Thursday, July 29, 2010

Former Liberal Supporters of Obama Should Come Back to the Fold

As President Obama's 49th birthday approaches, I'm thinking about his presidency, the nastiness of politics, the increase in threats against a sitting U.S. President, and the widening divide across the country. I'm thinking about all the work that went into getting him elected and all the wounds this country has felt ever since.

Oh sure, Obama's a great orator. He says all the right things and he's not hard to look at, either. But for me, there's gotta be more to hold my interest - and my loyalty. I've gotta have substance and I believe with all my heart that there's plenty of that in Barack Obama.

Yes, I know. Some people think that supporters of President Obama drank the kool-aid and can't see the forest for the trees. This one's for them: President Obama has actually made decisions I disagreed with! I don't like FISA, the Patriot Act, Tim Geithner, Rahm Emanuel, or the way he "lets" the most egregious of Republican insults go by without a word. There are things he hasn't done that I don't like either: Guantanamo's not closed, our service men and women are not yet home from Iraq, we haven't repealed DADT, he didn't comment on the Gulf oil spill until the damage was horrendous, and he didn't fight for health care reform the way I wanted him to.

For the Republicans and Tea Baggers who don't like President Obama, I get it. At least for some of you, I get it. I get it that you don't think we should pay for more social programs, that people should take care of their own instead of depending upon the government. I get it that you believe business is the heart and soul of this country, and that you're worried our constitutional freedoms are being eroded. I know you believe we just want to take more and more of your hard-earned money to pay for the dead-beat who is too lazy to work and the illegal alien delivering her child in our hospitals. I don't share your perspective but I respect you and your beliefs.

For the Republicans and Tea Baggers who are too lazy to do their own homework, who don't know much of what it going on with our government and choose to let FAUX News keep you updated on what's going on instead - shame on you. If you actually believe a single word that comes out of the mouths of the Becks and the Limbaughs, the Angles, and the Bachmanns, or the Queen-T herself, Sara Palin - shame on you. Shame on you for succumbing to their fear techniques and buying their lies. Shame on you for allowing your own prejudices to be so easily manipulated. Shame on you for hiding your puritanical, racist, evangelical, elitist values behind the cloak of "freedom." You're the first on the protest line, carrying the biggest bullhorn, dressed in the most outlandish of Uncle Sam attire, demanding we tell the truth about what our commie-pinko-fascist-socialist agenda is really all about but you don't even have the balls to tell the truth about why you stand where you stand.

But I digress. Ahem.

The Tea Baggers and the Republicans have one plan and one plan only: block everything this administration tries to accomplish and then run for re-election on the platform that the Democrats haven't done anything. I'm actually grateful to them for being clear and consistent in their agenda.

It's my friends on the other side, the liberals and the progressives who I wish I could shake by the shoulders, pull a Cher in Moonstruck and say, "Snap out of it!!!!" Disenchanted liberals and progressives are leaving the flock and starting other, more progressive organizations. Independents are swearing to vote Republican. Libertarians and Green Party members want to vote out every incumbent out and start over with a clean slate.

The restlessness is palpable. What is happening here?

To my leftie friends, remember the early days of this presidency? Remember all the criticism Obama got for taking on too much, doing too many things? Remember how we gave each other high fives because Obama was so ON it? Now some of you are complaining that he hasn't done anything since he's been in office. Yet, the fact is, Obama has already accomplished more in his 18 months in office than Bush did in 8 years. That's not opinion, that's fact, one that can easily be verified with a simple Google inquiry.

Let's not forget the conditions Obama stepped into when he assumed office. The country on the brink of financial collapse. Soaring unemployment rates. Engaged in two wars. An auto industry that was failing. A racial divide as large as any we've seen since the '60s. And yet, the moment he was in office, he began working on all those problems PLUS the myriad of issues he promised during the campaign. On his first full day in office, he signed executive orders mandating the closure of Guantánamo Bay prison camp in one year, prohibiting extreme interrogation practices and revisiting military tribunals for suspected terrorists. On his next day of office, he signed the Lily Ledbetter bill into law giving equal rights to women and people of color. In his 2nd week of office, Obama signed into law the stimulus bill that gave 95% of Americans a tax break, and money to all states for unemployment and repairs to roads, bridges, schools, etc. What followed in his first 100 days of office are marked by the boldest intervention of government into the affairs of business since the Truman era.

There is NOTHING the President can do to make this entire country happy. Can anyone? You know that old saying, "you can't please everyone." Never were words more true than in Obama's case.

Those leftie friends of mine who gave up, who claim Obama is just more of Dubbya, are now on to bigger dreams. They're building new grassroots organizations, recruiting from the old grassroots organizations, and trying to whip up the same level of anger and frustration as our Republican friends. It doesn't look good on us and it smells funny, too. We can't compete. If there's one thing the Republicans are really, really good at, it's united fury. They don't have a platform, they don't have any ideas, and they don't have any good candidates, but lordy, lordy, they've got anger. And it wraps them up in one great big hate-fest snuggie. They're willing to use tactics we won't, and they know that about us, which is another reason we suck in the united fury department.

The Republicans don't do that. They just say "no" and get home in time for dinner.

But that's not stopping the disenchanted among us from trying it anyway. We've got our tried and true Democratic Party organizations. We've got Organizing for America. Now there's Change.org, Serve.gov, Volunteer Nation, the Coffee Party, Democracy Now, Democracy for America, Moveon.org, Courage Campaign, and countless others. Unless it's a special interest group (education, disability, LGBT, etc), why must we choose one over the other? Why can't we work together?

We fail to see that our factions are duplications rather than inventions which will come back to bite us at ballot time (can you say Nadar, Perot, or Kucinich?). We're so busy nitpicking with each other, analyzing this or that, intellectualizing a comment here, a comment there, and dissecting the president's every step, that we've compartmentalized ourselves to the point where we're in danger of becoming a moot point. We're not just angry with the Republicans or the President - we're angry with each other, evidenced by the amount of time we spend arguing about what the priorities are and how we should be going about dealing with them. We are passionaate people who live by the creed of "you're wrong and I'm right."

If you're one of those people who just can't accept less than perfect, or you're not happy until someone else is unhappy, shame on you, too.

WE'RE our own worst enemy.

This continued, systematic effort to dilute our greatest resource - the US in this grassroots movement - will be the death of us.

I keep remembering Obama's words during the campaign, when he said that he would always listen to us, and that we needed to change Washington so that our voices could be heard. He said we might not always like what he had to say, but he would always tell us the truth. I keep hearing the word "us".

Not "me", not "you", not "them" - but "US". That means each and every one of us - and Obama IS changing Washington by finding ways to best represent the majority's interest by way of the greater good.

Yes, I could choose to focus my energies on what hasn't been done. Or I can focus them on what has been accomplished and continue to press forward in that vein. I still believe that Obama is a good man who wants to do right by and for his country. I believe that he will tell us the truth when we ask him a question. And I believe that there are some decisions he will make that we will never make sense out of because we won't have (nor should we) all the information he has. But I haven't had a single second of regret over working to get him elected. I haven't even questioned it - not once. Not only was the alternative too hideous to contemplate, but he was and still remains, the clear and obvious choice to lead our country into its next defining period.

So join up with whatever cause you like. But please ask yourself whether your support of that organization is truly going to champion the issues who want to see brought to the forefront, whether they will elect the person who want to see in office, and whether they have enough clout / money / volunteers / know-how to make it happen this November. If they don't, what are you doing there?

Sunday, May 23, 2010

Arizona's Got A Big Problem - Itself

No one need speak English to understand that Arizona's recent slate of legislation was their way of coming out. They opened up that closet door and now proudly strut their hatred of anyone who doesn't look, speak, or act just like them. Within a few short weeks, Arizona began demanding proof of U.S. residency, banning ethnic studies, throwing teachers with accents out of English classrooms, and spending exorbitant amounts of money and time conducting immigration stings. It seems pretty clear that Arizona has made up its mind to become a homogeneous haven for white, non-Hispanic people.

Arizona claims the passage of anti-immigrant law (SB 1070) was not racially motivated. The first clue that something is wrong is the evaluation of the law's architects. The language was crafted by a lawyer named Kris Koboch who acts as counsel for the
Immigration Reform Law Institute, the legal arm of the Federation for American Immigration Reform (FAIR), which the Southern Poverty Law Center has listed as an anti-immigrant hate group since 2007. SPLC's Mark Potok had this to say about FAIR:
FAIR is listed as a hate group by the Southern Poverty Law Center, which publishes annual listings of such organizations. Among the reasons are its acceptance of $1.2 million from the Pioneer Fund, a group founded to promote the genes of white colonials that funds studies of race, intelligence and genetics. FAIR has hired as key officials men who also joined white supremacist groups. It has board members who write regularly for hate publications. It promotes racist conspiracy theories about Latino immigrants. It has produced television programming featuring white nationalists.
Mr. Koboch is a birther who is listed on SPLC's profiles of 20 Anti-Immigrant Leaders. He's also currently running for Secretary of State in Kansas.

God help Kansas.

Next in line comes Arizona Republican State Senator Russell Pearce. He's the guy who introduced the legislation. He's described by Change.Org as someone who has "
made it his personal mission" to institute state policies attacking undocumented immigrants. A decades-long veteran of the Maricopa County Sheriff's Department, Pearce has repeatedly attempted to coerce local law enforcement to get more involved in federal immigration policy.

Pearce is also an associate of J.T. Ready, a well-known neo nazi and advocate for "white pride." Here's a picture of the two of them together at a neo nazi rally in Nebraska.

....and a picture of Mr. Ready participating in a neo-nazi rally in Minnesota.....


And again at a rally where Ready lauds Pearce for the statesman he is by supporting white-pride perspective....



Then there's that incident in 2006 when Pearce sent out an email to his supporters promoting a white supremacist publication called "Who Rules America." It criticized the media for promoting multiculturalism and racial equality, for portraying "any racially conscious White Person" as a bigot, and for promoting the silly idea that the Holocaust actually took place. He got called on the carpet for it and apologized. Apologized for sending it out. Not for believing those things or for seeing the incredible inappropriateness of being an avowed racist while holding an office that requires him to protect the interests of ALL the people he represents.

Take a look at the last three months of legislation sponsored by Pearce:

February 2010 - April 16, 2010 - Passage of SB 1011 via SB 1108 which requires colleges and universities to allow faculty to carry concealed weapons on campus. This required an amendment to the state's constitution.

February 18, 2010 - Passage of SB 1102, allowing citizens to carry concealed weapons without permits anywhere except for those locations prohibited by law.

April 16, 2010 - Passage of SB 1108, allowing any American citizen who is not a felon to carry a concealed weapon anywhere within the state of Arizona except in those places already prohibited by law. Limits concealed weapons in bars to those with Arizona permits.

April 23, 2010 - Passage of SB 1070, law enforcement to determine the residency status of anyone the have reasonable suspicion of being in the U.S. illegally.

April 30, 2010 - Arizona State Board of Education removes teachers with accents from classrooms.

May 7, 2010 - Passage of SB 1018, that allows for the continued use of controversial speed cameras on city roadways, which many contend violate civil liberties and are merely for revenue.

May 11, 2010 - Passage of HB 2281, prohibiting courses on ethnic studies in schools.

May 11, 2010 - Passage of HB 2629, originally introduced by then Rep. Russell Pearce in 2008, which allows residents to draw their weapons and/or use deadly force without attempted to retreat first in situations where they consider their personal safety at risk. Also prohibts the collection of serial numbers or personal information about gun owners.

May 14, 2010 - Introduction of SB 1097, a bill that would compel teachers and administrators to determine the legal status of students and their families before allowing them to enroll in school.

Rachel Maddow did a short piece on Koboch and Pearce. It's boggles the mind that their association is going on right in front of us and few people are even blinking.

Visit msnbc.com for breaking news, world news, and news about the economy

Then there's the self-proclaimed "toughest sheriff in America." Joe Arpaio of Maricopa County has been cheerfully ignoring the rights of citizens, his staff, and the undocumented for many years. Not content to stop there, he also ignores direct instruction from the federal government to stop conducting immigration stings, saying they have no authority to tell him how to do his job.

Sheriff Joe's inhumane treatment of others, including those that resulted in death, is
well-documented. As a result, Maricopa County has paid out more than $43 million in lawsuits for abuse and neglect at the hands of the Sheriff's office. In 2009, Arpaio stated on national television that he considered it "an honor" to be compared to the KKK. So it shouldn't be surprising that charges of civil rights violations continue to be reported to this day or that Arpaio is under investigation for alleged abuse of power on a number of occasions. When asked for examples constituting "reasonable suspicion" for demanding to see someone's proof of residency, Arpaio replied that one of them was speaking Spanish.

No matter how much the folks in Arizona claim this bill isn't racially based, the facts say otherwise. This legislation is lambasted by labor and civil rights organizations all across the country and crafted by folks who invest money and time into "white pride." Arizona has made anyone with dark eyes, brown skin, or speaking a language other than English suspect.

Pearce and Koboch and Arpaio have ulterior motives alright, and it's to make sure they get to go about the business of ethnic cleansing with as little resistance as possible.

Saturday, May 1, 2010

Why The Arizona Boycott Is Fair

The passage of Arizona Senate Bill 1070 has the country on edge. Regardless of which side folks are on, emotions are running high. There are those who feel a state boycott is appropriate. Others believe Arizona had little choice but do what it did in light of an unresponsive federal government.

You'll find me on the side supporting the boycott.

Boycotts are standard tools of political protest.
Are innocent residents being unfairly punished as a result? Well, that depends upon whether they're really innocent or not. Just because the bill was not a ballot issue doesn't mean the people of Arizona were powerless.

Where were the voices of outrage while the state legislature was hearing the bill? Where were the protests like the ones that occurred after Gov.Brewer signed the bill into law? If people didn't like what was being considered, why weren't there concerted efforts to get members of the state legislature to listen to the people and vote the will of their constituents?

Where were the businesses in all this consideration? Those so inclined to do so were still hiring illegals. Other businesses were not making a whole lot of noise telling them to stop, or reminding them of the effects it would have on everyone.

Some people claim they were on the firing line, doing everything they could to create a different outcome. In that case, you have my sympathy and my apology. I apologize for any harm you may experience as a result of a situation you did not create. And you have my sympathy for living in a state where the majority is made up of blockheads.

Whether the reason residents didn't stand up to SB 1070 was because of complacency or actual support for the bill matters little now because the outcome is still the same: there is a new law in place that was put there by either tacit approval of the bill or abject failure to try and stop it.

Which means that citizens of Arizona bear responsibility for what has happened. Folks around the country were warning the state of a possible boycott weeks before the bill was signed into law. Even your own Rep. Grijalva was advocating for a boycott. So it sounds just a little disingenuous to hear residents cry foul over the same situation they did little to prevent and a consequence they were warned would occur.

Standing Up for What's Right

Last week, Arizona passed a law requiring law enforcement to determine the residency status of individuals they had "reasonable suspicion" of being in the U.S. illegally. Many people, myself included, were outraged and began boycotting the state as a result. Such a decision doesn't come without consequence.

To be fair, Arizona really does have a serious problem with illegal immigrants. There are a lot of them there; their presence has strained state resources, brought about an increase in crime, and given the Mexican drug cartel a stronger foothold in the U.S. Tired of waiting for the federal government to address the issue, the Arizona Senate crafted and passed their own bill to deal with the problem. But this bill isn't the right way to achieve their goal.

When the law goes into effect, local police officers will be required to question people about their immigration status if they have reason to suspect they are here illegally. Those who fail to produce documents could be arrested, jailed for up to six months, and fined $2,500. Of course, those who are found to be here illegally will be deported.

But what is sufficient documentation? Last week, two different truckers were stopped and detained until their wives could produce birth certificates for them. A driver's license and social security card were considered insufficient evidence. One waited for four hours in handcuffs. Turns out he really was born and raised here in the U.S.

Some say the law can only be enforced if an individual is stopped for some other observed offense. If that is true, it seems to be on paper only. Not waiting for the law to actually take effect, Sheriff Joe Arpaio of Phoenix conducted an immigration sweep two days ago and said in a post-sweep interview that he considers the inability to speak English reasonable suspicion. But before that, he said exactly the opposite.

Others say the law is only enforcing the federal statute. Even if that is true (which I don't believe for a second), the state does not have authority to circumvent federal authority. (Hint: it says that right there in the U.S. Constitution: Article I - Section 1, Article I - Section 8, Article VI - Clause 2, the Fourth Amendment, and the Fourteenth Amendment).

Either way, the law makes racial profiling legal. It not only allows it, it requires it, all the while thumbing its nose at the silly notion that the federal government has supreme authority over this issue. Folks can deny it all they want but the actions of law enforcement and the seeming tacit community's approval of same tell a very different story than what proponents of the new law claim.

While the bill was being considered in the state legislature, people from all over the country, including Arizona's own member of the House of Representatives, Raul Grijalva, warned of a nationwide boycott if they passed the bill. Now folks are all up in arms because people like me are actually following through. How dare we hurt innocent citizens? Don't we know the economy is already terrible in Arizona? It's not fair to make things worse. Or so they say. My thinking is this: if you supported the bill, you deserve to be boycotted. If you didn't support SB1070 but did nothing to prevent it, you lost your right to complain about the outcome.

But now that it's done, the country has quickly become divided. Hate mail, threats, and violence has increased against elected officials who oppose hate, threats, and violence. Personal attacks are no longer limited to elected officials or public community leaders. More and more, individuals are being targeted on websites, social media outlets, and in their communities. How do I know? Because I'm one of those targets.

All because I'm doing what I said I would do if they did what they did. I have been subjected to vile and hateful missives, promising to do all kinds of terrible things. I'm receiving threatening emails from people I've never heard of. Callers hang up when I answer the phone. And though I haven't been able to verify it, I'm told that my picture and my personal information have been posted on two Republican websites with the note that I am a target.

The racist, homophobic, misogynist, intolerant people among us are willing to use tactics we are not. We won't fight fire with more fire. They know that about us and get away with their garbage as a result.

We all know that racist, bigoted people have been subjecting minorities to all kinds of atrocities throughout time. The difference between those situations and this one is that Arizona is a legal entity of this country, bound by the U.S. Constitution and the Bill of Rights, and it made discrimination and racial profiling legal. This law says to all the world that we're done limiting discrimination to good ole boy circles and KKK cliques; we're done trying to keep it quiet. We're taking our hatred, bigotry, racism, and intolerance public and declaring to all the world that this piece of trash represents the new America.

It will be up to the courts to decide if the law is actually unconstitutional. I think it's just another stellar example of GOP hypocrisy: Accuse Democrats of injecting too much government into the private sector when it suits you but consider a law like this to be completely appropriate and not at all intrusive when you want to put "those" people in their place.

Thursday, April 22, 2010

Supporting Wall Street Reform

Today I had a letter to the editor published in both the Las Vegas Sun and the Las Vegas Review Journal. The letter had to do with record earnings on Wall Street and my support for Senate Majority Leader Harry Reid and Wall Street reform. Here is the letter:

"On Monday, Citigroup announced it raked in $4.4 billion in the first quarter of this year and its stock went up. Last week, JP Morgan and Bank of America reported it earned $3.3 billion and $3.2 billion, respectively, during the same time.

They’re back in the black after Americans bailed them out (of the worst national economic debacle we’ve seen in decades), but Nevadans aren’t so fortunate. While Wall Street rejoices, thousands of Nevadans like myself are still making hard choices between food or medicine, shelter or education.

I’m proud of Senate Majority Leader Harry Reid of Nevada for having the courage to hold Wall Street accountable for the mess it created and insisting on financial reform. If folks don’t get behind Reid and get this done, Wall Street will still be posting record profits next year and Nevada will still be in the dumps."

Oops. I forgot to include the part about Goldman Sachs, currently under federal investigation and being sued for fraud, also posting earnings of $3.3 billion in the first quarter of 2010.

And let's not forget the bonuses.


Earlier this month,
Goldman Sachs paid $5 billion in bonuses to staff for just three months of work. THREE MONTHS.

Eric Daniels,
CEO of Lloyds, is up for 9.5 million in salary and bonuses this year.

And that's just a sample.


I think it's reasonable to assume that it's not too difficult for a bank to make money. Think about this: they get to borrow from the Federal Reserve a rate of zero and then lend that same money back to the Treasury at an interest rate of 3% through (bond purchases). But if they're not totally profitable, they can fool their customers into thinking they are because we don't require transparent accounting. And while the Obama administration set up programs to help Americans from losing their homes, the banks are not being very compliant and they're getting away with it because there is little if any oversight or enforcement.


Republicans like to tell us that lower taxes and less regulation on business is the key to national economic health and stability.They call it "Supply-side Economics". Others call it "Reaganomics," a term coined in the '80s to describe President Reagan's economic policies while he was in office. Still others call it the "Trickle-Down Effect", claiming that businesses able to put all its resources into their product without impediment will ultimately reward the consumer with lower prices and greater availability.


The problem with the trickle-down effect is twofold: 1) - It requires the poorest of the nation to carry the greatest burden while business and corporations (the richest among us) get all the breaks; and 2) - It doesn't work. Business rarely passes down the benefits, choosing to keep them for their own instead. This is one of the reasons why banks have such record profits.


Although Republicans promote this idea that if business is successful, they will share that success with the consumer, it's simply not true. They do not share the wealth.


Bring in the Tea Party. Patriots are outraged over any suggestion that would ask them to share the wealth. What's theirs is theirs, they worked hard for it, and they're not going to share it with you or me or anyone. A great many Republicans also subscribe to this philosophy, telling us that we've created a nation of people dependent upon government for their very survival. They want government to stop giving handouts to the weak, the lazy, and the illegals. Kick the bums out and make everyone else pay their own way. That's the American way - or so they say.


So it came as some surprise to me today when I saw that the Review Journal changed the title of my letter from "Why We Need Financial Reform" to "Share The Wealth." What a bunch of hooey. I never asked the banks to share anything. Instead, I'm asking them NOT to rip off their customers and NOT to give bonuses to the very same people who nearly bankrupted this country. Call me crazy but I think it's wrong to reward the people who brought us to our knees, who required us to go to China to get loans, and whose greed and fraud forced the very people they screwed to have to rescue them in the largest bank bailout in American history.


While it looks like the recession is turning around for the banks, you'll forgive me if I don't wait around for the infamous trickle-down effect to feel the benefit. I've never seen it work nor have I ever seen a bank willing to share it's good fortune with the common folk. Instead, what we need is meaningful financial reform, the kind the banks are opposed to, the kind that will keep them from screwing over their customers again and again. Without it, it's just business as usual, at the peril of the people.

How To Help The Tea Party

Yes, it's been quite the Tea Party season. We watched history made as humans sunk to new lows with rising amounts of violence, hatred, racism, and modestly clever adaptations of well-known political sayings. But the effort of useless repartee is beginning to take a toll and patriots are showing signs of fatigue. Even Rupert Murdoch and FOX has started going critical of the Tea Party. Could defection be on the horizon?No need to wait to find out. I've created a few new tools to use for deprogramming if (and when) the situation presents itself. Here's a few bumper stickers:
  • Tea: Not Just For Classy People Anymore
  • The Tea Party - Where Imaginary Friends Come to Life
If you sense doubt on their part about the truth of what they're saying, use these:
  • Hey Tea Party - How's that whole Truth-ey Honest-y thing working out for ya?
  • I'll take the Party of Know for $1,000, Alex

You can take the coy route.....

  • Teabag Party: Want To Know What It REALLY Means?
  • I Can See The Moon From Where I Stand. Please Don't Bend Over Again.
or go elitist....
  • Silly Tea Party - Tax Cuts Are For the Middle Class
  • For The First TIme in My Adult Life, I Am Ashamed of my Countrymen
but these last two can be used for just about anything. Put 'em on signs, bumper stickers, hats, or just tape 'em up on front of the outhouse:
  • Tea Just Makes Me Need to Pee Really, REALLY Bad
and
  • TP - No Matter How You Spin It, It's Still Just For Wiping Asses

Tuesday, March 23, 2010

Going Forward with Health Care Reform

Today, we were witness to history as H.R. 3590 became law with the stroke of a pen. Well, okay, with the stroke of 20 pens. Health care reform is something that most of us feel passionately about and have been working on for a long time. Typical of liberals, we had split camps among us about the best way to approach reform. Some said it was single payer. Others said it was revoking the anti-trust exemptions. Still others said it was public option. It was impossible to come together as one cohesive unit and work toward one common goal. But today, one version of HCR was signed into law.

Regardless of where you stood in the debate, I want to take this moment to say thank you. Thank you for standing up for what you believe and taking an active role in the process. Thank you for deciding to do something about a national disgrace, for developing a platform and organizing to make yourselves heard. Thank you for doing it an honest and ethical fashion. The majority of Americans are not willing to do what you did, which was to step away from the kitchen table or armchair dialogue and translate an opinion into action. Whether I agreed or disagreed with your position, you have my respect and appreciation for taking action.


I know that some of you are unhappy about the passage of this bill. We heard you say that it's an insurance company windfall, it's a snow job on the American public, it costs too much, it penalizes the poor, it doesn't go far enough, it won't really help small businesses, it won't do what it promises, etc. I sincerely hope that those predictions do not come to pass. But one way it could happen is for us to fall apart now.


Which is why I ask those who are unhappy with the way things turned out to get on board and help refine the bill over time. No one believes this is over. We've still got much work ahead of us. The best possible way for us to do that is to unite, to deal with the reality of what is, and then find a way to make that reality look more like the vision of how we want it to be.


We need you. We need us. It is my fervent hope that every one of you are still up to the challenge. Thank you for all that you did. Thank you for all that you do. Please stay with us; we need you now more than ever.

Why the HCR bill is Not Health CARE Reform

There are many in our own camp who declare the HCR bill to be a victory for corporate America. Many believe that single payer is the only way to truly reform our health care system. Others say the current HCR bill is meaningless without a public option. As someone who devoted my life to a career in health care, I think it's really, really important to distinguish health care from health insurance. What we just accomplished was a modicum of health insurance reform. If we want to reform health care, I suggest focusing on the following instead.

1. Nursing Shortage
According to a report conducted two years ago by the Health Resources and Services Administration, The nursing shortage is considered critical in more than half of the U.S. Unable to fill positions, 90% of long term care facilities do not have sufficient staffing to provide even the most basic care and home health agencies are being forced to refuse new admissions. The nurses who remain are overworked, underpaid, and undervalued. The number of unfilled nursing positions across the country is expected to reach 1.1 million by 2012. If you want to improve health care, we need to examine why nurses are leaving the field, strengthen the infrastructure, develop retention programs, and give them the respect, salary, and voice they deserve.

2. Local Budget Cuts to Higher Education
Seems like one solution to the nursing shortage would be to promote the heck out of nursing schools. But nursing programs across the country have had their budgets slashed repeatedly over the last 10 years, so much so that many junior colleges no longer even offer accredited nursing programs and state universities have long waiting lists for classes. Waiting times have been reported to be as long as two years.

3. Fewer Physicians to Choose From
In today's world of litigation, tort reform, and skyrocketing malpractice insurance rates, many physicians are being forced to amend their services, take early retirement, or shut down their solo practices altogether. Ob/GYN has the highest number of casualties with 25% of physicians no longer offering obstetrics care as part of their practice. With malpractice insurance rates quadrupling in many states, physicians are being asked to pay more per year than they actually make.

4. Access to Facilities
In the '80s we saw the rush of private investors taking over a large chunk of facilities across the nation. The Rick Scott's of the world got together with their buddies and decided that health care was a great financial investment. So they began buying up hospital after hospital, merging some with others, and permanently leaving doors closed on others. Which ones? Mostly the charity ones. Health care became a high stakes investment managed by a bunch of lawyers and few medical experts (except the token ones who also served in Congress). With companies like Humana, Galen, Columbia, Hospital Corporation of America all coming together to form a conglomerate that included 166 hospitals and 112 outpatient centers across half the U.S. (and England, too) they were prime to do whatever they wanted, marginalizing standards of care for ROI all the way. With strategic facilities kept closed, people really were at the mercy of getting health care only if they could afford it.

Interestingly enough, in 2006, HCA underwent another merger that allowed it to become a private company once again. Who were the investors? Affiliates of Bain Capital, Kohlberg Kravis Roberts & Co. and Merrill Lynch Global Private Equity, and HCA founder Dr. Thomas F. Frist, Jr. Isn't that interesting.

With fewer facilities to choose from, fewer practicing physicians, a critical nursing shortage, and fewer people entering the field, my question is this: Who is going to care for all the millions of people now able to enter the health care system? Answering these questions is how we're going to fix health CARE.

Wednesday, March 17, 2010

So, You Think You Can Get Health Care If You Need It?

In the raging discussion about the need (or lack thereof) for health care reform, one of the arguments that comes up frequently is that there are already laws in place guaranteeing medical treatment for those who are sick, irrespective of their ability to pay.

Not true.

The majority of indigent care is provided by charity hospitals. They may be funded by their local government or have various private benefactors. In order to be designated a 501(c)3 non-profit facility eligible for federal tax-exempt status, the IRS requires that they provide a "community benefit" (as stated in the Internal Revenue Code). As such, charitable hospitals are judged on whether they provide sufficient health benefits to the community.

The key word here is "sufficient".

Much of what is considered sufficient is dictated just as much by local governments and benefactors as the regulating agencies. The facility doles out care as described in its charter and as required to keep its non-profit status. That generally involves treating those at or below the poverty line. So if you're super poor, you'll most likely be able to get the treatment you need. It may take awhile to get, and it may not be as good as the care your neighbor got when he had the same thing, but you'll get treated.

But who is treating the guy making $70,000 per year, providing for a family of four, who doesn't have health insurance? He won't meet the charter of the community hospital. What if he gets sick? At the end of the day, real world practice is much different than any ideal penned in a lofty mission statement.

The Emergency Medical Treatment and Active Labor Act (EMTALA) was created in 1986 to prevent hospitals from rejecting patients, refusing to treat them, or transferring them to "charity or county hospitals" because of inability to pay or Medicare or Medicaid coverage. EMTALA makes sure you or I get care no matter what if it's a life or death situation. It provides for women in active labor or those requiring emergency treatment to avoid long-term consequences (i.e. broken bone, etc.). But the reality is that many private facilities consider EMTALA a bad word and do everything they can to minimally stablize patients and boot them out the door as fast as possible.

When I worked in the emergency room of a large, for-profit hospital, I can't tell you how many times we had to turn patients away because they didn't have insurance. Or how many times the E.R. docs claimed it wasn't safe to let a patient leave but the hospital administrator refused to allow them to be admitted. The rule of thumb was do to as little as possible in the least expensive way to be able to transfer them somewhere else.

During my time there I saw three patients die after E.R. docs were forced by hospital administrators to discharge them. One of them died not 10 feet away from the E.R. doors, another died in the hospital lobby, and another died in the car as her husband was taking her to the county hospital. And at the end of the day, what did the hospital gain? They had to pay huge legal fees to represent them in court.

The only ones who have the "right" to care now are those with insurance who show up at the right provider's door (the one in their network), the independently wealthy, and the super poor. It's the middle class that's having the problem - and they represent the largest group of citizens in America.

Sources:
1. EMTALA: http://www.emtala.com/faq.htm
2. IRS Regulations for Non-Profit Facilities: http://www.irs.gov/publications/p557/ch03.html
3. Portrait of the Middle Class:http://www.commerce.gov/s/groups/public/@doc/@os/@opa/documents/content/prod01_008833.pdf
4. How the Middle Class Struggles: http://www.usatoday.com/money/perfi/general/2003-09-14-middle-cover_x.htm

Monday, March 8, 2010

Progressives Working Against Progress

I'm running out of heart and patience for angry Progressives doing their best to defeat the health care reform bill. I expect Republicans to try to thwart this legislation, that's pretty much a given. But when those who call themselves Democrats or Progressives or Liberals, etc. do it I feel frustrated. While each side's reasons (and values) are different they have one thing solidly in common, and that is the insistence on total purity and the complete unwillingness to consider anything but the everything they want.

Listen, I know that all of us are trying to do what we believe is right. I know that no one is undertaking this cause out of any malevolence. But I'm here to say that unless you're someone whose very life depends upon whatever action Congress takes, there is no way you can fully understand or appreciate what health care reform means to me or thousands of other Americans like me in similar shoes. And unless you've been practicing mainstream medicine of late, you can't really know what takes place in the medical setting, who is doing what, and what the mentality is.

I worked for nearly 30 years in a variety of clinic and hospital settings: the emergency rooms, acute care, oncology, hospice, quality improvement, administration, outpatient doctor's office, and the clinical research settings. I've been on the floor unit, hospital administrator, and clinic director. I've worked in hospitals and doctor offices in half of the U.S. states. And I spent nearly 20 years serving on board after board, committee after committee as a volunteer in the non-profit sector, successfully developing and implementing medical care plans for those in under-served, under-represented, and poor areas that most people don't care about. I think I know a little something about nearly every medical perspective on this issue and learned about community and legislative resistance the hard way. And after being a patient with chronic illness for nearly 10 years, I know a little about the system and how it treats people like me.

Something has to be done.

Now.

I agree with much of the progressive argument against this bill.
Yes, it's been watered down. Not enough is being offered. It leaves too many people out. Corporations will find ways to get around certain provisions. But I'm not going to overlook the good this bill will do simply because it has problems. I won't ask that several thousand lives be sacrificed now in order to hopefully save more lives in a few years. To me, that makes no sense. And I'm not willing to take a chance that we won't HAVE another chance if reform fails this time around.

The irony here is that while progressives claim Washington is not listening to them, they're not listening to me - or anyone else who has a differing opinion either. And they fail to see that their efforts not only hurt people like me but fracture our ability to get anything done. In their unwillingness to compromise anywhere on this issue they've become just as dogmatic and self-righteous as the right wing.

So if you're one of those Progressives reading this now, I pose the following directly to you:

I know you think I'm a deluded, kool-aid drinking, spineless Democratic Obamabot wandering aimlessly in my drunken crush-on-Obama stupor. I know I hold no credibility with you. Still, I want you to know that if you get your wish and the current health care reform bill dies, so will I. A successful defeat of this bill will eliminate my chance of getting the transplant I need. If the bill succeeds, I will be able to purchase the secondary insurance required to be accepted at a transplant center. That option will become available almost immediately, it's not one of the things that will be phased in over several years. Short of a new miracle drug or other cure, without that option, I have no options.

So, if you still want to continue this fight and your efforts to defeat the bill are successful, I have one final question for you. Will you give the eulogy at my funeral and explain why it really is a victory to my grieving family?