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The Expansionist
Sunday, September 20, 2009
 
Effectively Uninsured. A new Harvard University study says that 45,000 Americans die each year from lack of health insurance. I knew that the figure I had seen, 18,000 a year, had to be wrong. But there is an even larger number that has not been investigated: the number of uninsured AND insured who die because they don't go to the doctor because they feel they can't afford it.
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A great many Americans who have some health insurance are unable to use it, so are actually uninsured as a practical matter. How is a person who has $2 left at the end of the week supposed to pay a $25 co-pay for a visit to a doctor, and another $15 or $50 for a prescription?
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How many Americans technically have health insurance but can't afford to take advantage of it because after the many charges taken out of their meager pay, including the employee portion of the grossly inflated health-insurance premiums the company they work for has to pay, they do not really have the money to use their health insurance? They can't afford the co-pay! They can't afford the prescription/s, even if there is a prescription component to their supposed insurance, because there is so much still to pay after the insurance has paid as much as it's going to pay, that they simply can't afford it. They can't go to the doctor. They can't pay for the medications the doctor may prescribe. So, if they feel so bad that they have to sacrifice other parts of their life — including responsibilities to their children — and go to the doctor because they are concerned that what they have might kill them, and they find out that what they have is only temporary and not potentially fatal after all, they have to ask the doctor what will happen if they don't take the meds he prescribes — or just not tell him they can't afford what he tells them to take. Some are too embarrassed to admit that even after insurance, they can't afford prescriptions. So they make a personal decision to suffer for a while longer, hoping that something in their financial life changes for the better — but it rarely does — and gamble that the doctor is right that it won't kill them. Some people take even riskier gambles than that. They go against the doctor's advice that it is very important they take their medication, because they simply cannot afford the medication, especially if it is for a chronic condition, so will entail an out-of-pocket expense month after month.
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Were they able to admit to the doctor that they can't afford the medicine he wants them to take, he might be able to steer them to a public subsidy program, Astra Zeneca's private assistance program for drugs they make, etc. But some people are too proud to admit any such thing. They are literally embarrassed to death.
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Is this a good way, as comic Blake Clarke says, to "Thin the herd!" of the stupid? I don't think so, because people who don't want to be a burden to society but to take care of themselves have a character trait that, in moderation, we want not just to survive in the gene pool (if it has a genetic component) but also become dominant. Even if this self-reliance trait is merely psychological, if it can be passed along (again, in moderation) to their children, so much the better for society. We don't want people to let guilt over becoming a burden or not "paying their own way" kill them.
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It is one of the most astonishing things that has ever happened that the Republican Rightwing has persuaded poor, uneducated "white trash" who assuredly have much higher uninsured rates than educated people of the same ethnicity, that Liberals, who want them to live well, be paid well, have good working conditions, be treated with dignity, and to have free, high-quality healthcare, are their ENEMIES, but the plutocrats who have exported millions of jobs to China and other low-wage countries to bring crushing pressure on Southern white trash to take less pay, fewer benefits, and accept either a total lack of health insurance or impose a plan that is so costly that they cannot use it, are their FRIENDS. How on Earth did they do that?
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Sadly, the answer is tribalism. The rich and Radical Right have used the lack of education and intelligence in poor white trash to manipulate them into FEELING that the programs that would benefit them the most are put forward by their tribal enemies who hate them. They will point to verbiage like mine, about "poor, uneducated white trash" as proof that we are their enemies — never mind that we don't want them to be poor, or uneducated, or self-made trash (subverting their lives by dropping out of school, subverting their health by smoking tobacco and using methamphetamine, etc.) but want them instead to "straighten up and fly rite". We lose patience with their stupidity, in letting themselves be led around by the nose by magic chains labeled "gay marriage" and "abortion", into working to kill themselves and their children by so delaying medical care they cannot afford because The System is rigged against them by the rich, that they DIE or are permanently disabled. We want them to wake up to who the real Enemy is: the Radical Right in the service of the rich. But no, they'd rather pretend that the rich who use them see them as their equal — HA! — and treat them with respect. Oh yeah, of course they do. To your face. But the instant you are out of earshot, they say horrendous things about the stupid rubes and worthless white trash whose only use is to keep Congress from acting to rein in the abuses of the obscenely rich.
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What are Liberals to do or say? Play the same game of tribalism? "Hey, man, we're just like you. No, we're not uneducated, poor, and illiterate. No, we don't work for cents on the dollar of a fair wage, and no, we don't subvert our health with chronic smoking, alcohol excess, or drug use. But in every other way, we're exactly like you!" Who is going to believe that?
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And there is one unbridgeable line that poor white trash won't cross. They'll accept a Jew as House minority whip, but they won't accept a black President or Congressman as someone "just like them". And they won't accept no damned faggot as "just like them" — even if cousin Billy Bob never married and doesn't date. We're not fools. We know you look down your nose at us. But our friends in the Republican Party treat us like equals. They really need our votes, and look out for us.
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Sure they do.
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Listen, you ignorant morons. WE know you are ignorant morons. YOU know you are ignorant morons. Wake the f* up! If you had the sense of a retarded chipmunk you would know — and do know, in your unspeaking heart — that the Republican Party doesn't give a crap about your lives, and Republican members of Congress do NOT regard you as their equal. They are playing you, fool.
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We Liberals will tell you that we are better than you, because we are. We stayed in school. We got our education. We work not just hard, but also smart. We'll tell you you're being used by your betters. Not us, tho yes, we are better. But by the rich in your own region, and other parts of the country, who HATE you. We feel sorry for you, and we're angry at you when you shout us down and even threaten violence to preserve your own economic and sociological oppression! We're trying to help you, you sh*heads. Do you really LIKE being white trash? Do you really LIKE being poor and having nothing? being unable to go to the doctor — or, crucially, dentist — so having aches and pains and fevers, and not being able to chew without pain? Do you like paying thru the nose for health insurance, and not being able to use it unless you're afraid you'll die if you don't come up with the co-pay and prescription costs? Does it do your heart good to see your kids cough and hear them cry thru the nite?
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"Well, my life may not be great, but at least I'm not a goddamned nigger!" That's a comfort to you, is it? Poor black people reach out and say, "Hey, we're all in the same boat. We've got to get past this race nonsense and work together for better pay, better healthcare, dental care, working conditions, education. These are the things that matter, not the color of our skin or the texture of our hair." And you say? "Go f* yourself."
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And that's the way you f*k yourselves, decade after decade, generation after generation. The people who want to work with you to improve your lives are the Enemy. The people who want to use you and keep you down are your Friends. Of course. What were we thinking?
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(The current U.S. military death toll in Iraq, according to the website "Iraq Coalition Casualties", is 4,345 — for Israel.)



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