28 August 2009

Pope, Church Leaders not Mourning Edward Kennedy

Without intention to offend any Catholics who may be reading, I can't help but think that reports that conservative Catholic leaders are not mourning Edward Kennedy, with whom they had prickly relations, and that the Pope has remained silent on his passing, do these Catholic leaders no credit whatsoever.

27 August 2009

Sen. Kennedy succession

There's a lot of discussion everywhere in the media of Sen. Kennedy's "dying wish" that Massachusetts change the "Kerry Succession" law (unused, since Kerry failed to win), and allow Gov. Patrick to appoint an interim successor.

Personally, I'm not insensitive to the argument that this sets bad precedent; that it's too highly politicized, etc. I think the original law was probably ill advised. Better to have provided that the governor could appoint whoever he liked, but that the interim Senator would be barred from running for the seat, and a special election would have to be held within 60 days, or something like that. If that were the law, there would be no problem.

Anyway, I think the politics of the moment trump procedural and state constitutional integrity arguments in this particular case. Health Care reform could be the essential legacy of Sen. Kennedy, if it can be made to happen, and the galvanizing effect of not wanting to be seen as destroying that legacy could make the difference. So, in this case, I am hoping the Massachusetts Legislature accedes to the late senator's wishes and gives Gov. Patrick the ability to appoint an interim successor who can provide a YES vote for real health care, for which Sen. Kennedy almost literally fought his entire career.

26 August 2009

Byrd calls for Health Bill to be named for Kennedy

TPM reports Robert Byrd is calling for the Health bill to be named after Kennedy. Perhaps there will be a 'galvanizing' effect. Could it be that Kennedy's death will act as a catalyst to shame Blue Dogs into voting for the bill, which can maybe be beefed up a bit in view of that? Obama could give a speech saying that we must honor the memory of Teddy Kennedy by passing a bill that includes meaningful health care choices for all Americans, i.e. public option. Or is that just wishful thinking?

I gotta say, if the White House doesn't get it that the President has to appeal directly to the American people, and explain exactly what effect the bill will and will not have in ordinary terms everyone can understand, and soon, I think the whole thing is doomed.

21 August 2009

Mind and Brain

«I used to think the brain was the most wonderful organ in the body. Then I realized who was telling me this.» --Emo Phillips

I confess I still have a bit of this brain bias. This quote is jokey, but it has a certain serious side too.

Traditional IndoTibetan Buddhist teaching (which comes from Ancient Hindu beliefs) has it that the mind is not the brain, or even co-located with it, but is a completely nonphysical continuum. Mind, the teaching goes, is separate from memory and mental abilities, and independent of what most people think of as concsciousness. What we call consciouness is really what Buddhists call self-grasping ignorance, the deluded perception of "I", which is what causes us to experience suffering. Ancient Buddhist teachers would have considered it fundamental and pervasive mental illness: a disturbance, like waves in an ocean, or even mud in water, which does not intrinsically affect the underlying purity of the water, but is merely contamination that can be removed. Pure awareness is mostly unfamiliar to us.

The mind, according to this thinking, has no physical existence, but is nonetheless "located" inside the body, in the region of the heart, according to this tradition. It is the "cognizer," that is, the awareness, which arises from previous moments of awareness and can never cease to exist.

Ancillary to all that: Computers may be smart, in the sense that they can perform calculations quickly, and integrate complex functions to yield an output, maybe even a simulacrum of human behavior. But, according to this thinking, they are merely physical systems, complex toys, completely devoid of awareness. Hence, the hope of some extreme materialists that they will be able do download their minds into a computer memory and achieve virtual immortality is a ridiculous pipe dream.

I still perceive what seems like awareness to me to be located behind my eyes, in my head (it's a cultural thing, I guess), and I have my doubts about some aspects of these abidharma teachings. But on the essential distinction between brain function and mind, I'm pretty sure the old Buddhists had it just about right.

19 August 2009

Another e-mail to Obama on health care

Look, folks. Let's get it straight. Bipartisanship is not working. The Republicans have one agenda and one agenda only: to kill health care reform. They are succeeding. The President is being far too conciliatory. Anthony Weiner on Chris Matthews' show had it right yesterday. The President needs to clearly articulate exactly what the health reform plan should be, and DEMAND that Congress enact it, using the Reconciliation process if necessary. And that plan ABSOLUTELY MUST include a public option program, with real teeth and ability to negotiate costs. ALSO, the plan needs to have more ability to introduce regulation later on to move towards eliminating for-profit medical care, which gives us high costs, poor outcomes, and completely wrong-way-around incentives.

The president needs to use his very considerable ability to communicate to articulate a clear agenda, articulate exactly what it needs to contain, and why we need it, and sell, sell, sell. The hell with the Republicans. They will only obstruct.

To which I add, the hell with the most conservative of the Blue Dogs, too, because they really are Republicans. We can pass a decent health care bill in the House, and we should be able to strongarm 50 Senators into voting for it. Biden can break the tie, and the Reconciliation process can make the whole question of a filibuster irrelevant. It is absolutely time to show the Republicans the mettle of Obama's mandate, before it evaporates completely, which given the White House's strange, almost psychotic behavior lately, will happen soon if things don't change.

13 August 2009

White House Points on Health Care Reform

The White House has put out the following series of three 8-point summaries of 1) why health care reform provides security and stability for all; 2) myths about health care reform; and (3) reasons we need health care reform now. These are offered specifically to dispel the large amount of deliberate disinformation and propaganda being disseminated by insurance industry and Right Wing lobbies, media outlets, commentators and political organizations, who have organized and/or promoted "shoutdowns" in an attempt to stifle and shut down reasoned debate on this issue. It's one thing to have civil disagreements and policy differences. It's quite another to use scare tactics, deliberate lies, and intimidation to try to shut down debate.

PLEASE READ. This is a crucial issue for the future of our country. Thank you.

8 ways reform provides security and stability to those with or without coverage
  1. Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
  2. Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
  3. Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
  4. Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
  5. Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
  6. Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
  7. Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
  8. Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.
Learn more and get details: http://www.WhiteHouse.gov/health-insurance-consumer-protections/

8 common myths about health insurance reform
  1. Reform will stop "rationing" - not increase it: It’s a myth that reform will mean a "government takeover" of health care or lead to "rationing." To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies.
  2. We can’t afford reform: It's the status quo we can't afford. It’s a myth that reform will bust the budget. To the contrary, the President has identified ways to pay for the vast majority of the up-front costs by cutting waste, fraud, and abuse within existing government health programs; ending big subsidies to insurance companies; and increasing efficiency with such steps as coordinating care and streamlining paperwork. In the long term, reform can help bring down costs that will otherwise lead to a fiscal crisis.
  3. Reform would encourage "euthanasia": It does not. It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.
  4. Vets' health care is safe and sound: It’s a myth that health insurance reform will affect veterans' access to the care they get now. To the contrary, the President's budget significantly expands coverage under the VA, extending care to 500,000 more veterans who were previously excluded. The VA Healthcare system will continue to be available for all eligible veterans.
  5. Reform will benefit small business - not burden it: It’s a myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses, provide tax credits to help them pay for employee coverage and help level the playing field with big firms who pay much less to cover their employees on average.
  6. Your Medicare is safe, and stronger with reform: It’s myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform will improve the long-term financial health of Medicare, ensure better coordination, eliminate waste and unnecessary subsidies to insurance companies, and help to close the Medicare "doughnut" hole to make prescription drugs more affordable for seniors.
  7. You can keep your own insurance: It’s myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.
  8. No, government will not do anything with your bank account: It is an absurd myth that government will be in charge of your bank accounts. Health insurance reform will simplify administration, making it easier and more convenient for you to pay bills in a method that you choose. Just like paying a phone bill or a utility bill, you can pay by traditional check, or by a direct electronic payment. And forms will be standardized so they will be easier to understand. The choice is up to you – and the same rules of privacy will apply as they do for all other electronic payments that people make.
Learn more and get details:

8 Reasons We Need Health Insurance Reform Now
  1. Coverage Denied to Millions: A recent national survey estimated that 12.6 million non-elderly adults – 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market – were in fact discriminated against because of a pre-existing condition in the previous three years or dropped from coverage when they became seriously ill. Learn more: http://www.healthreform.gov/reports/denied_coverage/index.html
  2. Less Care for More Costs: With each passing year, Americans are paying more for health care coverage. Employer-sponsored health insurance premiums have nearly doubled since 2000, a rate three times faster than wages. In 2008, the average premium for a family plan purchased through an employer was $12,680, nearly the annual earnings of a full-time minimum wage job. Americans pay more than ever for health insurance, but get less coverage. Learn more: http://www.healthreform.gov/reports/hiddencosts/index.html
  3. Roadblocks to Care for Women: Women’s reproductive health requires more regular contact with health care providers, including yearly pap smears, mammograms, and obstetric care. Women are also more likely to report fair or poor health than men (9.5% versus 9.0%). While rates of chronic conditions such as diabetes and high blood pressure are similar to men, women are twice as likely to suffer from headaches and are more likely to experience joint, back or neck pain. These chronic conditions often require regular and frequent treatment and follow-up care. Learn more: http://www.healthreform.gov/reports/women/index.html
  4. Hard Times in the Heartland: Throughout rural America, there are nearly 50 million people who face challenges in accessing health care. The past several decades have consistently shown higher rates of poverty, mortality, uninsurance, and limited access to a primary health care provider in rural areas. With the recent economic downturn, there is potential for an increase in many of the health disparities and access concerns that are already elevated in rural communities. Learn more: http://www.healthreform.gov/reports/hardtimes
  5. Small Businesses Struggle to Provide Health Coverage: Nearly one-third of the uninsured – 13 million people – are employees of firms with less than 100 workers. From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. Much of this decline stems from small business. The percentage of small businesses offering coverage dropped from 68% to 59%, while large firms held stable at 99%. About a third of such workers in firms with fewer than 50 employees obtain insurance through a spouse. Learn more: http://www.healthreform.gov/reports/helpbottomline
  6. The Tragedies are Personal: Half of all personal bankruptcies are at least partly the result of medical expenses. The typical elderly couple may have to save nearly $300,000 to pay for health costs not covered by Medicare alone. Learn more: http://www.healthreform.gov/reports/inaction
  7. Diminishing Access to Care: From 2000 to 2007, the proportion of non-elderly Americans covered by employer-based health insurance fell from 66% to 61%. An estimated 87 million people - one in every three Americans under the age of 65 - were uninsured at some point in 2007 and 2008. More than 80% of the uninsured are in working families. Learn more: http://www.healthreform.gov/reports/inaction/diminishing/index.html
  8. The Trends are Troubling: Without reform, health care costs will continue to skyrocket unabated, putting unbearable strain on families, businesses, and state and federal government budgets. Perhaps the most visible sign of the need for health care reform is the 46 million Americans currently without health insurance - projections suggest that this number will rise to about 72 million in 2040 in the absence of reform. Learn more: http://www.WhiteHouse.gov/assets/documents/CEA_Health_Care_Report.pdf

12 August 2009

Public Health Care -- an Anecdotal Account

There's a common belief among Americans, which I believe is almost entirely the result of deliberate disinformational propaganda, that in countries which have universal, fair public health care, such as the UK, Taiwan, South Korea, Canada, Japan, France, Germany, the Scandinavian countries, etc.,* people resent the public systems and receive unreasonably rationed, substandard care. (This bad reputation is most often attached to the UK's National Health Service, probably because there is a segment of society (some rich people) in the UK that opts for private medical care). Anecdotal evidence must always be discounted, but this account, published in TPM today, certainly shows that the automatic assumption that "public" health care automatically means "lousy" health care should not be taken for granted:

I am an middle aged, white male American who lives in the UK working for a medium sized US company. The following is a true story about my many years experience of the NHS (National Health Service) in the UK, only the names have been changed to protect the identity of my family.

I live with my wife and son just outside of London. When our son Leo was due to be born, like virtually every family in the UK (rich or poor), we went to our local NHS hospital for the delivery. An unpredictable chain of events resulted in unforeseeable complications during his birth. Leo was born in very poor health and was immediately transferred to a SCBU (Special Care Birth Unit) in another hospital. Because of the severity of Leo's condition we were transferred to the most advanced SCBU in the region.

Leo spent the next three weeks in the SCBU being cared for 24/7 by highly trained nursing staff using the latest technology and a team was formed with about a dozen specialists from around the country working together to ensure Leo's many complex problems were dealt with using the best medical knowledge available. As parents we stayed with Leo in the parents residence just down the hall from the SCBU. Our room was basic, but it had cable TV and we got clean bedding and towels as well as three meals a day for three weeks. How much did all of this cost? I will never know because as a UK resident and taxpayer it was provided as a public service. By the time Leo was three months old it was obvious he was experiencing many very difficult problems. Leo was referred to one of the top specialists in Europe, a professor consultant in neonatal neurology. The professor determined Leo needed a MRI scan, but because of Leo's small size and constant abnormal movement, no existing scanner could safely be used. It was decided the newest and fastest scanner in the country would be modified to accommodate Leo's situation. When we arrived for the scan we were greeted not only by the professor and her team but by a team of technicians and scientists from the manufacturer. The MRI magnets were partially dismantled and recalibrated and a frame for Leo was built on the spot so he could safely undergo the scanning procedure. How much did all of this cost? I will never know because as a UK resident and taxpayer it was provided as a public service. The scan showed that Leo had received a profound brain injury before birth. He had many different tests to determine the extent of his disabilities including EEG, X-ray, video fluoroscopy, endoscopy, sight tests, hearing tests, and others. Leo was referred to eight different specialists to deal with his problems and underwent surgery to implant a portal in his stomach so he can be fed directly by tube, without danger of food being "swallowed" into his lungs. Leo's dietary requirements are very special and all food, as well as the daily feeding kits and the pump needed to deliver the feed are provided by the NHS. Leo is on about a dozen different medications and all meds, syringes and other daily disposable equipment are provided by the NHS. Leo has a wheelchair, sitting frame, standing frame, sleep system, leg and hand splints and other equipment, all designed for him and all replaced or adjusted every few months because he is a growing boy. All equipment as well as the technicians who maintain the equipment are provided by the NHS. How much does all of this cost? I will never know because as a UK resident and taxpayer it was provided as a public service. Is the NHS perfect? Far from it! Can it be more bureaucratic and slower than I would like at times? Of course! Has there ever been an issue about Leo not receiving care because he is profoundly disabled? Never! Have we ever had to stand before a "Death Panel" and justify the vast ongoing expense of Leo's care, even though he will never be a productive member of society? NO! When surveys ask people what is the single thing they are proudest about the UK, the winner is The National Health Service.
* There are so many... in the developed world, other than here, health care is generally considered a right.
Of course, what the NHS is is universal public service health care, which according to the right-wing framing we all blithely accept, is misleadingly called "single payer" in this country. We're so benighted with right wing propaganda in this country that (almost) no one in public life is even proposing such a system. Yet the unsatisfactory compromise with the health care denial and profiteering industry (inaccurately referred to as "insurance") being proposed is being labeled as "socialism," "fascism," etc. etc., and the outrageous antics of the far right are actually being acknowledged as politically effective, as in likely to result in still more watering down of reform.

Sometimes it's just unbelievable to me what our country has come to.

My Letter to President Obama on Health Care today

Dear President Obama,

I am writing to strongly urge you to become much more proactive in the program to achieve serious and meaningful health care reform. This was a keystone of your campaign to become president, and will, if successful, become a major element of your legacy. But there are well-organized and surprisingly effective forces on the right arrayed against this effort, and I fear that they are having much more effect than their relatively small numbers — in terms of public support — would indicate. I refer, of course, to the right-wing interest group funded “Astroturf shoutdowns” which are drawing far more media attention than is justified. I also have serious concerns that your legislative program is not effective enough in making clear to members of Congress that the bill must include a meaningful public program.

Part of the problem is framing the issue and communicating with the public. I understand you have read and been influenced to some extent by George Lakoff, who has discussed the importance of not accepting the right-wing framing. We must avoid terms like “public option” and “single payer” and use words like “fair health care for all” and “meaningful competition.” I urge you to use the bully pulpit, as often as necessary, with your very considerable communication skills at their fullest, to explain to the American people exactly what is at stake. Ask for their support. Ask them to demand support for your bill. And communicate to Congressional leaders exactly what the bill must contain.

Rahm Emmanuel is way off base condemning progressives for resisting attempts by so-called “Blue Dogs” to sell out to the Republicans. We need to make it clear that this is a critical issue, and we will pass this bill without Republican support if necessary— which it will be. Reconciliation should remain an option. But first, you need to stand firm. You need to be willing to say to the American people that the time is now, this opportunity cannot be allowed to slip away, and you will not sign a bill that does not contain meaningful reform, including a robust and effective public plan to ensure affordable health care for all.

Please, Mr. President. This is a crucial issue. It’s the reason many of us contributed more of our hard-earned money and time than we could comfortably afford to elect you. You simply cannot let us down on this.