Bring it on!
If you listen to the presidential debates, you have to wonder how the party front-runners will ever find commonality to face off against one another. They don’t talk about the same America … proving Edward’s point, but that’s a later post.
The Dem’s are hot into health care — the Pub’s don’t mention it at all; it’s “socialized medicine,” doncha know. Socialism … which is what? Soviet or something? All marching in lock-step, all hushed and cowering, all desperate but stoic, dissenters punished and jailed … oh, wait — that’s us, that’s now.
Every time I hear a Republican or a news anchor tell me that America has “the best health care in the world” I flinch — for Bush’s “Have More’s” that may be true; for all the rest of us … even the well-insured … that’s a very bad joke. Moore’s Sicko tells the tale … and a trip to the doctor these days should make that more than personal.
In the last month, emergency room treatment for neighbors has required multiple trips, returning home those many miles between visits with unabated symptoms, and resulted in thousands of dollars in unnecessary testing leading to the wrong diagnosis. And that’s hardly random … it’s happening every day, and it’s painful to watch someone you care about make their way through the arduous health care system and come home with no relief, no help, no end to their emergency. [It’s really startling how everything is falling apart at the same time … really!]
McCain pushed a big Pub talking point that Jon Stewart called him on the other day — this “making insurance affordable” nonsense; for many, it isn’t and won’t be, even if you give them tax credit all the way to China. America is living on its credit cards, now that it can no longer refinance to meet the bills — and up-front money is tough to come by.
Bush is still set to try to veto child health … and his rationale should bring us all to a screeching halt: that the $100 or so public bucks it would take to see a doctor prior to a crisis is too close to “socialized,” better to take a $1000 visit to the emergency room. Mr. Compassionate Conservatism? HA! Mr. Fiscal Irresponsibility.
As I’ve said before — socialism? Bring it on! Just another myth to squash. Pure socialism never works — and obviously neither does pure capitalism. Time to get real, forget the ideological crap and consider the common good.
The first piece below is TERRIFIC … because of its myth-busting and because it’s written by the leader of the moderate Evangelical movement, himself. THOSE are the voices we need!
Excellent reads here — Krugman, Herbert, more.
Jude
My Encounter with [Insert Scary Music] … Socialized Medicine!
Jim Wallis, Sojourners
My foot had been sore for a couple of weeks and it wasn’t getting better. I usually would ignore that, but we were about to leave on a two-week vacation with my wife Joy’s parents to celebrate both of our big anniversaries (their 50th and our 10th). Then I have to fly to Singapore for the World Vision triennial conference. So I wouldn’t be back home for many weeks and my Washington, D.C., health care provider (over the phone) strongly urged me to see a doctor in London before we left.
I realized then that I was about to have my first encounter with SOCIALIZED MEDICINE!
Now it’s one thing to advocate health care reform in America and even to be politically sympathetic to the idea of a single-payer government-supported system like they have in most of the world’s developed and civilized countries (such as Canada, Germany, and Great Britain). But it was another thing to actually go to the emergency room (or ER, but in the U.K. they call it Accident and Emergency) of a hospital in the British National Health Service. After all, I had heard the horror stories—long waits in incompetent, dirty, and substandard medical facilities; bad doctors and faulty diagnoses; and, of course, incredible bureaucracies like everything in “socialist systems.” Rush Limbaugh and every other conservative pundit have warned us all in America about the horrific practices of British socialized medicine.
So I prepared myself. I brought a big novel to read, along with my eyeglasses, a bottle of water (no telling what they would not have in socialized medicine), and emotionally steeled myself for the ordeal. Ann Stevens, the Anglican vicar with whom we stay in London (she’s my son Luke’s godmother and Joy’s old pal) took me to St. George’s hospital, dropped me off at “A and E,” and wished me luck at 9 a.m. Hoping I would be home that night for dinner, I took a deep breath, walked across the street, and made my way into socialized medicine.
The waiting room was actually quite peaceful and not crowded, I noticed, as I walked up to reception. The woman at the reception desk smiled. I didn’t expect that. “Can I help you?” “Yes,” I replied, “you see, I am an American—I guess you can tell—and I’m visiting family here—my wife is British—and we’re staying with our friend the vicar, and I have a sore foot, which I normally wouldn’t worry about but we’re going away for several weeks on vacation, and I called my health care provider in the U.S., and they told me to come in here and thought I should get an X-ray or something.” (I wondered for a moment if it would help to tell them that I was a friend of the prime minister, but decided not.) “What do you need from me?” I asked hesitantly. “Just your name and address,” she replied with another smile. “Oh … Okay.” She told me it would be about 10 minutes to see the nurse. “Yeah right,” I thought to myself.
I settled into the waiting room chair, looked around at all the people who didn’t seem to be in any distress, and opened my book for a good long read. It was five minutes before the nurse called me in to a little office adjacent to the waiting area, which seemed to be an intake room. She was pleasant and professional as she asked me what was wrong, and how long I had felt the soreness. She gently examined my foot and then told me I would be called in to see a doctor in about 10 minutes. “Sure thing,” I thought. So I went back out to the waiting room and settled in again to read my novel.
It was five minutes before a young woman appeared and called my name, “Mr. Wallis?” She was a young Asian doctor named Dr. Gillian Kyei. She was also very pleasant and professional, taking time to ask me lots of questions about how I might have hurt my foot, etc. She examined the injured foot carefully, told me that it didn’t necessarily look broken, but that we should get an X-ray to make sure. I waited in her examining room for a couple of minutes while she called down to the X-ray department to say that I was on the way.
Then she came back and escorted me herself.
When I got to X-ray, I checked in by just saying my name and took a seat in the waiting area. Finally, I was going to get to read my book! But five minutes later, the technician came out to bring me in. She took her time with me, taking several different angles of my foot. When I was done, she sent me back to my young doctor, with another smile.
This time the wait was a full 10 minutes because, I later learned, Dr. Kyei was reading the results of my X-ray, which had already been sent to her computer. She showed me what looked to her like a fracture of my fourth metatarsal bone, but said she wanted to consult with the orthopedic specialist. I waited about 10 minutes more while she did that and so got a few more pages read.
Dr. Kyei then came back with the definitive diagnosis—my fourth metatarsal bone was indeed fractured. She went over their preferred treatments and my options with me. Normally, if this injury had just happened, they would put me in a cast to hold the broken bone in place and give me crutches. They were still happy to do that now. But since I had been already walking on it for over a week and the bone was still in the right place, I could also have the option to just using a therapeutic soft boot to keep the weight on my heel and off my fourth and fifth metatarsals. While the fracture was at the base of the fourth metatarsal, as she carefully explained and showed me on the X-ray, the pain was being felt lower down—across both my fourth and fifth metatarsal area. If I chose the boot, I could still swim with my kids and get around a little easier, but I would have to really try to keep my weight off the injured area. I chose the boot and she told me she would be back in a minute.
It was actually about two minutes before she got back, and I was getting nowhere with this novel. She handed me a very stylish black boot (so much better than other colors for fashion coordination), and gave me my final instructions—be very cautious about the foot, try to stay off it as much as possible but keep it mobile and flex it so the blood circulates, get another X-ray as soon as I get home and, of course, then consult with my home physician. Then she wrote me a nice long letter for my home doctor, describing their diagnosis and treatment. Dr. Gillian Kyei then wished me the best of luck, hoped I would have a great vacation despite my foot, smiled, and sent me back to the front desk.
“How can I call a cab?” I asked. “Oh, I’ll do that for you,” she said. “Just take a seat over their and the cab will be here in about 10 minutes.” As I sat there, I realized something. Nobody had ever asked me to pay. Everything was FREE, including my nice new boot. How about that? They think health care is a right for all citizens, and even foreign visitors like me. Amazing.
The cab came in five minutes. I thought I would tell him some horror stories about my experiences in the American health care system, but decided not to. I was back at Ann’s in just over an hour from when I left—with my letter, my boot, and my tale of smiling, pleasant, and efficient health care workers. And somehow I began to believe that back in America we weren’t being given the whole truth. And guess what? Ann tells me that David Beckham and Wayne Rooney, the biggest British soccer (football) stars, have had metatarsal bone fractures, just like mine. In about six weeks, I too will be back on the field, thanks to socialized medicine! And in the meantime, I will keep my foot up … and maybe get that novel read.
A Socialist Plot
Paul Krugman, The New York Times
Monday 27 August 2007
Suppose, for a moment, that the Heritage Foundation were to put out a press release attacking the liberal view that even children whose parents could afford to send them to private school should be entitled to free government-run education.
They’d have a point: many American families with middle-class incomes do send their kids to school at public expense, so taxpayers without school-age children subsidize families that do. And the effect is to displace the private sector: if public schools weren’t available, many families would pay for private schools instead.
So let’s end this un-American system and make education what it should be - a matter of individual responsibility and private enterprise. Oh, and we shouldn’t have any government mandates that force children to get educated, either. As a Republican presidential candidate might say, the future of America’s education system lies in free-market solutions, not socialist models.
O.K., in case you’re wondering, I haven’t lost my mind, I’m drawing an analogy. The real Heritage press release, titled “The Middle-Class Welfare Kid Next Door,” is an attack on proposals to expand the State Children’s Health Insurance Program. Such an expansion, says Heritage, will “displace private insurance with government-sponsored health care coverage.”
And Rudy Giuliani’s call for “free-market solutions, not socialist models” was about health care, not education.
But thinking about how we’d react if they said the same things about education helps dispel the fog of obfuscation right-wingers use to obscure the true nature of their position on children’s health.
The truth is that there’s no difference in principle between saying that every American child is entitled to an education and saying that every American child is entitled to adequate health care. It’s just a matter of historical accident that we think of access to free K-12 education as a basic right, but consider having the government pay children’s medical bills “welfare,” with all the negative connotations that go with that term.
And conservative opposition to giving every child in this country access to health care is, in a fundamental sense, un-American.
Here’s what I mean: The great majority of Americans believe that everyone is entitled to a chance to make the most of his or her life. Even conservatives usually claim to believe that. For example, N. Gregory Mankiw, the former chairman of the Bush Council of Economic Advisers, contrasts the position of liberals, who he says believe in equality of outcomes, with that of conservatives, who he says believe that the goal of policy should be “to give everyone the same shot and not be surprised or concerned when outcomes differ wildly.”
But a child who doesn’t receive adequate health care, like a child who doesn’t receive an adequate education, doesn’t have the same shot - he or she doesn’t have the same chances in life as children who get both these things.
And insurance is crucial to receiving adequate health care. President Bush may think that lacking insurance is no problem - “I mean, people have access to health care in America. After all, you just go to an emergency room” - but the reality is that the nine million children in America who don’t have health insurance often have unmet medical or dental needs, don’t have a regular place for medical care, and frequently have to delay care because of cost.
Now, the public understands the importance of health insurance, even if Mr. Bush doesn’t. According to a recent New York Times/CBS News poll, an amazing 94 percent of the public regards the fact that many children in America lack health insurance as either a “serious” or a “very serious” problem.
So how can conservatives defend the indefensible, and oppose giving children the health care they need? By trying the old welfare queen in her Cadillac strategy (albeit without the racial innuendo that made it so effective when Reagan used it). That is, to divert public sympathy from people who really need help, they’re trying to change the subject to the supposedly undeserving recipients of government aid. Hence the emphasis on the evils of “middle-class welfare.”
Proponents of an expansion of children’s health care have, as they should, responded to this strategy with facts and figures. Congressional Budget Office estimates show that S-chip expansion would, in fact, primarily benefit those who need it most: the great majority of children receiving coverage under an expanded program would otherwise have been uninsured.
But the more fundamental response should be, so what?
We offer free education, and don’t worry about middle-class families getting benefits they don’t need, because that’s the only way to ensure that every child gets an education - and giving every child a fair chance is the American way. And we should guarantee health care to every child, for the same reason.
Holding Kids Hostage
Bob Herbert, The New York Times
8/28/07
The governors of New York and New Jersey were upset and not trying to hide it.
“We had zero forewarning,” said New Jersey’s Jon Corzine. “It was sprung at 7:30 on a Friday night in the middle of August, the time when it would draw the least fire.”
He was talking about the Bush administration’s latest effort to thwart the expansion of the popular Children’s Health Insurance Program. Governors in several states are trying to include more youngsters from the lower rungs of the middle class and have vowed to fight the president on this issue.
Acting during a Congressional recess, and making a distinct effort to stay beneath the radar of the news media, the administration enacted insidious new rules that make it much harder for states to bring additional children under the umbrella of the program, known colloquially as CHIP.
The program is popular because it works. It’s cost effective and there is wide bipartisan support for its expansion. But President Bush, locked in an ideological straitjacket, is adamant in his opposition.
In addition to the new rules drastically curtailing the ability of governors to expand local coverage by obtaining waivers from the federal government, the president has threatened a veto of Congressional efforts to fund a more robust version of the overall program.
“It’s stunning,” said New York’s Gov. Eliot Spitzer. “He says he’s going to veto health care for kids because it’s too expensive at the same time that these continuing resolutions for the war, where we don’t even know what the cost is, are going through unabated. This is insanity.
“Everybody agrees this is the right thing to do except the Bush administration.”
Health coverage for poor children is provided by Medicaid. CHIP was originally designed to cover the children of the working poor. That has worked well, but there are still huge numbers of families who need help.
“The reality,” said Governor Spitzer, “is that there is an enormous proportion of American society above the poverty level but in the lower middle class that simply can’t afford health coverage.”
Wherever there are large numbers of families without coverage, you will find children who are suffering needlessly and, in extreme cases, dying. They don’t get the preventive care or the attention to chronic illness that they should.
“That has not only an immediate effect on their development,” said Mr. Spitzer, “but a long-term cost to society that is incalculable.”
Several states, including New York and New Jersey, have used federal waivers to raise the family income ceiling for eligibility to participate in CHIP. New Jersey, for example, offers coverage to the children of families with incomes as high as 350 percent of the official poverty rate for a family of four, which is $20,650 a year. New York has an upper limit of 250 percent of the poverty rate and is trying to raise it to 400 percent.
State officials said the onerous new rules would make it all but impossible to offer coverage beyond 250 percent of the poverty level.
Administration officials have argued that the CHIP program should adhere closely to its original intent of limiting coverage to families only slightly above the official poverty line. They said there is a danger that families with higher incomes would begin substituting CHIP for private insurance coverage.
The reality is that under the administration’s approach enormous numbers of children in families without a lot of money will be left with no coverage at all, private or otherwise. The expansion of CHIP is the most efficient, cost-effective way of reaching those youngsters.
Denying CHIP to such families forces them to seek out hospital emergency rooms when medical treatment can no longer be postponed. “I see it every day,” said Governor Corzine. “If you’re uninsured, particularly with children, if you don’t have a place to go, that’s where people show up.”
What’s happening is cruel. Children who should be eligible for CHIP are being held hostage to policies driven by a desire to protect the big insurance companies and an ideology that views CHIP, correctly, as yet another important step on the road to universal health care.
Ronald Reagan, one of the tribunes in the fight against Medicare and Medicaid back in the ’60s, pumped up the warnings against “socialized medicine” by saying that if Medicare becomes a reality “you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.”
I wonder what crazy things the ideologues think would happen if CHIP is expanded to cover the children who have no health insurance today.
The Best
by digby, Hullabaloo
Patriotic Americans who insist that the United States is the highest pinnacle to which any nation can aspire, really should be shocked and embarrassed by things like this:
- An estimated 2 million babies die within their first 24 hours each year worldwide and the United States has the second worst newborn mortality rate in the developed world, according to a new report.
American babies are three times more likely to die in their first month as children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland or Norway, Save the Children researchers found.
Only Latvia, with six deaths per 1,000 live births, has a higher death rate for newborns than the United States, which is tied near the bottom of industrialized nations with Hungary, Malta, Poland and Slovakia with five deaths per 1,000 births.
“The United States has more neonatologists and neonatal intensive care beds per person than Australia, Canada and the United Kingdom, but its newborn rate is higher than any of those countries,” said the annual State of the World’s Mothers report.
[…]
Tinker said some nations ranked high in part because they offer free health services for pregnant women and babies, while the United States suffers from disparities in access to health care.
I don’t know why these Republicans aren’t embarrassed that their great country ranks lower than every developed country in the world except Latvia, but they aren’t. But then, they just lie, don’t they? Here’s your possible next president Rudy:
- America has the best medical care in the world. People come here from around the world to take advantage of our path-breaking medicine and state-of-the-art treatments.
Well, rich people do anyway, and those are the only people who count.
I guess this argument works on Republicans who don’t give a damn about anyone but themselves (most of them) and are employed. Let’s hope they don’t lose their jobs.
I’ve said this before but I really think this is something the Democrats should get into the health care debate. They need to inject a little righteous indignation that we are so lame in this — appeal to the national pride. They should say “I’m embarrassed that this great country ranks below every developed country but Latvia,” — launch a sort of JFK “man on the moon” competitive thing that challenges the country to have the kind of health care we can be proud of, where we don’t have babies dying needlessly because we don’t provide their mothers adequate access to health care.
John Edwards brought up some passion on this in one of the debates and it was very effective. He mentioned it again in his speech last week:
- A few weeks, ago I met a man named James Lowe in Wise, Virginia. James spent the first fifty years of his life without a voice — literally without a voice — because he didn’t have health care. All he needed was a simple operation to fix a cleft palate. That a man in the richest country in the world could go unable to speak for 50 years because he couldn’t pay for a $3,000 operation is something that should outrage every American. We are better than that. America is better than that.
I think that is the correct way to talk about this. It’s outrageous. We should all be embarrassed and ashamed that this happens in our country and we should insist that something be done. But I’d go even further and put this in explicitly patriotic and competitive terms.
If you love your country and believe it is the greatest in the world, you will not let it continue to be anything less than the number one nation in every metric of good health. It’s the American way to be the best.
Most of us don’t need this kind of argument and plenty of others can be persuaded by a good plan or by the sense of their own precariousness. But there are those, I believe, who are temperamentally unable to make the leap to compassion or even, “there but for the grace of god go I” self-interest, at least not openly. They just can’t do it. But this might be a way to give them a path to fundamentally changing the health care system. It’s worth a try. We really need to get this done.
“So keep fightin’ for freedom and justice, beloveds, but don’t you forget to have fun doin’ it. Lord, let your laughter ring forth. Be outrageous, ridicule the fraidy-cats, rejoice in all the oddities that freedom can produce. And when you get through kickin’ ass and celebratin’ the sheer joy of a good fight, be sure to tell those who come after how much fun it was.”
~ Molly Ivins, 1944 - 2007
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Add comment August 28th, 2007