Death, dying and an abrupt step back from death's door have dominated our summer. Lessons to date: you'd better have fabulous insurance and a lot of it, know the difference between "gravely" and "mortally" ill, and have tenacious advocates looking out for your best interests, on whichever side of The Great Divide those interests may lie. All this would have been sufficient to radically personalize "health care" and America's faux-system for me. Then I had to factor in the ubiquitous craziness generated by a fear-mongering, deluded few, acting against their own best interests and on behalf of Big Insurance's obscene mega-profits, devil take the hindmost. Add a dash of my personal furies exacerbated by Atlanta's ever-filthy air keeping me captive indoors month after month while driving up all kinds of directly correlated but uncaptured and dire health-related costs.
What links all three? Ill-gotten gains and a savage disregard for the health and well-being of all but the most privileged among us.
Personal dramas aside, I cannot leave to chance the urgent need for each and all of us to stand up and be counted. To push back against out-of-control Big Status Quo -- abetted by crony capitalists and corporate philistines who have rolled over to this outrage by blindly yielding to the soaring costs eating our economy alive and actively causing death to those who simply can't pony up the ever-bigger buck. Never has there been a better time to challenge the tortured and degenerate Calvinism that lets the powers that be determine that somehow only a wealthy few are worthy of life's blessings.
These collective interests have now clearly demonstrated the depths and breadth of their ignominy. They will do anything -- anything -- to stop reform of our appalling health insurance industry and their richly-rewarded pals. The enormity of what today's slick and, yes, evil spirits are intent on pulling off -- defying the clear will of the American people to reign in the abuses to our health in the name of their profits -- is beyond breath-taking.
We really are seeing the work of the usual suspects. They run this country whenever we let them. They're the all-too well-known, self-aggrandizing Newts and Palinistas. The scum of TV, cable and Radioland. And as usual, they're aided and abetted by the shameless likes of incendiaries including Grassfire.org, ResistNet and other paranoid extremists. And never give a pass to the GOFERs -- Good Old Fashioned Establishment Republicans (with due apologies to authentic gophers).
Their self-serving ideas have wormed their way into uncritical and poorly educated minds with the intention of turning us against each other -- eating away at the core of our democracy -- while profiteers and fundamentalists of all stripes attack the best interests of the vast majority.
Our long cultural legacy bears a disturbing resemblance to the current and unacceptable condition in the extensive industry allegedly responsible for our health. A difference between today and once upon a time is that the scary and loud extremists are no longer relegated to the margins of society. Now, they've captured significant megaphones, which makes them appear to have credibility. It is "standing" that they have not earned, do not deserve, and for which they must be held accountable.
They own, outright, entire systems of mass distribution, including but not limited to the FoxFauxNews phenomenon. While these reactionaries seem always to have been utterly shameless, now they have intimidated the dainty and faint-of-heart that pass themselves off as our main stream media. No surprise, the latter are owned by giant corporations also vested in the outrageous status quo and generating outsized revenues REGARDLESS of the consequences. Craziness gets covered as news, filth flung defending their masters' profits gets respectfully reported as if it were a legitimate perspective. At least Jon Stewart and Stephen Colbert remind me to laugh at wicked ways and spur me on to act.
The wrong-wing influence in the public arena is no abstraction to me. Every single day, relentlessly, we are bombarded with the thought-grenades these parasites drop. We get rained on by people and organizations intent on the rabid exploitation of our weakest citizens, barraged by the diatribes, drenched with the lies that the reactionaries spew.
Make no mistake. These are demagogues and fear-mongers who would give cockroaches a bad name. The result? My e-inbox, I regret to report, smokes. And the stuff coming in makes killer-tobacco look mild, radio-active fall-out a balm.
Then we see this same stuff popping up in the garbage dished out by shady characters getting rich off this drek. We receive the end-poison on the airwaves that are allegedly public, witness the blogosphere tainted with anti-truths, distortions and bald-faced lies, peppered with nuttiness like "Life and Government Without Taxes!"
These instruments of kleptocracy have a very long track record of running roughshod over our common wealth. They remain fiercely determined to retain or recapture the reigns of power that for decades have allowed them aggressively to undermine our health, restrict our options and the will to act, while cheerfully enriching themselves. And as practically every person in America can testify -- what gets dished up to us is the WORST health care extortion can buy.
The Bigger the Lie the better. These propagandists care not a whit that the vast majority of the rest of us are suffering the results of what Robert Kuttner aptly described as Everything For Sale and more recently Thomas Frank diligently outed in his reportage of the net result of their minions in The Wrecking Crew.
My horror grows ever greater as I follow the dark places that current, extraordinarily well-funded business interests are merrily plumbing, intent on again having their way with us. While rape, pillage and plunder -- the effects of the current industrial-model, profit-based health administration not-system -- are far from new, they do not improve with age. What we are witnessing is what they have done for decades
As a matter of well-documented fact, the United States has a long and dishonorable history of facile and masterful exploitation of our most vulnerable individuals. The susceptible get stirred up, then cuddle up to their worst fears, grow and cherish their fullblown paranoia.
Yes, the rampant mania we're all witnessing under the cover of August "dog-days" does appear to me to be a misanthropic Hobbesian Leviathan on steroids and the farthest side of sanity. But that is hardly the beginning or the end of it. Be ready.
We do well to remember that America has had more than our fair share of lunacy hovering around the endeavors of our better angels. If you can find a history textbook not distorted, tainted and/or sanitized by the Texas Board of Education and other hard-rightists, you'll find the stories of legions of the disaffected and heavy-hearted arriving here from our first moments on. Dissidents, malcontents, criminals (remember I live in Georgia,) religious zealots, latter-born sons powerless in the face of primogenitor and just plain folks desperate enough to try to start all over.
European diseases had emptied much of the continent of earlier peoples; slavery dulled the entire culture to exploitation; we became expert at xenophobia; flourished by taking what we wanted from those who could not defend themselves -- most workers, all women, too many children -- until the Labor and Progressive movements, one mighty persuasive Depression and a long climb out of its depths and into world war effected changes that opened the way for a genuine middle class.
Alas, reactionaries know how potent demonizing The Other is so they created one. Senator Joseph McCarthy and the Dulles brothers delivered on the fear by the bucket-full and an exhausted, distracted post-war America bought it. Whatever your opinion of the Cold War, one thing is indisputable -- it was astronomically profitable to those Eisenhower clearly warned us about.
It took a while for the reactionaries' waterboy from Wisconsin and his terror tactics to be shamed, but even when McCarthy was held modestly accountable, the Senate vote to censure him was opposed by 22 -- TWENTY-TWO -- Senators, Republicans each and all. It is now abundantly well documented how this first "Joe" is the spiritual wet nurse to a certain confused plumber who shares the name, and a snarly host of others including the sycophant Joe who shills for America's second-favorite stimulant on weekday mornings (along with our most-favored drug: adrenalin.) Not coincidentally, numbers for all of them grow along with profits for the entire anti-health industry that continues to buy political favors, indifferent to party labels. Heavily funded "astroturf" groups add to the noise, confusion, disinformation and distortions.
This dark, stark and,yes, sinister 300 years of baggage rebounds every time those of us vested by our Founders with sovereignty let down our guard. We woke up long enough to get Obama to the White House, but that was the beginning, not the end. In spite of the painful current reality foisted on us by out-of-control pseudo-free-marketeers, we're still in the deadly grip of profit-über alles. Shame on us.
It's hardly news that a well-oiled machine is intensely focused on derailing long overdue reforms to our deeply flawed delivery system, a bloated monstrosity that administers over-priced, under-performing services. OF COURSE the "town halls" we are seeing covered by media outlets as if they were genuine news events are fake, the false-fears shouted manufactured.
However, the deluded individuals who've swallowed whole the lies are real enough. The same arrogance and abuse that is now loosed into the public policy sphere is now countenanced in even the most ordinary day-to-day exchanges.
The Republicans' decades-long and shocking destruction of a civil and civic society leaves us with challenges at every turn. Democrats' complicity is one of those challenges.
Challenges, yes. Intractable, no. Hard? You bet. Worth the effort? Absolutely.
To paraphrase the exemplary Bo Lozoff, if we're going to make the drastic changes that decency and democracy require, it will take practice. So in addition to being a "regular" in my Senators' and Representative's in-boxes, voice-mail and offices, I'm taking my own advice to heart in even the little stuff. Example one:
Yesterday afternoon, I returned to my office to a curt, booming and unfamiliar voice, a message from "Dr. Somebody Something". He demanded that I call back. Immediately. Now we gets lots of calls for companies with names similar to ours, so the mistake was no surprise, but his tone was.
Hey, I'm nice. I called back to tell him he'd reached the wrong number. (OK, the devil made me do what came next.) When he answered, I asked for him by name, dropping the "Dr." part. He shot back 'DR. Somebody!' Then he continued, "Who are you? Who are you with?? And what took you so long to return my call???" As politely as I could manage, I repeated, "I believe you have called the wrong number, sir ... who are YOU and who are YOU with?"
Now he shouted at me, "I AM DR. SOMEBODY and I am CEO of SOMEBODY, INC!" I graciously matched him rank-for-rank. I said, again, that I was extending to him a courtesy in returning his erroneous call, and even managed to laugh at the absurdity of it all as he hurtled the best insult he could manage -- he was taking me off his list! -- and slammed down his phone.
I did not "win." But I did feel I'd made my mark for civility. 'Sides. He WAS a "doctor."
This is not how people in a civil -- as in "civilized" and "civilization" -- society govern themselves. It's also not how decent human beings should talk to each other. This IS how the schoolyard bully gets away with abuse. This is how the Aetnas and erroneous collection agencies and the Rush -- Gingrichs prevail. They corrode the private square as surely as they are doing in the public one, advancing the predation of their masters.
We must resist the provocations from Big Insurance and small-time hustlers (including now the arriviste Palin ... trust me, it's the money). We must confront and defeat them, and there's no better or more necessary place than our failed health delivery system.
In the meantime, raw wounds will take healing. It's past time to take back the conversation, on every level, starting with making sure we GET a major overhaul of our health delivery would-be system. And it can happen. That requires immediate attention from us each and all, everyday people choosing to turning down the volume, telling each other the truth, calling people out when the occasions arise, pointing out errors or, as now, lies.
Example number two from my own life. My cousins and I cover a broad political spectrum and several generations. That insures, shall we say, some lively exchanges. AND, across our differences, we quite simply love each other. Over the years, we've actually built some trust. And I dare say, we've learned from each other.
A couple days ago, one cousin forwarded a scorching piece from a garbage-monger intent on denying us all the right to well-being and reform of today's sorry excuse for a system addressing pressing economics and very real heath needs -- getting between me and wellness. I give my cousin credit. His subject line was "????" Another cousin, generally slow to take political bait, is deeply knowledgeable about the entire medical system, from the inside, and she took a very real chance. I could almost hear her inhaling as she took the time to carefully examine the lies and misrepresentions, then offer reasoned, fact-based views in their place.
She carefully demonstrated how and where the misrepresentations and distortions -- and lies -- are costing us. She subject line? "I don't want to start an argument, but..." and she gave us all a chance to learn. Here are excerpts. The page numbers refer to pages of A DRAFT version of the partial reform of our pseudo-system, followed by Republican former Florida Governor "Bob" Martinez's selective perversion of reality. Then my cousin's reality check:
Page 280:
(Martinez) Hospitals will be penalized for what the government deems
preventable re-admissions.
This is already the case with all medicare and private insurance patients now. It protects patients from being kicked out of the hospital because the insurance company or medicare has decreed the number of days for their diagnosis have passed.
Page 298:
(Martinez) Doctors: if you treat a patient during an initial admission
that results in a readmission, you will be penalized by the government.
Same as above. If the doctor is just tired of you or is not making enough money on you he can decide you are ready for discharge. This prevents that. This is an excellent idea and worth the whole bill being passed.
Page 317:
(Martinez) Doctors: you are now prohibited from owning and investing in
health care companies!
Wow. About time. I love it. Doctors really milk the system with this one. I have seen it to many times. Do you want to go to a hospital or nursing home the doctor actually owns? I don't.
Page 318:
(Martinez)
Prohibition on hospital expansion. Hospitals cannot expand
without government approval.
This is now called "certificate of need". It very effectively keeps hospitals from over building. There is absolutely no need for a hospital to spend millions of dollars adding beds that are not needed. You and I would pay for that when we go to the hospital and they have big unnecessary building costs. Again I like this one and always have. Hospitals always want the biggest most expensive equipment even if it is already available in the community. Duplication can be avoided and millions of our dollars saved.
Page 321:
(Martinez) Hospital expansion hinges on "community" input: in other
words, yet another payoff for ACORN.
This does not just apply to ACORN - everyone has input. I have even entered comments when hearings were held on hospital expansion. Hospitals would all move to the rich part of town and leave the middle class and poor and small communities without hospitals, if they could. Everyone working in a hospital would prefer their hospital to be in a nice, rich suburb. Is that where you want all the hospitals? Do you want a hospital in a small town near you or do you want them all in the State Capitol?
Page 335: Government mandates establishment of outcome-based measures:
i.e., rationing.
The VA system bases all their care on outcome based measures. When Vioxx was pulled from the market, it was because the VA system was measuring the outcomes of patients taking this medicine for arthritis. They discovered that not only did the patients have no better outcomes than with Tylenol but that a large portion of them were having Heart Attacks. This outcome based measure saved millions of Americans from taking Vioxx and having heart attacks. All use of chemo therapy drugs is based on outcomes. If one drug is successful and has good outcomes cancer centers tell other cancer centers the outcomes are good. Please do not treat me with a drug or procedure that does not have outcome based evidence behind it.
Page 341:
(Martinez) Government has authority to disqualify Medicare Advantage
Plans, HMOs, etc.
Yea! finally. Some of those guys are crooks and worse.
My cousin's closing comment: "I do not need a Republican, Ex Governor of Florida to translate Health Care for me. He is just simply wrong on some points and lying on others. He covers every 'talking point' given him by the Republicans and the Insurance Lobby. The tactics they are using to scare people, especially the elderly, are a crime."
Now, there was no predicting what any one of the family would say in response, but what came back from the creator of "????" was particularly telling. "THAT's what I needed to know. Thanks! Although it seems we veterans are being used as guinea pigs. Expendable, you know ...."
When the admirable Senator Barbara Boxer was our guest years back, she reminded me that the ship of state is big and bulky and hard to steer. It will take longer than we'd like to get us back on course, especially considering the calamitous eight years we've just endured.
Senator Boxer's doing her part in the Senate -- championing health care industry reform and more -- and inspiring me to do mine. A good way to begin is by not rolling over to bullies, liars and scoundrels as we've been doing since Joe McCarthy, Dick Nixon, then Ronald Reagan and two Bushes insinuated and cheated their way to power.
We can do no less than to get out there and push back if we are to begin to get the kind of health services we've been denied while insurance and HMO executives have taken home disgracefully bloated paychecks.
What we'll get this time is far from perfect. But it IS a huge step in the right direction; it is a start. And given what the "free-market" insurance industry and ancillary bottom feeders have done to us, right now, any measures that genuinely begin to correct today's rotten system head us in the right direction. Support it we must. Now. There's no time to lose if we EVER are to move back from the ethical, economic and human precipice created by the current predatory delivery system.
The status quo? In the incomparable Lawrence Kasden's words, immortalized by Danny Glover in Silverado, "That ain't right."
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