Is "Health Insurance Fraud" an Oxymoron?

‘As the US demonstrates, when the profit motive is introduced into a health delivery system, ways of gaming the system and outright fraud schemes are easier to devise, and they are a far more profitable business to engage in than treating patients.’
David Lindorff

This article in the London Review of Books details conventional fraud, but the fraud behind the system is the system itself: healthcare for profit.

Obamacare was a necessary set of innovations to protect more Americans, and its reliance on private insurance was politically inevitable.  But the system is still a massive fraud.

Or maybe I'm just a little ticked as I survey my past year's expenses and look forward to the next.

For example, for 2018 Social Security granted a 2% cost of living adjustment, after several years of pretending that the real cost of actually living as a senior hadn't gone up at all, gosh, weren't we lucky.  All the price rises on food, clothing etc. must have been senior moment delusions.

Unfortunately also for 2018 Medicare Part B increased its rates to those same seniors (including me), cutting the adjustment roughly in half.  It's a common assumption that Medicare is free.  Well, it ain't.

Only Medicare Part A, which covers hospital costs (though of course not all of them) doesn't charge a monthly premium.  Medicare B (doctors costs, but not all of them, oh no) is deducted from the Social Security check.  Not to mention Medicare C and D plans (if you can afford them) which cover other stuff, and are run by private insurance companies.

Then there are the so-called Medigap private insurance plans that cover what Medicare A and B don't cover.  Though still not all, oh no.  My AARP plan told me my premium for them is also going up in 2018, so forget the cost of living increase.  The cost of living increased beyond it, before I got out of the insurance category.

(AARP also told me that the monthly premium I'm paying is not the actual monthly premium, oh no, it includes a discount.  "Discount" is not a word I've heard from them before.  But apparently this is going to keep going up every year.)

In the past year, the AARP plan paid for--what a surprise--virtually nothing.  It just paid their executives, lobbyists and their fraud insurance.  So here's my 2017: practically all medical goods (prescriptions) and services (including dentist and eye doctor) I paid for entirely out of pocket, plus some doctor bills Medicare and AARP wouldn't pay for, plus copays.

 Meanwhile I paid thousands of dollars in the semi-private Medicare Part B insurance and the private Medigap insurance, for which I got pretty much nothing but pieces of paper telling me why I was getting nothing.

Fraud may be more profitable than treating patients.  But insurance must certainly be.

Regarding Wave

On the day that marked one year since the notorious election of 2016, results from elections on Tuesday showed impressive gains for Democrats and their issues, from coast to coast.  Some call it a Blue Wave, and why not, we need the rush.

For some, it suggested re-thinking conclusions based on 2016 results.  Jennifer Rubin in the Washington Post wrote that pundits, like the DNC, underestimated how unpopular and polarizing a figure Hillary was, which doesn't account for other R victories.  Nevertheless one of her conclusions seems borne out by results Tuesday:

Jennifer Rubin:
"...the mood of the country a year after Trump’s victory may not be as anti-government as some thought. Instead of unrelenting hostility toward government, verging on nihilism, we see voters going for pro-government candidates, even ones seeking to expand health care. You never know what you stand to lose until you look into the abyss and see the loss of a politically sane and functional government."

Health care was the top issue in Virginia, guns was second.  These victories in Tuesday's elections aren't the only evidence on healthcare.  Despite the worst efforts of this administration to incrementally destroy Obamacare and discourage participation, new sign-ups are surging.

Analysts also pointed to the educated white vote, which flipped from R to D in Virginia.  More broadly:

New York Times:

The American suburbs appear to be in revolt against President Trump after a muscular coalition of college-educated voters and racial and ethnic minorities dealt the Republican Party a thumping rejection on Tuesday and propelled a diverse class of Democrats into office. From the tax-obsessed suburbs of New York City to high-tech neighborhoods outside Seattle to the sprawling, polyglot developments of Fairfax and Prince William County, Va., voters shunned Republicans up and down the ballot in off-year elections."

At Slate, the emphasis was on the importance of women, as candidates as well as voters.

In Washington, an ebullient E. J. Dionne saw a sea-change:

Forget those repetitious tales about some piece of President Trump’s base still sticking with him. It’s now clear, from Virginia and New Jersey to Washington state, Georgia, New York, Connecticut and Maine, that the energy Trump has unleashed among those who loathe him has the potential to realign the country.

In droves, voters rebuked his leadership, his party and the divisive white-nationalist politics that was supposed to save Republican Ed Gillespie in the Virginia governor’s race, the centerpiece of the GOP catastrophe...

The gun issue was supposed to hurt Democrats whenever it was salient. It was the No. 2 issue in Virginia, after health care. But in a historic rebuke to the National Rifle Association, voters who said they cast ballots on gun policy split narrowly. Sane gun policies are no longer a political third rail. It’s time for fearless opposition to the NRA’s extremism...

Republicans take note: You can demean yourselves all you want by trumpeting Trumpian themes. It won’t buy you gratitude, and — except in the most deeply red parts of the nation — it won’t buy you victory. The leader of your party is a boor, an ingrate and, as Northam declared in his effective Democratic primary advertising, a “narcissistic maniac.”

Dionne wasn't alone, though John Cassidy's  analysis was more tempered.  The most salient observation to me in terms of electoral futures was the impression that since 2016 Democrats recruited good candidates for the kind of offices up for election in a non-presidential, non-congressional year.  This has been a longstanding problem, and is reflected in the apparent dearth of clearly superior candidates for higher offices, including president.  That a not great candidate like Northam could win such a convincing victory in Virginia is fine in the short term, but for years Ds have not matched Rs in creating infrastructure for identifying and supporting candidates.

Another measure of the D wave is that the current internal strife over the 2016 campaign, especially related to Donna Brazile and her book, didn't deter voters.  Her own analysis of the results was: Tactically, Tuesday was nothing short of a blue wave, which proved that grassroots campaigns are the key to the Democratic Party’s success next year. Democrats must no longer cherry pick which states and which dates to invest in the grassroots. We must go everywhere. And we plan on doing that."

This was President Obama's veiled critique of 2016 and advice going forward, which he made shortly after that election.  It seems key to future elections.

Though D leaders anticipate 2018, at least one analyst says prospects are still difficult.  Of course as this tragic anniversary suggests, the damage to the country and the world at a very delicate time will continue and could very well get worse, because Homemade Hitler is still in the White House, and even if it does nothing else, Congress enables the destruction to continue through policy reversals and appointments of the profoundly ignorant, rigidly ideological and thoroughly corrupt.

Washington Week: Unhealthcare on Life Support

Many people, including Republicans, may have forgotten that Senator John McCain was once their candidate for President.  I don't think McCain has forgotten it.

Senator McCain announced his opposition to the latest GOP unhealthcare bill, which likely has doomed it.  Although this particular zombie proposal has come back to life so many times, nobody will count on its death until the September 30 deadline drives a stake into its heart.

McCain is again one of the heroes of the opposition.  The other--which I'm sure no Republicans nor anyone else saw coming--was talk show host and comedian Jimmy Kimmel.  This description/analysis of his series of devastating monologues and their influence is the best I've run across.

As for the unhealthcare bill itself, the best single description of its nature I've seen is in the New Yorker, by Atul Gawande, a staff writer and cancer surgeon.  It begins:

"The fundamental thing to understand about Senate Republicans’ latest attempt to repeal Obamacare is that the bill under consideration would not just undo the Affordable Care Act—it would also end Medicaid as we know it and our federal government’s half-century commitment to closing the country’s yawning gaps in health coverage. And it would do so without putting in place any credible resources or policies to replace the system it is overturning. If our country enacts this bill, it would be an act of mass suicide."

Why would congressional Republicans insist on a such an extreme, lunatic and suicidal bill opposed by nearly every healthcare institution and organization, and a majority of the citizenry?  The usual excuse that Republican voters demand an end to Obamacare doesn't wash (since the numbers don't bear it out), according to Eric Levitz in New York Magazine.  Only a small number of people actively support the bill, and nearly all of them are billionaire GOP donors--principally the Koch brothers.  This whole exercise is further evidence that 48 United States Senators are bought on a continuing basis.

Such is one result of extreme income inequality.  Another was quantified this week in how much income most people have lost so that the very few can become horribly wealthy.

The unhealthcare bill fight dominated this week's Washington frenzy but there were notable additions to what's known about the progress of the Russian interference investigation, helpfully summarized by Ryan Lizza.

The Test

A portion of President Obama's speech on working for a better future focuses on the latest unhealthcare bill the Senate is gearing up to consider next week.  The test of working to make things better he says is when you encounter resistance, when reversal is threatened.  Hey kids, it's test time.

Below is the full address, because it's always time to hear this voice, not only for good sense but optimism, inspiration and hope.  Remember those?

Heroes and Villains

Senator John McCain's week is already becoming legendary.  Diagnosed with brain cancer, he made a dramatic reappearance in the Senate, and was the deciding vote to take up the Republican unhealthcare bills.  He promptly made a speech castigating the secret, cynical and increasingly corrupt process led by Mitch McConnell and maintained by his fellow Republicans.

 He reminded them that matters of this weight and complexity require the regular committee process and open discussion, and that matters that involve virtually every American and a significant chunk of the economy require at least an attempt at bipartisan legislation.  Then he stunned his colleagues by being the deciding vote that brought down the last Republican unhealthcare plan, and ended this particular long nightmare for the time being.

McCain's first vote should not have been a surprise.  When asked earlier if he would vote to take up the bill he replied "I always do."  That's part of the regular order of how Senate business is conducted.  His vote against the plan mostly supported what he said in his speech, which Andrew Sullivan considers was significant in itself:

"And I wonder if historians will one day look back and see Senator John McCain’s speech last Tuesday as some kind of turning point. Diagnosed with an aggressive brain cancer, McCain nonetheless returned to give one of the best-scripted speeches of his career. Excoriating the chaotic process by which repeal of the ACA was being forced through the Senate, McCain reminded his fellows that they are the president’s equals in the government of this country and not his subordinates. He appealed for a bipartisan fix for a national problem, and for a return to regular order. He spoke for a mere 15 minutes, but they remain worth watching several days later. He seemed for a few moments like an actual voice of authority in a capital where all such authority has withered into mere positioning or cowardice. And in the early hours of Friday morning, McCain appropriately provided the critical vote to kill the skinny repeal of the ACA. It was, in some ways, his finest hour."

(Parenthetically, I find myself agreeing with Sullivan, the former conservative, not only on the Republicans but on excesses of the left, particularly the stifling of free speech, and on Democratic failures.  His column from two weeks ago merits serious consideration.)

But lost in all the attention on McCain was the courage of Alaska Senator Lisa Murkowski, who defied actual and meaningful threats from the Sec. of Interior and backed by the apprentice dictator in the White House, threatening to screw the state of Alaska if she didn't play ball on unhealthcare.  It was no small threat.  Interior essentially runs more than half the state.

Murkowski, who in 2010 fell in the primary to a far right fellow Republican but spectacularly won on a write-in vote, cast an essential no vote on unhealthcare anyway, when fellow Republican Senators who knew better took the coward's way out.

It's significant that the threat got big play in Alaska itself, and worth noting that administration outrages make the local press, too, in areas where the apprentice dictator looks for his constituency, as in Long Island Newday's coverage of the a.d.'s encouraging police brutality.

He also made a lot of waves in middle America with his bizarre speech to a gathering of Boy Scouts, where scouting and its traditions are as close to sacred as anything secular.  The Borowitz satire that the Girls Scouts obtained a restraining order preventing the a.d. from coming within 300 feet of their gatherings, had the unfortunate ring of an actual news story.  As did the tweet he imagined the a.d. issuing in response:“Failing Girl Scouts bad (or sick) guys,” Trump wrote. “Mints, cookies terrible. Sad!”

As for villains in this unhealthcare saga there are at least 49, but the most pernicious needs to be named: Mitch McConnell, who now holds the record for the most evil perpetrated by an American over the past nine years.  Even without formidable ongoing competition in the White House, let's hope he's done his worst.

Obamacare Lives

The last ditch, post-midnight effort by Republicans ended in failure when Senator John McCain joined the only other Republican Senators with an ounce of courage: Senator Susan Collins and Senator Lisa Murkowski in voting no on the last gasp version of a Republican unhealthcare bill.

The vote was viewed with triumph and optimism by Jonathan Chait, so since that's pretty rare these days I'm passing on excerpts:

"I remember where I was and how it felt when the House of Representatives held the deciding vote to establish the Affordable Care Act. It was a feeling of elation, but, sitting in my living room by myself, an oddly solitary one. I ran out into the street of my residential neighborhood, half-expecting jubilant V-J Day-style crowds. But it wasn’t just that my neighbors were at work. The months and months of legislative grinding had cast a pall of depression over even many enthusiastic Obama-voting liberals, who saw the health care law as hardly worth celebrating.

The death of Obamacare repeal, in the early morning hours of Friday, July 28, was a very different experience. “Nothing in life is so exhilarating,” as Churchill is reputed to have said, “as to be shot at without result.” Obamacare has gained not only positive approval in broad opinion polls but a genuine mass following. Hundreds of thousands of Americans rallied to its defense, making its repeal impossibly painful for the Republican government that had once assumed it would sweep the law away in a January lightning strike."

Republicans in power will weaken Obamacare, Chait cautions, but America will never go back to the way things were done before Obamacare became law of the land.

"The desire on the right to destroy Obamacare will probably never disappear. In 2005, 70 years after the establishment of Social Security, confident Republicans sought to privatize the hallowed program. That, too, was a painful failure. And there is a lesson in this. While elections swing back and forth between right and left, there is a reason that the United States is more humane place today than it was 25 or 50 years ago. Social Security, civil rights, Medicare, Medicaid, and Obamacare have survived. Legalized child labor, supply-side economics, and unlimited pollution have withered. Ideas that bring real improvement to peoples’ lives have more staying power than ideas that do not.

Obamacare has brought life-changing access to modern medical care to 20 million Americans. It will endure."

Yet there is that other reality to face, and it becomes starker every day.  Check out this remarkable opening to Eugene Robinson's Washington Post column this morning:

"The Court of Mad King Donald is not a presidency. It is an affliction, one that saps the life out of our democratic institutions, and it must be fiercely resisted if the nation as we know it is to survive.

I wish that were hyperbole. The problem is not just that President Trump is selfish, insecure, egotistical, ignorant and unserious. It is that he neither fully grasps nor minimally respects the concept of honor, without which our governing system falls apart. He believes “honorable” means “obsequious in the service of Trump.” He believes everyone else’s motives are as base as his.

The Trump administration is, indeed, like the court of some accidental monarch who is tragically unsuited for the duties of his throne. However long it persists, we must never allow ourselves to think of the Trump White House as anything but aberrant. We must fight for the norms of American governance lest we forget them in their absence."

The Tipping Point of Cruelty

Update 6/27: Senate Republican leadership withdrew their Kill Obamacare and the People It Serves bill from immediately going to the floor for debate and a vote when it became clear that not enough Rs supported this first step.  The next opportunity comes in two weeks, after negotiations with key Senators may result in a revised bill.  The nail in the coffin of this bill appears to be the Congressional Budget Office estimate that 22 million Americans would lose coverage.  Meanwhile opposition is growing, both from healthcare related organizations, including the American Medical Association, and voters, who may have the opportunity to move their demonstrations from Senate offices to the home districts during the Fourth of July break.  Laurence O'Donnell and guests on his show suggest that the bill actually had the support of from 5 to 20 or 30 Republicans, which would seem to make getting to 50 an uphill climb.

This piece of video is amazing, one of the best sequences I've ever seen on Rachel Maddow.  It starts as a mundane story about the upcoming Fourth of July weekend, and what happened in Denver in 1978 on a similar weekend, with the 4th on a Tuesday.  It then becomes a story of a successful social justice campaign, that over a scandalously long time, won rights for the disabled--providing them the liberty of free movement on public transportation.

Then it comes up against the current Senate Kill Obamacare and the People It Serves bill, specifically the draconian cuts in Medicaid which will devastate the lives of a large proportion of the disabled.

The climax of this piece is a bit of video of disabled demonstrators outside the offices of Senator McConnell that is heartbreaking and haunting.  The woman being dragged away while pleading "Don't touch Medicaid!" is very powerful video.

This segment illustrates and suggests why this bill is the tipping point of cruelty.  If it passes, it will change America more than any single act of this regime, and tips the future into a very ugly place.

Medicaid is the insurer for a third of disabled adults and 60% of disabled children (and 40% of all children.)  Medicaid insures nearly half the births in America.  Medicaid is by far the largest health insurance provider in the United States--75 million Americans--much bigger than Medicare.

And here's what Republicans are trying to do:

Washington Post:

"Congressional budget analysts plan to issue their projections as early as Monday on the legislation’s impact on the federal deficit and the number of Americans with insurance coverage. Already, proponents and critics alike are predicting that the Senate proposal would lead to greater reductions through the Medicaid changes than the estimated $834 billion estimated for a similar bill passed by House Republicans last month."

This is almost incredible, as most observers assumed the Senate bill will moderate the crude brutality of the House bill.  But this one is worse, particularly on Medicaid.

 Medicaid is not only enormously important, it is also popular with the American public.  The Post again:

"Part of the pressure the moderates now face is that Medicaid consistently draws widespread support in surveys. A poll released Friday by the Kaiser Family Foundation found that three-fourths of the public, including 6 in 10 Republicans, said they have a positive view of the program. Just a third of those polled said they supported the idea of reducing federal funding for the expansion or limiting how much money a state receives for all beneficiaries.

Even among Republicans, the foundation found, only about half favor reversing the federal money for Medicaid expansion."

The money that the federal government won't pay into Medicaid goes directly to a tax cut for the wealthy.

America's first social programs may not have been purely or even largely motivated by compassion.  In the 1930s, even the bankers worried about revolution.  But FDR's programs, including Social Security, put social justice on the agenda, and gave permission to politicians to act decently.

When Michael Harrington published his landmark book on poverty in the early 60s, he estimated that a fourth of the population was below the poverty line.  Dwight McDonald, in his review of the book in the New Yorker, suggested that in practical terms it was more.

Harrington's book caught the attention of President Kennedy, who had already proposed the program that became Medicare.  Kennedy identified poverty as the domestic issue he would emphasize in his reelection campaign in 1964.  Following his lead and using his memory to get it passed, President Johnson got enacted the programs that made up his War on Poverty.

For awhile, poverty did decrease. But with the additions and subtractions of programs and especially the rapid changes in the economy affecting jobs and incomes, poverty--especially child poverty--has increased, and many Americans are living so close to the edge that nearly 40% could not sustain an emergency costing just $400.

The expansion of Medicaid under Obamacare was the single most important social justice effort in decades, as it provided medical care for the most vulnerable, especially poor and disabled Americans.  The Senate bill erases the expansion, and limits Medicaid in ways certain to decrease coverage and increase harm.  Here's a pretty good summary from, of all places, Cosmopolitan.

The Senate version, should it become law, will directly threaten the independence and the very lives of the disabled and the elderly requiring care beyond Medicare.  Many more will be hurt.  In the long run it will increase poverty in America.

Harrington's book is called The Other America. Poverty in the 50s and 60s was hidden outside the mainstream, in urban ghettos among people of color, and in isolated rural areas--in Appalachia for instance--where poverty was often white.  (Even today most welfare and Medicaid beneficiaries are white.)

Today there is homelessness everywhere that would have been a scandal in the 50s but which has become invisible except as nuisance or threat.  Major parts of cities like Detroit look like the bombed out streets of European countries after World War II.  And rural poverty is widespread again, if it ever abated.

But as two new books from Princeton U. Press (reviewed here and in the June 22 issue of New York Review of Books) describe the greater extent of economic vulnerability.  Because of volatility in jobs and incomes, fully a third of all Americans are living below the poverty line for at least one month of the year. Costs of necessities have risen enormously in just the past decade.  Social programs are generally not flexible enough to respond.  They need to be improved, not destroyed.

Social justice movements made injustices painfully visible.  With this Senate bill it may be happening again.

If this bill passes, it will pave the way for more self-defeating cruelty in the proposed Republican budget.  But more immediately, this Senate bill will devastate not only the lives of the most vulnerable, but the American soul.

First, Do No Harm

Among the first to react to the suddenly revealed Senate "Kill Obamacare and the People It Helped" bill was President Obama.  His statement in full is on Facebook and at the Atlantic.  Quoting:

"I recognize that repealing and replacing the Affordable Care Act has become a core tenet of the Republican Party.  Still, I hope that our Senators, many of whom I know well, step back and measure what's really at stake, and consider that the rationale for action, on health care or any other issue, must be something more than simply undoing something that Democrats did.

We didn’t fight for the Affordable Care Act for more than a year in the public square for any personal or political gain—we fought for it because we knew it would save lives, prevent financial misery, and ultimately set this country we love on a better, healthier course."

"The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely."

Simply put, if there’s a chance you might get sick, get old, or start a family—this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation."

"To put the American people through that pain—while giving billionaires and corporations a massive tax cut in return—that’s tough to fathom. But it’s what’s at stake right now. So it remains my fervent hope that we step back and try to deliver on what the American people need.

"After all, this debate has always been about something bigger than politics. It’s about the character of our country – who we are, and who we aspire to be. And that’s always worth fighting for."

On the bill itself, most news outlets agree.  The New York Times:

Obamacare raised taxes on high earners and the health care industry, and essentially redistributed that income — in the form of health insurance or insurance subsidies — to many of the groups that have fared poorly over the last few decades.

The draft Senate bill, called the Better Care Reconciliation Act, would jettison those taxes while reducing federal funding for the care of low-income Americans. The bill’s largest benefits go to the wealthiest Americans, who have the most comfortable health care arrangements, and its biggest losses fall to poorer Americans who rely on government support. The bill preserves many of the structures of Obamacare, but rejects several of its central goals."


Passage of this program will not only mean fewer Americans will get the health care they need as it makes healthcare more expensive, a new study says it could cause an economic recession:

A new report from the Commonwealth Fund and George Washington University researchers," writes the Atlantic, found that the very similar House version  "would slash total jobs by about a million, total state gross domestic products by $93 billion, and total business output by $148 billion by 2026. Most of those jobs would be shed from the health-care industry, which would contract severely over that frame. Most of the losses in economic activity would come in states that have expanded Medicaid to low-income adults under the Affordable Care Act."

It's about cutting taxes for the wealthiest, and let the others suffer and die.

That's the Republican credo.  Their greediest supporters see the opportunity in holding Congressional majorities and the White House: more bucks for us.

"Follow the Money" was the catchphrase of Watergate, and it is again for the Russian connection investigation.  But more than that, it is the first place to look for anything Republicans in Washington do.

It's there in the generous donations from fossil fuel corporations, and so on.  As for our apprentice dictator, it is all summed up in his allegiances--in the Middle East and elsewhere, he loves whatever country his companies do business in, and any country that doesn't want his businesses is America's enemy.

It's Blood Money: Senate R's and Healthcare

Reporting has been consistently inconsistent on how close Senate Rs are to bringing their healthcare bill to a vote, although most recently the chances for that to happen by early July are said to be alarmingly good.

As to what actually is or will be in the bill, nobody except those R Senators involved really know.  The whole thing is being done in complete secrecy.  So far there doesn't even seem to be a written bill, and there likely will not be until it is time for the vote, which will be called only if the R leadership knows it already has the votes to pass it.

So not only is the process of writing the bill being done without outside scrutiny--even and maybe especially expert scrutiny--once the bill is written, there will be no process for evaluating it.

The entire criteria for what gets into this bill seems to be what will get the needed votes.  They are not evaluating what will make the best healthcare system for the most Americans.  They aren't even getting outside evaluation on whether the thing will work at all.  It mirrors the autocratic White House attitude.  It is irresponsible, cynical and corrupt on an immense scale.

From the beginning, the repeal and replace of Obamacare has been a cynical and carelessly cruel excuse for giving more tax breaks to the very rich.  That is, as they say, the bottom line for the R party.

Here is Sarah Kliff at Vox:

"Republicans do not want the country to know what is in their health care bill.

This has become more evident each day, as the Senate plots out a secretive path toward Obamacare repeal — and top White House officials (including the president) consistently lie about what the House bill actually does.

There was even a brief moment Tuesday where Senate Republicans flirted with the idea of banning on-camera interviews in congressional hallways, a plan quickly reversed after outcry from the press.

“The extreme secrecy is a situation without precedent, at least in creating health care law” writes Julie Rovner, who has covered health care politics since 1986 and is arguably the dean of the DC health care press corps.

I don’t have quite as long of a tenure as Rovner, but I have been covering health care politics since Democrats began debating the Affordable Care Act in 2009. It’s become obvious to me, particularly this week, that Republicans plan to move more quickly and less deliberatively than Democrats did in drafting the Affordable Care Act. They intend to do this despite repeatedly and angrily criticizing the Affordable Care Act for being moved too quickly and with too little deliberation.

My biggest concern isn’t the hypocrisy; there is plenty of that in Washington. It’s that the process will lead to devastating results for millions of Americans who won’t know to speak up until the damage is done. So far, the few details that have leaked out paint a picture of a bill sure to cover millions fewer people and raise costs on those with preexisting conditions.

The plan is expected to be far-reaching, potentially bringing lifetime limits back to employer-sponsored coverage, which could mean a death sentence for some chronically ill patients who exhaust their insurance benefits.

Senate Republicans do not appear to be focused on carefully crafting policy that reflects a more conservative, free-market attempt at achieving President Donald Trump’s goals of covering every American at lower cost. They’re focused on passing something, by whatever means necessary. That may come back to haunt them electorally, but not after millions suffer the consequences."

Not Healthy, Not Wealthy, Unwise (with Updates)

You're living in a neighborhood you'd rather not live in, or you're having trouble paying the mortgage or the rent, and you see strange people around, probably poorer than you are.  One reason you can't afford to move is the proportion of your income you must spend on healthcare.  So who do you blame?

Do you blame the strange people you can see, or the super rich you have never seen, who run the corporations that export jobs and together haven't raised the average American wage in a decade, who lost little in the Great Recession and have mightily prospered since while you lost and have not recovered?

The ACA at least helps with medical care, and in certain cases it can be the difference between life and death, or some security and certain ruin.  The CBO analyzed the Republican-passed replacement, and found how devastating it will be for tens of millions of Americans--cutting them off from healthcare insurance, offering them extremely expensive policies when they're sick and utterly inadequate policies otherwise.

Michael Grunwald in Politico put it succinctly:

"Obamacare has had plenty of glitches, especially for the small minority of Americans who don’t get their insurance through the government or their employers, but it basically succeeded in taking some of the top 1 percent’s money to improve the health security of the bottom 99 percent.

The GOP wants to take money that the government has been spending on the poor and working class—mostly for expanded Medicaid coverage or tax credits to help moderate-income families afford their premiums—and give it back to high earners.

...what’s really being contemplated is a gigantic redistribution from health to wealth."

This was the agenda all along, and it is behind the regime's proposed budget: enrich the rich.  It's just an extreme version of the basic Republican plan.  It can be so extreme--and so extremely obvious--because of what Shadowy stuff has been stirred up to obscure this, or in the minds of way too many, make it not matter. They don't call it blind rage for nothing.

On a somewhat different matter, when a reporter tweets that a Montana congressional candidate has just body slammed him and "broke my glasses" on election eve, the cynical response has to be, this guy just got elected.  The "broke my glasses" especially.  The Republican candidate was charged by police with misdemeanor assault. We'll see what level of civilization proves out at the polls on Thursday.

Update: Apparently this assault was witnessed by, of all people, Fox reporters, and it seems to have been a good deal uglier than the reporter's tweet suggested.  According to NPR:

According to three Fox News reporters who were in the room preparing for an interview with the GOP nominee, Gianforte "grabbed Jacobs by the neck with both hands and slammed him into the ground ... then began punching the reporter. As Gianforte moved on top of Jacobs, he began yelling something to the effect of, 'I'm sick and tired of this!' "

The Ginaforte campaign claims the reporter was the aggressor but witnesses from Fox News make that awkward for Fox News to agree with.  Meanwhile the Borowitz headline is REPUBLICAN HEALTH-CARE PLAN LACKS COVERAGE FOR INJURIES RESULTING FROM BODY SLAMMING.  Satirical but true.

Apparently there's a lot of early voting in Montana in this statewide race, so nobody knows the possible impact of this story on an election that experts guess is close.

Second Update: The Republican Ginaforte won the Montana seat in the US House of Representatives.  Before he goes to Washington, he'll have to answer to the charge of assault on a reporter.  Who knows, he may get a medal for it from this White House.

Courage

The media headline from President Obama's speech accepting this year's Profiles of Courage award from the JFK Library inevitably was his defense of Obamacare, and his call for members of Congress to display courage in supporting its substance. The quotes were largely accurate and obviously President Obama knew what the headline was going to be, but these were only a few lines in the speech, and missing the context.

He didn't bring up the topic of the Affordable Care Act out of the blue.  First of all, its passage was, according to CNN, one of the reasons he was given the award: The John F. Kennedy Library Foundation said Obama received the award for "expanding health security for millions of Americans, restoring diplomatic relations with Cuba and leading a landmark international accord to combat climate change."

It is an award honoring President John F. Kennedy, whose birthday this month is 100.  As a senator, JFK authored the book Profiles in Courage, about eight US Senators throughout history who exhibited principled courage in difficult political situations.  As President, JFK proposed the healthcare program that became Medicare.  His younger brother Senator Ted Kennedy, championed an expansion to all US citizens to make healthcare a right.

 In his speech, President Obama told a story about how Ted Kennedy walked the halls of the hospital where his young son was fighting for his life and talked to people there worried that they couldn't afford the next cancer treatment for their children.  He made healthcare his cause, and shortly before his death, urged President Obama to make it his first legislative priority.

Welcoming President Obama to Boston on Sunday

So in talking about courage in Congress, it was completely in context for President Obama to remember those who voted for the ACA, knowing they might lose their next election because of it--and many in fact did.  After talking generally about John and Bobby Kennedy as inspiring him to enter politics, he said:

"Our politics remains filled with division and discord, and everywhere we see the risk of falling into the refuge of tribe and clan, and anger at those who don't look like us or have the same surnames or pray the way we do.

And at such moments, courage is necessary. At such moments, we need courage to stand up to hate not just in others but in ourselves. At such moments, we need the courage to stand up to dogma not just in others but in ourselves. At such moments, we need courage to believe that together we can tackle big challenges like inequality and climate change. At such moments, it's necessary for us to show courage in challenging the status quo and in fighting the good fight but also show the courage to listen to one another and seek common ground and embrace principled compromise."

He spoke about the beginning of his presidency and the courage it took to vote for the Recovery Act, to support the auto industry and regulate Wall Street, and especially, the complex and previously impossible task of what came to be called (by his opponents) Obamacare:

"And there was a reason why healthcare reform had not been accomplished before. It was hard. It involved a sixth of the economy and all manner of stakeholders and interests. It was easily subject to misinformation and fearmongering.

And so by the time the vote came up to pass the Affordable Care Act, these freshmen congressmen and women knew that they had to make a choice. That they had a chance to insure millions and prevent untold worry and suffering and bankruptcy, and even death, but that this same vote would likely cost them their new seats, perhaps end their political careers.

And these men and women did the right thing. They did the hard thing. Theirs was a profile in courage. Because of that vote, 20 million people got health insurance who didn't have it before."

Many lost their seats in the 2010 elections, his said. And this was the context for his comments on the future:

"It was a personal sacrifice. But I know, because I've spoken to many of them, that they thought and still think it was worth it.

As everyone here now knows, this great debate is not settled but continues. And it is my fervent hope and the hope of millions that regardless of party, such courage is still possible, that today's members of Congress, regardless of party, are willing to look at the facts and speak the truth even when it contradicts party positions.

I hope that current members of Congress recall that it actually doesn't take a lot of courage to aid those who are already powerful, already comfortable, already influential. But it does require some courage to champion the vulnerable and the sick and the infirm, those who often have no access to the corridors of power.

I hope they understand that courage means not simply doing what is politically expedient but doing what they believe deep in their hearts is right."

But then President Obama expanded his examples of profiles in courage to include ordinary people who sacrificed for their families, who did the right thing even when it was difficult.

He included political activists who worked nonviolently for change. And he powerfully restated his credo for involvement in creating political change, ending with a ringing call to keep the faith and keep working for the future:

"I know that the values and the progress that we cherish are not inevitable, that they are fragile, in need of constant renewal.

I've said before that I believe what
 Dr. King said, that "the arc of the moral universe is long but it bends toward justice," but I've also said it does not bend on its own. It bends because we bend it, because we put our hand on that arch, and we move it in the direction of justice and freedom and equality and kindness and generosity. It doesn't happen on its own."

"And so we are constantly having to make a choice because progress is fragile. And it's precisely that fragility, that impermanence, that is a precondition of the quality of character that we celebrate tonight.

If the vitality of our democracy, if the gains of our long journey to freedom were assured, none of us would ever have to be courageous. None of us would have to risk anything to protect them. But it's in its very precariousness that courage becomes possible and absolutely necessary.

John F. Kennedy knew that our best hope and our most powerful answer to our doubts and to our fears lies inside each of us, in our willingness to joyfully embrace our responsibility as citizens, to stay true to our allegiance, to our highest and best ideals, to maintain our regard and concern for the poor and the aging and the marginalized, to put our personal or party interest aside when duty to our country calls or when conscience demands.

That's the spirit that has brought America so far and that's the spirit that will always carry us to better days."

Another video and full transcript of the speech is at TIME.

Friday's GOP Defeat and Empty Victory

For America and its people, it was the best news of the calendar year: the  arrogantly slapped together, cynically altered and altogether horrendous Republican replacement for Obamacare died a hidden but ignominious death, because it couldn't get enough Republicans in the House (where they have a 44 seat advantage) to pass it by majority vote.

Then surprisingly, the White House regime and the R leadership announced that it would not be revised or revived.  The threats to healthcare are over for the foreseeable future.  It's too bad that sensible improvements won't be made in the current system, but that is far outweighed by the virtues and advantages that will remain, and that would have been ended or crippled, with vast consequences to a lot of people and eventually the American economy.

Obamacare, celebrating the 7th anniversary of its passage, remains the law of the land, with its highest number of insured and its highest poll numbers as well.

While most of the attention for the past several days was focused on the rabid right conservatives in the House opposed to the bill for not destroying enough, several accounts on Friday agree that the nails in the coffin--not just for this go-round but the near future--were hammered by "moderate" Rs and Rs from blue states, all fearful of these consequences to their constituents, especially the changes demanded by the rabid right and granted by the desperate House leadership and White House.  For example, the Atlantic:

And as opposition mounted, Republicans representing swing districts and Democratic states began to pull their support, worried about cuts to Medicaid, a broader projected loss of insurance coverage, and a potential backlash from voters in the midterm elections next year. The nonpartisan Congressional Budget Office found that the proposal would increase the number of uninsured Americans by 24 million people over a decade, and a Quinnipiac University poll showed that just 17 percent of potential voters supported the plan, with 56 percent opposed."

It was widely reported as a serious defeat for the Rs and specifically for the apprentice dictator in the White House.  With the media's track record, that might be taken with a grain of salt, but there are some interesting numbers, for whatever they are worth.  The LA Times added:

"A Quinnipiac University poll published this week said that 56% of voters disapproved of how Trump was handling his job; only 37% supported him. Other polls have shown similar numbers. Worse for the president, some of the voter groups that have most strongly backed him have begun pulling away, the poll indicated.

“We’ve been polling for 24 years and have never seen anything like this,” said Timothy Malloy, the assistant director of the poll. “Far and away, the worst numbers ever seen in a president."”

The LA Times story echoed an observation I read earlier in the week, that part of the failure of Homemade Hitler to seal the deal with House Rs was his inability to defend what was actually in the bill--even to them.  That could definitely recur.

Repealing Obamacare was the national Rs main campaign promise; another was building the Keystone XL pipeline, which would add about fifty permanent US jobs while churning up a lot of carbon--perhaps enough to doom civilization--and lacerating habitat for threatened animal species down North America from the Alberta wastelands.  

The current regime announced Friday that it was approving this project, an apparent victory.  But several articles (in the Forbes business magazine, an oped in the Baltimore Sun newspaper as well as EcoWatch) said there were several reasons that the pipeline would not be built immediately and probably not at all.

The reasons range from litigation, state and local permits still needed, and the distinct possibility that the Canadian government might well not give its permission, in order to meet its Paris Agreement commitments on carbon waste.

 But the most compelling reason given may be that the expense of building the pipeline versus the much weaker market for coal sands oil as well as the overall steep drop in oil prices since it was first proposed, will mean that the company itself will drop out, because the damn thing won't make anybody any money.

Ryan's War-- on Seniors

The Paul Ryan healthcare proposal--fully embraced by Homemade Hitler--is hurtling through Congress, hoping that it's moving too fast for anyone to read it first.

Too late.

Senator Bob Casey released a 50 page report detailing how the plan raises premiums and lowers coverage as citizens age, with seniors (not quite 65) of the lowest income paying the highest percentage of their income.

Paul Krugman: "Affluent young people might end up saving some money as a result of these changes. But the effect on those who are older and less affluent would be devastating. AARP has done the math: a 55-year-old making $25,000 a year would end up paying $3,600 a year more for coverage; that rises to $8,400 for a 64-year-old making $15,000 a year."

Low income seniors--even those on Medicare, which covers only part of healthcare costs--depend on programs through Medicaid.  The Ryan plan would end much of this support by 2020.

But news is Republicans have gotten concessions from Ryan and the White House: they have agreed to wound Medicaid even more.

This is the Cruelty State's proudest boast--thanks for your service, now that you're too old we'll kill you, painfully.

What "Universal Access" Means

Does the Republican plan for healthcare guarantee universal coverage?  Nope--something better: Universal Access!

Universal Access means everybody can get health insurance!  After all, it's the American way.

Americans have Universal Access to lots more than healthcare, too!  For instance, Americans have universal access to flights in private jets whenever they want one---provided they pay for the private jet.  But other than that, there are no restrictions.  This is America!  (Well, depending on other factors, you might not actually be allowed to fly in it--but you could still own it.)

Universal Access to health insurance also means that you can buy a really cheap policy, way cheaper than under Obamacare.  Of course it won't cover anything much, but it will be way cheap!

But if you want health insurance that covers lots of stuff, even everything, you have Universal Access to those plans, too!  Provided you can pay the very steep prices, which get steeper the older you are.

Listen, you can even have Universal Access to the Universe if you want, if you can pay, if you can wait for faster than light spaceships.  After all, facts are just limitations, and they don't matter anymore.  Universal Access is what they used to call bullshit, when that was still a word and not White House policy.

So don't worry that the Republican plan won't cover everybody, or even everyone now covered under the suddenly popular Obamacare. (CBO Update: 24 million people fewer than Obamacare, which is even fewer insured people than before Obamacare.)  Universal Access is what will make America great again.

(Well, yes, anybody can get health insurance now under Obamacare, but that isn't Universal Access.  Because...well, because they don't call it that.  What is this anyway--fake news?)

Show Me

Ever think at this point you'd watch an hour on healthcare?  I didn't.  And yet...I did.  And it gets better as it goes along.

That Evil Obamacare

Update: On Dec. 16, President Obama announced that Thursday "was the biggest day ever for HealthCare.gov. More than 670,000 Americans signed up to get covered, and more are signing up by the day."

Here's that evil Obamacare that Republicans can't wait to get rid of.  In talking about the sign-up period now underway, President Obama outlined what all those horrible provisions are, that cause such righteous anger on the alt.right.

So when Nazi Millennium healthcare comes around, come back here and check on what you no longer have...


"Like most Americans who get coverage through HealthCare.gov, there’s a good chance you’ll find a plan that costs less than $75 a month. And while the enrollment period lasts until the end of January, as long as you sign up by this Thursday, December 15, you’ll be covered starting January 1.

"Now, this doesn’t apply to the roughly 250 million Americans who already get insurance through the workplace, or thanks to Medicare or Medicaid. But here’s what does. Every American with insurance is covered by the strongest set of consumer protections in history – a true Patients’ Bill of Rights.

 You now have free preventive care, like mammograms and contraception. 

There are no more annual or lifetime limits on the essential care you receive. 

Women can’t get charged more just for being a woman. 
Young people can stay on a parent’s plan until they turn 26, and seniors get discounts on their prescriptions. 

Every American can rest free from the fear that one illness or accident will derail your dreams -- because discrimination against preexisting conditions is now illegal. 

And since 2010, we’ve seen the slowest health care price growth in 50 years.

Whether or not you get insurance through the Affordable Care Act, that’s the health care system as we now know it. Because our goal wasn’t just to make sure more people have coverage -- it was to make sure more people have better coverage. 

That’s why we want to build on the progress we’ve made -- and I’ve put forth a number of ideas for how to improve the Affordable Care Act. Now Republicans in Congress want to repeal the whole thing and start from scratch -- but trying to undo some of it could undo all of it. All those consumer protections -- whether you get your health insurance from Obamacare, or Medicare, or Medicaid, or on the job – could go right out the window. So any partisan talk you hear about repealing or replacing it should be judged by whether they keep all those improvements that benefit you and your family right now.

One new study shows that if Congress repeals Obamacare as they’ve proposed, nearly 30 million Americans would lose their coverage. Four in five of them would come from working families. More than nine million Americans who would receive tax credits to keep insurance affordable would no longer receive that help. That is unacceptable.

We can work together to make the system even better -- and one of the best ways to do that is make sure that you’re in it. So remember: Sign up on HealthCare.gov by this Thursday, and your health insurance will be there for you when you wake up on January 1. Thanks everybody, and have a good weekend."

Update: On Dec. 16, President Obama announced that Thursday "was the biggest day ever for HealthCare.gov. More than 670,000 Americans signed up to get covered, and more are signing up by the day."

Defining the Darkness.6

"Gutting Obamacare might be the least controversial part of Tom Price’s health care agenda.

By tapping the tea party Republican as his top health care official, President-elect Donald Trump sends a strong signal he may look beyond repealing and replacing Obamacare to try to scale back Medicare and Medicaid, popular entitlements that cover roughly 130 million people, many of whom are sick, poor and vulnerable. And that’s a turnabout from Trump’s campaign pledge — still on his campaign website — that he would leave Medicare untouched.

“They will … not just roll back five or 10 years of progress — but 50.” said Anthony Wright, executive director of Health Access California, a consumer advocacy group that supports Obamacare."

Politico
11/29/2016

The Doctor Won't See You Now

"People don't eat in the long run, they eat every day."  That Hopkins quote is, in a nutshell, why I supported Obamacare.  It did  not solve the increasingly stark problems of medical care in the US, but it made improvements in the insurance system that are already proving for some many Americans to be the difference between getting medical care and not getting it, and therefore, between health and pain, between life and death.

But the successes of driving a stake in the heart of the worst private insurance excesses (like "pre-existing conditions") and making insurance available and more affordable to more people haven't driven the utter insanity out of the system.  Some of the less publicized reforms--in efficiencies and so on--may eventually make some difference.  But the basic system is still out of kilter, and very onerous.

One simple but massive disproportion: There are now diagnostic and treatment methods using expensive technology that didn't exist a generation ago.  According to the true cost of using this technology and the time of skilled personnel, one would expect them to be more expensive, and even "expensive" relative to other costs and income.

But one would expect that procedures that are simpler, that don't require these technologies, would be cheaper--that is, affordable, as they were before.  But mostly they are not.  In America, absolutely anything that requires hospitalization, and almost anything that requires a physician, is impossibly expensive.  What was once a relatively minor illness or injury can easily become financially ruinous.  In this respect and others, affordable medical care for many in America has deteriorated from what it was 40 or 60 years ago.

The cost of medical care to patients has gone up faster than most peoples' incomes, and this has been going on for so long that the disproportion is extreme.  And that's for people with insurance.

Opponents of Obamacare from the left called for a public system dubbed "Medicare for all."  In the debate before the Obama bill was written, I favored this alternative.  But I knew then and I certainly know now that even this is not the solution.  Relative to what recipients receive in Social Security, Medicare is expensive insurance.  It is not free--the part that covers doctors costs in the neighborhood of 15 to 20% of an average Social Security monthly payment.  And there are deductibles and copays, just as in private insurance.  And there are enough holes in coverage that supplemental insurance is a big business (with the usual fraud we've come to expect from insurance companies.)

Moreover, between the machinations of private health care companies contracting with Medicare, and the bureaucracy of Medicare itself,  getting care is at least a part-time job.  And not a nice one.  It's a lot to ask of people who are old and sick as well.

Add to that the tests and procedures that aren't needed, but that involve time, expense and anxiety:

"In 2010, the Institute of Medicine issued a report stating that waste accounted for thirty per cent of health-care spending, or some seven hundred and fifty billion dollars a year, which was more than our nation’s entire budget for K-12 education. The report found that higher prices, administrative expenses, and fraud accounted for almost half of this waste. Bigger than any of those, however, was the amount spent on unnecessary health-care services. Now a far more detailed study confirmed that such waste was pervasive...

Virtually every family in the country, the research indicates, has been subject to overtesting and overtreatment in one form or another. The costs appear to take thousands of dollars out of the paychecks of every household each year. Researchers have come to refer to financial as well as physical “toxicities” of inappropriate care—including reduced spending on food, clothing, education, and shelter. Millions of people are receiving drugs that aren’t helping them, operations that aren’t going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm."

This hodgepodge of systems has roiled the world of physicians, clotted their hours with paperwork and thrown everything into chaos.  The money involved means that physicians are clustered in high income urban areas, and leaving places like Humboldt County in droves--there just aren't enough rich people here to make up the low income from Medicare and programs for the non-rich.  The number and proportion of doctors who will not see Medicare patients also seem to be increasing.

Getting sick or injured is always a crapshoot, and so is getting the right medical care for it, especially in proportion to your wealth.  The odds are increasingly against.

The Good Deal

Oooh--what are the politics of the Iran nuclear deal that President Obama announced Thursday?  What do Republicans say?  Why is this a dramatic whatever for the President?

How about: what's in the deal, and is it a good one?

At least one nuclear proliferation expert says it's an "astonishingly good deal" for the West, that it diminishes the Iran nuclear program to a face-saving minimum, and outlines inspection regimes that are close to ideal.

All of that is part of this detailed analysis--the good and the ugly--in Vox.  The New York Times and other paywalled sites quote global security and other experts in praising the deal.  The New Yorker covers all the bases.

As for the Republicans, Borowitz sums it up satirically:

“President Obama is hailing this framework as something that could enhance the prospects for peace in the Middle East,” McCain told reporters at the United States Senate. “For those of us who have looked forward to bombing Iran for some time now, that would be a doomsday scenario.”

On another doomsday scenario for Republicans--Obamacare Doomsday, the success of Obamacare that they must deny--a point by point refutation showing how the law is working by Jonathan Chiat.  Its interesting because it's not just the numbers, it's the complexities of the insurance system, which was the biggest practical gamble.  Yet the law turns out to be amazingly well designed to reform this for-profit system that itself still has no ethical validity.

Hope on Monday

So what was the most inspiring, hopeful and useful for the future event of Monday March 23?

Well, it sure wasn't this guy announcing he's running for President.  Although the Onion's story about announcement took a little of the edge off. Tues. Update: Not to mention this classic Borowitz.

Nor was it even the 5th anniversary of the signing of the Affordable Care Act, aka Obamacare. Not that it shouldn't be celebrated--so far it has been very successful, and will very likely be seen in the future as one of President Obama's most significant achievements.  And just as it took a generation before the transformational success of aspects of the New Deal, of the G.I. Bill of Rights after World War II--to name two programs opposed by "conservatives" that either barely made it into law (the G.I Bill) or were prematurely destroyed (the New Deal)--were widely acknowledged through real life testimony, it may take that long for this program to take its place next to Medicare (another program opposed then and still in essence opposed by--well, that guy who announced Monday) as crucial to the American future.

No, the big event Monday was the White House Science Fair.

For those of us whose memories of school science fairs involve sweating over a half-assed and embarrassing exhibit the night before it was due, this is nothing like that.  These kids are more than awesome--they are awe-inspiring.

Here briefly are some of their projects:

 Kelly Charley, 15, noticed that communities lacking electricity often build fires to stay warm, but that particles and ash from wood-burning fireplaces can be dangerous to breathe. She developed a solar-powered radiation system that circulates air and heats the interior of buildings. It can run without access to electricity or running water. Kelly, a sophomore at Navajo Preparatory School in Farmington, New Mexico, received a United National Indian Tribal Youth 25 under 25 Youth Leadership Award for her work to promote spiritual, mental, physical, and social well-being. Her heater design made her a finalist at the 2014 International Science and Engineering Fair.

Inspired by the global energy crisis and the lack of electricity around the world, Pittsburgh ninth-grader Sahil Doshi designed an innovative carbon-dioxide powered battery called PolluCell. Comprised of multiple electrochemical cells wired in parallel circuits, PolluCell harnesses the power of carbon dioxide and waste materials to generate electricity, reducing the environmental effects of pollution.

Jose Valdez, Casandra Dauz, and Jaleena Rolon are a team of elementary school students who competed in last year’s Future City Regional Competition, which challenges students to tackle infrastructure and natural resource challenges by designing cities of the future. The team created the “City of Crystal Water,” where agricultural “fish pens” separate industrial, commercial, and residential zones and vehicles travel along dams equipped with paddles that produce hydro energy. Recognizing the importance of connecting their idea with their rural, desert community’s cultural diversity, the team incorporated four languages into their City presentation: Spanish, English, American Sign Language, and Tewa, a Tanoan language spoken by Pueblo Native Americans.

During the summer before ninth grade, Bluyé DeMessie, 18, visited his relatives in Northern Ethiopia and was shocked by the lack of clean water. Over the last four years, Bluyé developed a novel method to convert agricultural waste into a bio-charcoal that is capable of removing pollutants from water within a short contact time.

When Sophia Sánchez-Maes learned that algae has the potential to yield 5,000 gallons of biodiesel annually per acre, she wondered how best to harness that promise. She computationally modeled algae growth in order to optimize that phase of the biofuel production process. Then she began work as a National Science Foundation Young Scholar, investigating how to convert a particular extremophile algae from Yellowstone into biofuel, with promising results.

A team of Ohio 6th graders got inspired after befriending some Haitian students in 2010, right before the region’s devastating earthquake. Team “Quake Safe” wanted to find a solution to help make the many structurally unsound buildings in Haiti safer. The students experimented with materials that could withstand pressure and unique construction shapes to find a building design that would be both cost effective and structurally sound. Their hyperbolic bamboo creation takes on a paraboloid shape, inspired by the shape of Pringle chips, and uses bamboo – a fast growing renewable resource that is easily accessed by most in the region.

And listen up, California:

A team of Florida grade schoolers set out to find a renewable way of generating safe drinking water from ocean water – currently a costly process. The team designed WateRenew, a conceptual system that uses wing-like structures to harness energy from the vacillating hydroelectric forces of the underwater swells. WateRenew converts energy from the elliptical motion of waves into electrical energy that can power desalination of ocean water into drinking water. The desalination process incorporates a special “reverse osmosis” membrane made out of graphene to trap salt while allowing water molecules to flow through.

A number of participants developed projects to respond to mental and emotional needs of children and adolescents. Some invented projects inspired by medical conditions of grandparents, family members or themselves.  For example:

Emily Bergenroth, Alicia Cutter, Karissa Cheng, Addy Oneal, and Emery Dodson, 6 (Tulsa, OK). After chatting with their school librarian, the “Supergirls” Junior FIRST Lego League Team from Daisy Girl Scouts’ troop 411 discovered that some people have disabilities that make it difficult to turn the pages of a book. They came up with the concept of a battery-powered page turner that could turn pages for people who are paralyzed or have arthritis.

Looking for a little hope?  Look no further than these.