The Drake's Take

In Wyoming, the working poor remain uninsured

Kerry Drake
Kerry Drake

—December 31, 2013

He could be a poster boy for the uninsurable, pre-Obamacare. At 58, the Wyoming man has a host of pre-existing conditions: a stroke, quadruple bypass heart surgery, high blood pressure, diabetes and chronic depression.

Laid off from his job of 19 years in January, he lost his company health insurance and, being newly unemployed, couldn’t afford the price of more than $1,000 per month to keep it through COBRA coverage.

He helped start a nonprofit business that, 10 months later, has failed to produce enough revenue to allow him to draw a salary. He worked part-time and did whatever jobs he could pick up while trying to keep his business going and/or find a permanent position elsewhere. In November, his unemployment benefits at both the state and federal level were exhausted.

As medical bills piled up, he looked forward to the health insurance he would be able to obtain beginning Jan. 1 under the Affordable Care Act (ACA). Knowing he couldn’t be turned down for health insurance because of pre-existing conditions, the man reasoned it would at least help reduce the cost of future medical care he would undoubtedly need.

How do I know so much about what he was thinking? Well, with apologies to Pogo creator Walt Kelly: I have met the working poor, and he is me.

And I’m still uninsurable.

On Christmas Eve, I tried to meet the deadline to sign up for what has become known as Obamacare. After hearing horror stories about the difficulty of accessing the website, I decided to use the phone so I could actually talk to a human being. I had some questions I didn’t expect a computer program to be able to answer.

After waiting more than an hour, a woman’s pleasant voice came on the line. She answered my queries, and assured me that if I supplied the correct information, I could sign up for the insurance plan that best fit my family’s needs.

I supplied the data, letting her know that while I wasn’t earning much now, I expected to have a full-time paid position in the near future. She said to just let them know about any changes in my work status.

After feeding all of the information into whatever program she needed to, she came back on the line and told me I qualified for Medicaid. My family’s medical care would be completely covered, at least as long as we remained in financial straits.

“I could still get insurance, the woman said, I would just have to pay for it myself… my cost would be more than $1,300 a month.‘That’s more than I’m regularly making a month now,’ I told her.‘I know,’ she said.”

But there was a catch, and it was a huge one. Since Wyoming rejected the Medicaid expansion that was part of Obamacare to ensure low-income adults health care coverage, I couldn’t sign up. And those tax credits and subsidies that are also part of federal health care reform, to make insurance affordable? Since I qualify for Medicaid, those aren’t available to me.

But I could still get insurance, the woman said, I would just have to pay for it myself. My repaired heart sank a little, and I again waited for her to come back with a plan for myself and my wife.

She explained it was part of the bronze package, which was the lowest form of coverage offered by the health exchange. The deductibles were fairly high, and my cost would be more than $1,300 a month.

“That’s more than I’m regularly making a month now,” I told her.

“I know,” she said.

But she added that there was a bright spot: Because I applied for health insurance by the deadline, I wouldn’t have to pay the $90 a month penalty for not having coverage. I find it difficult to thank the government for at least not taking more money I don’t have away from me.

Any regular reader of this column knows I’ve strongly supported Medicaid expansion in Wyoming. I’ve done so for two primary reasons: It’s paid 100 percent with federal funds for the first three years, and it is gradually reduced to 90 percent until 2020. And, for the working poor people who would benefit from health care coverage, it could be a life-saver. Basically, it’s the right thing for the state to do.

I didn’t expect to ever need help from Medicaid, but at least temporarily, I do. Obviously, my current situation has only deepened my belief that Gov. Matt Mead and the Republican-controlled Legislature have made a devastatingly harmful mistake by not expanding the program.

“The governor and GOP state lawmakers who decided to join the unsuccessful lawsuit against the feds on the ACA’s constitutionality made it clear they are fully willing to sacrifice Wyoming residents who need help…”

It’s been obvious from the beginning of this conflict that the state’s argument the federal money could disappear is bogus. The governor and GOP state lawmakers who decided to join the unsuccessful lawsuit against the feds on the ACA’s constitutionality made it clear they are fully willing to sacrifice Wyoming residents who need help in an attempt to show that Obamacare isn’t working.

As one of the 17,000 or so people in Wyoming who qualify for Medicaid coverage but have been denied because of this political game, I can attest to the fact that being thrown under the bus is a painful experience – especially because it’s totally unnecessary. I will continue to make that point as loud and as long as I need to, until the working poor are not treated like second-class citizens.

Even staunch Obamacare opponents like Gov. Jan Brewer of Arizona and Gov. John Kasich of Ohio saw that what they did was harmful, and stopped blocking Medicaid expansion. Why won’t Mead?

I don’t expect to remain in the boat I’m in, and I realize I’m in it because it was my choice to do what conservatives always tell people to do – be an entrepreneur and achieve the American dream. Well, I’m working quite hard at that, but the results haven’t materialized yet. Meanwhile, I will continue trying to make our community news website a success while taking every paying freelance assignment I can get my hands on.

But the majority of people who would benefit from Medicaid don’t have any options for climbing out of poverty. It’s difficult to maintain a steady job if you’re sick and don’t already possess job skills. Training opportunities are few and far between. How are they supposed to get ahead and beat a system that is stacked against them? The governor and the GOP leadership in the Legislature act as if they are expendable. And to them, maybe they – I mean we – are.

I don’t think the legislative solutions proposed so far will actually fix the problem, but that’s a topic for another column. For now, let’s go back to my phone conversation with the woman who told me I can’t get Medicaid assistance solely because of where I live.

“I thought this system was designed to help people like me, who can’t get affordable insurance,” I said.

“I’m sorry this didn’t work out the way you wanted it to,” the woman said. “If you don’t have any more questions, I hope you and your wife enjoy a very merry Christmas.”

I thought I detected a hint of humanity in her voice, and hoped she wasn’t just reciting lines from her script. I also figured it has to be terrible to have a job that forces you to give people bad news on Christmas Eve.

“Happy holidays to you,” I replied, and I meant it. I just wished the governor and legislators would stop blocking help for people who deserve to be happy, too.

— Veteran Wyoming journalist Kerry Drake is the editor-in-chief of The Casper Citizen, a nonprofit, online community newspaper. It can be viewed at

— Columns are the signed perspective of the author, and do not necessarily reflect the views of WyoFile’s staff, board of directors or its supporters. WyoFile welcomes guest columns and op-ed pieces from all points of view. If you’d like to write a guest column for WyoFile, please contact WyoFile editor-in-chief Dustin Bleizeffer at

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Veteran Wyoming journalist Kerry Drake has covered Wyoming for more than four decades, previously as a reporter and editor for the Wyoming Tribune-Eagle and Casper Star-Tribune. He lives in Cheyenne and...

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  1. Cecil

    My position regarding the provision of single payer healthcare in the US is stated in the four paragraph sample law I provided earlier, which stated that (civilian) Medicare would be the system used. I merely used DOD- and VA-provided medicine as examples of socialized health care that works. That was quite clear and could not be misconstrued. You, on the other hand, with these questions are muddying the waters to create confusion where none existed. A common tactic of rhetoric in flailing defense.

    Re Von Moltke and his plan for the Franco-Prussian War, I was using “German” as a general term since European military history is not a common branch of knowledge in the US. Throwing in “Prussian” to imply I don’t know German history is simply pedantry, something for which I have nothing but contempt.


  2. Dear Mr. Hoskins,
    Regarding Van Moltke, the Elder, my comment was made to insure that other readers would not be confused as to what the position he held in the Prussian Army(not the German Army, as it did not exist at the time you referenced.) I could understand that you made a mistake however other readers might not.
    Concerning, “It is implied that doctors who (over)charge for services and are paid only a percentage of what they charge will be forced out of business. How many doctors, medical groups, or hospitals have gone out of business for that reason?” there was no implication on my part, only fact. Physicians choose to retire, limit their practices, or become employees of large clinics who take on the business end of medical practice in return for the physician being allowed to practice their particular medical speciality. Effectively their practices are closed, i.e. :out of business.”
    As you earlier pointed out, the medical care you received in the Armed Forces was (good, very good, exceptional, etc.) and this was socialized medicine. I can assure you that the Medical Officers that you were exposed to, rendered the best care that that could provide and were compassionate, as all the other health care providers. Was the military medical experience interpreted by anyone rendering care as socialized medicine, I would proffer “no”. The duty was to take care of combatants and offer the best that was available. We, the USA, was at war, as we still are in Afghanistan. ( we can discuss whether that should be the case at another time as it is not what Mr. Drake’s column encompassed.)
    I am glad that your injuries were treated successfully whether they happened in the USA or the Middle East. If your definition of “socialized medicine” is one of physician officers taking orders from the United States government is what you think should be the practice of medicine in the United States please acknowledge this as your position.

  3. I never go home, Robert–but some of us are not retired…and I believe the Heritage article was your talking point.
    You posted, “No one in countries with single payer goes bankrupt as a consequence of medical expenses.” Correct as to the hapless population–they either just die, or live in pain. Incorrect as to the country–the nation state indeed goes broke.

  4. I see Reid took his ball and went home. I guess he ran out of talking points.

    Re: Von Moltke. I said his plan for the invasion of France in 1870 worked perfectly. Was I misunderstood?

    It is implied that doctors who (over)charge for services and are paid only a percentage of what they charge will be forced out of business. How many doctors, medical groups, or hospitals have gone out of business for that reason?

    Costs must be reduced. One way to do that is to eliminate the fee-based system. All it does is create perverse incentives.

    The chaos and disaster that is American health care requires careful thought, experimentation, and courage to address. The promulgation of ideological talking points about the free market and competition, when clearly we don’t have either and haven’t had since at least before WWII, won’t cut it. I know for a fact from my own experience in the military and living in Europe and Canada that for all its faults single payer works on a day to day basis. No one in countries with single payer goes bankrupt as a consequence of medical expenses. That alone makes it worthy of consideration. It deserves a chance here.


  5. This needs to have a bottom up community approach to work. can we do it in Wyoming , or do we just keep blaming every one but ourselves. What are our other real options?

  6. Dear Mr. Hoskins and Dewey V,
    I applaud your enthusiasm in your posts; however, you do need to address the actualities of the proposition to expand Medicaid, which I believe was the thrust of Mr. Drake’s column. Mr. Hoskins, knows the difference between strategy and tactics. In your posts terms and phrases such as “affordability” and “Doctors etc. will be paid for ensuring their patients’ health, not for jacking the prices up through the fee system as they do now. People have a right to make a living, not a killing.”
    Mr Dewey V states he can not afford much more than $200/month, I have no reason to disbelieve him. Does this mean that dollar amount is what everyone should pay if it is “affordable” to them?
    With regard to” jacking up prices through the fee system”, the following is an example of Medicare reimbursement and the charged fee. A board certified Neurosurgeon( B.S., M.D. 7 years of training = 15 yrs of education) 15 years of clinical practice, including service in the military, preforms a multi-level lumbar laminectomy submits a fee of $1980. Medicare allows $1100. Effectively 55%. Does he then reduce the salary of the nurses, secretaries, and others employed by him by 55%? How much longer can this practice be sustained?
    Again it is time to discuss the impact of the Medicaid/Medicare program and ACA on the Health Car Providers. Rallying against “Big Pharma”, “Big Drug”, “Big Insurance” may allow you to relieve your frustrations. It is time to consider the Health Care Providers in the trenches. (No pun intended, Mr. Hoskins.)

  7. Mr. Hoskins,,
    Before continuing the thread regarding Mr. Drake’s column I must comment on your post regarding Von Moltke, the Elder. In that he was Chief of Staff of the Prussian Army (The predecessor of the German Army) the fact that his plan worked for his forces and not that of the French speaks to its success.

  8. Oh, and by the way, Von Moltke’s plan for the invasion of France in 1870 worked perfectly–for the Germans. Not so good for the French though.

  9. Robert–

    Laughing. Progressives are consistent in their false equations and omissions when the facts don’t support the argument. First–a paper by one guy at a think tank in 1989 is now the position of conservatives? Really? So the recent article by Rolling Stone that we should go completely pinko commie to solve all our problems is the position of liberals? (It is the viewpoint of progressives). And the closed, internal system of the military to protect those going in harm’s way is akin to national socialized medicine? Puuuuleeeese.

    And, btw–you forgot to mention this part of the heritage article back there in 89–so much for that single payer idea:
    Many ideas have been put forward to address this problem. Increasingly, pressure is building for some kind of national health insurance system in America. I believe that eventually the U.S. will have a “national health system,” in the sense of a system that assures-each citizen of access to affordable health care. At issue is the kind of national system we should have. Unfortunately, many of the seemingly attractive proposals being offered have such serious side effects that they woul d be a step backward. Government-Funded Systems Consider the government-funded national health systems such as those found in Britain and Sweden. The system in Canada, now so fashionable as a Proposed panacea, is similar to these European models establishe d many years ago. In these systems, all citizens have virtually free access to hospitals and physicians, and government pays the cost. In Britain, even millionaires and royalty can, if they wish, receive free medical care. The problem with these systems is that, with government controlling the purse strings and a system that is free at the point of consumption, demand for services always outstrips the supply. Thus Britain has for many years functioned on a triage principle. Rationing based on such factors a s age and political sensitivity in practice determine who gets what services. In addition, long waits – sometimes months or ev,– years for services that would be treated as urgent in the U.S. – are endemic to the British system. Canada is twenty-rive year s behind Britain, but we are beginning to see the same system of rationing and shortages slowly emerge within the Canadian system.”

    Nice try. beeeeeeeeeeeeeeeeep. New contestant.
    It has been a pleasure conversing with you gentlemen. But I have a half mile of fence to repair so I am not chasing critters over a frozen wasteland, and five chapters due shich are tardy. This conversation wil have to continue without yours truly, though I am keen on finding out what Kerry comes up with–appears cecil and I were both headed to the same destination with those thoughts. Best of luck to you, Dewey, and you, Kerry. I hope things sort out on your coverage, that it is reasonably priced, and that there is a doc somewhere who will accept it. Golden Calfs are always shiny, always hollow, and always false.

  10. RLR and Cecil

    Well now, Obamneycare ostensibly is a “market-driven” system. Remember? All those for-profit insurance companies are still in business, jacking up premiums and paying healthy dividends to their shareholders, not to mention obscene salaries to their executives. That’s the American way, and Obamneycare is fully linked to the American Way. After all, industry lobbyists wrote the ACA, under the “supervision” of people like Montana Democrat Max Baucus. Are you ideologues denying that? Or are you denying that Obamneycare is a Republican idea–particularly the individual mandate? Came out of the Heritage Foundation.

    Of course, for strictly political reasons the right wing attempted an end run around its own idea and call it “socialism” as a weapon against Barack Obama. What hypocrisy. I do recall however that one of the most delightful aspects of the last presidential election was Mitt Romney running as fast as he could from Romneycare in Massachusetts, with Romneycare firmly attached to his derriere flapping in the breeze. Almost as funny as him running from his 47% comments.

    I’d point out that US military medicine is socialized. (You know, the American military, which you patriotic conservatives fully support. Or so I’ve heard). Socialized military medicine got me through several broken bones and many surgeries. My daughter was born in the system and she’s now a healthy, happy, productive young woman. I’ve had no problems with it. Further, as a consequence of the wars in Afghanistan and Iraq, socialized military medicine is revolutionizing the treatment of severe trauma, especially brain trauma. Finally, the VA medical system is also mostly socialized. Once you get through the bureaucracy, it’s not bad. Definitely superior to the bureaucracy the private sector puts people through, except of course for the wealthiest Americans.

    I don’t particularly care about ideology. I care about what works. Single payer works, if not perfectly. I’ve seen it work first hand. America’s rube goldberg medical system doesn’t work, and Republican-spawned Obamneycare just makes it worse.

    Yes, medical bills will be paid out of government funds, supported by taxpayers to control costs. That’s what single payer is and does. Doctors etc. will be paid for ensuring their patients’ health, not for jacking the prices up through the fee system as they do now. People have a right to make a living, not a killing. If that’s socialist, so be it.

    As for war plans, the simplest plans are still the best. I know this for a fact. Do you? Gotta start somewhere.


  11. Robert–

    you miss the point. Market driven health systems (great care, few gov fingers in the pie, profit–contingent good results and customer staisfaction with price and outcome) works. one of many to helop you and dewey out:

    as to your solutions–right back to the government trough, eh? Using medicare which has been gutted to the tune of 715 billion for obama does not care by liar in chief? And you would trust congress to determine what is “reasonable” in taxation? How about the unilateral and illegal manipulations of the immigration laws by liar in chief–or a successor of his? Those millions now allowed to stay in the USA via executive fiat would be considered “legal residents”? Not to say we dont concur that simple is good. But I think simple starts with cutting off the crony capitalism/corruption which drives all aspects of health care right now. Once the playing field is leveled, then the oppurtunity for change–simple change since special interests have been eliminated–can be realized. We agree on the desired end result–but disagree on the steps to get there.

  12. Mr. Hoskins,
    Well, under your proposal, (may I call it single payer or government run health care?), everyone now has an insurance card. Who is going to provide the actual care for this patients at Medicaid rates? Are you going to demand that, or coerce physicians, to treat knowing that they cannot sustain their practices at Medicaid?Medicare reimbursement rates? What do you tell the personnel of these practices who will no longer have employment?
    Two other minor points, you state that the Secretary of HHS will supply the regulations, (Kathleen Sebilius, really?), a poor fit with your KISS narrative. Secondly in referencing German Generals, you might remember what Moltke said, to paraphrase, ” No plan survives contact with the enemy.”

  13. It appears that DeweyV got to an exposition of the wonders of the Indian and Thai medical systems touted by RLR before I did. Good show, Dewey.

    RLR says he could write a health care law in 200 pages. However, his recommendations are no less complicated and equally as unworkable and unjust as Obamneycare itself, which is no surprise, since Obamneycare is a Republican idea designed not to benefit the American people, but the medical industry.

    On the other hand, I can write a health care law for all Americans in four paragraphs, to wit:

    1) Congress has determined that health care is a public good necessary to the well-being and security of the American people.

    2) All citizens and legal residents of the United States, irrespective of income, social status, and age, shall be enrolled in the existing Medicare program. The Medicaid program shall be terminated one year from the date this Act becomes law.

    3) The Medicare tax rate on all personal income shall be calculated progressively from the lowest incomes to the highest, not to exceed 10 per cent [or any other reasonable percentage determined by Congress] of gross income at the highest levels. Said tax rate shall also apply to gross business or corporate income, irrespective of the source of that income.

    4) The secretaries of the Departments of Health and Human Services and the Treasury shall write regulations necessary for the implementation of this Act. Such regulations shall be implemented within one year of the date this Act becomes law.


    Note: one of the things I learned from military service is the value of the KISS principle–Keep It Simple, Stupid. This derives from 19th century German general Karl Von Clausewitz’ observation that “everything in war is simple, but even the simplest things are difficult.”

    The more complex a plan is, when implemented the more likely it will fail because of the difficulties that arise naturally from human social behavior. Simplicity is the key to overcoming those difficulties, especially at larger scales of human activity, such as the Nation as a whole.


  14. DeweyV

    Did not see the repeat of your recurring residency question at the bottom of your post. In three of the twelve southeastern most counties of the state. That is as good as you are going to get, so stop wasting your time and mine on red herring, out of line, private info questions which are none of your business. On the healthcare front–I never believed liar in chief, have understood from day one what the real marxist intent is (and it ain’t you and kerry getting health care), and have a calculator which I trust more than government promises, so let’s just say neither I nor my folks are in the same unfortunate position as you and Kerry.

  15. DeweyV-

    BS to your BS. You did not even bother to look up medical tourism. And Bloomberg? The organization run by the guy whou would tell you what size cup to use? Right. Like believing the white house. Here is an exercise for you, since I am familiar with the “Bloomberg study”–investigate their assumptions in compiling the rankings. You folks think this stuff comes out of thin air. It costs money. Here is another exercise for you. Google up “Japanese economy last ten years”. Here is another one, google up “ECB finance European National Banks”. Finally, “Eurorpean cental banks buying national (or sovereign) debt”. Here is a clue–they are ALL broke, done, finished, over. And should you care to google up the breakdown of government expenditures by those top ten “health sanctuaries” you will be further enlightened. If that is possible. I gave you my fixes. Agree or not. I don’t much care. But here is a riddle for you bat man–liar in chief had two years of unfettered control–passed obama does not care–and not one–NOT A SINGLE ONE–of those big, cost savings fixes to this system was enacted, or even put in a draft of the bill. Now google up campaign contributions to liar in chief by american trial lawyers, big pharma and aarp. And you think obama does not care is about quality, quantity, cost and the uninsured? La la land.

    Lousewort–we agree on much when it comes to costs. However, dig deeper–there is certainly greed going on, along with crony capitalism, as in big pharma and liar in chief, but many of these ridiculous costs (which become our expense when receiving care) are due to government beauracracy and over regulation. Regs cost money. period. And blaming Meade for upholding his responsibility to keep wyoming away from the fiscal train wreck that is obama does not care and medicaid expansion, is like blaming the firemen who rescue 85% of the inhabitants of a blazing apartment, at the risk of 15%, rather than putting 100% of the tenants in jeopardy trying to stretch his water from a hydrant which could dry up on an overnight whim of the water commisioner (who was the arsonist to begin with).

  16. affordable starts with not letting hospitals or drug manufactures overcharge because it is hard to bargain when your in pain. affordable starts with not charging people without insurance the highest prices. affordable means that excess profiteering on other,s pain is bad for all people. affordable means that top-down special interest politics never works. affordable means that wyoming heath care providers who receive tax dollars need to start reducing costs in a very intelligent and caring way. affordable means that american health-care consumers democrat or republican start looking at other countries with better models and better results.
    why should,t wyoming lead the way.

  17. Cecil L-

    I cannot answer your query about what ” affordable ” health plan would look like in Wyoming. It’s an oxymoronic loaded question.

    I see nothing in any Wyoming scenario coming or going that helps the currently uninsured , especially if they are 50+ years . They are screwed. What was marginal or demonstrably ‘Bad’ health coverage take it or leave it before ACA has apparently been ratcheted up to ‘Worse’, and folks are getting cancelled left and right. The Wyoming market for healthcare and insurance for that care is oppressive. Folks at or below any percieved poverty line are all but excluded by this wonderful for profit market driven medical machine.

    The only thing that will save Wyoming’s uninsured—and the rest of the nation — from going over the medical cost cliff is to do a complete Reset to a Single Payer – Public Option healthcare system and simultaneously begin a massive push towards emphasizing preventive care. That way everyone gets baseline care. Those who can afford it can build on it with supplemental private insurance or Health Maintenance Accounts or whatever. The current situation is unacceptable: poor people having no insurance who become a ball and chain on the entire system. I shudder to think how bad it would be if there were no ” government interference” in our present healthcare…no Medi-Care, no Medicaid, and the insurance companies could do as they please , l’aissez faire.

    As it is right now, I’ve seen reports that fully 1/6th of the American GDP is the medical and healthcare sector. With or without ACA, that is likely to double to becoming 1/3rd of our entire economy. Which is a recipe for utter collapse of America. A full non-governmental free market solution for our healthcare fix would be utter disaster.

    I have no insurance, so am not qualified to chime in on any systemic plan offered by public or private sectors. I’m 62 years old, self employed, and barely eligible for Social Security and Medicare is a ways off, but haven’t looked sideways at any of that yet. I can tell you I am not capable of paying much more than $ 200 towards whatever , if that. But it’s moot…with no insurance track record or existing plan , the best I have been able to have quoted is ~ $ 1200 / month with deductibles from $2k to $?–more than I even make . Don;t believe for one moment that the preexisting condition disallowance will automatically do anything for the consumer who has one or more… every case is still treated uniquely.

    I do know my married friend recently negotiated her new Obamacare plan very successfully here in Cody. She has several preexisting conditions, and was paying privately for a plan at $ 1600 / month and a $ 5000 deductible in a joint plan with her husband . Her new ACA plan ( the Silver ? ) has her paying $ 700 a month now and the deductible is down three thousand to $ 2K with NO restrictions on preexisting. So Obamacare came thru for her.

    When Wyoming’s conservative GOP leadership made the selfish ideological idiotic decision to not extend Medicaid coverage at the very least , all they did to the 50,000 of us who have little or no insurance is give the blade a hard twist. Oh by the way , it’s a Seppuku sword, not a surgeon’s scalpel I speak of.

  18. DeweyV,
    Please elaborate on what you consider affordable health care. Is it $100/month, $300/month, etc.? Should it be based on one’s income?, One’s net worth?, One’s potential future earnings? The word affordable as we have learned needs to be defined.

  19. It sure ain’t the cowboy way to let less fortunate people suffer needlessly. Beside the politics, that is the question Brad Meade needs to answer every day.

  20. REID- gotta call BS on some of your assertions. Sifting thru a few journals at Bloomberg, The Economist , and the World Health Organization’s findings, it appears that Thailand’s care system is ranked ~ 47th and India’s ~ 112th in overall efficiency and success towards its overall population. The US is ranked ~ 37th and Canada pegs in at ~ 30. This is based on availability of healthcare to a nation’s entire population weighted on outcomes and mortality factors without respect to incomes. In other words, how well are its people served by the medical care available ( or not) to them all across the board ?
    The nations at the top of the list for best, most far reaching care are no surprise. Singapore and Hong Kong ( which are unique nation-states ) . The top performing country is Japan. Then comes the likes of Australia, Spain , Sweden , South Korea, Taiwan. The next tier is the rest of Western Europe, most of South America. I note that both Venezuela and Cuba outrank the US.

    Your assertion that India and Thailand work well is very flawed. India has a caste system which has horrible socioeconomics , and Thailand does tremendous medical tourism as you point out. I’ve indulged a bit of that …I spent six months in and out of Bangkok. If you really care, I can provide a link to one of my online photoessays on the medical care in Thailand , vis-a-vis the oppression of the Karenn Paduang tribes near the Burma border in the Golden Triangle . All the healthcare thereabouts is via the UN , Red Cross, Oxfam etc since the Thai government abandoned its own people and responsibility. You have seen deplorable healthcare till you’ve spent some time in a jungle HIV-AIDS clinic. On that same trip I realized that the outer islands of Indonesia I visited at depth had better local healthcare available to all than rural Wyoming ( and every Indonesian post office had fast satellite internet connection and public computer terminals courtesy of the government , for that matter, when Cody Wyoming had that good old free market pathetic 26kbps dialup modem. This was in 1999. But I digress)

    Both Thailand and India do provide good medicine to those who can pay for it or have the requisite social status. So good they outsource it. There’s a better than even chance that any CT, MRI, or soft tissue X-ray you’ve had done recently was uploaded to Asia , probably Bangalore or Bangkok , and diagnosed by a radiologist there. For 20 cents on the dollar , but your healthcare provider took that scan and marked it up 150 percent anyway since that is all medi-Care will let him/it get away with. What a fabulous market solution !

    But as you seem to forget here, we are not talking about the care available only to the privleged and the affluent alone , in Asia or Wyoming or Canada ( where I have also had good medicine even as a ferengi ) , but to an entire resident population that included the Kerry Drakes and Basque sheepherders alongside the True family of Casper or Sam Walton heirs of Jackson Hole.

    So please, given where Wyoming is right now, with or without the spectre of Obamacare looming , and just considering the goal of extending medical coverage to all the state’s citizens so that Kerry Drake and myself could actually afford a health plan of some sort that would be accepted at my nearby clinics and hospitals by resident physicians. What is the Wyoming solution with respect to affordability and accessibility to all ?

    How will the medical marketplace serve Wyoming going forward ? I contend it does not, and refuse to be lectured that it’s the federal government driving the bus; that somehow this is all Obama’s doing and the feds have utterly flummoxed our fine for profit capitalist consumer medical system with all these rules. That is propaganda. Why can I say that ? because the good ole US of A is the ONLY nation on Earth that has this overwhelmingly for profit healthcare system where people’s lives, their health, and their bodies are treated like a commodity to be brokered in a trading pit or sale ring. When inf act it is the lobbyists in the shaded sanctums of Washington writing the regs and pulling the strings on behalf of their clients—& Big Med, Big Pharma, Big Insurance, et al. ( Hint: Just look who the major contributors to Barrasso’s and Enzi’s political warchests are ).

    Your ” solution” is no solution , Reid . Just bandaids , deflections, right wing talking points. By the way , Wyoming already has a fine medical review board comprised of six lawyers and six MD’s if I recall , to help weed out frivolous malpractice lawsuits and investigate other form of medical tort.

    What is your actual plan for providing a balance of affordable available healthcare to l’il ole Wyoming ? To Kerry and me .

    I’m concerned about this issue because I personally had a near-death case of the flu over the New Year’s weekend and realized that the Grim Reaper was sitting in my living room , smirking. That does sharpen the issue somewhat.

    P.S. Care to at least tell us what Wyoming COUNTY you ranch in , and perhaps what your own healthcare plan resembles therein ? You are still dodging the question of your residency. That’s a yellow flag to me, given your prolificity without attribution.

  21. “Why won’t Mead?”
    Because he is an ALEC/ Koch Bros. shill, our “Equality State” status applies only to those that are Libertarian purists!
    Until we elect politicians into office that understand the plights of ALL of the citizens of Wyoming and not just the “hate the black guy in the White House” crew, like the Cheneys, not just the chosen few that get most of their campaign contributions from a Texas corporation and Virginia carpetbaggers seeking power et al.

  22. Dear Mr. Drake,
    I apologize for attributing to you, remarks from “Dewey V”. The ad hominen attacks are obviously his and not yours. A rereading on my part brought my mistake to light. Please accept my apology.

  23. To Cecil Lena:

    I am confused by your recent post. Just for the record, I made no such attack on Mr. Rosenthal or ever suggested that someone has to be from Wyoming to comment on my opinions. That would be ridiculous. I also directly and quickly responded to your earlier questions. As for your question in your most recent post, I do not believe the ACA representative I spoke to is a Wyoming resident, but I did not ask her, since the question is irrelevant to the information I was seeking.

    I am attempting, as several readers have suggested, to clarify my status related to Medicaid eligibility. I will certainly keep readers informed about my case in a future column, once I have some answers as I, like many other Americans, struggle to find out exactly how the ACA affects them. I would like to thank everyone for their interest and for sharing their views.

    I think it is important to remember, though, that no matter what happens to me, there are still more than 17,000 Wyoming residents who are eligible for Medicaid but can’t get on the program, and as far as I can tell nothing is being done to actually help them.

    — Kerry Drake

  24. The fundamental problem still is the cost of American healthcare. political fear-mongering will not solve the problem. We pay twice as much and receive less, compared to other educated economies. we don’t need obama-care or romney care.
    we need good affordable care. the medical system is broken in regards to all. That is the issue.

  25. Thank God for Gov. Mead and our Legislators for studying the real numbers and the real cost to Wyoming and thank you Reid Lance Rosenthal for continuing to speak the truth. It is this President who is really to blame … he will not negotiate … it is always his way or no way … I hope our Governor and Legislators hold fast and do not cave in on this … please stick to your guns! Do not take that bit of a poison apple! We will all suffer if you do. The Feds should vote to change the law they passed to allow those who qualify for Medicaid to receive it no matter what state they live in! This is their fault .. not our Governor or our Legislators …

  26. Mr. Drake,
    Why do you resort to an ad hominem attack against Mr. Rosenthal? Is it a requirement that only WY residents can respond to your writings and comment on WY issues? Mr. Obama and his administration, non are WY residents, imposed the ACA on WY over the protestations of our representatives in D.C. Mr. Mead chose not to take the state in the direction of increased Medicaid eligibility. I believe Mr. Mead is a resident of WY.
    I am sorry that you chose not to reply two my question regarding your investigation of Medicaid coverage. By the way was the representative of the ACA a WY resident?

  27. Mr. Rosenthal, you can keep providing facts to Dewey V and he will continue to ignore them. He lacks any willingness to understand anything other than his opinion – factual or otherwise. Even when presented with hard cold facts, he ignores them and moves on to something else. You are just wasting your typing skills. I have been down that path before.

    Mr. Drake is correct, the Department of Health estimated the initial 6 year costs savings of the ACA/Medicaid provision would save the State $47 million over 6 years and $80 million by adopting the ACA/Medicare provisions. But what about the costs when the State has to pick up the 10%? 100% is the bait, the 10% is the switch – assuming the Fed’s follow through on their commitment to fund that 10%. As mentioned previously, we have watched the Administration steal the mineral royalties Wyoming is entitled to, what is to stop them from increase the participation to 15% or 20%?.

    The Kaiser Family Foundation – having by far more expertise than anybody I have seen comment about this issue at WyoFile – predicts the ACA/Medicaid provision will cost the State of Wyoming on average $29 million a year beginning in 2022 – the so called savings will easily evaporate in 4 years. This does not include the approximately $22 million of additional costs in 2020, $25 million in 2021 costs to the State prior to that.

    The ACA is a bad law, using bad math, using bath assumptions. The simple fact the Administration is changing the requirements of the health care plan on the fly should be warning enough. Nobody with any common sense would take the ACA/Medicaid bait based on past Federal practices or what the unknown costs of ACA will be to the State budget beginning in 2020.

    In summary, sure, the State saves a few million today to adopt the ACA/Medicare provision – but will pay a heavy price beginning in 2020 and beyond – with no end in sight………

  28. DeweyV-

    Yep, a resident of and living in Wyoming…and yep, both my base ranch and high country spreads are in wyoming.

    Before I get to your query, you mentioned in a post below–and Kerry also alluded to–the “millions in savings” to the state if WY would only embrace the red herring of expanded medicaid. You presume the Federal government that has lied and broken promises to the people repeatedly and has exhibited nothing but disdain towards the tenth ammendment and the constitution in total, will keep their word (this trust after their recent theft of mineral severance royalties from WY and others, and unilateral/illegal changes to ACA on overnight whims and a host of other lies). And in your list of big this, and big that in your post, you left out big government–which is the problem, not the solution. This country was built by people, not government.

    With those thoughts as foundation, health care could be revamped in 200 pages:
    –end deal with big pharma inked by Obama–savings 80 billion per year
    –tort reform–savings estimated depending on the experts, and based on actuals in MS and TX, of 90 to 140 billion per year, including pass through costs to patients by docs of up to 300k per year for premiums (reduced by 2/3 in the states referenced above)
    –insurance across state lines. No longer the three or four, whatever carriers open to residents of this state or that, or the one or two available in many states after Obama does not Care. Estimated savings in premiums via unfettered competition of 60-80 billion per year
    –reduce regs existing even prior to the 17,000 pages of new HHS nonsense promulgted by DC control freaks–estimated savings 20-40 billion per year (talk to any doc about the paperwork/compliance costs–both gov and insurance under Obama does not Care).
    –establish an independent fraud board (rather than the IPAB rationing/death panel) composed of 1/3 forensic accountants, 1/3 docs who know the medicaid/medicare systems and how to game them, and 1/3 pit bull attorneys with prosecutorial power specializing in medical fraud and eliminate (rather than spew rhetoric) fraud in those systems–estimated savings 200 billion per year.
    –reinstate the personal health savings tax deduction (eliminated by Obama does not Care) for folks to put away money to cover deductibles, small claims
    –eliminate the 675 billion in new taxes (480 billion from the pockets of folks making less than 200k per year–yet another lie) enacted and now in full effect to support this farce, and instead levee a 100 per policy surcharge–calling it exactly what it is, no subterfuge and no increases without a 2/3 vote of both houses–that goes into the high risk pot below
    –finally, the savings from all those steps (and others) goes into a national high risk pool, the insurers are mandated to service the pool pro rata, and the pool includes the indigent, pre existing conditions, folks needing a temporary hand and certain others, all of whom must prove their eligibility to eliminate fraud at that level.
    –The above could also be integrated with a voucher system for certain areas/classes–but that is yet another topic.

    Having many friends in England, and Canada, and having owned ranches in Canada, I can tell you unequivocally that those systems are mostly broken, rationed, regarded with disdain (particularly by rural populations) with substandard care outside the big cities, and long waits for what we would consider mundane procedures, the IPAB Board equivalents in those countries approve the procedure to begin with based on their subjective view of your remaining value to society. The answer is NOT increased government tampering–just the opposite. The two most efficient medical systems in the world are currently India and Thailand. Completely market based, procedures by top notch docs upon demand, for 1/3 the cost of the “civilized” western countries. Check out “medical tourism, India and Thailand”…a real eye opener.

  29. Reid Lance Rosenthal—-two questions. What is YOUR concept of a working healthcare system that reaches all of Wyoming’s residents ?

    And are you yourself even from , or residing in, Wyoming at this moment. For all the words about you scattered across the web , I have yet to sift your physical address from the western chaff . It seems to be purposely hidden. My best guess ( and it’s just that ) is you are writing from somewhere in western Colorado in the swath between Durango CO and Baggs WY. But I really don’t know. Where ya coming from here ?

    I was born ,raised , and still live in Cody Wyoming and will likely expire here. The 4th gen of my family here, three gens of whom were similarly raised here. Some of my kin are up to six of same ( I never married). In the past 62 years in Cody I have seen health care go from country doctors and clinics working from a privately built and gifted county hospital, to a massive array of specialties beholden to profit and a hospital that although it still recieves 3 mils of property tax funding ( several million $$$ per year ) is most definitely one of those For Profit nonprofit facilities run by an HMO out of Nashville. It’s all about the money these days, not the medicine. The American Health Care system is an oxymoron , and nowhere better illustrated than right here in Cody. Follow the money . The USA alone in all the world has a for profit private run publically subsidized commercial medical industrial complex. Yet our healthcare statistics ( those that matter ) are abyssmal on the global scale. Babies born in Botswana have better infant mortality than Wyoming. It’s an extremely long list of comparative statistics that prove the price/cost of health care is not proportional to quality of care recieved. Anyone who looks at the root causes of our medical dysfunctionality and out of control costs comes to the inescapable conclusion that we need to get away from For Profit-Big Medicine , Big Pharma, Big Insurance- Medical Wall Street . Ad absurdum.

    The solution ? Single payer public option. Example: the Canadian federal healthcare system administered by the provinces ( states) , a decent model worth examining. As are most of the western European models. The rest of the world wonders why America is so incredibly stupid about all this…putting a price on life. Corporatism and Capitalism have no place in healthcare.

    Again, Reid, what is your solution within the Wyoming framework ?.

  30. Kerry–

    It is probable you are not being told “the rest of the story”, as Paul would say, by the representative, who is furnished a list of talking points and mechanics (designed to push the agenda), and whose training as a so-called navigator is paltry (twenty to thirty hours) at best. For instance, I believe you will find that the “ninety dollars per month” penalty she informed you you would avoid by now having shared your most intimate personal medical and financial information with all the agencies of the united states (read disclaimer on site itself) and hackers around the world (see transcripts of congressional testimony on site security) is actually 90ish dollars PER YEAR.

    In addition, there are loopholes in Obama care. Obama’s illegal manipulation and changes to the law have created yet others which you might use to your advantage. Some portions of the law are unequivocal–you are not fined, nor in violation if you have coverage–and that coverage does NOT have to be through Obama care. In other words, any “legal” coverage, gets you off the violation hook. The definition of “legal” is in almost daily flux by a frantic white house–including their most recent ok to catastrophic plans. I frankly don’t know what the result of your investigating my next suggestion might be…but I do know that the mess you find yourself–along with millions of others who supposedly were to be the beneficiaries of this purported affordable healthcare reform–might best be resolved bypassing the wreck. Sometimes the best way to avoid the accident is drive around it, not sit in traffic waiting for the clean up. A) call a private insurance broker, and see what they can come up with for your family, and B) simultaneously contact the medicaid office at the STATE level and see what oppurtunities might exist, outside the boondoggle of Obama (really does not) care. I personally would be fascinated to know those results. I’m sure most of the rest of the good folks posting here, regardless of persuasion, might be, too. And you might wind up with something that works–or at least a temp fix to get you over the hump created by the DC control freaks. Just a thought. As an aside–very well written article, despite my disagreement with where you feel the blame lays for your situation. Happy New Year.

  31. Mr. Drake,
    Thank you for your reply. To be clear, you have not applied for Medicaid in WY nor have you spoken with anyone in the WY Dept. of Health, the state medicaid administrator, rather you were told by a representative (unnamed) of, the ACA website that you would not receive Medicaid benefits from the state of WY and you accepted this at face value?

  32. Thank you for your question, Cecil.

    The representative of, the ACA website, that I spoke to told me I meet all of the income requirements to obtain assistance through Medicaid. If I lived in one of the states that approved the Medicaid expansion made available by the federal government through Obamacare, she said I would likely receive it. But because Wyoming rejected expansion of the program, it is impossible for me to obtain it unless the state changes its position. There is no point for the 17,000 low-income adults in the state in the same situation as I’m in to apply for the program, because our rejection is automatic given the stance our officials have taken.

    At the same time, we are not eligible for the federal tax credits or subsidies available to others under the ACA, because we are eligible for Medicaid and that’s the assistance we should be receiving. It’s a perfect Catch-22 scenario: you can only sign up for this program, but you can’t because it’s not available where you live.

    Let me address one other point I didn’t mention in my column, but was reminded of when I read Marguerite Herman’s comment. Contrary to the statements of several people who have weighed in on the subject here, accepting the Medicaid expansion would actually save the state of Wyoming money — and our representatives knew it before they made their decision.

    A Wyoming Health Department study concluded that the expansion would not only save the state $47 million over six years, declining to do so would cost Wyoming nearly $80 million over the same period. So by rejecting expansion of Medicaid to make a political point, the governor and the Legislature not only punished thousands of low-income people who would benefit from the program, taxpayers will have to pay $80 million more to NOT help people. That’s a decision that simply cannot be justified by politicians who claim to be fiscal conservatives who act in the best interests of the state and their constituents. We all lose because of their decision.

  33. In the large sparse social landscape that is Wyoming, this state’s medical care system has always been of far less quality and dysfunctional availability than the states around us . Wyoming was, is and will remain a giant sinkhole of medical care when you look directly at the quantity and quality of service and the population at the same moment. This is due to several reasons that compound and amplify one another, beginning with a low population that cannot sustain basic on-call services all around or provide a viable market for minimalist preventive care , let alone elective or universal care. Way before Obamacare became a derogatory buzzword, medical care in Wyoming was a dice roll ; discriminatory ; dysfunctional —IF you were not affluent. Too few of Wyoming’s residents had the wherewithal, ways and means to afford and utilize good private health care before the 90’s Clinton health reform campaign ( failed) and Obamacare ( jury still out).

    Regrettably , with the wa the ACA has gone down and our boneheaded ossified narrowminded GOP leadership’s knee jerk inverted ideological reaction to Obamacare being one of denial and moreso denying its citizens even a glimmer of hope for some equanimity in health in heaving the Medicaid component over the rail , it has only gotten worse. And that was done on purpose. The only explanation that fits the facts is it was an act of political spite.

    Kerry Drake. Exhibit A. I could be ” B” . There are 15 to 45,000 more where we come from. Wyoming.

    It’s tragic.

  34. Mr. Drake,
    Please clarify something for me: you state “But there was a catch, and it was a huge one. Since Wyoming rejected the Medicaid expansion that was part of Obamacare to ensure low-income adults health care coverage, I couldn’t sign up.”
    Does that mean that WY Medicaid rejected your application, if so what reason were you given? Or does it mean that you were unable to access, by whatever means, a Medicaid representative to process your claim? Or is there some other reason that you “couldn’t sign up”? Thanks in advance for your explanation.

  35. Mr. Drake, it is unfortunate the situation you find yourself in. Starting your own business is never easy and it can take years of blood, sweat and tears to possibly turn a profit. As you do with your columns as they relates to your views, hopefully you are gaining a better understanding of the challenges we face as small business persons. Contrary to popular belief, it is not easy and we rarely have money just falling out of our pockets to pay all of the taxes, fees and assessments government likes to impose.

    Forget Republican, Democrat…….what you have found is the ugly truth about the ACA and unfortunately there is more to come as the employer mandate is imposed at some point in the future. Mr Rosenthal hits the nail on the head directly with his comments. While some of you are unwilling or unable to see anything other than your current political views, the conservative side of the fence has been warning the masses that the ACA is not what it was sold to be. Most if not all of the politicians supporting the ACA have never even read the ACA. ACA is not the free lunch the people were promised.

    Mr. Drake’s situation is a perfect example of the ACA not working – and we are just getting started. The millions that have lost their current plans after being lied to is another example – those are facts. Just wait until later in 2014 when small businesses begin dropping coverage because they cannot keep their current plan or the rates increase so much for the “new” small group plans that small business owners throw up their hands and send everybody to the exchange – which hopefully are working betting than they are right now. Those huge rate increases are coming………no executive order will stop the rate increases.

    Let me add one comment about the State of Wyoming not taking the bait with Medicaid. Sure, the Fed’s will cover 100% of the cost right now, but does anybody understand what the cost to the state will be when the State of Wyoming has to cover the 10%? Unfortunately, I do not have any hard data to support what the number will be, but considering the underlying political unknowns of the ACA, I suspect the cost to the State will far exceed the short term “incentive” of covering 100% of the cost. Plain and simple, it is a loss leader being sold by the Federal Government. The State is wise to pass on something where the 10% is such an unknown – that 10% could far exceed the ability to fund the mandate without drastic budget cuts in other areas or instituting new taxes. Keep that in the back of your minds as the States begin covering those new costs.

  36. I wish the Wyoming legislature and Gov. Mead would accept the federal Medicaid funding. They do have a point, however. Congress kept millions in mineral severance funding that is Wyoming’s money by law–NOT just a PROMISE of funding!! Why do you trust Congress and the administration now? If Wyoming had the money that is ours by law, then I believe we would have other funding to expand Medicaid.

  37. The situation Mr. Drake describes must be very difficult. However, expansion of Medicaid, and the implementation of another entitlement program designed to punish the middle class is not the answer. I am not advocating an abandonment of the poor by government, I want to put that up front. However, implementation of certain pieces of legislation, one at a time may prove to be very beneficial. Such as, implementation of state portability of medical insurance, tort reform (which has been very successful in Texas), and reward of practitioners who have qualified improved patient outcomes. There is a cost for everything, and with the nation 17 trillion dollars in debt, and spending money on ridiculous research like drinking in prostitutes in China, must stop! The ACA was never about making health care affordable…unfortunately

  38. Daddy’s Girl–

    You miss the point, perhaps intentionally. I believe Kerry’s poignant, compelling and unfortunate tale to be completely true. It is the reasons for his predicament that you and yours twist from a fairy tale spool. I purposefully left out my “go to’s” for information, instead furnishing you YOUR sources–the government– Federal Register, Congressional Record, Transcripts of Congressional Hearings and the New York Times, the Chicago Tribune, CNN, ABC, etc. It is easy to saddle that horse–simply call up the sites and hit the search bar. Have a Happy New Years, Daddy’s Girl. And keep in mind that the touchstone of the past is often the guide post for the future.

  39. Some advice for Mr. Rosenthal:
    Move out the the 19th century and join the rest of the world in the 21st.
    Stop believing sources that lie to you.
    When you read WyoFile and other real news sources, don’t just dismiss them as untrue. I suspect the reason you read them is just to argue.

  40. DeweyV–

    I am chuckling. Stetsons indeed and proud of it. And those #1 bestselling novels I pen in between the chores of the ranch? Though they have romantic threads (I do have a softer side :-)), they are much more about this country in the 1800’s–brave men and independent women of uncommon cultures, differing origins and competing ambitions–some dark, some light–and how they weave into the whole cloth of the nation here in the west. It is a subject which fascinates me, this tapestry of America we all call ours. And that, perhaps, is the reason I thunder against those who would tear it down under the false cloak of “good for the People”. Precious little, if anything happening in DC right now–on either side of the aisle–is good for the people. Have a Happy New Year.

  41. Kelly – You are just another victim of the state’s ownership by the big-bellied, whiskey-nosed livestock and oil men through their wholly-owned legislature. Thank God I joined the military so now have a composite Medicare/VA program that pays for 100% of my medical costs and 80% of hospital care; and I now live in Colorado , that has an affordable and coherent Medicaid program. In other words, I enjoy what every citizen would have under a single payer program. However, thanks to the corrupt Senator “Broadway Joe” Lieberman, whose whole constituency was/is the state’s insurance industry, the people ended up with this “mess of pottage”. I found another major hole in the insurance program when I was told that I would have to pay the whole premium of $1200/mo for a supplementary plan to cover supplemental hospital insurance. A working man can’t win for losing, as the old adage goes.

  42. Daddy’s Girl–

    Based on your enthusiasm for the public option, Daddy would be the government, I presume? You are flatly and completely incorrect, and given the number of sources out there from the congressional record, to under oath testimony, to ABC, CNN, the nyt and chicago tribune, shame on you.

    The grand father clause was built into the law that was passed. The law also provided for implementation of regs by admin or HHS. Sebellius, with full knowledge of white house, and Liar in Chief, filed regs (check the 35,000 area of pages in fed register) in june of 2010–three months after signing of the bill, which eliminated virtually all policies from the grandfather clause with a clever, sinsiter and devious clause in the regs that excepted any plan with certain changes (to include premium increases of over five dollars and fifty cents–or which did not conform to minimum Obama care requirements such as prenatal care for grammas, pregnancy coverage for men, pediatric dental care for childless couples in their fifties) from grand fathering. It has been futher admitted that this was purposeful–that those being thrown off private insurance, or to be abandoned by employers when their group plans could not be grandfathered, would have no choice but to join obama care, their higher premiums supporting the health insurance of others. You can wiggle, waggle, distract as progressives do, or attempt to divert, but them’s the facts, Daddy’s girl. And it is a fact that every single one of them lied through their teeth about it repeatedly and for years–includuing prior to, during and after passage. It is also true that the Dems again voted unanimously against Wyoming Sen. Enzlie’s bill introdueced immediately subsequent to the reg and designed to insure that folks really could keep their plan. The next shoes to drop are the increased costs, doubling or more of deductibles, narrowed networks (you wil NOT be keeping your doc or hospital–or even in some cased your prescriptions) and another 80 million who are about to be uninsured in the employer market place. And I will emphatically repeat–known, intentional, part of the plan. And the plan, as so notably promulgated by Marx is “from each according to their abilites, to each according to their needs”. I give not one hoot about the “western nations”. They are all–with the temporary exception of Germany–broke (the ECB and central banks buying their own bonds) due exactly to the failure of this precept and their wild, irresponsible social programs which are not about the people, but about buying votes to maintain the power of the elite using other people’s money.

    The Republicans have proposed plans–five are now introduced as bills–however Harry won’t bring them to the floor, and the MSM wont give them the light of day…and Liar in Chief while on the one hand gushing he is open to “all ideas for anyone”, on the other states emphatically, “I will not negotiate.”

  43. Reid Lance Rosenthal who comments here wears several hats—all Stetsons. The one he is most proud of his work as a Western romance writer, but you’d never know it from the contents of the thundermug he emptied here. Revisionist historian , maybe.

  44. Those who are toughing it out in drafty trailers, and voting Republican every election, need to think long and hard about the consequences of their support for a party that, behind closed doors, thinks you’re a joke and those of the Koch brothers ilk as supreme leaders. The GOP is no more a religion than the Dems, and the Dems are not the devil. Those Cowboy Staters in their 90s will remember that the Democratic Party provided employment during the Great Depression while the Republicans fought it tooth and nail. Some of the irrigation facilities, still in use today, were provided, during the Depression, by the Dems. This turned mountain deserts into usable ranchland.

    Wyoming will continue to be a solidly “red” state for some time to come. But the Legislature is in need of a conscience. The small minority of Dems in the Legislature are that conscience. In keeping with the deeply held religious principles found in the State it’s time we make sure that voice of conscience does not go silent. Your local Republican legislator may be a kind and honorable man or woman. But what has he or she done for those who do NOT count stock dividends, or oil royalities, as a major part of their income? The Legislature needs about a dozen more people–all Democrats–who see as their moral duty the plight of that family living in the drafty trailer.

    My email:

  45. Mr. Rosenthal, the “you can keep your plan” promise was correct. The plans that were already in place by the time the law was signed in 2010 were all grandfathered in, even if they did not meet the better standards of the ACA. After that, any plans sold that did not meet the requirements are the ones being dropped. Insurers knew that, but of course made no overt efforts to inform their customers. Insurers also knew that when they dropped those plans, they could try to sell more expensive plans to those people, while hoping folks didn’t check out their options with the ACA.
    The whole thing would have been so much better with the public option. That is the way that, as you put it, “truly lowers cost, increases access, gives security to the previously uninsurable and neither undermines choice in care providers nor bankrupts the country and your children.” Republicans have proposed no such plan. Any and all problems with this law have been created by republican monkey-wrenching.
    And by refusing to use the 100% federal funds to expand Medicaid for those who are now eligible (under the ACA, mind you), they are proving they care nothing about the life or death of their constituents. Their only motivation is hatred of this president.
    What a lame excuse to say the federal government may not pay what it says it will. How many people are going to be allowed to sicken and die while republicans claim that? After 3 years of paying 100%, federal funding will GRADUALLY decrease to 90% BY 2020. How many lives lost will equal the 10% the state pays AFTER 2020? You think that’s worth it?
    In all other civilized Western countries, taxes are not much higher than ours, yet their taxes go toward taking care of the people who pay them instead of to the powerful industries that are bankrupting us and ruining the planet.
    And as for all your other claims about so-called “scandals,” you obviously watch Fox, where most of what they broadcast is made up lies.

  46. Thank you, Kerry, for your honesty and sharing your experience with this. In September I went to and went through the online process of seeing if I qualified for Medicaid coverage before applying for ACA coverage. As you know, applying for insurance these days using any method is tedious. At the end of the process they told me they didn’t have enough information to make a final decision and that someone would contact me by phone or mail. It never happened.
    I was gainfully employed full time for 20 years with medical benefits until the Fall of 2008 when I was laid off. Since then I have worked 2-3 part time jobs to pay the bills and have not had any medical coverage. I have NEVER applied for or received any social subsidies and applying for Medicaid was truly an act of desperation. If Wyoming’s HealthLink staff can’t even get back to me, I’d rather spare myself the torture of applying for ACA coverage.

  47. To Robert–

    I see. So it is Reagan we should bame for the Obama care debacle. He is the one who threw the elderly under the bus in an 80 billion deal with big pharma for their support of this law, and it is he who rolled into bed with the insurers to create a captive market that he swore more than thirty times over four years would never exist (you can keep your policy–period).

    Amazing. Keep that cartoon of the fine dinner in mind as you pay your share of 100 million dollar jaunts to Africa, one billion for a flawed web site to Michele’s school chum (previously terminated by Canada for rip off non work), 7 million per year for cape cod summer flings, Air Force 2 flying the family dog, and 20 million per year for fun in the sun in the Hawaiian surf–and don’t forget to blame Ronnie for the big birthday bash planned at your expense for Queen in Chief next week.

  48. I empathize. But that is as far as my sympathy goes. You were for Obama care. You got what you wanted–a UNANIMOUS vote by democrats playing parliamentaary games on Christams eve back in 09…compounded by a steady stream of oft repeated fraudes on you and all Americans–you can keep your doc, you can keep your policy, the uninsured will now be insured, premiums will decrease by 2500 per year and the beat goes on. Had the focus been on getting a true safety net under the 15% like yourself and cost control, rather than controlling the 85% (and one sixth of th eeconomy) the results would be far different. Had you and others been even half awake to the out right lies–and the incontrovertible math– rather than wallowing in deprecation of conservatives and lighting candles at the altar of liar in chief, you, the thiry plus million like you, along with 6 million (so far) previously insured, now uninsured, would be covered and would not be in this position. Yet here you, and a number of others above, are still casting stones. What exactly does it take for you folks to “get it”? The Republicans did not promise you all the goodies–your fellow democrats did–knowing unequivocally at the time of the promise, that their words were false.

    “Medicaid is all paid by federal dollars”. Where do those dollars come from? YOU and me and all others. And you think Wyoming should risk it’s fiscal stability based on the promises of federal officials who have lied through their teeth to YOU on obama care, the IRS, Benghazi, employment numbers, the NSA and etc? You don’t think that a government which has so far illegally altered 14 provisions of this train wreck without congress and in contravention of the constitution could not simply say “so sorry–no more money–too bad, Wyoming”. Only a fool trusts his security to power hungry liars. Don’t blame Wyoming for having the smarts to stay out of this deplorable, intentional debacle–instead why not focus your energy on getting rid of this abomination, and replacing it with a plan that truly lowers cost, increases access, gives security to the previously uninsurable and neither undermines choice in care providers nor bankrupts the country and your children? The Republicans had no part in this law–not a single vote. Cast blame where it lies, stand shoulder to shoulder with folks who truly want a good outcome born from repeal, and stop wasting energy on band aids (Wyoming medicaid).

  49. I am sorry, Kerry. What was meant to be helpful to all of us was corrupted beyond all belief by the politicians, Democrat and Republican – but especially the latter. Robert Hoskins put it very well. May the Good Lord bless you and keep you, and may 2014 turn out to be a good year for you.

  50. You have made the point well, Kerry, with yourself as an example of someone who is working hard but caught in the irrational coverage gap created by that strange Supreme Court ruling. The governor and Legislature could have fixed this a year ago (while saving millions of dollars). What are we waiting for?

  51. As a guest celebrant last Sunday with the Gospel lesson being the Prologue of the Gospel According to John, among other points I emphasized that the image of humanity revealed to us through Jesus, the Christ, was compassion that included healing the sick; that Physicians for Universal Health Care were totally ignored to the benefit of insurance companies. There are those who try to incarnate the compassionate Christ through their care/advocacy for the poor and the sick. There are those who continue to identify with the power structure that crucifies the compassionate Christ.

  52. Of course you’re expendable, Kerry. We mere citizens all are. Wyoming is an oligarchy masquerading as a republic, and oligarchs enjoy watching people suffer while stealing both their labor and every last dollar from them.

    I remember a Doug Marlette cartoon from the Reagan years. Ronnie and Nancy are sitting at a window table in a swanky restaurant drinking wine and examining a menu. Outside the window, a starving mother and her children are staring at the royal couple. Very Dickensian. Ronnie says, “Waiter. This window is dirty! Give us another table.”

    Reagan’s vision, if you can call it a vision, has finally attained fruition in America. The whole country’s that way. Why so many people expect Obamneycare, and that’s what is, to benefit the citizens of this country, I don’t know. At best, it’s wishful thinking. Anyone with a shred of reason and compassion knows the only practical solution to the disaster that is the American medical system is Single Payer. Fat chance of that, though.

    Obamneycare is a Republican idea clothed in Democrat tatters, designed for one purpose and one purpose only–to sustain profits in the insurance, pharmaceutical, and medical industries while conning the American people into believing its rube goldberg, bait and switch payment system provides real benefits. It’s nothing more than another means of transferring wealth from real people to oligarchs. We’ll soon see that “affordable” is another Orwellian word.

    Ultimately, what I take from this exercise in futility is that the Progressive Era, a time when government actually tried to do more than service the rich and do something for real people, is over. The oligarchs killed it with the assistance of both Republicans and Democrats, including Barack Obama.

    The first step toward living a life of dignity is to recognize that fact.