Friday, August 14, 2009

Radical opposition

Paul Krugman:

President Obama is now facing the same kind of opposition that President Bill Clinton had to deal with: an enraged right that denies the legitimacy of his presidency, that eagerly seizes on every wild rumor manufactured by the right-wing media complex.

This opposition cannot be appeased. Some pundits claim that Mr. Obama has polarized the country by following too liberal an agenda. But the truth is that the attacks on the president have no relationship to anything he is actually doing or proposing.
The truth is that the factors that made politics so ugly in the Clinton years — the paranoia of a significant minority of Americans and the cynical willingness of leading Republicans to cater to that paranoia — are as strong as ever. In fact, the situation may be even worse than it was in the 1990s because the collapse of the Bush administration has left the G.O.P. with no real leaders other than Rush Limbaugh.

Proper forums and FB decorum

Over on FaceBook I am completely outnumbered by friends and family who lean rather hard to the right and are (in my view) totally misinformed and thus adamantly opposed to any type of health insurance reform. It is tempting to get into “discussions” on FB with some of these folks, but I am afraid that FB is not the proper forum so I hold off on commenting. If they want to have a discussion, they can comment on my FB page or find my blog. The fact that most do not reassures me that my instincts in this matter are correct.
Still, when I see a comment like this one - “we can see the waste and fraud in medicare, medicaid, social security, food stamps, and i am sure numerous other govnt run programs and know why they should not be in charge of health care!!!” - I want desperately to respond.
So I will do so here on my blog - even though the person making the comment will never see it, but that is probably just as well.
Waste and fraud in Medicare, Medicaid, etc.? Sure. I’m sure you can find waste and fraud in almost every government program. But you can also find waste and fraud in most private businesses as well. There is nothing inherent about government that leads to waste and fraud, it is just a human phenomena. Any large organization or operation is going to have these problems.
For those who think private industry is so much better than the government, here is a reminder from a few years ago -- The Corporate Scandal Sheet
Remember these guys? Enron, Worldcom, Adelphia, HealthSouth, Tyco, Arthur Anderson, Global Crossing....
Or how about all the private contractors in Iraq who were bilking the government for millions of dollars?
The only reason that government waste and fraud will seem more prevalent is because it is always out in the open. Much of the private scandals go unreported, unnoticed and uncorrected until they grow so large that the whole thing collapses like a house of cards the way Enron did.
Medicare, Medicaid, Social Security, Food Stamps and the numerous other government-run programs referenced above have all got their share of problems. But they also do a tremendous amount of good for the nation and provide a necessary level of service that could not be replicated by private charity. Without these social support programs that rightwingers resent so much, our entire economic system which props up our middle-class society would collapse. Talk about pending disasters... We’ve already seen what happens when rightwingers are put in charge of every aspect of the government for eight years. We are dealing with the fruits of that woeful experience right now.

Wednesday, August 12, 2009

Response to a smear

Since Dr. Ezekiel Emanuel has been besmirched here in the comments recently, I thought it would be good to repost this article from TIME that lets him respond to the smears and the craziness.

Dr. Ezekiel Emanuel, the medical ethicist and oncologist who advises President Obama, does not own a television, and if you catch him in a typically energized moment, when his mind speeds even faster than his mouth, he is likely to blurt out something like, "I hate the Internet." So it took him several days in late July to discover he had been singled out by opponents of health-care reform as a "deadly doctor," who, according to an opinion column in the New York Post, wanted to limit medical care for "a grandmother with Parkinson's or a child with cerebral palsy." (Read an interview with Obama on health care.)

"I couldn't believe this was happening to me," says Emanuel, who in addition to spending his career opposing euthanasia and working to increase the quality of care for dying patients is the brother of White House chief of staff Rahm Emanuel. "It is incredible how much one's reputation can be besmirched and taken out of context." (See pictures of health care for the uninsured.)

It would only get worse. Within days, the Post article, with selective and misleading quotes from Emanuel's 200 or so published academic papers, went viral. Minnesota Representative Michelle Bachmann, a fierce opponent of Obama's reform plans, read large portions of it on the House floor. "Watch out if you are disabled!" she warned. Days later, in an online posting, former Alaska Governor Sarah Palin attacked Emanuel's "Orwellian thinking," which she suggested would lead to a "downright evil" system that would employ a "death panel" to decide who gets lifesaving health care. By Aug. 10, hysteria had begun to take over in places. Mike Sola, whose son has cerebral palsy, turned up at a Michigan town-hall meeting to shout out concerns about what he regarded as Obama and Emanuel's plans to deny treatment to their family. Later, in an interview on Fox News, Sola held up the Post article. "Every American needs to read this," he declared. (Read "What Health-Care Reform Really Means.")

By this point, Emanuel, who has a sister who suffers from cerebral palsy, had arrived in northern Italy, where he planned to spend a week on vacation, hiking in the Dolomites. Instead, he found himself calling the White House, offering to book a plane home to defend his name. "As an academic, what do you have? You have the quality of your work and the integrity with which you do it," he said by phone from the Italian Alps. "If it requires canceling a week's long vacation, what's the big deal?" (Read TIME's cover story "Can Obama Find a Cure?")

The attacks on Emanuel are a reminder that there is a narrow slice of Americans who not only don't trust government, but also have come to regard it as a dark conspirator in their lives. This peculiar brand of distrust helps create the conditions for fast-moving fear-mongering, especially on complex and emotionally charged topics like the life and death of the elderly and infirm. Prairie fires of that kind are hard to douse when the Administration's own plan for health care remains vague, weeks away from being ready for a public rollout. The health-care bill that recently passed the House does not contain, as some have suggested, any provisions that would deny treatment to the elderly, infirm or disabled like Sola's son. One provision allows doctors to be reimbursed for voluntary discussions of so-called living wills with patients, but does not in any way threaten to deny treatment to dying patients against their will. The legislation anticipates saving hundreds of billions of dollars by reforming the health-care system itself, a process that would try to increase the efficiency of medical care by better connecting payments to health outcomes and discouraging doctors from unnecessary tests and procedures. The Obama Administration hopes that many of these reforms will be made in the coming years by independent panels of scientists, who will be appointed by the President and overseen by Congress. (See 10 health-care-reform players.)

This is where the criticism of Emanuel enters the picture, since he is just the sort of scientist who might be appointed to one of those panels. For decades, Emanuel has studied the ethics of medical care, especially in situations where a scarcity of resources requires hard decisions to be made. His work sometimes deals with the hardest possible decisions, like how to choose who gets a single kidney if there are three patients in need, or the reasons that doctors order tests with little medical value. Emanuel's reputation ranks him among the top members of his field. He is published often in the best journals; he has been given multiple awards for work to improve end-of-life care. At the White House, he has taken a free-floating role at the Office of Management and Budget, advising on a wide range of health issues.

But in a country where trust is in short supply, Emanuel has become a proxy for all the worst fears of government efforts to rein in costs by denying care. "The fundamental danger is that the American people are being asked to delegate all these life-influencing decisions," explains Betsy McCaughey, the conservative scholar who wrote the New York Post attack on Emanuel. "There is a lack of transparency here."

In her Post article, McCaughey paints the worst possible image of Emanuel, quoting him, for instance, endorsing age discrimination for health-care distribution, without mentioning that he was only addressing extreme cases like organ donation, where there is an absolute scarcity of resources. She quotes him discussing the denial of care for people with dementia without revealing that Emanuel only mentioned dementia in a discussion of theoretical approaches, not an endorsement of a particular policy. She notes that he has criticized medical culture for trying to do everything for a patient, "regardless of the cost or effects on others," without making clear that he was not speaking of lifesaving care but of treatments with little demonstrated value. "No one who has read what I have done for 25 years would come to the conclusions that have been put out there," says Emanuel. "My quotes were just being taken out of context."

For Emanuel, the entire experience has been a painful education in the sometimes brutal ways of politics, something his brother has long endured and dolled out. "I guess I have a better appreciation for what Rahm had to go through for years and years," Emanuel says. But that appreciation does not solve the question raised by the controversy. There is universal understanding that the nation's fiscal course is doomed without major changes to health care, but whom will the American people trust to carry it out?

Emanuel, for his part, plans to continue his work, which is focused on finding the most equitable and ethical way for this reform to be carried out, even if he has opted against returning from the Italian Alps. "I am an Emanuel," he says. "We are pretty thick-skinned. I am not going to change my colors. I am not going to crawl under a rock."

The Conservative Pledge

Rightwingers are really big on making pledges and so I found this "Conservative Pledge" to be most interesting. Following is the pledge with my comments and interpretations in bold...

I will support the People’s right to self-defense.
And the right to carry loaded guns anyplace we feel like... and not just little small-caliber pea-shooters either. We mean big-honking elephant guns and bazookas with automatic firing and unlimited clip capacity.

I will be devoted to the principle of blind justice.
And “blind justice” means being completely oblivious to any ounce of empathy or human compassion. It means applying the harshest penalties and sentences regardless of the attenuating circumstances. It means closing your eyes to the consequences of so-called “justice”.

I recognize the media for its bias, bullying and deception.
This is pure projection coming from the folks who get all their news from the radically-biased, bullying and deceptive Fox News and the rightwing radio talk shows. What could be more bullying than people like Bill O’Reilly and Glenn Beck screaming at and shouting down people on their shows who dare to disagree with them?

I will emphasize self-reliance and being able to keep the fruits of one’s labor.
Pure selfishness and greed dressed up to sound not quite so bad.

I will promote teaching self-help rather than dependence on government and others.
Self-help and self-reliance are the buzz words of the rightwing movement that wants to dismantle the social safety net underlying the foundation of the American economy. It is all part of the Ayn Rand philosophy of selfishness and greed that has taken control of today’s Republican Party.

I will place conservative values and principles above personal desires, weaknesses, fears and regrets.
Naturally. Wouldn’t want any of those namby-pampy feelings or empathies to get in the way of efforts to slash government services for the poor, the sick and the destitute.

I will emphasize charity, with its unexpected benefits, rather than support compulsory tax-and-spend programs.
Charity is another way of saying “Let somebody else take care of those poor saps.”

I will have a never-ending quest for the truth, despite obstacles based on emotion and personal experience and will spread such truths for the benefit of all.
Once again “emotion” is viewed as something that is bad and which should be avoided because it gets in the way of the quest for “truths” and even “personal experience” is bad because you just can’t believe your own eyes when they show you Obama’s birth certificate or pictures of the Apollo astronauts on the moon. LIES!!!! ALL LIES!!!!!

I will give those in authority due respect, however, not to the extent of taking orders or assertions that are contrary to conservative values or moral logic.
In other words, I will only respect authorities who agree with me based on my interpretation of “conservative values” and “moral logic”

I will emphasize humility and open-mindedness instead of the arrogant certainty about one’s own views.
Phhhhhhttthhhhhh!!! Oh yeah, sure. Let’s just throw that one out there for grins. (wink,wink)

I will not simply complain, but rather will take practical action toward improving my situation.
Like sending money to rightwing groups promising to take action for me!

I will use self-control as opposed to a self-indulgent search for instant gratification of desires.
Oops. I think Gov. Mark Sanford, Sen. John Ensign, Sen. David Vitter, Rep. Chip Pickering, and many others overlooked this part of the pledge.

I will downplay the significance of wealth, disparities in wealth and materialism in general.
Because it is easier to hold these selfish beliefs if you ignore the big pink elephant in the room.

I will recognize and utilize the benefits of competition and hard work in my daily life.
Because all those undeserving poor people just don’t work as hard as I do and even if they do they just lost out in the “competition” so tough luck.

I understand that a rising tide lifts all boats, e.g. tax cuts benefit all.
Surely whatever benefits me personally will benefit everyone else. Right?

I will recognize the power and liquidity of the free market.
All bow and prostrate themselves before the mighty and all-powerful free market!

I will emphasize self-restraint against hurtful activities.
And hope that other people will use “self-restraint” too when we can no longer afford our military and police forces.

I will reject the deification of government officials.
You know!! The Obamessiah! HaHa!! We called him that to taunt liberals and now we can use it as an excuse to vilify him even more!

I will support those who prove frugal and efficient.
Or those who cut my taxes and slash programs for the poor.