Tag Archives: health care

Journalistic Query

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Do you lack health insurance or are you underinsured? A journalist friend of mine wants to talk to you.

I’m writing a feature about the differences between the presidential candidates’ health plans, and am looking for New Yorkers who either lack insurance or are underinsured. Do you know of anyone in this situation who’d be willing to be interviewed and photographed? Basically I’d like to find someone who works, either for themselves or a small employer that can’t afford policies for their staff, and has either taken the gamble to go without coverage or has bought a policy on their own – maybe a policy they still own, or one they have since let go of because it cost too much. They should know up front that I’d be asking them somewhat personal questions – what their health care needs are, how affordable care is based on their salary and other basic expenses, and what they would like to see change in access to coverage following the election.

I prefer five-borough residents, but Long Island, Westchester and North Jersey are also OK. I’m hoping to get the interviews and photo shoots wrapped up in the next couple days.

Let me know if you’re interested and I’ll pass your information on.

Obama v. Clinton on Gays II

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I’m actually getting tired of the “who’s better for the gays” debate on Obama and Clinton. I think they’re actually pretty similar when it comes to gay rights.

There’s an interview in the Blade today with Hillary about gay rights. While Obama thinks DOMA should be completely repealed, Hillary isn’t ready to repeal the section that allows states to ignore what other states say about gay marriage.

Ideally, DOMA should be completely repealed. But I do understand Hillary’s support for keeping the part about state recognition, for now. That section of the law does keep some people from supporting the FMA, because they say that as long as states can do what they want, there’s no need for an amendment banning same-sex marriage nationwide. (Same-sex-marriage states can’t “infect” other states, if one were to put it in so unfortunate a manner.) We don’t live in an ideal world.

Also, as I’ve pointed out before, even though same-sex marriage is an issue that’s very important to me personally, there are so many issues that are more important and will affect many more people, such as health care, foreign policy, and a president’s general ability to lead and/or get things done. Same-sex marriage seems fated to remain a state-by-state issue for the foreseeable future.

Some people talk about Bill Clinton’s signing of DOMA in 1996 and say that it wasn’t his idea, that it was forced on him by the Republicans. It’s true that it wasn’t his idea; but he was safely ahead in the 1996 election (which he wound up winning by 9 points) and he didn’t have to sign it. Unfortunately, this was at the beginning of his triangulation-and-Dick-Morris era. He spent no political capital protecting us.

DOMA might very well be the only thing preventing a constitutional amendment against same-sex marriage right now, but I’ll always be peeved at Bill for signing it.

Obama and Health Care

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I’m planning to vote for Obama in tomorrow’s primary, but one thing eats at me: his wholly inadequate health care plan. Paul Krugman of the New York Times has written several columns about it, and today’s is one of the most incisive.

Clinton’s plan requires everyone to have health insurance; Obama’s doesn’t. And no matter how affordable his plan makes health insurance, some people still won’t enroll. History has shown this to be true. And if people choose not to enroll until they develop health problems, this raises premiums for everyone else.

According to one paper Krugman cites:

[A] plan without mandates, broadly resembling the Obama plan, would cover 23 million of those currently uninsured, at a taxpayer cost of $102 billion per year. An otherwise identical plan with mandates would cover 45 million of the uninsured — essentially everyone — at a taxpayer cost of $124 billion. Over all, the Obama-type plan would cost $4,400 per newly insured person, the Clinton-type plan only $2,700…. One plan achieves more or less universal coverage; the other, although it costs more than 80 percent as much, covers only about half of those currently uninsured.

Krugman concludes:

If Mrs. Clinton gets the Democratic nomination, there is some chance — nobody knows how big — that we’ll get universal health care in the next administration. If Mr. Obama gets the nomination, it just won’t happen.

Clinton and Obama have debated health care a few times. But I don’t recall Obama ever explaining why his health care plan is better than Clinton’s.

It nags at me.

[Update: some rebuttals are collected here.]

Gay Voters in 2008

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The New York Times covers gay voters. The article contains this huge bombshell:

[G]ay voters in New York are looking past the issues that have long guided them toward a candidate. They are talking about the conflict in Iraq, universal health care and whether it is more important to have a president with experience or exuberance.

Wow! Gay people care about more than just gay issues? You’re kidding! Gay people care about the war in Iraq and health care? Amazing!

Last time I checked, gay people were not just single-issue voters. “The issues that have long guided gay people toward a candidate”? What the hell is that supposed to mean? From reading this article, one would never think that gay Americans live in communities, pay taxes, go to war or have relatives and friends who go to war, care about other people, or consider themselves American.

All this article manages to do is dehumanize and ghettoize us.

Voting Decisions

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I spent my entire therapy session last night talking about politics.

Seriously. Except for one sentence at the beginning about something else, I spent the entire 45 minutes talking about the presidential race. But it was not a waste of money — it tied into my psyche.

I’m taking my vote in the New York Democratic primary next month very seriously. I’ve never thought so hard about a vote before. This is my first time voting in a primary, so it’s my first time having to choose between two or more Democrats.

Voting is a completely irrational act. The idea that my single vote will make a difference in an election is ridiculous — rare is the election that has been decided by one vote. There’s no need for me to spend so much time deciding whom to vote for when it’s extremely unlikely that my vote will matter.

And yet my vote does matter, because everyone else’s vote matters. Each individual voter, making up his or her own mind, is an important molecule in a large weather pattern.

And anyway, we should all think hard about our opinions on important issues, whether we get to vote on them or not. Thoughtful opinions lead to thoughtful discourse.

So, I keep going back and forth between Obama and Clinton.

I’m wary of anyone who’s too enthusiastic about Obama. All the Obama-worship is unsettling. This comment touches on much of what I feel about him. “Obama is a self-conscious messianic figure who is running a messianic campaign.” Yes. I find it creepy.

Our civic culture is going down the tubes, and it goes beyond the White House. Special interests control Congress; the media is lazy, distorting, and entertainment-driven; the American attention span shrinks by the month. A charismatic president alone can’t fix things. In fact, the executive branch isn’t supposed to be able to fix things all by itself. Our constitutional system is set up to resist change. It’s naive, idealistic and foolish to think that one incredibly well-spoken man (and he is incredibly well-spoken) is going to bring us all together, that he’ll inspire the Republicans and the corporations and the insurance companies to hold hands with all of us as we solve health care and skip down that happy yellow-brick road into a land filled with rainbows.

New Hampshire was a relief. Some people were speculating not if, but when Hillary should drop out. I saw or read something like the following: “The Clintons will have to decide if they really want to be the ones who tried to get in the way of this amazing historical moment.” Something like that. It felt like drug-induced euphoria, and even I got caught up in it, and looking back at those giddy five days from Thursday through Tuesday, it was really, really weird.

On Tuesday night I decided I was probably going to vote for Clinton. And despite what I just said in the previous few paragraphs, I’m ashamed to say that the reason was almost entirely emotional. Call me a sap, but when Hillary got on stage and said, “Over the last week, I listened to you, and in the process [pause, then softly:] … I found my own voice,” it touched something inside me. I’d never heard her say anything like that before. It built on her famous emotional moment the day before. (Which was not “tears” or “crying,” by the way, and I wish people would stop mischaracterizing it. And fie on anyone who thinks she was faking it. One, she’s not a good enough actor to fake it, and two, why would she want to, when conventional wisdom told us that an emotional breakdown would mean instant death to any female presidential candidacy?)

What really got me was the next day. I was talking to my mom over the phone the day after the New Hampshire primary, and I asked her what she thought. “Good for her,” she said emphatically. She said Obama seems to be all talk and she liked seeing Hillary win.

Listening to Hillary, talking to my mom, hearing my mom support Hillary… this all mixed together in my brain, and I realized what was behind my feelings. When I finally saw Hillary’s softer side this week, to me it made her seem… maternal. I love my mom, and I received enormous affection from her when I was growing up. So I guess something in me adores middle-aged maternal women, and I saw it in Hillary in those two days.

And I thought, that’s the only thing Hillary had been missing: heart. She has experience, she’s tough-minded and practical, she knows how to deal with Congress — and on top of all that, she’s actually human after all.

I’d yell “You go, girl!” if it wasn’t such a cliché by now.

All of this started to fade yesterday to the point where I don’t know anymore. I’ve realized Obama isn’t an idealistic empty suit after all; it’s just that the messianic fervor around him turns me off and makes me wary. But Clinton isn’t a valueless Machiavellian; she really does want to make the world a better place.

I’m still leaning toward Clinton right now. But I reserve the right to change my mind again and again before February 5 — and I probably will.

NJ Civil Unions

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From the New York Times: 2 Months After New Jersey’s Civil Union Law, Problems Finding True Equality.

I’m not sure what to make of this article, even though I did learn things from it.

Its thesis seems to be that civil unions are causing problems for gay couples that would be solved if they had access to marriage. It begins with several anecdotes about people who are being denied health insurance coverage by their civil-union spouses’ employers, when married spouses would be granted coverage. The nut graf states that these problems “rais[e] questions about whether the new arrangement adequately fulfills the promise of the State Supreme Court ruling that led to it.” The writer of the article seems to have an agenda, which is often the case when an article states that something “raises questions.”

[R]esidents who work for companies headquartered in other states, and those whose insurers are based outside New Jersey, have found it difficult if not impossible to sign their partners up for health insurance. Unions and employers whose self-insured plans are federally regulated have also denied coverage in some cases. Staff members in doctors’ offices and emergency rooms have questioned partners’ role in decision-making. Confusion abounds over the interplay of state and federal laws governing taxes, inheritance and property.

Can you really blame a law on the fact that people disobey it or don’t understand it?

The article also deals with several instances of unequal treatment that would persist even if the New Jersey legislature had granted marriage rights, and not just civil union rights, to same-sex couples.

For example, some companies provide only “self-insured” health care plans, which are financed by employers rather than purchased from state-regulated insurers. Because self-insured plans are governed by a federal law – ERISA, the Employee Retirement Income Security Act – apparently insurers and employers think the plans are also subject to DOMA. But apparently that’s not true:

[G]ay-rights advocates said federal law did not prohibit self-insured companies from providing benefits to same-sex couples. A 2006 report by the Human Rights Campaign Foundation found that more than half the Fortune 500 companies, most of which have self-insured plans, offered benefits to domestic partners.

“It’s the employer’s own choice to decide who’s a beneficiary, and the federal government doesn’t prevent employers from doing the right thing,” said Michele Granda, a staff lawyer with the Boston-based Gay and Lesbian Advocates and Defenders. “Those employers are purposefully choosing to discriminate against their employees.”

Which would be the case even if New Jersey allowed gay couples to get married. Because DOMA theoretically applies to them, too.

The article does point out the problems inherent in divergent state/federal marriage schemes, though – problems involving taxes, Medicaid, and bankruptcy.

Civil union partners filing taxes jointly in New Jersey have to file federal tax returns as if they were single, then calculate what they would owe on a joint federal return to figure their state credits and deductions, said Stephen J. Hyland, a lawyer and writer of “New Jersey Domestic Partners: A Legal Guide.”

“Civil union couples will most likely be treated as if they are single for purposes of qualifying for Medicaid, which can jeopardize the couple’s home if one partner needs nursing home care,” Mr. Hyland said.

Bankruptcy is governed by federal law, although state law determines how married and civil union couples hold title to their property.

There’s a real tension between federal schemes and traditional states’-rights theory. Federal programs are so much more a part of Americans’ personal lives than they used to be. What’s the solution? Either the federal government should recognize all marriages that a particular state recognizes, or state-married (and state CU’d) couples just have to deal with two different schemes until we get a more enlightened Congress and president.

It’s probably going to be the latter. Whenever that happens.

Oh. And so much for my trying to write short blog entries.

Andersen v. King County

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Well, I’ve read the main opinion by the Washington Supreme Court stating that the legislature is empowered to limit marriage to opposite-sex couples. I have to say – although I disagree with the ruling (primarily on the issue of fundamental rights), the three justices who signed onto the main opinion go out of their way to be respectful of gay relationships. (Except for granting them any rights, of course.) This decision is much better written than the recent New York decision, which came out a mere month after oral arguments and appeared to have been a rush job. This decision took 17 months.

Basically, the decision says, “Gay marriage would probably be a good thing, but as judges our hands our tied.” For instance, the court acknowledges that the lack of the marriage option for gay couples can be harmful to them:

We do not dispute that same-sex couples raise children or that the demographics of “family” have changed significantly over the past decades. We recognize that same-sex couples enter significant, committed relationships that include children, whether adopted, conceived through assisted reproduction, or brought within the family of the same-sex couple after the end of a heterosexual relationship. We do not doubt that times have changed and are changing, and that courts and legislatures are increasingly faced with the need to answer significant legal questions regarding the families and property of same-sex couples. …

We are also acutely aware, from the records in these cases and the briefing by the plaintiffs and the amici supporting them, that many day-to-day decisions that are routine for married couples are more complex, more agonizing, and more costly for same-sex couples. A married person may be entitled to health care and other benefits through a spouse. A married person’s property may pass to the other upon death through intestacy laws or under community property laws or agreements. Married couples may execute community property agreements and durable powers of attorney for medical emergencies without fear they will not be honored on the basis the couple is of the same sex and unmarried. Unlike heterosexual couples who automatically have the advantages of such laws upon marriage, whether they have children or not, same-sex couples do not have the same rights with regard to their life partners that facilitate practical day-to-day living, involving such things as medical conditions and emergencies (which may become of more concern with aging), basic property transactions, and devolution of property upon death.

In its conclusion, the court states that “given the clear hardship faced by same sex couples evidenced in this lawsuit, the legislature may want to reexamine the impact of the marriage laws on all citizens of this state.”

Some other points:

Washington Supreme Court justices are elected, not appointed. That might have had a bearing on the outcome.

Interestingly, the court states that the plaintiffs didn’t ask the court to consider civil unions or the rights inherent in marriage, but merely to consider marriage or nothing. If that’s true, one can ask whether that strategy was a good one. Still, I’m pretty sure that courts aren’t limited to considering the narrow issue before them, and this court could have ruled for civil unions if it was so inclined. Instead, it appears to have been very cautious.

The opinion singles out the author of the concurrence, Judge James Johnson, four times for criticism. The concurrence is somewhat more hostile in style, and the concurring judge refers to one of the dissenters as “paranoid.” (Judge Johnson also cited a discredited study finding that same-sex relationships don’t last as long as heterosexual relationships; it’s been pointed out that such studies don’t take into account the fact that marriage is not available to same-sex couples.)

In sum: while I’m not happy with the main opinion, at least it’s not mean.

What’s next? The forthcoming New Jersey opinion. Things are not looking good this summer for court-granted gay marriage. Legal strategies are bound to change and focus more on state legislatures, which haven’t been accepting of gay marriage.

At least the decisions of the Washington and New York courts show strongly why a Federal Marriage Amendment is unnecessary.

Michigan, Health Care, Gays

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Michigan Preparing To Let Doctors Refuse To Treat Gays. Are you fucking kidding me? No, seriously, are you kidding me?

The bill wouldn’t apply in emergency medical situations, but still, this is disgusting. Just plain disgusting, and the members of the Michigan Catholic Conference should be ashamed of themselves. “Individual and institutional health care providers can and should maintain their mission and their services without compromising faith-based teaching,” according to Paul A. Long, vice president for public policy for the Michigan Catholic Conference. If we’ve come to a point where religion trumps human health, for fuck’s sake, then we’re already back in the Dark Ages.

Thoughts on Goodridge

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It’s been a busy day, and I haven’t yet had time to read the Goodridge decision. I haven’t felt like reading much commentary on it, because the arguments pro and con have been laid out endlessly over the last few months. I’d say they’ve been “debated,” except there’s been no true debate on the issue — conservatives have not even been hearing our arguments in support of giving legal protection and security to the relationship of loving couples. For them it’s all about this institution of marriage itself, as if marriage is some damsel in distress being beset upon by wild Zima-drinking boars.

I’ve already written about conservatism and about backlashes. There’s going to be a conservative backlash — it happened in Hawaii, and it will possibly happen again, although apparently the Massachusetts constitution can’t be amended until 2006. That leaves a small window — starting in six months and ending in (November?) 2006 — in which gay couples can get married in Massachusetts and perhaps show the rest of the country that it will not bring down fire and brimstone on the rest of the nation. That is, if the rest of the country is willing to open its eyes, and I’m doubtful that will happen.

I’m not feeling the same elation I felt when Lawrence v. Texas came down in June. That was a clear-cut decision that undid a horrible wrong, Bowers v. Hardwick. Sodomy is now legal across the country, period. The marriage issue, on the other hand, is not clear-cut or simplistic: it brings up property rights, child-rearing, taxes, the Full Faith and Credit Clause. Sodomy is at least distinguishable from vaginal intercourse. The gays want sodomy? Fine, let them have sodomy. But the gays want marriage? Marriage is ours, the conservatives say.

It would all be much simpler if we just called gay marriage something different from “marriage.” It’s the word that does it. Unfortunately, most people are too stupid to tease apart the various strands of the arguments and realize how little a threat legalized gay unions are.

If this country ever gets universal health care coverage, I think every American should be ordered to undergo psychotherapy; every American should be forced to confront his or her fears, to verbalize them, to realize what it is that they’re really afraid of. So many of our problems would go away.

Pad See Yew, Too!

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Pad See Yew, Too!

So much to write about today. I’m going away for the weekend. I’m going to West Virginia, of all places. I have this very close group of friends from college –we all moved into the same dorm at the beginning of my third year of school, and we all lived there for two years. We just clicked from the get-go. There are about ten of us, mostly male, some female, and they’re some of the funniest, most talented people I’ve ever known. A couple of the guys have arranged for us to rent a suite in Berkeley Springs, WV, and their e-mails to the rest of us have been sort of strange and filled with odd portents. I think they’ve concocted some sort of business venture in which they want us to take part. I’m just looking forward to renting a car and going on a road trip with my friend CanadaGirl, who’s part of this group. I haven’t done a road trip in ages. I’m looking forward to getting out of the New York area, I’m looking forward to being away from a computer and not being able to blog for a couple of days.

I think at some point I’m going to have to read this. Fascinating! (Thanks, Dean!)

I talked to my boss today and I’ve persuaded her to give this horrendously dreadful assignment to one of the other clerks. I’ve been working on this thing for about three weeks, or attempting to work on it, and I’ve made no headway. There are either four or five companies involved, and there are either four or five cases consolidated here, I’m not even sure. It involves solid waste and host community benefits and sole source facilities and transfer stations. I don’t really know what any of that means. I have this mental block against the whole thing. I can deal with people. I can deal with a human story. I can deal with someone suing for certain rights, or suing to recover certain costs, or an agency taking action against someone to get his or her (argh) professional license revoked, or even someone suing for Medicaid benefits, despite the confusing technical world of Medicaid. But this case has no human story. A city is suing four solid waste companies to get money from them because they take up space in the city. Or maybe just because the city was strapped for cash and thought this would be a good way to get some. Not even is there no human story; there’s no damn story here at all. I can’t wrap my brain around this thing. I try to read the briefs and my mind drifts off. It repels me. The papers and I are both northern ends of magnets.

I didn’t want to admit defeat, but this morning I decided it was finally time. I can’t take it anymore. And so my boss said she’d give the assignment to one of the other clerks and give me whatever that clerk is doing. It’s embarrassing. As lazy as I am, I’m not a person who likes to quit. Or rather, I don’t like the perception of quitting. Sure, I’ve never had trouble passive-aggessively surfing the Net and getting no work done, but actually giving up? But I guess sometimes you have to know when to quit. You are the Clinton health care plan. Goodbye!

Last night I had dinner with my friend Nick. For the second time in five days we went to Lemongrass and got Thai food. On Sunday we went to the Lemongrass on University Place, and last night we went to the one on Barrow Street. As I turned off Hudson onto Barrow, I realized that a movie was being filmed. Along Hudson there were these fluorescent green flyers that said “To the Set,” with arrows. So I walked along Barrow and there was a Citroen on the street and a Volvo behind it. A man was hosing down the street to make it wet. A handsome, well-dressed couple were sitting at an outdoor table at a restaurant with spotlights around them. I asked a woman with headphones and a tanktop what they were filming, and in a European accent she said, “A commercial from France.” Oh. That’s all.

I met up with Nick and we had the same things we always get — he got Pad Thai and I got Pad See Yew. As I placed each broad noodle and piece of Chinese broccoli into my mouth with a pair of chopsticks, we talked about me and my stuckness. But see, I never feel uplifted when I talk with him. He says things that are meant to be positive and uplifting but for some reason he winds up making me feel worse. I think it just makes me think he’s much more capable a human being than I am. Nothing he said was making sense. Maybe I shouldn’t have tried to let it make sense — maybe I should have let it just wash over me.

I think I’m going to send my resume to Lambda. Also, I think I’m going to look into finding a roommate in Manhattan. Nick suggested that to me. I said okay, even though I’m wary of roommates (I had a bad experience last year). But then he told me there were no right answers. I said okay, I guess you’re trying to signal that it’s better to find my own place? No, he said. Huh? I said. And it went on like that. He was talking about the fact that certain things require work and effort and I was saying that I don’t want to make yet another bad decision. I’m not even summarizing the conversation very well because I don’t really know what the point of it was. It was like going down the rabbit hole. Eat me! Drink me! Make me into a Mobius strip! The point seemed to be that I need to put more effort into making decisions but that I also need simultaneously to worry less about the consequences and yet also pay attention to the consequences. Make a choice that works for me, but don’t obsess about falling into a bad situation. Worry and not worry. Or something. I didn’t get it. He might as well have been talking about solid waste facilities. I couldn’t process what he was saying and I just felt worse.

Some of this has to do with Nick himself. There are certain people whom I meet and then find myself feeling really competitive with. When I met Nick back in September, I fell for him almost immediately. I thought maybe he was the one, or at least a one. We became good friends, and we spent almost every Saturday walking around Manhattan. I was enthralled by him. But I was never sure how he felt about me, and when I finally told him about my feelings, he politely told me he wasn’t looking to date anyone at that time, that he was recovering from a bad breakup. That was the truth, but a couple of months later he entered the dating scene again, just not with me. This upset me, and we were out of contact for a month or so. When we got back in touch, things were like new. My crush was gone — I’d realized he wasn’t the person I’d thought he was anyway. With my romantic yearnings out of the way, our friendship is much improved. We’re less guarded around each other now.

But I find myself envious of him and his success. For one thing, he seems to get all these dates through PlanetOut, while I can’t remember the last time I had one. But more than that, he’s such a go-getter. He works for a cable TV network and he’s the youngest management-level person in the company’s history. He just turned 25, and in two weeks he’s starting a job at a different cable network, where he’ll be making $80,000 a year. Just a college degree. He had a screwed-up childhood — an alcoholic, emotionally needy mother who’s on either her third or fourth marriage. Whenever I tell him that his life seems great, he tells me about how internally anxious and screwy he actually is. Yet at the same time he knows that this screwy childhood has given him strength and independence and worldliness. Instead of killing him it made him stronger. He has this manic energy that chaotically bursts out of him. He’s a great schmoozer, he’s a real people person, he knows how to work all the office politics, and on top of that he’s creative and energetic. He’s either going to be the next Jeff Zucker or he’s going to wind up jumping off a cliff to his death. My god, he can be exhausting to be around.

Sometimes I still see the world as an elementary school, where they give out just one award. Only one person can get it. If someone else gets the acclaim, then you lose. I’m just thinking of fifth grade, where my smart friend got the language arts award and the math award and the science award and he kept walking down the aisle to receive one certificate after another while I kept looking back at my mom with this upset look on my face and wound up getting nothing.

But really, the world doesn’t work that way. There are no awards, or if there are, they’re all just hype-fests propelled by big corporations. There are no Egyptian gods or pyramids to greatness here. We’re all just human beings scraping ourselves off the pavement. It’s just that some people happen to look really good while doing it.

Have a nice weekend.