Wednesday, May 07, 2008

A lose - lose proposition for people who work for a living. 

It has been the wet dream of the U.S. elite, big business, the U.S. Chamber of Commerce, and the National Association of Manufacturers for decades to destroy the U.S. trade union movement and radically decrease the wages paid to American workers.

In the late 1980s they were quite open about their desire to run the U.S. working class into the ground:

For the first time, American manufacturers are talking openly about a new and startling wage goal: They want to greatly narrow the gap between what they pay their factory workers and the earnings of workers in South Korea, Brazil and a handful of other third world countries.

That does not mean that businessmen want wages to plunge from the $13.09 an hour that is the average total compensation of the United States factory worker. ''Wages overseas will come up, but one way or another, the gap will have to close,'' said Robert E. Mercer, chairman of the Goodyear Tire and Rubber Company. Walter Joelson, chief economist at General Electric, added: ''Let's talk about the differences in living standards rather than wages. What in the Bible says we should have a better living standard than others? We have to give back a bit of it.'' [Note: Where in the Bible does it say that corporate executives should earn twenty gazzilion times more than regular workers? I guess economists at General Electric don't get paid to ask those types of questions though - O.W.]

However the case is put, a common view is emerging. ''Many manufacturers now feel that we are not going to be able to afford the wage difference,'' said Jerry Jasinowski, chief economist at the National Association of Manufacturers. Their concern is directed mostly at six countries whose modern, high-tech factories turn out products often competitive with ours. The six are South Korea, Brazil, Mexico, Hong Kong, Taiwan and Singapore - and each has an average factory wage of less than $3 an hour.

And of course, helped by "free trade" agreements which essentially serve to destroy unions and give corporations easy and secure access to highly exploitable labor (in addition to helping them to exploit U.S. workers more), the above has gone a long ways towards being converted into reality.

For example, for many decades the automobile industry has been viewed as the industrial backbone of any developed country and automobile workers the "aristocracy" of the industrial workforce which often made it to "middle class" status in countries like the United States. But as workers at huge auto parts manufacturers such as Delphi, Dana, and American Axel know, they are now facing huge wage cuts (40 to 50%) and no longer need consider themselves part of the middle class.

In fact, the war against the American worker has been so successful that the share of U.S. GDP going to wages is the lowest it has ever been since records were first kept in 1947 while corporate profits are now have a higher share of GDP than they have had since the 1960s.

In short, all these trade deals have screwed American workers. Truth be told though, we knew that all along.

But the paid apologists for "free trade" long ago came up with a sophisticated arguement that was supposed to make people feel better about U.S. workers getting the shaft.

"Free trade is what will lift the third world out of poverty" they say as they also added "why should we defend the interests of rich American workers at the expense of poor third world workers".

I.e, they make the argument that progressives should back free trade as it will help the "truly poor" as opposed to "greedy" and "overpaid" American workers.

Specifically with regard to NAFTA it was sold as something that would develop Mexico, improve the lot of Mexican workers, and stop mass migration of Mexicans to the United States. So even if U.S. workers didn't fare well at least SOME workers were going to be better off!

Sounds compelling doesn't it?

Thing is, it is also false. It turns out, for example, that workers in Mexico saw their wages go DOWN after the North American Free Trade Agreement was implemented. In fact, read this study by the Carnegie Endowment and you will see that in addition to wages going down, almost no new jobs have been created in Mexico, wages and productivity have been de-linked (ie, workers make more but get paid the same or less the difference going to corporate profits) and income inequality has increased significantly in Mexico (gee, same as the U.S.!)

In sum, workers in both Mexico and the U.S. have been made worse off since the implementation of NAFTA. But corporate profits and the income of the elite are way up in both countries.

How much you want to bet they don't bring those facts up the next time they try ram a free trade agreement through?


Monday, May 05, 2008

What maybe the $500 billion COULD have been spent on? 

It is well known that the U.S. has spent hundreds of billions of dollars fighting its little war in Iraq (well, little for the U.S. - not for the millions of Iraqis having their lives destroyed courtesy the U.S. taxpayer and military). A famous economist has even asserted that the war will ultimately cost the United States several trillion dollars.

Some observers might think the U.S. is rich and can easily afford it. And if they were thinking of the United States government they might be right.

But if they were thinking of the American people they most definitely would not be correct in that assertion. For those who don't live in the United States, you might benefit by reading the following to get an inkling of the humiliation, degradation and inhumane treatment many millions of Americans have to put up with while their government pisses away their country's riches in the Fertile Crescent:

Cash before chemo: Hospitals get tough

By BARBARA MARTINEZ, The Wall Street Journal

LAKE JACKSON, Texas — When Lisa Kelly learned she had leukemia in late 2006, her doctor advised her to seek urgent care at M.D. Anderson Cancer Center in Houston. But the nonprofit hospital refused to accept Mrs. Kelly's limited insurance. It asked for $105,000 in cash before it would admit her.

Sitting in the hospital's business office, Mrs. Kelly says she told M.D. Anderson's representatives that she had some money to pay for treatment, but couldn't get all the cash they asked for that day. "Are they going to send me home?" she recalls thinking. "Am I going to die?"

Hospitals are adopting a policy to improve their finances: making medical care contingent on upfront payments. Typically, hospitals have billed people after they receive care. But now, pointing to their burgeoning bad-debt and charity-care costs, hospitals are asking patients for money before they get treated.


M.D. Anderson says it provides assistance or free care to poor patients who can't afford treatment. It says it acted appropriately in Mrs. Kelly's case because she wasn't indigent, but underinsured. The hospital says it wouldn't accept her insurance because the payout, a maximum of $37,000 a year, would be less than 30 percent of the estimated costs of her care.


M.D. Anderson, which is part of the University of Texas, is a nonprofit institution exempt from taxes. (Please see article below.) In 2007, it recorded net income of $310 million, bringing its cash, investments and endowment to nearly $1.9 billion


Nataline Sarkisyan, a 17-year-old cancer patient who died in December waiting for a liver transplant, drew national attention when former presidential candidate John Edwards lambasted her health insurer for refusing to pay for the operation. But what went largely unnoticed is that Ms. Sarkisyan's hospital, UCLA Medical Center, a nonprofit hospital that is part of the University of California system, refused to do the procedure after the insurance denial unless the family paid it $75,000 upfront, according to the family's lawyer, Tamar Arminak.

The family got that money together, but then the hospital demanded $300,000 to cover costs of caring for Nataline after surgery, Ms. Arminak says.

Federal law requires hospitals to treat emergencies, such as heart attacks or injuries from accidents. But the law doesn't cover conditions that aren't immediately life-threatening


Mrs. Kelly's ordeal began in 2006, when she started bruising easily and was often tired. Her husband, Sam, nagged her to see a doctor.

A specialist in Lake Jackson, a town 50 miles from Houston, diagnosed Mrs. Kelly with acute leukemia, a cancer of the blood that can quickly turn fatal. The small cancer center in Lake Jackson refers acute leukemia patients to M.D. Anderson.

When Mrs. Kelly called M.D. Anderson to make an appointment, the hospital told her it wouldn't accept her insurance, a type called limited-benefit.

"When an insurer is going to pay the small amounts, we don't feel financially able to assume the risk," says M.D. Anderson's Mr. Tietjen.

An estimated one million Americans have limited-benefit plans. Usually less expensive than traditional plans, such insurance is popular among people like Mrs. Kelly who don't have health insurance through an employer.

Mrs. Kelly, 52, signed up for AARP's Medical Advantage plan, underwritten by UnitedHealth Group Inc., three years ago after she quit her job as a school-bus driver to help care for her mother. Her husband was retired after a career as a heavy-equipment operator. She says that at the time, she hardly ever went to the doctor. "I just thought I needed some kind of insurance policy because you never know what's going to happen," says Mrs. Kelly. She paid premiums of $185 a month.

A spokeswoman for UnitedHealth, one of the country's largest marketers of limited-benefit plans, says the plan is "meant to be a bridge or a gap filler." She says UnitedHealth has reimbursed Mrs. Kelly $38,478.36 for her medical costs. Because the hospital wouldn't accept her insurance, Mrs. Kelly paid bills herself, and submitted them to her insurer to get reimbursed.

M.D. Anderson viewed Mrs. Kelly as uninsured and told her she could get an appointment only if she brought a certified check for $45,000. The Kellys live comfortably, but didn't have that kind of cash on hand. They own an apartment building and a rental house that generate about $11,000 a month before taxes and maintenance costs. They also earn interest income of about $35,000 a year from two retirement accounts funded by inheritances left by Mrs. Kelly's mother and Mr. Kelly's father.

Mr. Kelly arranged to borrow the money from his father's trust, which was in probate proceedings. Mrs. Kelly says she told the hospital she had money for treatment, but didn't realize how high her medical costs would get.

The Kellys arrived at M.D. Anderson with a check for $45,000 on Dec. 6, 2006. After having blood drawn and a bone-marrow biopsy, the hospital oncologist wanted to admit Mrs. Kelly right away.

But the hospital demanded an additional $60,000 on the spot. It told her the $45,000 had paid for the lab tests, and it needed the additional cash as a down payment for her actual treatment.

In the hospital business office, Mrs. Kelly says she was crying, exhausted and confused.

The hospital eventually lowered its demand to $30,000. Mr. Kelly lost his cool. "What part don't you understand?" he recalls saying. "We don't have any more money today. Are you going to admit her or not?" The hospital says it was trying to work with Mrs. Kelly, to find an amount she could pay.

Mrs. Kelly was granted an "override" and admitted at 7 p.m.

After eight days, she emerged from the hospital. Chemotherapy would continue for more than a year, as would requests for upfront payments. At times, she arrived at the hospital and learned her appointment was "blocked." That meant she needed to go to the business office first and make a payment.

One day, Mrs. Kelly says, nurses wouldn't change the chemotherapy bag in her pump until her husband made a new payment. She says she sat for an hour hooked up to a pump that beeped that it was out of medicine, until he returned with proof of payment.

A hospital spokesperson says "it is very difficult to imagine that a nursing staff would allow a patient to sit with a beeping pump until a receipt is presented." The hospital regrets if patients are inconvenienced by blocked appointments, she says, but it "is a necessary process to keep patients informed of their mounting bills and to continue dialog about financial obligations." She says appointments aren't blocked for patients who require urgent care.

Once, Mrs. Kelly says she was on an exam table awaiting her doctor, when he walked in with a representative from the business office. After arguing about money, she says the representative suggested moving her to another facility.

But the cancer center in Lake Jackson wouldn't take her back because it didn't have a blood bank or an infectious-disease specialist. "It risks a person's life by doing that (type of chemotherapy) at a small institution," says Emerardo Falcon Jr., of the Brazosport Cancer Center in Lake Jackson.

Ron Walters, an M.D. Anderson physician who gets involved in financial decisions about patients, says Mrs. Kelly's subsequent chemotherapy could have been handled locally. He says he is sorry if she was offended that the payment representative accompanied the doctor into the exam room, but it was an example of "a coordinated teamwork approach."

On TV one night, Mrs. Kelly saw a news segment about people who try to get patients' bills reduced. She contacted Holly Wallack, who is part of a group that works on contingency to reduce patients' bills; she keeps one-third of what she saves clients.

Ms. Wallack began firing off complaints to M.D. Anderson. She said Mrs. Kelly had been billed more than $360 for blood tests that most insurers pay $20 or less for, and up to $120 for saline pouches that cost less than $2 at retail.

On one bill, Mrs. Kelly was charged $20 for a pair of latex gloves. On another itemized bill, Ms. Wallack found this: CTH SIL 2M 7FX 25CM CLAMP A4356, for $314. It turned out to be a penis clamp, used to control incontinence.

M.D. Anderson's prices are reasonable compared with other hospitals, Mr. Tietjen says. The $20 price for the latex gloves, for example, takes into account the costs of acquiring and storing gloves, ones that are ripped and not used and ones used for patients who don't pay at all, he says. The charge for the penis clamp was a "clerical error" he says; a different type of catheter was used, but the hospital waived the charge. The hospital didn't reduce or waive other charges on Mrs. Kelly's bills.

Mrs. Kelly is continuing her treatment at M.D. Anderson. In February, a new, more comprehensive insurance plan from Blue Cross Blue Shield that she has switched to started paying most of her new M.D. Anderson bills. But she is still personally responsible for $145,155.65 in bills incurred before February. She is paying $2,000 a month toward those. Last week, she learned that after being in remission for more than a year, her leukemia has returned.

M.D. Anderson is giving Blue Cross Blue Shield a 25 percent discount on the new bills. This month, the hospital offered Mrs. Kelly a 10 percent discount on her balance, but only if she pays $130,640.08 by this Wednesday, April 30. She is still hoping to get a bigger discount, though numerous requests have been denied. The hospital says it gives commercial insurers a bigger discount because they bring volume and they are less risky than people who pay on their own.

The hospital has urged Mrs. Kelly to sell assets. But she worries about losing her family's income and retirement savings. Mrs. Kelly says she wants to pay, but, suspicious of the charges she's seen, she says, "I want to pay what's fair."

Understandably, Mrs. Kelly must feel bad. But maybe she can take comfort from the knowledge that while millions like her may lose everything or simply die from lack of access to health care at least the United States Army will have all the bombs, rockets, and bullets it needs to keep those uppity Iraqis in their place.


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