The Broad View

The Reaper Chronicles

Every aspect of the health insurance "debate" makes me purple with rage. This morning's AP story quotes Sibelius' claim that the wretched Obama is willing to drop the public option in favor of the useless co-op nonsense.

There are no words to describe my complete disgust with Obama and the rest of the Washington Democrats. Their gutless incompetence has in all likelihood doomed real health insurance reform for another generation. Actually, a humane, civilized health care system is probably impossible in the U.S., given our hostility to doing anything to help our fellow citizens -- especially those who aren't white -- and the opposition of a loud, easily manipulated plurality of stupid Americans. Yes, there is a significant percentage of American citizens who are proudly ignorant, gullible dolts. These are the kind of people who give Democracy a bad name.

The Rabid Right's latest cri de coeur -- "Obama Death Panels" -- has been scooped up and amplified by an equally stupid and irresponsible media class. So far, Obama has been singularly ineffective in countering the hysteria. As Maureen Dowd writes in today's NYTimes:

Sarahcuda [Sarah Palin] knows, from her brush with Barry on the campaign trail, that he is vulnerable on matters that demand a visceral and muscular response rather than a logical and book-learned one.

Okay, here's a visceral response to the idiotic notion that Obama will pull the plug on Grandma. Here's the story of a real Grandma, my husband's Grandma.(All names have been changed.)

Louise had metastatic cancer. She had survived breast cancer many years earlier but now, in her eighties, the cancer had returned. One bout of chemotherapy was enough to convince her that she didn't want to spend what was left of her life enduring painful torture. I think it was the right decision. She lasted another two years and was relatively healthy until the last three or four months. The "cure" would probably have killed her far more quickly by weakening her with poison and pain. And it is those last three or four months that concern us now.

Harry, my husband's grandfather and Louise's husband, was in his mid-eighties. He was amazingly vigorous and sharp as a tack, but old age had amplified his peculiarities. He was a miser and a hoarder. And he was totally paranoid about having strangers come into his home. That, in itself, wasn't unreasonable. The elderly have good reason to feel vulnerable to strangers. As his wife's health deteriorated, however, he insisted on coping with caring for her by himself and then, when he could no longer lift her to change her soiled bedding, he enlisted his daughter Joanne's help. My husband's mother was well into her sixties and not in great shape herself.

The combination of ignorance and despair was determinative. Joanne called me one day to ask, amazingly, for my advice. She didn't know what to do, how to proceed, how to handle an increasingly untenable situation. Her stubborn, paranoid father refused to allow anyone into the house -- no nurses, no home health workers, not even Meals on Wheels.

I advised that she convince Harry that he must allow her to have professional help. At no point, I said, should she allow her father to hospitalize Louise. I told her that once her mother was in the hospital, her agony would be prolonged. She would have the tubes inserted, the machines hooked up, and she'd be kept alive as long as possible, in misery. I advised her to contact someone about home hospice care.

All Louise needed at that point was to be kept clean and comfortable. At home, she could spend her last days with family in familiar surroundings with a view of her lovely garden outside.

Harry was an autocrat and would have nothing of it. Joanne, even in her sixties, was still a cowed and impotent child when facing her father. So Louise was taken to the large hospital nearby. She was hooked up to a feeding tube, IVs and monitors. Her view out the window was of a brick wall.

Louise spent the last forty-two days of her life on her back in that hospital. No one asked about alternatives. Standard operating procedure was to prolong her life through any and all means.

There's also a dirty little secret that nobody in this health care "debate" talks about: Doctors are paid by the procedure and there's nothing like a helpless, elderly patient for the opportunity to pile on the tests and procedures. During a patient's last days in the hospital, doctors come out of the woodwork to peek in the door, glance at a chart, order an expensive test, and walk out to bill Medicare accordingly.

When Louise wasn't staring out the window in pain, she was being hauled all over the hospital for tests and x-rays for -- what, exactly? There was no question that she had terminal disease and that the end was very near. Did they think this blood test or that x-ray would tell them something they didn't already know? Did they expect to predict the exact day and hour of her death?

So for forty-two days, Louise was mindlessly kept alive while her body was being eaten to death by the cancer. Her bones had become so fragile that some time in the last week her hip broke merely from lying in the bed. Her guts had turned to putrid goo. Finally, she died.

The hospital bill was, of course, stratospheric. Miserly Harry didn't care, though. Medicare picked up most of it and what they didn't cover, supplemental insurance did. And it was all totally, utterly unnecessary. Harry was rich enough that he could have paid for round-the-clock nursing at home. There would have been no feeding tube, no monitors, no IVs. Louise would have died weeks sooner, in her own bedroom, and been spared what passes for "care" in America's modern hospital system.

But no one in a position of authority spoke up. Louise wasn't given the chance to choose her own fate. Every day in the hospital, she begged to go home. Instead, she had a husband more concerned with money and his own paranoia, a willfully ignorant man happy to have someone take the problem off of his hands for free. She was left to a system that has perverted its mandate for mercy into a soulless, hypocritical exercise in milking the helpless for every penny that can be squeezed from Medicare.

So don't talk to me about "Obama's Death Panels." Don't talk to me about "pulling the plug on Grandma." Don't pretend to care about people when all you care about is demagoguing and demonizing humane health care reform to score political points.

I'm in despair that any real reform will ever be enacted. I'm sick of a country informed by brutality and stupidity. I wonder what all those imbecilic "Town Hell" screamers would be screaming if they found themselves in Louise's hospital bed.

(Cross-posted at The Followspot.)

RJ is brilliant...again

This is a MUST READ!

An excerpt:

You probably remember Rumsfeld's line: "Democracy is messy." But you may not remember when he said it. It was in response to widespread looting of banks, offices, and museums. That says a lot. To this crowd, "democracy" is a violent mob. Representative government is an unpleasant necessity, not a value or an ideal. The rest of us think "war is too important to be left to the generals." They think self-government is too important to be left to the voters.

To some extent this is nothing more than greed and lust for power, the misuse of conservatism as a cover for naked self-interest. But it also reflects a difference in political philosophy that goes back to Locke and Hobbes. Their equation of democracy with mob rule, so clearly mirrored in Rumsfeld's comment, helps explain why they feel morally entitled to lie, cheat, and steal votes. To them, voters aren't reflections of a democratic ideal. They're suspects, threats, enemies. They're the Iraqi mob looting the Museum of Antiquities.

"Because he's black"

H/T to Andrew Sullivan for this extraordinary video of the AFL-CIO's Richard Trumka speaking on racism and Obama. As Sully says, "Something truly profound could happen in this election, if we want it to."

I weep for us...for our poor, broken country

Glenn Greenwald: "Today's coverup of surveillance crimes and Barack Obama — The Democratic nominee's support for this bill speaks volumes about what he is and isn't."

Read it and you'll weep too.

Obama the Octopus? Superdelegates take note!

The "other shoe" keeps dropping.

Just how many legs and feet does Obama have, and thus how many more shoes are there to drop? As I wrote to a friend, an Obama supporter, "What's next? Asking Joe Lieberman to be his running mate?"

Put another way, a question I put forward in a much earlier post: Just how many progressive principles is Obama willing to sacrifice in order to achieve "post-partisanship"? We are beginning to get the answer.

Consider his recent stance on FISA; the pandering to the right with his proposed augmentation of Bush's "faith-based initiative;" the obfuscations of his position on ending the war in Iraq; and his, uh, restatement of just what it means for a woman to have a "right to choose."

To my fellow-progressives, my fellow-liberals, those of you who giddily parroted Obama's "change" mantra, projected your own "hope" onto a blank screen, confused style with substance -- how are you feeling today about your candidate?

I know that the FISA business has caused a great stir on the listserves and in the comment area of Obama's website. But that may not be enough.

It may be time for serious re-thinking. It's not too late for superdelegates to change their minds. All it would take is a caucus, and a vote for Hillary, and the nomination could be hers after all.

That's what superdelegates are all about...being the grown-ups who keep the Democratic Party from being hijacked. And make no mistake, it is being hijacked, by a charismatic orator whose only ambition is for himself and who has now proven that he will say anything and do anything, including sacrificing family, friends, surrogates, supporters -- and the bedrock principles of the Democratic Party -- if they get in his way.

Toobin on Obama says it all

Today on The Situation Room (made palatable by the absence of Wolf Blitzer, with John Roberts replacing him) -- Jeffrey Toobin had the last word. He turned to a fellow panel-member and said,

I'm old enough to remember when Barack Obama was a Democrat.

Whitewash and hogwash

As long as I'm talking about corporations, Republicans and branding, I'd like to segue to the related issue of image manipulation and control.

Corporations have learned to use image advertising to effectively change the public's perception of the corporation's business and reputation. (Since most corporate types are Republicans, the Party has naturally adopted the same techniques.)

There are two commercials currently being broadcast widely that I find galling. Every time I see one, I literally yell at the tv and whoever's in the room.

The first, and most infuriating, is the ad for the PPA -- the Partnership for Prescription Assistance. It opens with a string of ordinary slobs expressing their heartfelt thanks to the PPA for enabling them to get their prescriptions, i.e., to remain alive. Then we get spokesman Montel Williams cheerily informing us that through the goodness of America's pharmaceutical industry, poor people around the country who had difficulty affording their prescriptions are now getting free meds. Then we see the PPA Bus trundling over the countryside presumably dropping anti-depressants and statins off the back to the grateful groundlings.

This is image manipulation on a world class scale. The rapacious pharmaceutical companies know that news stories about poor people suffering and dying because they can't afford their meds -- anywhere from $155 to $398 for a month's supply of Advair or $31 to $82 for Lovastatin -- would be the end of their sweet deal. Not even their trained seal legislators would be able to withstand the public roar for draconian regulation. This must be avoided at all costs.

So even though the blood-sucking pharmaceuticals will get those extortionate prices from Americans who can somehow afford it, they manage to avoid the worst publicity by giving medicine away to the poor to shut them up. It's just good business for them, the same as buying friendly congressmen and senators or taking doctors on lavish junkets so they'll remember your pills and potions when they take out the Rx pad. And in the end, given the obscene profits the pharmaceuticals rake in, giving pills away and bribing people is small change.

Meanwhile, those of us with prescription insurance coverage rarely hear or see the actual list price for the drugs we buy. Sure, we know the co-pays have gone up precipitously and may be killing us at $35 a pop for brand names, but we can hardly fathom that some drugs cost a king's ransom. And many don't make the connection between outrageous drug costs and premiums rising at double-digit rates.

But hey -- we've got Montel Williams to soothe us with tales of pharmaceutical philanthropy.

The second ad is one of those commercials with lush photography, romantic images, intimate music and a sentimental, feel-good narrative -- all saying exactly nothing about the product. Behold "The Human Element":

Quite a stretch from the Dow Chemical of my youth, the loathed manufacturer of napalm. The despoiler of our nation's air and waterways. The negligent corporate parent of Union Carbide, the company responsible for the disaster of Bhopal, still toxic after more than twenty years.

It's so sad. "The Human Element" is a lovely series of images and sentiments. It's obscene that it's in the service of a transparent whitewash.

It's not that we don't understand that chemical manufacturing is an indispensible part of our lives. It's not that we don't appreciate the chemical products that make our lives better. But none of that excuses crimes against our planet and criminal neglect. To Dow Chemical though, it's easier to manipulate public opinion through a pretty ad than to clean up their act.

And there are others -- the ads for the extractive industries that tell us how much they care about the environment as if they did more than the bare minimum to comply with regulation. My favorite is BP with the sunny flower logo. We're supposed to applaud because they're researching alternative energy technologies now. Yay! It would be rude to remind them that they're also part of the global oil racket that is determined to keep pumping and selling at ever-higher prices until there's not a drop left. Bah.

The ACLU has a blog!

Here!

"A sign of profound desperation"

The Times has a story up that should make us weep, or rage; I'm not sure which. One thing seems certain, though: This country has entered an economic and political landscape that is uncharted, and who the hell knows where we'll end up.

BEND, Ore. — Last month, right after he had the heart attack and then the heart surgery and then started receiving the medical bills that so far have topped $200,000, Melvin Tsosies joined the 91,000 other residents of Oregon who had signed up for a lottery that provides health insurance to people who lack it. [...]

Despite the great hopes of people like Mr. Tsosies, only a few thousand of Oregon’s 600,000 uninsured residents are likely to benefit from the lottery anytime soon. The program has only enough money to pay for about 24,000 people, and at least 17,000 slots are already filled.

Let's consider this for a moment: Health care by lottery. It sounds like the plot of a dystopian movie, perhaps "Mad Max: Beyond Medicaid."

“There’s so much need that there’s really no way you can meet it,” said Chris Coon, the outreach manager for the Community Clinic of Bend....

“Using a random process to decide who gets health care is a sign of profound desperation,” Mr. Coon said.

This is in the United States in 2008, a mere 63 years after we vanquished enemies in two hemispheres and strode the earth as the richest, most enlightened and most powerful nation the world had ever seen. How do we find this even remotely tolerable?

Methinks he doth protest too much

Wow. I happened to catch a break in the Spitzer Scandal and Totally Tanking Economy news coverage: Emperor Bush commanded some live teevee time for a little barking from the bully pulpit on the House Dems' "partisan" FISA bill. Let me tell you, he's trying to sound pissed but it's looking more and more like panic to me.

Anyone who believes Bush is merely an inarticulate clod hasn't seen him when he's really focused and right now he's totally focused on getting telecom immunity. In just a few minutes, he pulled out every bogus argument, hammered each at least twice, implied that House Dems would rather embolden terrorists and trial lawyers than keep your children safe, vowed to veto the House bill and demanded they pass his bill before Easter break. He then turned and stalked off.

I don't expect the craven Dems to hold the line against this. They have no idea how to counter Bush's version of reality. They're too frightened of President Twenty Percent to see or even care that in this we've finally found his Achilles' heel.

Bush knows these telecom suits will pry open the doors of his administration's dungeon and that he could be found criminally liable. I believe there is no issue more important to Bush right now. From now until next Jan. 20 the White House will do everything to shred, burn and bury the evidence of eight years of high crimes and misdemeanors.

The miserable Pelosi may have taken impeachment off the table but there's no reason Bush couldn't be indicted in criminal court or sued in civil court once he's an ordinary citizen again. (Here I must admit to a small irrational fear that Bush and Cheney will engineer the October surprise to end all October surprises, such that elections are "postponed" indefinitely.) The idea -- no, the certainty that Bush and his criminal gang will walk is intolerable.

Update: Kagro X over on DKos is feeling more sanguine about the House Dems' ability to resist Bush:

Every time Congressional Dems actually slow down and take stock of the situation -- from Senator Chris Dodd's brave (and lonely and seemingly futile) stand, to the cautious maneuvering of House Dems today -- new revelations arise that should make all Americans who value our freedoms glad they did. [...]

Every time the Congress seems ready to give in on FISA, we find out more about how crazy Bush is, the deal falls apart, and the Constitution wins back a few inches of turf.

No one will be happier to be wrong about the House Dems than I. If enough of them rediscover their backbones -- with a little help from blogosphere activism -- to defy Bush's demands, I will do a happy dance. Update 2: Glenn Greenwald has more.