Archive for category: medical

Hospital visits to health care reform.

Don't look now, but…

Since there’s not really anything to talk about, I’ll just link you to this post I wrote for Jewschool.  Wouldn’t you know it, Alan Dershowitz is back again!

An unsung benefit of reconciliation

Jessica Arons has written a fabulous piece for The Nation, explaining just how moronic the thinking behind the Stupak amendment is (and thus reminding me of how glad I am it won’t be part of the final reform bill):

No transaction in our modern society is completely free of government involvement. The food we eat costs less because of farm subsidies. Students attend private universities with the help of Pell Grants and Stafford loans. Our churches and temples can afford to operate in part because they are tax-exempt. And employers who offer health insurance do so because of tax incentives. Stupak’s reasoning, taken to its logical extreme, would mean that virtually every activity in which we engage is government funded, regardless of whether it is condoned or condemned.

As I see it, the extension of her argument is that in supporting, for example, transportation subsidies, a person makes a judgment that the good derived from the availability of public transportation outweighs the harm done by freeing up citizens’ personal money to be used for an abortion.  Thus, opposing insurance premium subsidies is a judgment that the benefits of providing people with health insurance are less important than preventing those people from having abortions.

Simultaneously opposing insurance premium subsidies on abortion grounds while also supporting other federal subsidies shows that you prioritize your own religious or social beliefs over someone else’s health.  While this isn’t a logical inconsistency, I’d say it demonstrates a severe lack of empathy and a healthy dose of self-righteousness.

But then, those are all in a day’s work for congressional opponents of health care reform.

The political obligation: constructive or not?

Are we obligated to be politically involved?  Does being a citizen of a republic impart on me an ethical obligation to vote, to be politically informed, and to communicate with others about such topics?  Certainly public awareness and discourse is improved by that kind of activity, but the question is whether it’s ethical to impose it on other people.

This is a particularly relevant question right now because of the mass political ignorance we see around issues like health care.  The BBC has a great article on this, explaining some of the psychological reasons that the Democratic strategy hasn’t worked:

If people vote against their own interests, it is not because they do not understand what is in their interest or have not yet had it properly explained to them.

They do it because they resent having their interests decided for them by politicians who think they know best.

Of course, the current reform proposals do not presume to know what’s best for every individual person.  That’s why they leave open the option of choosing where you buy your insurance plan from, something that I believe to be ultimately wrong.  I see the purpose of health care reform to be laying the stage for an eventual progression towards single-payer.

But that’s neither here nor there.  Where I disagree with the article is in what the ultimate problem is.  It’s an uninformed electorate.  In a healthy, functioning democracy, people have every right to disagree with the government, and to vote it out of office.  In fact, that’s what we did in 2006 and 2008.  Overwhelmingly, voters in this country voted out the Republican ideas that had run the country straight downhill.  And if in 2010 they want to do the same thing for Democrats, they will.  That’s how democracy functions.

Of course, it becomes more complicated, when you have a GOP propaganda machine busy undeducating everyone as fast as possible.  The equation’s different when the minority party is deliberately lying to the public about what it is they’re opposing (and why they’re doing so).  Frankly, given the Democrat’s historical and current inability to accurately and clearly explain their stances to voters, it’s even more amazing that we won so decisively in the last two elections.  People must have been really fed up.

But go back a second.  What’s the real issue here?  I argue that it’s the nature of Democrats’ stances that they can’t be easily explained.  And I don’t think that’s a bad thing.  Yes, we’re losing the message war.  That’s because economic stimulus is complicated and “five-year across-the-board spending freeze” is easy.  ”Free market” is easy and the subtleties that make it inapplicable to health care are complicated.  “Soft on terror” is easy and criminal law is complicated.

So what do we do?  Do we dumb down to face the increasingly ignorant electorate?  No.  We pass something that has tangible, immediate benefits, and we campaign on it.  Because what does the country see right now?  They see Democrats with a giant majority still not getting anything done.  If we can break that view, we’re golden.  In the political free market, political capital is allocated to whoever shows than use it to get results.

And that’s as it should be.  We can decry public ignorance all we want, but ultimately, a voter shouldn’t have to have intimate knowledge of congressional politics in order to hold an opinion.  I’m not condoning total ignorance of the way the government functions, but if we apply some kind of moral standard for what constitutes “enough” knowledge to be involved in politics, we’re setting a risky precedent.  Remember poll taxes and literacy tests?  That’s what happens when the government makes a decision on who deserves to be involved in the democratic process.

Political ignorance is a constitutionally protected right.  But that doesn’t mean we have to assume it is a necessity of the political system.  We need to be fighting two battles at once.  One, to get our legislation passed, so we have something to campaign on.  Two, an agressive information campaign in the form of TV ads and public speaking engagements.  The fact that Democrats have been completely disconnected from voters has harmed us.  We’ve seemed like aloof liberals who know nothing about the plight of ordinary people.  We need to show the public that we are the party with their interests in mind.  In other words, show people why our proposals will help them.  ”Oh, you’re having trouble getting insurance because you have a pre-existing condition?  The legislation we’re passing will prohibit that.  And you know what?  The GOP used to agree with us, but they’re voting against it now to score political points.  You can’t afford your premiums?  Let me tell you about how our legislation will help you.  And you guessed it, Republicans are against that too.”

We’re losing the information war right now, but that doesn’t mean we should dumb down.  Yes, the bill is ridiculously long.  For crying out loud, it’s federal policy.  This is not simple stuff.  Let’s not capitulate to the GOP’s dumbed-down message.  We should be speaking to voters as equals, not pretending that we’re dumb and confused like congressional Republicans are doing.  It’s stupid, degrading, and ultimately unproductive.

If the GOP wants to win elections, they’re on the right track.  If Democrats want to, we need to change course.  And we can’t pass health care without winning elections.

The dangers of euphemisms

  1. Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism.
  2. Collateral damage.
  3. The Internet Freedom Act.

What do these things actually mean?  Answers:

  1. Illegal wiretapping (courtesy of the Bush administration).
  2. Dead civilians (courtesy of just about everyone ever).
  3. For-profit bandwidth throttling (courtesy of Sen. John McCain, #1 beneficiary of telecom lobby money)

Honestly, I’m pretty pissed of at Sen. McCain.  Every time I think he’s reestablished himself as a paragon of GOP morality in an ever-more-decadent political climate, he slips up again.  Given the state of rural broadband, there are a lot of people who can get service from only one ISP, and the idea that that ISP should have the right to control what that person does and doesn’t see is just ridiculous.

Dear GOP: The only thing your insistence on absolute (there it is again) government non-interventionism does is let someone else do the intervening.  If you don’t make it illegal for someone to take away someone else’s civil liberties, rest assured that someone will find a way to do it, and to make money off it.  Healthcare.  Social Security.  Internet.

America, wake up and smell the coffee.  The people defending corporations and saying that they need protection from the big bad government are getting paid to do so.  The reality is that a culture of profit in this country is deeply entrenched.  Government regulations aren’t changing that.  We are not poised on the brink of communism, despite what John Boehner, Sarah Palin, and Rush Limbaugh would like you to think.  This country is more firmly capitalist than perhaps any other.

So now, can we make it a little more moral?  Or is that too much to ask of you right-wing GOP extremists who care about nothing but where your campaign money’s coming from?  Now, I know I’m sounding like just another left-wing nutjob, but Matt Yglesias was right when he said that Alan Grayson had broken an unspoken rule.  And Barney Frank’s comment about Grayson was just as accurate.  If the left would just stop bowing to the GOP’s attention to minute details and stick to the moral message, we’d win.  I happen to think we’re right on both fronts, so I fully support and engage in debate on financial details of Democrat’s plans, but I think that the reason we’re bogged down in that is that we’ve lost sight of the moral message.  If we worked to reframe the debate in terms of “whose political morals are in support of the people?”, we’d practically have won.  If we can talk to Americans in terms they understand about moral differences, instead of leaving that entirely to the GOP, they’d listen.  Democrats have never been good at this – Grayson is refreshing.

Let’s follow his example.  No more dodging points and hiding behind euphemisms.  The right does out of dishonesty.  The left does it out of  inaptitude.  If we both stopped, we’d have one person saying “I want to ensure that corporations continue to profit” and another saying “I want to ensure that you have money to stay healthy”.

The choice is clear.

Reflections on the college experience thus far

It’s pretty different, to say the least.  Living on my own poses some definite challenges.  I have a nasty cold, and there is no one to bring me soup or tea.  And I realized that I didn’t know where the Health Services building was.  That’s no good.  I had to go out and buy myself a thermometer and cough syrup.  I mean, in normal life, these are just things that I expect to be there.  But I guess someone had to buy them at some point.  Which is an interesting thing to think about.  At what point in your life, living on your own or with someone else, do you buy household things?  Plates, Advil, soap, etc.?  I guess I’m more self-sufficient now.

I’m swamped with work.  And that’s even after I switched out of the basic freshmen Chem class down to an introductory one that is more appropriate to my level.  I’m in a math class that’s intended more for math majors, so it’s very theoretical and proof-based.  I like it, but it’s definitely my most difficult class.

I also don’t really like having huge lecture classes.  There are so many people in them who have so many interesting things to say, but I don’t get to here most of them.  It’s a bummer.  It’s also demoralizing, and a hard thing to pay attention to first thing in the morning because of how impersonal it is.

I’m adjusting to the whole experience in some ways, but in others I think my Western-MA, small-homey-school mentality that I’ve been operating within my whole life is pretty deeply embedded in me.  And I’m okay with that.  I find myself feeling lost in such a huge place as this.  Not to say that I don’t have friends or feel comfortable around people.  I just don’t like not knowing everyone.  It’s weird that I see people I don’t recognize every day.  In my dorm, even.  I feel like if you live in the same building as people, you should know them.  It’s weird.

I’m definitely learning a lot.  I do have one class that’s a small seminar, on Talmud, which is great.  I mean, all of my classes are, but this one’s just very personal, and the other people in it are really smart and talkative.  We’re going to cover various aspects of the Talmud, including historical background and context, legality, morality, ethics, and others.

Also, I am swing dancing weekly.

It’s going to be a good four years.  Tiring, but good.

Is there a place for observers in the health care debate?

First of all, I should say that I’m a bit ashamed to call it a debate.  I’m tired of trying to include in discussion those who don’t wish to be discussed with.  And I fully support the notion of decrying them as such.  Good job, Congress.

We’re letting the policy discussion on this issue be co-opted.  I know I’ve written about this before, but it’s an issue that I continue to see additional sides to, additional angles from which to approach it.

I’ve moved past the “no cooperation” phase, but I’m feeling more and more strongly about the GOP’s essential hypocrisy: claiming to support reform and oppose the slew of Democratic plans for moral reasons, but failing to generate any serious proposal based on those so-called morals that supposedly resonate so strongly with the American public (as if a lawmaker has the right to make blanket statements about what “Americans” want).

And another thing: GOP attempts to portray this as a scientifically hasty and baseless move should be looked in the same light as climate deniers: lying.  Because they’re wrong.  If they know that (which they must), they’re lying.  If they don’t, they should, and that’s a serious enough breach that they deserve to lose their elected positions.

No one is “ramming” a health care bill through Congress.  Obama’s disengagement from the legislative process up until his speech was, I believe, responsible for how slowly the whole thing moved.  And in practical terms, we’ve been “studying” this phenomenon for half a century.  I don’t think Obama’s going to get his wish of being the last president to take up health care (although I fully intend that this should be the last time such a major overhaul is required), but he’s right that this is not a new problem.

Joe Wilson, you’ve now been formally reprimanded.  Chuck Grassley, you voted for the same thing you’re now calling “death panels”.  Michelle Bachmann, you expect us to take you seriously when you say stuff like this?  To you, Rush Limbaugh, Sarah Palin, Glenn Beck, and every other fear-mongering racist xenophobe out there: sit down.

Evan Handler is totally right.  This thing’s going to happen sooner or later.  To the Democrats: how much more time will you waste?  Let’s get something done, and, come 2010, let’s not be afraid to remind people who it was who did it.  GOP, either become advocates of progress, or stop labeling yourself as such.  Really, I have no problem with supporting a status quo in a vacuum.  It’s not like everything always has to change.  But saying that you support change while stubbornly working against it is dishonest.  You might gain some seats in 2010 for it, but does that matter?  Obama’s already been quoted as saying that he wouldn’t mind being a one-term president if that’s what it takes to get meaningful health care reform.  Democrats, this puts the ball in your court.  If you don’t sell the package well enough, then the GOP can ride in on a white horse in 2010 and 2012 and repeal whatever does pass.

It’s up to us now to prevent that from happening.  This is something that the vast majority of Americans will benefit from.  Lawmakers, don’t let your opponents shout you down about that.  They’re loud, but wrong.

And as for we the people?  The pressure can’t let up.  Every person in this country with misinformed opinions, who gets their analysis from rich white people and has never bothered looking around at the rest of society, or who stops short of condemning people like Glenn Beck for what they are is going to cost us down the road.  Economically, as we shoulder the bill for emergency room care for the illegal immigrants those people want excluded (out of some pathetic sense of patriotism even when it’s to your direct financial advantage not to exclude those people).  Diplomatically, as we lose even more credit in the eyes of the world.

And ultimately, morally.  I’m not threatening my opponents with some kind of judgment in the world to come.  But if we fail to do this, we, as a society, slip further away from our already tenuous grasp on the claim of high moral standards.  That alone is enough to make this fight worth it to me.

So, a summary of the argument.  Progressives: Health care reform is a moral imperative.  GOP: But it’s too expensive.

Seriously, guys?  Get your priorities straight.

“In a functioning civil society, people take care of each other.”  Elizabeth Smith, the 27-year old Kansas waitress who was laughed at by her Representative (Lynn Jenkins) and told to “go be a grown-up” when she told Jenkins that she’d lost her insurance and her son hadn’t seen a doctor in almost two years (receiving only ER care) because she couldn’t pay for insurance or check-ups, said it best.  Would any GOP lawmaker dare disagree with that statement directly?

And if they would, what the hell are they doing in the federal government?

The threshold of doubt

Last night, I attended the third of our mandatory class meetings.  The first was on alcohol use, the second on issues of identity and bias, and this one was on sexual assault.  Oddly enough, I had actually been looking forward to it the most, because I thought that it would be the most applicable presentation.  The first two were certainly interesting (great speakers, excellent presentations), but this one went beyond.  The featured speaker was Katie Koestner, whose story and presentation were incredible.  I’ve never seen so many people so attentive.  I don’t think I heard a word spoken out loud throughout the entire thing.

But what I really want to write about is a discussion I had afterwards.  I approached some of the event coordinators who had told us how to get involved with some peer-education programs, to ask some questions, and got involved in a discussion with another guy about the ability to criticize the actions of a victim of such abuse.  The discussion lasted a while, but where it ended up was with the concept of a threshold of doubt; a point past which we have no reliable way of asserting how we would act in a situation.  I submit that rape is over such a threshold.  None of us can predict how we would act given such an intensely demoralizing and disempowering event.

That being said, the guy I was discussing with made the very good point that if we always hold off on judgment based on a lack of certainty, we never reach any conclusions, because nothing is certain.  It’s when we make assertions without declaring or implying the proper level of uncertainty that problems happen.

The result of the conversation was the dismissal of several assumptions.  When I first heard this guy speak, I assumed him to be an angry, misinformed, and subtly sexist person who denied the role that society and masculinity play in a culture of sexual abuse.  By the end of the conversation I had realized that I was completely wrong.  This was a thoughtful person who personally knew several rape victims, and was extremely dedicated to moral and practical consistency on opinions and debates relating to this topic.

And I will venture to say that I had taught him something.  At the end, we agreed that it was important to understand the context in which one criticizes the actions of a victim of something like rape.  I had spuriously accused him of doing more damage than good by bringing it up.  He made the very good point that none of the three of us (another person was also involved in the conversation) were in a position, had a desire, or were likely to spread dangerous misinformation.  So, with this in mind, I amended my statement, and said that I wanted to make sure he understood the ways in which one must modify such speech in a public forum.  This he agreed with.

So we both left the conversation with a heightened respect for the other (he had initially accused me of getting “violent” when I raised my voice following his assertion that beating up a sexual aggressor would help solve the problem), and an increased awareness of how difficult it is to engage in meaningful debate about these issues.

This is the kind of discussion we need more of.  Not to sound self-centered, but I think we exemplified the way people should be talking about these things.  Especially because both of us had spoken to Katie after the presentation and conveyed our gratitude and interest.

Make no mistake, these issues are incredibly hard to discuss.  Emotionally, logically, and morally.  But we owe it to the past and future victims to try.

Obama's best speech yet

Tonight’s health care speech was solidly the best speech I’ve ever seen Obama deliver.  He backed the public option.  He called out the liars.  He put forward a plan.  And he did it without sacrificing bipartisianship.  He conceded tort reform, supported an individual mandate, and mentioned the people who’ve worked with Kennedy across the aisle.

The speech had exactly the right mix of stubbornness with regard to morals and understanding of GOP positions.  But he also wasn’t afraid to condemn those who don’t have any interest in reform.  People who have legitimate concerns will be heard, now, as ever.  People who don’t won’t be invited to negotiate.

To the supporters: Keep your minds open and your morals strong.

To the opposers: Bring us your concerns and we’ll work through them together.

To the naysayers: Your time is over.  Get out.

This is the bottom line.  Reform now.

Know your enemy?

I’ve just returned from a health care reform town hall meeting and rally in West Hartford, CT.  It was quite an experience.  After shouting into a megaphone for hours, holding signs, arguing with all sorts of people, and listening to peoples’ questions, I’ve learned a lot.  First of all, I’ve learned that people will try any tactic to distract you from the issues at hand.  I had people come up to me today, observing my various bits of Jew-apparel, and tell me that I should feel unsafe about the socialist direction the country was headed in, because socialism would lead to Naziism, etc.  And not only that, but that therefore I should be “pro-Israel” (a phrase I DESPISE), as it would be my last refuge when this country went down the tubes.  I say, when your last refuge is an introverted, outwardly violent, and discriminatory establishment, something is seriously wrong somewhere.

But I digress.

Sort of.

Because during that conversation, in which the gentleman I was discussing with said that we need to “break radical Islam”, he said something else that struck me: “You need to know who your enemies are.”  I responded by saying, “Sir, I don’t have enemies.  I have differences”.  But I’m not so sure that’s true.  In a way, my constant obsession with dialogue and discourse has blinded me to some important realities:

  • The GOP, as a party, does not support health care reform.

The GOP is not interested in compromise.  They want to kill this bill (as many protesters today chanted) as a political tactic.  Now, I know this is nothing new in terms of political wrangling, but to pose as having legitimate opinions on reform is just deceitful.  Make no mistake: the GOP opposes reform.

  • The GOP relies on misinformation and fear to keep its constituents behind it.

Today, I saw a lot of smart, educated people, who were very afraid.  I saw children younger than my youngest sister screaming hateful slogans.  What is it that makes these people want to live like this?  It’s the media’s willingness to pander to make money, and the GOP’s disgusting willingness to capitalize off of that.  Spreading fear of socialism is not constructive.  I had an entire crowd of people chanting “Get-A-Job” at me today, as I yelled through a megaphone about my MassHealth and my experiences with the system.  And when I talked to people afterwards, they said “You’re a Marxist”.  I said, “I’m not a Marxist, I believe in the free-market.  But you can’t turn peoples’ health into a profiteering racket”.  And then they said “What are you doing here?”  I was stunned.  I said “This is a free country.  All ideologies are welcome.”  The GOP should hold itself in higher esteem than to court the values of xenophobes and racists.  Being insular is not a political philosophy, it’s a moral shortcoming, and one that the GOP is exploiting for political gain.  That being true, I will call the GOP what it is: an immoral organization with no regard for real progress of any ideological flavor.  It is a self-serving organization, not one that exists for its constituents.

  • There are people who will do anything to make you feel as though your opinions don’t matter.

I was decried as a Marxist, a Communist, and (along with my Jewish friend next to me), an anti-Semite.  These are accusations meant to take away from the substance of the argument.  This is not an ideological issue.  This is not a political issue.  If you believe that everyone has a right to health, there is no more debate except on how.  But that’s not what these people are debating.  When someone stood in front of me and said “I worked for my health insurance, and they should to”, I said, “So you are calling 47 million people slackers?  Are you prepared to stand by that?”.  They said, “Well, not all of them.”  So I said, “Then what about the ones who aren’t slackers?  How many are there?”  He couldn’t answer.  When faced with the reality of the issue, that millions of people who work just as hard, if not harder, than any of us, do not have the insurances we do because of disadvantages and fundamental inequalities that they have no control over, they can say nothing.  He tried to change the topic, he fear-mongered some more about my religion.  I told him I was quite comfortable with my existence as an American Jew.  He said, “Then why do people die trying to come to this country?”  I said, “Because there is a promise.  A promise of opportunity.  And the current health care system is a fundamental betrayal of that promise.”

I don’t mean to just write about my exploits, but I am coming to realize that not being able to negotiate is not a bad thing.  When you’re facing people who don’t want to talk, people who don’t respect progress or change, when people like Senator Enzi walk away, you have to cut your losses sooner or later.  This bill is going to happen.  And if we have to do it without the naysayers, so much the better.  Anyone who has something to contribute is welcome to join.  Welcome to talk to me or any other Democrat in the entire country any time.

But if you don’t have anything constructive to say, your time is over.  Fox News may be filming you, but they’re not making the policy decisions.

I’m extending a hand.  Will you take it?

Ideas for actually getting stuff done

My last post expressed my significant frustration with the status of the “debate” over health care.  That frustration has definitely not decreased since then (it’s increased, if anything), but I have been doing a lot of thinking about what to do with it.  In other words, how should I be responding to the outrageous things that are going on?  For one, it’s useful to understand their significance.  There have always been ignorant people in this country.  They are easily ignored for most of the time.  But the right is incredibly good at harnessing those people’s ignorance by lying.  And so far, Democrats, or at least those on Capitol Hill, have been terrible at doing anything about it.  Jon Steward did an extremely good job of pointing this out last two nights ago, with a great montage of stuttering incoherent Democrats.

What they/we need is a cohesive message.  I don’t really know who should provide it.  More and more, what I’m seeing from this debate is how much of politics is about disparate interests.  The issues is of balance between elected representatives’ right to free choice and a centralized leadership.  Ultimately, it wouldn’t be right to have one body making strategic choices; that would undermine the democratic process.  So it’s an issue of individual responsibility.  Do I have confidence in every person in Congress to make honest choices based on their beliefs?  The short answer is no.  Too many of them are in the pockets of lobbyists and special interests.  That includes Democrats as well as Republicans, and not just those labeled “Blue Dog.”  Enough of these divisions.  We elect these people to have honest debates about values and concepts, and we need to require more of them.

So ultimately, this is the electorate’s problem.  Let’s debate and discuss on our own, let’s talk to our senators, let’s stay engaged.  The tactics we see now from every part of the political spectrum have arisen because Americans didn’t care, because we were content to be lied to because it sounded nice, because we were content to vilify instead of unite.

The best time to plant a tree was thirty years ago.  The second-best time is now.  Similarly, the best time for change we could believe in was at the dawn of humanity.

The second-best time is now.