The Reformation

I blogged a lot last year on health care reform. I wrote a lot on the public option - give people a place to pay their premiums! - and I went to congressional meetings (one with Maria Cantwell, one with Cathy McMorris Rodgers). I was horrified at the traction that the phrase "death panels" got, when all the bill proposed was to give people the opportunity to not have to pay for a discussion with their doctor on end-of-life issues.

And even when I stopped writing about it - at some point these last couple of months, so exhausted I was by the rhetoric - I still followed it. I didn't actually sit and watch the seven-hour meeting between the parties, but I read synopses of it - cared about it - agreed with Sen. McCain that the special side deals should be taken out, was buoyed when the President said "good point".... I even got the chance to feel like a Microsoft commercial (you know, the ones where a single person who shared an idea with Microsoft believes the company actually got his email and ran with the improvement) because, on a recent Thursday, I called Maria Cantwell's office in D.C. and said that something needed to be done about all those pet projects, it was the principal of the matter, that I'm the choir for them and even I am unhappy about that... And then two days later, the Prez asked that the pet project funding be taken out of the final bill. Wow, I thought. I need to make phone calls more often!

But I didn't take part in that final push of phone calls this past week. I was still discouraged by the private deals, I suppose. Besides, in my corner of the world, the votes were already essentially cast (senators in favor, representative opposed). I did get the emails asking that I take this action or that... but for better or for worse, I let them slide.

Then, this past weekend, somehow I started to feel the enormity of it - how this was doing something that had simply not been doable at any other time - that this really was happening. I felt proud of the people who had kept on keeping on. I felt gratified that I had, at least, helped out early on, and periodically. And I was suddenly glad to see the bill pass, frailties and all.

Then on Tuesday, I received an email from Mitch Stewart, head of Organizing for America. The president wanted to talk to me. Well, now, apparently he also wanted to talk to his 500,000 or so closest friends (don't really know the number, am just guessing) but still, I was invited. "For all my hard work," the email said - or some such thing. Hmm.... I felt a little guilty, since I hadn't been working all that hard in recent weeks.

But still, I got on the call. And I heard the president thank us all. And I had a few tears, as I realized again the mountain that had been moved, by this bill being signed. He called it an "improbable journey" - and it was. He told us to savor the moment - and we did. He said that the bill "enshrines the idea that everyone" should have some security when it comes to health care - not just some, but everyone - and that once the principle is enshrined, it means that people will have enormously more secure lives than they do now. And he said that neither illness nor accident should endanger the American dream. That last line - schmaltzy, you know? - but it's right. He's right. It matters that much, at that much of a core level.

He said there was more work, to help explain what the bill really contains (and he went through a list - he mentioned, btw, that Congress will be on the exchange when it gets in place, which does give some hope that the exchange will work). He said - in response to a question - that one thing he learned was to stay focused, stay with the big picture, and then stay dogged. And then he said again, thanks - that our hard work was his inspiration.

This morning, I went on line and a few things warmed my heart again. One was this clip from the signing ceremony, where he spoke about young Marcelas. And then there was this excerpt from Teddy Kennedy's obituary from 2009 - from the Boston Globe:

Despite his illness, Senator Kennedy made a forceful appearance at the Democratic convention in Denver, exhorting his party to victory and declaring that the fight for universal health insurance had been "the cause of my life.’’

He pursued that cause vigorously, and even as his health declined, he spent days reaching out to colleagues to win support for a sweeping overhaul; when members of Obama’s administration questioned the president’s decision to spend so much political capital on the seemingly intractable health care issue, Obama reportedly replied, "I promised Teddy.’’

Those are the kinds of promises that have to be kept.

The Guardian: Live Blogging Health Care Debate

Well, I didn't - couldn't, because of schedules - really watch the day long health care summit that was televised live last week at the Blair House in D.C. I watched some highlights, enjoyed the recap on "The Daily Show" (they're so funny). But I just ran across this live-blogging summary in the UK's "The Guardian" that is short (maybe shortened for the final version) but also helpful and funny. Sounds like they did a good job of highlighting things. Here's the link:

http://www.guardian.co.uk/world/richard-adams-blog/2010/feb/25/live-blog-healthcare-summit-obama-republicans

Some funny parts from the blog (just things that made me laugh - there's much more substance in the body of the blog) - funniest line is at 3:27 p.m.:

10.03am: You could cut the tension with a tissue. So far: lots of mainly old white men sitting around a table reading bits of paper. In other words: what most of Washington DC looks like most of the time...

10.21am: Now it's the Republicans' turn – via Senator Lamar Alexander of Tennessee. He's not the most exciting person in the world, but compared with the Republican Senate minority leader Mitch McConnell he's dynamite. But then so is mold. "I'd like to begin with a story. When I was elected governor..." great, thanks Lamar. (Is narcolepsy a pre-existing condition on my health insurance?)...

12.57pm: Slaughter relates a tale of a woman unable to afford dentures – and so wore her dead sister's dentures. "Did you ever believe that in America, that's where we would be?" asks Slaughter. My colleague Ewen MacAskill mentions that this used to be quite common in Scotland, 20 or 30 years ago. So, ah, another triumph for the US healthcare system....

Presidental Cigarette Break / House Vote / Lunch: What better time to sum up where we are, after nearly three hours. Um...

2.48pm: Biden's still going ... bending the curve ... and so on. I've got the sound down. Shot of John Boehner, who appears to be chewing a thistle. He really does look like a character out of Mad Men. Meanwhile, Mike Enzi hunches forward and thinks about selling shoes in the good old days while slowly scratching the side of his face. John McCain looks vaguely angry...

3.27pm: Republican House leader John Boehner speaks: "This bill is a dangerous experiment with the best healthcare system in the world." What, this bill also affects Japan?

3.55pm: And the Republican big finish comes from ... John Barrasso! What do you mean, who? John Barrasso – the former chief executive of the largest hospital in Casper, Wyoming. And now senator.

4.00pm: Oh, wow, John Barrasso thinks all members of Congress should only have "catastrophic" health insurance – so, just cancer and big stuff. Why? asks Obama. "Because then we'd have more skin in the game," says Barrasso. And so people would save more. "But what if you were on $40,000, John?" says Obama. That floors Barrasso, who struggles to come back with a fish imitation ("glub glub glub") about park rangers... Fantastic – this was by far the best exchange of the day so far. It clearly shows the difference between the two sides.

5.08pm: Obama's performance, whether you like him or not, has been impressive here. For seven hours, with just 45 minutes off in the middle, he's kept this up, and is still talking and making sense under the spotlight. It's hard to imagine some former presidents managing something like this. I thinking there of .. let's see ... Calvin Coolidge. Coolidge's father was once asked to describe his son. He paused for a considerable period before replying: "He ain't sassy."

Sixty Votes - and Tom Coburn's Prayer

Early this morning, at 1 a.m., the Senate voted to begin the process of closing debate on the health care reform bill - called cloture. They needed at least 60 of 100 senators to vote yes. There are two more procedural votes before a vote on the bill can be taken. The bill itself needs only 50 votes to pass. But ending the debate takes 60, starting with last night's vote. This means that every Democrat plus two independents needed to vote yea last night. All Republicans voted nay.

Included in this 1 a.m. vote was Democrat Sen. Robert Byrd from West Virginia. He's 92. He's been in and out of hospitals, and was home yesterday because of his weak health. But he was going to attend the procedural vote. He would be the 60th vote needed. It would have been better for his health had the vote taken place at a more respectable time, and not in the middle of a snowstorm. But apparently the Republicans resisted that, so he needed to trudge out of the house, in his wheelchair, in the middle of the night instead.

Sen. Tom Coburn (R-Okla.) apparently wished for his demise earlier in the day. At 4 p.m. yesterday afternoon, Coburn said, "What the American people ought to pray is that somebody can't make the vote tonight. That's what they ought to pray." Later, Sen. Dick Durbin (D-Ill.) called him out on it. "This statement goes too far," Durbin said. "We are becoming more coarse and divided here ... When it reaches a point where we're praying, asking people to pray, that senators wouldn't be able to answer the roll call, I think it has crossed the line... This statement troubles me, and I’m trying to reach him [Coburn] come back to the floor and explain exactly what he meant about a senator being unable to make the vote tonight."

In spite of Tom Coburn's apparent call for prayer for his demise, Sen. Byrd was there at 1 a.m. - like clockwork:

Coburn was wearing blue jeans, an argyle sweater and a tweed jacket with elbow patches when he walked back into the chamber a few minutes before 1 a.m. He watched without expression when Byrd was wheeled in, dabbing his eyes and nose with tissues, his complexion pale. When his name was called, Byrd shot his right index finger into the air as he shouted "aye," then pumped his left fist in defiance.

Here's an article on what happened.

And here is some of the video:



Bottom line - and Tom Coburn's prayers notwithstanding - the 60 votes have gathered. For as frustrating as it's been - and as frustrating as the compromises are - this is a great, great thing, that this bill has moved.

Health Care Phone Calls

I just received an email asking me to call my U.S. senators and ask them to support health care reform. Well, of course both of my senators already do support it. But it's an important weekend in the Senate - the threat of a filibuster hangs over the heads of these men and women - so I thought a phone call from me and hundreds (thousands?) of others could be helpful.

This is what I said to both Sen. Patty Murray and Sen. Maria Cantwell's offices: stand firm. Fight for the public option. And if Repubs and conservative Dems want to filibuster that - let them filibuster. The polls - even just this week - show that the public supports the public option. If the naysayers want to fight upstream on that issue, let them. Let's see if they will join in that filibuster already. Let it all unfold. Let the chips fall where they may. I'd rather see a fight for the public option than have my senators not fight for it at all.

(BTW - a filibuster is when senators fight against agreeing to consider a bill. This bill only needs 50 votes to pass on the floor, but it needs 60 votes for cloture. If the senators want to delay that consideration, then they have to have something to say in the meantime - hence, the "filibuster." This is when they might start reading from the phone book, just to keep the bill from floor debate. This happens only in the Senate, not the House. In modern times, apparently just saying the word "filibuster" was enough to keep the thing from consideration. But the Senate leader has the option of requiring a traditional filibuster too. Okay, so now I just called Harry Reid's office - Senate leader - and asked that he require a traditional filibuster, if it comes to that.)

Abortion Statistics

So I'm watching "Morning Joe" in the a.m. again (but only when I wake up at 4, or when I'm getting ready for 6 a.m. boot camp). This morning, Lawrence O'Donnell was on, looking about as sleepy as I felt. They started talking about coverage for abortions in insurance. I guess the RNC found out that it had insurance coverage for abortions in its insurance policy, and has now eliminated that coverage (after Politico reported on it). So Joe Scarborough asked O'Donnell what he thought about that. O'Donnell began by saying that the majority of Americans support abortion rights. Scarborough interrupted him, said it isn't 1972 anymore, and that the statistics show that Americans don't support abortion rights anymore. O'Donnell said to go ahead and show his poll, but O'Donnell remained correct. O'Donnell then cited an interview with John McCain from some time ago. Apparently McCain was asked if he would be against abortion if his daughter was pregnant. McCain said that he'd have to think about that. (I can't find the quote.) O'Donnell rephrased it: so it's fine for everyone else to ban abortion, but maybe not for my daughter, but I'm still against abortion because I'm a Republican. O'Donnell then used that quote to say that politicians treat abortion as a political issue, regardless of personal belief, and it keeps them out of touch with the reality of the country's leanings, to be so black and white about it.

The discussion got me thinking: are Americans against abortion now? So I looked it up and found a great compilation of surveys taken over the years, including recent surveys taken in 2009. Taken as a whole, and not cherry-picking favorite results, I think the polls are pretty solidly consistent: a majority of Americans believe in a right to choose, with some concern about the circumstances (which I attribute, at least in part, to misinformation out there about third trimester abortions) and only a handful believe that abortions should be outlawed in all cases. Another interesting stat: most see it as one of many issues, not the key issue for which they must vote yea or nay on a candidate. Some of those same people who believe in choice also see themselves as pro life, which is perhaps where some of the confusion lies. Bottom line, however, O'Donnell was right, Scarborough was wrong, and Congress is doing what it often does - it is listening to the loudest, most boisterous voices, not the much-quieter majority.

Health Care Moves

What an amazing night for health care. I watched only a little, and then some highlights this morning. I'm sorry to have missed seeing the vote live.

It is just the one step. But I feel glad. And vindicated. And I think - I think - that the paper tiger of the Repubs is starting to look frayed. When John Boehner (R-Ohio) went on and on about how terrible it was that the bill had a provision that would make people pay a penalty if they don't get insurance (which comes with subsidies for people who can't afford the premiums, and is basically the way we already do auto insurance) - well, he just looked dumb. Especially since we all know that those who aren't insured will still get medical care in cases of emergency, which means we pay for their lack of foresight in failing to get insurance in the first place. Isn't that a Republican principle? No free rides? And he's against that provision? Hmmm. Something smells in the state of Ohio.

They also look silly in light of the fact that both the AARP and the AMA have come out and endorsed the bill now. I happened to see an AMA doctor talking in support of it. He was even-handed, but clearly advocated for the bill's passage. I figured he had to be some random doctor, so supportive he was of the bill. Then they flashed his title - head of the AMA. Wow. Really?

It is one of those great times, when people step up and stand for something. It started with Rep. John Dingell (D-Mich.), who hit the gavel to being the proceedings. It was his father who introduced health care legislation for years, and it was his son who took over that legacy for the past 54 years (and who started the proceedings for the Medicare bill back in 1964). Every year, he introduced a health care reform bill. Every year.

And then during the press conference after the vote, Nancy Pelosi made a point of calling up to the podium Rep. Patrick Kennedy (D-RI), the late Teddy Kennedy's son - another champion of this cause, up through his death. "My dad was a senator," Patrick Kennedy said. "But tonight his spirit was in the House."

I'm unhappy with the restrictions of funding for abortions. But it seems like a hollow victory for those who want it. At least, I hope it will be, in the end. As in, there's no guarantee it stays in the bill. And even if it does, it doesn't end abortion (though it does affect the poorest of women out there.) We'll have to wait and see what happens. In the meantime, the bill has passed, 220 to 215.

And my brother made a great point last night. Why do they need 1,000 pages? The Medicare bill back in the 1960s apparently was 28 pages. I haven't read the current bill, though am very familiar with its concepts, but the number of pages does seem daunting. I suppose it's the evolution of the times, and the law. When we lawyers write "briefs," they hardly ever are anymore.

Politics. It's the making of sausage, isn't it?

And Calling...

Yesterday began an onslaught of calls to Congress from supporters of health care reform, organized through the Organizing for America website. I wrote about my own experience of making the phone calls here.

And the numbers keep rising. People called other people all throughout the country yesterday, to make these phone calls again today. The number, at this moment, of calls made is 319,279. Apparently the president joined up with the people in New York who had been making the phonebanking effort.

And then there were the stories, as people talked to each other about how important it is to make these changes. Here is a sample of a couple of those stories:

This evening I and three other volunteers got together and made calls. As I was calling, one of the women I spoke with told me that she was inspired by my story -- shared in the email earlier that day -- to get her entire family to call Congress. She didn't know it was me on the phone, but she said she just couldn't stop saying "this isn't right" when she heard my story. It gave me so much hope -- during the evening we made 213 calls and got 64 commitments to call tomorrow.

-Jenny U., Missouri Volunteer

Seeing the tally go up, hearing voter after voter agree to call, and listening to the real excitement people have about finally fixing this broken system, I was reminded why we do this. Each of us can only give so much -- but when we all do it together, we move mountains. Health insurance reform, here we come.

-Sean Knox, California New Media Director

And here's a message from Mitch Stewart, director of OFA, where I got the above quotes.

And then here's the president from last night. Really great speech. He starts at about nine minutes in. He starts to get funny at 28 minutes, and then really funny at about 30 minutes.

Calling All Legislators!

So I got a couple of phone calls today, asking me to call my congresspeople and urge them to support health care reform. Sure, I said. Happy to do it. Apparently there were some details I didn't get - like, after I made the phone calls, I was supposed to record that fact at the Organizing for America website, etc., but I figured that out too. I watched to see if my name came up at all on the OFA website - "Beth B. from Spokane, WA, just called Rep. McMorris Rodgers," but after half a minute I let it go. It'll show up or it won't, but I'll never know...

It was an interesting process. I made my phone calls before realizing that I was supposed to ask if they support the health care reform plan. I did of course explain nuances of why it mattered to support the public option in particular. Probably went on too long for some of the folks answering the phones! But then I went to fill out the form that said I'd made my phone calls and realized I hadn't asked the congresspeople's position on all that I was talking about. Oops.

I knew my senators supported it (Cantwell and Murray), so I marked "yes" that they did without calling back. And I mean, for the love of all that is good and right, I was sure Rep. McMorris Rodgers did not. But hey, before checking the "no" box, I should ask, right? So I called back (the D.C. office instead of the Spokane one) and asked that burning question: what does my congresswoman actually support?

Now, I didn't phrase it "does she support the Obama plan," because that would necessarily receive a "no" answer and - besides - I'm mostly concerned about the premium-supported public option anyway. So I asked about that. The nice young woman on the phone (they are so nice at McMorris Rodgers' offices - she hires well) wasn't exactly sure, and offered to have a legislative aide contact me at some point. Great, I said - because I write about this a lot on my blog, and I want to know what she thinks, and where her concerns might lie...

I cannot imagine there will be a meeting of the minds here. But - and to her credit (and I give her this credit), McMorris Rodgers was one of the few Republicans who urged people to stop scaring each other with talk about death panels (which do not exist), and talk about the real issues instead. Have a dialogue. So I guess that's what we might be doing. One way or the other.

Just checked the log of phone calls this afternoon, on the OFA website. 182,774 - and counting.

photo credit: Jeremiah Aguilar, found here

Four Who Died

I just posted an entry, saying I want to at least know about the people dying because of a lack of health insurance. I did a quick search - and found an article by Deb Richter, a physician in Vermont, who says that she sees this often, where her patients die of preventable diseases. She then speaks of four of her patients who died that way. Three were from the same family - unable to keep track of their diabetes - and one had cancer symptoms for years, finally got the insurance to treat it, but died two weeks later. It was too late. Dr. Richter thinks that 44,000 dying a year like this is a low number, given her own experiences. As she says, take her dozens of cases and multiply them by the 700,000 doctors in this country, and what do you get? A lot of people dying.

Who Are They?

Rep. Al Grayson (D-Fla) cited to this Harvard study when he stated that 44,000 Americans die every year because of a lack of insurance. That's one every 12 minutes. And although the study is one of correlation and not specific examples, the numbers are there. Mortality and lack of insurance are inexorably tied.

Who are they? Who are the people who died? I want to know.

What I really want is for my country to provide health care to them, preferably in the form of affordable health insurance, so that they get care early, and not so late that it's too late. Barring that apparent miracle, however, at least I want to know who they are. Who has died? Who have they left behind?

On September 11, 2001, we all sat in horror, helpless, watching our televisions. Doctors rallied to health care centers, waiting for the injured. But there were no survivors. So no one came.

For that week, I watched what I could, when I could. For as much as there was nothing I could do, I could do that. I could witness. I could cry. I could let my heart break for those left behind.

So it is the least that I can do now. The very least. And if I have no names, no faces, if they remain statistics in a study - at least I can have my intentions.

Al Grayson

In the midst of all the health care reform angst and anger - real, imagined, and manufactured - I had started to tune out. I'm sure I'm not alone. I had sort of given up on Congress doing the right thing.

Then on Friday, when we heard that President Obama has received the Nobel Peace Prize. I started wondering: is it time to shed the crap and insist, really insist, that Congress move?

Parallel to my personal feelings has come several times in the news recently the name of one congressman from Florida: Alan Grayson. A week (or two) ago, he gave a speech where he said that Republicans' plan for health care reform was, don't get sick, and if you do get sick, die quickly. Republicans were angry at this first-time congressman, and insisted he apologize. So he got on the floor of the House this past Friday and said absolutely not. The following clip gives a lead-in from Lawrence O'Donnell and then Grayson's speech on Friday. He is also the one who has said that the way to beat a Republican is not by being a Republican. It is time for our elected officials to stand up and deliver.

Paul Krugman's Right

The past week or two - especially the past week - I've been only slightly interested in politics. The turning point, I think, was a one-two punch. First, they took out the end-of-life counseling in the Senate bill (giving in to the "death panel" baloney). Then, they waved the "no public option" flag, which means that people still will be without health care - or at least effective health care. I would know more if I were paying closer attention. But those two bits of information, coming one day after the other, just has me skimming headlines and hoping someone out there knows what they're doing. I sure don't.

So this a.m., I read a column by economist Paul Krugman entitled "Obama's Trust Problem." In it, Krugman explains how people who voted for Obama are disillusioned with many of his choices. The choice to back big bankers and bonuses, for instance. Or the choice to back away on these extremely important health care reform points. Or the choice to embrace Sen. Charles Grassley (R-Iowa) even after he joined the "death panel" scare by saying that people should be scared and that he wouldn't agree to something that would kill grandma.

And Krugman's right. I'm not one to be blinded by ideology. When I campaigned for Obama, I said he would work to find middle ground, even if he didn't need to, because he believes in buy-in by everyone (or as many people as possible).

But there's compromise and there's selling out. As Krugman put it, "There’s a point at which realism shades over into weakness, and progressives increasingly feel that the administration is on the wrong side of that line." Or, as I read recently from blogger Matt Taibbi:

I’ll say this for George Bush: you’d never have caught him frantically negotiating against himself to take the meat out of a signature legislative initiative just because his approval ratings had a bad summer. Can you imagine Bush and Karl Rove allowing themselves to be paraded through Washington on a leash by some dimwit Republican Senator of a state with six people in it the way the Obama White House this summer is allowing Max Baucus (favorite son of the mighty state of Montana) to frog-march them to a one-term presidency?

Explanation of Proposed Health Care Reform

This is just an excellent and entertaining explanation of what is being proposed by health care reform:



(Okay, can I just say how impressed I am with myself that I finally figured out how to put a video on my blog???) (oh, and it's actually phenomenally easy - will be using this as a metaphor for my life in upcoming weeks...)

And here's an interesting column by Bob Herbert, talking about the success of Vermont health centers that serve rural communities.

No Can Kickin'

I got pretty upset yesterday, late in the afternoon, when I read that the Senate Finance Committee has caved to hysteria and lies and has taken out of their proposed health care reform bill the part where Medicare will pay for people who want a counseling session on things like living wills.

Insanity. And then I heard how the former chief of staff for Sen. Baucus (D-Montana) is on the Obama staff now, and how that means it's likely the president has acquiesced to this caving.

It's such a good proposal. But it's been hijacked by "death panel" talk - by the very people who have, in the past, endorsed going to the hospital to get this kind of advice. And this was an amendment proposed by a Republican congressman!

Others have covered the issue, have explained the hypocrisy of the Republicans to call this "death panels" - people like Rachel Maddow, Paul Krugman, and then this blog entry which explains how the Republicans tried to pass that very same thing just a few years ago. (Sen. Grassley - R-Iowa - for all his blustering and fear-mongering two days ago, voted for it back in 2003.) Still, hysteria appears to have won the day.

The worst of it was - how upset I have been with Obama. Why cave to the crazies? (Crazy like a fox.)

So then I saw this. And I got some perspective, I think. It's a radio interview of a Rep. Boswell (D-Iowa), who explains that President Obama told him he'd be a one-term president if he has to, but the country needs to pass health care. "I'm not kicking this can down the road," he told Boswell...

I do really want the answer to my "crazies" question. And I don't know that I would be making the same decision. BUT - while this counseling provision is a great idea, it does not make or break health care reform. And for a president who is committed to doing this now and not later... Well, I respect it. And I appreciate it. Not for myself - my health care insurance is fine - but for all the people out there who need a way to buy health care insurance.

My only fear? That it won't work. If you cave to the crazies, it's like saying, "Oh my gosh, you're right! We did have death panels in the bill! Oops." And then what do you say when they go after the next provision, and lie about that? We could compromise our way out of a bill altogether. Sigh.

Joan Baez, Idaho Falls, and Protestors

I haven't written about the raucous town halls. I read about them, as is my civic duty (I think - I guess), but they are too depressing for my written word. How can people feel justified in shouting down the debate? I don't have a problem with people who shout their questions when it's their turn to ask a question. Neither do I have a problem with people protesting outside. They should do it in droves, if they want. But shouting down answers? Shouting down other questioners? My biggest worry is all the people who simply aren't coming to any town halls because of predictions of mob behavior. Which means they aren't getting their questions answered. Which, I guess they wouldn't get them answered anyway, given the way the town halls have gone. Sigh.

And of course the other part that's upsetting is all the misinformation out there. Here's a link to a new website started by the White House to confront and resolve the lies. Oh, and here's a link to a three-minute video debunking the now-floating-out-there claim that Obama really intends to eliminate private health care insurance. (Apparently someone has cobbled together various statements he has made to leave that impression when the statements themselves have been all taken out of context.)

And then to have Republican congresspeople validate these lies - not just talking heads and radio jocks, but actual congresspeople... Chuck Grassley, of all people...

Alaska Senator Lisa Murkowski deserves credit for toning down the rhetoric yesterday, and confirming that there are no death panels. In her words: "It does us no good to incite fear in people by saying that there's these end-of-life provisions, these death panels." Not that she likes the bill, mind you. Just that she doesn't want lies to be spread. I've called her office to let her know it was appreciated. (My own congresswoman, Cathy McMorris Rodgers, also deserves a thumbs-up, as she apparently stated yesterday that there are no death panels in the bill.)

Okay - with all that said - here is a very touching description, with photos, of what went down yesterday at a Joan Baez concert in Idaho Falls. Four Vietnam vets came to protest her concert. Before the concert started, she came out and talked to them, told them their misunderstandings. And she listened. Her merchandise salesman, a Vietnam vet himself, came out and talked to the protesters too, vouching for Joan Baez. They left with signed protest posters - mostly on the back, though, as she didn't want to sign on the front when such awful things were being said about her.

When she got back in the building, she cried - not for the things that were said, but because her merchandise salesman had stuck up for her like that. "Did you hear his voice shaking?" she said. "That was bravery..."

Let freedom ring.

Health Care Dreams

Okay, maybe I'm going a little bit nuts on health care reform. Last night, it took over my dreams. Literally. The whole night, I dreamt that I was in various rooms in Washington, D.C. that were filled with congresspeople - mostly House of Representatives - and I kept going up to the various Republicans and asking how it was that they possibly could be against a public option. "Public option," I'd say, stressing the second word (in contrast to a single payer public plan, which would be like Medicare for everyone).

None of them had an answer. It was unanimous. Each one would stand, flat footed, a little shocked that I had asked. Then each would mumble something unintelligible and walk away from me. I don't remember all their names. I do remember that one of them was Senator Jon Kyl from Arizona. (Where in the heck did that come from?)

I ended up in a room where people - a mix of congresspeople and citizens - were going to discuss their favorite bills. (OMG - I NEED A LIFE.) In my dream, I figured this was my chance to ask the room - "Will anyone explain to me why they oppose a public option?" One dark-haired congresswoman - perhaps that bizarre one? Michele Bachmann - was very interested in having a substantive discussion with me about it. So we got paired up. I was so interested in what she had to say. Someone actually had a reason! Just as the conversation was to begin... I woke up. So I still have no answer to my question.

It's odd that I wanted to have this discussion with Republicans and not Democrats (since if all Dems voted for the public option, the thing would pass) and that I was talking mostly to Representatives and not Senators (since the public option actually is currently in the House bill and likely will stay there, since there are enough non-Blue Dog Dems in the House to pass it that way).

I did find out something interesting about how I feel about the single payer option. I told one congressman that I actually preferred the single payer idea, but that it was just too different from our current system to get enough public support for passage. I didn't know that is how I really felt.

You know, my health care insurance is fine. My concern about this issue is for everyone else. But I must be pretty worried, to be dreaming about it...

I do think our dreams are our subconscious speaking to us. I also think our dreams can often be soul connections, and not just symbolic for our individual, day-to-day lives. So maybe this room was a truth-telling serum kind of room - where people talk as souls, not as physical beings - and maybe that was why none of them had answers for me. Because there is no legitimate reason to oppose a public option.

Health Care Scare Tactics

This a.m., a friend of mine forwarded me an email that was sent to her household recently that was entitled "Page 425 Healthcare Bill." In the text of the email, the author wrote, "O.K., folks - I 'think' this will 'shake us up' - read and listen to the Interview - "IF" this does not cause every red-blooded American to contact their Representative, I don't know what will!! It's time for ACTION! Americans!! Both Democrats and Republicans beware."

Wow. Well, let me read on. I certainly am willing to contact my Representative and take ACTION if necessary. (Though, truth be told, I'd already gotten a heads-up from my friend that this was junk - as if the weird punctuation and hyperbole hadn't already alerted me to potential misinformation.)

Seems that (according to this email) page 425 of the health care bill requires euthanasia of grandma. (Actually, requires counseling "to learn and to choose from ways to end your suffering (and your life).") The email goes on to say that seniors will be denied health care and that paying for your own care will not be an option.

How outrageous! How un-American!!

How totally untrue.

Of course. The more outrageous the claim, the more unlikely the veracity of it. But here's the thing: people receive this email and think it may be true. It hurts my heart to imagine that people may think this is true.

Here's the truth. There is a section of the health care bill - beginning on page 425 of the draft - that requires Medicare to pay for a counseling session every five years so that Medicare recipients can receive accurate information with regard to their state's laws and end-of-life care. What are the local resources for the patient? What is a Living Will? That sort of thing. A member of AARP wrote up a fine summary of page 425 in terms of the specifics. Here's a link to the bill itself. And here's a "truth-o-meter" evaluation of the claim that gives a "pants on fire" conclusion.

Page 425 is not about euthansia. It is about making sure that people actually get accurate information and are not kept from that information based solely on an inability to pay for the counseling session(s). So this is bad? Huh. Oh, and the sessions themselves are not mandatory. What is mandatory is that Medicare pay for them at least once every five years and more often if the patient becomes very ill and needs further information.

When poking around on the Internet about this, I found a facebook entry promoting the scare tactic along with comments from an individual who explained that the claim was baloney. (In that case, the claim was that people will be instructed on assisted suicide.) Here's a link to that dialogue. After pointing out that the word "suicide" is nowhere in the bill, the commenter went on to say, "It's fine to debate reform but you really shouldn't misrepresent the plain language of the bill."

I'm with the commenter. How frustrating, when people are trying to have a legitimate debate, to have to fight off lunacy as well. It's a waste of time and energy.

Senator Maria Cantwell and Health Care

Yesterday, I somehow got invited to a health care forum held at Spokane's city hall, sponsored by Maria Cantwell, one of Washington's U.S. senators. This is what happens when you get on one email circulation list - you end up on all of them. But I was glad to get the invitation and attended. As noted in an earlier entry, I'm willing to participate in this push for health care reform. That makes information key.

What an interesting forum! It was a panel of health care experts, and included physicians, nurses, hospital CEOs, and insurers. One of the key points at the outset was how there are fewer primary care physicians now than ever before. This is an issue that my sister (an ER doctor) has mentioned. It impressed me that this panel was on top of that issue, and that Sen. Cantwell has proposed a bill in Congress to attempt to support primary care physicians financially. Apparently Spokane has a lot more primary care physicians (i.e., family doctors) than a lot of places around the country. Also, and I did not know this, it turns out that Washington is a cutting edge state in the medical field in a lot of ways. I did know that my monthly insurance premiums are cheaper here than they would be in other states. Apparently that has to do with various networking and streamlining programs - designed at cutting costs - that the state of Washington has.

It was also interesting to hear how states with the highest per patient medicare costs do not provide better health care. In fact, the opposite appears to be true. Here's an article from the New Yorker where the reporter went to McAllen, Texas - with the highest per capita spending of medicare is - to try to figure out why the costs are so high there. The article compares costs in McAllen to El Paso - a similarly situated community where the costs are half the costs of McAllen.

Also interesting was the intention of the panelists and the senator to figure out a way of acknowledging quality care versus quantity care. Right now, the financial reward goes to quantity (number of tests done, procedures, etc.).

There was one guy there, a doctor, who was chosen to be on the panel because of his advocacy for a single payer system (meaning, a publicly funded private health care system). Every time he talked, the audience clapped. Tough crowd for the follow-up speaker, who happened to be an insurance guy. Though he did hold his own. One thing he said, which I think took a lot of courage, was that there are no "sacred cows," that what might be best for the country may not be best for the insurance companies, and that the insurance companies will have to bite the bullet and accept that. He also spoke about how his company (Blue Cross Blue Shield) had promoted a wellness program, and that 1,500 employees had lost a total cumulative of 18,000 pounds through the program. It seemed almost symbolic of what needs to happen with the health care system overall. You know - cut out the fat.

At about the same time yesterday, in Chicago, President Obama was talking to the AMA about the problems with health care costs - too much discussion about insurance, too many tests being run. He told the doctors, "You entered this profession to be healers - and that's what our health care system should let you be." (Here's a short article on his speech, though I don't particularly care for the "corrupt" comment. To me, the health care system is like the legal system, when it comes to the professionals - most doctors, like most lawyers, do a stand-up job. And then there's the few that ruin it for the rest of us.)

Speaking of lawyers... With health care, there is that additional issue of lawsuits, and the cry for tort reform. It came up only briefly in the forum. Personally I've never filed a medical malpractice case (and have turned down several). And I'm sympathetic to doctors who feel they are in front of a firing squad when they practice medicine. I see it, I understand it. I'd like to see control. No sacred cows.

I do have strong feelings, however, against capping jury awards, for at least two reasons. First: the claim that awards are getting larger is only reflecting the change in laws already, since many states (like Washington) have created huge procedural and financial hurdles to even filing a medical malpractice lawsuit so that, now, virtually the only cases filed are the ones where damages are both substantial and easily proven. And those are the cases that we, as a society, would want to see filed - where we want to see some justice done. Second: insurance companies feed on caps. When there is a cap, insurance companies do not settle cases. It is only the threat of a large jury award that brings insurance companies to the negotiation table. And even then, the agents can be so arrogant, and their actuary tables so set up, that they simply ignore plaintiffs until the day the case is set for trial. If there were caps, the insurance companies would no longer have anything motivating them to settle.

Lawsuits only bring money. It is an incomplete system. But money brings motivation, creates accountability down the road. And the losses suffered are often phenomenally real. How much money would you be willing to accept for a doctor amputating the wrong limb by mistake? None, I know. No money can compensate. That doesn't mean that no money should be paid. Luckily, amputating the wrong leg is the extraordinary case, not the ordinary one. It's the kind of case that can be absorbed in a responsible health care system. So - how do we protect those patients with legitimate, significant claims while also giving good doctors relief from bad lawsuits?

I do think there's a difference between negligence and gross negligence - a mistake, versus a mistake of such grand proportions that we all are shocked it could possibly have occurred. Maybe there is a line to draw there, when it comes to medical malpractice cases. But have no doubt - if power corrupts, then absolute power corrupts absolutely, and insurance companies with capped jury awards is not a world you want to live in.