death panels revisited

Us folks on the far left should a) actually listen to the folks on the far right and b) tell the truth. How many left/liberal folks have you heard stand up and belittle conservatives for jumping from a proposal for funding advance directives (i.e., living wills) to being concerned about “death panels”? A lot I imagine. Did any of these left/liberal folks ever take even 60 seconds to try to figure out where all you conservatives might have gotten the idea from — or consider that there might actually be some logic to seeing a link between those two things.

The link is Ezekiel J. Emanuel, M.D., Ph.D. Dr. Emanuel is Head of the Department of Bioethics at The Clinical Center of the National Institutes of Health. He is currently on extended detail as a special advisor for health policy to the director of the White House Office of Management and Budget. These are facts obtained from the National Institutes of Health. Other facts also available from the NIH website include that Dr. Emanuel developed The Medical Directive, a comprehensive living will that has been endorsed by Consumer Reports on Health, Harvard Health Letter, the New York Times, the Wall Street Journal, and many other publications. also, he has published widely on the ethics of clinical research, health care reform, international research ethics, end of life care issues, euthanasia, the ethics of managed care, and the physician-patient relationship in the New England Journal of Medicine, The Lancet, JAMA, and many other medical journals.

One particular publication by Dr. Emanuel is frequently cited by the far right is “Where Civic Republicanism and Deliberative Democracy Meet” in The Hastings Center Report, Vol. 26, No. 6, In Search of the Good Society: The Work of Daniel Callahan (Nov. – Dec., 1996), pp. 12-14. Official URL: http://www.jstor.org/stable/3528746 –however, since you have to have a paid subscription to see the whole article at this URL, here’s an alternative that that has the entire (brief as it is) article in pdf format: http://www.ncpa.org/pdfs/Where_Civic_Republicanism_and_Deliberative_Democracy_Meet.pdf. The portion of this paper that is most frequently cited by those on the right is taken out of context from this larger quote:

Thus, it seems there is a growing agreement between liberals, communitarians, and others that many political matters, including matters of justice–and specifically, the just allocation of health care resources–can be addressed only by invoking a particular conception of the good. We may go even further. Without overstating it (and without fully defending it) not only is there a consensus about the need for a conception of the good, there may even be a consensus about the particular conception of the good that should inform policies on these nonconstitutional political issues. Communitarians endorse civic republicanism and a growing number of liberals endorse some version of deliberative democracy. Both envision a need for citizens who are independent and responsibile and for public forums that present citizens with opportunities to enter into public deliberations on social policies. This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. Substantively, it suggests services that promote the continuation of the polity–those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations–are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia. A less obvious example is guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason. Clearly, more needs to be done to elucidate what specific health care services are basic; however, the overlap between liberalism and communitarianism points to a way of introducing the good back into medical ethics and devising a principled way of distinguishing basic from discretionary health care services.[emphasis added]

So here we have a current advisor to President Obama, who is well known for developing the definitive living will (advance directive), who has also published work that refers to the use of “public forums” to make decisions about who should and who should not be guaranteed health care paid for with public dollars. [Note no where does it say that people would be denied health care, just that they would not be guaranteed public money for that care.] So if I’m a conservative, who has been trained since the days of Ronald Reagan to distrust everything about the federal government — except of course the military — and I dislike the current president intensely, perhaps because of his race or just because I think he’s a socialist and I’ve been trained from infancy to have a knee jerk reaction to socialists and socialism, then I learn these facts (above) about someone who is clearly in a position of influence on developing the health care plans of the current administration, well then….

I’m not saying that I is reasonable or correct to decide that a provision in the legislation to pay for a visit to your family doctor to discuss a living will is the same thing as advocating “death panels,” but I am saying that this connection did not come out of thin air, there is a logic — however, twisted — to it. This is why we should listen to the far right. The things they are concerned usually have some shred of truth and reality in them, even if they are highly distorted.

That gets me to part b) telling the truth. Read Dr. Emanuel’s short article. He is speaking truth — we cannot as a society afford to provide all the technologically, medically possible treatments to all the citizens of this society. We do not do it now. Now, we allow the problem of not having enough resources to provide all treatments to all people to be solved by corporations. We let Humana and Cigna and Blue Cross/Blue Shield determine what treatments will and will not considered “basic” and who will be entitled to care. Depending upon the state and on the insurance company, various studies estimate that between twenty and twenty-five percent of claims to insurance companies are denied as “medically unnecessary.” One example in a CNN article from two years ago was surgery for cleft-palates in children in the United States, are frequently denied as being for “cosmetic” purposes.

We should be honest, both the right and the left know that our society cannot afford to provide every possible medical treatment to every single individual in society. The difference between the right and the left is who they want to have make the decision and on what basis they want the decision to be made. The right wants private corporations to go on making the decision about who gets treatment and what treatment they get, and the right wants the basis of the decision to be a monetary decision, based on who has the money to pay. The left wants the citizens of the country to make decisions through the political process, and to based those decisions on societal consensus. What Emanuel suggests is that one criteria that might be used has to do with contributions and participation in society. But that is only one possibility, the idea is for members of society themselves to discuss and debate this and set ground rules.

I suspect that one of the problems that the right has with the left on this, is that folks who are conservative is basically distrusting of human nature, and do not trust their fellow citizens to make fair and equitable decisions. Another problem is that most people don’t want to be responsible for making decisions about life and death, they’d rather leave that to faceless corporations that they can then bitch about if they don’t like what happens, rather than feel responsible for the lives of others.

 

an antique economy

Read something just now that hit me square between the eyes:  our economy is a relic of the 17th century.  We’re trying to deal with 21st century problems with an economic system (capitalism) whose basic principles and mechanisms were designed in the 1600’s. 

This is one of those facts I’ve always known, but some how it took someone else to point out the absurdity of this.

 

and what’s wrong with Europe?

The best thing about newspapers on-line is the comments section. Every local and regional newspaper has its on-line presence and most provide on-line readers with the opportunity to post their reactions to news articles. One learns more about the hearts and minds of Americans from reading these comments than one can possibly learn from a Gallop or Harris poll.

One comment that I see frequently, on any post that has anything to do with American politics, is some one from the right decrying the Obama administrations efforts on the economy, health care or the environment and offering the dire warning that if we are not careful we’ll end up just like Europe.

Which leaves me to scratch my head and say — exactly so, and good for us if we do!

Some smarty pants out there is likely to respond with a “if you love Europe so much why don’t you just go live there?” Because I was born here; this is my home, and I just want it to be as good a home, as comfortable a home, as safe a home, as other industrialized countries. Besides which, outside of England, they don’t speak English and being a product of American schools I don’t speak any thing but English.

Every time I see this comment I wonder, exactly what is it that these folks think is so awful about Europe?  What is the source of their images of Europe? What do they think they know that I don’t know?

 

…and Michael Jackson is still dead.

Is it just me, or does the news coverage of Michael Jackson’s death remind any one else of the classic Saturday Night Live News bit from its very first season during which Chevy Chase gravely intoned “and Francisco Franco is still dead”?

Michael Jackson was an enormous musical talent, and a very troubled individual. The American music scene is diminished by his loss, as is his family, especially his children. But, what is happening with the cable news networks is ridiculous — until Sarah Palin had the good grace to resign and Kim Jong Il blessed us with some missiles, it was impossible to find any news about anything other than Michael Jackson for an entire week.

I mean no disrespect to Mr. Jackson or his family or even to his millions of fans. I’m just floored that every time I turned on cable news for an entire week, the only story I could find concerned Michael Jackson’s death. Where is my hour of political sanity with Rachel Maddow?

 

fear and maybe a little loathing in the heartland

Every time I hear some politician, political pundit, or news person use the phrase “red state” I feel a sense of disorientation.  I thought a “red state” was one that had gone communist — you know like the old Soviet Union or Cuba or North Korea or Vietnam.  Am I the only child of the sixties that thinks this is just plain weird?

So, here I sit in a “red state” — wishing with all my radical left heart that this really was a red state — contemplating the New York times map of political shift, that shows the area where I live has shifted more to the right in the election this week compared to 2004, while most of the rest of the country has moved more to the left.

I can’t help but wonder why? Particularly since most of the people I associate with not only do I think they would gain enormously from “left” programs in areas like health care, they think so too, at least as long as one discusses the specifics of programs and leaves off labels. . When I talk with to people in this region(which I do alot!) about the specifics of what they want to see happen with health care, jobs, energy, etc., the suggestions they make and the ideas they like (when detached from political labels) are in fact the ideas of liberal politicians. 

I am left to conclude that it all boils down to religious weirdness, xenophobia and homophobia.

 

rampaging paranoia

Just because you are paranoid doesn’t mean some one isn’t out to get you!

When I visited my favorite political blog this week and read the comments on last Sunday’s post, I was both glad and scared to see that at least two other people out there share my paranoia. It’s been more than twenty years since there was a serious attempt on the life of a president (or presidential candidate), and however, I fear that Obama is a magnet for one now.

Some of us are old enough to remember what this country was like in the months following Martin Luther King’s assassination — riots in almost every large city with a significant African American population.  That historical moment will pale in comparison to the wave of violence that would hit this country if Obama were to be assassinated. The violent reaction would come not just from blacks, but from whites as well, especially young people. 

Moreover, such a wave of violence is likely to be met by a much more extreme repression than occurred in 1968. My real fear — that the result would be a loss of democracy altogether in a police state.

 

McCain hiding ties to Gay Liberation movement?

His middle name says it all.  John SIDNEY McCain is clearly a pansy, nancy-boy, who is overcompensating with his macho warmongering for his lack of masculinity.

“Sidney” is also hiding communist sympathies.  When offered the chance to get out of prison camp in Vietnam, he chose to stay so he could pal around with those pajama wearing communist soldiers.

Then there’s his Irish heritage, which leads us to suspect that he secretly sympathizes with former IRA terrorists. Sure, he went to an Episcopalian high school (more evidence of his wussy-ness), but with Irish ancestors, he’s probably got leanings towards Catholicism, and will give credence to the position of the Pope.

 

_______
And if you bought into any of that, you’re crazier than the folks that McCain and Palin are whipping into a frothing frenzy with talk of Obama not being “like us” — and that my friends is really crazy.

 

black hats

One of the blogs that I read regularly is written by an articulate political and economic conservative. For more than a year now, I’ve been concerned about this fellow’s false consciousness. He was just so deluded about so many things. He seemed like a nice guy, smart too. Sometimes I wondered if he just acted clueless to generate discussion. Then the other day, the other shoe dropped. He’s not one of us, he’s one of them. He’s an owner of capital, an exploiter of labor – albeit petite bourgeois. Suddenly it all makes sense. He’s not suffering from false consciousness, he has excellent class consciousness. His positions all make sense now, they serve his class interests. I still think he’s totally wrong about just about everything, but now I can see that those positions are consciously taken to serve self-interest. I no longer worry about him, only about those he employs.

 

moron lovers of American

Saw this piece of Canadian humor on a science blog.

I was struck by the same as a commenter to the science blogger was: “”George Bush IS a moron, but we shouldn’t have pointed it out. And the fact that George Bush is a moron shouldn’t reflect poorly on the American people– it’s not as if you actually elected him.” I love it when someone remembers that….”

Problem is, the American people don’t get credit for anything, because even if we didn’t “elect” him in 2000, Americans (not me of course, but the vast majority of American voters, who must be moron lovers) did in fact undeniably vote for him in 2004. What makes it worse, is that by 2004 it was pretty clear to any one with half a brain themselves what an imbecil George W. was.

 

rooting for global warming

Today I read a piece that touted the objectivity and disinterest of science as an enterprise when it comes to global warming.  This completely ignores the fact that most of the people involved in the political promotion of anti-global warming policies are not scientists, and are motivated by many different agendas. Even when scientists enter into the political arena their activities in that arena are no longer governed by scientific review.

I’ve heard some people say that the real test in the difference between those who support the idea of anthropogenic global warming and those who deny it, is that no one who supports the idea really wants it to exist -they’d rather be wrong than right, and their acceptance of the rightness of it is reluctant. Well I’m here to say that’s bullshit. Of course there are people who want humanly caused global warming to be real, and I’m one of them.

First let me make a distinction between the scientists, who has a professional interest in not having his/her career go up in smoke because some one comes up with contrary findings, and some one like me who actively is rooting for a warmer earth. Most of those scientists may have career investments to protect, but they’d really rather be wrong than right, because the enterprise of science is highly dependent upon a stable, high tech, wealth industrialized society, and that’s precisely what global warming threatens.  Folks like me on the other hand, and there are quite a few of us, actively detest highly centralized, large scale, global, industrial capitalism and would really like to see a very different kind of social system in its place. We’re opportunists who see global warming as a chance to either convince people to make changes we think are necessary anyway, or force them by circumstances to change.

Now I don’t agree with the “mother earth” lovers, who whine about the earth dying and view humanity as a form of locust that should be exterminated. I think humans are a fine species. I like being human. I like most other humans.  I just think we’ve gone a very long way in the wrong direction, and need a course correction to a simpler, more localized, more decentralized, more humane way of life.

I’m not talking about reverting to foraging, or even becoming true agricultural societies. There’s not a thing wrong with computers or the Internet, or with electricity. However, I have overcome a prejudice of my youth that held flush toilets to be the epitome of civilization, and can now see that composting toilets, with the compost recycled back into local farms would be far more sustainable.

I’m a big fan of the writings of Murray Bookchin (Remaking Society: Pathways to a Green Future, South End Press, 1990), who envisions “decentralized communities, united in free confederations or networks for coordinating the communities of a region, …[reflecting] the traditional ideals of a participatory democracy…” (page 181).  Bookchin sees the “need to rescale communities to fit the natural carrying capacity of the regions in which they are located and to create a new balance between town and country” as an “ecological imperative” (page 185).

As I see it, if the climate scientists are right, and I suspect that they probably are, environmental circumstances will force upon us changes that will disrupt global capitalism, and combined with the loss of fossil fuels will result in greater localism whether we want it to or not. However, if we wait to be forced into this chances are the changes will come about due to more oppressive governments to deal with the extremes of dislocation and social unrest almost certain to appear.

So I’d rather use the fear of global warming as a tool to get people to willingly, gradually restructure society. Even if it turns out that the world doesn’t get warmer and the environmental catastrophe’s don’t happen, the end result of a restructured, more localized, slower, less energy intensive, more democratic society is more than worth it. But all in all, I think humanity — a  least what’s left of it — might be better off in a warmer world.