Thursday, August 13, 2009

Nonsense Feedback Loop: A Public Whose Gullibility Should Never Again Be Underestimated

I don't doubt that some will be less than thrilled that I am still on the subject here of health care reform. Or, more specifically, the right-wing anti-American campaign that wants to be sure we fail to achieve any meaningful reform (or even any useful dialogue on the subject!). That would be reform in the sense of providing higher-quality health care to more of our fellow citizens at lower cost while no longer insisting that the highest principle in health care is lining the pockets of the filthy-rich who profit off human misery. Can you say Big Pharma and the Insurance Industry?

Why can't we at least engage in some debate about the subject rather than bury it under a propagandistic storm of totally dishonest blather and fearmongering? "Death Panels"?? Give me a break. Why not a Mushroom Cloud? The health insurance industry in this country today is far more engaged in "death panels" in the sense bandied about by that truly deranged coward/child exploiter who couldn't complete her gubernatorial term than any of the (sadly lackluster to me) bills under consideration. Many people die in this country every day due to refusal of service decisions by the very mega-corporations funding that coward and the o'liars and grassleys and limbaughs et al.

And the reality is that the relatively timid measures in the bills under consideration that relate to end-of-life decisions revolve around insurance paying for voluntary counseling with those at risk regarding death-bed decisions and the like. I.e., laying out the options in terms of medication and heroic measures and letting the patient weigh in while still in a position to do so.

Alas, the calling of fire in the theater, propaganda, and lying by those who apparently want the status quo maintained (USA: most expensive health care, least effective care, most unnecessary deaths of any "first-world" country? Health-care corporations: filthy-rich.) seems to have conned many folks. A prior post here included a squib that we should all take to heart. However much we love our country and are generous in our caring for the downtrodden and less-fortunate (while realizing that those fighting health-care reform don't shop in those stores), we are embedded in

a public whose gullibility should never again be underestimated

Alas, I will not likely be done even with this post. As long as we have lobbyists and deep-pocketed mega-corporations boosting the lying antics of these stage-struck wingbats, it seems necessary to make attempts to try and drive the dialogue, at least for those wanting to think and engage in dialogue, back onto the tracks.

Please bear with me. It's not as if I do not have other material in the wings. It's the time and access to the creative muse that are the issue. Well, and the priorities. Remind me to tell you about the fun we had combing a hazardous waste site on a beach in California. Or the agate-less Agate Beach. After you have come to your senses and realized that the "Death Panels" meem and all about it are a total crock and shared that return to reality with whoever got you twisted in the first place. We're not in the gun-carrying, violence-prone censorious school here. Free-thinking encouraged.

I'm going to link to the relatively light-hearted satire first, not wanting to end dishonestly on a light-hearted note. I have savored several of Anne Lamott's books (Operating Instructions, Bird by Bird) and have a couple others queued up (Crooked Little Heart, Traveling Mercies). Great writer with a heart of gold. This article at Salon did not get proper byline, but I have to think it is my AL:

Dear Mr. Obama,

Like many Americans, I was initially shocked upon hearing of your proposed death panels. But after a short cooling-off period, I have come around.

It troubled me at first to hear that your followers would be deciding the fate our grandparents -- i.e., who would be rescued, and who would be thrown on the death pile. Then I began to wonder if there might be some sort of rebate program for those of us whose grandparents are all dead. Since no one in my family from this generation will need to be processed, I wonder if the government might be willing to pay $100 in savings per grandparent -- sort of a variation on the "Cash for Clunkers." You and your people would make it worthwhile for us not to have random old people lying around. It goes without saying that this would only include American grandparents. My mother's father, John Wyles, died in Liverpool in 1933, and would therefore not qualify. I think we could all agree on this.

Another troubling thing: I do not know when you first began to insist that Sarah Palin's baby boy would need to appear before one of your panels, but I can tell you this, Mr. President, it is not going to fly with the American people. If you are going to try to ram the death panels through Congress, I have three words of advice: Easy does it. Certainly there are people we can all agree are of borderline value. For instance, there is this guy I know named Harold who is a total monster. Everyone hates him. No matter how friendly we are to him, he never returns our greetings, but instead gives us the stink-eye, and a sneer. It is hard for me to believe that even Jesus would argue on his behalf at one of your panels. But the little Palin baby? No way, no how.

There would need to be a system of checks and balances so that we could all rest assured that favoritism was not a part of determining who would receive healthcare. Some people would say that if someone more closely resembled an Alturien than an American citizen, that person might be considered for the death pile. But that strikes me as being very cavalier. Life is precious, Mr. President, and just because somebody's appearance makes you think of space aliens and anal probes rather than car seats and root beer, it is no reason to throw them away, as you have proposed. Obviously, if there is going to be a lot of killing going on in your healthcare program, panels would have to be made up of people with impeccable credentials. Otherwise, this would be a real deal-breaker for a lot us. For God's sake, what if someone like Harold ends up as a judge on the panel, instead of coming before it, like the little Palin baby, or someone's perfectly good grandparents?

This death panel of yours will require people of sensitivity, fairness, efficiency and patience. And that is why I would like to volunteer to serve: I am fair, fast and fun. Mr. President, I am at your service.

Best wishes, Anne Lamott

Did you hear the one about Stephen Hawking and how he would likely be dead long ago if he had the misfortune to have been a UK citizen and hence subject to the "socialized medicine" they use to aggressively cull the population in the British Isles? Oops, never mind:

TPM has a fascinating headline today about about mistaken assumptions: on the face of it, it's just an embarrassing blunder. The editor of Investor Business Weekly speculated that the eminent scientist Steven Hawking would have been eliminated by NHS death panels had he been, erh.. British.

As embarrassing as that is, not knowing Hawking's nationality is a mere detail. The real mistake, far more ominous for its ignorance, are the mistaken assumptions flourishing in the media about "hell hole socialist countries" and "death panels."

I live in such a country (France) though I am American and I should probably go ahead and admit that I am also a citizen of the place.

I haven't blogged in here much lately because I was recently diagnosed with breast cancer and I've just (today even) gotten a letter from one of those "death" panels. Amazingly, I wasn't shaking when I got the letter. They are called Medical Councils here and they determine whether someone is eligible or not for 100 percent medical coverage provided by the state, due to a prolonged illness that is in no way the fault of the patient.

This "Council" provides an essential service that is desperately needed in the US. It makes a decision about a patient's health that does not depend upon considerations like age, income, pre-existing conditions or lifestyle. The council has only one question to answer: does the patient have an illness (or trauma) that requires long term treatment? If the answer to that question is yes, the person is immediately covered at 100 percent for the duration of the illness. the NHS functions in the same way, hence Hawking's extended care.

In every country, there is a percentage of the population that falls victim to these situations. Our consistent inability to provide sustained medical care to these people regardless of income is the main reason we are a country that spends the highest percentage of our GDP (16 %) on healthcare of any developped country while maintaining the highest unnecessary death rate among these countries.

Let's stop the hype and starting looking at the facts.


If there is a Net connection in reach I never fail to check in at Talking Points Memo at least once a day:

Jonathan Cohn, who succeeded in bring an unforced smile to the faux-grave face of Stephen Colbert the other night, brings a grim look to my own with this urgent blog about what he rightly calls "The Swiftboating of Health Reform." Everyone should read it. Right now.

Could it be that the crazies--them with their "Death Panels" and "Doctor Deaths" and government takeovers of Medicare--are winning?

What with a USA Today/Gallup poll that finds 34% of "adults" on Tuesday saying that town-hall demonstrations "have made them more sympathetic to the protesters' views; 21% say they are less sympathetic," it's big-worry time. (David Axelrod's attempt to explain away these numbers with a technical objection, cited in Susan Page's USAT piece, I don't find convincing.)

The combination of insurance lobbyist money and have-gun-will-travel thugs and shout-down artists (see Adele Stan's exposé) has pumped new enragé energy into the wacko desperados who are an apparently permanent feature of the landscape--not only in America, by the way, which distinguishes itself with the demonization of health care rights, but in every so-called advanced country (with respect to immigration and other hot-button numbers).

These institutions and their mobs suffer from pre-existing conditions, all right: greed and ignorance, much of it willful. The value added to national health by insurance companies is approximately nil, after all. Last time I looked, the right to cherry-pick healthy people was not one of the sanctioned prerequisites for "life, liberty, and the pursuit of happiness."

Time to pull out the stops, White House. Time for stadium rallies. Time for mass peaceable clamor. Time to flood TV with truth-telling ads. Past time.

That Cohn article is here, excerpted only but definitely worthy of full read via link:

Recently, in two separate conversations, I heard senior Democratic officials remark that they were taken aback by the right's distortions in the health care debate. My initial reaction was surprise: What did they expect? We've seen this before. But I'm coming around to their point of view.

Exhibit number one is the treatment of Eziekel Emanuel, the distinguished oncologist and bioethicist who is working on health reform at the Office of Management and Budget. In the course of his writings, which span academia and popular publications, he has argued forcefully and clearly against physician-assisted suicide. Yet somehow Emanuel finds himself accused of--wait for it--advocating physician assisted suicide.

Writing in the New York Post, Betsy McCaughey suggested that Emanuel wanted to ration care so that a "grandmother with Parkinson's or a child with cerebral palsy" couldn't get care. Soon Michelle Bachmann, Sarah Palin, and right-wing websites were piling on, calling Emanuel "Doctor Death." All of this about a man who, rather than using his considerable talents to get rich, has devoted his life to healing individuals--and improving the human condition. Oh, and did I mention his sister has cerebral palsy?

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The plan Obama and his allies support would make coverage avialable to everybody regardless of pre-existing medical conditions. It would require insurers to cover a broad range of medical servcies. And it would police insurers to make sure they didn't try to get around those requirements. No less important, the health reform measures moving through Congress have special provisions within them to help people with disabilities, like the Community Living Assistance and Services and Supports (CLASS) Act that disability community advocates support strongly.

It'd be one thing if the lunatics on the right had a coherent argument for why these initiatives might be ineffective or counterproductive. But they don't even bother to acknowledge them, preferring instead to throw out scare quotes like this one from Palin: "Who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course."

Of course, not all conservatives stoop to this level. You can have a rational, if still contentious, deate over health reform with the likes of Stuart Butler (who studies health policy at the Heritage Foundation) or Gail Wilensky (who ran Medicare for George H.W. Bush). But Butler, Wilensky, and others like them aren't driving the conversation right now. Palin, Bachmann, and their allies are.

We're stuck in what Josh Marshall has called a "nonsense feedback loop"--a conversation in which Zeke Emanuel wants to kill grandma, health care reform is bad for the people who can't get health care, and Stephen Hawking has been snuffed out by the British National Health System. Instead of arguments that are unrelated to reality, we're getting arguments that are the very opposite of reality.

Like I said, maybe those Democratic officials are right. Maybe this really is worse than what we've seen before.

And, just on the pragmatics, if we have to settle for somewhat of a sleazeball with zero progressive cachet and a reputation for being the definitive asshole in terms of personality on the WH staff why is it that Grassley has not been found in flagrante delicto yet? Rahm, please come to the front desk:

I've said this before: It's getting past time for President Obama to spell out specifics about which healthcare reform plan he supports, given the five House and Senate bills and umpteen other proposals circling Washington. And unfortunately for Obama's dreams of bipartisanism, it's way past time for him to give up his hopes that he can bring "sensible" Republicans on board with a smart, fair bill.

I've suspected that was true for a while, but today is the day to, well, pull the plug on that project. Unbelievably, one GOP senator who's been held up as a paragon of reason and bipartisan comity, Iowa's Chuck Grassley -- one of three Republicans negotiating with three Democrats on the Senate Finance Committee -- trashed Obama's plan today in terms that went beyond Sarah Palin's ignorant rant. (I debated Tony Blankley about this on "Hardball"; video at the end of this post.)

"There is some fear because in the House bill, there is counseling for end-of-life," Grassley told a town hall crowd. "And from that standpoint, you have every right to fear. You shouldn't have counseling at the end of life. You ought to have counseling 20 years before you're going to die. You ought to plan these things out. And I don't have any problem with things like living wills. But they ought to be done within the family. We should not have a government program that determines if you're going to pull the plug on grandma."

"You have every right to fear." What a statesman! Where to start? There are at least five different healthcare reform bills vying for support, and their many provisions can be confusing, but there is not one sentence in any of the five that mandates either "death panels" or "pulling the plug on grandma" -- and Chuck Grassley knows that much much better than I do.

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I never cease to amaze myself by my naiveté and unwarranted optimism. I think it's time for Obama to use his political capital to whip the Democrats, including the nippy, yippy selfish and untested Blue Dogs, into shape. If he compromises with the likes of Chuck Grassley after Grassley betrayed him, he can give up the rest of his agenda -- and maybe even a second term. But I trust Obama to know that he's been punked by Grassley, and to act accordingly.

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