Categories
Money Rant

Healthcare? You gotta be kidding!

me in hospital

From Steve Dunkley, first published on the BBC news website…with a few edits by me.

I should have credited him previously but failed to do so.  Sorry about that Steve!

If I do quote other writers I usually highlight in italics.

Duncan

Forgive the pun, but I’m sick of listening to the ideological bigotry being used by both sides in the current debate over healthcare reform. Even the fallacy that the debate could possibly be encapsulated by “two sides” makes me so angry. The very idea that being able to shout louder than someone else or that a few words written on a placard contributes anything to a debate on such an important issue is simply asinine. Such behavior, including mindless chanting of simplistic slogans, effectively halts all objective discussion and obscures the real issues.
So, stop mouthing off, stop quoting anecdotal examples and stop using prefabricated, emotive labels designed to perpetuate already polarized thinking.
This maybe a revolutionary idea, but why don’t we start looking at factual evidence backed up by legitimate research. Yes I know this a new concept, but just bear with me for a while, you never know, we might then draw some reasoned and sensible conclusions.
Here are some facts:
• The United States of America does not have the best health system in the world
• The United States of America does not have the worst health system in the world
• The United States of America has some of most advanced healthcare expertise in the world
• The United States of America’s delivery of overall healthcare and its health outcomes do not compare well to most other industrialized countries
• The United States of America has the capability to offer expert treatment to patients of all ages
• The United States of America has an illogically high incidence of infant mortality and avoidable death rates

Here are some factual statements and observations:
• The United States of America spends more (per capita) on administering the bureaucracy of its healthcare than any other country in the world. Sometimes by a factor of three or four over countries with effective universal systems.
• There is no particular reason why employers should continue to be responsible for providing healthcare. It is an invidious practice that can be extremely detrimental to both employee and employer interests. The practice has its origins in the pay freezes of World War II, yet now seems entrenched in the American working life. Why should your employer decide what health cover you get? Your family physician doesn’t tell you where you should work!
• There is no reason why a national, universal health plan should increase individual or government healthcare costs. Individual tax costs will increase but, if a scheme is implemented effectively, there will be no health insurance premiums to pay. Employers should no longer have to pay their portion to the insurers and there should be no co-pay. In case you missed that – NO CO-PAY! Your employer may even pass his or her savings on to you as a wage increase.
• Effective preventative healthcare makes an enormous contribution to the quality of life and the longevity of that life. In the current situation prevailing in the United States of America, there is little incentive for health insurers to finance preventative care. The premise is that, as people change jobs and healthcare insurers, the financial benefits of preventative medicine might be enjoyed by organizations other than those that originally funded it.
• Viewed from afar, the citizens of the United States of America are hypochondriacs obsessed by illness. This hypochondria is fueled by a constant barrage of television commercials for prescription drugs containing information that should only really be evaluated by competent medical professionals. Trendy acronyms only exacerbate the obsession – why not become obsessed by health and wellness instead?
• Market forces and human nature are generally inappropriate in healthcare. Physicians are encouraged to treat where treatment is perhaps unnecessary. Pharmaceutical companies need a steady stream of new illnesses, gullible or mercenary physicians and new drugs to keep them in business. Health insurers need to be able to promise nurturing care from cradle to grave and yet be able to deny treatment on all possible occasions.
Now that you’re thinking about shouting or painting a placard, here are some comparisons that will restore your faith in man’s inhumanity to man
Universal schemes can only provide the greatest good for the greatest number and will spend any and all amounts of money provided
Private schemes will drop you if it looks as though you might get a long-term illness
• Universal schemes will always treat acute cases first and will generally do these well. less urgent cases may well wait some time for treatment
• Private schemes will treat your acute or less urgent conditions entirely in respect of financial considerations, but will have you back in your car about the same time the anesthesia wears off, often causing you to come back again (with another co-pay) in a couple of days
• Universal schemes often provide unintentional long-term accommodation for the homeless
• Private schemes always use the latest and most expensive treatments irrespective of whether they are superior to proven treatments.
• Universal schemes are often unwilling to adopt new procedures until cost and/or patient benefits have been established

Here is a dirty word:
Single-Payer
Actually it’s two words, but you get the drift. Most universal or national health schemes operate this policy. Supporters of the status quo in United States health policies consider it blasphemy. It is a prime example of the emotive labeling so apparent in current healthcare discussions.
Single-payer simply means that payment for medicines and treatment comes from a single source. That single source is the organization that operates the health service – almost invariably the government. Pharmaceutical companies and medical practitioners abhor this policy because they are unable to play numerous payers (with differing priorities) off against each other. Instead they have to deal with a single body that has the single objective of balancing cost and patient benefit – more simply known as value for money. The VA health system bureaucracy “sorta-kinda” operates in a similar way to single-payer.
This does mean that many medical practitioners will get less for the work that they do. Pharmaceutical companies will undoubtedly claim that they will be unable to research new treatments. Personally, I can live with this because the physicians that earn substantially less will only be those who have been financially focused in their practices. Pharmaceutical companies will continue to research and develop because that is what they have to do to exist. Maybe these new pressures will force them to be more focused on effective remedies? Am I the only person who wonders whether drug companies develop new products and then look for an illness to treat with it? The objective of a healthcare system is to look after the receivers of that healthcare – not to make a few professionals obscenely wealthy.
The bottom line is that the current healthcare systems (in terms of delivery and outcomes) in the United States of America are ineffectual and probably irreparable in their current form. Federal and state politicians are scared to death of the pharmaceutical lobby and failure to be re-elected (but then I repeat myself). The AMA represents the interests solely of the medical profession and has stood four-square in the way of any proposed initiatives that benefit patients at the expense of their members. I don’t think insurance companies care one way or the other because they think they will still get a large slice of the cake whatever happens. When it dawns on them that single-payer may become a reality, they will get the rest of the politicians that the pharmaceutical companies missed.
It should not (and cannot) be beyond the wit of the US Government to take the time to investigate the healthcare schemes that are the most successfully operated in other industrialized countries. Surely, somewhere in this nation, we have officials with the ability to judge and evaluate the best of those and surely we have the expertise to implement such a scheme here.
According to the Organization for Economic Co-operation and Development (OEDC), in 2003/2004, per capita health expenditure in the United States of America was $6,120 (15.3% of GDP), life expectancy was 77.5 years and infant deaths, per thousand, were 6.9. During the same period in Japan, per capita health expenditure was $2,249 (8% of GDP), life expectancy was 81.8 years and infant deaths, per thousand, were 2.8.
Here are some final kickers. How can the country that considers itself the most advanced economy in the world, allow its citizens to be denied preventative healthcare because of corporate avarice? How can it allow around 700,000 families each year to bankrupt themselves seeking healthcare? How can it let people die for lack of healthcare?
For those that say government cannot afford universal healthcare, consider this: in 2003 (according to the World Health Organization) the United States government spent more, per capita, on healthcare than each of the governments of the United Kingdom and Sweden. Two countries that each have universal healthcare, the citizens of these countries did not have co-pays and both countries achieve generally better health results than the United States of America can boast.
Personal net expenditure on healthcare would drop significantly under a properly implemented universal scheme and a single payer scheme would have the potential to cut billions of wasted dollars out of administrative costs.
Finally, President Obama’s scheme will not work because it does not address the fundamental underlying problems. The supporters of the status quo will gladly watch the percentage of GDP spent on healthcare rise to 20% in the unreasoned belief that the marketplace will deliver effective healthcare and that we already have (of course) the best healthcare in the world. Basically we’re screwed!

Categories
Malibu

silence

can i sit with myself for more than 30 mins without doing anything at all?   can I sit without making a call?  checking facebook, text messages or emails?     can I sit in my own body listening to the twittering humming birds fighting, the waves crashing below me, little dog breathing deeply on my lap.

can i just stop imagining for just one god damned minute?  can I stop being so bloody infuriated by injustice?  can I just concentrate on the blood pumping around my body?

I sat alone in malibu all day and I did not nap, I did not look at pornography, i lit a huge fire, i fed the dog tinned salmon, i picked up my godson from  his drama class and ate chocolate with him in the truck as we drove down the PCH in the rain.

I like being on my own.  i have no idea what being with anyone would be like anymore.  I don’t know if I can share what I have.  being a curmudgeonly bachelor may be on the horizon.  was it meant to be like that?   probably.

strangely peaceful tonight staying over in deep malibu where my phone does not work.

i am a very lucky man.  i am surrounded by people who love me, who include me, who will catch me if I fall.

Categories
Poem

LOVE POEM

London.  I crave the capital of my Island jewel.  I am too far now from cream teas, steak and oyster pie.  Oh London and the Home Counties I miss you with all my aching heart.

I am tired of selfish boys.  Tired of his jet-black hair.   Tired of waiting.  Tired of mistress censorship.

I want to see Amanda, Tim and banter; with Simon Finch and hold my nose in the air.

I want to stroll down Old Bond St in my red suede boots, visiting Patrick in Hanover Square.

I want to smoke cigarettes in West London with Katrina.  Let me ride horses in Hyde Park with Martha; explore electrical hardware stores with Toby and Arthur.  Clandestine giggles with Joe and Adam and Eve, cottage amusements with George.

The train to Bromley and Chatham through the Garden of Eden.  Where the Thames meets the Medway and the Swale beyond.

I am tired of you because I don’t trust you, but I know very well what it is to lie to some one you say that you love.  To meet in some dark, wet guinnel, to feel your warm body under your navy blue coat.   To feel your lips and always your lips.

Oh I miss you so much my darling hometown, and wish you invited me Whitstable style.   Up on the downs overlooking the sea.  Turbines, the horizon that chased me away.   I have arrangements with banks to consider and beg that homeland security take me away so decisions are easier where no choice is to stay.  Wholesale foreclosure, redistribution of wealth.

Take me.  Take me away.

I am tired of selfish boys with raven black hair and myself in every one of them.   Just you.  I met just you.

Let me forget these people, struggling with prosperity and stemming the tide.    Seeking solution and tanning the hide.  Let me go home. Let me go home.  The 12 step recovery clichés that keep me in purgatory with less time to go than one hundred years of perfect sobriety.  Oh please send me home to smoky church halls and WI and no multi-malls.  Remind me of jet beads stitched onto her bodice, of peplums and bagels and tottenham forest.

I am TIRED of you showing me men that are hot, hotter than me or you for that matter.  I am tired of boasting to keep us alive, to stimulate interest and punish my precious child.   I am naked before you my darling creator.  This and more like it is all I can offer.

So take me away with you darling Ophelia on the Thames and the Medway and the Swale far beyond.

Categories
Gay Malibu Rant

Public Option/Private Option

without beard in sydneyWhenever some catty reader tells me to go home to the UK because I write optimistically for positive governmental change, fair taxes or that there might be a public option in the healthcare bill-where am I meant to go?  I live here!  Some of you can be very cruel, writing vile and damning notes to me-do I care about your vile and damning notes?

Do I fuck!  It takes a great deal more than a few inarticulate insults to upset this old goat.

What could any of you possibly do to upset me?   Well, like my errant lover, you could keep me hanging around LA waiting for you when all I want is you beside me-that’s pretty unsettling.  I am unsettled. Bemused by adolescence.

Even though I know you are fragile, it’s hard not to be selfish.  I love you. I need you.

I want to fuck you.

However, I loved laughing with you last night Mr. Darling NYC.  Sitting together by the fire in Malibu with Chris. Laughing like we should be doing when two people meet and fall headlong into…whatever men like us fall into.  I wish there was a word for that exciting moment just before you fall in love.

I couldn’t sleep last night.   I remembered the giant from twin peaks.

This is all I am permitted to say.

So, I was thinking about just how lucky I am surrounded by like-minded friends who want the best for all of us-rather than just themselves.

I was thinking about God and how regardless of circumstance I am never alone because I have faith.

A great deal of faith.

There’s a man in a smiling bag.

I have faith that the good of the people will overcome the evil in men’s hearts.

I was thinking about being a liberal.   I was wondering what American’s mean when they say the word ‘liberal’?  When they think of a liberal what do they see?  I was thinking that in some countries even Glenn Beck would be perceived as a liberal and that it’s all a matter of context.

Actually, regardless of whichever country Glen Beck lived, he would still be a simpering, self-obsessed cretin – a suppurating sore on the backside of humanity.

Unable to sleep I was thinking a great deal last night-holding my lover in the night gently snoring and fragile in my arms.

Without chemicals he points.

Having been one, I was thinking about the British Aristocracy.   Drunk aristocrats, dressed in tartan, over glasses of port rueing the day the British media went bad, nostalgic for a truly right wing rag.

Some would raise a glass to Oswald Mosley.

I met Oswald Mosley,  leader of the British Union of Fascists and his beautiful wife Diana Mitford in Paris when I was 19.    By the time I met him he was a demented old man wracked with Parkinson’s disease.  Lunch was cancelled because he took a dump in the sitting-room-I remember the smell and thought to myself  ‘that was a stinky poo’.

Until his dying day, Oswald Mosley was convinced that the British people would eventually come to their senses and call him home to lead the country he believed vehemently he was born to lead.

Oswald Mosley was not a rogue British fascist.  It is well known that had Hitler invaded the United Kingdom the aristocracy, of whom Hitler was in awe and had great sympathy, made a pact to hold onto what they owned.  Edward VIII‘s pro-German views made him a source of concern for the British government. “He’d always admired Hitler. He was, frankly, very pro-Nazi,” says John Julius Norwich.

Edward’s affair with Wallis Simpson – an American with a racy past, who was even more pro-fascist than Edward – was of great worry to the Royal Family. In 1936, Edward gave up the throne. The couple married as the Duke and Duchess of Windsor in 1937, and went on a tour of Nazi Germany, finally settling in Portugal. While Adolf Hitler plotted to seize the duke and use him as a puppet king, Churchill banished him to the Bahamas – where he could do the least damage to the British war effort.

I want to write about the private option.

The man I met in New York, the scruffy handsome man is gone.  There’s no two ways about it.  Gone, gone, gone. I just didn’t call him back and now friends are calling pissed at me for my summary dismissal.   One night he lays there in my arms as gently as a baby the next he is on the streets diving into gay bars in The East Village.

Jake bauman Jake Bauman

That, my friends, is the way it is in the life of a sex addict.

What do these things mean?

LUNCH:  Cold poached chicken with watercress sauce.  Delicious.

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Categories
Dogs Hollywood Love Rant

World of Wonder

Anna and Melanie beneath a mermaid pinata.

It is a world of wonder.  The day opens thus:  the clouds have cleared over Los Angeles.  The sun is bright and the air is clean.  The birds are singing.  The squirrels are playing in the palm trees within feet of my window.

Everyday I wake up is a new day to think about what life has to offer and I am all at once terrified and enchanted.

I frantically tidied the house, put all the clothes that were stacked in my room in their correct places.  I remembered to fold my teeshirts and not put things in draws that were inside out.

I have to move the car at 9am so I don’t get a parking ticket.  The little dog is looking at me expectantly.  We need to walk, we need to take the trash to the building dumpster.  We need to go to yet another 12-step meeting and rip my heart open again and again.

I want to smoke cigarettes.  I want to lay in bed and not feel.  Please.

Right here, right now.  That’s what John A says.  Reminding me to stay right here right now.   Not yesterday or tomorrow.   Right here, right now.

Everything happens for a reason.  Collating the artwork made me take an essential inventory.  It seems that there is more value in what I own than I first suspected.  The choices I made for 20 years have been good ones.

Everything happens for a reason.  That’s what they say.  That’s what they tell me.  That’s what I have come to believe.  The plan is set, the dye is cast.

I felt sickly last night, too sickly to leave the house then spontaneously decided to visit my friends Anna and Melanie.  Driving through the heavy rain the little dog and I arrived in Silverlake and ate slow roasted pork, black beans, plantains and lemon sorbet.   Chatted to my arty filmmaker friends and loved every minute.  Drove home, lay in bed waiting for the anticipated thunder but none came.

Silverlake, Los Felis, Arcadia, La Canada, Flitridge, Brentwood, Malibu, Santa Monica, Pasadena, the map of LA unfolding like an old linen backed map in my head.  The freeways, the concrete LA river, the Pacific Ocean all wrote in Indian ink.

I once owned a 17th century map of Venice that I found in a library in Dorset when I was a boy.   It was folded into a marbled envelope and each painstakingly hand drawn section of that map remains engraved in my memory.

Venice stretches across 117 small islands in the marshy Venetian Lagoon along the Adriatic Sea in northeast Italy.

For a moment this morning I remembered that map and wished to be magically transported to the saltwater lagoons that stretch lazily along the shoreline between the mouths of the Po and the Piave Rivers.

When I die the various maps of many cities will be lost.  I think often of that.  The many and various maps of  all the cities I explored that will be lost along with the smell of fresh snow, the taste of my lovers mouth, the unmistakable sound of my own childish footsteps running down warm unusual, sunlit corridors.

Categories
Money Rant

Seventeen Thousand Dollars

Oh what a tangled web we weave.   Loads on my mind today: Taxes, Tiger Woods, and Mr. Darling NYC.

The dogs are sitting on the bed looking expectantly but God only knows when we will walk again judging by the gloomy weather reports.

I seemed to have stirred up yet another hornets nest.

I want to make something clear to my hornets.  Like many of you I pay thousands of dollars in tax: federal, state and local taxes.  I pay sales tax, road tax and property tax.  In fact of all the taxes I pay the one that galls me most is my property tax, which at  $17,000 a year is unforgivably huge.

SEVENTEEN THOUSAND DOLLARS A YEAR.

An equivalent property tax in the UK for a similarly priced home would be $3,000 at most.

I pay all of my many and various taxes begrudgingly because if I don’t the state will take my home.  Why begrudgingly you may ask?  Well, a good proportion of my tax funds bogus wars I do not agree with and bank bailouts that counter my free market sympathies.   Wars and bailouts that just make a few people very, very rich and kill many, many innocent people.

My tax dollars help kill thousands of innocent people.

As one reader points out, I can’t vote so I am not able to have a say in the way my taxes are spent.  I am not allowed to get involved with politics here in the USA so I have no legitimate soapbox from which to stand and complain.   I only have this blog.

Rather than cast me as unpatriotic, ungrateful or as an America basher why can’t you understand that I, as a taxpayer have every right not to agree with the status quo.  The attitude some of my readers have that we have no option, that we are powerless in the face of government, that an opposing view is un-American, that the IRS has a right to rip us off so we may as well get used to it..is simply astounding.

My desire for all of us and our children is that we get what the rest of the developed world takes for granted:  that for just about the same amount of tax we pay or less in the case of the British the PEOPLE get so much more.  Let me tell you again:  three free years of education, public transportation, well maintained highways, healthcare, public arts, BBC etc. etc.

It is sickening that the majority of our tax dollars are simply drained away from the public to fight expensive wars, imprison people in private prisons, subsidize the pharmaceutical industry..the list is endless!    As a taxpayer I am outraged that so little of our hard earned cash works for the common good, for the investment in people so that we might halt this rapid decline and encourage invention, entrepreneurialism, and industry.

The price for a total lack of investment in the American people will be catastrophic.

Is it even logical to saddle the young with huge student loans and expensive health insurance whilst you fight costly wars or fund bank bailouts?  Can’t you see that education and healthcare are basic human rights and serve any prosperous nation? An educated and healthy workforce will serve a country so much better than those who live in fear of economic insecurity or health related bankruptcy.

I maintain my assertion that yesterdays mad Joe into the IRS stunt was a metaphor and should be understood as such.

Let me make one thing perfectly clear to all of you.  I believed in this country so much I moved all of my personal wealth from Britain only to see it vanish because of appalling fiscal mismanagement and endemic government mandated greed.  Greed that has not only destroyed our shared dream, the American Dream that many of us still believe in but the dreams of the next generation.

Of course I don’t want to fly an airplane into an IRS building but can understand the murderous frustration of someone who does.

Categories
Rant

Joe Stack

So, another radical Joe hits the airwaves-literally.  Last year it was Joe the Plumber and this year it’s Joe Stack the radicalized taxpayer.   I can only repeat what I have been saying for some considerable time:  The first strike from the dispossessed will come sooner or later and this may very well be the opening volley.

However we may dismiss Joe Stack’s angry, murderous ways he has perfectly articulated the frustration so many folk have with the system. There are a lot of disenfranchised people out there who will consider this guy a hero. Unemployed, homeless, in foreclosure, hopeless, powerless-millions of them.

All they need is a moment of clarity to start fighting for their lives.

Revolutions begin at moments like this.  Everybody knows just how unfair the tax system is.  This week I read that the top ten percent of taxpayers pay less tax than anyone else.

The ‘haves’ are not been factoring in the desperation of the ‘have nots’.

I write all the time about how little taxpayers in this country get for their huge tax bills other than unsanctioned or covert wars that line the pockets of the already super rich.

What is the government of a bankrupt country like the USA doing engaging in wars the people cannot afford whilst it cannot provide decent healthcare or education?

As for my friends who bleat about the loss of life-life is cheap isn’t it?  How many of you howled when 12 innocent people were killed in your name in Afghanistan last week?

I am reminded again and again by my less philanthropic friends that America was designed without safety nets.  Pity.

Categories
Uncategorized

New Blank Document

My apartment looks like an art gallery, paintings neatly stacked and waiting to be sold.  Everything here is for sale.  I am slowly getting ready to move back to Malibu and all that entails.   As I have written previously, my pack rat collection of more stuff is getting me down.  It all needs to be sold.

Last night I decided that I couldn’t see Mr. Darling NYC ever again, that it was doing me in.  Yet, for all the hopelessness there is still an unavoidable truth-we love each other.  What am I meant to do?  Just walk away from what may very well be the best thing to ever happen to me?

I am prepared to wake up alone every morning until he can wake up with me. I loathe waking up alone, alone is not good for a man who obviously has so much to offer.

I long to try something I’ve never had..lover man oh where can you be?

We both have so much.

Up until now I craved a companion on my terms.  After our conversation today I now crave a lover on our terms.  As he was quick to point out-this is not just about Duncan Roy.  My beautiful boy has feelings too, feelings that until today I was ill prepared for.

HE DOESN’T WANT TO MOVE TO LA.

So what of Malibu?  I would move anywhere if it meant we could be together.  I looked online at houses in Upstate New York, London and Paris.    After our long and emotional conversation I understood just how selfish I had become.  Yet, sometimes you just have to go with your heart.

This morning, after writing yesterday’s sensible blog, I woke up alone and angry.  Angry with him, angry that our fragile love affair could be so easily tossed aside, unless of course I fully appreciated his situation.  I shouted at him.  He burst into tears.

He is lost and terrified of loneliness.   And that description could so easily be mine.

His wracked, desperate sobs silenced and shamed me.

After he tearfully described his fears I knew that things were not as simple or solvable as I had kidded myself.  The thrill of romance will not solve this problem.  Resolve, strength and patience on my part may be all I can offer him.

I prayed for guidance this morning.  God can and will set me straight.  Even if it can’t keep him..straight.

I love a married man.  A married man loves me.  Send in the fucking clowns.

I read a really great blog called Love in The Time of Foreclosure.   The blog charts the ups and downs of a couple facing the loss of their house and staying in love.   Adversity, so it seems, keeps people fighting for what they believe in.

It’s odd how much one can learn about oneself when love is at stake.   I have not really been in love since Matt and I broke up 10 years ago.  The sort of love that makes one desirously wild with anticipation.  Delirious.  Desirous.

Listening to him cry made me love him more.  After all, when one is craving authenticity to hear another man cry is as about as authentic as it gets.

I usually write my blogs when I get up in the morning.  I breach the surface of the new day with a description of the previous day but this evening I am sitting at home with The Little Dog listening to old tunes and eating Swiss chocolate.   Somehow, my darling man crying has settled something deep within me.

All of me, why not take all of me, can’t you see I’m no good without you. Take my lips I want to lose them, take my arms; I’ll never use them.  Your goodbye left me with eyes that cry.  How can I go on my dear without you?