Redistribution Of Health Care From The Poor To The Wealthy

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Above Photo: (Image: Health care costs via Shutterstock)

Health Spending For Low-, Middle-, And High-Income Americans, 1963–2012

By Samuel L. Dickman, Steffie Woolhandler, Jacob Bor, Danny McCormick, David H. Bor, and David U. Himmelstein

Abstract

US medical spending growth slowed between 2004 and 2013. At the same time, many Americans faced rising copayments and deductibles, which may have particularly affected lower-income people. To explore whether the health spending slowdown affected all income groups equally, we divided the population into income quintiles. We then assessed trends in health expenditures by and on behalf of people in each quintile using twenty-two national surveys carried out between 1963 and 2012. Before the 1965 passage of legislation creating Medicare and Medicaid, the lowest income quintile had the lowest expenditures, despite their worse health compared to other income groups. By 1977 the unadjusted expenditures for the lowest quintile exceeded those for all other income groups. This pattern persisted until 2004. Thereafter, expenditures fell for the lowest quintile, while rising more than 10 percent for the middle three quintiles and close to 20 percent for the highest income quintile, which had the highest expenditures in 2012. The post-2004 divergence of expenditure trends for the wealthy, middle class, and poor occurred only among the nonelderly. We conclude that the new pattern of spending post-2004, with the wealthiest quintile having the highest expenditures for health care, suggests that a redistribution of care toward wealthier Americans accompanied the health spending slowdown.

From the Discussion

The slowdown in health spending growth between 2004 and 2013 was widely reported and much celebrated. Our data suggest a sobering interpretation: Slower spending growth (at least through 2012) was concentrated among poor and middle-income Americans, leading to a growing disparity in health expenditures across income groups. It is unclear whether the recent acceleration of spending growth will reverse this trend.

The pattern of sharply rising spending for the wealthy and flat or slow growth for others mirrors the widening gap in the consumption of other goods and could represent a shift from need-based to income-based receipt of medical care. We fear that it might presage deepening disparities in health outcomes.

Prior to the implementation of Medicaid and Medicare in 1966, the poor had the lowest health expenditures despite their greater medical need, while expenditures for the wealthy were nearly twice as high as those for the poor. Subsequent to these public investments, health spending tracked closer to medical need, with the poorest income quintile having the highest expenditures and the top quintile the lowest. (However, after adjustment for age and health status, the health expenditure gap between income groups was never fully reversed.)

The rising income-based disparity in spending suggests a shift from allocation of health care according to need to allocation by willingness (and ability) to pay. It is unclear whether this shift arises from the underuse of needed care among the poor or overuse of unnecessary care by the wealthy. The sharp spending increase among the nonelderly top income group merits further study and could be caused by the widening gap in cost-sharing requirements in private insurance plans for employees of small versus large firms (the latter of which tend to pay higher wages), the rise of concierge medical practices, or supply-induced demand. Irrespective of the cause, the pattern suggests that the efficiency of medical spending is declining, with an increasing share of medical resources devoted to people with the least medical need.

Conclusion

Increasing income inequality has drawn much attention in recent years. Our findings suggest that inequality in health care spending is also on the rise: Expenditures for the poorest (and sickest) segment of the population are actually falling, while those for the wealthy are growing rapidly and now exceed those for other Americans. This pattern, which has not been seen since before Medicare and Medicaid were introduced, could portend a widening of disparities in health outcomes.

  • Those of us in the 99 Percent who are old enough to have a long-term view of USian politics should begin our analysis of this newest health-care crisis with the fact the One Percent has been clamoring for forcible population reduction since the 1960s.

    Given the reality of class war, the One Percenters’ targets are those of who are no longer exploitable for profit: that is, those of us who are elderly, disabled or otherwise reduced to permanent unemployability.

    In this context, three facts about USian “health care,” specifically the Affordable Care Act, Medicare and Medicaid, show that each of these programs are designed to provide USian propagandists the illusion of adequate health services even as the services themselves are deliberately structured to exclude lower-income people. Specifically:

    (1) — The ACA (“Obamacare”) programs affordable to lower income people have co-pays and deductibles that are deliberately (maliciously) prohibitively expensive. Therefore ACA’s lower-income victims — and victims is precisely what they are — are required by law to pay premiums to for-profit insurance companies for insurance for which they are permanently excluded by the additional paywall. This — which provides the insurance barons with 100 percent profits from these programs — is Obama’s deliberate gift to his capitalist masters. This is intentionally deadly — remember again the One Percent’s demand for population reduction — and is perhaps the most egregious part of Obama the Orator’s long-premeditated shift into Barack the Betrayer.

    (2) — Medicare, which has a $1000.00 annual deductible and requires co-pays of up to 50 percent, is a (blatant) gift to the USian upper classes but is utterly useless to those of us who are low-income — which is now about 60 percent of the Medicare-recipient population. Thus — if indeed we lower-income folks are to receive any health care at all — our only option is so-called Medicare Advantage, through which a consortium of for-profit and (allegedly) non-profit insurors (theoretically) provide lower-cost services in return for additional premiums and minimal co-pays.. But these additional premiums and co-pays have skyrocketed since the turn of the century, which again imposes an eternally impassible barrier between ourselves and the health care we need. My case is exemplary: I am 76 years old and dying of congestive heart failure, but it costs me $50 — this out of a total monthly discretionary income of $224 (from which come my groceries, prescription drugs, clothing and any other needs) — every time I see a cardiologist. Hence I often have to chose — literally — between eating or getting medical care.

    (3) –.Medicaid, which is supposed to come to the rescue of people in my circumstances — capitalism’s profit-taking contraction of 2007-2009 cost me nearly 70 percent of my retirement income, leaving me nothing but a minimal Social Security pension — is increasingly restricted by the state bureaucrats who administer it. In fact, In the state of Washington as in the state of New Mexico — and probably in the 48 other states — welfare bureaucrats are now rewarded for fraudulently manipulating eligibility data to deny Medicaid and other social services services to the needy. Again my case is exemplary: effective 1 January 2016, the Washington State Department of Social and Health Services slashed my food-stamp allocation from $103 per month to $17 and cut my Medicare Extra Help from $22 per month to $4 and again denied me any Medicaid assistance. This was done by maliciously reducing or eliminating entirely my deductions for rent and medical expenses. Nor have I any recourse: if I confront DSHS, its bureaucrats are bound to retaliate with further cuts. The only way I can get the help to which I am entitled is to hire a lawyer to represent me and file a formal appeal — which of course I cannot afford to do.

    All of these atrocities, in which Democrat collaboration with Republicans demonstrates the hideous truth we are in fact governed — tyrannized actually — by One Party of Two Names, are the results of a genocidal war against any of us who are deemed unprofitable. The One Percent and its Ruling Class vassals want us dead. But death camps remain unfashionable, even in the ever-more-obviously Nazified United States. Hence the obviously genocidal barriers to health care; the cuts in welfare, food stamps, Medicare and Medicaid;, plus the equally genocidal de facto cuts in Social Security imposed by malicious manipulation of the formula for cost-of-living
    increases.

    Such is life — and more likely death — in the present day USian Homeland. .

  • Get government out of the health insurance business as much as possible. Limit them to limited regulation and financial support for health insurance to those who need it.

    Government is about half the health insurance market with Medicare, Medicaid and the VA. This is why the health insurance market is not functioning like a normal market in any other industry.

    Obamacare, Medicaid, Medicare and VA hospitals should be phased out. People under these programs and those who are financially below the poverty level should be given a yearly amount that they could use to purchase health insurance.

    Keep the federal regulation stating that insurance companies have to cover pre-existing conditions as long as the person had previous insurance.
    Allow people to purchase insurance from any state. Deregulate state health insurance markets. Unhinge medical insurance from employers in the tax code.

    Getting government out and increasing competition in this way will lower health insurance costs. It cuts the bureaucracy costs, cuts the fraud costs and improves competition and quality of care.

    Why not do financial assistance for health insurance the same way we do financial assistance for food?

  • Margaret Flowers

    Simple answer – that would be the most expensive and least effective system.

    It is the health insurers that are the problem. We don’t need them. They just stand in the way between patients and the care they need.

    Because of all of the insurers and plans, the US has the most complex bureaucatic system in the world (and it has nothing to do with the government). We spend a third of our health care dollars on administration. Physician practices spend 10% or more of their income on billing. Some hospitals have more billing people than nurses. This is crazy.

    And for what? Insurers don’t care about people’s health. They exist to make profits for their investors and multi-million dollar salaries for their executives. They sell policies that don’t include major medical centers so that if patients need to go there, they have to pay out of pocket. Health insurers deny care that they say they cover – hoping that patients won’t figure that out. I could go on and on.

    I can tell you, as a physician, that the health insurers are the problem and subsidizing them (as we are doing with the ACA) is not making things better. We need to use a system that works all over the world and has created some of the best health systems.

    Get the private insurers out – create one system – one set of rules – spend our health care dollars on health care. A single payer system does that.

    Public systems are publicly accountable. Private insurers hide information and behave with impunity. We need improved Medicare for all.

  • DHFabian

    Since the 1980s, nearly everything taken from the poor has been redistributed to the middle class, which trickles upward to the rich. For a clearer understanding of how things are today, it’s important to understand that the poor view the middle class as negatively as the middle class view the rich, for many of the same reasons.

  • If people want single payer in health care; why not a single payer for food, water, clothing, housing, electricity, gas, auto insurance, life insurance, internet and cell service?

  • Government is about half the health insurance market with Medicare, Medicaid and the VA. This is why the health insurance market is not functioning like a normal market in any other industry.

  • DHFabian

    You clearly have very little understanding of these issues. At the least, note that there is no “financial assistance for food” (or for anything else) for the very poor. If you’re referring to food stamps, these are for some low wage workers, the elderly poor and the disabled. Note that food stamp allotments for the elderly poor/disabled were cut from roughly $115 per money, down to $10.

    Are you saying that govt. should take controls off of health insurance companies and then maybe privide a $10 per month voucher to enable Americans to buy their own insurance? Where do the disabled, the jobless, the elderly, the uninsurable, etc., fit it? Maintain our super-expensive emergency room care for them?

  • DHFabian

    Actually, we’re stuck because of the notion that we’re the 99%. Finding solutions requires first realistically assessing the problems. America is profoundly divided, rich vs. middle class vs. poor. What we’re seeing today: The rich are now doing to the middle class what the middle class already did to the poor. This fact ruffles some feathers, but it’s true all the same.

    My impression is that many know only a little about Medicare, and less about Medicaid. There are people who qualify one, the other, or both, and the masses of truly poor only have emergency room services.

  • SNAP Benefits by Household Size

    Household Size , Maximum Monthly Benefit Fiscal Year 2016, Estimated Average Monthly Benefit Fiscal Year 2015
    1 $194 $143
    2 $357 $255
    3 $511 $374
    4 $649 $459
    5 $771 $540
    6 $925 $641
    7 $1,022 $728
    8 $1,169 $755
    Each additional person $146

    http://www.cbpp.org/research/a-quick-guide-to-snap-eligibility-and-benefits

  • These numbers are absurdly high — probably the result of the many neoliberal donors to the data source — and what you also deceptively omit is each state administers SNAP in accordance with its own political ideologies.

    Hence for example Washington state — ostensibly “blue,” but due to behind-the-scenes collaboration between Democrats and Republicans in economic policy, actually the most “red” state in the U.S.* — is methodically slashing food stamps by the same illegal method New Mexico is using: that is, by maliciously deleting data to make it appear supplicants have many times more income than we actually have.
    _________
    *Washington’s consummate “redness” is proven by its tax structure, which is the most regressive in the U.S. (and probably in the entire western world), and by the fact it is the only USian state in which tenants effectively have no rights at all.

  • Unfortunately your analysis makes it obvious you are deceived by capitalist propaganda. The so-called middle class (a designation socioeconomically meaningful only in the contest of capitalist disinformation) did not assault the poor. The true assailants of the poor were the One Percent, the Ruling Class, who merely used the middle class as puppets and human shields.

    The socioeconomic truth is that under capitalism there are only two classes, the Ruling Class (those who own the governments, the land and the means of production), and the Working Class (those of us whose de facto enslavement becomes ever more obvious as final-stage capitalism progresses toward its apocalyptic end). That end is now upon is, whether by World War III. (as in the attack on Russia and Chine and the subsequent thermonuclear annihilation a Hillary presidency will make inevitable), or by environmental ruin (which is the ultimate and equally unavoidable legacy of capitalism regardless of the identity or affiliation of the emperor, i.e., the president. .

    In this context bear in mind the ultimate message of our present-day circumstances: that without economic democracy there is no democracy at all.

  • The so-called middle class (a designation socioeconomically meaningful only in the contest of capitalistic exploitation) did not assault the poor.

    Sorry, but you are WRONG.

    Here is a little reminder to middle class voters/workers of the way they have treated, and continue to treat, the poorest of the poor – those who are too sick to be able to work, those for whom there are no jobs, those who can only get work as 1099 contractors in the “freelance”/”gig” economy who are SOL when there’s no work or when they get sick (or when their boss stiffs them and doesn’t pay them anything for their time), and those who were barred entry to living wage jobs due to discrimination:

    “Pull yourself up by your bootstraps”

    “No one owes you a job”

    “If you want medical and dental care, get an education so you’ll qualify for a good job”

    “Stop making excuses and blaming other people for your failures”

    “Stop the victim mentality”

    “It’s your bad attitude that’s the reason you’re poor”

    “You need to take personal responsibility for your life”

    “You should have planned better”

    And the list goes on.

    Due to the politics of white male revanchism and middle class selfishness, vindictiveness, and gratuitous cruelty towards the poorest of the poor (70% whom are WOMEN), Congressmen and presidents have been elected by this overprivileged selfish class these past 40 years on the very platforms they now cry about that are coming around to biting them in the tushy – union-busting, globalization, “getting touch on crime”, “ending welfare as we know it”, creating an “ownership society”, “meritocracy”, etc.

    Middle class voters demanded that this country’s poorest and most marginalized and disadvantaged women – who NEVER got to have any of the good paying job opportunities that middle classers (especially white MALE middle classers) got because of systemic discrimination – be cut adrift and thrown out onto the streets. Because the middle class, and even the working class aspiring to become middle class, resented paying taxes that went towards a miserly, grossly inadequate welfare benefit for feeding and housing poor women, claiming that poor women “wouldn’t keep their legs shut” and only “popped out babies just for the welfare check.”

    At the same time, many of these middle class workers (including blue-collar union workers, many whom were/are WHITE MALES, who drove around in expensive Ford trucks with bumper stickers reading “Rush is right!”), actively prevented POOR WOMEN from being able to get into unions and get chances for those good-paying jobs, and justified their economic discrimination against women with excuses of men being the “breadwinners” that are somehow victims of “women’s libbers taking away man’s jobs!”).

    Many middle class voters/workers simply never wanted the poorest of the poor to ever have any chance at all. And this is due to a toxic combination of sexism, racism, gratuitous cruelty, vindictiveness, and the “need” to have someone worse off than themselves that they can feel superior to – with or without any politician openly pandering to them.

    LBJ said it best: “If you can convince the lowest white man that he’s better than the best colored man, he won’t notice you’re picking his pocket. Hell, give him somebody to look down on, and he’ll even empty his pockets for you.” And you can just as easily swap “colored man” for “woman of any race” and that also holds true.

    Every step of the way from Reagonomics to Welfare Reform these past 40 years, despite attempts to educate the mainstream voting public as to what would happen if they supported politicians that campaigned on platforms that were ALL about hurting women, black people, and punishing the jobless/unemployable poor, etc., the middle class (including blue-collar union workers – most whom were white males who were determined to get back at “women’s libbers” for “taking away white men’s jobs”) not only voted for these politicians but demanded and supported these very same policies, even after they were told of the harm it would cause. They didn’t care so long as they had theirs – tough sh*t for everybody else.

    Now the middle class is whining about the very policies that they demanded and supported. If you’re in the middle class, you’re in the top economic 20%, among the MUCH better off. The life expectancy rate for the poor has fallen to age 60. This is not to be confused with the working class who are fortunate to have W-2 jobs with minimum wage protections – UNLIKE poor 1099 contract workers who have NO job or wage protections at all who are often ripped off and not paid anything, not even unemployment benefits or the ability to qualify for food stamps because “self-employed.”

    And who is most likely to be stuck with only 1099 contract/”freelance” work options? POOR WOMEN – especially poor OLDER women in their 40’s and 50’s who’ve suffered in abject poverty all our lives because of economic/job discrimination.

    Minimum wage W-2 workers qualify for food stamps and Medicaid. But the self-employed (who pay double the taxes as W-2 employees but get NO protections at all) and the jobless poor with NO incomes at all don’t qualify for ANY aid at all in most states.

    Many middle class workers/voters use their money from their good jobs (or generous retirement plans) to buy the bodies of poor vulnerable sex trafficked women and kids being sold on Backpage and Craigslist – an increasingly frequent phenomenon now that prostitution has become our capitalist “free market” social safety net for those who are most likely to be poor and unable to economically provide for themselves because of discrimination. (Because men – especially white men – always felt that prostitution is the only thing poor women are good for, and they would rather see poor women suffer without housing, clothing, medical and dental care, starve to death, or die out on the streets before giving poor women ANY money in the absence of adequate and equal job opportunities and the guaranteed right TO a livable job.)

    Courtesy of the politics of middle class white male revanchism, and general overall middle class self-centeredness, greed, vindictiveness and propensity for gratuitous cruelty towards the poorest of the poor (70% whom are WOMEN OF ALL AGES AND RACES), Congressmen and presidents were elected over the past 40 years on the very platforms – union-busting, globalization, “ending welfare as we know it”, “meritocracy”, forcing women back into “their place” to keep us “barefoot and pregnant and in the kitchen” (for those lucky to have a home in order to have a kitchen to be forced back into) by eliminating access to birth control and abortion so that us poor women wouldn’t be able to “take away white men’s jobs”, and “creating an ownership society” – that this over-privileged selfish class cheered for, but now complains about now that the economic chickens have come home to roost.

    That selfish class didn’t bat an eye as all those policies these past 40 years – especially Welfare Reform, the elimination of what miserly stingy social safety net we once had very briefly, and rollbacks in affirmative action hiring (which never alleviated job discrimination against working class and poor women) – resulted in destroyed families, a domestic child sex trafficking crisis, a skyrocketing homelessness crisis, and burgeoning permanent underclass of unemployable jobless poor people with no means of being able to survive and NO hope (and not even a voice in the public square).

    First they came for Poor Women – who have yet to be accorded full equal human and civil rights – and forced them into human sex trafficking and reproductive chattel slavery at cost to their health and lives, after denying them real equal citizenship, real equal rights, and real equal job opportunities while also denying them dignified economic support via a social safety net.

    Then they came for Poor Blacks whose ancestors were brought here as slaves, and paid them lip service about “progress” and “equality” as they incarcerated them in privatized for-profit prisons, re-enslaving them at $1/day.

    Then they came for Poor Whites and swept them up into debtors prisons, “tent cities”, and profited further by keeping them poor and jobless and sending them on wild goose chases to seek resources from the Non-Profit Industrial Complex, depriving them of basic human rights to food, shelter, and medical and dental care because they were only “poor white trash.”

    Then they came for those fortunate to even have any kind of jobs at all, even of those jobs weren’t unionizable and didn’t pay well (or have wage protections, unemployment benefits, health and dental and retirement benefits), and sold them over-priced “rent-to-own” furniture and appliances (because golly, who wants to sleep on the floor?), and sold them fraudulent mortgages (because they merely sought a modicum of housing security), only to have those mortgages blow up and render them homeless and out everything.

    Then they came for the long-term unemployed job-seekers over age 40, refusing to hire/re-hire them after pushing them out of the economy, leaving them to suffer unrelieved abject poverty with NO INCOMES, NO medical and dental care, NO hope, NO retirement funds, and NO place to live forcing them to struggle for their lives in “tent cities” – and then criminalized them for their homelessness and poverty, as well as criminalizing anyone for sharing food with them.

    Then they came for those who went to college to get educations and “marketable degrees” because they didn’t want to be poor, and saddled them with over a trillion dollars in student loan debt that can’t be discharged in a bankruptcy and which their social security can be (and is) garnished for.

    Then they came for the protesters against social injustice, labeled them as “terrorists” and “criminals” for being a threat to the status quo, and employed militarized police forces against them.

    Then they came for the disabled and elderly poor on social security incomes below the poverty level, and slashed their paltry food stamp allotment from $115/mo down to $10-15/mo.

    And if these same middle class voters/workers will NOT own their screw-ups and support any measures to make shit right to the poorest of the poor and speak up for all the people who’ve been harmed by these policies rooted in the “Just World Fallacy” that they demanded and supported because they are NOT one of them and “its not my problem”, then here is something for them:

    Now they’ve came for the MIDDLE CLASS, under the guise of “supporting” the middle class and “working families”, because YOU are the ONLY group left who has anything left to take. And these special snowflakes – these corporate “persons”, these “free trade” global markets, and the imperial military industrial complex – do NOT care about you. But now there is no one left to speak out for you.

  • While I applaud your passion, it is nevertheless s disingenuous to blame “the middle class” for the savagery of the One Percent. While — as I said — part of the “middle class” countenances and facilitates much of the One Percent’s malevolence, the “middle class” is most assuredly not its origin.

    Indeed it is at least arguable more impulse toward progressive change comes from the so-called “middle class” than from any other single source. By no means all the people you damn as “middle class” support the JesuNazi/Ayn Rand/fascist/patriarchal agenda you rightfully denounce. Many of us put our lives on the line in the Civil Rights Movement and were active participants in every progressive uprising from the Anti-Vietnam War Movement to Occupy. I myself am a Civil Rights alumnus of the Knox County Jail (1963) and was at least thrice targeted by the Ku Klux Klan, who fatally poisoned the beloved German shepherd who saved my life during their first attempt to kill me. I am not the dilettante the tone of your lecture suggests you imagine me to be.

    However, when you speak of the petite bourgeois as the prime source of socioeconomic malevolence, you are absolutely correct. Your error is confusing the petite bourgeois — the staunchest ally of the bourgeois or Ruling Class — with the so-called “middle class.” . As I said originally, “middle class” is meaningless outside the context of capitalism. But the “petite bourgeois” are a very specific group of wanna-be One Percenters who will do literally anything to achieve their gains and are therefore as morally imbecilic as their One Percent masters — if not more so.

    Apropos “the very poor who have absolutely nothing,” my desire to be of service to them is one of the constants of my life..During the part of my childhood I lived in East Tennessee, I walked home from elementary school,with children who gathered lumps of coal that had fallen onto the L&N (Louisville Nashville) railroad tracks; These kids were so impoverished, the coal they collected was their families’ sole source of heat for cooking and warmth, and of course I helped them with their foraging. Later I served as a Regular Army soldier in Korea c. 1961-1962, where because of the Korean War (1950-1953), there were still millions of homeless people; so many of these poorest of the poor froze to death at night during the winter, the government sent trucks around every morning to pick up their corpses. Of course there was nothing I could do about that massive atrocity save remember what I had witnessed — an ultimate indictment of capitalism.

    Back in civilian life, a journalist, I covered Southern Appalachia, where people still lived in cardboard shacks. Later, back home in New York City, I photographed the Lower East Side ghetto to help raise funds for the free clinic program run by Beth Israel Hospital. And now, though I am being murdered by genocidal denial of health care, whenever I am able I join my Communist Labor Party comrades in feeding homeless people on Thursday nights. Too often it is their only hot meal all week.

  • kuji

    Looking at the evidence of how the neoliberal heath agenda has functioned in practice globally — in contrast to how it is represented to function by the heraldry of its ruling-class sycophant promoters, (This is an agenda promoted widely by the World Bank, the IMF, and international financial institutions, the 1994 Clinton proposal and 2010 Obamacare being offspring):

    “Senator Jorge Robledo, documenting monopolistic practices, delayed payments, corruption, high overhead, increasing legal actions due to denial of care, and illegal investment of health funds by for-profit insurance companies… concluded: “Statute 100 [the reform’s legal name] does not work, because it is not a law intended for the health of Colombians, but rather a law intended to finance the business of the health of Colombians.” *

    This statement can be generalized to the USAn neoliberal privatized for-profit mandatory Obamacare where the rich now carry the least tax burden and receive the most care while the rest suffer in varying degrees of neglect depending on their social power in this unjust neglectful system.

    Obamacare is about financing the business of the heath care delivery & insurance industries, which are oligopolistic, and which will never be a “normal competitive market” as promoters claim, because our current historical phase of capitalism is monopoly-finance capitalism. It never was primarily about delivering health care to the public. It’s about delivering hand-outs to the already rich. These neoliberal policies parasitically suck the lifeblood out of the productive sectors of the economy, and hit working people, the poor, and the disadvantaged with Dickensian cruelty. Anything’s game. They are cruelly forced upon us by the duopoly parties who, in tandem with widespread msm indoctrination saturation, encourage and perpetuate an ideologically polarized public to distractedly fight each other within class boundaries all the while commercially promoting and profiting from the political circus meleé in which the public is blinded from seeing the source of the heist and its heinous results.

    *http://monthlyreview.org/2016/05/01/obamacare/

  • While I applaud your passion for progressive change, it is nevertheless s disingenuous to blame “the middle class” for the savagery of the One Percent.

    I don’t blame the middle class for the savagery of the rich. I blame the rich for the shit they do and I blame the middle class for the things that the middle class has done and still does to the poorest of the poor – those whom many well-fed, well-clothed, well-housed so-called “socialists” derisively dismiss as “lumpen” – who are the REAL human casualties of capitalism whom NOBODY that’s better off is economically supporting, or helping, or even just speaking up for – while wringing their hands and paying lip service to social justice, saying that they “care about the poor.”

    I am almost 50 years old. I never got to have medical and dental care my whole life. Ever. I’ve been violently ill and unable to hold down anything except broth for the past 3 weeks. I’m too sick to work, even if anyone were willing to hire a poor 50 yr old woman. I went to the ER – the ONLY medical care available to me – and was sent home with nothing but a discharge sheet (and a hefty bill I am unable to pay) that advised me to go see a specialist for tests – which I can’t because poverty and NO medical care.

    Throughout my life I have personally suffered gratuitous cruelty and abuse at the hands of the middle/working classes who were MUCH better off than me as a poor woman who is also a survivor of child sex trafficking that was rendered unemployable throughout most of my adult life by the stigmatizing prostitution record incurred as a direct result of having been trafficked as a homeless 12 yr old girl (escaped when I was 17).

    Before food stamps were eliminated in my state for the jobless/unemployable poor 2 years ago, I was subjected to heaps of abuse and scorn in supermarket checkout lines, because of being on food stamps, from middle/working class people who were far better off than me. Not “the one percent” – but these so-called “comrades” who are notorious for turning their backs on their “brothers and sisters” the minute said brothers and sisters are economically pushed out and reduced to begging on the streets (or through Gofundmes).

    I refuse to apologize for having nothing but contempt for the very same people who’ve abused me – both while I was being trafficked into forced prostitution as a homeless CHILD, and long after I escaped that hell (with no help from ANYONE else, mind you) – and who did all the things I enumerated in detail in my previous post to the poor, and they STILL refuse to own up to it and do anything to make shit right. And yeah, that DOES make them worthy of my contempt.

  • chetdude

    In civilized countries the People have decided that Health Care is a Human Right and they provide their People with better health care at half the price.

    In those countries the ONLY “health insurance” that is allowed is heavily regulated private or public “insurance” for comprehensive, universal care or is a single-payer system…

    USAmerica is the only industrialized country that treats “sick care” as a commodity and allows private, for-profit corporations to drive the “market” and set prices and fees… 60% of which is paid by the taxpayer with almost NO control over how sick care is provided or what’s covered….

    This is exactly how the corporations running the failed for-profit system want it…

    Health Care is NOT refrigerators or cheap plastic crap on the shelves at Mal-Wart!

  • chetdude

    Indeed! WHY NOT!!?!??!?

    Now you’re getting it…

    Internet/cell service? USAmerica has the slowest and most expensive because it’s all private, for-profit corporation’s monopolies “providing” it…

    Every human being should be provided by the Community with their Basic Human Needs for housing, food, water, clothing, electricity, gas AND HEALTH CARE!!!

    The only thing keeping us from that marvelous situation is the vulture capitalist system for the benefit of the point 1 of 1% that you’re defending…

  • chetdude

    Have you tried to feed yourself on $200 a month????

    Are you nuts???

  • North Korea does it the way you want.

  • kevinzeese

    North Korea? Where did that come from? Never heard that in a single payer discussion. Now, Taiwan is a much more interesting case. They used to have c crummy insurance based system like the US, but they switced over to single payer very easily and have much better healthcare as a result. That is a country worth looking at.

  • Obviously Ms. Homan there is nothing I can say to you save that I am dreadfully sorry to hear of your circumstances. I can empathize a bit with your childhood circumstances as my mother tried to murder me when I was five years old, and shortly after that my father, fearing my mother’s insanity indicated I too was genetically tainted, tried to abandon me in a Virginia orphanage. He failed, but from then on I was never more than an emphatically unwanted child, so much so the Regular Army in which I enlisted in 1959 was a paradise of respectfulness compared to my family. More to the point I can empathize with your medical difficulties to the extent I am literally being murdered by capitalism as punishment for my inability to pay for treating my congestive heart failure. Both our circumstances typify why, at at 75, I finally put my money where my intellect and emotions have been since my teens and joined the Communist Labor Party. Hence for what it’s worth you most assuredly have my emotional support and hope-your-life-gets-better thoughts.

    These days I am too physically disabled to be of much service, but at least I am sometimes able to participate in the Harry Bridges Chapter’s efforts to feed Tacoma’s homeless people what is often their only hot meal each week, and my agitprop skills — useful for writing brochures and educational materials — seem as good as ever. I also edit, photograph and produce a monthly informational newsletter for the occupants of the low-income senior housing project in which I live with 89 other low-income elderly and disabled people. It isn’t much, but it is the best I can do.

    That said, I have encountered the same malevolence you describe, both in the South as a Civil Rights advocate c. 1963-1965 (after which I fled back to New York City), and here in Washington state as a person who is obviously old, crippled and poor. The hatefulness one encounters from fellow customers in checkout lines while using food stamps is breathtaking,

    .

  • chetdude

    SOUTH Korea does!

    SOCIALIZED 100 mBit download for $10 a month…

  • Good sir, I want to first say that you are VERY much wanted and valued by me and other poors fighting for basic human rights.

    I am not surprised at all at the fact that you received heaps of abuse from other white people in the supermarket for using your SNAP card. That was my experience, too. I live in Pennsylvania, which not only is not providing Medicaid to the sick and unemployable jobless poor, but also has eliminated food stamps for those who have NO jobs (and therefore NO incomes at all). From what I understand through reports from other poor people across the country, this has happened in many states. So you have to be fortunate enough to have a job and not be too sick to work in order to get helped with anything at all. We need to see a LOT more discussions about this and other issues concerning the unmet basic needs of the poor.

  • Two Americas

    Excellent post as always, Loren. Good to see you, old friend.

  • Two Americas

    Great post. Thanks.

  • Ms. Homan: Unfortunately Discus is showing its true Nazi self by not allowing me to respond to you. I had much to say, including the suggestion that should you choose to write a book about your circumstances, I might be able to help find a significant publisher. But Discus has obstructed that entire transmission. Hence to my great sorrow all I am allowed to do is send you my very best wishes. Blessed be.

  • Thank you. But unfortunately I have (again) run afoul of Discus political censorship — the reason I had not been here for so long — and now, no doubt because I identified myself as a Communist, it will not allow me to pass some potentially very helpful information to Ms. Homan. Hence, lesson learned; I won’t be back, not ever again.

    Foxtrot Yankee, Discus censors, my righteous anger underscored by an uplifted middle finger.

  • Margaret Flowers

    Nothing of the sort happened. When you include a link in your post, we have to approve it (protects from spam). We are traveling and were delayed in seeing your post. Our apologies.

  • Two Americas

    My guess is that it is Popular Resistance that is responsible.

  • Apologies accepted — but why was there no such blockage — not even for a minute — when I posted not one but three links to socioeconomic data yesterday?

  • Turns out you’re right. See below. Curious. The last time I was censored, I never found out why or by whom. I assumed it was Discus — not the least because other major Left websites have dumped Discus, not just for its censorship but for other problems (like its absolute prohibition against writing posts off-site) — but maybe then it was PR this other time too. I don’t remember the details, just the lingering bad taste.

    I know I’m not popular with PR’s moderators because as a former Occupy activist I committed the cardinal sin a few years ago of describing how Occupy was destroyed as much from within — by reflexive USian anti-intellectualism combined with its attendant ignorance and my-way-or-the-highway egotism disguised as “anarchy” — as it was slain by oppression from without.

    In any case maybe now I’ll stick around. Meanwhile again my thanks to you.

    (If you wanna see daily or nearly daily stuff from me,
    go to Reader Supported News. Better yet sign up there as a poster. When the trolls aren’t turning the threads into Charley Foxtrots, we have some excellently informative, genuinely thought-provoking dialogues, and I’d iove to see your comments within them.)

  • Two Americas

    I will see you there. Thanks.

    Disqus delenda est is my motto.

  • Margaret Flowers

    Because we weren’t traveling at the time, most likely. We try to stay on top of it but we are human.

  • And why is it now being censored again — despite the fact there are no new links added? Please, if you will, explain this new intrusion — that given the givens will probably delay the post for at least 12 hours.

  • Hear, hear. Despite what Dr. Flowers says — for which see below — Discus has never, on several Discus-plagued websites, allowed me to post a link to the international Marxist archive, an invaluable website containing every Marxist and anarchist document ever written prior to about 1990. Its contents were defiantly uploaded to the Internet by Soviet officials as the USSR was dying, and it is (of course) the most complete such library on the planet. Nevertheless, Discus bans it as spam — or has done so each time I’ve tried to link to it — which is why I assumed my admission of Communist Labor Party membership was the reason my (again obstructed) response to Ms. Homan was obstructed earlier.

  • Indeed.

  • Obviously — given the fact the post in question has now been completely removed (and therefore presumably trashed) — your apology was meaningless, and my acceptance of it was premature. Be advised PR’s destruction of my work does not hurt me in the least; whenever I am dealing with Discus, I have learned from bitter experience with its inexplicable tyrannies to always make a copy of anything important I have written. The tragedy here is the suppressed information might have been useful and possibly even financially beneficial to Ms. Homan, who is obviously in dire straits. Thus the fact PR chose to dump it down an Orwell hole is surely troubling, particularly in terms of the site’s stated commitment to empowering the 99 Percent — precisely what I hoped my remaining book-publishing connections might have been able to do for Ms. Homan were she to choose to write of her experiences. Alas, I can only assume the suppression of the post means any further such efforts on my part will be similarly obstructed (if not destroyed), rather as if PR were denying a drowning person a life preserver merely because its source was deemed unacceptable.

  • And MANY who are eligible for food stamps because of being in abject poverty with NO INCOMES are DENIED food stamps and get nothing at all.

  • I would say another country worth looking at would be Libya prior to the unlawful toppling of the Qaddafi government and Qaddafi’s assassination. I was researching something last week and came across Qaddafi’s Green Book and some very interesting facts about Libya and about Qaddafi.

  • I have long suspected that there was illegal and deliberately malicious deleting of raw data. But the only way we can prove it is if people on “our side” were provided with the adequate financial resources (the ability to afford a server, electricity and 24/7 Internet access don’t come free to those without any incomes) to build our own data-driven application that would build and aggregate the raw data of those who are, on paper and in theory, eligible for SNAP benefits (and other aid for the poor such as Medicaid and SSI) but who have been and who are being denied help.

    Raw data does not lie. But people with their own agendas who know how to manipulate data DO lie. And therein lies the problem.

    If I were able to get my basic living needs met and therefore was able to keep myself alive long enough to complete such an extensive data-building project, and have the ability to afford to keep my electric and Internet service from being interrupted due to shut-offs from lack of ANY income, I DO have the skillset to build such a project.

    What we would then have to decide is who would be in charge of overseeing and maintaining the raw data and which database to use (i.e. Postgres, MySQL, Mongo, etc.) and which functional programming language (preferably one that supports R) to use, either Haskell or F# (which I can do – I was in the middle of working on an F# programming book contract for $3,000 payable in installments by Packt publishers before I fell ill and started vomiting blood last month).

    Next, we would then have to decide whether this would be a cross-platform web app (something on the Internet that can be accessed by people whether they are on a Linux, a Mac, or a Windows computer or on an iPhone/iPad or Android) that the people denied aid could directly provide this raw data, or a console application that requires others to enter the raw data gathered from talking with (or otherwise interacting with) the people whose lives are in immediate jeopardy due to being denied food or any other theoretically available assistance for the poor.

    So, if anyone wishes to contribute to a fund for me to provide me with a paycheck so that I can keep myself alive long enough to work on and complete such a project (i.e. fed and housed w/ electric and Internet access for the duration of architecting, designing and leading the building of such a data-heavy application), please get the word out that this CAN be done and that I can do it and definitely would be willing to do it and make that project my ipso facto full-time job. I have the knowledge and skillset to do this.

    I started such a project in F# last year for aggregating data on all the poor trafficked women and girls that are not being helped by all these anti-trafficking charities while those who’ve benefited from the systemic discrimination and structural oppression that results in poor women and kids being trafficked are the ones getting nice paychecks off of the “trafficking awareness” bandwagon.

    Unfortunately, since poor marginalized women who are trafficking victims are only an afterthought in every social justice movement, my trafficking victims data project got very little (read: almost nothing) support by the way of funding and support (unless one considers $4,000 enough money to survive on and keep the utilities on for a whole year and a half in order to complete a project that is very extensive and intensive).

  • Margaret Flowers

    Your post was not dumped. It was in the pending file. I found it and approved it.

  • In any case please let me know your decision on the possible book, and
    if indeed it is affirmative, I will start the proverbial ball rolling on
    this end.

    Affirmative. And yes Loren, you may call me Jacqueline.

  • In any case please let me know your decision on the possible book, and if indeed it is affirmative, I will start the proverbial ball rolling on
    this end.

    Hopefully this response won’t be put on indefinite hold, but to answer your question about a book: Affirmative.

    My prior attempt to respond more fully and address your post to me was held up and was not posted. In it, I mentioned an exposing and well-documented article I wrote for Betsy Leondar-Wright’s organization, Class Action, regarding the media blackout on deaths due directly to unrelieved poverty.

    I hope Dr. Flowers sees this and approves my other post so that you can read my detailed response to your inquiry as to news/media links about poor people dying because of not getting helped with anything from food assistance to utility shut-offs in the dead of winter courtesy of deregulation.

  • In any case please let me know your decision on the possible book, and if indeed it is affirmative, I will start the proverbial ball rolling on this end.

    Affirmative. And yes Loren, you may call me Jacqueline.

    Apropos your stomach, what you describe is indeed a troubling symptom, though the best I can suggest is use of the Internet to search for possible herbal sources of symptom relief.

    I’m an adept researcher and using the Internet to try to narrow down a possible self-diagnosis was the FIRST thing I did.

    However, I must say that years of having to literally eat from garbage cans – on top of not getting any medical or dental care throughout my life plus the sheer stress of poverty and homelessness – probably has a lot to do with it. Poverty takes a HUGE toll on your health and costs people their lives.

    Unrelieved abject poverty is nothing short of extra-judicial execution that also meets the definition of torture,and yes, genocide based on socio-economic class.

    But the denial of social services to the poorest of the poor is as blatantly genocidal as anything I’ve yet heard of. Indeed — assuming it has been reported in the press — please send me links, and I will damn well lead my next blog post with them.

    That’s just it. There has been a complete media blackout on deaths due directly to unrelieved poverty. I wrote a scathing short article titled “Tis the Season That the Poor Are Freezin” for Betsy Leondar-Wright’s organization, Class Action, several years back, enumerating exactly how poor people were dying as a direct result of not getting helped after being charged 35-50% more for basic utilities than those
    fortunate to have adequate incomes to live on (due to perfectly legal
    but egregiously unfair rate tiering schemes) as part and parcel of the
    whole utility deregulation mania.

    I included testimony from the former Pennsylvania State Consumer Advocate, Sonny Popowski in my article, too.

    I also included documented proof that people were turned away and DENIED the aid that was supposed to help prevent them from dying due to utility shut-offs. I cited cases in Pennsylvania, Ohio, and Michigan – one of which was that of a poor single mother who lost 3 of her 7 children in a deadly fire from a faulty space-heater as a direct result of her gas being cut off while it was bitter cold during a deadly cold snap in the first week of March in 2010.

    Adding insult to injury, the state of Michigan and the media demonized and criminalized the mother (Sylvia Young) – taking her remaining children away from her on the grounds that she was “unfit” because she was that damn poor. The media painted Ms. Young as the stereotypical “welfare queen” whose children died in a fire due to her negligence while she “went to a party store.” The truth was that Sylvia Young trudged through snow on foot to a Dollar General store to buy more two more space-heaters so she and her children would hopefully not freeze to death.

    I cited other cases in my article too, and the fact that there really isn’t “all this help out there” for the poor.

    And the response from those who were better off was…crickets. Nobody helped. Nobody reached out or spoke out. Nobody cared.

  • Thank you. And my apology for the belated expression of gratitude. (Assumed I was probably banished, hence did not return until I noted several messages in my email.) My apology too for the incorrect assumptions — certainly no reflection on you, Dr. Flowers, but on many (mine and others’) less than pleasant experiences with Discus, which I frankly despise. As Two Americas said learnedly above, “Discus delenda est,” to which I would emphatically add, “and salt the ruins.”