Saturday, February 28, 2009

Doctors Without (Ethical) Borders

"(Health Care) is a cost that now causes a bankruptcy in America every thirty seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes...It is one of the major reasons why small businesses close their doors and corporations ship jobs overseas...Given these facts, we can no longer afford to put health care reform on hold. So let there be no doubt: (it) cannot wait, it must not wait, and it will not wait another year."
Barack Obama: Address to Joint Session of Congress 2/24/09

Considering that I have lived without health insurance for seventeen years, last week's check-up was pretty good. When I told the doctor that I was excited about the prospect of finally obtaining insurance, he replied that he hoped Obama "wouldn't make him into a federal employee." I would have argued with him, but he was examining my prostate at the time. The doctor knows better than to believe he is about to be drafted into some triage system for the wretched, but he defended his ground because he has been a part of the problem. And the problem has existed for thirty years. Doctors are sort of like truckers: once, a long time ago, they were courteous. Since I am now a "retail" patient, who's insurance cannot be exploited, I have received second-class treatment and taken my seat in the back of the medical bus. I have to enter a doctor's office, hat in hand, and ask for favors and discounts, and thus, have not received the same treatment as an insured patient. Melody urges me to go to the Church Health Center, but I feel I would be taking the place of someone who is truly destitute. I can afford insurance, but the HMOs have determined me "uninsurable." I can't buy it at any price.

Since all the current institutional and infrastructural decay can be traced back to the Reagan administration, that's when the crisis in health care began as well. The nation voted for "less government," and that's what we got. Reagan, the Great De-regulator, was saying it was "Morning in America," but that was mainly for opportunistic capitalists who could see their dreams of unfettered greed finally realized. So the big insurance companies, in collusion with the medical/hospital industry, and the American Medical Association, allowed the formation of the HMO and began herding all citizens into groups of managed care. That was the Conservatives' version of "socialized medicine." I recall having to join the National Council of Jewish Women to get a group rate, but the premiums grew so astronomically that the insurer finally thought better of paying the medical costs for a bunch of elderly, Jewish woman, and dropped the whole group.

Since then, I have been considered an "untouchable." Millions of people take anti-depressants and still obtain insurance. Because mine was initially prescribed by a psychiatrist, I have what is considered a "pre-existing mental condition," which disqualifies me from consideration by the beancounters who decide who's a bad risk for the insurance company. My internist told me to transfer all my records to him and he would prescribe the medication, allowing me the extreme Freudian pleasure of firing my psychiatrist. But when I again applied for coverage, the doctor sent in the same old records and I got the same old answer. So, I am one of those people who fear a catastrophic illness, only more financially than physically. It amazes me that those who can get health insurance are granted it through the workplace, or otherwise have to prove themselves healthy, while others who actually need medical attention are routinely denied. But as long as those papers kept shuffling between doctor's offices, insurance companies, and the government, it was a sweet deal for everyone but the patient. Doctors were so well compensated, they began to think more about Medicare payments and profits than patients. That's why, when you walk into a doctor's office, the first thing they examine is your wallet. And why is it that every time you're in the waiting room, a tight-dressed, spike-heeled, drug representative pulling perks on wheels gets ushered right in?

While the Medical/Pharmaceutical Complex was pulling in huge profits, they failed to re-invest any of it in the upkeep of hospitals. Once the avant-guarde of innovation, hospitals across the country lie in states of decay with antiquated equipment and intrusive devises that are monitored from an understaffed nurses' desk. How could hospitals become the last institutions to embrace new technologies? Confining the ill to be monitored may be a convenience for the doctor, but it has become the equivalent of checking into a seedy hotel for the patient. The last time a relative was at Baptist East, they charged extra for cable on that Motel 6 TV that's been mounted in the corner since 1972. The understaffing is another result of greed within the industry. I'm of an age to have observed several loved ones go through the hospital "system," and their halls are full of only bad memories for me. I only hope that if I'm incapacitated, rather than be hooked up to all that pre-historic shit and left to linger, that I be allowed to go home and die in my own bed. Of course, the technology exists where you could be monitored from home, but where's the profit in that?

I was delighted to hear President Obama announce that health care reform was among his priorities. The Conservatives can scream "socialized medicine" all they like, but that's exactly where we were going with health management organizations that had nothing to do with health, and everything to do with maximizing profits on the backs of the ill. The Right can't tolerate socialistic ideas because they believe they all lead right to Mussolini. But the Bush regime's hands-off, business first policy created no incentive for reform and so health care costs have exploded during the past eight years. Bush's statement that "Too many good docs are getting out of business...Too many OB/GYNs aren't able to practice their love with women across this country," wasn't out of concern for doctors or their patients, he was defending the insurance companies.

Now that we're all in a mid-sociological bungee jump, I wonder how that first big drop is treating everyone's stomach? I first developed stomach problems several years ago and when the doctor asked if I was experiencing any unusual stress, I told him, "I don't know Doc, but it didn't hurt during the Clinton administration." Since then, I've experienced enough invasive procedures to add a wing to his clinic, but they found nothing and since I had no insurance they wanted to spare me the expense of an Ultrasound. Ultimately, the Ultrasound I was forced to purchase turned up an ulcer so aggravated, it even surprised the doctor. It's been treated, but I've been left with a gastric condition that was further enflamed by the stress of no health insurance and no hope of getting it under the previous administration. I can't afford any more "oscopies," so I live with the condition. I have, however, named my pain. So until I am able, and hopefully soon, to obtain some health care coverage, when I am stricken with sudden gastric distress and have to excuse myself, I plan to say, "Pardon me. I have to go take a Bush."

Monday, February 23, 2009

You Talkin' To Me?

I wouldn't suppose anyone likes to be called a coward, even if you are one. Yet Attorney General Eric Holder said we were a "nation of cowards," when it comes to discussing matters of race. I understand Holder's purpose was to chastise and challenge people of all races about our national unwillingness to have a dialogue about what is really going on in our society, but only a month after we elected our first African-American president with an unprecedented outpouring of good will, and only two weeks since Holder was sworn in as our first black Attorney General, was "cowards" the wisest terminology to describe American society? Where I come from, those are fighting words. I recall another first, Andrew Young, who became Secretary to the United Nations under Jimmy Carter, and in debate with the British delegation said the English were intimately familiar with racism since "they pretty much invented it." What he said may have been factually correct, but his job description was supposedly to be a diplomat.

Perhaps I've lived in the South so long that I've developed a touch of redneck, but Holder's comments unexpectedly made my blood rise. It was akin to being a kid on the playground being pushed to the ground by the class bully. You can either sit there and put your cowardice on display, or charge the bully and try to inflict as much physical pain as possible while simultaneously praying that someone is there to break it up. There are, in fact, readers of this post that if you called "cowards" to their face, your next act would be gathering your teeth from the floor. I'm a pacifist who understands the intention, but Holder's unfortunate choice of words served to inflame many of the people who were already on his side and feeling uplifted over our historical national achievement. The really unfortunate part of this episode is that Holder is right about the need for racial dialogue, but his message was lost in the rancor of his clumsy and intentional provocation.

Holder succeeded in pretty much offending everyone, including, I imagine, President Obama. The President has so far been very careful to be non-confrontational and inclusive in his speeches, I wonder if Holder ran that little doozy past him first? In a joint appearance shortly after the inauguration, when Joe Biden joked about Chief Justice John "No Notes" Roberts mangling the Oath of Office, Barack grabbed his elbow and gave him a glance like a parent would a feckless child. I hardly believe the President would approve of his new Attorney General, in one of his first public speeches, making well-intentioned but ultimately divisive remarks. A racial discussion would be a good thing, but just right now, it's a few notches down in urgency than the economy, health care, and fending off an impending Depression. First, clean up the Justice Department, then we'll talk.

In fact, had Holder taken the long view, he might have seen what I have in recent years. I am among the remaining members of a generation who never sat in a classroom with a black student until I reached college. Attempting inter-racial friendships took some outreach and understanding on all parties, but I was never afraid to discuss race with anyone. Early on, I noticed a curious thing about both whites and blacks from a segregated society attempting to talk to one another for the first times. Whites would adapt some imagined hip-patois or jive lingo trying to relate to blacks, while blacks would become stricter and more pronounced in speech with white people than they were with each another. I managed to find a way to be constant in my behavior with everyone while resisting the temptation to perform multi-layered handshakes. An entire generation of people are still awkward around each other simply because of their forced separation in childhood. Such is not the case with young people like my step-son, Cameron, who know not the curse of segregation.

I marvelled at the seamlessness of his friendships with people of all races. Cameron didn't have "black" friends, or "Asian" friends, they were all just his friends. Holder's "nation of cowards" is of a certain generation, a remnant from the past when races were separated by law, along with the casualties of the "Reagan Revolution" who were either enriched or institutionally impoverished by "trickle-down" economics. Like 1968, we are a nation divided by young and old, rich and poor, black and white, Christians and everybody else. But the warriors of the Civil Rights movement, as well as their opponents, are rapidly aging now, soon to be replaced by this post-racial society we speak of, but have yet to experience in our time. Since Eric Holder was being blunt to make a point, let me be blunt as well. General Holder, before you come out swinging wildly and calling people of good will "cowards," you may wish to first display some personal courage yourself. The conflagration at Waco and the storm-trooper mission to retrieve Elian Gonzales are not sterling references on your resume. I already know you will be a wiser Attorney General than John Ashcroft or Alberto Gonzales by default, but maybe you should shut up until you have at least passed the Janet Reno threshold.

Friday, February 06, 2009

The Simmering Pot

Thank you, Michael Phelps, for pointing out the most glaring hypocrisy in American life that we have now lived with for over forty years; the foolish and childish demonization of marijuana, existing cheek by jowl with the romantic and seductive image of alcohol, created and sold to us since birth by the liquor industry. The Olympic star is 23 years old. Old enough to be responsible for his decisions. But the only misjudgement I see here, is that he trusted his rat bastard friends to not take cell phone pics of him, thus proving Cindy Lauper's warning, "Money Changes Everything." Sure, pot is still against the law, another sign of the failure of my generation, but suddenly Phelps' photo is all over the world, as if he were caught in a Chinese opium den, and he is being forced to grovel before the cameras to save his sponsorships. Kellogg has already announced they are dumping him. If I wasn't hooked on Raisin Bran, I'd consider boycotting the company.

And all this was simply over a photo. I thought it was only illegal to possess marijuana, but Phelps is being persecuted for a picture of him smoking sometime in the past. The reactionary governing body of some obtuse organization called U.S. Swimming has suspended Phelps for three months, cancelling several meet appearances and cutting off all financial support, "effective immediately." The board's statement could have come right out of 1968:
"This is not a situation where any anti-doping rule was violated, but we decided to send a strong message to Michael (Burt Bachrach take note) because he disappointed so many people, particularly who look up to him as a role model and a hero."

Spoken like a true member of the 50% of American society that still denies trying pot. Are those hard-won gold medals less worthy because of a bong hit? Fools! Your children already know more about it than you do. I understand that still developing brains have no business trying any mind-altering substance whatever. That's why we don't sell whiskey to children. But it's easier for your children to get pot than alcohol, especially with the profit motive and the outlaw mystique that comes along with the procurement and use of the illegal herb. And the smoking of anything is not healthy for the body, but a lung full of pot is far less harmful than a gut full of whiskey. Had Mr. Phelps been photographed at the same party with a large tumbler of scotch, no one would have raised an eyebrow, and that's just asinine.

Eric Schlosser has written the book, Reefer Madness: Sex, Drugs and Cheap Labor in the American Black Market, where marijuana is claimed to be the largest cash crop in the country. At the same time, Schlosser claimed in 2003, that "there are more people in prison today for violating marijuana laws than at any other time in American history." First outlawed by the states in the 30s to threaten illegal migrant workers not yet sufficiently exploited by their employers, with arrest as well, a government sponsored misinformation campaign of marijuana hysteria continued unabated until the Beatniks and Hippies exposed it as lies and propaganda. According to Schlosser, "The war on drugs launched by President Ronald Reagan in 1982 began largely as a campaign against marijuana, organized by conservative parents' groups." When Reagan secretly supplied the Contras in Nicaragua with weapons, we now know those supposedly empty CIA planes came back to this country filled with cocaine which, depending on who you ask, created the nationwide crack epidemic. Yet, the know-less-than-nothing Reagan began his War on Drugs on a weed that grows wild in almost every continent. He may as well have declared war on Kudzu.

The cultivation of marijuana is now an American industry. In the mid-60s, they once estimated that three million people had smoked marijuana, now it is estimated that three million people grow it. Entire counties in Northern California have been given over to pot farming and the legalization of medical marijuana has not just brought relief to sufferers of a variety of maladies, from Glaucoma to symptoms of AIDS, it has made pot as easy to obtain as a pizza. Still, the federal laws clash with the state laws and the DEA goes in periodically like the bull in the china shop to bust everything up on principle. And marijuana laws in other states, particularly in the South, are as draconian as ever, despite the ever-rising number of pot-related arrests. With the out-of-proportion public flogging of Michael Phelps, perhaps the indignation will be sufficient enough for the public to be amenable to the reform of marijuana laws. Ohio State University scientists have recently shown marijuana has the capacity to reduce memory impairment in the aging brain and those few who still claim that pot is a "gateway" to more dangerous substances have yet to discover that the gateway leads to a bag of Fritos and a Snickers Bar. Wouldn't it be something if there were a movement underway to re-educate the public, decriminalize, regulate, and tax marijuana? Well, there is.

Reps. Barney Frank and Ron Paul have introduced bi-partisan bills: H.R.5842, which allows the states to decide to decriminalize or allow medical marijuana without interference from Federal authority, and H.R.5843, officially called "The Act to Reform Federal Penalties for the Personal Use of Marijuana by Responsible Adults." The intrepid people from NORML helped to write the bill, which would end the criminal prosecution of Americans in possession of 100 grams, or nearly four ounces, which would be considered as personal use. Presently, the government classifies pot as a Schedule 1 controlled substance, just like heroin and PCP. The Marijuana Policy Project states marijuana arrests "outnumber arrests for all violent crimes combined," yet I never knew anyone who ever held up a liquor store because he was out of pot. Barney Frank said, "The vast amount of human activity should be none of the government's business." The Congressman added, "I don't think it is the government's business to tell you how to spend your leisure time." With all the problems on the new President's shoulders, it would seem that an innocuous weed would be a low priority. But if President Obama is looking for new and profitable businesses, he need look no farther than California, where an already burgeoning marijuana trade, if properly regulated, just might take a huge bite out of the national debt. This is one project that is literally "shovel ready."