human being to use their body as an unwilling receptacle for an unwanted pregnancy and all its metabolic, psychological, economic and social consequences.

It's about controlling women.

It's about denying them agency.

It's about "valuing" the potential life of a blastocyst above the humanity and self-determination of a living, breathing, feeling, thinking being-- because of her gender.

It's about FORCED BIRTH.

Which is what masters have always done to slaves. What owners do to livestock.

What Republicans want to do to women.


The Sick Romance of Homophobia and Misogyny

...and why if you slay the dragon of homophobia you ALSO strike a killing blow at misogyny. (Yes, I've turned my response from this thread into an OP at the suggestion of several responders.)

Start with this beautiful image, the cover of today's TIME Magazine:

Sure, homophobia is definitely its own thing, and the whole "ick factor" of straight insecure males being terrified that they're going to be hit on by other guys... or that their daughters are going to take to comfy shoes and shack up with another woman... is rooted in its own existential inadequacy.

But homophobia is ALSO rooted, very deeply, in patriarchy, which rigidly defines gender roles, assigning them based on the supposed 'superiority' of the male and the 'inferiority' of the female.

The whole "traditional marriage is one man and one woman" thing goes back to that patriarchal requirement, heavily bolstered by (in the Abrahamic religious traditions and particularly the Catholic and Orthodox Churches) the tangled legal and economic webs of property assignment and inheritance.

I remember my genuinely ignorant but truly well-intentioned grandmother asking my gay sister, after she came out, "but if you and another woman are together, which one of you is the man?"

Cue a whole range of half-scared, half-mocking comments and queries about "tops" and "bottoms" in gay and kink relationships and a whole range of misogynist and patriarchally-fixated assumptions about "pitchers" and "catchers" in gay male relationships.

The assumption that a patriarchal misogynist culture has attempted to hardwire into us is that in any relationship involving sex, there is one party who "does it to" the other party. And the implication there is that the "doing it to" party is "the man" in the relationship, and the "done to" party is "the woman" in the relationship.

Gay people- and kink people- know that's bullshit. And that's a huge part of the reason that such sexual relationships have been outlawed and regarded as transgressive. It squicks the hell out of people who think in the patriarchal misogynist mindset that any two people in a sexually intimate relationship might actually both "do it" to each other and have it "done to" them in equal measure as their fancy dictates at any given time. That there might be a regular exchange of roles, and that power as expressed in sexual giving and receiving, soliciting and responding, might not be dictated by gender AT ALL!


And that is an often-unspoken but deep-rooted part of the objection to gay marriage- it does, indeed, 'destroy' the "traditional marriage" model in which gender dictates who does what and why.

Every gay marriage is also a blow at misogyny. I'm delighted for us all.


If the forced-birth cult wins...

...they will not like what they win, ultimately.

The problem is, most of them are not old enough to remember what that form of slavery cost last time.

They were not young nurses working in hospitals watching other young women die.

They were not teachers finding the empty desks in their classrooms.

They were not grieving parents attending their daughters' funerals.

They did not see that quiet holocaust.

I'm old enough to remember.

And I remember the Litany of the Unnamed that I heard again and again, from other women. The haunted eyes while they told the stories in soft, anguished voices.

I remember finding out that my devout Catholic grandmother was not part of the cult. She had her own Litany of the Unnamed. There were parts of it she wouldn't tell me about.

Many years later, I recognized that same shut-down, refuse-to-talk-about it response from veterans who'd come back from a combat zone with PTSD.

Back then, there were far more levers of control to keep the conspiracy of silence and to keep the holocaust under wraps.

There were far more conscienceless cult members in positions of power who were willing to lie on death certificates and push alternative explanations for those deaths.

There was a robust infrastructure of institutions that absorbed despairing and vulnerable young women and coldly forced them to carry pregnancies to term while abusing them, shaming them, silencing them. And then taking their babies from them.

There was a mainstream media-wide collaboration with the silence and the shame and the coercion.

There were laws defining who had control over women, and it was not the women.

Banks did not allow women to open their own accounts or apply for credit. There were few avenues of escape or independence.

And a misogynist patriarchy on one hand treated their female chattels like disposable sex toys, and on the other, punished them brutally with forced birth when, with almost nonexistent access to birth control, the inevitable happened.

But that bottle has been shattered into millions of pieces and not even the most dedicated forced-birth cultists can stuff the genie back in.

Women will not stand for it.

If the holocaust starts up again, it will not be quiet this time.

They are sowing the wind.


Self-inflicted wounds add up- this one could be fatal

Here's what he ([Redacted], that is) said, at his Wisconsin pep rally last week:

“The baby is born. The mother meets with the doctor. They take care of the baby. They wrap the baby beautifully. And then the doctor and the mother determine whether or not they will execute the baby.”

This actually happened, Saturday night, April 27th.

I'm pretty sure that [Redacted]'s intention was just to toss a well-done chuck steak to the base in the form of the 'abortion doctors as murderers' meme that the forced-birth advocates are pushing.

There were plenty of ways he could have phrased it that would accomplish that purpose, but [Redacted]'s only talent is his rhetorical skill with flammable embroidery. That is, coming up with the words, the best words, the most incendiary words, the most emotionally-laden words, to push powerful buttons in his specific audience. Even when the actual words themselves are nothing but salad with zero factual or logical content.

He does it on the fly, instinctively, without planning or preparation, without consultation or testing. Without considering second- or third-order consequences. It is the dark gift of the demagogue, the con artist, the accomplished grifter.

So that was an "applause line" when he tossed it out to that audience of cult-addled worshippers.

Then it started getting reported, per usual, on the post-sploogefest list of "outrageous antifactual utterances from The Guy With The Nuclear Launch Codes". A long list, every time. The cumulative list would beat George RR Martin's page count. Or Gibbon's.

And therein lies the trap: Any one thing on those lists can (and often does) serve as outrage fuel for the already-outraged. But there's just so much, it dilutes the impact of any one thing. And the context of the list- "It was just pep-rally hyperbole"- provides a layer of insulation. Thus, he generally gets away with it.

This time, though, I'm not so sure.

Scroll up and read those words again.

The calculated inhuman murderous sadism he attributes to... mothers? Physicians? -is almost nauseating to contemplate. Sure, his pep-rally audience is on board with it.

And sure, the already-outraged are, predictably, outraged. By that among many other sources of horrific outrage.

But what about the people who haven't drunk his sploogefest koolaid and who haven't already spent countless hours on social media trying to gin up awareness of just how morally bankrupt he and his co-conspirators are?

The ordinary folks whose response to him, up to this point, have ranged from a mildly inattentive "He says some outrageous things but he also said some things I agree with, so BFD." to an avoidant and distasteful wish that he'd just STFU and quit tweeting, FFS. Those people.

They're reading those words. The words that explicitly state The Guy With The Nuclear Launch Codes thinks mothers and doctors calculate a kind of coldly sadistic infanticidal postpartum ritual on a regular basis.

And they're starting to respond.

And it's not good.

Anyone who's ever been touched by infant death (check the infant mortality statistics for the past fifteen years, and then think about the number of people touched by each of those deaths- parents, siblings, medical teams, counselors, and more) or who's experienced neonatal crisis and the kind of all-out mortal combat the nurses and doctors mobilize to save a child's life is seeing those words.

He thinks that about mothers (like the one(s) I know) and doctors (like the one(s) I know)?


What kind of SICK FUCK can even CONTEMPLATE that bullshit, much less say it, in public, from the bulliest pulpit our government provides?

And they're starting to realize that yes, The Guy With The Nuclear Launch Codes is THAT kind of sick fuck.

And they're not happy with the knowledge.

They're unlikely to actually do much with it, in terms of, say, demanding impeachment right this instant, or using some media/social media outlet to express their horror, or whatever. The vast majority of them will never be polled about it.

But they vote.

And I suspect the queasy, uncomfortable memory of just what kind of sick fuck is on the ballot WILL have an influence.


When I was a kid, we used to laugh at something called...

..."the National Legion of Decency".

That was okay, even in retrospect, because that organization was worthy of ridicule and laughter in its narrow-minded quest to keep "pure young minds" from being polluted by anything even vaguely suggestive of sex (and, with much less fervor, crime and violence) in movies.

That organization co-opted the term "decency" to redefine it in relation solely to anti-prurience and pro-prudery. They were the source of decades of married couples being portrayed as having "Hollywood beds" in their bedroom- matching twin beds, of course, because any suggestion- even a purely visual allusion to the possibility, of married people sharing a bed was anathema to the legion.

So for years "decency" was a term degraded and pretty much relegated to discussions of Church Lady types.

But "decency" has been making a comeback, in the last few decades. Slowly, mostly under the radar, it's been rehabilitated. It's poised on the brink of being the go-to term to describe people whose actions exemplify things like conscience, compassion, integrity, honesty, kindness, and commitment to the well-being of others, even strangers. Even people who are diverse in appearance, gender, religion, national origin, etc.

Now, like the term "wholesome", decency has taken on a whole new and even slightly subversive tone of "opposition to corrupt, debased, greedy, skeevy, hateful ideas that are trying to become cultural norms".

In other words, the anti-GOP, the alternative alt-right, the counter-sleazy.

And so, after last night's town halls, and after weeks of scrutiny of the field of Democratic Primary candidates, I should like to propose a new collective noun for that cadre:

The New Legion of Decency

By and large the women and men running for President as Democrats are as variable a bunch as you could assemble- diverse in race/ethnicity, in gender, religion, economic and social background, regional identification, etc.

But one of the things they seem to have in common is that they are almost all outstanding as decent human beings. Not just posturing baby-kissing and charity-supporting and 'take a note and get constituent support staff on that person's problem' looking good for the camera. But real, honest-to-goodness attention to the humanity of the people they run across, and commitment to helping in the simplest, most essentially human ways.

This is the most striking difference, today, between Democrats and GOPpies running for office.

When I was a lot younger you could find a good many decent human beings among GOPpies running for, and elected to, public offices. Their ideology and policies may have stunk but they were respectful of the humanity of everyone, even those who differed in opinion and party affiliation. The fixed and settled policy of the GOP was not "to dehumanize our opponents, break apart their families, crush their will to resist, and kick them to the gutter."

As it is now.

So, to oppose this, Democrats have assembled a New Legion of Decency, and I believe that decency WILL prevail.

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