Kristallnacht Revisited

[The handiwork of some others committed to uncivil discourse, the burned out center of the ROTC building, University of California Berkeley, February, 1985.]

According to a letter in today's Kitsap Sun, an Alabama militiaman is calling for the smashing of Democratic windows, and obviously, some are heeding his call. I wonder if the word "Kristallnacht" means anything to these people as well as to all the people who are styling Obama and his supporters as Nazis?  Somehow, I don't think that those of us who support the new health care legislation are on the wrong side of history.--EFP

Palm's Progress

[In February, 2006, I was part of an educator's trip to China.  We visited a number of Chinese educational institutions, including a medical school, where we were introduced to this high-tech resuscitation simulator named "Medi-Man."]

Weighed in today at 185.7.  I'm pleased to report that I ran 3 miles, covering 6.55, and I caught up on my grading.
      The big news today is that 14 states, including mine, have filed suit against the federal government, charging that the new health care plan is unconstitutional.  The principal argument seems to be that the federal government cannot compel people to purchase anything from a private company, much less health insurance.  
       By extension of that logic, is it not unconstitutional for the states to compel drivers to purchase automobile insurance from private companies?   Of course, one could argue that requiring drivers to be insured serves a compelling public interest.  Uninsured drivers who have accidents drive up insurance rates for the rest of us.  But the fact of the matter is that people with no health insurance drive up health insurance rates by receiving emergency medical care they can't pay for,
       Of course, one could argue that the analogy doesn't hold because driving is a privilege and not a right.  I still remember that the Delaware state driver's manual of my youth made that point most emphatically.  I have to wonder, therefore, if the people so upset about the new legislation hold health care to be a privilege and not a right.  If so, what sort of comment would that be about America? 
        Also, I  have to wonder just what we've become when the opponents of health care reform engage in ad hominem attacks grounded in race and sexual orientation instead of the issues.  The demagogues and hate mongers have whipped their followers into a frenzy.  I keep hearing Obama and his administration called fascists and Communists both.  (The people mouthing this rhetoric don't seem to understand that these two political philosophies are antithetical.) The irony is that the Tea Baggers and Obama's other populist opponents have more in common with the mobs that helped Hitler to power than Obama and his supporters.  Yet Obama is the one we see caricatured as Hitler.  I humbly submit that either Glenn Beck or Rush Limbaugh's image would make a better caricature of Mussolini than Oama does of Hitler. 
       It's time for people to get a grip.  --EFP

Rush Rushes to Judgment

(Visiting a Chinese medical school, February, 2006)

On Sunday, I caught a few minutes of a Rush Limbaugh program being replayed from one day last week.  (I'm not sure which one.)  Demagogue and ideologue that he is, Rush was citing a passage from a Florida hospital's H1N1 contingency plan as evidence that the Obama administration's health care reforms will include "death panels."  Apparently, in the event that mass casualties overwhelm this hospital, and they lack adequate facilities and equipment to care for everyone, they plan to concentrate on those with the best chance of survival.
     The charge would be laughable, were it not for the fact that so many people seem to idolize and believe Rush.  This Florida hospital's mass casualty plan merely reflects the standard operating procedure in military and civilian emergency rooms alike.  It is called "triage."
     Battlefield aid stations routinely have to practice triage.  When they're faced with more casualties than the available doctors, corpsmen, and nurses can handle, they first help the seriously wounded people with reasonable chances of survival.  Those with little or no chance of survival wait, as do the lightly wounded.   Otherwise, two soldiers or Marines may die instead of the one who is likely to die no matter what the doctors do.  It's a tough calculus, to be sure, but it is also the only moral thing to do.
      Civilian emergency rooms usually don't have to make such tough calls, but they routinely practice triage nevertheless.   If you arrive with a minor cut requiring a few stitches, and a man with chest pains arrives a half hour after you do, guess who will be seen first?
       In all fairness, though, what really bothered Rush was a statement indicating that, if there are not enough ventilators to go around, the hospital may have to take patients with little or no chance of survival off their ventilators.   Rush, of course, sees this as a slippery slope toward "death panels."  He's wrong.  The hospital was merely positing the worst-case scenario, one that may never come to pass. But, if it should, and you were an attending physician at that hospital, would you take a chance on losing two patients instead of one? The hospital in question clearly intends to save as many people as they can, not to select people for euthanasia.  --EFP

A Postscript--Mother's Cloudy Crystal Ball

Mother was actually quite progressive.  (Just kidding.  This young entrepreneur was charging to pose for pictures at the Pike Place Market in Seattle.  I gave her $1.00.)

Apropos to today's discussion of health care reform, I can't resist sharing a bit of advice my mother once gave me.  It was the early sixties, at the latest, when my mother, who was paying bills at the time, looked up and told me that I should never be without health insurance.  Mother had "Blue Cross/Blue Shield."  She went on to tell me that "it's cheap enough and you could lose everything if you have to go into the hospital and have no health insurance."
     I should add that Mother, at the time, was a divorced single parent working as a bookkeeper for a small electronics supply firm in Wilmington, Delaware.  That firm did not subsidize her Blue Cross/Blue Shield, and she never made very much money, yet she could afford the premium to cover both of us.  How did we get from there to here?  --EFP

A Frank Exchange of Views on Health Care Reform

I couldn’t resist baiting a conservative friend earlier today. He had sent me a derogatory cartoon caricature of Obama, and I accused him in return of being a “rightwing nut job.” I trust he knows I was just kidding about that, but I also have to give him credit for sending me a better and more thoughtful response than I deserved:

Ed,
I don't think anyone believes that health care/insurance in this country doesn't need some attention. Certainly this right-wing nut job believes it does. My disagreement is with government doing it. The lefties I know absolutely reject things like tort reform, allowing insurance sales across state lines, eliminating insurance policy mandates (sex change operations, health club memberships, etc.) that increase costs, medicare/medicaid bargaining with big pharma for drug prices as foreign countries do, allowing private citizens and small business the same tax relief on insurance policies that big corporations get (pay with pre-tax dollars, not after tax dollars), and so on.
     Some of the above would require regulation, I understand that, but all would save money (the single biggest problem with health care) and none would involve a new and very expensive entitlement program.
     The biggest point of disagreement I see is between those who insist on a government program (public option) and those who want to keep health care in the private sector. I come down on the side of "private sector."
     When, I ask you, has government ever done anything efficiently?
     I could argue this for along time, but will not aggravate you with further discussion unless you wish to continue it. Blast your ideas? Not with malice in my heart, you can be sure.
Warmest regards,

      I think my friend makes some good points here. I’m one of the “lefties” who supports tort reform and eliminating unnecessary and absurd insurance policy mandates. But, at the same time, I do have a few quibbles here.
     First, like many conservatives, my friend seems to have taken it on faith that the controversial insurance mandates he mentions are widespread and indeed largely responsible for making health insurance unaffordable. I have to hand it to conservatives. They certainly seem to have gotten “on message” in blaming liberal government mandates for our economic woes.
      Other conservative friends of ours, for instance, fervently believe that the main reason for the mortgage meltdown was a government mandate requiring lenders to give mortgages to insolvent and irresponsible minorities. To the contrary, I have to believe that young Americans of all races, colors, and creeds felt entitled to houses they really couldn’t afford and were willing to gamble on ever-increasing housing values. And there was no shortage of unscrupulous private-sector lenders eager to capitalize on this housing bubble before it burst. Similarly, I have a hard time believing that the poor insurance companies have been victimized by liberal government mandates.
     Second, while I do believe that malpractice suits have driven up our health insurance costs, private-sector lawyers are largely responsible for that, not the government. And I dare say that if a surgeon mistakenly amputates your good leg instead of the gangrenous one, you will see the tort reform issue from a different point of view.
     Third, behind every argument against Obama’s public option, I can hear echoes of Reagan’s famous maxim: “Government is not the solution to our problems; government is the problem.” That maxim is more rhetorical than meaningful. Granted, the military I served in was rife with waste and malfeasance. But only the most rabid of conservative ideologues would ever consider entrusting our national defense entirely to private security firms like Black Water. (At least, I hope that’s the case.) The answer is not to give up on government; it is to insist on better oversight and accountability of government functions and officials. There are some functions that only government can muster the resources to accomplish, and providing health care for all its citizens is one of them.
     Finally, if we did give completely free reign to the insurance marketplace, would competition really bring health care costs down? Private companies exist, first and foremost, to make a profit. Meeting our needs comes second—if at all. Capitalism is Darwinian by nature, and only government can temper that impulse. --EFP

Health Care Reform: No Need for a Public Option?

Andrea and I found this solicitation today at the annual Wooden Boat Festival in Port Townsend, Washington.  (Click on the photo for a better view.)  A local shopkeeper gave us the back story:   This young cancer sufferer was a classmate of the shopkeeper's son.  She couldn't afford health insurance, and now she is battling brain cancer.  

         This young woman's plight reminded me of something Obama's critics are loathe to acknowledge:  How many young people today manage to land jobs that provide or even subsidize health insurance?  I know that our son, age 32, would be up the proverbial creek if his employer didn't provide it.  I also know that entry-level jobs with benefits are even harder to come by today than when our son got out of college ten years ago.  

          Sometimes, when I'm driving, I find myself listening to the conservative pundit Michael Medved.  I recently heard him challenge the administration's number of the uninsured.  Sorry, I don't recall Medved's exact numbers.  But Medved claimed that a large percentage of the uninsured are old enough for Medicare but are choosing not to pay the modest premiums that program requires.  Fair enough, I suppose.  But he also went on to subtract a large number of the people in the 18- to 30-year-old range--most of whom are in good health and many of whom, according to Medved, choose to spend their money in other ways.  True, the majority of these young uninsured people probably win this actuarial gamble.  But many don't, and I think we have a moral obligation to help them get the care they need.  

          Medved always starts his show by proclaiming that this is "the greatest country on God's Green earth."    If that's true, no American should have to beg for the money to pay for health care on the streets.

--EFP