Thursday, January 21, 2010

The Dubious Honor of the 41st No


With health care reform chances currently swirling around a very deep drain (I'll avoid the clichéd "life support" analogies no doubt peppering other blogs and columns) in the wake of this week's magical transformation of Massachusetts from blue to red, and with the breaking news of a landmark Supreme Court case effectively handing next year's election over to the party of corporations and multinationals, it would be surprising if those of the liberal persuasion were not stumbling about with shell-shocked looks and offering vague mutterings on "retrenchment" and "soldiering on". Tuesday's special election undeniably dealt a devastating psychological blow to the Democratic Party, but, as always, both the losers and the winners are breezing over the myriad reasons fiscal conservative, waterboarding-supporter and 1982 Cosmo nude centerfold hunk Scott Brown swept into a Senate seat held since 1962 by Ted Kennedy and assumed to be sacred ground by left-leaning New Englanders. Sure, "populism" played a role, as did Tea Party anger and independent voter concern over deficit spending. But this wasn't simply a national referendum on health care reform - not if the battlefield is the state of Massachusetts, where health care reform was already passed in 2006, with support from the Senator-elect. And not when the opponent was the likes of the hapless Martha Coakley, who ran an incompetent, elitist, tone-deaf campaign that failed to energize whatever base she apparently believed she owned and angered or annoyed everybody else. And knowing Boston baseball culture, I suspect that Coakley's she-says-it-was-a-joke / I-say-it-was-a-gaffe pronouncement that Red Sox pitcher Curt Schilling was a "Yankees fan" cost her as many votes as any single issue at play in the election. It would be a plot worthy of a great satirist if Curt Schilling could be considered to be the major reason health care reform failed in 2010, but there's no reason to discount the possibility. Whatever the causes and whatever the reasons, this off-year election would seem to have cost the nation yet another shot at tackling the health care situation in this country. For the second time in my relatively short life.

There are plenty of logical arguments to be made against specific or even broad provisions of the current health care bill, mostly rooted in fiscal or economic concerns. Details, one notes, continue to be rather shadowy and vague. Yet, arguments for fiscal restraint (seemingly the most obvious and clear-headed reason for opposition) have been employed less often then a frothy mixture of outrage, taunts of communism, accusations of death squads and pandering to pharmaceutical and insurance companies. There's a reason such tactics are used - they are much easier to digest than a painstaking deconstruction of financial realities. And so we have been treated to the spectacle of politicians and public alike wringing their hands over illegal aliens receiving medical attention and Nazi squads taking grandma out with suicide machines. I could point out that very few of the individuals raising their voices over the utterly fantastic charges of "death squads" made any kind of objection when our previous leaders sent very real military squads across the Atlantic to lay waste to the cities of Baghdad and Tikrit.
But it's always easier to get behind a vague military course of action than a vague health care overhaul course of action.

Rational discussions concerning specific concerns and highlighting limitations of health care reform would have been quite welcome and probably rather enlightening. Instead, we were treated to road blocks and obfuscation. And as the news percolated throughout the blogosphere and the pages of Facebook that health care reform was, in its current manifestation, dead, an odd smugness and glee pervaded the messages of many. Political victories should always be relished, and far be it from me to deny anybody an opportunity to enjoy a thick slice of schadenfreude. But when people react to the news that millions of their fellow citizens will likely not receive medical coverage with whoops, cheers and even a "ha ha!" (this from a physician, no less), you'll have to excuse me if I suspect they never had any rational or persuasive arguments against the movement in the first place.

But why should anybody expect empathy from a national movement that still finds some sort of inspiration from that emblem of compassion Rush Limbaugh, who, in an attempt to clarify an earlier comment made concerning aid and donations to earthquake-stricken Haiti, suggested this week, "Nobody here ever said don’t donate. We just pointed out you already contribute to the government with your income taxes". If one subscribes to the chilliest brand of pragmatism on the market, then it does become easy to mock liberal pieties as soggy, immature and fiscally reckless. I've been known to mock certain liberal pieties myself. Yet empathy remains that rarest of human traits - one of the few characteristics that firmly lift us beyond the lesser beasts, childhood and barbarity. Of course, one can't be aware of every misfortune or painful truth currently afflicting most of humanity. I've had the misfortune to share seating space with these types of individuals, and their inability to rationalize why bad things happen to good people, while perhaps noble and certainly compassionate, results in a near paralysis of action. So I'll take a good dose of cynicism with my compassion. But there is little nobility or pride in choosing a path that always sets up opposition, closes one's eyes to the plight of others and looks out for number one.

You may disagree, but I suspect our national distrust of socialized medicine has little to do with those truly informed individuals capable of laying out specific fiscal concerns and sociological ramifications of national health programs. Rather, there exists a murky and perhaps unconscious mélange of thought that combines quasi-biblical notions - of the rewards of hard work, say, and a suspicion that misfortune only impacts the unrighteous - with a well-worn copy of Adam Smith's The Wealth of Nations. Do we still, as a people, view the afflicted as ultimately reaping the price of some earlier sin? Scoff if you must, but in this intensively religious nation, no practice lies untouched by some aspect of theology.

So, who knows what may eventually become of this drifting health care bill, already declawed and neutered beyond anything resembling true reform? I would respectfully note that despite all the hushed tones concerning the loss of the fabled 60 votes, as long as that farkakte schnook Joe Lieberman was on the case, there were never 60 votes in play anyway. But I'll conclude by suggesting (and here comes the liberal piety bit) that it is always important to remember the human cost when somebody gleefully runs as, and somebody gleefully votes for, "the 41st vote" to kill health care reform. I'm not normally inclined to cite entertainers, but Vic Chesnutt isn't an ordinary entertainer. A witty yet bleak Southern singer-songwriter, he first gained fame in the 1990s with a series of moody acoustic albums that were produced and praised by members of R.E.M. While it was never the main focus of his music, the 1983 car accident that left him partially paralyzed seeped through every aspect of his work. He spoke to Terry Gross on NPR early last December, an interview that included this brief, passionate and ultimately very sad discussion over his health struggles. Chesnutt committed suicide later that month through an overdose of muscle relaxants at the age of 45.

GROSS: I read that you're in debt like $50,000 because of health insurance issues.

Mr. CHESNUTT: That's right.

GROSS: So - and this is because you had a series of surgeries and although you pay a lot for your health insurance, it didn't cover all of it. Is that - do I have that right?

Mr. CHESNUTT: That's exactly true, yeah.

GROSS: Uh-huh. So, what are your thoughts now as you watch the health care legislation controversy play out?

Mr. CHESNUTT: Wow. I have been amazed and confused by the health care debate. We need health care reform. There is no doubt about it, we really need health care reform in this country. Because it's absurd that somebody like me has to pay so much, it's just too expensive in this country. It's just ridiculously expensive. That they can take my house away for a kidney stone operation is -that's absurd.

GROSS: Is that what you're facing the possibility of now?

Mr. CHESNUTT: Yeah. I mean, it could - I'm not sure exactly. I mean, I don't have cash money to pay these people. I tried to pay them. I tried to make payments and then they finally ended up saying, no, you have to pay us in full now. And so, you know, I'm not sure what exactly my options are. I just - I really - you know, my feeling is that I think they've been paid, they've already been paid $100,000 from my insurance company. That seems like plenty. I mean, this would pay for like five or six of these operations in any other country in the world. You know, it affects - I mean, right now I need another surgery and I've been putting it off for a year because I can't afford it. And that's absurd, I think.I mean, I could actually lose a kidney. And, I mean, I could die only because I cannot afford to go in there again. I don't want to die, especially just because of I don't have enough money to go in the hospital. But that's the reality of it. You know, I have a preexisting condition, my quadriplegia, and I can't get health insurance.

GROSS: Is it true you can't get good health insurance?

Mr. CHESNUTT: I can't get - I'm uninsurable. The only reason I have any insurance now is because I was on Capitol Records for a while. And I had excellent health insurance there. And then when I got dropped from Capitol, I Cobra'd my insurance for as long as it was legally possible. And then -which was insanely expensive, to Cobra this very nice insurance. And then, when that ran out, the insurance company said they could offer me one last thing and that is hospitalization. It only covers hospital bills. That's all it covers. And it's still $500 a month. So, it doesn't pay for my drugs, my doctors or anything like that. All it pays for is hospitalization. And yet, I still owe all this money on top of that.

GROSS: Wow. Well, I wish you the best with your health and your music. And I really want to thank you...

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