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.

How Much Are You Worth?

The list of the highest paid CEOs was released last week, and guess what: your name isn't on it! Frankly, I don't believe anyone is worth $100 million a year, especially when the economy is tanking and stock values are falling. Something is wrong here, very wrong, because this obscene acquisition and concentration of wealth is robbing companies of the capital they need to reinvest in America.

Stephen Schwartzman, CEO of Blackstone Group, whose stock is down over 2%, made over $700 million last year. That's right. Who deserves that kind of money? What does that kind of money do to the psyche of an individual?

Larry Ellison from Oracle was bumped from his top position despite the fact that his salary and benefits rose to over $550 million, up from $192 million the year before. I got a $5,000 raise last year, not a $250 million raise!

The rest of the white men on the list of the highest paid come from the oil and gas industry, no surprise, in light of the price of oil and its fluctuations.

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.

Who's Buttering Your Bread?

So Sarah Palin, the mistress of the Hillbilly Right, moves back and forth between promoting end-of-life counseling and then calling the same provision in the proposed health care reform package "death panels."

She's not the only right wing fanatic to change her mind.

The Daily Show with Jon Stewart has some great footage from January 2008 when Glenn Beck, then on CNN, was complaining about how horrible the health care system was after his own bout with surgery. Of course, sixteen months later, now that he is on Fox News, we purportedly have the best health care system around. Watch the clip and wonder how these people have such chutzpah.

Come on, folks, get involved. At least write some letters to members of Congress and let's get this reform package together and started before it's too late.

Sarah Palin Just Loves Being in the Public Eye

So in April 2008, when Sarah was still governor of Alaska, she signed a law urging attorneys and doctors to engage with residents in "end of life" counseling, what she now calls "death panels." See ThinkProgress, August 13, 2009. Then she called it "Health Care Decisions" Day.

These end of life statements are so important. With my mother, she made it very clear to her family that she didn't want anything other than palliative care when she was diagnosed with stage-four cancer that had begun in her lung and eventually broke two vertebrae, and moved into her brain and pelvis. With my father, eight years later, I was his health care proxy and had to negotiate with the hospital to remove him from life support after he had a 105 degree fever, two cardiac episodes, and was clearly filled with infection from a botched operation. These should be private decisions, not made by insurance companies or doctors, but by families in consultation with their physicians.

So for Sarah Palin to "Facebook" her supporters and claim that there is nothing inconsistent in her stance, is redundant of why she resigned as governor and everything else she has said once the greedy light of celebrity stunned her into being an idiot.

Chick Flicking With My Daughter

To escape the "non-summer" of horrible weather, hysterical news, and economic woes, my twenty-year old daughter and I have made the rounds of this season's chick flicks. First it was (500) Days of Summer, which we found quirky, delightful, interesting because the guy wasn't a moron and could articulate his feelings with his friends while getting drunk and still making fools of themselves nevertheless.

And last night it was The Proposal. It was preposterous! But with a large popcorn in lieu of dinner, we had a blast. Sandra Bullock who better swear off further face lifts because according to my daughter, she is beginning to look a little like Michael Jackson, plays the worst boss, the editor-in-chief of a book publisher. Her name is Margaret, not Maggie. Ryan Reynolds plays her all-suffering assistant, whose name is Andrew Paxton. Margaret is about to be deported back to Toronto because she has allowed her visa to expire. So she proposes marriage to Andrew to save her job.

The comedy proceeds from there with a visit to the Paxton family in Alaska, and this is where I got a little annoyed, because in order for Margaret to really fall in love with Andrew, she has to find out that his family is totally and absolutely loaded with money and power that he is trying to avoid so that he can prove himself worthy on his own turf.

That was annoying, although after a few minutes of Margaret, one understood that she was indeed that shallow.

The film is about how they eventually fall in love, which isn't a spoiler, because that is the theme of all chick flicks: how to fall in love.

We laughed out loud at some of their antics. Bullock is a wonderful comedic actor, and Ryan Reynolds, whom I had never seen, held up his side of the duo.

It was a perfect way to spend a rainy summer night avoiding the teabaggers! And for the second time, I got the senior discount of $1 off the ticket price.

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.