Big Changes in November or We Move Towards Fascism

With the wins in Iowa by Huckabee and Obama, Iowans sent a firm message that they are concerned about the direction of this country. That Romney, Giuliani, and even Hilary represented too much of the "old boy" school of politics that has damaged this country so much in the last seven years. I think that many who are uncomfortable with continuing more of the same still do not, or cannot, see that we have been moving towards fascism - steadily, and not so slowly. The exact definition of fascism has been debated for years, but let's look at a few:

1. A system of government marked by centralization of authority under a dictator, stringent socioeconomic controls, suppression of the opposition through terror and censorship, and typically a policy of belligerent nationalism and racism. (Webster's)
2. Fascism is an authoritarian political ideology (generally tied to a mass movement) that considers individual and social interests subordinate to the interests of the state or party. Fascists seek to forge a type of national unity, usually based on (but not limited to) ethnic, cultural, racial, or religious attributes. The key attribute is intolerance of others: other religions, languages, political views, economic systems, cultural practices, etc. Various scholars attribute different characteristics to fascism, but the following elements are usually seen as its integral parts: nationalism, statism, militarism, totalitarianism, anti-communism, corporatism, populism, collectivism , and opposition to political and economic liberalism. (Wikipedia)

We saw what happened when fascist governments gained tremendous power in the middle of the 20th Century. We need to be equally afraid when we see our own government curtailing the Constitutional rights of its' citizens, critics of the government are called "unpatriotic" and fired(or kicked off the air), when the government can spy on us, get our medical records, and even our library reading list at will and without a court order or our knowledge. When we see accelerated discourse about the "illegal immigrants" and fear of an increasing population of foreign-born in our country, when we want to build high walls to keep people out, and when we want to push our religion, politics, and multinational corporations on the rest of the world at the point of a gun, we should have no doubt that we are becoming a fascist nation.

In the mid-20th Century we saw the symbiosis of corporations and fascist governments. As corporate political power has expanded to such an extreme, a fascist government and powerful multinational corporations can now build themselves into a feeding frenzy of power.

And - most worrisome - when we deny the development of fascism as a possibility because "we are the best society, the best nation" - "under God" - and shouting "USA-USA-USA" - that should make us stop and shudder deep within our souls.

Sinclair Lewis said: "When fascism comes to America, it will be wrapped in the flag and carrying a cross".

But even though most Americans do not see us moving towards a fascist state, the underpinnings of fascism are making them very uncomfortable. Americans want to move back to a government that doesn't torture, make war, and spy on its citizens. Americans want to move back to a government that cares for its people, that is tolerant, that is helpful. A government that takes all opinion into account and that can be criticized without lashing out. That is the promise - or at least the expectation - from Obama, and that is why voters are turning away from Romney and Giuliani who promise more of the same - "increased military and reduced taxes" (read reduced public services) and who cannot even view issues such as immigration with compassion. This November marks either the turning of the fascist tide, or the beginning of a very terrible time for the world. We can - and we must - make a difference.

-sb

"The Economy is Great" he said. "RUN" I shouted to the others!

What is my problem with the current administration, he asked. "The economy is great, the unemployment rate is low, things couldn't be better!" he said. I was dumbstruck. I wasn't sure what cave he had just emerged from. I wouldn't consider a budget deficit of 600 billion dollars to be a sign of a great economy, I answered. "That is nothing - not a problem" was his quick reply.

I had just confronted a giant-walleted neocon (Neoconus greediosis), and although I had survived the encounter, it left me shaken to my core. I knew in my heart that if there were many more like this out there, life as we know it could be in grave danger.

For those on the far right who do not believe in evolution, I offer up the neocon as proof that evolution does indeed happen. Evolved from early Republican man, the neocon has developed a vision deficit that sees only tax relief but which is no longer able to focus on a budget deficit. Its brain has evolved so that a bloated military budget no longer causes irritation to its conservative nerve roots. In fact, while its predecessors might have balked at nation-building and using the federal government to push its moral agenda on the entire world, the neocon is able to do so without even blinking an eye. Its tough skin is not penetrated by sharp words cast by the starving and homeless, and its heart has evolved to be steeled against hordes of children without access to healthcare - something which had been known to occasionally weaken the heart of its predecessor, Republican man. Indeed, Neoconus greediosis is a model of adaptation for not just survival but for domination.

The neocons narrowed visual field enables it to travel with herds of pro-life creatures and yet still kill thousands without seeing any hypocrisy. It thinks nothing of visiting tropical Florida to protect the brain-dead and yet ignores those facing death because they have no health insurance. Fortunately, the neocon has evolved so that it cannot see its own reflection in the mirror. And it truly believes that the economy is great because it cannot count below $200,000. When it counts the economy above $200,000 yearly income, all it can see is colored green.

And the most amazing skill that has evolved with the neocon to help him survive is that he can smell creatures that earn less than $200,000 per year, and he gains nourishment by sucking their blood. Although early neocons were crude in their blood-sucking skills, the later-day neocon has evolved with the ability to suck the lifeblood from others with subtlety while his victims are lulled off to sleep by his soft-toned reassurances. "The rising tide raises all boats" he whispers into their ears. Every day his victims are a little weakened, but have no recollection of what happened to them.

That is the truly scary thing about the Neoconus greediosis – this specie could take over the country not with a bang but a whimper. I can only hope that I personally survive to see the day when they no longer have enough victims upon which to feed and must begin eating their young and feeding upon themselves.

Veteran's Health Crisis

Almost 13% of veterans – 1.8 million - lack health insurance, and many who might be eligible for care in VA facilities do not live close enough to one to utilize it. Like most Americans without health insurance, most of these vets are employed but their employer does not offer insurance and they cannot afford to purchase it privately. In addition, 3.8 million family members of these vets lack health insurance.

The crisis in veteran’s care is only getting worse, and will get much worse as mental and physical problems associated with the Iraq war continue to increase. When elected to congress I will propose a fairly straightforward solution: the creation of “Medicare Part V”. Medicare Part V would have benefits equal to those provided by VA coverage, but would reimburse any Medicare provider (physicians, hospitals, labs, physical therapy centers, imaging facilities, etc.). Any veteran who does not have health coverage could then receive coverage through Medicare Part V. Any veteran who lives far from a VA facility who would prefer to get care through local providers could “opt-out” of the VA System and select Medicare Part V instead. We should decide also if we would want to extend this to uninsured families of veterans, or at least allow them to purchase coverage through this system if they cannot get private coverage. This would lessen the pressure on the VA system and remove the backlog of vets waiting to get care.

Free Enterprise in Healthcare?

No one will argue that free enterprise doesn’t stimulate innovation and hard work. One of the biggest challenges we face in health care is how to provide health care to all Americans while maintaining a system which fosters innovation, research, and development. But when health care is out of the financial reach of many Americans (over 42 million receive Medicare, another 42 million receive Medicaid, and over 46 million have no insurance) one has to wonder where the profit is going to come from – and why their must be profit – if everyone is to be covered. Rudy Giuliani recently compared health care to plasma TV’s – saying that all we need is more people buying health insurance through the private sector to drive down the cost – “just like the cost of plasma TV’s has come down over the past few years.”

Rudy – I got news for you: American health care is NOT an example of free enterprise! There is no competition! Let’s look at some examples: About 25 years ago Tagamet came out for treating ulcers. A wonderful drug, it was quite pricy for the time at $65 per month. But people bought it because it worked – it was a wonder drug. Soon Zantac came out, which worked as well but had fewer drug interactions, so it quickly became very popular also. Over a few years Pepcid and Axid came out. When their drug reps would come into my office to chat me up about their products, they would compare them favorably to Zantac. Not better, but just as good. I would always ask – will they cost my patients any less than Zantac? I was always told that they were priced “comparably” – meaning the same! I always told the reps to tell their corporate bosses that if their product were priced competitively I would prescribe it. Pepcid and Axid never gained much market share because they never competed. Eventually Pepcid was allowed to market an OTC (over-the-counter) version which was a 10mg tablet, keeping the 40mg tablet by prescription only. The pharmacy cost for a 40mg tablet (prescription) was $2.60, or $78 per month. The pharmacy cost for a 10mg tablet (over-the-counter – with competition from Maalox, Mylanta, Tums, Rolaids, Zantac 75, etc.) was only $0.20! So there was never any price competition for the prescription drug – only for the one people paid for out of their own pockets. Regardless of this rip-off, insurance companies continued to happily pay the $78 per month for 40mg Pepcid. Likewise, many insurance companies paid $50 for a tube of “Lotrisone” cream – a patented mixture of common steroid and antifungal creams, each of which could be purchased for $2 or less. Of course the insurance companies get secret rebates from the drug companies, so we never really know what they pay for a given medication. This keeps the normal retail price high so that those without insurance get screwed. This is only legal because it is arranged through intermediary shell companies called “Pharmacy Benefit Managers”, or PBM’s.

Every service in health care costs far more to the cash-paying patients than is charged to insurance companies. A CT scan at our local hospital costs $3,000, when no insurance company pays more than about $650. A new-patient visit with a specialist may set you back $420, when Medicare pays them $160 or so. In a free-enterprise system you would think that cash would be more valuable than a future payday that requires billing and record-keeping expenses. I had a patient who needed a stress test – he called the hospital to see what it would cost him – and they could not or would not tell him! He was supposed to just wait until he received the bill to know what the cost would be! Likewise, if you are in the hospital or the office, and I or another doctor tells you that you need a CT scan or a consultation from a specialist, do you get to price-shop (or shop quality?)? THAT would be free enterprise!

Rudy thinks that with competition health care will become cheap like plasma TV’s. Well, Rudy, a LOT of old folks buy hearing aides, and the price of those is now $2-3,000 each – about the only electronic device that has gotten MORE expensive! Interestingly, the VA system, which provides hearing aides to about a million veterans per year, and which negotiates for the best price, pays about $300 a unit for hearing aides. And meanwhile Dave Weldon voted to prevent the U.S. government from negotiating lower drug prices for the Medicare Program. Our current approach to health care has failed an unacceptable number of Americans. It is time for a serious look at the system.

Bush just waiting for the poor to die?

Nine million children in this country lack health insurance. To not have health insurance means they miss well-child checks and may rely on the emergency room for care when they are ill. These aren't necessarily homeless kids - with more and more jobs in this country not offering health insurance, it should be no surprise that 70% of kids without health insurance have at least one parent who works. Kids with chronic diseases may not be able to get the medications and the care they need to stay well. In a country as rich as ours, this is intolerable. The Medicaid Program exists to help the poorest of the poor, and the Children’s Health Insurance Program (S-CHIP) was created to help those not-quite-so-poor get health care. Congress recently voted – both Republicans and Democrats - to extend eligibility for this program to families of four earning up to around $40,000 per year. This would be funded by an increase in cigarette taxes – a move which in itself will benefit public health by reducing smoking, especially among teens and young adults. The majority of Americans support government assistance to help families obtain health coverage. Our president, however, feels that this is a threat to the free enterprise system – a White House spokesman said: “This will have the effect of encouraging many to drop private coverage, to go on the government-subsidized program”. Apparently Dave Weldon agrees with Bush, since he voted against the CHIP expansion. Bush has threatened a veto, and there may be enough votes to override his veto. So now he has ordered the CMS to adopt new rules which would prohibit any state from expanding services unless they have provided services to 95% of those under the poverty level. NO state has that high a participation rate, so he again is trying to get around the desires of congress and the American people.

Also – I have news for Weldon and the president. I am self-employed, and I buy health insurance for my family of four. It is a standard plan – nothing fancy and no dental insurance included. I pay almost $12,000 per year for this. Do Dave Weldon and President Bush really think that a family earning $35,000 or even $40,000 per year can buy health insurance? It just isn’t possible. Long ago our country realized that education needed to be publicly subsidized – that there was a basic injustice in keeping education out of the reach of poor kids. (Dave Weldon would like to do away with public education also)

Kids have no control over their situation. Shouldn’t every child in this country have health care?