Michael Steele, Can You Believe Him?

The Republicans might have gotten to the point where even my dad's old friend Nat, the most right-wing crazy, gun-toting, racist asshole I've ever met, would say: Huh? He was interviewed this morning on NPR, and he made no sense. While screaming that government shouldn't be in the business of health care, he was trying to protect Medicare. Medicare is government-run health care. Listen or read and tell me, does this make sense to you?

With Ted Kennedy dead, perhaps the Democrats might get their act together and pass health care reform just as the Civil Rights Act was passed in the wake of his brother JFK's death. Read Josh Marshall's post on talkingpointsmemo.com.

George Lakoff, the linguist who has been trying to get the Democrats to counter the language of the right, has an interesting article on how to frame health care on truthout.org.

And Just What Planet Do You Come From?

Watch Barney Frank address a "constituent" at a town hall meeting on health care.

Nothing else need be said. Just how do people end up equating Obama with Hitler?

What's Wrong with Self Policing?

What we know for sure is that we are incapable of self-policing, despite everything that the free market advocates say. Whether it's doctors, lawyers, bankers, pharmaceutical companies, or the other giants of industry, there is the tendency to hide our mistakes so that no one sues. It's called cowardice and greed. So rather than blame the trial attorneys, and the "lottery" sense of some victims of corporate neglect that they are entitled to collect damages that will launch them into another class, let's reexamine the concept of self-policing and come up with some less costly alternatives.

And remember, I'm a former trial lawyer who often refused to take cases for one reason: there were no real damages.

We need layers of regulation and enforcement, but the regulation and enforcement should be to make change systematically so that these kinds of mistakes won't happen again, not to enrich the victims or their attorneys.

I read with some trepidation this morning in the New York Times, a piece about the cervical cancer vaccine Gardasil.

Believing the literature when the vaccine came out, and understanding that the way I raised my daughter, to love her body, that she would be sexually active, I wanted her protected. Now I see that the testing of the vaccine was incomplete, because like most FDA testing, it was unsupervised corporate-backed research. It's trustworthiness is highly suspect.

So back to health care reform, we need a way to police the medical profession to lower the cost of malpractice insurance, remove incompetent doctors from practice, and encourage improvement in how medical services are delivered.

Intelligent Discussion

Finally it's hot. Finally it's summer here in the Northeast. While sitting around the pool with friends, their daughter, son-in-law (who is a doctor), and grandson (who is four and thinks he's Spiderman), we began to discuss the issue of health care reform. We all admitted that with another 50 million people to cover, there would be some additional delays, but let's face it, we are accustomed to delays already. Just this summer, it took three weeks for my mammogram to be read and reported on, a process that used to occur right there in the office with the radiologist on the day of the procedure, along with a manual breast examination. Remember when?

Not anymore and more people are without access to mammograms.

We also agreed that health care reform would not work without a real education program to get Americans to live more healthfully: obesity, diabetes, hypertension, and asthma are the worst of the chronic diseases, and to some extent, these are controllable with educational campaigns, and perhaps a jab at the fast food industry, although there was disagreement on that.

A Big Mac without cheese is 572 calories, 50% of which come from fat, 60% of which is saturated, that's the bad kind.

A Big Mac with cheese is 704 calories, almost 70% of which comes from fat.

The cost of a Big Mac is $3.57, which makes it financially affordable to too many people, while making the consequences of eating a diet of Big Macs unsustainable for the planet and for the rest of us.

So how do we get people to eat nutritionally well and affordably? Admittedly the poorest people in the country are often not compliant, having fewer resources with which to make decisions. But can any system of health care reform work without getting Americans to eat properly?

That's where the CEO of Whole Foods John Mackey comes into the argument. According to the leader of the "whole and fresh foods" movement, we don't need health care reform, we need tort reform, and need to change our way of eating.

As an attorney, I agree that we need tort reform on medical malpractice suits, too. However, in order to make it work, we need a policing system that will remove incompetent doctors, streamline medical records and track those better, and turn individual cases into opportunities to review and reform the mistakes that have caused harm.

So this afternoon we chose to disagree about the level of calamity that might be upon us, its timing, and whether we can do anything to stop it, but no one raised a voice, everyone listened, and frankly, we would be better to defy history and act like grownups about this issue.

Rick Perlstein of the Washington Post wrote a great article about just how much crazies have been a part of American political discourse.

Somehow I wish we could be ahistorical just this once before it's too late.

Goons in the Room

Whether the health care reform debate is framed by the Republicans who appear to be sending hysterical, angry people to disrupt town hall meetings being held by representatives and senators around the country, watch The Daily Show for a dose of what is happening there, or framed by the President at his civilized meeting in New Hampshire, know that the debate needs to be conducted by adults, because the issue we are facing is complex and has the potential to further erode our nation's ability to climb out of a recession.

When I cared for my ill mother, who had Medicare and supplemental insurance, my biggest complaint then was that Medicare didn't send us notification of medical bills submitted by doctors until after they were paid. Consequently, we could have prevented clear fraud. For example, my mother had stage four cancer when she was diagnosed once two vertebrae in her back broke from a tumor. She immediately made the decision that she would only submit to palliative care: radiation at the site of the tumor. She refused to see the oncologist who came to her room, not once, but twice. However, for the weeks that she was hospitalized, that oncologist was charging Medicare for services he never rendered. We didn't know for months, not until after the fraudulent bill had been paid. So one way to streamline Medicare is to allow patients to review the billing before it is paid. Patients could, as we did, find the fraud and reduce the costs.

"I'm afraid of Obama," was the call at some of the disrupted town hall meetings. I'm afraid of the steroid-injected hysteria pumped up by Fox Cable, Sarah Palin, and Rush Limbaugh. While we self-destruct, India and China are moving ahead, folks. That's where the future is, whether you like it or not.

What's Truth Got To Do With It?

Now the Republicans are sending in irate voters who are disrupting town hall health care reform meetings held by Democratic representatives. At one meeting, someone shouted: What's wrong with profits? That's what a moron asked in the Napa Valley. Too much wine perhaps?

What's wrong with profits? This is what: some things shouldn't be a profit center, because too much is at stake. Competition among insurance companies hasn't produced a lean, mean health machine. Instead it has produced a system of squeezing out the sick and making sure that only the healthy have health insurance. And the salaries. David Klein, the CEO of Excellus Blue Cross Blue Shield makes $2.73 million. It's his profit that's at stake!

Ummmm.

Remember those phony demonstrations outside of the ballot recounts in Florida after the 2000 election debacle? It sounds like these phony demonstrations at town hall meetings come from the same Republican playbook.

Now it has been revealed that insurance companies are urging their employees to write to Congress telling them not to reform health care. See the piece in talkingpointsmemo.com.

Read the email sent to employees of Excellus Blue Cross Blue Shield, explaining to them how to fill in the postcards to their Senators, also posted on talkingpointsmemo.com.

Now take out a pen and piece of paper and send your own letters to Schumer, Gillibrand, and your representative saying that the future of this country is tied to health care reform that streamlines the system, encourages healthier habits, and takes the decisionmaking away from the insurance companies and back in the hands of doctors. I sent mine last week to Peter King, who has never responded to any letter I've sent. Such a dear!

Profiteering on War and Health Care

Not everything is a market possibility, not everything should be a profit, especially war, prisons, and health care. (I would add public education to the list.) If you are a Bill Maher fan, and I am, his show Friday night was totally on point, on everything he said. Here is his column from the huffingtonpost.com, based upon the closing segment, "New Rules," where he sets out how we should be acting as a society or as individuals.

"In the U.S. today, three giant for-profit conglomerates own close to 600 hospitals and other health care facilities. They're not hospitals anymore; they're Jiffy Lubes with bedpans. America's largest hospital chain, HCA, was founded by the family of Bill Frist, who perfectly represents the Republican attitude toward health care: it's not a right, it's a racket. The more people who get sick and need medicine, the higher their profit margins. Which is why they're always pushing the Jell-O."

With a profit incentive, Republicans don't want to lose the opportunity to make a buck, even though those bucks are breaking Americans, our businesses, and our future. As Senator DeMint said, it is about making health care reform Obama's Waterloo. and as President Obama said in response, it shouldn't be political.

It is also about keeping health care as a profiteering center. Read about who is behind the racist Obama cartoon and the "patients' rights" movement, really teaparty nuts and health industry lobbyists.

Bill Moyers' Journal did a segment on decoding the talking heads on health care reform. Take a look.

Health Care Debate--Listen, Learn, and Then Press For Action

As I watched the press conference last night with my twenty-year old daughter, we marveled at how articulate and smart President Obama is, especially when we compare the spectacle of his press conference to what we suffered through rarely, albeit, with Bush, Jr. No one ever pressed Bush like Obama was pressed by reporters last night. Why is it that Bush silenced the press so and now suddenly we are asking for Obama accountability? There is an element of "truthiness" in Obama that somehow makes us feel smarter ourselves.

Being in the midst of a health care dilemma myself, I support a single-payer system with private options for those rich folks who want another level of health care. My husband and I were solicited last year, before the sky fell in, with a boutique medical plan: no insurance would be allowed, we would pay a premium to have access to a cadre of doctors immediately without waiting. We turned it down then, and I would turn it down now, too.

On one level we need to continue to fund research in medicine. The advances in cancer and heart disease are spectacular. The understanding of human fertility, genetic conditions, immune-deficient disease, well, it's inconceivable how much information has been amassed. The technology is also pretty phenomenal, too. The issue raised by this technology was well stated by Mike Dowling, the President and CEO of North Shore LIJ Health Systems, the largest health care provider on Long Island. At a luncheon several years ago for the Health and Welfare Council, Dowling described the new body scan machine that the hospital had purchased. This procedure could "see" inside the body, find blocked arteries, almost any abnormality, way beyond the PetScan, which only finds cluster of cancer cells once they reach about 1 cm. in size. The question raised by this advanced technology is: do we have the resources to treat all of the conditions such a body scan might reveal? Do we need to?

Where we haven't advanced is matching the diagnosis and treatment with the best practices. And let's not fool ourselves: most people have to wait uncomfortably long periods of time to see doctors, get a diagnosis, and begin treatment. So all of this crap about health care reform meaning rationed health care is bull. Here on Long Island, many board certified doctors don't take any insurance. You pay the doctor directly and then fight with the insurance company. If you are in an HMO, forget it. You have to go to less qualified physicians, when a more experienced doctor might provide a better outcome.

Here is a transcript of the press conference last night.

Dead in the Water--Not Quite

This afternoon President Obama engaged in "truthiness." He quoted a Republican Senator who said that if they could defeat his health care plan, Obama will be dead in the water.

Listen to Obama's comments, his first real push back on the Republican messaging that any health care reform is too expensive.

According to the President, this shouldn't be about him or about politics. But it is, because this fight is about power and money, about privatizing medical care rather than opening it up to everyone, and about the future of the Republican Party. Actually, according to me and a lot of other people, it's about the future of our economy, too.

Here is a wonderful resource--FactCheck.org-- to help wade through the propaganda that is being put out there by the lobbyists who don't want to do anything that will change the status quo. Remember these lobbyists are being paid by folks like insurance companies, for profit health care systems, and pharmaceutical companies. Notice that I didn't include the doctors, because many of them, especially the younger ones, acknowledge that the current system is unworkable and as my generation ages, will bankrupt the nation. This FactCheck.org article deconstructs two "independent" ads that make claims about the Canadian single-payer system. Beware!

It's time for Obama to do more than just set out guiding principles. It's time for a health care reform summit and for all of us to demand an end to the politics of destruction.

Post Script: Watch Lewis Black from The Daily Show on July 21 make fun of the Republicans tirades against health care reform.

Pre-Existing Condition

As we age, the thickness of everyone's medical file, whether healthy or not, increases, and inevitably most of us evolve into a "pre-existing condition," a chronic or episodic illness that makes moving from one to job to another nearly impossible without major lapses in health care coverage.

The reason: portability of health care. The new insurance, if the prospective employer offers it, or more likely, the insurance privately purchased after the 18 months of COBRA extensions end, will exclude coverage for any pre-existing condition.

That's what bankrupts most people. According to recent studies, two-thirds of all people who file for bankruptcy had health insurance at the time of the onset of the disease, but lost it either from attrition, inability to continue working through the crisis, or being fired.

So when I see this kind of crap from the GOP, I want to scream. Check out the new confusing way the GOP is describing the Democrats incremental attempt at health care reform.

Millions of dollars are being poured into the debate on health care reform. Voice your opinion, voice it more than once. Write to your legislators and insist upon real health care reform. NOW!