Way Over Yonder

It seems to me that part of what makes health care issues so inflammatory is that they shine an intense light on the difference between those with an embed of care for others (sometimes "empathy") and those with "the rules don't apply to me" and "I've got mine, Jack" as their credo. (Interestingly, the latter can remarkably often be rorshached'd quite reliably based on their apparent graduate certification in both entitlement and victimhood.)

It's probably hard to get up much enthusiasm for the dishonest and distorted fear-inducing mock image of health care reform being touted by the bobbleheads who dominate the airwaves for the latter group. Conversely, it's hard to imagine a person with genuine care for actual people outside their immediate sphere (or, say, someone truly "different" from their circle) being less than enthusiastic about the idea of expanded health insurance coverage and an aggressive program of reform to hopefully allow the US to begin to move in the direction of an enlightened first-world country.

We have ever so far to go.

This Digby post touches on a critical aspect of this:

I heard Ashton Kutcher on Bill Maher launch into a diatribe that I've been hearing a lot recently. Here's David Horowitz describing it:

Kutcher put forth sensible views and engaging, informed opinions on the issue of health care which brought some consensus to the table.

Discussing the issue of a greater need for an emphasis on promoting wellness instead of just treating sickness, Kutcher expressed a view on socialized medicine that hasn’t been discussed as much as it should:

“Frankly, I don’t want to pay for the guy who’s getting a triple-bypass because he’s eating fast food all day and deep-fried snickers bars. I don’t want to pay for him! Whether he’s wealthy or he’s not!”

He’s right. Should the taxpayer have to pay for other people’s unhealthiness? Should the taxpayer pay for the guy who smokes four packs of cigarettes a day and then gets emphysema?

This isn't confined to to the far right and arrogantly fatuous celebrities. I was asked the same thing at Drinking Liberally by someone who felt the same way.

Here's how the freepers put it, as only they can:

It’s not just fat people and smokers - promiscuous gays with AIDS, promiscuous heterosexuals with STDs, drunks injured in car crashes,...the list goes on & on.

-clip-

We all know that our grandparents visited a doctor only a few times in their whole lives. Allowing the government to take control will send us all down a path where a medtech behind a bullet-proof glass with dictate who is or is not served by the last living doctor in each socialist locality.

-clip-

Evidently, these people all believe that if you get sick you either did something to deserve it, in which case you also deserve to go bankrupt even if you have insurance -- or, if you are a "good" person, perhaps you can be taken care of by charities, at least until they "push" you out. On their planet, there are no insurance companies denying care to people, no decent hard working Americans losing everything they have to a health crisis, nobody tied to a job they hate because they won't be able to get insurance if they leave, no CEOs making sickening profits while people suffer, no health care inflation making it impossible for businesses to compete. On their planet it cannot happen to them.

-clip-

I am not the type of person to wish that someone would get sick and lose everything they have, but if I were, these are people I would wish it on. It's a hateful thing to say, but these are hateful people and I'm not going to pretend they aren't just to be politically correct. Watch the fevered looks on their faces, high fiving and stimulated to near hysteria at the notion that they are completely self-sufficient and need not care for their fellow man. It's quite clear that they have no empathy at all and therefore must personally experience things in order to understand them. I certainly can't see much hope of rationally explaining why they themselves are likely to suffer under their own philosophy and I wouldn't even bother trying to appeal to them on grounds of being a decent human being.

I guess they think they are immortal. Clearly they believe they are superior. But contrary to this self-destructive, unenlightened worldview, many of them are going to be disabled or stricken with illness and if they are lucky they will get old and infirm. And I hate to break it to them, but every last one of these people, good or bad, fat or thin, rich or poor, is going to die someday. Being a selfish jackass won't save any of them from that fate.

And Robert Reich makes cautionary noises about taking the self-annointed insiders sounding the knell for a "public option" too seriously (I agree with Lefkoff that "American option" has a much clearer ring):

Washington, D.C. is an echo chamber in which anyone who sounds authoritative repeats the conventional authoritative wisdom about the "consensus" of inside opinion, which they've heard from someone else who sounds equally authoritative, who of course has heard it from another authoritative source. Follow the trail to its start and you often find an obscure congressional or White House staffer who has seen some half-assed poll number or briefing memo, but seeking to feel important hypes it a media personality or lobbyist who, desperate to sound authoritative, pronounces it as truth. In any other place on the planet it would be called rumor, gossip, or drivel. In our nation's capital it's called "inside information." The process would be harmless except that it creates self-fulfilling prophesies. Since most of our elected representatives would rather not stick their necks out lest they lose their heads, they tend to rush toward whatever consensus seems to be emerging -- which, of course, is based on authoritative reports about the emerging consensus.

In the last few days authoritative sources have repeatedly told me that the public option is dead, that the President won't be able to get a comprehensive health care bill, and that the White House and congressional leadership already know the best they'll be able to do now is move incrementally -- starting with insurance reforms such as barring insurers from using someone's preexisting health conditions to deny coverage -- with the hope of more reforms in the years ahead. The rightwing media fearmongers and demagogues have won. Don't believe it. The other thing about Washington is how quickly conventional authoritative wisdom changes, especially when the public is still in flux over some large matter. Rightwing fearmongers and demagogues thrive only to the extent the mainstream media believes they're thriving. Although polls continue to show that while most Americans like the health care they're getting, they also dislike their insurance companies, worry that they or their families will be denied coverage, and are anxious about the increasing co-payments, deductibles, and premiums they're facing. Most are still eager for reform.

In addition, we've come to the point where health-care incrementalism won't work. To be sure, the health-insurance industry is powerful and will fight reforms that threaten their profits. But they won't fight if they know their profits will be restored when everyone is required to have health insurance. (This isn't just conventional authoritative wisdom; it's political fact.) Obviously, in order to require everyone to have health insurance, tens of millions of Americans will need help affording it. The only way the government can possibly pay that tab is to raise taxes on the rich while also getting long-term health-insurance costs under control. And one of the surest ways to get long-term costs under control is to force private insurers -- which in most states and under most employer-provided plans face very little competition -- to compete with a public insurance option that can use its bargaining clout with drug companies and medical providers to negotiate lower prices.

When you go through the logic, it starts to look a lot like comprehensive reform.

Years ago, as the story goes, Britain's Parliament faced a difficult choice. On the European continent drivers use the right lanes, while the English remained on the left. But tunnels and fast ferries were bringing cars and drivers back and forth ever more frequently. Liberals in Parliament thought it time to change lanes. Conservatives resisted; after all, Brits had been driving on the left since William the Conquerer's charriot. Parliament's compromise was to move from the left to right lanes -- but incrementally, on a voluntary basis. Truckers first.

Lest anyone in Washington repeat this story authoritatively, it's a joke -- but with a kernel of truth. Sometimes reform has to occur in a big way, everything or nothing, if it's to happen at all. That's the way it is with health care reform at this stage. Every moving piece is related to every other one. That's also why a public option is necessary.

So forget the authoritative sources. Mobilize and organize. We can get comprehensive, meaningful health care reform if we push hard enough. And we must.

High on the Hog

We're finding food - preferably made largely from local materials - an increasingly essential part of life here, nourishing us in more ways than are measurable on a strictly metabolic scale. When the conditions are right, procuring it, fixing it, and consuming it can all be pretty rewarding. Often it takes more than one imaginative soul to bring these things together.

I did not get a picture of our second pass at Beer-can Chicken tonight. Nor, for that matter, the first. But you basically know what a perfectly browned grilled chicken looks like, ehh? Moist, tender, and succulent these are. Give it a try - I'm sure the google will not let you down.

I made note of a recipe for slow-roasted tomatoes at Orangette a while back (okay, actually I think I first read of it in Molly's book). I actually dozed off before retrieving these beauties from the 200F oven after six hours or so. I went with some nice-looking Yakima-valley Romas procured from vendor at the Pike Place Market. Per Molly, a dusting of freshly-ground coriandor and sea salt and patience is all it takes.

And I have a couple pics to document the remarkable provendor in the Pacific Northwest in this unusually warm summer. Thai peppers raised to the state of red, something I would not have imagined, by co-worker gardener. I would not have had the chutzpah to put in the plant. But beans and tomatoes, now we're talking! Co-worker has far more tomatoes in his warmer location, but we are doing pretty well too. And we're are all about beans, especially in the Scarlet Runner vein. I have preserved multiple pounds already, and we feed off them at least a couple times a week as well.

And, speaking of feeding, Eric can often be counted on to be imaginative. He assembled some truly delectable "Lettuce Bundles with Grilled Beef," a variation on a Vietnamese recipe the other night for the two of us. That last part is key, as it allowed for a more generous inclusion of jalapenos and fish sauce, two not-always-fully-sanctioned ingredients otherwise.

I was inspired to try my hand at candying ginger after annoyance at price of a little box a while back. I am a big fan of ginger in any form (okay, the powder does nothing for me), and the candied sort is a special treat, wonderfully tangy and evocative of exotic places and climes and somehow stomach-soothing as well. It was a little time-consuming, but the result was quite satisfying. I don't even have to be greedy, since from what I can tell there are no other takers here! If only it were an antidote for H1N1.

Hope you are enjoying the bounty of the season as well.

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.

-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.

Glass

Our recent vacation perambulation involved a couple nights in Fort Bragg on the Northern California coast. It seems a pretty modest place, reportedly benefitting from tourists who naturally crave the scenery and find the more-famous nearby Mendocino fully booked, too precious (or pricey), or otherwise not to their liking. We were intent on Mendocino area and settled on FB because it had more accommodation choices. Fort Bragg suited me fine.

Either in the course of ambling through the limited shops in town or reviewing guidebooks, I came across a reference or two to "Glass Beach," with subtext that the prized beach glass had origins in an old landfill. When a little research suggested said beach was only a decent walk from our pied a terre via relatively new trail exploiting former rail ROW, it seemed an appropriate afternoon expedition.

Okay, it wasn't a walk to swoon over. The high crossing of creek was great, but then it was mostly sidewalks in barely-inhabited subdivision.

Anyway, this was not supposed to be a hike description. We found Glass Beach, and indeed there were folks down there scrabbling for something in the intertidal area. "Beach" seemed a bit of a misnomer, however. The site at the end of the road was very scenic for sure, featuring stacks and kelp beds. And, yes, there were a few of what might be better termed "beach-ettes." We stumbled down the steep bluff to what seemed the most promising beachette, already conspicuously being foraged by a pair of folks equipped with a little more gear (trowel, etc.) than we had even conceived of.

Sure enough, even at first glimpse glass fragments were apparent at a much higher density than I have ever seen on a beach before. I guess I am more of a hanger-on than a principle in the glass search anyway. But I do make for a good enabler for those like Marg and Mara who, while perhaps not true devotees, are avid enthusiasts for this.

But here's the thing, at least for me. While winnowing wonderfully polished glass shards out of the gravel, limited in our case to bare hands, I couldn't help but ponder the idea that I was adjacent to an indeterminate quantity of what amounted to solid waste possibly including hazardous materials. My career over the last couple decades has involved evaluating and hopefully cleaning up sites with some commonality to this tourist attraction. What is different in this case?

I know of a number of instances here in my home state where major moolah (millions) has been spent to either remove similar waste material and place it in a properly engineered landfill or attempt to sequester the debris and waste so it does not leach and erode into the aquatic environment. I favor that approach, finding a way to limit environmental impacts of nasty chemicals. In FB they brag (so to speak) about their beach-side dumps. It turns out that we saw only the most recent sea-side landfill, circa 1940's or so - there are two older ones that apparently feed a local mini-economy involving polished-glass jewelry and who-knows-what-else.

BTW, I did scrub energenetically several times and rinsed our gleanings similarly. But the experience does leave me in a state that combines puzzled, anxious, and amused. Bemused, bewildered, and bedazzled. But hopefully not in possession of anything like dangerous waste.