Category Archives: Health Care

Caliban Chronicles: “The Will to Change” the System

Saturday, December 2, 2017

There are news reports Mr. Flynn has allegedly been “flipped” and will likely be giving damaging testimony against associates of President Trump who worked on behalf of his election. I seriously doubt that anything said in a court of law is going to result in Trump resigning, and as long as Congress is controlled by the GOP, does anyone believe that he would actually be impeached?

In fact, to be blunt, impeaching Trump would not really solve anything. Pence is no better. “Even mad chief need sane lieutenants,” said Hayden Carruth in a poem about “Adolf.” The only way to stop the madness in which those are who wealthy disclaim any responsibility for the health and well-being of their fellow citizens is to alter the party in power in Congress in 2018, and at least bring to a halt the dismantling of the social safety net. It will not be possible to rebuild what is being torn apart until at least 2022, but we can minimize the damages that will accumulate between now and then, if and only if we vote in sufficient numbers to change an unbalanced system.

The best analysis I have read of our situation can be found in Larry Smith’s latest edition of the Caliban Chronicles, and I urge you to read it. The only “friendly amendment” I would attach to Larry’s call to action is that the Baby Boomer generation is far too susceptible to the illusion that changes in Social Security and Medicare will most likely affect the next generation. Hey, folks: that’s the plan. First, the next generation is asked to make “adjustments,” and then they will come after the Baby Boomers and demand that they, too, reduce the economic returns on their lifetime of hard work.

Consider the following:
The United States is already facing a gloomy fiscal landscape. The federal deficit this year topped $660 billion, despite healthy economic growth, and the national debt now exceeds $20 trillion. Janet L. Yellen, the outgoing chairwoman of the Federal Reserve, appointed by President Barack Obama, warned last week that the national debt “is the type of thing that should keep people awake at night.”

The “Grand Off-shore Party” knows that the secret of political domination is to divide the opposition, and their plan is to fuse the resentment of Generation X and the Millennials over their “raw deal” and cause them to band together in viewing the Baby Boomers as their “enemy.” Unfortunately, Bernie Sanders’s campaign failed to see that his proposals about assisting each block of these voters was widening this generational split at an early point in this crisis. Sanders played right into the hands of the GOP’s long-term strategy.

Here is the link to Larry Smith’s call to action:

http://calibanonline.com/newsletter/CC26.pdf

“How would you feel if your father smoked pot?” (circa 1970)

July 15, 2017

“How would you feel if your father smoked pot?” (circa 1970)
(or, “Don’t Bogart That Joint, Dad. Pass It Over to Mom.”)

Buttondown Collar PS - 2

This advertisement appeared almost a half-century ago in a student newspaper. Under the guise of stimulating thinking, its lead question asks “how would feel….” The blending of the initial rhetorical emphasis (“how would you feel…”) and the purported value of “thinking” is quite intentional. This appeal to an emotional outcome of a supposedly rational consideration of drug laws is a standard tactic of those who wish to repress the Dionysian exploration of consciousness in any form whatsoever.

One also might reflect upon the stereotyped image of the older generation: did the advertisers expect young people to imagine their fathers being so up-tight as to keep their collars buttoned down, even as they are halfway through their joints?

It is still difficult for me to believe that the cultivation of marijuana will become legal in large swaths of the United States. I would caution those who might take this shift to be a permanent alteration in the consciousness of the American electorate to remember that this country is on the verge of making abortion, once again, a felony. The individual’s right to control her body has been under relentless attack for several decades, and we see the consequences. The shift in drug regulation could also turn out to be a temporary alleviation of repressive state control, unless we are more vigilant than we were about reproductive rights. Let us remember that many people have gone to prison for the possession of marijuana in the past, and if Jess Sessions and his friends have their way, such will be the law of the land again.

In the meantime, I choose not to light up. Or to light up when you least expect it.

I would also call for a Democratic member of Congress to introduce an amendment to the current Republican bill to repeal and replace Obamacare that would make a doctor’s prescription for marijuana a mandatory part of any health insurance policy sold in the United States. Just so we can do a head count to remind ourselves of how temporary this respite might be.

I am curious if anyone can guess the name of the sponsor of the ad. Trust me that there’s more than a touch of irony involved. Feel free to send me your guesses at William.BillMohr@gmail.com.

President Trump’s Twinkie Cabinet

February 19, 2017

President Trump’s Twinkie Cabinet

There are two ways to take the title of today’s post. The first is obvious. If there is anyone who can possibly vet their diet, please be vigilant: under no circumstances whatsoever should anyone serving in Trump’s cabinet be allowed to consume Twinkies. The individuals appointed to Trump’s cabinet possess rapacious impulses that are already out of control, and the slightest increase in their consumption of such confections might well result in the entire world being treated as if it were the reincarnation of George Moscone and Harvey Milk.

On a more quotidian economic level, of course, the Twinkie Cabinet is a reference to the financiers who exploited the workers of the Hostess Company. If Trump found himself the beneficiary of a miniscule margin of victory in just enough states to tip the Electoral College in his favor, it was in large part because of the displaced anger of workers at companies such as Hostess, whose executives walked away with their portfolios intact during the bankruptcy proceedings earlier this decade.

The problem confronting these workers, when they had to make a choice in the 2016 election, was that no major party offered any remedy for their plight. If you were an employee of Hostess, age 53 years old, and you faced the loss of everything you had worked for, what was your choice during the spring primaries of 2016? If you had been such a worker, the question you should have asked yourself was “What would have turned out different if any of these candidates had been president between 2011 and 2013?”

We absolutely know that nothing different would have happened if one of the GOP candidates had been President, but would there have been a different outcome if Hillary Clinton had been President? Or Bernie Sanders?

No.

It’s not that I would be sad if Clinton or Sanders had been president then, or now for that matter. But let’s be blunt about it: Would Apollo Global Management and Dean Metropoulos have operated any differently five years ago, if Bernie Sanders had been president then?

No.

The laws under which capitalism eviscerates the lives of those whose work generates wealth would have been no different under Sanders, when Hostess declared bankruptcy, than under Obama, just as they were no different under Bill Clinton than under George W. Bush.

“Betrayal without remedy” is the phrase that appears in “The Great Twinkie Caper – how U.S. Workers Get Flipped” by Lawrence J. Hanley.

http://www.huffingtonpost.com/lawrence-j-hanley/hostess-sale_b_6250650.html

Justifiable rage blinded workers into settling for vague promises of how America could be made “great again,” as a result of which one of the great political tragedies of this epoch is unfolding in front of our unbelieving eyes.

I wonder how many months will go by before these workers realize that they have been duped. What they deserve is a future retirement with some sense of dignity that includes decent shelter, excellent health care, and nutritious food to eat. This is the minimum that any person who has worked all of her or his life deserves. I would hope that a candidate would emerge in 2020 who will bluntly campaign on this kind of platform.

Until then, let us hope that another complete meltdown of the economy will not happen again. The risk of that kind of collapse is accelerating. Laws are being expeditiously revised right now to make the U.S. economy vulnerable to the same set of plundering usurers who drove this nation to the precipice ten years ago. The current Money Mob will make certain that the same laws invoked in the last crisis remain on the books to save them from prosecution, too.
It is indeed “betrayal without remedy.”

Well, not quite. There is one remedy, and it is radical beyond anything ever witnessed in this nation. Something much more radical than anything called for by Bernie Sanders is needed. It begins with changes in our diet, both physical and intellectual. Hard as it is to break old habits, we must do so if the pursuit of human dignity is to prove itself worthy of that ideal. And it ends with the complete abolition of the death penalty, for above all, we must confront the fact that as long as nuclear weapons exist, we have all been judged and sentenced to death. This is an unacceptable horror, and must be utterly reversed.

In between those two points, much will have to change in the hierarchies of privilege and power, and it will be an unfamiliar discomfort for those presently ensconced at the highest levels of administrative turpitude.

Let us start with a good night’s sleep, having faith that this can be accomplished.

Post-Script: I woke up to find an article in the Los Angeles Times giving an account of a speech at the Ace Hotel in Los Angeles on Sunday, February 18. When I posted this blog entry, I had no idea that he was in town asking his audience to identify with the workers who have been traumatized by massive shifts in the global economy.

http://www.latimes.com/politics/la-pol-ca-bernie-sanders-event-20170219-story.html

An Academic Walks Next Door to the VA

Friday, September 23, 2016

The Academic Walks Next Door to the VA

My father was a career enlisted man in the U.S. navy, and my mother also served in the U.S. armed forces during World War II. My father died in late September, 1994, but my mother is still alive. She is somewhat frail, though certainly capable of conversation. This past summer, for instance, we discussed the meaning of the word “balmy” and spoke of the various regions in the world with occasional climates to which that word might apply.

My mother is currently living in a skilled nursing facility (SNF) about a fifteen minute walk away from where I live in Long Beach, and I suppose one could say that I have chosen to write about her tonight because I have just come back from visiting her there. I brought her a ripe avocado and one of her favorite cookies to eat, but she was too full from dinner to consume more than a fourth of the cookie. Her appetite had been faltering in recent months, so I am heartened that she seems to recovering it enough in the past week so that she is eating three times a day.

Being responsible for and monitoring the care of an elderly parent can be an overwhelming task, and certainly the next few months are going to be even more challenging than this past summer. Of my mother’s six children, I am the only one living in the vicinity of her current residence. It gave me a boost of solidarity, therefore, to get a message from the poet Garrett Hongo this afternoon that included a photograph of him with his mother. I don’t spend much time with poets my age these days, and it was reassuring to see a poet I have known for a long time also helping a parent along the same road, the one that leads (as he put it) to the River of Heaven.

This afternoon, the contingent part of that road led me once again to the VA center on Seventh Street in Long Beach. The VA is right next to the CSULB campus, so I am able to park at work and just walk over. I felt very fortunate this afternoon. Several people, one named Tim and the other Monique, were exceptionally helpful in helping me move my mother’s paperwork along. There were a couple other people, whose names I didn’t manage to record, who also were helpful. On behalf of my mother, I want to thank the VA for the assistance they are giving her. Being a Navy brat was a difficult way to grow up, but seeing my mother get this assistance helps compensate for those hardships.

Getting my mother assistance, including her benefits as a WWII veteran, during the past three years has involved keeping copies of all her service related documents, including her honorable discharge.
One detail, however, almost eluded my search. Fortunately, my mother can still recall her mother’s maiden name. Most of the time, when the VA asks that question of a veteran, they are not expecting a name to be cited that was exchanged for a husband’s surname well over a century ago. In fact, the name the VA had on its records for my mother’s mother’s maiden name was wrong, and it was satisfying to get that tiny part of her record corrected.

As I walked back to my car on the CSULB campus, I thought to myself how few of my fellow faculty ever have the need to walk onto this adjacent institution. I must admit that one of the factors in my discomfort with academic culture has to do with my upbringing in the military and the sometimes contradictory virtues its discipline fuses into a sense of duty and honor. While I wish it were otherwise, I don’t think it’s possible for my fellow academics to understand how much it shaped me, or how that shape will always make me a stranger in their midst.

Feel the Big (Very Big) Chill, O Baby Boomers!

Thursday, February 18, 2016

Feel the Big (Very Big) Chill, O Baby Boomers!

In a recent column covering Bernie Sanders’s campaign for President, I began to understand his popularity with young people. His ability to stir them to action is, in fact, a cynical use of his own polling date. Sanders no doubt knew at least a year ago that he would not be able to make any inroads by promising to make a difference in the lives of aging baby boomers, so he decided to focus his campaign promises on those who were soft and susceptible targets: the young.

I can certainly sympathize with the plight of the young; their attraction to a pied piper who promises Medicare for all, funding for child care, and free college tuition is easily understandable. I would ask his youthful supporters, however, to compare the promises made to them and the penury behind his plans for those who have worked all their lives to maintain this country’s flirtations with prosperity.

In addressing his enthusiastic and largely youthful audience, Sanders’s most important issues and their subsets are:

HEALTH AND FAMILY CARE ISSUES
Medicare for all
Planned Parenthood
Family leave
child care

ECONOMIC ISSUES
Wealth inequality
minimum wage increase
tax on Wall Street speculation
prosecute Wall Street offenders
trade policy
campaign finance reform
free college tuition

Nothing on this list addresses the very real economic crisis this country faces in dealing with an enormous surge in aging citizens during the next 20 years. Let’s compare what Sanders is offering two different generations. On one hand, he is offering free college tuition to young people. On the other hand, if you take a look at his proposals for social security on his website, he is planning a tax on the higher income brackets that will allow an average increase in social security income of $65 a month.

And that is the overwhelming bulk of his “progressive” plan for the Baby Boomer generation.

The total amount of improvement in old people’s lives will be less than a thousand dollars a year. In fact, less than $800 a year, plus a piddling raise to account for a minimal amount of inflationary pressure. Total amount of peanuts tossed to the Baby Boomers: somewhere between $900 and $950 a year.

The last time I checked, you can’t pay for a lot of college with $1000 a year. Sanders is basically saying that for every $30 he will spend on the young, he will spend $1 on the aging.

In privileging a specific segment with almost all the benefits of progressive change, Sanders is egregiously pitting one generation against another, and doing so only because it suits his quest for power. He has no more respect for the Baby Boomer generation than President Obama has had. Obama threw the working people of the Baby Boomer generation overboard without a life vest, and he did so with full knowledge of what he was doing. Sanders is equally determined to throw Baby Boomers under the steamrollers.

I find it extraordinary that Sanders would have the nerve to call himself a progressive, and yet not even think out the basics of what the Baby Boomers in this country will need in the next twenty years. According to a recent report, the real shortage in doctors will be those specializing in gerontology. It does not escape me that he speaks up for child care, but has no plans for caring for the old. He urges voters to endorse a program of Medicare for all, and that is indeed a worthy goal; I would like to hear Sanders first explain his exact provisions for adequate medical care for those whose taxes have propped up the Medicare system all their lives. Without a sufficient number of properly trained doctors, one must as well come out and say it: “I don’t care about you.” In truth, I suspect that Sanders’s medical plan for aging Baby Boomers is not much different than the GOP attitude: “Just hurry up and die, would you?”

“Feel the Bern”? The only thing that Baby Boomers should feel is how — yet again — we are the ones who are going to get burned.

The Campaign for Justice in Health Care (CJHC)

The Campaign for Justice in Health Care (JHC)

In 1992, I had been working as a typesetter for the better part of a decade and a half, and yet another “minor” recession was eating away at the possibilities for economic self-sufficiency. The savings and loan debacle of the late 1980s is hardly remembered now, but it did extraordinary damage to the American economy, and the fact that very few of those responsible for that damage ever paid any social penalty for their role no doubt encouraged a new generation of economic plunderers during the first decade of the 21st century.

Four years earlier, I had actually done more than vote during the presidential campaign. I actually volunteered to work during Michael Dukakis’s campaign, and I put in enough hours to be offered tickets to a Dukakis rally at UCLA in the last ten or so days of the campaign. It was an inspiring rally, though it was too little, too late for Dukakis, who had squandered an early lead in the summer by heading home to Massachusetts right after the Democratic convention instead of hitting the campaign trail. At that point, campaigns were thought of as “fall” affairs, and Labor Day was the kick-off point. The first Bush knew better. Attack as soon as possible, and don’t let up. Dukakis never recovered from his failure to build on the momentum created by the Democratic national convention.

After three consecutive terms by Republican presidents, I was hungry for victory and looking for a candidate. Tom Harkin from Iowa struck me as a decent man and progressive enough that I see myself voting for him. I heard that he was going to appear at a gathering in West Hollywood. There were well over 100 people in the room as he gave his speech, which seemed spirited and upbeat until there was a pause for questions near the end. A voice from the back of the room shouted out, “What about AIDS, Senator Harkin? This is West Hollywood.” Harkin flinched slightly and then became slightly angry, not at the person who had asked the question, but at himself for having trusted those who arranged this event. I knew what he was thinking: “Why didn’t someone tell me in advance about my audience, so that I could emphasize my record here?” In point of fact, Harkin had done far more than others to push for the AIDS research, but he hadn’t seen that as a major part of his record. Unfortunately, the incompetence of his staff in not notifying him about the location of his event, and the importance of this issue to them, left him high and dry, and made him look as indifferent to an historical health crisis as the majority of politicians back then. It was a moment that taught me a great deal about the value of knowing where you are and understanding the groundswell of the times.

At this moment, there is a health care crisis that is only becoming worse by the day. I am hardly an economic expert or a recognized authority in the matter of public health care, and yet I remember enough about the depredations on the lives of working people during the past quarter century to believe that the AIDS crisis of the 1980s and 1990s is not unconnected with the Black Lives Matter movement. I offer the following five-part article on the need for justice in health care as my contribution to this ongoing discussion. Thank you for reading.

Part One: Memories of the Job Crisis and its Impact
on the Health Crisis to Come

In recent decades, the Republican party has succeeded in large part because it has manipulated the voters who support its candidates by making promises about social issues that it has only been able to deliver on an installment plan. Symbolic victory is more prevalent than any actual effacement of the gains made by women and people of color since 1950. Conservatives often feel disregarded by the party Elites except when it comes to voting in elections.

Not to be outdone in that kind of campaigning and underperformance, the Democratic party has often talked a good game, but delivered far less than its supporters have a right to expect. In the most recent debate (Sunday, January 17, 2016) involving the two leading candidates for the Democratic nomination for President, Hillary Clinton listed jobs as her first priority. Where have we heard this before? From her husband, Bill Clinton, who ran in 1992 as someone who told us that indeed jobs would be lost to technology, but that there would be job training. And he was right. Jobs were lost, but there was no job training available to those workers in any meaningful number of programs.

Hillary Clinton would like to forget that by 1995, three years after her husband took office, jobs were being lost at an extraordinary rate, and while one can argue that things briefly got better from 1997-1999, that was only after the havoc of much unnecessary turmoil in employment. The shedding of jobs – especially union jobs – helped out his corporate sponsors immensely and devastated the day-to-day lives of workers. Bill Clinton did not care about anything other than empowering Wall Street firms. Workers were last on his list of priorities.

Hillary Clinton’s reiteration of jobs as her first priority deserves more than just the skepticism rightfully generated by the memory of her spouse’s betrayal of working people in the 1990s. One only has to look at the woeful incompetence of the Democratic party in handling the job crisis of 2007-2010 to estimate the likelihood of Hillary Clinton being a “jobs President.” Let us go back eight years and take a look at how well President Obama handled the crisis. Here is the policy statement that explains the plan:

http://otrans.3cdn.net/45593e8ecbd339d074_l3m6bt1te.pdf
“A key goal enunciated by the President-Elect concerning the American Recovery and Reinvestment Plan is that it should save or create at least 3 million jobs by the end of 2010. …. We expect the plan to more than meet the goal of creating or saving 3 million
jobs by 2010Q4. There are two important points to note, however: First, the likely scale of employment loss is extremely large. The U.S. economy has already lost
nearly 2.6 million jobs since the business cycle peak in December 2007. In the absence of stimulus, the economy could lose another 3 to 4 million more. Thus, we are working to counter a potential total job loss of at least 5 million. As Figure 1 shows, even with the large prototypical package, the unemployment rate in 2010Q4 is predicted to be approximately 7.0%, which is well below the approximately 8.8% that would result in the absence of a plan.”
(policy document dated: January 10, 2009)

That was the plan that President Obama and his team of advisors from Wall Street came up with to meet the crisis of massive unemployment. The actual outcome is that the plan did not begin to ameliorate the damage done to the economic lives of working people. By the end of 2010, the unemployment rate was 9.3 percent, not 7 percent. (http://data.bls.gov/timeseries/LNS14000000 )

The shortfall, as stunning as it is, hardly represents the real evil at work here. How could anyone think that the goal of resolving this crisis should be 7 seven percent unemployment? That aspiration is in and of itself a hideous, reprehensible failure of social imagination on the part of Obama and his co-conspirators from Wall Street. Of course, that Democrats would put forward a plan that they had to know in their muscle-bound brains would be completely inadequate would not be surprising to anyone who remembered Bill Clinton’s inability to deliver on job training in the 1990s. As with Bill Clinton, Obama and his cohort merely went through the motions of alleviating the catastrophic distress of working people. Nor did things get better in 2011. In September, 2011, the unemployment rate was 9 percent. The prolongation of the crisis and its cantilevering on the backs of working people reveals exactly how little those in the professional ranks of politics and social and economic policy understand ground-level existence.

And does anyone care to remember that this figure of nine percent unemployment in 2010-2011 is totally manipulated? Anyone who had despaired of finding work by the summer of 2011 was not counted. You were not unemployed, these statistics insisted. And the nightmare was only worse under the surface. How many hundreds and hundreds of thousands of people found that their unemployment benefits were insufficient and found themselves depending on relatives and friends who could barely sustain themselves? The damage done to working people during that period is at a level that those who hold positions of authority cannot imagine. They do not have enough intelligence to make that kind of empathic leap.

Bernie Sanders at least has the common sense not to make jobs his first priority. It is too late to redeem that tragic implosion. While he listed “jobs” in third place in his list of priorities, he knows that the coming crisis involves health care and that the only way to address the onslaught of health care needs of the baby boomer generation is the single-payer system. “Medicare for All,” he calls it, and in making this his anthem he brings to a complete stop a system in which generations exploit each other.

It should be noted that the baby boomer generation has subsided Medicare for the population born between 1910 and 1935. This rather large cluster of people paid very little into the Medicare system and reaped continuous coverage. By the end of this decade, it will be the turn of those born between 1946 and 1955 to receive the same benefits that their hard work provided to their elders. But will that promise be kept? Why should it be kept, especially when there are fewer people paying into it, all the while suspecting that it will not be there for them when it is their turn? I can hardly blame Gen X and the succeeding generations from being cynical. There is a tsunami of unfunded health benefits about to come due, and they are being asked to let themselves be drowned by a health care system dominated by corporate culture.

So Sanders wisely sees that the only way – the only fair way – to make sure that the promise made to the baby boom generation is kept is to provide the same level of access and care to everyone, and to provide this health care as a right. The pursuit of health is the foundation of whatever happiness we are fortunate enough to share with others. It is an inalienable right, and those who are 35 or 45 years old have as much right to it as those who are 70 or 75 years old. Health care is one of the essential critical fulfillments of social cohesion and requital. To diminish its status is to guarantee a debilitated social economy. If Sanders’s plan seems radical and daunting in its unfamiliarity to Americans, then they need to remember how badly both Democrats and Republicans handled the job crisis. They will do no better with their current plans (including Obamacare) to resolve the coming health crisis. Millions of economic lives would have been saved if Obama had acted with the boldness required in 2009. Millions of lives – literal lives, this time – are at stake, if we do not act with similar boldness in altering the health care system in the next four years.

A minority of our fellow citizens, however, would prefer to benefit from the unequal distribution of “health wealth.” This fraction of business as usual administrators has a vested interest in a system in which HMOs become “too big to fail.” Anyone can see what such a system has in mind: public money subsidizing private profits. Wall Street’s health is the only check-up they need to have an annual report on.

PART TWO: “Mega-mergers” versus Obamacare paranoia

The obsession of the right-wing with Obamacare and how the Federal government might “socialize” medicine is a long-standing resentment. One of the most popular programs administered on a national level is Medicare, but it was strongly opposed in its original formation by the Republican party and its more extreme sympathizers.
The fear of centralized control of such an intimate matter as one’s individual health has some reasonable basis. Anyone who works at a large institution knows the enormous discrepancy between the ideological claims of those who administer the institution’s programs and the actual delivery of those services. “Student success” is the mantra in higher education, but I have seen first hand how students needing classes and registered for those classes are left empty-handed. And I myself, at a critical moment in my health care between July and November, 2010, nearly died because of the bureaucratic ineptitude and indifference of my HMO medical plan; indeed, I have seen this personal experience replicated several times in the past decade and a half in my first-hand network of friends and family. The difference between the level of care announced in HMO press releases and the dilatory delivery of that care when it is needed is enough to make one highly suspicious of claims that urgent medical attention, under the thumb of HMO financial expediency, will be superior to the care that a single-payer system will deliver.

The part that I don’t understand about people’s fear of Obamacare, or a single-payer system administered by the federal government, is their concern about the centralization of medical power. Hey, folks – it’s already happening. All you have to do is look at the articles in newspapers about the mergers of various HMOs to understand that massive mergers of health insurers have already created a vortex of centralization that has the profit-motive as its primary engine: your health is merely an inconvenient obstacle to the maximization of that overriding urgency.

The issue of “mega-mergers” was recently the subject of a very fine article by Chad Terhune, an award-winning journalist, in the Los Angeles Times.
http://www.latimes.com/business/la-fi-agenda-health-mergers-20160111-story.html
This article is dated January 11, 2016, and it is merely the latest installment by a reporter with an impressive backlog of articles on the health industry crisis. It appears, however, that this will be his last article as a reporter for the Los Angeles Times. I heard recently that David Ulin is no longer with the LA Times, and I note with dismay on the bio page for Chad Terhune that “he left the Times in January 2016.” If so, the departure of two writers of the caliber of Ulin and Terhune is not a good sign for the future of that newspaper. I am deeply concerned about how the Times plans to cover the current debate on health care. To whom will this crucial assignment be given? I have substantial doubts that someone of Terhune’s exceptional caliber will replace him.
In the meantime, the question I have for conservatives who fulminate about Obamacare’s centralized control of medical plans is why the same vigorous disdain is not brought to bear on these mega-mergers. It seems, quite frankly, hypocritical to lambast Obama’s program on one hand, and then to shrug one’s shoulders with a “business-as-usual” slouch as companies interweave with one another in a winner-take-as-much-as-possible competition.
For Terhune’s biography, see:
http://www.latimes.com/la-bio-chad-terhune-staff.html?page=2&#

PART THREE: Healthy Black Lives Matter, Too: Race and the Single-Payer System

Physicians for a National Health Program (PNHP) has a website I would urge all of you to take a look at. In addressing “Frequently Asked Questions” about single-payer health systems, one word that scarcely appears, however, is “race.” How would a single-payer system affect the dynamics of social stratification of race? How would the hierarchy of white privilege fare under single-payer? The answer to this is the slogan that Bernie Sanders should have adopted over a year ago:

Healthy Black Lives Matter

In the single-payer system the phrase “all are equal in the eyes of the law” extends firmly into the world of health care. I suspect, however, that the possibility that African-Americans and Latin@s would have equal access to high quality medical diagnosis and treatment is precisely the factor that makes the single-payer system unacceptable to many people who vote in a conservative pattern.

The crisis in Flint, Michigan regarding the lead poisoning of its population should be monitored under many different rubrics, but the quality of health care that the afflicted residents receive should be given particular attention. If “Black Lives Matter,” it is not simply that they should be free of antagonistic treatment by police, but that these lives should be as healthy as possible.

In this regard, one of the most important FAQs (Frequently Asked Questions) on the PNHP website is: “Why shouldn’t we let people buy better health care if they can afford it?” PNHP responds by saying that “If the wealthy are forced to rely on the same health system as the poor, they will use their political power to assure that the health system is well funded. Conversely, programs for the poor become poor programs. For instance, because Medicaid doesn’t serve the wealthy, the payment rates are low and many physicians refuse to see Medicaid patients. Calls to improve Medicaid fall on deaf ears because the beneficiaries are not considered politically important.”

This answer could be thought of as the equivalent of everyone having to drink the same water. If the families of high level automobile manufacturing executives had had to drink the same water as the families in Flint, Michigan, do you not think that more care would have been taken to monitor the quality of water? Health care, like drinking water, is a fundamental human right. “Healthy Black Lives Matter” should become one of the primary demands — perhaps the primary demand — for those of us who want to see a fundamental change in the distribution of medical knowledge and resources.

PART FOUR: Dignified Black Deaths Matter, Too

In the past decade, one of the most important civil rights battles has involved the ability of an individual to put an end to useless suffering when confronted with the checkmate of mortality. Conservative factions insist that self-determination should be insisted upon when it comes to economic matters, yet the same groups will all too often call for their moral choices to be imposed upon others in the realm of health care. The West Coast of the United States has been leading the way in promoting the right of an individual to give herself or himself the same degree of compassion that we would give to any terminally suffering animal, and the recently passed legislation in California will no doubt cause the smug self-righteousness of conservative institutions, such as hospitals run by the Catholic church.

Regardless of whether a single-payer system is put into place in the near future, the sobering fact remains that the access that individuals will have to the “right to die” under this new law is a matter yet to be determined. Michael Hiltzik in the Los Angeles Times has written recently of the problems that patients have incurred at Catholic hospitals when a woman wants a tubal ligation. One of the questions that the PNHP website does not address is how to integrate an institution that is ideologically hostile to the needs of the population it would serve under a single-payer system. What will happen, for instance, when a terminally ill patient — who is trapped in a Catholic hospital designated as the only provider by her HMO — is not interested in being starved to death in a hospice, but instead adds her voice to the chorus of Kurt Vonnegut’s poignant question as he neared the end: “Can I go home now?”

(Let me be clear about one point: hospice care would claim that pain-killing drugs enable people to have all nutrition cut off and yet experience no suffering. Unfortunately, the accuracy of medical claims falls far short of the guarantee needed in such an intimate matter, and skepticism in regards to this claim by hospice organizations and their advocates is utterly justified.)

In enforcing the right of individuals to terminate their lives when pain approaches the point of intolerable duress, I can easily see a crisis looming for the baby boom generation. A lot of people are going to die in the next 15 years, and some of them will passionately yearn for release from their protracted suffering. What is completely predictable is that Catholic hospitals and the hospices under their control will refuse to allow doctors in residence to grant the legal wishes of their patients.

In countering this obstreperousness, one point to keep in mind is the all important exchange of money for services and where that money comes from. If Catholic hospitals accept any tax money whatsoever, then they need to bow to the rights guaranteed by law to all who have contributed to that tax system. In point of fact, this is one of the things that brought the integration of schools to a flashpoint at mid-20th century. School districts would accept federal money, for instance, that was given to them to sustain the education of the offspring of military personnel stationed in their districts. Often these areas loved the presence of the military, since their payrolls contributed to the local economy. The edge of that sword, however, was less welcome. If a school district accepted funds from the government to educate the children of military personnel, it could not then turn around and say that the African-American children of these soldiers and sailors could not then attend the same public schools as the children of white soldiers and sailors. In a similar manner, Catholic hospitals will have to get used to the idea that they cannot be exceptions to the rule of law and they will have to integrate their services with the rights of those who want to end their suffering.

Finally, my most profound concern about the enforcement of right to die legislation is how it might play out along racial lines. Given the disparity in treatment of African-American citizens by police forces in this country, one would be naïve to believe that such discrimination stops there. Hospitals run by the Catholic Church do not tend to be much different than most urban police forces: the hierarchy in the work force is largely white at the top and in the middle. As such, one is not unreasonably nervous in anticipating that white people in charge of caring for dying African-Americans might take it upon themselves to subject their patients to one final jolt of contempt and humiliation. (The presence of crucifixes throughout Catholic hospitals should suffice to remind us that Catholic hospitals fester with an ideology that valorizes suffering as a necessary component for so-called eternal salvation.) When baby boomer African-Americans, who somehow survived the gauntlet of random gunfire from any number of sources over the past several decades, finally arrive at the waiting area of personal embarkation, they deserve equal access to the “right to die” law. To assume that equal access to the right to die will of course be granted to African-Americans is as foolish as assuming that every African-African is treated by police officers with the same respect as Caucasian citizens. Black Lives Matter. Healthy Black Lives Matter. And Dignity in Death matters for Black lives, too.

PART V: The AIDS crisis as a Forecast of Baby Boomer Amnesia

I have been reading Queers in Space: Communities/Public Places/Sites of Resistance (Seattle, Washington: Bay Press; 1997) the past few days, and in particular want to recommend Ty Geltmaker’s chapter, “The Queer Nation Acts Up: Health Care, Politics, and Sexual Diversity in the County of Angels, 1990-92.” The years cited in the title are slightly deceptive, since Geltmaker does an excellent job at compressing the sordid history of how little effort was made by elected politicians in Los Angeles to deliver even a minimal level of health care to those subjected to the ravages of HIV. In reading his article, I was struck by how vividly he made the first full decade of the epidemic come back in memory, and I was also struck by a contemporary disparity in awareness of how the pandemic altered the development of Gay consciousness.

In fact, I often wonder how much knowledge young people (those born after 1990) have of the AIDS crisis. What percentage of them know how many tens of thousands of people in the United States died from the debilitating onslaught of HIV between 1980 and 2000? How many died in Africa? In Europe? In Asia? In Latin America? And it’s just the millennials that I suspect of wearing hip-boots of ignorance as they wade through that roll-call. At this point, I am not even certain that most baby boomers are cognizant of the enormous number of deaths exacted in the aftermath of officially sanctioned neglect of AIDS patients. It is all too easy at this point to imagine that life has become “normal” again in the United States; in fact, with the majority approval of gay marriage, it would seem that the nightmare of AIDS, at least in the United States, can be said to be rapidly receding as a tragedy that will mainly stay present as a dramatic element of novels and poems and the occasional screenplay.

What needs to be asked, though, for those who want to press the issue of the single-payer system, however, is to demand a thorough analytical report of how the crisis would have been handled, had a single-payer system been in place in 1980. That difference will tell us how urgent it is to depart from the care system currently in place, which hardly differs from the one in operation thirty years ago. Stop deceiving yourself, my fellow citizens. If you think that AIDS is the last massive attack virus that will hit this country for the remainder of its history, then you are living in a fantasy. It is crucial to apply proposed models of health care to a representative crisis in the recent past if we are to resolve a future crisis with minimum casualties.

As I close this extended commentary on health care, I wish to circle back to the beginning, at which I talked about the crisis of jobs within the default systems of economic collapse. Consider this: if President Obama had truly looked at how other such periods of turbulence had been handled, he would have seen without any doubt whatsoever the scale of job programs needed to save the lives of working people. In the mid-1970s, even a Republican president signed off on CETA (the Comprehensive Employment Training Act), and Gerald Ford did so when unemployment was far less than was happening in Obama’s first months as president. At this point, we need to study how effective a single-payer system would have been in meeting the AIDS epidemic of the 1980s. If that study shows – and I suspect it would – that a single payer system would have obviated the need for gay people to resort to ACT UP in order to get the level of medical and social care that should have been their fuckin’ birthright, then it is time to move towards a single-payer system now, and to send the system that made gay people’s lives and deaths a living hell to the perdition it so richly deserves.

The 1980s AIDS crisis as a Forecast of Baby Boomer Amnesia

Monday, January 25, 2016

PART V: The 1980s AIDS crisis as a Forecast of Baby Boomer Amnesia

I have been reading Queers in Space: Communities/Public Places/Sites of Resistance (Seattle, Washington: Bay Press; 1997) the past few days, and in particular want to recommend Ty Geltmaker’s chapter, “The Queer Nation Acts Up: Health Care, Politics, and Sexual Diversity in the County of Angels, 1990-92.” The years cited in the title are slightly deceptive, since Geltmaker does an excellent job at compressing the sordid history of how little effort was made by elected politicians in Los Angeles to deliver even a minimal level of health care to those subjected to the ravages of HIV. In reading his article, I was struck by how vividly he made the first full decade of the epidemic come back in memory, and I was also struck by a contemporary disparity in awareness of how the pandemic altered the development of Gay consciousness.

In fact, I often wonder how much knowledge young people (those born after 1990) have of the AIDS crisis. What percentage of them know how many tens of thousands of people in the United States died from the debilitating onslaught of HIV between 1980 and 2000? How many died in Africa? In Europe? In Asia? In Latin America? And it’s just the millennials that I suspect of wearing hip-boots of ignorance as they wade through that roll-call. At this point, I am not even certain that most baby boomers are cognizant of the enormous number of deaths exacted in the aftermath of officially sanctioned neglect of AIDS patients. It is all too easy at this point to imagine that life has become “normal” again in the United States; in fact, with the majority approval of gay marriage, it would seem that the nightmare of AIDS, at least in the United States, can be said to be rapidly receding as a tragedy that will mainly stay present as a dramatic element of novels and poems and the occasional screenplay.

What needs to be asked, though, for those who want to press the issue of the single-payer system, however, is to demand a thorough analytical report of how the crisis would have been handled, had a single-payer system been in place in 1980. That difference will tell us how urgent it is to depart from the care system currently in place, which hardly differs from the one in operation thirty years ago. Stop deceiving yourself, my fellow citizens. If you think that AIDS is the last massive attack virus that will hit this country for the remainder of its history, then you are living in a fantasy. It is crucial to apply proposed models of health care to a representative crisis in the recent past if we are to resolve a future crisis with minimum casualties.

As I close this extended commentary on health care, I wish to circle back to the beginning, at which I talked about the crisis of jobs within the default systems of economic collapse. Consider this: if President Obama had truly looked at how other such periods of turbulence had been handled, he would have seen without any doubt whatsoever the scale of job programs needed to save the lives of working people. In the mid-1970s, even a Republican president signed off on CETA (the Comprehensive Employment Training Act), and Gerald Ford did so when unemployment was far less than was happening in Obama’s first months as president. At this point, we need to study how effective a single-payer system would have been in meeting the AIDS epidemic of the 1980s. If that study shows – and I suspect it would – that a single payer system would have obviated the need for gay people to resort to ACT UP in order to get the level of medical and social care that should have been their fuckin’ birthright, then it is time to move towards a single-payer system now, and to send the system that made gay people’s lives and deaths a living hell to the perdition it so richly deserves.

Dignified Black Deaths Matter, Too: The Right to Die Law and African-Americans

Sunday, January 24, 2015

PART FOUR: Dignified Black Deaths Matter, Too

In the past decade, one of the most important civil rights battles has involved the ability of an individual to put an end to useless suffering when confronted with the checkmate of mortality. Conservative factions insist that self-determination should be insisted upon when it comes to economic matters, yet the same groups will all too often call for their moral choices to be imposed upon others in the realm of health care. The West Coast of the United States has been leading the way in promoting the right of an individual to give herself or himself the same degree of compassion that we would give to any terminally suffering animal, and the recently passed legislation in California will no doubt cause the smug self-righteousness of conservative institutions, such as hospitals run by the Catholic church.

Regardless of whether a single-payer system is put into place in the near future, the the sobering fact remains that the access that individuals will have to the “right to die” under this new law is a matter yet to be determined. Michael Hiltzik in the Los Angeles Times has written recently of the problems that patients have incurred at Catholic hospitals when a woman wants a tubal ligation. One of the questions that the PNHP website does not address is how to integrate an institution that is ideologically hostile to the needs of the population it would serve under a single-payer system. What will happen, for instance, when a terminally ill patient — who is trapped in a Catholic hospital designated as the only provider by her HMO — is not interested in being starved to death in a hospice, but instead adds her voice to the chorus of Kurt Vonnegut’s poignant question as he neared the end: “Can I go home now?”

(Let me be clear about one point: hospice care would claim that pain-killing drugs enable people to have all nutrition cut off and yet experience no suffering. Unfortunately, the accuracy of medical claims falls far short of the guarantee needed in such an intimate matter, and skepticism in regards to this claim by hospice organizations and their advocates is utterly justified.)

In enforcing the right of individuals to terminate their lives when pain approaches the point of intolerable duress, I can easily see a crisis looming for the baby boom generation. A lot of people are going to die in the next 15 years, and some of them will passionately yearn for release from their protracted suffering. What is completely predictable is that Catholic hospitals and the hospices under their control will refuse to allow doctors in residence to grant the legal wishes of their patients.

In countering this obstreperousness, one point to keep in mind is the all important exchange of money for services and where that money comes from. If Catholic hospitals accept any tax money whatsoever, then they need to bow to the rights guaranteed by law to all who have contributed to that tax system. In point of fact, this is one of the things that brought the integration of schools to a flashpoint at mid-20th century. School districts would accept federal money, for instance, that was given to them to sustain the education of the offspring of military personnel stationed in their districts. Often these areas loved the presence of the military, since their payrolls contributed to the local economy. The edge of that sword, however, was less welcome. If a school district accepted funds from the government to educate the children of military personnel, it could not then turn around and say that the African-American children of these soldiers and sailors could not then attend the same public schools as the children of white soldiers and sailors. In a similar manner, Catholic hospitals will have to get used to the idea that they cannot be exceptions to the rule of law and they will have to integrate their services with the rights of those who want to end their suffering.

Finally, my most profound concern about the enforcement of right to die legislation is how it might play out along racial lines. Given the disparity in treatment of African-American citizens by police forces in this country, one would be naïve to believe that such discrimination stops there. Hospitals run by the Catholic Church do not tend to be much different than most urban police forces: the hierarchy in the work force is largely white at the top and in the middle. As such, one is not unreasonably nervous in anticipating that white people in charge of caring for dying African-Americans might take it upon themselves to subject their patients to one final jolt of contempt and humiliation. (The presence of crucifixes throughout Catholic hospitals should suffice to remind us that Catholic hospitals fester with an ideology that valorizes suffering as a necessary component for so-called eternal salvation.) When baby boomer African-Americans, who somehow survived the gauntlet of random gunfire from any number of sources over the past several decades, finally arrive at the waiting area of personal embarkation, they deserve equal access to the “right to die” law. To assume that equal access to the right to die will of course be granted to African-Americans is as foolish as assuming that every African-African is treated by police officers with the same respect as Caucasian citizens. Black Lives Matter. Healthy Black Lives Matter. And Dignity in Death matters for Black lives, too.

Healthy Black Lives Matter (Single-Payer, Part 3)

January 23, 2016

Healthy Black Lives Matter: Race and the Single-Payer System

Physicians for a National Health Program (PNHP) has a website I would urge all of you to take a look at. It covers most of the issues that might concern us in shifting the economic and palliative paradigms of health care. In addressing “Frequently Asked Questions” about single-payer health systems, however, one word that scarcely appears, is “race.” How would a single-payer system affect the dynamics of social stratification of race? How would the hierarchy of white privilege fare under single-payer? The answer to this is the slogan that Bernie Sanders should have adopted over a year ago:

Healthy Black Lives Matter

In the single-payer system the phrase “all are equal in the eyes of the law” extends firmly into the world of health care. I suspect, however, that the possibility that African-Americans and Latin@s would have equal access to high quality medical diagnosis and treatment is precisely the factor that makes the single-payer system unacceptable to many people who vote in a conservative pattern.

The crisis in Flint, Michigan regarding the lead poisoning of its population should be monitored under many different rubrics, but the quality of health care that the afflicted residents receive should be given particular attention. If “Black Lives Matter,” it is not simply that they should be free of antagonistic treatment by police, but that these lives should be as healthy as possible.

In this regard, one of the most important FAQs (Frequently Asked Questions) on the PNHP website is: “Why shouldn’t we let people buy better health care if they can afford it?” PNHP responds by saying that “If the wealthy are forced to rely on the same health system as the poor, they will use their political power to assure that the health system is well funded. Conversely, programs for the poor become poor programs. For instance, because Medicaid doesn’t serve the wealthy, the payment rates are low and many physicians refuse to see Medicaid patients. Calls to improve Medicaid fall on deaf ears because the beneficiaries are not considered politically important.”

This answer could be thought of as the equivalent of everyone having to drink the same water. If the families of high level automobile manufacturing executives had had to drink the same water as the families in Flint, Michigan, do you not think that more care would have been taken to monitor the quality of water? Health care, like drinking water, is a fundamental human right. “Healthy Black Lives Matter” should become one of the primary demands — perhaps the primary demand — for those of us who want to see a fundamental change in the distribution of medical knowledge and resources.

NEXT INSTALLMENTS
Part Four: Dignified Black Deaths Matter, Too (End of Life Directives, White Privilege and Single Payer Equality)

Part Five: The 1980 AIDS crisis as a Forecast of Baby Boomer Amnesia

“Mega-mergers” versus Obamacare paranoia (The Health Care Crisis, Part Two)

January 21, 2016

The obsession of the right-wing with Obamacare and how the Federal government might “socialize” medicine is a long-standing resentment. One of the most popular programs administered on a national level is Medicare, but it was strongly opposed in its original formation by the Republican party and its more extreme sympathizers.

The fear of centralized control of such an intimate matter as one’s individual health has some reasonable basis. Anyone who works at a large institution knows the enormous discrepancy between the ideological claims of those who administer the institution’s programs and the actual delivery of those services. “Student success” is the mantra in higher education, but I have seen first hand how students needing classes and registered for those classes are left empty-handed. And I myself, at a critical moment in my health care between July and November, 2010, nearly died because of the bureaucratic ineptitude and indifference of my HMO medical plan; indeed, I have seen this personal experience replicated several times in the past decade and a half in my first-hand network of friends and family. The difference between the level of care announced in HMO press releases and the dilatory delivery of that care when it is needed is enough to make one highly suspicious of claims that urgent medical attention, under the thumb of HMO financial expediency, will be superior to the care that a single-payer system will deliver.

The part that I don’t understand about people’s fear of Obamacare or a single-payer system administered by the federal government is their concern about the centralization of medical power. Hey, folks – it’s already happening. All you have to do is look at the articles in newspapers about the mergers of various HMOs to understand that massive mergers of health insurers have already created a vortex of centralization that has the profit-motive as its primary engine: your health is merely an inconvenient obstacle to the maximization of that overriding urgency.

The issue of “mega-mergers” was recently the subject of a very fine article by Chad Terhune, an award-winning journalist, in the Los Angeles Times.

http://www.latimes.com/business/la-fi-agenda-health-mergers-20160111-story.html

This article is dated January 11, 2016, and it is merely the latest installment by a reporter with an impressive backlog of articles on the health industry crisis. It appears, however, that this will be his last article as a reporter for the Los Angeles Times. I heard recently that David Ulin is no longer with the LA Times, and I note with dismay on the bio page for Chad Terhune that “he left the Times in January 2016.” If so, the departure of two writers of the caliber of Ulin and Terhune is not a good sign for the future of that newspaper. I am deeply concerned about how the Times plans to cover the current debate on health care. To whom will this crucial assignment be given? I have substantial doubts that someone of Terhune’s exceptional caliber will replace him.

In the meantime, the question I have for conservatives who fulminate about Obamacare’s centralized control of medical plans is why the same vigorous disdain is not brought to bear on these mega-mergers. It seems, quite frankly, hypocritical to lambast Obama’s program on one hand, and then to shrug one’s shoulders with a “business-as-usual” slouch as companies interweave with one another in a winner-take-as-much-as-possible competition.

For Terhune’s biography, see:

http://www.latimes.com/la-bio-chad-terhune-staff.html?page=2&#