Wondering on Wednesday (v138)

Wondering, wondering, wondering... about hypocrisy, tonight.

I wonder if the people who are outraged - outraged, I tell you! - about Sarah Sanders being asked to leave a Virginia restaurant were equally outraged when gays were refused services? It's funny, because some of the same people who think the latter is OK think the former is not. And suggesting that 'we' (meaning liberals, or Democrats) would be outraged if a gay person was denied services, when we all should be outraged when that happens, right? And not for nothing 'we' already did the outrage thing on this, resulting in marriage equality, among other things.

I also wonder about people who think protesting administration officials is 'discrimination' - what particular protected class might Sanders and Kirstjen Nielsen represent?

And how about Transportation Secretary Elaine Chao rising to the occasion and defending her man, Kentucky's Republican obstructionist Senate Majority Leader Mitch McConnell? If you haven't seen it, you can watch it here -- and the article raises some interesting points, too, about how conservatives in particular reacted the incident. I can't help wondering if they get how bad they look?

Speaking of how bad they look, I wonder if the folks who think it's wrong for a business owner to refuse service to someone think it's OK when the president calls upon his followers to boycott American businesses? You know, when he gets mad at Amazon, or Nordstrom, or anyone else? Is it OK for him to do that in his official capacity, I wonder?

Thinking about the Supreme Court decision today that people can't be forced to pay fees to support non-political activities of unions, even if they directly benefit from those activities, made me think about another Supreme Court decision: the one about companies having deeply held beliefs.

Consider the argument about people working for companies like Hobby Lobby, which doesn't believe in providing certain types of contraception that are required benefits under the Affordable Care Act.  It's been said many times on my social  media pages and possibly yours as well, that a person doesn't have to take a job if the benefits aren't to their liking, and if you go to work for Hobby Lobby you know what you're getting, blah blah blah and you don't have to work there if you don't like it yadda yadda yadda. 

I wonder why a person who thinks it's OK for someone to be denied a benefit based on a company's belief thinks it's OK for person to get (for free) a benefit their coworkers pay for? How can both of these be OK?

I wonder about civility in the age of Trump. You know: talking about penis size during a presidential debate, and about the physical appearance of his female opponents, and of course the Access Hollywood tape, and promising to pay anyone arrested for assaulting protesters at his rallies, and all of that stuff and of course,lying about President Obama's birth certificate.

When the president says stuff (and by stuff I mean outright lies, abusive comments, insulting comments, derogatory comments, denigrating comments, racist comments, sexist comments, abject falsehoods and the like) it's OK, it's all rah rah and #MAGA and #AmericaFirst and the like, with not the slightest concern for civility or honesty or humanity, but when an FBI guy does a little reassuring pillow-texting with his paramour, all bets are off and he's nefarious and everything is deadly serious and he has to be lying about it being innocent? Why is that, I wonder? Why does nothing the president says or does matter, but everything everyone else says and does matters as if it were life and death?

And I'll stop after this one: why must the Mueller investigation end, I wonder, when it's been going on for not even 14 months and is producing results -- indictments and guilt pleas -- when the Benghazi investigations - 7 or 8 of them, I think? -  lasted years, cost millions, and resulted in nothing?

I wonder about all of this, I do. I could keep going, but I think you get the gist.  The outrage! Oh, the outrage!

No -- make it faux, the outrage.

About that, I don't have to wonder.

The Doctor-Politician-Patient Relationship

What is it with politicians, that they simply can't seem to keep themselves from getting in the way of things that really should be up to individuals to decide?

We've heard for years about how the government doesn't belong in the middle of the doctor-patient relationship, at least not as far as anything related to the Affordable Care Act is concerned, right? Except, of course, when we need the government to get in the way, we're led to believe.

We've gone through the battle on paying for contraception, even making legitimate allowances for actual religious organizations such as churches and their affiliates to not have to directly provide and pay for contraception, but leaving that up to insurance companies. And that hasn't been good enough.

And we've had the fight to make sure that companies that sell picture frames and baskets and similar decorative items also don't have to provide the full array of contraceptive methods to their employees because, well, because Republicans. And because corporations are people too, of course. We mustn't forget that.

The reason we have had the latter battles, the ones over contraception, are clear. Well, kind of,  Then-Representative (now House Speaker). Paul Ryan said back in 2012 that, when it comes to Catholics at least, what's constitutional is not up for discussion by mere mortals in the executive, legislative and judicial branches of our government - someone else owns that decision. Here's Ryan talking about covering contraception under the Affordable Care Act,after the religious opt-out was implemented:

The question is, can the government mandate that people violate their religious teaching, their conscience, their freedom of religion. Look, I can tell you as a Catholic the charities, and the hospitals, they don't enforce doctrine, they don't interpret it. It's the bishops and they're very clear in saying this is a violation of our constitutional rights. So it's an issue of constitutional rights and the government having the kind of power to trump them.

Seems we need the government to get in the way when the religious leaders tell us to, I guess, to help us understand what our constitution means. Except, of course, when the religious leaders say things that the politicians don't like, then all bets are off.

We've had the battle over paying for discussions about end-of-life care decisions - you know, health care proxies, DNRs, living wills, and MOLST and POLST forms, and things like that. We've learned how those critical documents, designed to ensure that a person has the right to define their own wishes and courses of treatment - and that others must honor those wishes - became death panels.

And we need a government to insert itself between patient and doctor in other cases too, such as keeping a person on life support - or taking them off - against medical advice or against patient and family wishes.

In this post from January 2014, we have both sides of that coin. On the one hand, we have a woman who was kept on life support against her wishes, because she was pregnant and in Texas. Because in Texas, where everything is bigger including their smaller government, it's illegal to remove life support from a pregnant woman, no matter the circumstances. The courts eventually ordered life support to end, after what I would only describe as eight weeks of torture for the family. I later found out that it's not just Texas where this type of 'pregnancy' exclusion applies.

On the other hand, we have a teenager who suffered complications during surgery to help relieve her sleep apnea, and was declared dead with no brain activity. In this case, the family believed their child was not dead, even though a host of medical professionals hired by the hospital, the family and the courts concluded she was. The court eventually allowed the family to move their daughter to a facility in another state where she could be 'treated', if that's the right word. Today, she is still 'alive' on machines. Legal actions drag on.

And now, it seems, we need a government to interject itself between the doctor and patient again, specifically when we're talking about a different type of end-of-life care.

Washington DC passed a bill allowing assisted suicide, the Death with Dignity Act. Under the rules, Congress has 30 days to overturn anything DC passes, but it was unable to get the overturn votes and a Trump signature in time. The DC bill survives -- for now -- as do bills in a handful of states that have made assisted suicide legal, allowing patients to truly and finally control their own destiny.

I can't help thinking we won't have to wait long belong before the next time the politicians will come into the examining room with us again. Because, as I noted above, they simply can't help themselves.

Who Uses Insurance-covered Birth Control?

I've been torturing myself reading comments posted on various Burwell v. Hobby Lobby articles. And out of fairness, I've tortured myself leftly and rightly, not wanting to miss anything. Trust me, there's a lot that's worth missing.

After reading through opinions ranging from the ridiculous to the sublime, it seems that people have no clue how insurance works. There's a huge misconception out there that a health insurance policy should be completely individualized, so that for example a man would never have to pay for maternity coverage, seeing as how he would never have to use that specific benefit. And now that thinking has been extended to include contraception, because a guy would never have to use The Pill or an IUD so why the (insert curse words of your choice) should he have to pay for it for anyone else?

Have you seen or heard a lot of complaining that insurance includes coverage for other things people have no intention of needing?  Have you heard any significant griping about having to pay for coverage of any other illness or affliction, or is it forever and always going to be the pesky female nether regions that cause this angst and hand-wringing?

In the overall scheme of things, only paying for what you plan on using would be fine if the intent of health insurance was to provide a draconian, ageist, sexist form of punishment, rather than something intended to help manage --and yes, even improve people's health.

• Only under an 'insurance as punishment' scheme would a person be required to pick and choose which benefits they think they'll need,with no coverage for anything else. Didn't think you'd get cancer? Sorry. Didn't think you'd have a stroke? Sorry. Didn't think you or a family member would ever need mental health services? Too bad, so sad. 

• Only in an ageist insurance scheme would people my age not have to contribute towards services for kids (well child exams, pediatric cancer services, newborn care, etc.) or for nursing home care or Alzheimer's treatment or other services most typically associated with older adults.

• Only in a sexist insurance scheme would men not have to pay for the girly services, and women not contribute towards the manly services like, I don't know, prostate cancer treatment and vasectomies (a form of contraception, in case that was unclear), and our prime-time friends erectile dysfunction and low testosterone. 

Most people would recognize this as a draconian way to finance health care, if we all were individually underwritten (that means no family coverage folks - we are all on our own), based on a complete medical history going back a few generations, a comprehensive medical exam including tests for all things known to man, God and nature, and an NSA-style examination of what we eat and drink and how we exercise or don't and how long we sleep or don't and with whom, and so on.  Full invasive medical and lifestyle exams for all -- paid for out of your own pocket, of course, because you can't have insurance that covers medical exams until you prove you're worthy. And done on a regular basis, because we know that lifestyles change, with age and circumstance and environment.

Health insurance is not a draconian, ageist, sexist punishment system. It's also never been intended to be a 1:1 premium-dollar-to-benefit-dollar investment. Nor has any other insurance I can think of.  So. Either people who have long had insurance of other kinds (homeowners or renters or auto insurance or life insurance or flood insurance) are totally clueless on how insurance works, or they're pushing an agenda under the guise of having a conversation about health insurance.

In reality, the hatred and vitriol (spliced with an occasional very detailed description of natural birth control) isn't about health insurance, it's about lifestyle and about women and about the 47%.  Because "if those whores would just keep their legs closed this wouldn't be an issue" and if they were good girls not "those skanks who sleep around and expect someone else to pay for their goddamn birth control" we probably wouldn't be having this discussion at all.

I suspect the men who are spewing this bile might know that the insurance they have has probably long covered birth control, lots of different kinds of birth control, as did the Hobby Lobby policies before the Affordable Care Act.  They might even know that their wife, teen-aged daughter, sister or mother is probably using some kind of FDA-approved birth control right now, paid for with their insurance. They might even have had a vasectomy, covered by their insurance. And certainly there are women commenting in these threads who are using or have used contraception paid for under their health insurance too.

But of course wife, daughter, sister, and mother on insurance-covered-birth control, and men with insurance paid-for vasectomies, and honest-to-God hardworking me, well, those are the antithesis of skank, whore, and 47%er.

And we know that those people are the only ones who are going to use the contraception covered under the ACA health insurance plans, right?

Because those people are the only ones whose sisters and daughters and mothers should have to trust the "$1 condoms" for birth control, right? Or keep their legs closed?

Because those people aren't like us, right?

Channeling Andy Rooney

Andy Rooney

Did you ever wonder...

...if the Hobby Lobby folks (who are suing because having to provide certain contraceptive medicines as required under the Affordable Care Act violates their religious beliefs) should interview potential customers to see what the customer's beliefs are before allowing them to spend money in the store?

Because I'm kinda thinking that if the religious beliefs of the company's owner by extension also apply to all of the company's employees, I would think that they would also extend to the customers.

And there certainly would be no reason for a moral business to accept money from people who don't subscribe to the same beliefs, right?  I mean, if I don't agree with the business, why would they want my money?

Here's what that interaction would look like if I was the customer:

HL employee:  Thank you for coming to our store today.  Before I give you this shopping basket, I'd like to ask you a few questions, is that OK?

Me: Uh, sure, go ahead, but I really just wanted to pick up a couple of cheesy picture frames.

HL employee: No problem, we have lots of those.  But first, do you believe that it's OK for a woman to receive the morning after pill if she needs it?

Me:  I don't really think it's any of your business, and I'm not sure what that has to do with me getting a couple of cheesy picture frames from your store?

HL employee: Well, our owners believe that those medications are morally wrong, and we want to make sure that we don't take money from anyone who doesn't share the same beliefs. So to make it possible for our company owners to sleep at night, we need to ask this question of all our customers. Your money is important, of course, and we'd love to take it, but our company owners' beliefs are more important. 

Me: No problem, I completely understand.  I'll go get my cheesy picture frames from the Christmas Tree Shops. I think I remember seeing them right near the Christmas tampons and Christmas toothpaste. You have a nice day.

HL employee: Thanks for almost shopping at our store. You have a nice day too.

Yeah, that would be fun to do, wouldn't it? Or maybe instead of asking customers the question, the store could just post a sign on the window?  Let me know if that's happening at HL now, will you? I went to the store once, long before this whole 'my religion is your religion' issue came up, and finding nothing to buy, haven't gone back.  Although I certainly would give them credit for honesty if they did something like this.

Speaking of honesty, remember the wing-flapping over Chik-fil-A and their support of anti-gay programs and charities over the years? Here's a compilation of issues if you're interested. There's been a lot of noise about these folks, particularly when the head of the company tweeted his thoughts last summer after the SCOTUS released its decision on the Defense of Marriage Act (DOMA) and California's Proposition 8.

In a refreshing burst of of honesty, here's what the company said about the (now-deleted) tweet:

Yesterday, President and COO of Chik-fil-A Dan Cathy tweeted a personal comment upon hearing the Supreme Court decisions on DOMA and Prop 8.  Dan recognizes his views do not necessarily represent the views of all Chik-fil-A customers, restaurant owners, and employees so he removed the tweet to eliminate any confusion. At Chik-fil-A, we are focused on providing great-tasting food and genuine hospitality to everyone. 

Good for Chik-fil-A for appreciating the difference between the owner, the people who work there, and the customers who eat there.

And, did you ever wonder...

...why so many of us, particularly those who scream and shout about getting government out of business, and letting the free market rule the world (with corporate welfare contributions, of course) get so up in arms when a business does what it wants without a lot of interference from the government?

We all know about the Duck Dynasty case, where the A and E Network decided to put the main Duck Dude on suspension because of his intolerant comments about gays and happy black people in the deep south. Suspension, while the show was on hiatus. Which is kinda like the fraternity on Animal House being on double secret probation or something. Or, as I noted previously, like a baseball pitcher being suspended and having games they were officially scheduled not to pitch count towards their suspension.

cvs.com

I'm guessing you've heard the news from CVS/pharmacy, the nation's second-largest well-stocked corner store that happens to have a pharmacy in the back. Like any good corner store, they have all the stuff we need -- sunglasses, sugary and salty/crunchy treats, personal hygiene items for folks of all ages, beer, cigarettes and what not.

Oh yeah, and they have that pharmacy, and they also do flu shots and the like, which in their business model qualifies them as a health care provider. And if you're a health care provider, it doesn't make sense to sell cigarettes. So, CVS  has announced plans to phase out tobacco products by October of this year. Let the games begin, folks.

A classic 'you can't win for losing', they are getting hammered as much as they're being supported, in some cases by the same subset of the population: doctors, business experts, college students, and of course the anonymous chatterboxes on social media.

• You've got the "I'll never shop there again, the bastages, since they took my cigarettes away" theme, as if there weren't a gazillion places to get smokes if you need them. Some 90% of all cigarette sales happen at convenience stores, people, not at CVS and Walgreen's.  And probably some 90% of CVS customers don't get their cigs at CVS.
• Then there's the "what about beer and junk food?" contingent, as if a person (and by person I mean corporation, of course) who makes one positive step deserves to be chastised for not making a million positive steps at the same time.  Can you even imagine the audacity of them, the bastages, not emptying their shelves EVERYTHING? Right NOW?!
• Then there's the 'Nanny state' group, those who believe this is some kind of black-helicopter, NSA-type plot, part of the government take-over our lives. As if this was done by law, edict or fiat, by some Obaman stroke of the pen. This was a business decision, not a government regulation. This was a company decision, not a Bloomberg big gulp chomp out of your personal freedom.
• And that of course leads to the next contingent, the people who question the real motive of CVS in making the decision. Some folks don't believe that this has anything to do with 'health care' and totally has to do with marketing and trying to be more competitive.  

Um, does it really matter why they're doing it?  I mean, if they had come out and said, "after much soul-searching, we bastages at CVS have decided to change our business model and stop selling cigarettes so we would look more like Target" would that make you happy?

If you think they're bastages for stopping selling tobacco, you have the right to stop shopping there, just as a person has the right to stop buying lunch at Chik-fil-A or shopping at JC Pennney or Abercrombie or  watching the Duck Dudes or stop buying knick-knacks at Hobby Lobby.

And that leads me to wonder about the deafening silence from the folks who are always Right There in support of businesses making changes on their own, without being forced to make them, without the government getting involved. Where the heck is Sarah Palin on this?  I checked her Facebook page, but she's pretty busy promoting her new TV show and wishing Ronald Reagan happy birthday, so she probably doesn't have time to jump in here in favor of free enterprise.

Where's John Boehner, chest-thumping and sobbing his eyes out, championing the 'certainty' that CVS has put out there in the market? That's what the Republicans in the House have been crying about for the past five years, isn't it?  The 'lack of certainty' that Democrats made happen?  Well, Crying John is focused on immigration, and the IRS, and the Keystone extra-large pipeline, not on free-market business certainty, apparently.

And Mitch McConnell? He supports "insurance policies tailored to those with preexisting conditions, promoting wellness and reigning in junk lawsuits" in this post on his website. I think the CVS move hits all three of those right on the head, don't you? Smokers with lung disease, cardiovascular disease and other smoking-related health issues fall right in his first bucket, and stopping cigarette sales is in the second bucket, and everyone knows that tobacco lawsuits are junk, right?  This is right up his alley, but he's a little busy focusing on getting the IRS to stop investigating 501(3)(c) organizations and on getting support for hemp-growing in Kentucky to pay attention to CVS right now, I guess.

Did you ever wonder if some of these folks are really just self-serving opportunists? Here's a thought: if CVS had made even the remotest connection to religion in their decision, these three would be all over this.

Let me know what's got you doing the Andy Rooney thing these days.