We have no option.

Somehow with all the give and take we’ve lost sight of the
fundamental healthcare issue before the nation.  A very large number of us either have totally inadequate
coverage or none at all. 
The second group is growing by the day, as unemployment threatens not
only foreclosures on their homes but on their insurance as well.  Those who can’t meet their mortgage
payments are likely unable to pay their premiums.

So we dance around the obvious and stand ready, or at least some of those
who can make it happen stand ready, to postpone the inevitable yet another
time.  We’ve stopped talking about
the disgrace of people left hung out to die in the wealthiest nation on earth
and rather are talking about what it might cost to at long last do the right
thing.  We don’t seem to lack the
will when it comes to building armaments and sending our citizens out to kill
and be killed, but somehow have become financial pacifists when it comes to
keeping them healthy.  We know that
other nations take care of all their people, spend less and have equal, or in
many cases better, outcomes.

To talk about healthcare reform without at least a public option (a
Medicare for juniors as well as seniors) is like Nero playing his fiddle as
Rome burns, but with blinders on.  Without
a public component, there is no reform, no a solution. It is a heartless joke.

On September 14, NPR reported on the results of new survey
conducted by Drs. Salomeh Keyhani and Alex Federman of Mount Sinai School of
Medicine and just published in the New England Journal of Medicine.   They found that 63% of the
physicians polled favored a public option and another 10% favored a public-only
program, in other words universal Medicare (my words not theirs).  That means that 73%, a decisive majority, were in favor of
at least the option.  Thinking back
to the historic opposition of the AMA and doctors in general to any public
program in earlier days, this is an astounding turn around for the people
closest to the problem.  I have
little doubt that if the same doctors were asked if they believe a Medicare
expansion and universal coverage is in our future, even a larger number would
agree.  It is inevitable.

So what are we waiting for? 
The facts speak for themselves, the solution is so obvious and now our
doctors want to write the prescription. 
Perhaps there has been no political incentive to join together, but I
really wonder how that will play out if Massachusetts, as now seems more than
likely, will allow its Governor to fill Ted Kennedy’s seat.  60 aye, 40 no?  For the sake of our democracy, for its moral compass, say it won’t be so.

Disincentive

Max Baucus has finally revealed his long heralded compromise
healthcare proposal, the one that promised some Republican support.  Perhaps that will happen, but for now
there was no joint press conference and even Senator Snow seems unready to commit.  Being the only one is impossibly lonely
these days.  In fact, unless you’re
angling for a Profile in Courage Award, it’s potentially suicidal. What’s going
on here?  Blame the system, a
system of disincentive.

We wring our hands a lot these days about a lack of
bi-partisanship.  The President,
who promised to seek collaboration, has thus far been disappointed and in fact
seems to be losing not gaining ground in that quest.  But this isn’t a problem reserved for Democratic
Presidents.   George W. Bush promised
to be a “uniter not a divider”, which after the acrimonious Clinton years
probably brought him more than a few votes.  He too failed. 
It serves no purpose here to question the sincerity of either man’s
campaign rhetoric; the system was against both of them from the start.

It’s hard to say whether democracy itself is inhospitable to
bi-partisanship, but if history tells us anything, it is that those in and out
of power mostly go their own way.  
Indeed the only time we see true bi-partisanship is at very extraordinary
moments and I stress the word “very”. 
On September 11, 2001 we saw it but, even then, only for a moment in
time. Why is that?

To answer this question, we have to ask another.  What’s in for the “other” party,
whomever that may be, to join hands with the opposition?  We would hope the answer to that is,
plenty, if nothing else the national good.  Dream on.  
The fact is that, whether Republican or Democrat, helping get things
done when someone else holds the White House is a no win game.   Presidents get all the credit or
the blame for what happens under their watch.  Joining in is a politically thankless exercise.  Why should a Republican want to support
a healthcare program that will always be known as an Obama achievement?  Conversely, while some Democrats, most
notably Ted Kennedy, supported it, No Child Left Behind is a Bush legacy, as
will be any improved version of it. 
Seen in that light, it may actually be better to stand in the way of
getting anything done and thus deprive the other party of any accomplishments,
or as few as possible.   Sound
familiar?

Of course we all deserve much better than this.  We would hope those elected to office
have our mutual interest in mind. 
Even assuming that they want to do the best, there is no practical
incentive to behave differently than what has become the norm.  We can think little of them, and for
the most part we do, but as things stand any change in behavior is more likely
to result in them losing their office than in a getting a constituent note of
thanks or one of those courage awards. 
Don’t blame them for that.  Blame
all of us.  We, the voters, don't reward them for bi-partisanship, and in fact through the partisan primary process do just the opposite.  It’s a system of
disincentive that we are all perpetuating, all the more so in making the environment so hostile.  So disincentive it is, and that really
sucks!

Déjà vu

Maureen
Dowd was spot on in suggesting Joe Wilson’s outburst was racial, especially
as seen in the context of the “birther” and other trash heard on talk radio and in rallies in the past two months. 
My son was right in pointing out that Wilson was “provoked” by the
thought that a penny of our money might land in the hands of immigrants.  He claimed to be talking the illegal
kind, but I’m not so sure.  When
Barack Obama was elected many of us naively, or at least hopefully, thought the
country had turned a new leaf.  For
the most part, it probably has – no it definitely has.  But Wilson, a son of a certain kind of
South, left me with an eerie sense of déjà vu, a sickening feeling in the pit of
my stomach.

Part of where we are bespeaks the culture of rage about which I wrote
on August 19, but this goes much deeper. 
The Republicans have been particularly deft at branding and slogan
making.  The Democrats still have
trouble with both.  As someone who
has spent decades helping clients invent or reposition themselves with labels
and words, I know something about this subject.  Some brands are stronger than others, and some companies can
change their name and still be thought of as who they were not who they are or
would like to be.  Altria is still
Philip Morris, the reigning riding cowboy of tobacco land.  Much of the Republican Party we know
today can proclaim itself “of Lincoln” all they want, but we know they remain
the Dixiecrats who ran Strum in 48 and (while not under that banner) George in
68.  Lyndon Johnson famously lost
these folks in signing the Civil Rights Act and the GOP gained them, dooming
all but the last whimper of Rockefellerism in their ranks.  Obama of Illinois is of Lincoln, the
newly infamous Joe Wilson and his ilk are not.

But let’s not put too much focus or blame on the messenger.  That outburst on the Floor and others
like it, many much worse, are giving us a message.  A fear of “the other” whether it’s of a different skin
color, a different sex orientation, a different belief system (include
atheists) or  a different (and funny) accent is alive and sick both here
and, for that matter, around the world. 
“That fella over there just ain’t like us – he don’t belong where he
is.”  Indeed, Dowd contends that
the fear and anger of the “other” is particularly heightened when it’s perceived
as being the “uppity N” kind, though she didn’t use those words.  It isn’t so much the audacity of hope,
but the audacity of being equal or, worse, better.  She summarized it best in quoting Don Fowler who remembers
his father’s dictum, “Boy, don’t get above your raising”.  The bounds of "raising" are just seen differently by many of us.

Part of the racist’s tool is to use fear.  Not merely fear of the other, but instilling the fear of
retribution in anyone who stands in their way.  That may explain the moral silence, the absent sense of
outrage, which is so audible in land.  The
few Republicans who still cling to some kind of center shy away from voicing
their opinions, or voting their conscience (if one remains), for fear of being
taken down in the next primary. 
Perhaps that’s why we don’t hear much about this growing problem from
any Republican “leaders”, those same people who proclaim themselves the
protectors of “values”.  But we
also aren’t hearing that much from those on the other side of the aisle.  Everyone is running scared, a fear that
can be our undoing – déjà vu!

I’ve asked it before and, sadly, must repeat it again.  Where are the religious leaders in all of  this and, for that matter, where are the captains of academia, industry and the professions?  Frank Rich complains, and appropriately
so, that the President has let too much go unanswered since taking office.  I agree, but what concerns me more is
what my father spoke of 46 years ago at the March on Washington – that “nation
of onlookers”, which is exactly what we are.  It isn’t enough to elect someone seen as an “other”
President.  The business isn’t
finished, but only begun…if that.

Hate, and that’s what we’re talking about, can grow and become
viral.   History suggests that
when “good people” sit on the sideline silently looking on, the potential of that
happening only increases.  The
Southern strategy put Republicans in power.  The thing about Reagan Democrats is that they remained in
play.  Nixon’s legacy is that he
turned over the store to what has become an increasingly entrenched and narrow group
of people who see anyone with whom they disagree as “the other”.  In that context, bi-partisan is as foreign a term as is
illegal alien.

Let’s not lose sight of the fact that a disproportionate number of
those without healthcare coverage are of color or talk with one of those funny
accents.  As the Republicans stand
together in shouting and voting their NO, one has to consider what may lie not
so far below the surface.  Surely
not all Republicans think or feel that way but I find it harder to say of them,
“forgive them father, for they know not what they do.”  They know.  Ironically, liar is the tamest of
words, and indeed is only a word. 
What lies behind its utterance, well that’s déjà vu.