Thoughts on a disaster
One of the problems people are having with this "grass roots" opposition to health care is that it is
so off-target. Think of it this way: Last night,
Austan Goolsbee, a member of the Council of Economic Advisers and chief economist of Obama's Economic Recovery Advisory Board, appeared on
The Daily Show, and actually managed to make a good deal of sense. Perhaps this is a small challenge for a triathelete and sometimes stand-up comedian, but when people are getting their distillations from a
comedy show? Indeed, Stewart covered the health care debate in the
opening segment—highlighting the madness of the right wing and the incoherence of the Democratic Party—including commentary by
Larry Wilmore about racism, Obama, and the white people's coming burden.
But given days of news coverage to sift through and analyze, there is little to glean from the cacophony that compares to Goolsbee's appearance on
The Daily Show.
Let that be a testament to how ridiculous this debate has gotten.
This morning on the
Diane Rehm Show°, a panel discussed the health care issue. Ceci Connolly explained that House Democrats have put together
three separate bills; the Senate Health Committee under Sen. Dodd has drafted and passed a bill, but the Finance Committee, which has run a failed campaign to negotiate a more bipartisan bill, has set a new Sept. 15 deadline for coming up with something useful. Susan Denser discussed nature of the protest against health care reform:
Denser: Well, Diane, as we've seen just in the last couple of weeks, just an enormous eruption—some people say it's grass roots, other people call it "astroturf", that is to say fake grass roots—of people who have concerns; some legitimate, some not, frankly, legitimate—not actually reflected in the legislation—about the direction it's going. There are concerns about rationing; that is to say that something will be enacted in health reform that will withhold care from people. There are particular concerns about rationing at the end of life. We're hearing phrases like, "The Kill Granny Provision", et cetera, et cetera. All kinds of noise—as I say, some probably borne out of ignorance, some possibly partisan motivated—that is suggesting that things that are not in the bill actually are in the bill, and could lead to deleterious results for many individuals.
Rehm: And Noam [Levey], yesterday you wrote a piece in the L.A. Times sorting out some of the claims being made about health care legislation. Let's talk about the one Susan just mentioned. Does this legislation include provisions to encourage senior citizens to commit suicide?
Levey: Quite simply, no. There is a provision in the House version of the bill, that would provide a benefit to senior citizens to sit down with a doctor and talk about options for how they would like to be cared for at the end of life. The way it's structured is a Medicare payment for the physician to actually do this consultation. These might include things like talking about living wills, how to be cared for when you become incapacitated. It's voluntary. There's no suggestion in any of the language that it would encourage a choice one way or the other. But as Susan mentioned, it has become incredibly inflammatory, and has been used, I think quite cynically by some, to suggest that somehow the federal government would be encouraging an end-of-life choice.
Rehm: Now, my husband and I have already done this. We've talked to our lawyer, we've talked to our doctor. I would presume that many people have already done this. Why has this particular area of the health care proposal, met such inflammatory discounting?
Levey: Well, I think there's a political reason for it, actually, more than a medical one. I think you're right, most people have made that decision. I think, like you and your husband have. There are a lot of seniors, though, who probably haven't for one reason or another. And doctors are often running from one appointment to another; perhaps they don't have time to talk to their patients about these sorts of things. There's a broad range of opinions among professionals that this is something that should happen. But remember senior citizens are a pretty important political force in this country.
Connolly: You know, Diane, only about thirty percent of Americans have living wills. It's a surprisingly low number, and I think there are a variety of reasons for that. It's a difficult conversation for people to have; it should probably often start as a family conversation. But again, imagine being the adult "child" saying to an older parent, "Okay, we need to sit down and figure out about, you know, your final weeks and months." It's such a very awkward, difficult subject for people to discuss. You mentioned going to your lawyer, which I think is what most people now do because they see it as a legal action that they take. But, again, the idea behind this provision of paying a physician to do a counseling session is that maybe it's a conversation you'd also like to have with a medical professional, not just a lawyer.
Denser: The statistics show, Diane, that almost ninety percent of Americans, when surveyed, say they would prefer to die at home. But actually eighty percent of Americans on Medicare who die every year die in institutions, either nursing homes or hospitals; many in ICUs, hooked up to tubes, when they actually would prefer not to do that. And as Cici says, part of the issue is that so few people sign not just living wills, but it's the whole raft of advance directives, including durable power of attorneys, which basically assigns somebody else the ability to make decisions on your behalf if you're incapacitated. Which some people think is the most important thing that people should sign. But, in any case, we have this incredible disconnect between what people want, what they do, and the fact that there's really no lever in the system that gets people to do this, even though, for example, we've had on the books since 1991 the Patient's Self-Determination Act, which means when you go into a hospital, the hospital has to tell you that you have the right to sign advance directives. And even despite that, we have this relatively low number of people—comparatively speaking—who are making these active decisions.
The rhetoric of the two sides of the debate are, presently, incoherent to the left, and outrageous to the right. One might hope that, as Congress moves closer to a final bill, some useful talking points will emerge. But even then, what will the conservatives do? Right now their rhetoric is simply intended to raise demons, spectral fears about things that don't even seem to be part of a rational discussion of the issue.
And this fearmongering is what brings us people weeping on video that they want their America back. Really? Well, just
what America
is that?
Is it an America of privilege, where only the rich are entitled to the benefits of society? Is it that fictitious America in which the hard-working people who accomplish much and rise to particular and notable heights did so without the slightest whiff of government assistance, nepotism, friendly courtesy, or other help from society at large? Is it an America we've never actually seen but in some weeping woman's fantasies?
Sometimes it feels like talking to children. One must be cautious to communicate that the cause of the child's distress is important, but we don't know what to do because they won't tell us what the problem is. You want your America back? Well, who took it away? When? How? What happened? They want to kill your grandmother? Who does? The government? Who said? Where? When? What did who say?
This is how ridiculous it's gotten. At the
Doonesbury Town Hall°, they run a regular series called "Say What?" featuring strange quotations from recent political news. For August 12, 2009, we were treated to this abstract moment:
"People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless."
-- from Investor's Business Daily
editorial on "death panels"
"I wouldn't be here today if it were not for the NHS [National Health Service]. I have received a large amount of high-quality treatment without which I would not have survived."
-- Stephen J. Hawking, who has
motor neurone disease, was born
in the UK, and has lived there
his entire life
It's not that the discussion should proceed without an ear to people's concerns, but the problem is that the most prominent concerns seem to have nothing to do with reality. This is why the "grass roots fury" is laughable. It's exactly what people expect for astroturf. The seeds are fake, which is why the surface has to be wrapped and stapled over the skeleton of the everyday anti-Obama movement.
There are legitimate concerns to be discussed. Goolsbee gave the Obama outlook on health care reform a frightening aspect when he said the president wasn't after socialized medicine but to keep the insurance companies honest. A Sisyphan labor, to be certain. Most liberals see this as an exercise in futility. And, to our horror, the rhetoric suggests a public option is not vital to Obama's consideration of the issue. For many liberals and independents, that was a deciding factor in their vote.
On the right, there are fair concerns about the cost, and whether it is possible to find all this money within the system in order to not raise taxes. This, of course is inconvenient to conservatives because it invokes a discussion of priorities, and between a defense budget to keep the dead Muslim statistics robust and what to do about corporate America, jobs, and the economy, it's not an argument that will serve their interests well.
So far it appears that a state health plan either was never on the table to begin with, or has been effectively killed by conservative opposition. And yet we keep hearing the same horrendous sewage pumped by the right wing and its all-too-willing patsies.
The most effective opposition to health reform has come from Blue Dog Democrats; the central problem for passing meaningful health reform legislation lies entirely within the Democratic Party.
The answer to the "grass roots fury", of course, is to just tune out the liars and histrionic freaks, but that would be somehow partisan and unfair. Or would it? While conservatives oppose affirmative action for things like being born female or black, they demand it for choices like the one to be a Republican. These people shouldn't be getting any serious coverage at all. But the need for easy headlines and efficient news content makes them an obvious call.
In the end, these astroturf windmills have nothing to offer. It's not that they're conservatives. It's not even that they're being ridiculous. Rather, it's that they are doing everything they can to distract attention from a serious, even vital debate, and contribute absolutely
nothing.
This is how ridiculous the debate has become. This is how ridiculous the right-wing lunatic fringe wants it. And this is why those lunatics are viewed as, in and of themselves, utterly ridiculous.
____________________
Notes:
° Diane Rehm Show — The segment in question is not presently listed at the web site; the podcast can be obtained for free from the iTunes Store.
Doonesbury Town Hall — The "Say What?" feature is not, to my knowledge, archived. I did, however, take a snapshot: DTH—Say What?
Works Cited:
The Daily Show. Comedy Central, New York. August 11, 2009. ComedyCentral.com. August 12, 2009. http://www.thedailyshow.com/watch/tue-august-11-2009/reform-madness
The Diane Rehm Show. WAMU, Washington. August 12, 2009. WAMU.org. August 12, 2009. http://wamu.org/programs/dr/09/08/12.php
Doonesbury Town Hall. August 12, 2009. http://www.doonesbury.com
See Also:
Will, George F. "The Democratic Economist". The Washington Post. October 4, 2007; page A25. WashingtonPost.com. August 12, 2009. http://www.washingtonpost.com/wp-dyn/content/article/2007/10/03/AR2007100302003.html
Levey, Noam N. "Sorting out claims about healthcare legislation". Los Angeles Times. August 10, 2009. LATimes.com. August 12, 2009. http://www.latimes.com/features/health/la-na-healthcare-qa10-2009aug10,0,4908371.story
"How House Bill Runs Over Grandma". Investor's Business Daily. July 31, 2009. Investors.com. August 12, 2009. http://www.investors.com/NewsAndAnalysis/Article.aspx?id=503058&Ntt=hawking
Note: The article has, since original publication, been corrected. An editor's note informs us that "This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK." That is a kind treatment of the point; Dr. Hawking's name has disappeared entirely from the article.