Balls on the Table: The Debate Rages

Fore Last night, I was a little drunk. I mean, not like, “put my foot through windows and take a dump in the microwave” drunk, but I’d found me a big bottle of Arrogant Bastard and enjoyed it.

Plus, I figured — if you’re gonna watch the health care debate, it doesn’t hurt to be a little sauced.

So. To clarify up front, I’m only half-smart. I fade in and out. I do my best with the limited means inside my skull. Plus, I’m still sipping my coffee, so for all I know, I’m writing in clicks and burbled coos over here. Bear with me. But here are my thoughts, in no cogent order, on the health care speech last night by Senor Presidente, Barack Obama.

Now, Obama’s good with the speeches. We know this. Maybe he speechifies too much. But, last night felt like an energized, commanding president. A guy who, as I’d hoped to see, had his balls out on the table. Just as Stella got her groove back, Obama got his testes back.

Let’s talk about Obama’s balls for a minute.

I bet they’re lovely. I bet they look like Cadbury Eggs.

Wait, shit, no, I mean metaphorically.

Obama was clear and forthright. That’s part of it, where — in the paraphrased words of Bill Moyers — he was speaking to the hearts and minds of the people as a leader rather than as a policy wonk talking nuance to Washington.

But, he also demanded that they smell what Barack is cooking. He called out some of the more potent lies, and he called them lies, deceptions, and misinformation (though really, it’s disinformation). He said that, in the coming weeks, if more lies gain traction, he’ll call out the liars — something that I think we all want done. Someone lies, get on the horn. Name them. Shame them. Put their faces on a Totem Pole of Public Humiliation.

So, all that is good. I like all that.

He was also very clear about how the system is an utter crap-nest right now, and how the status quo is not acceptable.

Good. Yes. Right on.

He stayed cool and unflappable when the Republicans got all bitchy in the back like a bunch of snotty cheerleaders (oh, did you watch Glee last night? You should’ve. It’s awesome). Of course, right there, I woulda liked him to call some of those rude fuckers out then and there, right on the floor — let’s get to the public shaming, dude. It’s the one time where you think, “Man, if someone did that to McCain, that cranky old bastard would’ve hurried over there and karate chopped them with his busted slot machine arm. Kapow!” But, y’know, I’ll take it, because now Obama looks like a gentlemen, and the GOP look like a gaggle of ill-mannered fuckwits.

Oh, speaking of those fuckwits.

Joe Wilson, as Salon notes, wasn’t the only turd waffle there last night (sorry, I overheard “turd waffles” at Target last night; had to use it). Read to the end, and you’ll also see that therein lies a really good way of showing him what-for. Yes, writing him clear missives will help. But you can also fund the election campaign of his opponent. Ta-da! Literally, vote with your dollar.

So, GOP, way to impress. Poo-throwing chimps of the world, unite.

And, by the way, despite my ragging on the Repubs, I sometimes lean fiscally conservative while going socially liberal. The idea there is reasonable. The GOP hasn’t been the party of fiscal conservatives for a long time, though. Not since Reagan. Obama, at present, is more fiscally conservative than a lot of the currently-installed Republicans, so chew on that and swallow.

Anyway. Back to the speech.

Obama did good. Mostly.

Some parts, maybe not so much.

I can’t get a read on his speech as to what the public option even is anymore. Listen, I’d rather have health reform that cuts insurance and the industry down to size without a public option if the only other solution is do sit on our asses and do nothing. Is the public option critical? Not technically. But it’s kind of morally critical, isn’t it?

Then comes the second problem with the speech — yes, health care for all is morally critical, which is apparently why it’ll be mandatory to have health care. Except, outside the shakily-conceived and outlined public option, this has to mean people getting fined for not having health care. Right? Am I misreading? Which is a conundrum on par with, “I got fined for not having money in my bank account.” Really, that’s what it is. It’s charging people money for not having money. Which makes negative sense.

Now, yes, Obama said it’ll be mandatory for all those who can afford it. So, once more, without details, we’re left flapping in the wind. I understand the mandatory part. The system is genuinely bogged by those without health care, and it is a financial drain on all. My wife works in the health care industry. That it bogs the system is a fact. That it costs us all is a fact. And hey, mandatory auto insurance is a good thing. I believe that. But one’s car and one’s body are different things. I can choose not to have a car and save costs. And right now, auto insurance is represented by a vibrant marketplace. Health insurance isn’t (though it’s “part of the plan”). More details, por favor.

[Edit: I favor a public option, but here is a thought against it, since I like playing Devil's Advocate sometimes. I am not so cynical as to suggest the government is incapable of running social programs. I am cynical enough to suggest that a "Whisper Down The Lane" effect can happen over the course of multiple administrations. Social Security and Medicare are two programs worth supporting, but neither are in particularly firm shape at present. The government is good at running social programs in the short term, but it kicks problems down the road.]

Final problem:

Geisinger.

Obama called out Geisinger in central Pennsylvania as a model worth emulating.

Let’s hope not.

I won’t name names lest I invoke legal wrath, but let’s just go ahead and say that my father, in coming back from Colorado, lived in central Pennsylvania. Let’s just say the health care he got there was less than stellar. Maybe, just maybe, he’d see a dozen different doctors with poor English-speaking skills who were not communicating with one another. Could be that they would fill his body with mind- and body-numbing painkillers and then tell him important medical details, which he’d promptly forget because he couldn’t remember if he’d just drank a glass of orange juice much less any complicated medical information that just passed through his head. And, in case you’re just getting caught up, my father has moved on to his Happy Hunting Ground.

The unnamed-health-care-in-central-PA (which may or may not rhyme with Fleisinger) is known for cookie cutter medicine. Sounds good from a cost-cutting perspective, until you realize that health care is not always an easy prescription, and that human health is not easily accommodated by cookie cutter solutions, and is better attacked from nuanced, specialized care.

So, hopefully that’s not actually the model we’re seeking to emulate.

Because if it is, we’d all better make sure our life insurance policies and our living wills are up to date.

8 comments

  • Cookie cutter or cookbook medicine is all about standardization. By dictating how each situation should be handled you improve the patient outcomes for the not so great docs. That’s good. You also potentially pull the performance of the truly amazing docs closer to the center. That’s not good. The problem with standardization is that health care deals with people, not machines. People want individual attention not a conveyor belt for medical care. I think that the real cost cutting can be better realized through the implementation of electronic medical records to reduce unnecessary or duplicate testing and through improved access to preventative medicine.

  • I have to agree with your wife, and I can imagine she knows a lot more about it from her side of things.

    I’m in a program with other pregnant women. We get our care together as a group, we get our ‘birthing classes’ together as a group. We get the same information and the same treatment. The doctor for this group is great and open minded and -almost- ‘crunchy’ enough for my tastes.

    If she weren’t there. If it were a doctor ignoring logic and going with all the old OB sterotypes about birth those women would be at the mercy of a terrible system because they have no other choice. Me, I’d pack up and birth on my damn own, but you tell that to a terrified 16 year old who can’t even get her mom to show up at the group.

    I don’t know, I’ve never been on the other side of the equation, but I have to imagine the really terrible end of that cookie cutter medicine problem is always going to work against the under educated poor. People who don’t know to go do their own research. I imagine there is a part of central PA, (no names named) where that is exactly the problem.

  • That’s weird to me. We had two babies happily with hospitals, so I’m not sure I understand being at the mercies of what horrible system where? I’m sorry if anyone’s birthing was less than stellar though, b/c it’s hard enough as it is.

    Well, as it stands the whole Health Care issue is important to me as the head of a family with no insurance.

    Not to make too much of it, but Sarah and I are very much victims of the system as it stands. Despite healthy raises every year, Health Care was why I was working poor and no small part of why I was laid off. Sarah’s father’s business is barely afloat and paying to insure his daughter or grandkids would literally shut down his business and any nest-egg he’s built over the past 30 years.

    Now my kids have no insurance, my wife and I have no insurance, and we’re at the mercy of systems who are so bogged down with similar stories that they simply don’t have the time, money or inclination to hear us out.

    CHIP swears they’ll get back to us someday when fund become available. Somehow I don’t see that happening anytime soon.

    So, yeah, enter public option and all (er, most) of those woes would be gone, b/c a system would be in place to keep up with these things. Seriously, I might still have a job. At the least I’d have had more savings and better credit; and in the worst case, my kids would’ve been covered par for the course (which they tell you it’s supposed to be now, and isn’t).

    So yeah, public option, fairer insurance. I don’t care how it has to happen, but it has to happen.

    That’s my two cents at least.

    –M

  • I know this is a bit late, but
    Chuck, I loved your ramble about the debate, and you indeed have an intelligent and beautiful wife.

    For anyone who’d like a bit more info on the most recent turn of events… i.e. the Baucus bill, I think this post of mine might be of interest to you. I would also sincerely love your opinion (both from a professional writing critique along with you opinion on the topic itself: http://musingsbytams.blogspot.com/2009/09/mixed-feelings-about-baucus-bill.html

    Have a lovely day!

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