Seeing into the future, how to use the crystal ball

[justpoz]

History, despite its wrenching pain, cannot be unlived, but if faced with courage, need not be lived again.

Maya Angelou

We know that historically political elections have swung back and forth like a pendulum, one side then the other, sometimes one side receives eight years sometimes its only four, but we know that no matter how much we want to see a certain action or reaction that when its time for that pendulum to swing back the other way there is no stopping it, even if we cover our faces and hope for the best it will not change the eventual result.

Perhaps that time is now and perhaps it is not, but we would be very foolish to not see what is plainly on the walls all around us.

We know for a fact that we have a serious issue with debt, that issue will have to be addressed and its very likely that it will be addressed by republicans, sure now they claim that they would never cut medicare or medicaid, but we know the truth.

The first thing they will cut is medicare for those people under a certain age, those that are disabled by medical conditions or by mental conditions, its coming don't think it will not effect you.

Of those people who will be effected by this cut a certain percentage of these recipients do not actually need the services for which they have applied, that percentage is less than 8 percent or even lower.

This leaves a certain percent of those of us that are on Medicare and have paid into the system and are now disabled due to a combination of illness and psychical injury.

When this happens they will say see these people are ok, they don't need medicare, but the truth is very different, for many of us if we were to loose medicare and the prescription plan we would not be able to afford our medications often much of which is to help care for many different conditions that we face.

So using our Crystal Ball analogy what can we do now when it makes a difference?

If we stand up and say hey, politicians, were not just an age or a number were people, we need help combating this illness, we paid for these benefits, were not freeloading, were not taking advantage of the system, we worked most of our lives and we did not choose to be in this situation.

Will we wait until its too late and wail about how unfair it is or will we take action now when it might make a difference, we know what is coming even if its four more or the first four of a new administration either way they will move to cut medicare benefits for those under a certain age, (mostly us)

That is something that will be a deciding factor this year and in the future.

If your in a position where you might one day need to apply for medicare because of a disability think about it now because if you wait to support this until later there may not be a medicare system in the future.

[mecch]

So what can we do about it?

And whats your opinion - Republicans more likely to cut medicare, or Dems?

And do you want to discuss Medicaid, Medicare, or both?  Is Ryan White part of the challenge, as well?

 If Obama gets reelected - do you think US had a chance at real, universal, coverage, whether through Medicare/Medicaid, or Affordable Care, or combinations? 

Its not obvious that a Republican President will be all that fiscally conservative nor that he would dare touch Medicare.  At the moment there is a lot of smoke and mirrors.  Pretend policy. 

I would be more concerned about a Republican controlled Congress running amok and getting away with draconian cuts to social welfare, including Medicare. 

Of course you should inform your Reps and Senators.  The squeaky wheel gets the grease. 

I don't see the rationale for future cuts the same as you do.  You seem to think cutting social/health safety nets is rather inevitible because of calls for dealing with the deficit.  In my opinion the deficit could be dealt with through drastic cuts in defense, higher taxes, and therefore its not necessary to cut social welfare.   The big question - do the Republicans have the balls to really gut everything in order to save defense and continue low income taxes?  All the left commentators are wondering. 

In a lollipop world Obama is reelected and the dialogue continues toward single payer and universal care.  Under another President.  It takes a sea change in American culture to go there.  Too many Americans still can't fathom the need.  Obama will just want to shore up Affordable Care, I don't see health care reform going further than that for 10 years, or more. 

If there is a future economic boom, and a future President with the balls to raise taxes, and fully fund a rich-country style social safety net, maybe these problems really aren't so difficult to solve.  Currently the rich get an easy ride, and clearly their rising wealth is doing nothing to build working class and middle class social and health security.  There is no trickle down.

[mecch]

In a nightmare scenario, we get Romney for 8 years. Then Ryan!!! Beware the Ryan!  Then what I see in my crystal ball is throwing health costs to the states.  Many of whom will drop the ball. 

Article in today's Huff Post:
http://www.huffingtonpost.com/2012/08/29/medicaid-health-care_n_1835101.html

Millions more poor families face risks to their health, and financial devastation, under a plan backed by Republican presidential candidate Mitt Romney to slash federal spending on Medicaid. A version of the proposal authored by Rep. Paul Ryan (R-Wis.), Romney's running mate, would cut the Medicaid budget by $810 billion over a decade starting next year.

Romney and Ryan also support repealing President Barack Obama's health care reform law, which would extend health coverage to about 30 million uninsured people.

The principles underlying Ryan's Medicaid plan, which House Republicans adopted in March, are that Medicaid spending is growing too fast and that states need freedom from federal rules to determine how to provide coverage to needy residents, according to a report by the House Budget Committee, which Ryan chairs.

But taking that much out of the system without establishing a replacement will result in 14 million to 27 million people losing Medicaid and nearly all of them would become uninsured, according to an analysis by the Washington-based Urban Institute and the Henry J. Kaiser Family Foundation in Menlo Park, Calif., two nonpartisan research organizations.

____________

So, what is the future under that scenario?  Poor houses?  Charity hospitals?  Dying clinics for everyone dying of diseases that were never treated?    Something rather Soylent Green, with gated communities and a large underclass living anxious desperate hard lives.   

I think how many "middle class" eventually fall to insecure lives will determine if there is, perhaps, a revolution of some sort.  What if, 5 years from now, 10 years from now, the younger generation is still massively underemployed in service jobs with hideous or no benefits? 

Can Republicans deliver that future and continue to get elected?  Not sure...

[mecch]

Specifically about AIDS activisitm:  If Obama gets reelected, activists should push hard for routine HIV screening and link it to Affordable Care's philosophy of reduced costs through preventive health care.  How many undiagnosed HIV+ people are there in the states, and what kind of Executive or Legislative branch is going to be prepared to take that blow. 

Could you imagine adding another 100,000 more HIV+ people to the health care system every 6 months or so, for several years???   What system is going to be able to handle this, except Medicare, and/or a successfully implemented Affordable Care? 

A Republican legislature certainly could not deal with it.  Probably would sabotage ANY effort to have wide spread routine HIV screening. 

I doubt a socially conservative Executive branch, Romney as President, or eventually, worse than him, would be able to actively deal with the complex issue of funding HIV treatment universally. Its an STD just too linked to their pea-brained prejudices.  I wonder if Romney would have any interest in going up against big health and big pharma, negotiating affordable care.   Obama caved to get his Affordable Care.  I don't think Romney types are that interested in the plight of HIV+ people and their care.  Ironically, with the Tea Party's fear mongering about "rationing" and "death panels", I could imagine a Republican controlled government more likely to let that be the norm, by inaction and inability to deal with a sexual disease. 

But, I could be wrong.  Bono managed miracles, under Bush, convincing Congress to fund AIDS prevention and treatment.   Romney might be vulnerable under the guise of "christian" morals, to help the sick and needy. 

Or, he might have more balls dealing with business, than Obama.  As President, he is supposed to be CUTTING deals and brokering with business, to LOWER the government's payout to business.  If he practices what he preaches.  If he isn't cynically, secretly, just ready to pipe as much graft to business as possible.  Can the US afford treatment for everyone with HIV, and keep paying the price of Big Pharma?

Would routine screening be the straw the breaks the governments back, and FORCE someone to cut deals with Pharma? 

Confusing.  Crystal ball is cloudy.   

[leatherman]

So using our Crystal Ball analogy what can we do now when it makes a difference?

when my late partner was dying, I realized that there was no crystal ball that would tell us what the future will hold. There are only the actions we can take now, and then consequences in the future that we must wait for.

Many people are already working to make a difference - and have been working at it for years. For example, ACT UP was formed over 25 yrs ago advocating for health care for HIV positive people. Because of many years of activism and advocacy, we have had drugs come to the market faster, ASOs were formed, and the Ryan White Act gave us state/federal ADAPs. To some extent even the Affordable Healthcare Act has come around because people advocated for better health care for HIV positive people.

Since crystal balls don't exist, instead of trying to imagine what might be or could be (you only seem to be imagining the pessimistic scenarios ), we would all probably be better off taking action by following some of these suggestions:

join your state's HIV/AIDS task force
start a grassroots advocacy group
join (or start) your ASO's (client) advocacy group
email/call your state and federal legislators
visit your state and federal legislators
     (make sure to leave them with a nice concise fact sheet)
register people to vote
encourage your friends and family to vote
     (help them to get to the polls on Election Day)

[mitch777]

Great commentary! You could all be on "UP" with Chris Hayes or The Rachel Maddow Show.
Wether one is an optimist, pessimist, idealist, or realist, there is a strong common bond that unites most of us in these forums.
Thank you all for your input and passion on this topic!