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Recovering backpacker, Cornwallite at heart, political enthusiast, catalyst, writer, husband, father, community volunteer, unabashedly proud Canadian. Every hyperlink connects to something related directly or thematically to that which is highlighted.

Thursday, 3 October 2013

Political Surgeons




The reason democracy wants representation of the people by the people is the assumption that regular folk will be able to relate to the daily plight of their peers - unlike the one percent, who can play political games that cost the people beneath them without having any clue, ever, as to what real loss feels like.

There's an anecdote the late Michael Crichton tells in his book Travels about working in a hospital (the inspiration for ER); a group of surgeons are discussing the most involved, interesting procedure for a patient that happens to involve a colostomy bag.  It never occurs to them what the actual patient might think of that option - because they probably didn't recognize the end recipient as a person

Keep that in mind as your read this:


THE G.O.P.’S EMERGENCY-ROOM POLITICS


“What a sick twisted old man to say, why would we want to do that?” Sean Hannity, of Fox News, said to Ted Cruz. They were talking about Harry Reid, the Senate Majority Leader, whose answer to a question about funding for the National Institutes of Health had become, for them, the story of the shutdown.
Once House Republicans refused to pass a spending bill on Monday night, the N.I.H. had to stop enrolling new cancer patients in clinical trials, among them some thirty children. This was such an indictment of the shutdown that the G.O.P. had suggested a micro-appropriation—part of a “piecemeal” funding tactic to keep anger at bay. Reid, talking to reporters, called it cherry-picking and said that he wanted the whole bill, sticking to that after Dana Bash, of CNN, asked why he wouldn’t help just one child with cancer if he could. If you listen to the exchange, something Reid then says—“Why would we want to do that?”—clearly refers to the pitting of different people hurt by the shutdown against each other. But he did give Fox a line, if one dependent on the idea that Reid would think that caring for children was an alien concept. “Pretty sick,” Hannity said, as Cruz tried to look sad. Also, “cold, callous, heartless, mean-spirited, hateful.” Guest after guest was outraged.
So many Republicans consumed by the idea that politicians ought to make sure that sick children get the care they need—one might call that novel. Do they plan to live out that conviction? The G.O.P. has shut down the government because it considers a law that will make health insurance far easier to get for the forty-eight million Americans who don’t have it—including millions of children, many of them sick—a threat to America. Will this talk of children with cancer lead them to read the provisions of the Affordable Care Act and, for once, think about what the law means for real people?
Being very ill in America without insurance is a disaster for anyone. You can easily be left bankrupt, even if you’re cured. Obamacare also addressed the particular ways getting sick could be terrible for children, even those with insurance. First, the law ended lifetime maximums, the catch by which insurance companies could decide that after they’d spent a certain amount they could walk away from a patient. Small children with cancer could, and often did, reach those limits before they’d made it through preschool. Next, provisions in Obamacare mean that these children won’t be kept from getting affordable (or any) insurance because of “preĆ«xisting conditions.” They can also stay on their parents’ health-insurance policies until they are twenty-six. And they are precisely the sort of young people who ought to: they need check-ups to be sure that there isn’t a recurrence of cancer. And their health struggles may have made it harder for them to jump into the job market, or just to sleep at night with the illusion that a twenty-something who doesn’t have insurance is just making a rational bet—being sensible and free.
Maybe the idea was that Reid should have just looked even more mournful than Cruz, praised American generosity and told a story, rather than actually doing something. But the professed anxiety by the G.O.P. about how children will be cared for doesn’t line up well with documents like the Paul Ryan budget, which translates into wholesale cuts in the Children’s Health Insurance Program and Medicaid. The American Cancer Society’s advice for the parents of uninsured children, which makes for depressing reading, talks about Medicaid and other low-income programs in terms of hope. Would Hannity call Ryan a sick, twisted young man?
This is not just about the hypocrisy of the G.O.P.’s rhetoric, or its practical cruelty. In bringing about this shutdown, the Republicans are infecting our political processes with the pathologies that made the American health-care system such a mess. The idea that it’s fine to stumble ahead with much of the federal workforce furloughed, that emergencies (the showy ones) can easily be disposed of with “piecemeal” spending bills, is another version of the argument, often heard in conservative circles, that we don’t really have an insurance problem in this country because people can always go to emergency rooms. This is America; we don’t let people die, except that we do. People who’ve had no preventive care get to that emergency room too late, leaving their families with bills for the ambulance. The parents of sick children have been put into the position of supplicants who have to wave their arms for attention, as if their child was having a heart attack in the middle of the street. They deserve that help, and it’s entirely in John Boehner’s power to give it to them, by bringing the six-week continuing resolution that the Senate has passed to the House floor. If Obama does intervene on behalf of the N.I.H., there shouldn’t be any illusions that a singularly harmful fluke has been dealt with. Children are quietly being put at risk because food-safety inspectors have been furloughed, their mothers aren’t being enrolled inWIC, and they lose their preschool spots. That is all less visible, unless you are among the most vulnerable.
We also seem to be heading toward a national version of the sort of personal financial crisis that our health system fosters. It’s an emergency; you stop paying bills, except maybe some when they catch you on the phone; you slash in some areas and spend more in others haphazardly. One day you wake up and your debt limit has been reached and your credit has been downgraded and you know it will take years to get back, if you ever can. The difference is that people don’t choose to get sick. The Congressional Republicans have not only chosen this, but they pursued it.
John Boehner and Ted Cruz and the House’s “suicide caucus”—willing to bring down the economy to derail Obamacare—appear to be making bizarre choices. Some in their own party think so. (Grover Norquist on Cruz: “He pushed House Republicans into traffic and wandered away.”) But their behavior should actually be quite familiar to anyone who has had the frustration of dealing with an insurance company. They are treating Obamacare—a law passed by Congress, affirmed by the Supreme Court, and whose namesake was reĆ«lected President—as a claim that they can avoid paying if they just come up with the right disingenuous angle. They are doing the same thing with their basic legislative responsibilities; they are the little men in the distant office, sending out letter after letter: deny, deny, deny. Obamacare might at least make that type rarer in the health-care system. When are we going to remake our politics?

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