The Republicans are racing to enact AHCA under cloud of secrecy and distraction provided by the Russia investigation. They are intent on their mission and won’t be denied. But why the hurry, why the secrecy, why the subterfuge and why the cruelty?
The AHCA and other upcoming bills tell us the agenda of the Republican party. If we analyze what they are doing, we can connect the dots as to why, and where they want to take our country. I can’t comment on the Senate version of AHCA because nobody has seen it. But I can comment on the House version. We can be confident that, while the Senate version may have some differences, the effect will be similar. The House and Senate are both controlled by Republicans, and those in charge share an agenda. Thus, while there may be differences around the edges, the substance will be intact.
We can derive from the CBO score that the House AHCA benefits those of privilege and the healthy young, while gravely harming the aged, the disabled, and the poor. The question we ask is why? Why are they protecting those in least need of protection and savaging those in greatest need of protection? What is the end game?
As I wrote in a post earlier (read it here), we are racing toward corporate feudalism. Based on their priorities and allegiances, it is obvious that this is the goal of the Republican establishment. They have a protected class, and the purpose of the rest of society is to serve, pamper and enrich the protected ones. The protected class consists of corporations and the wealthy. To complete corporate feudalism, they must have control of all factors of production, that is, the means of creating wealth. A read of the House version of AHCA and the CBO scoring of it shows that they are doing all they can to accomplish that. It also reveals a sinister undercurrent in the Republican Establishment thinking: Those who are not able to serve, pamper and enrich the pampered ones have a duty to die. I will say it again, those who do not fit the purpose of the elite have a duty to die. But, as I will explain later, they must die in the most horrible ways, and only after any wealth they may have been able to generate is returned to the corporations.
Let’s take a look at who is primarily targeted by the House AHCA. It is the elderly, the disabled, those with preexisting conditions, the poor and the sick. Why are they the targets? These are the people who contribute nothing or little to the corporate bottom line. These are the people Republicans have been calling the “takers.” Not the corporations making billions in profits while collecting millions in tax dollars. The “takers” are the people who continue to live while not enriching the protected. Based on the content of bills being pushed by the Republicans, it is clear Republicans believe these “takers” have a duty to die and stop using resources.
Those who are not targeted, the young and healthy at their peak of production, are covered by AHCA as long as they stay healthy. They bring in far more profit than they cost to cover. The protected class needs them to do the work. The young and healthy are the most valuable factors of production, and they are worth the investment to maintain. But the bill has some huge gotchas in it for them. If they have preexisting conditions, that will be out of pocket, and at a higher rate than the actual cost to treat those conditions. (For example, there is no way it costs $2000 a month to make and distribute insulin to a diabetic. But that is what they are going charge the diabetic. Same with a number of other drugs. The pharmaceuticals are having a heyday with life saving drugs.) The portion of the bill that allows lifetime caps on coverage for the employed is a way to exact maximum profit from workers and discard them when they are no longer profitable. It also discourages workers from accessing their coverage in order to have it available in time of great need.
Women and children are targeted in this bill. We should note that with this bill plus their other policies and practices, women are to be nothing beyond toys and incubators. There is to be no sex education (hence Betsy), no birth control (hence targeting planned parenthood and other Republican sponsored bills both in congress and in the states), no prenatal coverage (now, isn’t that crazy if you want a healthy baby?), no maternity coverage, no neonatal protection, and once the child is born, no public assistance (they are working on dumping WIC and severely restrict even food stamps), no assistance with child care. But if you don’t manage to raise the child the way they think the child should be raised, you can be fined, charged, arrested and even imprisoned. This only makes sense in a corporate feudal framework where women and children are little more than livestock. We should notice from their behavior that in their minds, the place of women in their society is the serving, pampering and enriching via sex. Going beyond reproduction, Republicans are pushing policies that would have children not from the protected class educated in institutions that push a religion that supports their caste system and restricts knowledge to those things that will make those children grow up to be little more than capital (financial assets, like machinery). Once their value is fully depreciated, they revert to being “takers.”
The “takers” have a duty to die. But if you look at the rest of the administration, you find that it is more than a duty to die. AG Sessions has spoken out against both medical marijuana and death with dignity laws. Why would he oppose those? The reason is evil in the rawest sense. Marijuana has been shown to relieve pain and other symptoms of disease and is relatively inexpensive. It has been shown to offer comfort for cancer patients, especially in their final stages. It has been shown to offer some help for dementia patients. Why not encourage its use? And why, when a person has been diagnosed with a terminal illness, not allow them to pass on peacefully and painlessly at a time of their choosing? I can only come up with one rationale for these things. People using medical marijuana are not using expensive pharmaceuticals. People who choose to die peacefully and at the time of their choosing wind up not using the pain killers or living in nursing homes. In other words, Republicans want to ensure that as you are suffering and dying, you will first cough up any assets you have managed to acquire in your life to corporate interests before you go. You have a duty to die, and to die broke and in agony. To serve the protected class.
I am not sure what can be done about our trajectory. Now that the GOP is in control of two branches of government and is about to cement their control in the judiciary (not only in the Supreme Court, but in all the Federal courts as well), a course correction may not be possible. As of this summer, we may be officially a corporate feudal state.
This is a letter My husband wrote to Cory Gardner and Mike Coffman. I think it is worthy of reading.
I trust you will read this letter in its entirety, rather than picking and choosing issues to respond to as has been the case in the past.
I am a retiree and depend on my earned benefits (Medicare, Social Security and a small pension).
I am a Viet Nam era veteran from the early 1970s where I was a part of the IC community. During that period, I developed a deep dislike for Russia and its corrupt behavior.
Politically I was active within the GOP from the 1970s to 2005. In the late 1990s the GOP left me and became a party I did not recognize. The party also left the American people. It no longer cared for the citizens and did everything to abandon the nation’s infrastructure and the health and welfare of people that matured under the Eisenhower administration. Yes, the Democrats were the opposition, but there was usually an attempt to find solutions. Today Democratic values are more closely aligned to the values of the GOP in the 50s and 60s and for that matter the 70s and 80s. Voter opinion was valued by the party. Huge donors didn’t rule the roost. There were no Koch brothers or DeVos family influences. People mattered back then. Today, who in the GOP cares about the people?
The issues I have outlined below are important to me because I still believe American citizens matter. Everyone who lives in this country matters (other than those who choose to destroy our Democracy). I hope you consider each, realizing this nation must be one of compassion and that today’s GOP cannot continue to shove their beliefs down everyone’s throats.
The Trump/Ryan Care legislation was unacceptable. It was cruel to those who need it most, many who have no choice. For example, my daughter-in-law has type 1 diabetes. Her employer does not provide insurance to ‘part time’ employees. By the way, she is not part time by choice, but rather because her employer (major American corporation), like so many, is avoiding the cost of benefits. Prescriptions alone could cost her $2,000 per month without insurance. A high-risk pool such as proposed by the GOP would mean no health insurance coverage and eventual death. Is what we really want? For the rich, I am sure that is the case.
The menu of EHCB under ACA has been a godsend. Yes, premiums and deductibles are high, but much better than the days before ACA. Why do I like the ACA? The answer is simple, ‘affordable health insurance for a person over 50 years old’. I was in the Defense industry for almost 40 years. My benefits were great, however with budget cuts, highly compensated employees like me and my wife were forced into early retirement. Retirement medical benefits were more costly than what I could find on the commercial market and the ACA. I was headed toward bankruptcy. Both Trump/Ryan didn’t give a damn about the over 50 population and even with increased tax credits the deal was rotten. How dare they use the legislation to reduce the taxes of the wealthy on the backs of people like us? This should be legislation for comprehensive health care for all at an affordable price no matter the individual’s age. Medicaid is an essential element of health care although it does not affect us. The GOP does not seem to care for the working people living in this country.
I am a firm believer in protecting the benefits we paid for, specifically, Medicare and Social Security. These are earned benefits. Now that I collect these benefits, I understand more than ever their importance and the need to protect them for all who have made contributions. It is important to keep these programs viable, but GOP plans are not well thought out. Why is the Social Security Cap not adjusted like it used to be? It seems like increasing a contribution to retirement a little each year is not a sin other than some Think Tank giving a Congressman a lower score. Congressmen work for us, not a Think Tank. Medicare must be kept intact and prescription prices kept affordable. Rather than adjusting retirement age (not a reality) why not consider an increase in taxes in line with inflation? Privatizing is not an option either. The Government is the best manager of my money. I’ve had so many investment firms rip me off over the years that I no longer trust them. That is the private sector.
The fabric of this nation is our immigrants, no matter how they arrived. It is special to see friends, co-workers, worshipers, store clerks, airport workers, public servants, etc. from so many different countries. Many came to this great country to flee oppression or poverty. Why on earth would we change something so special? Today’s travel bans and deportations are just two things that shock me. Why do we oppress people in or attempting to enter our country? I love Colorado because of its diversity. In a normal day I interact with people from at least a dozen countries. They are not here to destroy us. Why are DREAMers not citizens? What law did they break? They had no say in how they arrived and yet they are friends and peers. What about those escaping war-torn countries and areas of famine? For those of us of Christian faith, God would expect us to care for those in need. I cannot understand why Congress and the Administration are filled with such hate.
I am a firm believer in the separation of church and state. This line is being blurred by this administration and is being manifested by expressions of hatred towards believers of other faiths. I am stunned that Congress is seemingly silent on acts of violence and vandalism. Congress is guilty of not condemning this administration of promoting expressions of hate.
This is the biggest waste of taxpayer dollars. No one knows the exact price and Congress is making no attempts to find out the true cost. Congressmen will be held accountable for this failure. This wall reminds me of the Berlin wall. Is Mexico our enemy? No. They are our friends and trading partners. Is this wall going to hinder migration of wildlife? I am sure it will. The hatred of this administration seems to trump all considerations of the impact of the wall. Bottom line this Congress is lazy. It does not want to do the hard work required to find solutions.
This is another area where Congress is not pushing back. The travel ban is a Muslim ban. More importantly it has no impacts on the investments of the president because it excludes nations where he has properties. It harms our businesses and tourism. People will not feel welcome to visit our nation and other nations will likely not welcome us. It is making this a more dangerous world. The Colorado GOP delegation seems to embrace this expression of hatred. As written, this ban has nothing to do with the safety of this country.
Where do I begin? I have yet to meet anyone in Colorado that does not support green energy, does not want clean air and water, and that denies climate change. The actions of many in Congress and the current administration are advocating the destruction of all the progress we have made over the last several decades. Cost of regulations is not an acceptable excuse. The benefits have far outweighed the ‘costs’. People are healthier now. The world is better off.
This administration is failing the country in a major way. Ms. DeVos should never have been confirmed. First, this was a case for pay to play. Too many Congressmen accepted donations from a Michigan resident who in turn felt obligated to support her nomination. Quite frankly, I believe this was a criminal act. Second, she advocates on the part of religious education. This dilutes the effect of our public education system. Our tax dollars must not go to religious education under any circumstance. My tax dollars must not go to supporting a school whose beliefs I do not support or agree with. Religion must be kept out of our public schools (and I am a Christian).
Voting rights are being attacked in so many ways. Voter ID laws are making it impossible for the infirmed, minorities and seniors to cast their votes. A solution must be found so that all citizens can easily vote. Voting obstruction must end. Colorado may not be perfect, but does get higher grades than many states and should be held up as a good example for voting in national elections. I resent the criticism coming from the current administration on Colorado voting laws and I encourage our delegation in Washington to demand that it stop.
This is an area where the GOP has dropped the ball. Where are the investments in the power grid, highways, water lines, gas lines, rail, mass transit, internet access, etc.? Congress is zeroing these investments out and refusing to increase gas taxes. Bridges are falling apart. Pot holes are everywhere. Tolls are being charged for highways that were constructed using our tax dollars. Are we giving infrastructure public assets to the well connected to profit from our contributions? This is corruption. It is a failure on the part of Congress. This took hold in the 1980s and now we as a country are facing a case of deferred maintenance which will cost ten times more to fix. Will it take a major disaster to wake Congress?
This is a losing argument with you. Suffice it to say, voters will remember the Garland nomination. Why you were a part of this obstruction is beyond me. Neil Gorsuch, in my opinion, puts more value in businesses than the people of this country. There was no indication in the hearing that he would protect the lives of people in this country. Protecting big donors and big businesses seemed far more important. Is Congress throwing the poor and middle class under the bus? It appears that is the case.
Behavior of Current Administration
Our president has been in office roughly 75 days as I write this. It has seemed like 10 years of hell. Congress could become heroes if they were willing to put a stop to the chaos. Most of the EOs are not well thought out. Congress could correct the EOs, replace them, or pass legislation overriding them. We clearly have a president that has no clue on governing.
As a veteran, I am very sensitive to anyone’s relationship to Russia. I don’t trust them and I believe they are out to destroy our great country. The Senate seems to be doing the right thing, albeit a little slow for my taste. Whatever the case may be, Congress must get to the bottom of this mess and hold people accountable, even at the highest levels of government. Tampering with our elections and any subsequent cover-up is wrong. Personally, I could probably name at least a dozen who I believe are guilty of something. It could mean a new President and it might be down the line of succession. I know I am not only person that is worried. Senate leadership is going to be very important.
Congressmen Work for Constituents
This can be the toughest thing for a Congressman, but it is the most important. Colorado elected you, not donors, not Think Tanks. You must listen to your constituents. I will hazard a guess, as much as you may not like it, most of us in Colorado embrace the ACA. Your donors may not like that, but in 2020 the voters will provide you with an assessment on how well you listened to them. In person town halls are important. Voters need to release their emotions in person and you must listen. This is especially true today, when we have an Administration that is determined to tick everyone off. Unfortunately, you will receive most of the voters’ wrath even if you were not a part of the president’s actions. I don’t believe for a minute that the Colorado protesters are outsiders. They are my friends and neighbors from here in Colorado. We want our Congressmen to hear us. I believe you can. Do you have the will?
Continuing my hiatus on writing about corporate feudalism (research is hard), I write this to prepare you for what the Republican Party will do when the members are returning from their break. Those congresspersons who received heavy pushback from their constituents will be given permission to decry what is happening in the Trump administration, and to vote against bills when their votes aren’t needed to pass the Republican agenda. We must not allow them to get away with this. Trump is now the Republican standard bearer. If these congresspersons truly disapprove of the Republican agenda, they must repudiate being a republican. Otherwise, they own it.
As I have said before, I used to be an active Republican. I came by it honestly. My parents were active Republicans. I was in the mold of the Rockefeller Republicans. We were pro choice, pro women rights, pro civil rights, but we were Republicans. I served as treasurer of Republican Women in three states and worked on numerous campaigns. As the party became more anti choice, I was looked at funny, but they claimed they were a big tent, so I stayed. As the party became more anti women, it got more uncomfortable, but I hoped to move the party more to center, so I stayed. As the party got more evangelical christian, I was uneasy on behalf of my Jewish friends, but I stayed.
These views I held were not looked on kindly, however, and I found myself being edged out. We had arguments and long discussions. My own experiences were beginning to create conflicts with my party affiliation as well. I became a speaker for Planned Parenthood, and found myself talking with battered women. I volunteered for a program that helped K-6 homeless children. I learned about domestic violence, and I learned about what it was to be poor. I learned how people wound up homeless. I learned what the lives of homeless children were like. I found this knew knowledge contrasted with the slogans I had heard from the party. I tried to speak to my state legislators about the issue, and found no compassion or interest in helping.
At the time, I considered myself a strong Christian. But the more I read my Bible, the less I could reconcile the positions of the party with what I was reading. I read that taking care of the homeless was our responsibility. I read that feeding the hungry was our responsibility. I read that our job was to heal the sick. Since I had no talent in healing, it was my job to make sure the sick could access those with that talent. I pointed out these things to my Republican associates, but they always had an “answer.” It was interesting, the answer always began with “Yeah, but ….” I found that to be a Republican was to live by the Yeahbut.
Then Tancredo and Musgrave started saying horrible things about gays, and wanting to essentially persecute them. I had good friends who were gay. I knew these things were false. These things were horrid lies. There was no yeahbut that would work. I spoke up against these lies and implored my fellow Republicans to stop. One of my associates said to me, “I know you have been a Republican all your life. But if you are going to be a Republican now, this is our platform and you have to endorse it. Our standard bearers endorse it and you have to support them.” She was right. If I retained the title Republican, that meant I endorsed what they stand for, and I had to own it. It defined me. I could not endorse it. I refused to own it. It would not define me. I changed parties.
It was amazing how much easier it became once I left that party. I no longer had to twist myself into an intellectual pretzel. I no longer had to live on a diet of yeahbuts. I could look myself in the mirror.
Today, the party stands for a number of things I could never endorse. Their standard bearer is Donald Trump, and the rest of the establishment support him. If one is to be a Republican today, one is endorsing and supporting Trump and all he and the party stand for. Not just in the platform, but in their words and deeds since January 20. They endorse it. They own it. Because it reflects their value system, it defines them.
So what is it that they endorse? What do they own? What defines them?
- The Republicans call themselves the party of patriotism. Yet there is the distinct smell of Russian interference in our elections, where our President might be compromised, and our nation is at risk of becoming a Russian puppet government. The Republican congress killed a letter of inquiry into that connection. As a Republican, you don’t want to ensure that our election was fair, honest and open as long as your party wound up with maximum power. Foreign interference, from an adversary no less, is acceptable. Now Trump accuses, with no attribution, the former President of the U.S. of spying on him during the election. Trump is the Republican standard bearer. This is the Republican position. If you remain a Republican, you endorse it. You own it. It defines you.
- Republicans call themselves a Christian party. Jesus said to heal the sick. Republicans claim to support access to health care for all, but oppose coverage. Access means it is there, but not necessarily affordable. In many cases, a person has to choose between life saving medications (i.e. insulin) and eating. They may be allowed to get the medications, but they can’t afford them. In other words, choose the way you will die, just get on with it. This is not affordable health care, and it will kick some 30 million people off of any coverage. It will also make health care incredibly hard to afford for many millions more. Seniors will be especially hard hit. People will get sick, and people will die. However, it will mean inflated profits for health insurance companies, allowing them some of the highest profit margins on the planet. The new Republican health care plan not only kicks 20 million people off insurance roles currently covered by ACA, it also allows companies to stop providing health care to their employees. This amounts to around 30 million FAMILIES losing their health care. At an average of 2 children per family, this means 120 million more without health care. This is the Republican position. If you remain a Republican, you endorse it. You own it. It defines you.
- The Republicans call themselves to be the party of open doors. Donald Trump wants to ban Muslims from our country. He wants to deport millions of undocumented people, many of whom came here as children. He is deporting an Afghanistan veteran who served two tours of duty. Imagine a U.S. military trained soldier in another country and mad at the U.S. He says this is a Christian nation. He isn’t particularly happy with the words of Jesus, “For I was hungry, and ye gave me meat: I was thirsty, and ye gave me drink: I was a stranger, and ye took me in … Verily I say unto you, Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me.” He is prepared to rip families apart, remove people from their jobs, destroy communities to fulfill his wish. His travel ban had people stuck in airports for days with no direct access to their families or legal help. He is willing to leave refugees suffering as they flee oppression. He is willing to remove people who grew up in this country to places they have never seen (it is also likely they are actually deporting U.S. citizens under the pretense that they look undocumented). The only crime committed by Dreamers is that they stayed with their parents who were seeking a better life for their children. He has enabled the harassment of Muslims and the vandalism of mosques. He has enabled the vandalism of Jewish cemeteries and terrorizing of Jewish centers. He has enabled the bullying of Latino U.S. citizens. This is now the Republican position. If you remain a Republican, you endorse it. You own it. It defines you.
- Republicans call themselves the family values party. This is the party that wants to obliterate Planned Parenthood and all the health care services it offers to low income men and women (no, not just women). It is the party that wants an employer to have a say in whether a woman takes birth control. It is the party that demands that every egg be fertilized, but would deny pre natal coverage, coverage for a hospital birth, post natal coverage, assistance in paying for feeding or caring for the child, and should the mother not live up to their standards of raising the child, would jail the mother. This is the party trying to redefine rape to its narrowest possible definition, letting rapists off the hook so as not to “ruin the lives of fine young men.” This is the party whose standard bearer boasts about groping women, walking into dressing rooms of naked adolescent women, insulting women’s appearance, has been accused of physical abuse, and has walked through 3 marriages, two ending because of his infidelity. Rape, groping, domestic violence, insults and demeaning of women is not only ok, it is encouraged. This is now the Republican position. If you remain a Republican, you endorse it. You own it. It defines you.
- There are many other contradictions between how the Republican Party labels itself and the policies they support. But there are also many other positions they take that are harmful to Americans. Betsy DeVos’s education office is mandating that states accept vouchers and relax accountability in the quality of the education provided. While this would divert funds from public schools to private, it will not make them more accessible to the people. Rather, it will raise the rates charged by private providers (demand/supply) while not ensuring that the students are receiving the education they are paying for. At the same time, it will divert funds away from public schools, eroding the quality of education they are able to provide. Special needs students will be especially hard hit, as the private institutions will not be required to accommodate them, but the public schools will not be able to afford quality services. On a different subject, both members of Congress and the president have voiced support to violating or ignoring provisions of our treaties. There are too many treaties to name here (you can find lists of those treaties here and here.) These include both international treaties and treaties within our borders with Native American ties. The international treaties at risk include trade agreements, agreements for mutual support, treaties protecting the environment, and (can you believe it?) the Geneva convention. The number of treaties threatened with Native American tribes is in the hundreds, and all are RIGHT NOW being violated by U.S. corporations and the U.S. government. In addition, members of congress and the President have indicated a predilection to defaulting on U.S. debt. A default on this debt not only affects foreign investors, but every person who holds a U. S. savings bond. The violation of treaties and default on U.S. debt reduces the word and honor of the United States to zero. The Republican members of Congress and their standard bearer support these actions. This is now the Republican position. If you remain a Republican, you endorse it. You own it. It defines you.
All this and more is what it now means to be a Republican. You cannot bring the party back. You cannot urge its members away from it. It is the substance of who they are and what they believe. This is now the Republican position. If you remain a Republican, you endorse it. You own it. It defines you. And when the next elections come up, we will remind the voters of that.
I have come to the conclusion that sitting around blogging is not being the change we need to be. I have seen the pie fights, the trolls, the proliferation of meta diaries. I have seen those who support the President called “Obamabots,” as if agreeing with this President is proof that we have no brains of our own. I have watched the spectators throw tomatoes from the grandstand while the team is out trying to move the ball. I saw the result of all this nonsense in the 2010 elections and now we are suffering the consequences. Elections have consequences. 2012 is coming and I am grabbing a mop.
Our President has been faced with the worst succession of disasters, turmoil and nastiness that I have seen in my half century here or read about in my history books. Only Abraham Lincoln has seen more division in the country, only John Adams and Thomas Jefferson have seen such chaos. The response from American citizens has been to either attack the President or attack each other. I don’t have time for this. Our President asked us to grab a mop. I am grabbing.
I am grabbing a mop because I can’t afford not to. I am grabbing a mop because my own, my husband’s and my sons’ futures all depend on the success of this President and the failure of the new GOP agenda. I am grabbing a mop because my younger son will continue to need my company’s health care for a few more years. My husband and I are nearing retirement age, we will need social security and medicare. My mother needs both.
I am grabbing a mop because my parents did without niceties and our family growing up did without vacations so my parents could put money away for their old age. My husband and I did the same. If this GOP is allowed to hold our country hostage on the debt ceiling, demanding the entire middle class surrender for the debt ceiling to be raised, all that we have put away for a stable future turns to dust. Everybody’s savings, everybody’s investments will be rendered worthless. All of our old people who wisely put away for a rainy day will be standing in the rain in soup kitchen lines. I am grabbing a mop because I think that is a travesty.
I am grabbing a mop because instead of pushing social equality forward by legalizing rights for our LGBT community, this current crop of GOPers is trying to turn back the clock on women. They are also trying to turn back the clock on workers. They are trying to make our society into a nonagrarian feudalism, with major corporations as the holders of all the wealth. I am grabbing a mop because a society is made up of people and people should be valued more highly than companies. And they should be valued equally.
The mop I grab may not be the mop you may grab. You may not like how I wield the mop, and you may not agree that the place I choose to clean up is the best place to start. That is fine. Grab your own mop. Grab the mop of your choice and clean up the corner you prefer. But as the President said, “Don’t go criticizing how I am holding the mop.” At least I am mopping something somewhere.
Since I will be in the mopping business, I may not have time to show up and chat. I may wander into WYFP or Brothers and Sisters now and again, but I will have to use most of my time scrubbing those ugly corners where the GOP is trying to leave their smelly little droppings. Maybe after the 2012 elections I will have more time. Meanwhile, I am grabbing a mop.
I leave you with these lovely words from Scott McKenzie:
Hey, what’s the difference if we don’t come back?
Who’s gonna miss us in a year or so?
Nobody knows us or the things we’ve been thinking
So what’s the difference if we go?
Meanwhile, I hope my mop can make a difference.
Today the feather I pull out of the featherbed is the claim that Americans (US variety) have the best health care in the world.
We have all heard the claim that here in the United States we have the best health care system in the world. People are lining up to get here for our health care. Actually, people are dying to get our health care. Literally. They are dying waiting to get into the system and get some care. Below I discuss the health care of two good friends of mine: Henry (not his real name) and Fido (also not his real name).
I was told this story by Henry’s significant other. However, from conversations I have had with many people, it is not all that unusual. See how your own experiences match up.
Henry had a problem in his gut. It hurt. He went to his family practitioner. His practitioner looked him over and decided it was his bladder. She referred him to a urology specialist, an assembly line sort of doctor who only did bladders. The specialist botched the first scope, a horribly painful procedure so he performed it again. Henry went back to his family practitioner and complained about having to undergo two scopes without arriving at a diagnosis. Ho hum, said his family practitioner, and referred him somewhere else.
So here is the whole story from his significant other:
The procedure done by specialist 1 was a urethral scope. He had to do it twice on the same day because the first time failed. Note that every procedure done by all of the docs involves inserting a camera or device for snipping tissue from the bladder through the penis. Each is painful (obviously) and left Henry with significant discomfort for several days following.
The second doctor was the one who was highly recommended. He did the scope again, because he couldn’t (wouldn’t?) rely on the one performed by #1. Following the scope, they knew there was a tumor. #2 scheduled the procedure to remove and biopsy the tumor which involved the same process for inserting the device. Henry had his sister come from Ohio to be with him for this. Meanwhile, the day before the procedure doctor #2 called to tell Henry that he couldn’t do the procedure but another from his clinic could because he was in Oregon and couldn’t get back time. Then, when Henry had a tantrum, the doctor called back and basically said he had misread his calendar and would be back in time. Then the morning of the procedure, when Henry was already laying on the gurney without clothes on, doctor #2 and his staff had an argument in the examination room regarding whether the procedure might have to be rescheduled for sometime later because they had overlooked that he is allergic to latex and the staff thought the procedure should now be done at a hospital. When Henry started to put his clothes on and leave, they decided they would do the procedure.
This is the doctor who called several days later to tell Henry he had cancer and that they wanted to begin BCG therapy in four weeks and offered no support. They sent him one packet that included information on bladder cancer and BCG therapy, but when he read it, he focused primarily on what he read that was the worst outcomes and the negative side effects. This is when he really started to lose it and became so angry with dr. #2 that there was a “mutual agreement” that he would go somewhere else. Note also that the procedure done by doctor #2 seemed to have removed as much of the tumor as possible, but the lab report from the lab he used was contradictory, which made doctor #3 feel that he wanted to do the surgical procedure yet again, which became the 5th time there was a procedure involving inserting something through the penis. Meanwhile, Henry had gone into a total meltdown because this is where his family practice physician was failing to meet Henry’s expectations for communicating with him. Note that Henry’s expectations for return calls weren’t realistic in today’s medical environment, but in response to his urgent request to talk with her (I think perhaps on a Thursday), he received a call back from her physician’s assistant the following Monday. This is when he switched to another doctor. The new family practice doctor was a wonderful doctor in his day, but is past his prime. He didn’t even know what the BCG therapy was that Henry was to undergo and is the one who put Henry on an anxiety drug, whose side affects were known. Those side affects were contraindicated by Henry’s history and symptoms. All the side affects were realized – the medication resulted in four weeks of paranoia, rage, bladder and bowel problems. When I called this doctor’s office to let them know what was going on and to try to get help, no one at that clinic ever thought to look at the drug as the cause of the problem.
Anyway, once Henry got to specialist #3, that doctor wanted to do the insertion and biopsy again because he wasn’t satisfied with the results of the lab work from #2. Once that was over, they began the BCG therapy which involves inserting live tuberculosis bacteria into the bladder (again through the penis). The regimen involved six treatments of which he has completed four. These are done by a nurse. He has not seen doctor #3 since he began the treatments even though he is certain that treatments are inflaming his arthritis. Also, the treatments are incredibly painful and he has tried to find out from this doctor if he can have some sort of anesthetic. He finally has an appointment with doctor #3 tomorrow, but only after several ugly phone calls with the doctor’s office. When he talked to doctor #3 on the phone about the complications with his arthritis, the pain and some of the other symptoms, doctor #3 responded that “none of my other patients have ever reported anything like this”. The brochure that they gave Henry on the BCG therapy list exactly the same complications as reasons to “contact your physician”! At least he has an appointment with doctor #3 to determine if he should finish the last two treatments. However, it is important to note that if Henry would have been able to begin the treatment with doctor #1 back in September, he would be done by now and would be ready for a six month follow up.
I don’t really think his care is that much better now. He needs to find a good family practice doctor who is willing to help him through all of this. Specialist #3 is like the first two. He is focused on the success of the initial procedure to remove the tumor and on the BCG therapy that he has ordered his nurse to do, but his bedside manner is poor. None of them have understood how difficult this is for Henry and none have offered to help coordinate any sort of support through support groups, psych help, or god forbid simply sitting down and talking with him.
Now we get to Fido. Fido is diabetic as a result of Cushing’s Disease. When Fido came in, he was in pain. Fido’s doctor sat on the floor to examine and diagnose Fido to avoid the discomfort of putting Fido on the examining table. Fido’s doctor stated options and personally arranged care. The clinic called Fido’s owner (Henry) daily to advise of progress and discuss treatment. They performed hourly blood tests. When Fido came back, they (the clinic and the main care veterinarian) together coordinated ongoing care so the vet would be apprised of existing treatments for her ongoing treatment. When the dog began to lose eye sight due to the diabetes, the vet recommend one specialist. When Henry was unhappy with that specialist, the vet was glad to get the feedback and promised to never recommend that person again. She recommend a second specialist. This new specialist and the vet spoke daily to each other and to Henry. The vet watched medications for compatibility and balance. Calls were returned within 1 day, unlike Henry’s doctors. Henry was never put on hold when he called, whereas Henry’s doctors often required a 55 minute hold. Fido is feeling much better now, but his vet still checks in.
The moral of this story is that if you want quality, unified care, call a vet. Be a dog.
The feather I am pulling from the featherbed today is that American people have the best health care in the world. In fact, if you are in America, you get better care if you are a dog.