Our American Freakshow
In recognition of the death of Ted Kennedy, an omnibus post on health care, a key TK topic, seemed appropriate.
I have run across several calls for the docs to get into this scrum recently. I recall something from the AMA a while back, op/ed or otherwise as I vaguely recall in loosy-goosey terms supporting health care reform. But it is interesting that this seemingly powerful faction has not been more conspicuous. Of course they do not have the organization and sheer greed of the corporations to work off, being somewhat hampered by that olde Hippocratic Oath and a pledge to care for patients (and, presumably, in the majority of cases an actual internal caring motive at a very high level was probably key to their enduring med school and associated trials).
In that light, I enjoyed this at TPM:
From a longtime reader ...
I participated in a Doctors for America phone call tonight with the White House. Me and 2600 of my brethren listened to pretty low-level pablum from the speakers. The questions asked by those lucky enough to be chosen were also standard practitioner issues including reimbursement by the SGR and malpractice. At the end of the call, I was incredibly disappointed. Many have mentioned that doctors seem silent in this debate. I have been trying to figure out why and think I have an inkling. I think doctors, like everyone else, don't really know how their lives/practices will change with reform.
Every time the President says that Americans can keep their current insurance, every doctor shudders. Doctors, as a group, hate no one more than insurance companies. I went to an ACC lobbying session a few years ago where Frankie Luntz spoke. When he asked the room to identify the biggest problem in their practice, insurance company interactions were, by far, the number one offender. Remember our daily lives: every insurance company requires that we are certified with them, every company has a different form to use, every company says no to our initial request. Hospitals rarely collect more than 40 cents on the dollar billed. THEY DRIVE US CRAZY. So, why not enlist us in the cause?
There are many examples of low-hanging fruit: a universal billing form, available for electronic submission to cut down on paper work and administration costs; a penalty for a claim incorrectly rejected (say a 20% penalty paid by the company when their mistake causes the office or hospital to go back and forth); formation of a public-option malpractice insurance company to lower insurance premiums (participation may require use of electronic records or other public good); standardization of electronic medical record keeping so that all systems can read the others data; reimbursement for adoption of an EMR, etc. He needs to show us why reform will improve our working lives as well as our patients lives. If he did that, there would be no louder advocates.
And Henry Giroux has a thoughtful and provoking piece at Truthout:
The bitter debate that is unfolding over Obama's health care plan has garnered a great deal of media attention. The images are both familiar and disturbing - members of Congress are shouted down, taunted, hanged in effigy and, in some instances, received death threats. In some cases, mob scenes have produced violence and resulted in a number of arrests. Increasingly, people are showing up with guns at these meetings, revealing an intimate connection between an embrace of violence, politics and an unbridled hatred of both the public sphere and the conditions for real exchange, debate and dialogue over important social issues. Rowdy crowds, many of whom read from talking points made available to them by right-wing groups and legitimated by conservative television pundits, support a politics reminiscent of the proto-fascists movements and militia associated with authoritarian parties in the 1930s and 1970s, which often used them to disrupt oppositional meetings, beat up opponents and intimidate those individuals and groups that criticized right-wing ideologies. This is not meant to suggest that all of the protesters at these meetings are members of extremists groups as much as it is to reveal the deep historical affinity such mob tactics have with dangerous authoritarian tendencies - an ironic twist given that their invective of choice is to compare Obama with Hitler. Many of these fringe groups "leaping around the margins of American society," [1] are irresponsibly sanctioned by both politicians such as Republican Sen. Tom Coburn and right-wing television hosts such as Glenn Beck, Bill O'Reilly and Sean Hannity. [2] The United States is neither Nazi Germany, fascist Italy, nor does it bear a resemblance to Pinchot's Chile. What is important to recognize in light of these violent tendencies in the culture is Hannah Arendt's prescient warning that elements of totalitarianism continue to be with us and that rather than relegated to the dustbin of history, the "still existing elements of totalitarianism would be more likely to crystallize into new forms." [3] These tendencies have been around for the last 20 years in the form of militarism, religious fundamentalism, a rabid economic Darwinism and a growing violence against the poor, immigrants, dissenters, and others marginalized because of their age, gender, race, ethnicity, politics and color. What is new under the Obama regime is that the often hidden alliance between corporate power and the forces of extremism are now both celebrated and highly visible in the culture. What is new is that the production of violence and the organized attempts to undermine the most basic principles of democracy are now embraced, if not showcased, as a register of patriotism and then offered up as a spectacle in much of the mainstream media. Under such circumstances, politics is emptied of any substance as citizens are urged to participate in the public sphere by shutting it down - screaming inane slogans in order to cancel out the very process of political participation. Shaming and silencing those who are at odds with right-wing and corporate power and its orthodox and increasing reactionary views of the world has now become a national pastime, or as the fatuous Glenn Beck would claim, just common sense.
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Meanwhile, one seeking insight on how this at-best zany and quaint freakshow being hosted and sponsored by the republican establishment and their pet media and corporate masters is playing out elsewhere might start here:
When we Europeans – the British included – contemplate the battles President Obama must fight to reform the US health system, our first response tends to be disbelief. How can it be that so obvious a social good as universal health insurance, so humane a solution to common vulnerability, is not sewn deep into the fabric of the United States? How can one of the biggest, richest and most advanced countries in the world tolerate a situation where, at any one time, one in six of the population has to pay for their treatment item by item, or resort to hospital casualty wards?
The second response, as automatic as the first, is to blame heartless and ignorant Republicans. To Europeans, a universal health system is so basic to a civilised society that only the loony right could possibly oppose it: the people who cling to their guns, picket abortion clinics (when they are not trying to shoot the abortionists) and block funding for birth control in the third world. All right, we are saying to ourselves, there are Americans who think like this, but they are out on an ideological limb.
If only this were true. The reason why Obama is finding health reform such a struggle – even though it was central to his election platform – is not because an extreme wing of the Republican Party, mobilised by media shock-jocks, is foaming at the mouth, or because Republicans have more money than Democrats to buy lobbying and advertising power. Nor is it only because so many influential groups, from insurance companies through doctors, have lucrative interests to defend – although this is a big part of it.
It is because very many Americans simply do not agree that it is a good idea. And they include not only mainstream Republicans, but Democrats, too. Indeed, Obama's chief problem in seeking to extend health cover to most Americans is not Republican opposition: he thrashed John McCain to win his presidential mandate; he has majorities in both Houses of Congress. If Democrats were solidly behind reform, victory would already be his.
The unpalatable fact for Europeans who incline to think that Americans are just like us is that Democrats are not solidly behind Obama on this issue. Even many in the party's mainstream must be wooed, cajoled and even – yes – frightened, if they are ever going to agree to change the status quo. Universal healthcare is an article of faith in the US only at what mainstream America would regard as the bleeding- heart liberal end of the spectrum.
-clip-
The point is that, when on "normal", the needle of the US barometer is not only quite a way to the political right of where it would be in Europe, but showing a very different atmospheric level, too. For there is a mean and merciless streak in mainstream US attitudes, which tolerates much more in the way of inequality, deprivation and suffering than is acceptable here, while incorporating a large and often sanctimonious quotient of blame.
This transatlantic difference goes far beyond the healthcare debate. Consider the give-no-quarter statements out of the US on the release of the Lockerbie bomber – or the continued application of the death penalty, or the fact that excessive violence is far more common a cause for censorship of US films in Europe than sex. Or even, in documents emerging from the CIA, a different tolerance threshold where torture and terrorism are concerned.
Some put the divergence down to the ideological rigidity that led Puritans and others to flee to America in the first place; others to the ruthless struggle for survival that marked the early settlement years and the conquest of the West. Still others see it as the price the US pays for its material success. What it means, though, is that if and when Obama gets some form of health reform through, it will reflect America's fears quite as much as its promise. And it is unlikely to be a national service that looks anything like ours.
I have run across several calls for the docs to get into this scrum recently. I recall something from the AMA a while back, op/ed or otherwise as I vaguely recall in loosy-goosey terms supporting health care reform. But it is interesting that this seemingly powerful faction has not been more conspicuous. Of course they do not have the organization and sheer greed of the corporations to work off, being somewhat hampered by that olde Hippocratic Oath and a pledge to care for patients (and, presumably, in the majority of cases an actual internal caring motive at a very high level was probably key to their enduring med school and associated trials).
In that light, I enjoyed this at TPM:
From a longtime reader ...
I participated in a Doctors for America phone call tonight with the White House. Me and 2600 of my brethren listened to pretty low-level pablum from the speakers. The questions asked by those lucky enough to be chosen were also standard practitioner issues including reimbursement by the SGR and malpractice. At the end of the call, I was incredibly disappointed. Many have mentioned that doctors seem silent in this debate. I have been trying to figure out why and think I have an inkling. I think doctors, like everyone else, don't really know how their lives/practices will change with reform.
Every time the President says that Americans can keep their current insurance, every doctor shudders. Doctors, as a group, hate no one more than insurance companies. I went to an ACC lobbying session a few years ago where Frankie Luntz spoke. When he asked the room to identify the biggest problem in their practice, insurance company interactions were, by far, the number one offender. Remember our daily lives: every insurance company requires that we are certified with them, every company has a different form to use, every company says no to our initial request. Hospitals rarely collect more than 40 cents on the dollar billed. THEY DRIVE US CRAZY. So, why not enlist us in the cause?
There are many examples of low-hanging fruit: a universal billing form, available for electronic submission to cut down on paper work and administration costs; a penalty for a claim incorrectly rejected (say a 20% penalty paid by the company when their mistake causes the office or hospital to go back and forth); formation of a public-option malpractice insurance company to lower insurance premiums (participation may require use of electronic records or other public good); standardization of electronic medical record keeping so that all systems can read the others data; reimbursement for adoption of an EMR, etc. He needs to show us why reform will improve our working lives as well as our patients lives. If he did that, there would be no louder advocates.
And Henry Giroux has a thoughtful and provoking piece at Truthout:
The bitter debate that is unfolding over Obama's health care plan has garnered a great deal of media attention. The images are both familiar and disturbing - members of Congress are shouted down, taunted, hanged in effigy and, in some instances, received death threats. In some cases, mob scenes have produced violence and resulted in a number of arrests. Increasingly, people are showing up with guns at these meetings, revealing an intimate connection between an embrace of violence, politics and an unbridled hatred of both the public sphere and the conditions for real exchange, debate and dialogue over important social issues. Rowdy crowds, many of whom read from talking points made available to them by right-wing groups and legitimated by conservative television pundits, support a politics reminiscent of the proto-fascists movements and militia associated with authoritarian parties in the 1930s and 1970s, which often used them to disrupt oppositional meetings, beat up opponents and intimidate those individuals and groups that criticized right-wing ideologies. This is not meant to suggest that all of the protesters at these meetings are members of extremists groups as much as it is to reveal the deep historical affinity such mob tactics have with dangerous authoritarian tendencies - an ironic twist given that their invective of choice is to compare Obama with Hitler. Many of these fringe groups "leaping around the margins of American society," [1] are irresponsibly sanctioned by both politicians such as Republican Sen. Tom Coburn and right-wing television hosts such as Glenn Beck, Bill O'Reilly and Sean Hannity. [2] The United States is neither Nazi Germany, fascist Italy, nor does it bear a resemblance to Pinchot's Chile. What is important to recognize in light of these violent tendencies in the culture is Hannah Arendt's prescient warning that elements of totalitarianism continue to be with us and that rather than relegated to the dustbin of history, the "still existing elements of totalitarianism would be more likely to crystallize into new forms." [3] These tendencies have been around for the last 20 years in the form of militarism, religious fundamentalism, a rabid economic Darwinism and a growing violence against the poor, immigrants, dissenters, and others marginalized because of their age, gender, race, ethnicity, politics and color. What is new under the Obama regime is that the often hidden alliance between corporate power and the forces of extremism are now both celebrated and highly visible in the culture. What is new is that the production of violence and the organized attempts to undermine the most basic principles of democracy are now embraced, if not showcased, as a register of patriotism and then offered up as a spectacle in much of the mainstream media. Under such circumstances, politics is emptied of any substance as citizens are urged to participate in the public sphere by shutting it down - screaming inane slogans in order to cancel out the very process of political participation. Shaming and silencing those who are at odds with right-wing and corporate power and its orthodox and increasing reactionary views of the world has now become a national pastime, or as the fatuous Glenn Beck would claim, just common sense.
-clip-
Meanwhile, one seeking insight on how this at-best zany and quaint freakshow being hosted and sponsored by the republican establishment and their pet media and corporate masters is playing out elsewhere might start here:
When we Europeans – the British included – contemplate the battles President Obama must fight to reform the US health system, our first response tends to be disbelief. How can it be that so obvious a social good as universal health insurance, so humane a solution to common vulnerability, is not sewn deep into the fabric of the United States? How can one of the biggest, richest and most advanced countries in the world tolerate a situation where, at any one time, one in six of the population has to pay for their treatment item by item, or resort to hospital casualty wards?
The second response, as automatic as the first, is to blame heartless and ignorant Republicans. To Europeans, a universal health system is so basic to a civilised society that only the loony right could possibly oppose it: the people who cling to their guns, picket abortion clinics (when they are not trying to shoot the abortionists) and block funding for birth control in the third world. All right, we are saying to ourselves, there are Americans who think like this, but they are out on an ideological limb.
If only this were true. The reason why Obama is finding health reform such a struggle – even though it was central to his election platform – is not because an extreme wing of the Republican Party, mobilised by media shock-jocks, is foaming at the mouth, or because Republicans have more money than Democrats to buy lobbying and advertising power. Nor is it only because so many influential groups, from insurance companies through doctors, have lucrative interests to defend – although this is a big part of it.
It is because very many Americans simply do not agree that it is a good idea. And they include not only mainstream Republicans, but Democrats, too. Indeed, Obama's chief problem in seeking to extend health cover to most Americans is not Republican opposition: he thrashed John McCain to win his presidential mandate; he has majorities in both Houses of Congress. If Democrats were solidly behind reform, victory would already be his.
The unpalatable fact for Europeans who incline to think that Americans are just like us is that Democrats are not solidly behind Obama on this issue. Even many in the party's mainstream must be wooed, cajoled and even – yes – frightened, if they are ever going to agree to change the status quo. Universal healthcare is an article of faith in the US only at what mainstream America would regard as the bleeding- heart liberal end of the spectrum.
-clip-
The point is that, when on "normal", the needle of the US barometer is not only quite a way to the political right of where it would be in Europe, but showing a very different atmospheric level, too. For there is a mean and merciless streak in mainstream US attitudes, which tolerates much more in the way of inequality, deprivation and suffering than is acceptable here, while incorporating a large and often sanctimonious quotient of blame.
This transatlantic difference goes far beyond the healthcare debate. Consider the give-no-quarter statements out of the US on the release of the Lockerbie bomber – or the continued application of the death penalty, or the fact that excessive violence is far more common a cause for censorship of US films in Europe than sex. Or even, in documents emerging from the CIA, a different tolerance threshold where torture and terrorism are concerned.
Some put the divergence down to the ideological rigidity that led Puritans and others to flee to America in the first place; others to the ruthless struggle for survival that marked the early settlement years and the conquest of the West. Still others see it as the price the US pays for its material success. What it means, though, is that if and when Obama gets some form of health reform through, it will reflect America's fears quite as much as its promise. And it is unlikely to be a national service that looks anything like ours.
posted by Sir Gumbo at 9:07 PM
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