Transparency, Accountability, and Personal Responsibility in Health Care

Following a series of semi-unplugged staycations, I’ve been doing too much reading and not enough writing. Since I haven’t quite managed to recover my blogging mojo tonight, let me point readers to David Goldhill’s article on the problems with American health care and why the reforms working their way through congress are unlikely to improve outcomes and lower costs.

Goldhill is a Democrat who recognizes that his party’s proposed solutions are, at best, mommy kisses and a Dora the Explorer Band-Aid applied to a critical systemic illness.  His piece is very, very long, but very much worth your time.  He proposes a transparent, consumer-centered health care market in which comprehensive health insurance is no longer the primary mechanism for financing routine and predictable care.

While Goldhill characterizes his ideas as “radical,” they’re hardly as extreme as, say, tossing out the Constitution and starting over.  I don’t necessarily agree with his implementation recommendations, but the article is thoughtfully constructed and his ideas (thankfully) don’t hinge on the false notion that prevention of diabetes and heart disease would be a cost-controlling panacea.  Here’s a taste:

Some of the ideas now on the table may well be sensible in the context of our current system. But fundamentally, the “comprehensive” reform being contemplated merely cements in place the current system—insurance-based, employment-centered, administratively complex. It addresses the underlying causes of our health-care crisis only obliquely, if at all; indeed, by extending the current system to more people, it will likely increase the ultimate cost of true reform.

I’m a Democrat, and have long been concerned about America’s lack of a health safety net. But based on my own work experience, I also believe that unless we fix the problems at the foundation of our health system—largely problems of incentives—our reforms won’t do much good, and may do harm. To achieve maximum coverage at acceptable cost with acceptable quality, health care will need to become subject to the same forces that have boosted efficiency and value throughout the economy. We will need to reduce, rather than expand, the role of insurance; focus the government’s role exclusively on things that only government can do (protect the poor, cover us against true catastrophe, enforce safety standards, and ensure provider competition); overcome our addiction to Ponzi-scheme financing, hidden subsidies, manipulated prices, and undisclosed results; and rely more on ourselves, the consumers, as the ultimate guarantors of good service, reasonable prices, and sensible trade-offs between health-care spending and spending on all the other good things money can buy.

Take the time to read the whole thing.

Hat tip: Peg Kaplan

Published by Jenn Q. Public on August 14, 2009

5 Comments 

An Insulting Question and a Pointed Reply

Secretary of State Hillary Clinton was asked the following question by a Congolese student during a town hall event in Kinshasa yesterday:

Mrs Clinton, we’ve all heard about the Chinese contracts in this country. The interference is from the World Bank against this contract. What does Mr. Clinton think through the mouth of Mrs. Clinton and what does Mr. Mutombo think on this situation? Thank you very much

Responding to what turned out to be an unfortunate mistranslation of the student’s question, our nation’s lead diplomat replied:

You want me to tell you what my husband thinks? My husband is not the secretary of state, I am. You ask my opinion I will tell you my opinion, I’m not going to channel my husband.

Watch the exchange here:

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These remarks were followed almost immediately by a blogospheric uproar about Clinton’s “unprofessional” “temper tantrum.”  But I’ve watched the video more than once and I don’t see a “hissy fit” or “meltdown.” I see the highest ranking cabinet member demanding respect for her office and expertise.

The question, as translated, was entirely inappropriate and while the answer was not conventional enough for some armchair diplomats to swallow, it was not out of line.  If she had submissively accepted the insult or politely laughed it off, the same critics attacking her for “showing her true colors” wouldn’t be praising her for her tact, they’d be calling her an impotent pushover lacking the political chops to emerge from beneath Bill Clinton’s shadow.

Like it or not, Hillary Clinton is a cabinet member.  She is no longer the first lady and should not be expected to play that role.

And if you want to know what my husband thinks about all this, you can ask him yourself.

Published by Jenn Q. Public on August 11, 2009

6 Comments 

Jenn Q. Public, Failed Protester for Hire

I don’t know what I’m doing wrong.

According to an AFL-CIO statement published by The Huffington Post, corporations and lobbyists are bankrolling the militant right wing extremists protesting liberal health care reform. The Democratic National Committee says “‘grassroots protests’ are being organized and largely paid for by Washington special interests and insurance companies,” Rep. Lloyd Doggett says the “mobs” are being “sent by the local Republican and Libertarian parties,” and White House press secretary Robert Gibbs assured the press corps the town halls are rife with the “manufactured anger” of astroturfers.

So why is it that I have yet to see a single paltry dime?

I’ve blogged about my opposition to the way health care reform is being handled. I’ve attended more than one tea party rally. I’m an active member of a conservative women’s organization.  I’m even a freakin’ GOP delegate for my precinct.  Oh, and I’ve got genuine outrage to spare — no “manufacturing” necessary — but with the value of the dollar so low, I’m willing to pretend my grassroots activism is astroturf if it means I can supplement my income.

So why isn’t my phone ringing off the hook with calls from Big Insurance, Big Pharma, and the RNC? How do I get on the radar of the neocon corporate lobbyists and GOP bigwigs doling out cash for activism?

According to California Senator Barbara Boxer, the astroturfers are well-dressed. Maybe I need to up my fashion game?

Illinois Senator Dick Durbin believes the town hall protests are being orchestrated by birthers.  Should I get a “Deport Obama” t-shirt and show up with my birth certificate in a Ziploc bag if I want to grab the ‘turfers’ attention? Or would I not be well-dressed if I did that?

Liberal radio host Bill Press says right wing astroturfers are “taking a page right out of a Nazi playbook” to bus in paid professional protesters.  Anyone have the ISBN for that playbook? I was never issued my copy so I’m not familiar with the intricacies of this “Stalinist-style campaign.”

Nancy Pelosi says a sure sign of astroturfers is that “they’re carrying swastikas and symbols like that.”  I hadn’t realized Nazi accessories were a notorious tell of paid rabble rousers masquerading as authentic protesters, but hey, I’m not a professional protester (yet) so what do I know?

Perhaps if I could just muster up some of the “racial anxiety” Paul Krugman believes is fueling the health care protests I’d appear more authentic.  Then I could really pull off using the “Brown Shirt tactics” being used by “extremists” to prevent Rep. Brian Baird of Washington from holding in-person town hall meetings.

But maybe I’m approaching this all wrong.  Instead, I could take my cues from seasoned ‘turfers on the left, like the operatives at MoveOn.org who boast they’ve “hired skilled grassroots organizers” to “fight back against these radical right-wingers.” Or the “ordinary citizens” paid by SEIU to teach health care protesters a Chicago-style lesson.  Or the non-English speaking day laborers recruited to hold up slick, professional signs they can’t even read at a Denver protest. Or the grassroots activists who take their marching orders directly from President Obama.  As Ed Morrissey points out, “nothing says grassroots like the Obama campaign logo on the top, and Obama’s website URL on the bottom.”

And while I’m at it, maybe I’ll start compiling dossiers on lefties who say “fishy” things about health care reform.  But I’m pretty sure I’ll need a bigger hard drive.  Anyone know which shady corporate cabal I should hit up for funding?

Published by Jenn Q. Public on August 8, 2009

4 Comments 

With or Without Health Care Reform, We’re Screwed

Wikipedia is “the free encyclopedia that anyone can edit.”

It’s also a resource many American doctors use to find medical information.

According to a survey of 1,900 physicians by Manhattan Research, a health care market research firm, nearly half of doctors going online for professional purposes reported using Wikipedia as a source of medical information. That number has doubled in the past year alone.

The threat is obvious. Can you imagine your doctor stepping out from the exam room, tapping away at his or her computer seeking the advice of Wikipedia? Research has documented the danger. A study from The Annals of Pharmacotherapy compared drug information from Wikipedia with the Medscape Drug Reference, a resource whose information is reviewed by pharmacists. Researchers found that Wikipedia omitted important information, including drug side effects. Another entry overlooked a commonly prescribed pain medication’s association with miscarriages.

Forget the debate over single payer health care.  Forget the talk about a public option.  Quality health care is a pipe dream if doctors are cheap, stupid, or lazy enough to rely on a nonauthoritative, easily vandalized resource like Wikipedia for health information.

Published by Jenn Q. Public on July 20, 2009

11 Comments 

A Typical Conservative

Writing at Big Hollywood, John T. Simpson describes his life as a conservative Republican:

I go to bed full of hate and wake up the same.  I hate blacks, Hispanics, gays, women, abortion doctors, liberals, Lefties, Democrats, you name ‘em, I hate ‘em if they’re not like me. I especially hate President Obama for being black. Just ask Janeane Garofalo, although being a Stalinist Socialist doesn’t help Obama’s cause any with me. Fact is, Obama could be a GOP Michael Steele Uncle Tom, and I’d still hate him even more than liberals hate Steele. Skin color trumps all. Thank God I was born the right color, or I’d probably kill myself. Wait, the hoods are dry! Be right back.

Where was I? Oh, yeah. Joe is my hero and role model, Archie Bunker a distant second, Ted Nugent a close third. I have posters of all of them lining my walls, alongside such conservative Republican heroes as Dick Cheney, George W. Bush, Richard Nixon, Adolf Hitler and Darth Vader.

I used to have one of Robert C. Byrd, but he lost me when he left the Klan and became the Conscience of the Senate. Whatever that means. Didn’t know the Senate had one. But I never understood that. How can a white guy in good conscience leave the Klan?

The “Bush lied, people died” crowd and their celebrity mouthpieces delight in encouraging these stereotypes among centrists, independents, and so-called “low information” voters.  It isn’t ignorance, it’s an ongoing political strategy at work every day in American classrooms and newspapers.

Unfortunately, it seems to be a winning strategy.  Ridiculing it is a good first step, but not one that will win elections.  Until conservatives can recapture their role in shaping the political narrative, their message will be ignored by the voters in the middle who are unwilling to align themselves with what they see as the party of hate.

Published by Jenn Q. Public on July 16, 2009

5 Comments 

Sarahcuda Unbound

Sarah Palin’s political career has been declared dead on the vine by a bandwagon teeming with armchair pundits and D.C. insiders.  The announcement that she would leave office before the end of her first gubernatorial term has spun the commentariat into a frenzy, their musings equal parts funeral dirge and “Ding Dong the Witch is Dead.”  Her resignation is widely considered to be career suicide.

Do we really live in a country where a resignation is an act of political suicide, but serving as Klan kleagle is acceptable training for decades in the Senate?

Robert Byrd (D-KKK) cut his teeth as a recruiter for the Klan before becoming the longest serving member of the United States Senate.

Ted Kennedy (D-MA) drove his car off a Chappaquiddick bridge and failed to notify authorities, abandoning his 28-year-old passenger to death by drowning.  He is currently serving his ninth Senate term.

Unlike these men, Alaska Governor Sarah Palin has no blood on her hands.  She doesn’t even have dirt on her cuffs, having beaten every charge in the litany of frivolous ethics complaints flung in her direction by the liberal attack machine. If men like Byrd and Kennedy remain successful in national politics, how can Sarah Palin’s resignation possibly be considered political suicide?

As mayor of Wasilla, chair and ethics officer of the Alaska Oil and Gas Conservation Commission, and governor of Alaska, Sarah Palin never cleaved to conventional political strategy. Why should she start now?  As The Other McCain observes, “Just because you don’t know what Sarah Palin is doing doesn’t mean that she doesn’t know what she’s doing.”

Sarah Palin is not a tragic case of political seppuku or a casualty of the liberal war on conservative women.  She is a success story unfolding before our eyes.  Assured that a competent lieutenant governor is on hand to take her place, Sarah Palin doesn’t have to sit back helplessly and allow the liberal obsession with her uterus and her daughters to impede the agenda she set forth when she became governor.

Palin is finally responding to the rallying cry heard from her supporters during the 2008 campaign: Free Sarah!

At the end of the month, the shackles will slide off, and with them, the gloves.  Sarahcuda will be unleashed, unbound, and free to speak her mind, unencumbered by the concern that Alaskans are paying for the pulsating red target affixed to her back by the chattering classes.  She’ll be free to take speaking gigs, campaign for conservative candidates, join a policy institute, or start a foundation of her own.

The talking heads have speculated that Palin’s resignation is an implicit victory for the politics of personal destruction, proof that relentless attacks are indeed the way to bring a politician to her knees.  Quite the contrary, Palin has ensured that savvy political strategists and pundits will think twice before working feverishly to intimidate a popular politician into resigning.  Liberal strategists aren’t shaking in their Uggs yet, but they will be once they experience Sarah Palin unrestrained by the formality of office and the boundaries of Alaska.

Amy Siskind, president of The New Agenda, called Palin’s announcement a “dark moment for our country.”  A stalwart Palin defender, Amy saw the announcement as evidence that sexism and the politics of personal destruction had triumphed yet again.  “What am I going to tell my daughter?” Amy wondered.

While Sarah Palin’s resignation may be a reminder of the misogyny and classism that plagued the last election season, it is also a vindication of her resilience and adaptability.  Palin did what all women find themselves wanting to do at some point in their lives: she opted out of playing the game on everyone else’s terms.  She decided to thumb her nose at the critics, plow through the obstacles, and shape her own destiny.

Amy can assure her 11-year-old daughter that Sarah Palin remains the very embodiment of choice and self-determination.  She can explain that a true leader goes where she’s needed most, and right now, Sarah Palin can accomplish far more for our country outside of the Alaska governor’s office.

This is not a day to write Sarah Palin’s political obituary.  Her vitals are strong.  She’s no one’s marionette and conservatives have a newly minted activist to lead their cause.  Sarah Palin will be free to be Sarah Palin.

Published by Jenn Q. Public on July 6, 2009

8 Comments 

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