Garrison Keillor describes his stroke

What's it like to have a stroke, then get really lucky? Garrison Keillor tells it like only Garrison Keillor can tell it:

[A] neurologist shook my hand and said: "I hope you know how lucky you are." That was pretty clear as I walked down the hall, towing my IV tower, and saw the casualties of serious strokes. Here I was sashaying along, like a survivor of Pickett's Last Charge who had suffered a sprained wrist.

What's it like to get world class treatment for your stroke when you have a strong sense of social justice?

Rich or poor, young or old, we all face the injustice of life -- it ends too soon, and statistical probability is no comfort. We are all in the same boat, you and me and ex-Gov. Palin and Rep. Joe Wilson, and wealth and social status do not prevail against disease and injury. And now we must reform our health insurance system so that it reflects our common humanity. It is not decent that people avoid seeking help for want of insurance. It is not decent that people go broke trying to get well. You know it and I know it. Time to fix it.

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What KIND of health care?

The raging health care debate "debate" is almost entirely devoid of facts, an issue on which I've previously posted. Instead of discussing fact, then, we tend hurl vague accusations, like calling the reformers "communists" (and you've GOT to see this). I "blame" Obama for this lack of specificity, but I realize that the vicious opposition mounted by huge self-interested insurance companies and health care providers might require that he not play all of his cards at this point. But isn't it odd that our politicians aren't at least clarifying the term "health care coverage" when they refer to national health care coverage? Defining this term would make a huge difference to the public reaction to any national plan. Here are two possibilities (though there are others): A) The national plan will offer gold-plated coverage much like the expensive United Health Care coverage I buy for my family through my employer. For the record, the pre-tax cost of this coverage is about $20,000 per year for my family. Is the Obama proposal to provide every citizen with this kind of coverage? If so, I can see why there is massive resentment to the proposal. Many working people can barely afford health insurance coverage at all, and the coverage many people do purchase is not nearly as comprehensive as the expensive coverage I purchase. Of course people who can can only afford to buy their own rudimentary policies will resent that the government might buy gold-plated policies for everyone else, including many highly irresponsible people. B) The national plan will offer a rudimentary coverage only. It will cover x-rays and casts for broken arms, but not heart transplants and expensive drugs that only marginally increase one's chances of surviving an illness. It wouldn't keep people suffering from terminal illness on life support when there is no reasonable chance that they would ever leave the hospital. It would cover only a small subset of the treatments covered by gold-plated policies. It might be akin to the Oregon Plan. I believe that there would be massive resistance to the national coverage described in A) but far less resistance to the coverage described in B). At least Oregon's legislators had the cajunas to specifically state what was covered under their plan and what was not (Oregon's prioritized list is available for all to see). Oregon had the fiscal responsibility to make certain that they could afford the level of health care to which they were committing. Oregon dealt head-on with the accusation that they were "rationing" health care; absolutely they were, just like private plans ration health care only to those who pay those high premiums. Both responsible and irresponsible health care plans "ration" health care. Therefore, it is not a criticism of any health care plan that it "rations" health care. Here are the guiding principles to the Oregon Plan:

In 1987, the Oregon Legislature realized that it had no method for allocating resources for health care that was both effective and accountable. Over the next two years, policy objectives were developed to guide the drafting of legislation to address this problem. These policy objectives included:

• Acknowledgment that the goal is health rather than health services or health insurance • Commitment to a public process with structured public input • Commitment to meet budget constraints by reducing benefits rather than cutting people from coverage or reducing payments to levels below the cost of care • Commitment to use available resources to fund clinically effective treatments of conditions important to Oregonians • Development of explicit health service priorities to guide resource allocation decisions.

Our national conversation regarding health care is so dysfunction on so many levels that it's hard to know where to begin. I'll make only one more point in this post, however. Opponents of current proposals often make accusations that there will be "death panels," indicating that some sick people will be allowed to die. As a nation, we need to grow up and deal with the fact that this happens every day in every hospital in the country: we shouldn't be allocating huge amounts of money to maintain pulses in people who have become living corpses. There are some families who "can't let go" no matter what (e.g., Terry Schiavo), and our national plan needs to have specific guidelines for these situations. In fact, every private insurance plan should have guidelines for determining when further treatment is likely to be futile and a provision for ending coverage at that point. The alternative is to make policies so horrifically expensive that many people can't afford policies that cover tratments likely to make an immediate positive impact on their lives. Only when we put these issues clearly on the table can we begin to have a real conversation.

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Just how dysfunctional are we? Ask Bill Moyers.

Just how dysfunctional are we? Here's what Bill Moyers has to say:

Bill Maher asked me on his show last week if America is still a great nation. I should have said it's the greatest show on earth. Forget what you learned in civics about the Founding Fathers — we're the children of Barnum and Bailey, our founding con men. Their freak show was the forerunner of today's talk radio. Speaking of which: we've posted on our website an essay by the media scholar Henry Giroux. He describes the growing domination of hate radio as one of the crucial elements in a "culture of cruelty" increasingly marked by overt racism, hostility and disdain for others, coupled with a simmering threat of mob violence toward any political figure who believes health care reform is the most vital of safety nets, especially now that the central issue of life and politics is no longer about working to get ahead, but struggling simply to survive. So here we are, wallowing in our dysfunction. Governed — if you listen to the rabble rousers — by a black nationalist from Kenya smuggled into the United States to kill Sarah Palin's baby. And yes, I could almost buy their belief that Saddam Hussein had weapons of mass destruction, only I think he shipped them to Washington, where they've been recycled as lobbyists and trained in the alchemy of money laundering, which turns an old-fashioned bribe into a First Amendment right.

Continue ReadingJust how dysfunctional are we? Ask Bill Moyers.

How to have a conversation about health care reform

I commend the way that Al Franken engaged with these tea party folks recently: Watching this video makes me ever more suspicious that the media is driving unnecessary conflict (on health care reform and on everything else) in order to sell ads. It seems much easier to talk when the media isn't around spewing sound bites and featuring angry extremists, instead of focusing on the many ways we actually agree with those with whom we "disagree." I couldn't take my eyes off of the woman who tried to start the conversation in a contentious way. I kept wondering whether her views on Al Franken were shifting given the impressive way he discussed the issues surrounding health care reform.

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Government-Hating: An American Value

G.O.P. Chairman Michael Steele made a few remarkably in-your-face comments recently about the health care debate. Here, in his own words, is pretty much where he thinks the nation is going, why it shouldn't go there, and what the Republican Party stands for. This morning on NPR he tangled with Steve Inskeep, in particular over this. One quote in particular caught my eye: " Simply put, we believe that health-care reform must be centered on patients, not government." When you listen to the NPR interview it's clear that we're hearing another in the now decades-long tirades against the government which has become the hallmark of Right Wing politics in this country. In this country, in theory, the government is supposed to be us, the people. We elect our representatives, we tell them how we want them to vote, we change our minds, we are supposed to be in charge. In theory. Obviously, the reality is far from that. For one, we are not a full-fledged democracy, we are a republic, and while we elect those who operate the machinery of the republic on our behalf, we do not have a direct say in the running. Nor could we, really. it is simply too complex. We send our representatives to the various points of departure---state capitols, Washington D.C., county seats, city halls---to do that for us because it is a big, complex, often indecipherable melange of conflicting goals, viewpoints, and problems. We do not have the time to pay the necessary attention to do that work ourselves, so we pay people to do it for us. So why do we distrust it so much? Well, because we distrust each other.

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