30 Years Ago: The Day the Middle Class Died

Had to add a few comments to this one.

The Reagan worshipers don't want my emails. Too bad. I would truly like to understand how this narrative can be repudiated.

Didn't they actually live the life described below, too? I can't say with absolute certainty, but I'm pretty sure that no one I know grew up in places like today's Westlake, TX, Kenilworth, IL, Mission Hills, KS, or a whole list of NYC suburbs (http://www.forbes.com/2011/01/18/americas-most-affluent-communities-business-beltway.html), and they don't live there now.

My father was a high school graduate who put 3 of his 4 kids through college without crushing debt and with one decent paying union job at Westinghouse. He owned his own home after paying off the 30-year mortgage. We went on vacations to "exotic destinations" like Washington, DC, and Ocean City, MD. We occasionally but not all that often ordered a pizza or went out for dinner. (Anyone else remember the Ho-Jo fried clams? That was big time for us!). Every 6 or so years he was able to buy new middle class sedans like Plymouth Satellites, Dodge Darts and Ford Futuras (woo-hoo!) made in America by fellow middle class workers. He had decent enough benefits so that he and we weren't bankrupted when he was diagnosed with heart disease and needed a quadruple bypass in the late 70s.

He retired with dignity and with a pension that wasn't anything like a lottery windfall but at least was sufficient enough to keep him from having to find part-time work at a McDonald's or WalMart just to make ends meet.

What was so wrong with that America?

What would be so wrong with having some of that back?

How the hell did we screw things up this badly?

I'll tell you. The unvarnished, bald-faced, honest and harsh truth is that we got here exactly and precisely by believing the lies we were told by Reagan, Greenspan, the GOP, and the rest of the trickle-downers who convinced too many of us that if the rich got richer all our boats would rise with that tide.

It was and still is a lie. Now those of us left in the middle class are left to drown in that rising tide.


Published on Saturday, August 6, 2011 by CommonDreams.org
30 Years Ago: The Day the Middle Class Died
by Michael Moore

From time to time, someone under 30 will ask me, "When did this all begin, America's downward slide?" They say they've heard of a time when working people could raise a family and send the kids to college on just one parent's income (and that college in states like California and New York was almost free). That anyone who wanted a decent paying job could get one. That people only worked five days a week, eight hours a day, got the whole weekend off and had a paid vacation every summer. That many jobs were union jobs, from baggers at the grocery store to the guy painting your house, and this meant that no matter how "lowly" your job was you had guarantees of a pension, occasional raises, health insurance and someone to stick up for you if you were unfairly treated. [On August 5, 1981, President Ronald Reagan fired every member of the air traffic controllers union (PATCO) who'd defied his order to return to work and declared their union illegal. They had been on strike for just two days.] On August 5, 1981, President Ronald Reagan fired every member of the air traffic controllers union (PATCO) who'd defied his order to return to work and declared their union illegal. They had been on strike for just two days.

Young people have heard of this mythical time -- but it was no myth, it was real. And when they ask, "When did this all end?", I say, "It ended on this day: August 5th, 1981."

Beginning on this date, 30 years ago, Big Business and the Right Wing decided to "go for it" -- to see if they could actually destroy the middle class so that they could become richer themselves.

And they've succeeded.

On August 5, 1981, President Ronald Reagan fired every member of the air traffic controllers union (PATCO) who'd defied his order to return to work and declared their union illegal. They had been on strike for just two days.

It was a bold and brash move. No one had ever tried it. What made it even bolder was that PATCO was one of only two unions that had endorsed Reagan for president! It sent a shock wave through workers across the country. If he would do this to the people who were with him, what would he do to us?

Reagan had been backed by Wall Street in his run for the White House and they, along with right-wing Christians, wanted to restructure America and turn back the tide that President Franklin D. Roosevelt started -- a tide that was intended to make life better for the average working person. The rich hated paying better wages and providing benefits. They hated paying taxes even more. And they despised unions. The right-wing Christians hated anything that sounded like socialism or holding out a helping hand to minorities or women.

Reagan promised to end all that. So when the air traffic controllers went on strike, he seized the moment. In getting rid of every single last one of them and outlawing their union, he sent a clear and strong message: The days of everyone having a comfortable middle class life were over. America, from now on, would be run this way:

* The super-rich will make more, much much more, and the rest of you will scramble for the crumbs that are left.

* Everyone must work! Mom, Dad, the teenagers in the house! Dad, you work a second job! Kids, here's your latch-key! Your parents might be home in time to put you to bed.

* 50 million of you must go without health insurance! And health insurance companies: you go ahead and decide who you want to help -- or not.

* Unions are evil! You will not belong to a union! You do not need an advocate! Shut up and get back to work! No, you can't leave now, we're not done. Your kids can make their own dinner.

* You want to go to college? No problem -- just sign here and be in hock to a bank for the next 20 years!

* What's "a raise"? Get back to work and shut up!

And so it went. But Reagan could not have pulled this off by himself in 1981. He had some big help:

The AFL-CIO.

The biggest organization of unions in America told its members to cross the picket lines of the air traffic controllers and go to work. And that's just what these union members did. Union pilots, flight attendants, delivery truck drivers, baggage handlers -- they all crossed the line and helped to break the strike. And union members of all stripes crossed the picket lines and continued to fly.

Reagan and Wall Street could not believe their eyes! Hundreds of thousands of working people and union members endorsing the firing of fellow union members. It was Christmas in August for Corporate America.

And that was the beginning of the end. Reagan and the Republicans knew they could get away with anything -- and they did. They slashed taxes on the rich. They made it harder for you to start a union at your workplace. They eliminated safety regulations on the job. They ignored the monopoly laws and allowed thousands of companies to merge or be bought out and closed down. Corporations froze wages and threatened to move overseas if the workers didn't accept lower pay and less benefits. And when the workers agreed to work for less, they moved the jobs overseas anyway.

And at every step along the way, the majority of Americans went along with this. There was little opposition or fight-back. The "masses" did not rise up and protect their jobs, their homes, their schools (which used to be the best in the world). They just accepted their fate and took the beating.

I have often wondered what would have happened had we all just stopped flying, period, back in 1981. What if all the unions had said to Reagan, "Give those controllers their jobs back or we're shutting the country down!"? You know what would have happened. The corporate elite and their boy Reagan would have buckled.

But we didn't do it. And so, bit by bit, piece by piece, in the ensuing 30 years, those in power have destroyed the middle class of our country and, in turn, have wrecked the future for our young people. Wages have remained stagnant for 30 years. Take a look at the statistics and you can see that every decline we're now suffering with had it's beginning in 1981 (here's a little scene to illustrate that from my last movie).

It all began on this day, 30 years ago. One of the darkest days in American history. And we let it happen to us. Yes, they had the money, and the media and the cops. But we had 200 million of us. Ever wonder what it would look like if 200 million got truly upset and wanted their country, their life, their job, their weekend, their time with their kids back?

Have we all just given up? What are we waiting for? Forget about the 20% who support the Tea Party -- we are the other 80%! This decline will only end when we demand it. And not through an online petition or a tweet. We are going to have to turn the TV and the computer and the video games off and get out in the streets (like they've done in Wisconsin). Some of you need to run for local office next year. We need to demand that the Democrats either get a spine and stop taking corporate money -- or step aside.

When is enough, enough? The middle class dream will not just magically reappear. Wall Street's plan is clear: America is to be a nation of Haves and Have Nothings. Is that OK for you?

Why not use today to pause and think about the little steps you can take to turn this around in your neighborhood, at your workplace, in your school? Is there any better day to start than today?

P.S. Here are a few places you can connect with to get the ball rolling:

Main Street Contract for America
Showdown in America
Democracy Convention
Occupy Wall Street
October 2011
How to Join a Union by the AFL-CIO (they've learned their lesson and have a good president now) or UE
Change to Win
MoveOn
High School Newspaper (Just because you're under 18 doesn't mean you can't do anything!)


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"I thought Republicans believed in government out of our lives, the precious right of privacy, and the right to be left alone. Well, then what they hell are we doing in abortion, and gay/lesbian issues, and mental health…I have a cousin who was gay who was a war hero, World War II. We're all human beings.”
Former Wyoming GOP Senator Alan Simpson (http://bit.ly/k5FRjB)

Medicare Denials Higher than Commercial Insurers?

Here's the version of the email recently sent to me:

According to the 2008 Health Insurance Report Card (PDF) released by the American Medical Association, the “carrier” with the highest percentage of denials is . . . Medicare.

Metric 12—Percentages of claim lines (i.e., records) denied Description: What percentage of records submitted are denied by the payer for reasons other than a claim edit? A denial is defined as: allowed amount equal to the billed charge and the payment equals $0. Source: NHXS
Payer	Count of records	Denied records	Percent of claim lines denied	Date range
Aetna	637,239	43,317	6.80%	03/01/2007 – 3/10/2008
Anthem	250,070	11,546	4.62%	03/01/2007 – 3/10/2008
CIGNA	263,728	9,060	3.44%	03/01/2007 – 3/10/2008
Coventry	20,487	590	2.88%	03/01/2007 – 3/10/2008
Health Net	4,975	193	3.88%	03/01/2007 – 3/10/2008
Humana	143,026	4,142	2.90%	03/01/2007 – 3/10/2008
Medicare	6,938,431	475,566	6.85%	03/01/2007 – 3/10/2008
UHC	1,127,691	30,177	2.68%	03/01/2007 – 3/10/2008

My first reaction was to spend a few minutes simply looking at the table provided and thinking about what it meant. It was:

"So you're going to split hairs between Medicare and Aetna over 0.05% while Medicare processes 10 times as many claims and almost 7 times as many claims as the next largest processor, UHC?

That's something I call "reframing", (redacted friend's name), but I do appreciate the attempt.

Besides, statistically wouldn't it be fair to assume that the processing of the largest number of claims would yield the greatest likelihood of more denials?"

What's more telling on closer examination of the report card is that the commercial insurers are less efficient, less forthcoming with information, and more responsible for wasteful overhead than Medicare ever could be.

For example....

...CIGNA and Humana don't even reveal the date they receive a claim (Metric 1)

...while Medicare's median response time of 14 days (Metric 2) is among the longest, it's no longer than CIGNA and only one day longer than Aetna and Humana

NOTE: The "median" means the middle value, or the value at which there are an equal number of values above and below the median value. Think highway median dividing two sides of the highway equally. The "mean" is the arithmetic average. Further review of the details of Metric 2 show the following mean values:

Aetna: 13.81 days

Medicare: 13.83 days

CIGNA: 19.57 days

Humana: 21.85 days

...the coup de grace seems to me to be "Metric 5 - Contracted payment rate adherence" defined as, "On what percentage of records does the payer’s allowed amount equal the contracted payment rate?"

Medicare is 98.12%. The next closest is Coventry at 86.74%. Humana is 84.20%, Aetna is 70.78% and CIGNA is 66.23%.

Now I'm no expert, but it looks to me like commercial insurers don't seem to score very well at even paying what they contracted to pay. Some of them are getting what we called in school "failing grades."

And some of us think the big, bad government can't do things right? Please.

So if someone sends you something similar and wants to split hairs between Medicare and Aetna over 0.05% while Medicare processes 10 times as many claims as Aetna and almost 7 times as many claims as the next largest processor, UHC, then feel free to remind them that that is called "reframing the discussion." It's what people do when they want to cherry pick data, present it out of context, and without proper comparison to related data that forms the broader and more accurate picture.

Finally, the definition of "denial" seemed a bit unclear to me. I'm still not claiming to fully understand all of this but here is what it looks like to me.

Medicare's top reason for denying a claim (27.8%) is, "Claim/service lacks information which is needed for adjudication." Looks to me like something we call in the business world "cockpit error." Someone in the health care provider's office seems to have failed to fill out the form completely and/or correctly.

The carrier with the next highest percentage of denials, Aetna, has as it's top reason for denying claims (65.7%), "Payment adjusted because the benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated."

Again, I'm no expert but I've raised 2 kids, have power of attorney for my aging mother, and have reviewed my fair share of claims. I think what this means - 2/3 of all their denials - is that they have made their plans and the processing of claims so complex as to result in 2/3 of denials being essentially a duplicative claim. No need for reform there, right?

CIGNA's top reason for denying claims (37.6%) is simply, "Deductible Amount." Again, I wonder how it is that just over 1/3 of all the denials end up being this. Could it be that CIGNA's plan definitions, processes, and claims processing are so confused and confusing that 1/3 of all denials are because the patient and health care provider claims administrator can't tell that the claim is part of a deductible? I don't know; just speculating.

So before anyone starts reframing the discussion and dissecting and distributing misleading or self-serving information, ask questions, do some homework, and challenge the assumptions and conclusions.

I'm on the record as supporting single payer. If this report card is any indication of how that might work under a government-run program, I'll gladly pay higher taxes instead of insurance premiums to companies that have never proven and still can't prove that they can do a better job.

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"Everyone is entitled to his own opinion, but not his own facts."
Daniel Patrick Moynihan

The "Real" Victims in Health Care Reform

Must see.

http://pol.moveon.org/insurance_execs/?rc=homepage

“California’s Real Death Panels”–Data Reveals California’s Private Insurers Deny 21% of Claims

http://www.democracynow.org/2009/9/9/californias_real_death_panels_data_reveals

"The insurance companies aren’t in business to provide care; they’re in business to make profits for their shareholders. One of the ways in which they make profits, the main way they make profits, is by collecting money from patients and from families and not paying money back in claims. They call it a medical loss ratio, every time they make a payment on a claim."
Charles Idelson, Communications Director for the California Nurses Association/National Nurses Organizing Committee.


Wendell Potter, whom you may recall from a previous email, is the former p.r. head at CIGNA also appears in this story.

So does a mother, Hilda Sarkisyan, who lost her daughter who needed a liver transplant but whose insurance company, CIGNA, reversed their decision to deny the claim too late and only after public outrage was raised.


If you bother to read or listen or watch this and still think that the status quo - a market-based health insurance industry without a public option - can be trusted to do what is morally right and humane; if you think that it's best for America that every single fellow American cannot get health care because they all aren't insured and can't get it or have their coverage dropped or denied, then I have to ask you if you are simply in denial about the realities of health care in this country, or are you just resisting change over petty partisan politics?

I actually hope it's one of those two because the only alternatives I can come up with are much less palatable. One other possible explanation that occurs to me seems to be that money must be more important than human life.

Those campaigning against change seem to be simply lying about the notion that if people who don't have health care suddenly have some means of getting it means it can only come from something that is taken away from those who do have it need to hear one word; Ridiculous.

Something else about all of this debate troubles me. Whatever happened to being a Christian nation and taking care of one another? Is the guiding religious principle really just "cafeteria Christianity", allowing people to decide which teachings to accept and which to ignore? Whatever happened to the "least of my brothers" teaching? I'm not at all qualified to comment on Christian dogma, but I don't recall anything from Catechism classes about any qualifications or fine print that went along with that lesson.

Or is the real religion - especially among conservatives, it seems to me - really about worshiping wealth and the aspirations for wealth and the acceptance that stepping on whomever's neck it takes to get to whatever your own definition of prosperity might be perfectly fine?

I mean, what other possible reasoning and rationale can their be for not putting private insurance companies on notice? What other reasons are there for resisting change and everything that doesn't have a certain political party's stamp on it?

Only in America, it seems, does greed and lust for wealth take precedence over proper medical care for every citizen and the humane treatment of fellow human beings.

Only in America would the same people who want to bring the Christian Bible into the public schoolroom while they overturn a woman's right to choose using arguments about protecting the unborn life be the same people who place more meaning on shareholder wealth than they do on the life of someone who needs health care and can't afford it. (While they tend, it seems to me, to ironically also be the biggest supporters the death penalty.)

Only in America would the argument against a public option be based on an unfounded fear that those who have health insurance might somehow lose what they have if the less fortunate among us were to now have it.

Sorry, but I see all of this as just being greedy and hypocritical. In fact, I think it's totally and completely reprehensible. It makes my blood boil that some of us in this country continue to choose to vilify the poor and less fortunate because, as we all know, they are just a bunch of lazy, good-for-nothing slackers who want to sponge off the rest of us and don't deserve any help, including affordable health care.

Let them die in the streets or in over-crowded and under-funded emergency rooms, right? Let's keep turning a blind eye to patient dumping? Let's not do anything to stop health care bills from bankrupting good old fashioned middle class American families?

Let's let kids who need transplants die?

And please don't tell me that you think it's the illegal alien who'll benefit from health care reform or that your new hero is that uncivilized and juvenile buffoon, Joe Wilson. I think the GOP can kiss another Congressional seat goodbye in South Carolina.

I don't mind telling you that I'm about this far away from being one of those Americans who has to go without any health care coverage. I'm out of work and can't afford a grand a month to pay for health insurance much longer. I'm not looking for pity or sympathy, just making it real for those too far on the right-of-center on this one.

What confounds me about the GOP and makes their position so completely unbelievable is their resistance to changing the system. The financial services industry proved that they cannot be trusted, and it seems painfully obvious that the health insurance industry cannot, either. More of the same is simply more wrong, and the Rs really have become the party of No on this issue. They seem to have had too little interest in compromising on anything when they were in power, and now the chickens have come home to roost.