Our findings call into question the value of private health insurance today

How do we teach people to have empathy?

I know I cover a lot of horrifying shit in here and it can be hard to read sometimes but I believe it’s important to accurately depict the type of world we live in if we’re ever going to do anything to make it better. So it is with that in mind that I bring you the following impending reality from a recent story in the Wall Street Journal.

Barstool Sports-branded casinos.

I’m very sorry I don’t like it any better than you do. Here’s one more. I can’t decide if it’s more or less cursed.

Goldman Sachs CEO to DJ Sports Illustrated Super Bowl 2020 party.

Good luck out there everyone.

This is the saddest song I’ve ever heard and I think you should listen to it. Also someone remind me to call my niece later to say happy birthday.

A famous newspaper asked me if I wanted to write a piece about a subject I am not terribly familiar with yesterday and while I could’ve used the few bucks and it probably would’ve put me in front of a very large audience I said I would have to pass because I didn’t think I knew enough about the topic to do it justice and I wonder if that has ever happened in the history of opinion writing? If I didn’t have this outlet and support from you guys I would have had to say yes and half ass crash learn enough to bullshit my way through it because when you freelance you can’t say no to any work and that is why in large part everything is fucking stupid and bad.

In any case it’s approaching tax time and like many other freelancers I am basically fucked with how much I am going to owe in taxes all at once so if there was ever a time you wanted to chip in to support your old pal Luke this would be it thank you.

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I knew it was going to be a long shot but I requested an interview with Bernie Sanders this week and sadly was not able to secure the bag. Now I gotta become a Pete guy out of spite.

I had already started writing some questions I wanted to ask in my mind just in case and one I kept coming back to was simply this: How do we teach people to have empathy?

I think about this question a lot because whenever someone says something crazy like perhaps so many people in this country shouldn’t be malnourished or barely subsisting or going bankrupt from medical bills or dying because they avoided treatment in the first place there is always always always someone sitting there waiting in the fucking bushes that pops out and says something like maybe they should’ve worked harder like I did or that they’re just asking for free stuff.

I just read this in a Washington Post article about a book called “Dying of Whiteness: How the Politics of Racial Resentment Is Killing America’s Heartland,” by Jonathan Metzl.

…Metzl, a professor at Vanderbilt University, uses compelling data and focus-group interviews to show how white people are willing to die rather than be connected to or finance policies that they believe are giving resources to people they view as undeserving. Metzl opens the book recounting his conversation with a man he refers to as Trevor, a 41-year-old Tennessee man who was dying from liver damage and who was adamantly opposed to the Affordable Care Act, also known as Obamacare.

“Ain’t no way I would ever support Obamacare or sign up for it. I would rather die.” Trevor tells Metzl in the book before explaining why. “We don’t need any more government in our lives. And in any case, no way I want my tax dollars paying for Mexicans or welfare queens.”

“That was a quote I heard a lot. … The idea was that even if this program might benefit me, I’m not gonna support a program that might also benefit by his estimation undeserving immigrants or minorities,” Metzl told me in the latest episode of “Cape Up.” “Part of the jumping-off point of the book is how powerful is this idea about what it means to be white in America and this idea that basically to be white means to have to block the advances of other groups.”

How do you reach people like that? How do you convince them to recognize another person’s basic humanity?

In any case there are many people like that in the country I am sure and we are going to get them universal healthcare whether they like it or not. I look forward to owning the racists by providing them with basic societal protections and services.

People who have health insurance still can’t afford to receive the healthcare that insurance is intended to provide. This is not a surprise to you or to me but nerds still have to do official studies about this type of obvious shit because maybe it will help convince people who are somehow oblivious to it I guess. That’s the finding at the heart of a recent study from Harvard researchers published in JAMA Internal Medicine which I have definitely heard of and read regularly.

“The study found that despite a major expansion of insurance coverage in the U.S. during that period—most significantly through the 2010 Affordable Care Act (ACA)—’ most measures of unmet need for physician services have shown no improvement, and financial access to physician services has decreased,’” Common Dreams explains. “The study's authors noted that the rise of ‘narrow networks, high-deductible plans, and higher co-pays’ has contributed to the growth of unmet medical needs in the U.S. since the 1990s.

“Our findings call into question the value of private health insurance today,” [Dr. Laura] Hawks, a primary care physician, said in a statement. “When so many people can't get the care they need even when they have insurance coverage, it says that insurance is not doing what it is supposed to do: ensure that healthcare is affordable when you need it.”

The study found that, overall, the share of adults aged 18-64 who were unable to afford to see a doctor rose by nearly a third—from 11% to nearly 16%—between 1998 and 2017. Among adults with health insurance, there was a 60 percent increase—7% to nearly 12%—in inability to afford a doctor visit.

“Inability to see a physician because of cost also became more frequent among most clinical risk groups, especially those with coverage,” the study found. “In 2017, the proportion of persons with cardiovascular disease who were unable to afford a physician visit was 25.6%, 5.9 percentage points... higher than in 1998.”

Here read this deranged thread described below about all the hoops someone has to jump through in between healthcare coverage at jobs if you want to ruin your day. It basically explains how you have to be Indiana Jones evading a series of intricate boobytraps and spiked pits and ghosts and shit to get healthcare in America and that's just how it has to be.

Fuck that. Unless things keep getting worse which they very much still might lol there will come a day when not having been on the side of Medicare For All will be looked at in the same way as being on the wrong side of some of the greatest injustices in American political history. Everyone who is arguing against it today will someday pretend they were not. Better get your shit in order now.

I keep hearing ads for a recovery treatment facility on the radio and their number is 1-800-ALCOHOL which seems like it’s sending a lot of mixed signals.

Sometimes when you talk about the opioid crisis or more likely talk about an individual who has become addicted to opioids that same guy that jumped out of the bushes above will say some shit about how the addict is lazy or how they didn’t personally get addicted to drugs or some other horse shit which basically amounts to the idea of personal responsibility. But what that framing never seems to grapple with is the unseen machinations of power and money conspiring in the background of our lives every day to ensure that enough of us become and remain addicted to medications to provide bad actors with enormous wealth.

Consider this story about a tech company that provided doctors with needed free software systems to manage their practices then conspired secretly with a drug company to rig them to make sure they prescribed opioids to patients that may well not have needed them.

The company in question called Practice Fusion is being fined $145 million in the state of Vermont for a scheme by which they would nudge doctors into giving out opioids at the behest of a major manufacturer of the drug called only Pharma Co. X in the court filings. In return they received $1 million in kickbacks.

“The result was tens of thousands of additional prescriptions for extended-release opioids that may not have been medically necessary,” according to prosecutors.

From the Washington Post:

Calling the behavior “abhorrent,” Christina E. Nolan, the U.S. attorney for the District of Vermont, said in a Monday statement that Practice Fusion had allowed the opioid manufacturer “to inject itself in the sacred doctor-patient relationship” during the height of the crisis.

“The companies illegally conspired to allow the drug company to have its thumb on the scale at precisely the moment a doctor was making incredibly intimate, personal, and important decisions about a patient’s medical care, including the need for pain medication and prescription amounts,” she said.

I’m not exactly sure what the software looked like but I’m imagining an anthropomorphized cartoon opioid pill with a stethoscope around its neck popping up on the screen like a notification and saying Have you considered giving these bitches some heroin?

I saw a list of the cocktail options at a recent Trump rally and one of them was called the Sanders and haha you can imagine where this is going. “You buy the drink and we give it to someone who doesn’t have one” the menu said haha and that is very funny because being generous and kind is a good joke I think we can all agree. More than that though it struck me as particularly shitty because buying a drink for someone who doesn’t have one is such a lovely and joyous thing to do.

“I’m a little light this week.”
“Don’t worry I got you. Get me back later” is both the essence of drinking etiquette and also how a country should be run.

I read this the other night in the Long Goodbye which was written in 1953 and if you adjust the numbers a bit it precisely describes how we still live today.

“There ain’t no clean way to make a hundred million bucks,” Ohls said. “Maybe the head man thinks his hands are clean but somewhere along the line guys got pushed to the wall, nice little businesses got the ground cut from under them and had to sell out for nickels, decent people lost their jobs, stocks got rigged on the market, proxies got bought up like a pennyweight of old gold, and the five per centers and the big law firms got paid hundred-grand fees for beating some law the people wanted but the rich guys didn’t, on account of it cut into their profits. Big money is big power and big power gets used wrong. It’s the system.

Then there was this which probably won’t make as much sense unless you’ve read the book but still I love the language of it.

I have no regrets for Paul whom you have heard called Terry Lennox. He was the empty shell of the man I loved and married. He meant nothing to me. When I saw him that afternoon for the only time after he came back from the war—at first I didn’t know him. Then I did and he knew me at once. He should have died young in the snow of Norway, my lover that I gave to death. He came back a friend of gamblers, the husband of a rich whore, a spoiled and ruined man, and probably some kind of crook in his past life. Time makes everything mean and shabby and wrinkled. The tragedy of life, Howard, is not that the beautiful things die young, but that they grow old and mean. It will not happen to me.”

Holy shit this new Higher Power record is good. Younger readers will love it because this is what young bands sound like now but older readers will like it too because it sounds exactly like the nineties and older people like it when things sound like what they sounded like when we were young.

If you prefer what women in bands in the nineties sounded like we’ve got plenty of that for you now too.