The Followspot

The Reaper Chronicles

Every aspect of the health insurance "debate" makes me purple with rage. This morning's AP story quotes Sibelius' claim that the wretched Obama is willing to drop the public option in favor of the useless co-op nonsense.

There are no words to describe my complete disgust with Obama and the rest of the Washington Democrats. Their gutless incompetence has in all likelihood doomed real health insurance reform for another generation. Actually, a humane, civilized health care system is probably impossible in the U.S., given our hostility to doing anything to help our fellow citizens -- especially those who aren't white -- and the opposition of a loud, easily manipulated plurality of stupid Americans. Yes, there is a significant percentage of American citizens who are proudly ignorant, gullible dolts. These are the kind of people who give Democracy a bad name.

The Rabid Right's latest cri de coeur -- "Obama Death Panels" -- has been scooped up and amplified by an equally stupid and irresponsible media class. So far, Obama has been singularly ineffective in countering the hysteria. As Maureen Dowd writes in today's NYTimes:

Sarahcuda [Sarah Palin] knows, from her brush with Barry on the campaign trail, that he is vulnerable on matters that demand a visceral and muscular response rather than a logical and book-learned one.

Okay, here's a visceral response to the idiotic notion that Obama will pull the plug on Grandma. Here's the story of a real Grandma, my husband's Grandma.(All names have been changed.)

Louise had metastatic cancer. She had survived breast cancer many years earlier but now, in her eighties, the cancer had returned. One bout of chemotherapy was enough to convince her that she didn't want to spend what was left of her life enduring painful torture. I think it was the right decision. She lasted another two years and was relatively healthy until the last three or four months. The "cure" would probably have killed her far more quickly by weakening her with poison and pain. And it is those last three or four months that concern us now.

Harry, my husband's grandfather and Louise's husband, was in his mid-eighties. He was amazingly vigorous and sharp as a tack, but old age had amplified his peculiarities. He was a miser and a hoarder. And he was totally paranoid about having strangers come into his home. That, in itself, wasn't unreasonable. The elderly have good reason to feel vulnerable to strangers. As his wife's health deteriorated, however, he insisted on coping with caring for her by himself and then, when he could no longer lift her to change her soiled bedding, he enlisted his daughter Joanne's help. My husband's mother was well into her sixties and not in great shape herself.

The combination of ignorance and despair was determinative. Joanne called me one day to ask, amazingly, for my advice. She didn't know what to do, how to proceed, how to handle an increasingly untenable situation. Her stubborn, paranoid father refused to allow anyone into the house -- no nurses, no home health workers, not even Meals on Wheels.

I advised that she convince Harry that he must allow her to have professional help. At no point, I said, should she allow her father to hospitalize Louise. I told her that once her mother was in the hospital, her agony would be prolonged. She would have the tubes inserted, the machines hooked up, and she'd be kept alive as long as possible, in misery. I advised her to contact someone about home hospice care.

All Louise needed at that point was to be kept clean and comfortable. At home, she could spend her last days with family in familiar surroundings with a view of her lovely garden outside.

Harry was an autocrat and would have nothing of it. Joanne, even in her sixties, was still a cowed and impotent child when facing her father. So Louise was taken to the large hospital nearby. She was hooked up to a feeding tube, IVs and monitors. Her view out the window was of a brick wall.

Louise spent the last forty-two days of her life on her back in that hospital. No one asked about alternatives. Standard operating procedure was to prolong her life through any and all means.

There's also a dirty little secret that nobody in this health care "debate" talks about: Doctors are paid by the procedure and there's nothing like a helpless, elderly patient for the opportunity to pile on the tests and procedures. During a patient's last days in the hospital, doctors come out of the woodwork to peek in the door, glance at a chart, order an expensive test, and walk out to bill Medicare accordingly.

When Louise wasn't staring out the window in pain, she was being hauled all over the hospital for tests and x-rays for -- what, exactly? There was no question that she had terminal disease and that the end was very near. Did they think this blood test or that x-ray would tell them something they didn't already know? Did they expect to predict the exact day and hour of her death?

So for forty-two days, Louise was mindlessly kept alive while her body was being eaten to death by the cancer. Her bones had become so fragile that some time in the last week her hip broke merely from lying in the bed. Her guts had turned to putrid goo. Finally, she died.

The hospital bill was, of course, stratospheric. Miserly Harry didn't care, though. Medicare picked up most of it and what they didn't cover, supplemental insurance did. And it was all totally, utterly unnecessary. Harry was rich enough that he could have paid for round-the-clock nursing at home. There would have been no feeding tube, no monitors, no IVs. Louise would have died weeks sooner, in her own bedroom, and been spared what passes for "care" in America's modern hospital system.

But no one in a position of authority spoke up. Louise wasn't given the chance to choose her own fate. Every day in the hospital, she begged to go home. Instead, she had a husband more concerned with money and his own paranoia, a willfully ignorant man happy to have someone take the problem off of his hands for free. She was left to a system that has perverted its mandate for mercy into a soulless, hypocritical exercise in milking the helpless for every penny that can be squeezed from Medicare.

So don't talk to me about "Obama's Death Panels." Don't talk to me about "pulling the plug on Grandma." Don't pretend to care about people when all you care about is demagoguing and demonizing humane health care reform to score political points.

I'm in despair that any real reform will ever be enacted. I'm sick of a country informed by brutality and stupidity. I wonder what all those imbecilic "Town Hell" screamers would be screaming if they found themselves in Louise's hospital bed.

(Cross-posted at The Broad View.)

Time to roll the hard six

I watched Obama's online town hall this morning. It was a good performance that probably added to his considerable store of political capital. There's one issue, though, where I am extremely angry and pessimistic: health care reform.

Obama tried to make the case for "reform" that still reserves a place for "legacy interests," i.e., private insurance companies and employer-based insurance. Why? Supposedly because people are "familiar" and "comfortable" with that framework. Right. It couldn't possibly be because the insurance lobby has most of frakking Congress in its pocket. Yes, the single-payer system as it exists in Canada and Europe is just too radical and controversial for us American rubes.

It's bullshit, pure and simple. There is no way to make a case for reform, for saving money and getting the most health care delivery on the dollar as long as some of those dollars are being siphoned off for shareholder profit and executive bonuses -- profits and bonuses based on the denial of health care.

Instead, Obama kept peddling those same old bogus cure-alls: electronic medical records and preventive care, blah, blah, blah. I don't know about you, but I'm not wild about the idea of my entire medical history in online databases given the state of electronic security and the pattern of corporate abuse of private information. It's also just another thing for private companies to sell at exorbitant rates.

Obama revealed that in the administration's health care roundtables, the insurance companies (bless their hearts!) are "coming around." How are they coming around? They're willing to stop cherry-picking and excluding people with pre-existing conditions from coverage. Their price for doing the right thing? They demand universal coverage be mandated and bought from them. Nice, eh? It's like a license to print money. What business wouldn't want everyone to be forced to buy their product?

When is somebody in Washington going to come out and say it: There is no reform or affordability until health insurance companies are cut out of the mix. Obama must know this -- after all, he's no dope. But, as Admiral Adama would say, he's got to be willing to roll the hard six.

Later came a question about affordable higher education and Obama seemed unaware of the total logical disconnect between his answer on student loans and his line on health care affordability.

He made the case (an easy one to make) that the student loan system as provided by banks and other financial firms results in graduates burdened right out of the gate with payments that keep them from pursuing careers that are socially important but not lucrative or from starting families and buying houses. In other words, debt service on the student loans harm the larger economy as well as the individual graduates.

And so -- now get this -- Obama proposes that student loans should be provided primarily by the government to cut out the middleman profits ("billions of dollars") that would otherwise go to the banks. That's billions of dollars that could go toward more loans that are more affordable. As for the banks themselves, Obama said there are plenty of other places for them to make profits; they don't need to profit from students just starting out in life.

I agree. And here I would add that there are plenty of other places for insurance companies to make profits. They don't need to suck our lifeblood by profiting on health care. That would be billions of dollars that could be used to deliver more and better care rather than lining the pockets of frakking bloodsuckers. Insurance companies already have guaranteed customers for mandated car insurance. They have home and property insurance, travel insurance, life insurance and insurance on insurance. Enough. Frak 'em all. That's the one thing I'd like to see government do before I croak: Cut the insurance companies out of health insurance altogether.

Here's the transcript of the web town meeting Q&A.

Nature, the night and Battlestar Galactica

 
The women of Battlestar Galactica 

My family and friends indulge my obsession with "Battlestar Galactica," the epic story that will soon come to an end on the SciFi channel. Critics and fans have pleaded with the uninitiated to forget the campy 1970's original and join in watching this mythic "re-imagining" by Ronald Moore and David Eick.

There are myriad reasons to watch BSG: First, there's the powerful ensemble acting from a wonderful cast lead by Edward James Olmos and Mary McDonnell. There's the collection of strong, kick-ass women in a society that has given up gender discrimination. There's the consistently amazing scoring by Bear McCreary. Then there's the story itself -- a post-9/11 saga of the near-extinction of humanity following a genocidal attack by the sentient machines man himself created to make life easier. The remnants of human society subsequently retreat across the galaxy, ever hunted and harried by the humanoid Cylon machines, in a desperate search for a planet named only in their religious scriptures -- "Earth".

 
A signpost -- the 12 Constellations, supposedly as seen from Earth

In lesser hands, this would be the stuff of the typical space opera, filled with noble heroes, weird-looking aliens and ray-guns. "Battlestar" is, instead, gritty, bleak and filled with the fears and longings of a beaten people hanging onto to life by a thread, always in danger of running out of fuel, water and food. A dead fighter pilot's belongings are routinely auctioned off to the highest bidders. A prize for finding a habitable rock to land on will be the last tube of toothpaste in the universe.

There are no magic technological fixes when these people get into a bad situation. They get hurt, they are scarred, they die. The fleet, under the protection of the Battlestar Galactica -- a sort of space-faring aircraft carrier -- set out with 50,298 survivors. As the hastily-sworn-in president of the 12 colonies, Laura Roslin (Mary McDonnell) says: "The human race is about to be wiped out. We have fifty thousand people left and that's it. If we want to even survive as a species, then we need to get the hell out of here and start having babies." And there you have the backbone of the story. Along the way, the refugees must continually answer the question, "Are we worthy of surviving?" By last Friday's episode, the last before the two-week, three-hour finale, the survivor count was down to 39,521.

Tonight, though, I'd like to write about how I found a wonderful book through "Battlestar Galactica." You see, last week's episode was titled "Islanded in a Stream of Stars." I thought it was a beautifully poetic phrase and it's been one of the pleasures of the series that the writers typically reference a wide range of cultural touchstones. Then on one of the many blogs and sites devoted to BSG reviews and analysis, I found the source of the title. It's from "The Outermost House," by Henry Beston. Subtitled "A Year of Life on the Great Beach of Cape Cod," it's apparently one of the great American works of nature writing. I had never heard of it (there are a lot of things I've never heard of, to my chagrin) but I had to buy it immediately. Here is the enchanting passage that inspired the episode title:

“When the great earth, abandoning day, rolls up the deeps of the heavens and the universe, a new door opens for the human spirit, and there are few so clownish that some awareness of the mystery of being does not touch them as they gaze. For a moment of night we have a glimpse of ourselves and of our world islanded in its stream of stars - pilgrims of mortality, voyaging between horizons across eternal seas of space and time. Fugitive though the instant be, the spirit of man is, during it, ennobled by a genuine moment of emotional dignity, and poetry makes its own both the human spirit and experience.”

The book arrived today and I'm just filled with happy anticipation to hold such wonderful writing in my hand and sadness and loss that this beautiful Galactica saga is coming to an end. Do yourself a favor. Get the pilot miniseries, included in the Season One package, and start watching from there.