If I send Kaiser Permanente this still life of a pig instead of my $266.80 insurance premium, would that be “health news?”

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That was unfair. Pig shit can be used for fuel and fertilizer, and pork, although far from the cleanest of meats (just look at it), is widely agreed to be mighty good eatin’. $266.80 a month to Kaiser gets me a $6,500 deductible and cold calls from customer service (sic) pitchmen who want to schedule me for a routine checkup with an internist at an outpatient clinic run directly by Kaiser but can’t tell me how much I’ll have to pay. I’m paying Kaiser the equivalent of Medicare deductions on $220,800 in annual earned income, so, yeah, that’s kind of shitty bollocks for value.

Kaiser has a fairly good reputation for a health insurer, but it’s still a health insurer. The US health insurance industry does not enjoy paying claims. Before Obamacare, the industry was allowed to evade claims by refusing to cover the sickly, sometimes even by canceling the policies of existing policyholders whose medical conditions became financially inconvenient. Under Obamacare, the industry is no longer allowed to cherrypick its risk pool to exclude those who will actually need medical care. Instead, the ailing–precisely the frequent fliers the industry used to do everything it could to exclude–flock to the risk pool and the healthy, who either foolishly assume that they won’t need care (e.g., walking Millennial college girl caricature Anna Beavon Gravely) or plainly can’t afford the premiums, shun coverage. The inequitable old system failed because the insurers refused to honor legitimate claims. The current kinda sorta equitable system fails because the insurers are financially unable to honor claims. Because they’re boycotted by the healthy and flooded by the sick, the insurers cannot fully pay their claims from aggregate premiums. They need external financial aid to make ends meet, and little such aid has been forthcoming, because muh markets. Just who do these companies think they are? Defense contractors?

The resulting coverage is illustrated in the figure above.

This is why Kaiser Health News, a psy ops “partnership” with NPR (“lettuce” put ALL the neoliberals to work in the fields with short-handled knives), has put its flacks and pet experts up on the high horse to disseminate propaganda encouraging the use of “public policy” and “behavioral economics” (Cut lettuce, you hear?) to gladwelly nudge the poors into quitting the damn cigarettes. Eric Garner hasn’t had a cigarette in months, so it must not be a total failure. The tone of the piece was basically, “I watched a couple TED Talks in the middle of a Netflix binge the other night, so now I’m an expert on neurobehavioral socioeconowellness tax policy, and I fucking love it.” Being a bumptious poor-shaming shithead on the radio is the new black.

Notice that these fuckjobs aren’t saying anything like, “Many of you listening at home may wonder whether drinking that much Kendall-Jackson chardonnay makes you an alcoholic. The answer is yes. If you’re pulling that out of your purse and drinking that on the bus, you’re a lush. Most of you also have an Adderall problem, and health policy analysts are concerned about the industry’s exposure to additional emergency room admissions for cardiac tetanus due to rich assholes snorting the goddamned freebase all night long.” This isn’t Lillooet home cooking country. Coke has gone upmarket. The H Train, on the other hand, is disreputable, full of marginalized deplorables from flyover country and the fallen children of good suburban families who take to doing business and then socializing with the Sally don’t you go downtown set. Cigarettes used to be about FDR sitting around Hyde Park with his kebab skewer-looking fag holder and his Planter the Peanut monocle. These days, they’re more about how affluent busybodies who aren’t banging the working girl I banged the other day would be horrified that she doesn’t air her trailer out, if they deigned to set foot in a trailer park and interact with any of its residents as their equals. This is because somewhere along the line it became no longer okay for Don Draper and his old boys to stink up Pan Am with their little cancer sticks.

None of this has anything to do with race, class, or social controls. Obviously this is entirely about health. Be well, do good work, and keep in touch. Fall below the median and we’ll get mean.

The problem with the poor is that they keep performing these basic bodily functions like eating, drinking, and fucking without getting permission first. It’s as if they think they have normal executive function, autonomy, and competency, like any respectable adult.  They show no regard for the possibility that Hizzoner Michael Bloomberg is horrified to share a city of eight million with hella fat people who won’t stop smoking the Devil’s cabbage. Do they think it’s appropriate just because they’re acting like that in their own boroughs? Do they think they’re mentally competent to decide when they’re ready to have children? How can they possibly know when they’ve had enough soda without Old Bloomers and his crew there to cut them off?

He got you, fam.

Central Intelligence for Your Life Radio found a black woman in Harlem named Elizabeth Lane who complained about how smoking had always left her broke as fuck and borrowing money from her daughter. The first thing to realize about this is that it is not unusual at all for poor Americans to bum smokes off each other, or for one poorie to sell another a loosie or two because the latter doesn’t feel like going down to the corner store at the moment, or to lend or solicit cig money. Nothing about any of this is generally considered abnormal or antisocial in poor communities. Bougies who have never talked to anyone from a ghetto or a trailer park can’t fucking imagine this, I suppose, but I run into it all the time, and I don’t even smoke. The next thing to realize is that Lane was being bankrupted not so much by her habit as by the sin tax on her habit. Instead of being unhealthy, addicted, and maybe solvent, she was unhealthy, addicted, and broke. None of the NPR/Kaiser behavioral science hocus pocus in that piece mentioned anything about the negative effects of putting addicts under extreme financial stress, or the ethics of doing so selectively to poor addicts and not levying 200% sales taxes on retail alcohol sales at nightclubs. NPR is not interested in being a buzzkill for good middle-class white folk and their crews, you see. There’s nothing wrong with these dipshits getting blitzed like Coventry and brawling over skanks or dirtbags. #CanIGetAWhiteness The problem is obviously with out-of-shape hoodrats who don’t take care of themselves and need the government to force them to step up their health game. If they cling ever more bitterly to their pack of comfort in times of city-imposed financial desperation, that’s their own failure of self-control.

And of course Kaiser totally missed the intersectionality of Eric Garner’s street hustle and his recent cardiopulmonary health, which is worse than Elizabeth Lane’s has ever been. A man was choked to death by a rogue cop who was trying to root black market cigarettes out of a city that will never, ever be free of them under its current taxation regime, the police department retaliated viciously against the bystander who filmed this homocide under color of authority, and NPR covered this police killing extensively, but somehow it’s unable to mention even in passing that this killing was done under the auspices of New York City cigarette tax enforcement. “Killed by a gang of armed revenuers” is a pretty serious side effect for a policy supposedly crafted to encourage better health through abstinence from tobacco. Chattering about marginal decreases in tobacco use per dollar of tax in that context is either clueless and tone-deaf or just fucking sick.

Aside from the intrinsic Asperger’s-spectrum sickness of this piece on tobacco and colored people, there’s the broader question of why the hell NPR’s charter allows it to whore its news programs out to any corporate foundation with an ax to grind and business that it might be in the public interest for NPR, being public radio and all, to cover adversarially. It’s a crazy conflict of interest, but of course Washington in the Second Gilded Age knows how to do conflicts of interest. Kaiser isn’t actually concerned about some random Harlem prole’s health; it’s concerned that it may have to pay for medical care for smokers. The policy wonks who dignify these corporate rackets with their highbrow bullshit claim to be all about process. What they won’t admit in this case, because Kaiser wouldn’t cut them a paycheck if they did, is that theirs is the process of strongly endorsing Kwesi Millington for Sheriff.

I don’t approve of smoking, and I certainly don’t approve of heavy smoking. I do approve of locking everyone involved or complicit in NPR’s bogus health policy “reporting” in an unventilated room with John Boehner while he chain-smokes Camels all night. They don’t feel bad for getting a man killed under their shit pet policies. Maybe they’ll feel bad for making a man cry.

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