How many times am I going to have to write about this? I wrote about it after the shooting in Arizona when Congresswoman Giffords was shot. I wrote about it when Trayvon Martin was shot. And here I am writing about it again.
At first, I thought perhaps a little time was warranted...that I’d write about it next week. Then I read this excellent piece by E.J. Dionne, in which he says that discussing our strange obsession with guns and implementing reasonable gun laws isn’t any sort of exploitation of the tragedy (as the NRA likes to howl). It is recognizing a major problem in our country and wanting to do something about it. It is understanding that because of our lax gun laws, people who shouldn’t be are able to easily obtain guns. Even assault weapons designed to kill large numbers of people, and mass quantities of ammunition and high capacity clips so that as many as possible can be killed before having to reload. It is saying that any reasonable person thinks this is UNreasonable and wants to see at least an attempt to stop these sorts of massacres. Questioning our gun laws is a sane response to an insane situation. Continuing to insist on the ability of everyone to purchase whatever type of gun they want and whatever large quantities of ammunition they want is NOT a sane response.
I really don’t know how many times I can write about our bizarre gun worship in this country. I saw the usual tired responses yesterday...that guns don’t kill people, people kill people. That if everyone in that theater had been armed, the guy wouldn’t have gotten away with it. Let’s look at both of those for a moment, shall we?
Yes, the person who killed 12 people and wounded 58 was a human being. He was the one who pulled the trigger. However, you don’t see 70 casualties brought about by one person wielding a knife or throwing rocks. This is a ridiculous argument, because semi-automatic weapons are designed to rapidly fire numerous bullets, and injure as many people as possible. A madman coming in there with a knife would have been immediately taken down by several patrons after assaulting one person. Hell, I would have piled on. Instead, he was able to assault 70. SEVENTY.
The argument that if people in the audience had been carrying he wouldn't have been able to get away with it doesn’t hold up, either. The guy was in full body armor. Someone’s little .22 or .38 wouldn’t have stopped him for a second, and even a .45 wouldn’t have stopped him for long. He was on a mission. It was probably not great lighting in there; there was tear gas; there was chaos. Does anyone really think that some person could have stood up in the confusion and managed to take this guy out? It’s probably more likely that anyone trying to fire at the shooter would have only ended up injuring or killing even more innocent people. As some of us were discussing yesterday, the average person—even if well-versed in gun usage—is not trained for that sort of extreme situation; police officers, SWAT teams, and other law enforcement officials undergo extensive training in order to handle such situations. We need to get away from the mentality that simply carrying a gun and knowing how to shoot it makes us invincible, or some kind of hero who will know exactly how to react in very extreme circumstances. It defies logic.
Some family members might say that my feelings about this are making my Dad roll over in his grave. Well, that’s obviously not literally happening. But I really don’t think he would be all that upset at what I have to say. I think we’d have a good discussion about it, and I think he’d probably understand my viewpoint. I know he’d be proud of me for thinking for myself, rather than accepting that this is the way it has to be in our country. I think he’d be appalled that this person was able to walk into a packed theater and assault 70 people, and I think I’d get him to grudgingly admit that this person should not have been able to buy a gun.
I’d advocate for everyone wanting to buy a gun having to undergo a psychological evaluation. I know that’s not going to happen, but simple background checks don’t seem to be cutting the mustard, do they? I also know that we aren’t going to ban handguns anytime soon, if ever, and we certainly aren’t going to ban hunting rifles. But wouldn’t it be a good start to restore the ban on assault weapons and high capacity clips? I think so. So I started that petition at the White House website in the link right there. Please think about it and consider signing it, and if you agree, please share it with your friends and family. If we get 150 signatures, it will move to public viewing, so that people all across the country can see it; if we get 25,000 signatures in 30 days, it will be considered by the administration. It might not come to anything...but shouldn’t we at least TRY?
I asked how many blog entries I need to write about this. That’s really not that big of a deal...I’ll write blog entries all the livelong day about it. A better question is how many massacres like this latest do we need to see before we do something to attempt to curb them? An even better question is how many innocent people do we need to see gunned down in cold blood, in the prime of life (some before their life has truly begun, as we learned today that a 6-year-old girl is among the dead), before we say enough is enough? How many?
Saturday, July 21, 2012
Thursday, July 19, 2012
I won’t say I told you so, but....
I did! I did!
A few days ago, I wrote about Team Obama’s Bain Capital attacks on Mittens. I said that it was pretty impressive and brilliant work on the part of Plouffe, Axelrod, or whoever came up with it (and it may have been a complete team effort). Apparently, I wasn’t the only one who was impressed. Mark Halperin of Time wrote this:
Yikes! I’m not sure I agree that Mittens will release more tax returns. After all, Mrs. Romney has said that “you people” (I guess that means me, too) have seen all we need to see. But “ruthless killing machine” is right on.
And we’ve still got almost four months of this to go. Good grief.
Tomorrow evening is a special treat, as we head out to hear my buddy Jim’s band, Cornerstone Blues Band, at Martha’s Midway Tavern. Their original drummer is back in town for a bit, so they’re playing at Martha’s and all the proceeds from the $5 cover charge will go to help the owner with her medical bills. Martha’s is a blues fixture in the area, a little hole in the wall that has hosted some big-time blues players over the years. We don’t plan on making a late night of it, because Ken’s been working some long hours, but we’re looking forward to hearing some great music, having a couple of beers, and seeing some friends. I hope some of my fellow lab rats will be able to come out for a bit!
A few days ago, I wrote about Team Obama’s Bain Capital attacks on Mittens. I said that it was pretty impressive and brilliant work on the part of Plouffe, Axelrod, or whoever came up with it (and it may have been a complete team effort). Apparently, I wasn’t the only one who was impressed. Mark Halperin of Time wrote this:
Pause for two beats and pay Prizzi's Honor-style homage to the ruthless killing machine that is the combined White House-Chicago operation.
They have parceled out their opposition research in a manner both strategic and tactical, selecting specific news organizations at times of their choosing to maximize the drip-drip-drip of the twin stories [Bain Capital and the tax returns]. They have used left-leaning Web outfits as recipients of over-the-transom gifts as effectively (cumulatively) as the Romney campaign uses Drudge. And they have seen the Boston Globe use its credibility to drive a ton of news.
The Obamans have dominated numerous consecutive news cycles since the last unemployment numbers came out. And there is more to come for sure. The Gang of 500 is confident it is just a matter of time before Romney relents and puts out additional years of tax returns, an eventuality that the Obama campaign will drag out for days. When some said that the Bain issue was burning out through its use by Newt Gingrich, Rick Perry, and others in the nomination fight, Chicago was quietly confident the matter could be easily revived with new information and heavy advertising—and Chicago was right. And, make no mistake, the Obamans are sitting on even more research that they will unfurl down the road.
Yikes! I’m not sure I agree that Mittens will release more tax returns. After all, Mrs. Romney has said that “you people” (I guess that means me, too) have seen all we need to see. But “ruthless killing machine” is right on.
And we’ve still got almost four months of this to go. Good grief.
Tomorrow evening is a special treat, as we head out to hear my buddy Jim’s band, Cornerstone Blues Band, at Martha’s Midway Tavern. Their original drummer is back in town for a bit, so they’re playing at Martha’s and all the proceeds from the $5 cover charge will go to help the owner with her medical bills. Martha’s is a blues fixture in the area, a little hole in the wall that has hosted some big-time blues players over the years. We don’t plan on making a late night of it, because Ken’s been working some long hours, but we’re looking forward to hearing some great music, having a couple of beers, and seeing some friends. I hope some of my fellow lab rats will be able to come out for a bit!
Wednesday, July 18, 2012
All by myself
If you were successful, somebody along the line gave you some help. There was a great teacher somewhere in your life. Somebody helped to create this unbelievable American system that we have that allowed you to thrive. Somebody invested in roads and bridges. If you’ve got a business—you didn’t build that. Somebody else made that happen. The Internet didn’t get invented on its own. Government research created the Internet so that all the companies could make money off the Internet. The point is, is that when we succeed, we succeed because of our individual initiative, but also because we do things together. There are some things, just like fighting fires, we don’t do on our own. I mean, imagine if everybody had their own fire service. That would be a hard way to organize fighting fires.
~~President Obama, at a speech in VirginiaTeam Mittens is making a big deal of one phrase in this paragraph: “If you’ve got a business—you didn’t build that.” Implying that Obama is anti-business, or denigrating business owners; that Obama says the government is what built that business, not the individual owner.
I honestly don’t think that Romney is stupid enough to believe that, so this is obviously a cynical and misleading attempt to portray the President as something that he is not. Yeah, surprising, I know. [eye roll] I’m not complaining, or asking for an apology, because I know this is politics as usual, and unlike some, I don’t whine about it.
However, this illustrates a very basic difference between the two sides here. Mittens distills it down to simplistic terms of black and white; President Obama is anti-business. See? He said so himself! Perhaps there are some who accept this on face value and don’t want to read beyond the sound bite, but that is not me. There is an easy willingness to accept the simple explanation, or to take the attitude of “every man for himself” (and I use gender specificity for a reason) and refuse to accept a philosophy of working together for the greater good of the country and of society. They pay lip service to cooperation, but they do not act on it. Anyone who is unable to pay their bills needs to find another job. Anyone who wants health insurance needs to find a job that offers it. Anyone who isn’t rich just isn’t working hard enough. Anyone who is unable to feed their kids is just lazy and wants a government handout. And any business owner who started that business is brilliant and an extremely hard worker who is oppressed by excessive regulations and built that business up all by his own goddamn self and doesn’t owe anyone anything ever and deserves to keep every bit of his hard-earned money and fuck the government for wanting some of it!
[deep breath]
Let’s get a couple of things straight. First of all, not everyone who is struggling is struggling because they’re lazy and don’t want to work; that’s actually a pretty small minority of people who try to game the system. Sort of like...oh, I don’t know...very rich business people who pay accountants to put their money in offshore accounts so that they don’t have to pay the tax percentage on their income that the rest of us saps have to. Yeah, kind of like that. The vast majority of people want to work. They want a fair wage for a job well done, and they want to be able to provide for their kids and buy a house and maybe have a fighting chance at that “American dream” that conservatives like to say President Obama is doing his best to destroy. Really? A child of mixed race, raised by a single mother and his grandparents, who grew up to become President of the United States, and THIS guy wants to destroy the American Dream?! Crackuh, PLEASE.
Second, please explain to me what the fuck happened to “we’re all in this together?” What happened to compassion? What happened to a rising tide lifts all boats? What happened to the ability to understand—and it’s really not all that hard to grasp the concept—that investment in infrastructure, research, and education benefits everyone? THIS IS WHAT FUELS OUR ECONOMY. This is what makes us great as a country: our tax dollars going towards building the roads and bridges that allow business owners to ship their goods all across the country; our tax dollars going towards grants and scholarships that will provide a high quality education for every child in this country, or every adult that chooses to further their education; our tax dollars funding grants for scientific research that will save the lives of millions—not just Americans, but everyone—and provide new energy sources that will heal our planet and make it a better place for all; and yes, our tax dollars helping those who are down on their luck and need a hand up so that they can get back to being a productive member of society—one who also pays taxes to fund everything mentioned above.
I honestly don’t understand how anyone can NOT understand that this is all interconnected. Our economy requires investment. Our bridges are crumbling. Our healthcare system is failing and leaving millions to die or go bankrupt. Our children are falling behind the rest of the world in education, especially in science. In order to keep and maintain a home, you need to invest not just in your monthly payments, but in the upkeep of the structure, the grounds, and the utility services. When you make these investments, you are helping your community by driving local businesses and the local economy. You are helping yourself. When our government makes these investments in our country, we drive local industries and economies, which in turn drives the national economy. We help ourselves. All of us...together. Not by ourselves.
Our President gets it, but it seems that many on the other side do not, and block his attempts to raise the rates slightly on the highest earners amongst us in order to fund and invest in our country. No one does it all by themselves, so an investment in our country is an investment for all of us. Why doesn’t the other side understand this? Could someone please explain the reason for this strange behavior?
Monday, July 16, 2012
Bain in the Ass
(A big thank you to my friend Steve D. for coming up with that title on a recent Bookface thread!)
Hooo boy. Ol’ Mittens has to be trying to remember exactly why he wanted to run for President in the first place right about now. It’s been a brutal few days for him, and it doesn’t look like it’s going to let up anytime soon.
In case you missed it, Team Obama has been hitting Romney hard on his involvement with Bain Capital. He claims he was done with Bain in 1999, when he went to Utah to work on the Olympics, but SEC filings show that he was listed as CEO and owner until 2002. Why does it matter? Well, aside from possibly lying about it, or misrepresenting his involvement, apparently Bain was involved in outsourcing jobs quite a bit after 1999. Team Obama is trying to show that he is not a job creator, but a job outsourcer. That’s the gist of it, anyway. Romney is scrambling to address all this, and is now demanding an apology.
This is all pretty fascinating to me, mostly because it’s my guy who has the other guy on the ropes and is pummeling him relentlessly. David Frum also uses a boxing analogy in his opinion piece on the matter: “Wham. The first attack on Romney had been a jab, dropping Romney's guard against the haymaker.” Basically, Team Mittens walked right into the trap that was brilliantly laid by Team Obama. Now it’s a matter of trying desperately to do damage control, but the more Mittens talks about it, the worse he sounds. (His demand for an apology from President Obama prompted Rahm Emanuel to tell Romney to “stop whining.” If he can’t handle an attack ad, how is he going to handle harsh words from various world leaders?)
It also got all caught up somehow with Romney’s refusal to release more than two tax returns, which is its own shitstorm for him. Even conservatives like George Will are telling Romney to release several years’ worth, and it is causing the kind of speculation you can find in this New Yorker piece by John Cassidy. The question ultimately comes down to “What is he hiding?” As some have said, Romney released 23 years of tax returns to the McCain campaign when being vetted for vice-president, and McCain ended up picking...Sarah Palin?! The general consensus is that there has to be something damaging in them for him to double down on refusing to release more than two years.
In a pathetic attempt to change the subject, the Drudge Report released a bogus and irresponsible report that Condoleezza Rice was at the top of the list for Romney’s VP pick. Really? The pro-choice, pro-immigration reform Rice who had a huge part in the Iraq war and is still closely associated with W, currently at #1 with a bullet as the worst President in history? THAT Condoleezza Rice? (For the record, I don’t hate her. I think she’s a smart, strong woman who I happen to disagree with on quite a few things.) Drudge is widely known to be firmly entrenched in Romney’s pocket (I could have used another word...you’re welcome.), so this was an obvious and cynical attempt to divert attention from Bain and from Mittens’ tax returns. For shame.
Is it dirty politics? I would say it’s rough, but I wouldn’t say it’s dirty. Looks to me like someone is lying here, and I don’t believe it’s my guy. You’ll pardon me for not crying, “Leave Mittens aloooooone!” when the Republicans have been calling Obama everything from a Kenyan to a socialist. I don’t have a whole lot of sympathy.
I am also in awe of whoever it was on Team Obama who came up with this attack. David Plouffe? David Axelrod? Jim Messina? Maybe it was a concerted effort. Whoever it was crafted it perfectly, and I’m sure they were laughing with delight as Romney backed himself into a corner. They’re probably still laughing. I thought the 2008 campaign was brilliant, but this is on another level. I don’t believe that Romney has managed to define himself with the majority of people (some of my friends disagree), and Team Obama has gone a long way towards defining Romney as a plutocratic fat cat who wants to help the rich more than he wants to help the poor.
However, I realize that there are still four months to go before the election. I will enjoy this brief moment of schadenfreude while I can, but I won’t gloat forever. There is plenty of work to be done.
This has been pretty fun, though!
Hooo boy. Ol’ Mittens has to be trying to remember exactly why he wanted to run for President in the first place right about now. It’s been a brutal few days for him, and it doesn’t look like it’s going to let up anytime soon.
In case you missed it, Team Obama has been hitting Romney hard on his involvement with Bain Capital. He claims he was done with Bain in 1999, when he went to Utah to work on the Olympics, but SEC filings show that he was listed as CEO and owner until 2002. Why does it matter? Well, aside from possibly lying about it, or misrepresenting his involvement, apparently Bain was involved in outsourcing jobs quite a bit after 1999. Team Obama is trying to show that he is not a job creator, but a job outsourcer. That’s the gist of it, anyway. Romney is scrambling to address all this, and is now demanding an apology.
This is all pretty fascinating to me, mostly because it’s my guy who has the other guy on the ropes and is pummeling him relentlessly. David Frum also uses a boxing analogy in his opinion piece on the matter: “Wham. The first attack on Romney had been a jab, dropping Romney's guard against the haymaker.” Basically, Team Mittens walked right into the trap that was brilliantly laid by Team Obama. Now it’s a matter of trying desperately to do damage control, but the more Mittens talks about it, the worse he sounds. (His demand for an apology from President Obama prompted Rahm Emanuel to tell Romney to “stop whining.” If he can’t handle an attack ad, how is he going to handle harsh words from various world leaders?)
It also got all caught up somehow with Romney’s refusal to release more than two tax returns, which is its own shitstorm for him. Even conservatives like George Will are telling Romney to release several years’ worth, and it is causing the kind of speculation you can find in this New Yorker piece by John Cassidy. The question ultimately comes down to “What is he hiding?” As some have said, Romney released 23 years of tax returns to the McCain campaign when being vetted for vice-president, and McCain ended up picking...Sarah Palin?! The general consensus is that there has to be something damaging in them for him to double down on refusing to release more than two years.
In a pathetic attempt to change the subject, the Drudge Report released a bogus and irresponsible report that Condoleezza Rice was at the top of the list for Romney’s VP pick. Really? The pro-choice, pro-immigration reform Rice who had a huge part in the Iraq war and is still closely associated with W, currently at #1 with a bullet as the worst President in history? THAT Condoleezza Rice? (For the record, I don’t hate her. I think she’s a smart, strong woman who I happen to disagree with on quite a few things.) Drudge is widely known to be firmly entrenched in Romney’s pocket (I could have used another word...you’re welcome.), so this was an obvious and cynical attempt to divert attention from Bain and from Mittens’ tax returns. For shame.
Is it dirty politics? I would say it’s rough, but I wouldn’t say it’s dirty. Looks to me like someone is lying here, and I don’t believe it’s my guy. You’ll pardon me for not crying, “Leave Mittens aloooooone!” when the Republicans have been calling Obama everything from a Kenyan to a socialist. I don’t have a whole lot of sympathy.
I am also in awe of whoever it was on Team Obama who came up with this attack. David Plouffe? David Axelrod? Jim Messina? Maybe it was a concerted effort. Whoever it was crafted it perfectly, and I’m sure they were laughing with delight as Romney backed himself into a corner. They’re probably still laughing. I thought the 2008 campaign was brilliant, but this is on another level. I don’t believe that Romney has managed to define himself with the majority of people (some of my friends disagree), and Team Obama has gone a long way towards defining Romney as a plutocratic fat cat who wants to help the rich more than he wants to help the poor.
However, I realize that there are still four months to go before the election. I will enjoy this brief moment of schadenfreude while I can, but I won’t gloat forever. There is plenty of work to be done.
This has been pretty fun, though!
Sunday, July 15, 2012
A tough but good read
Since I’m between books for a moment, I decided to try to get caught up on back issues of Time magazine. I read Joe Klein’s cover story from the June 11 issue (wow, I am really behind!), “The Long Goodbye.” (I’m not sure if that link will provide the entire story to you...it might be available only to subscribers to the magazine. But if it gives you the whole thing, it is well worth the read.)
In his article, KIein writes honestly about the difficulties of losing both of his parents to dementia and other physical ailments last year. It was the often usual progression of a slow decline, with failure to take medications correctly, followed by a rapid descent into frequent medical problems, confusion, and in the case of his father, anger, belligerence, and stubbornness about how much help he needed. It was heartbreaking, and it must have been incredibly hard on Joe and his family.
He also wrote about the care they were able to get, through the Geisinger Medical Center in Pennsylvania. Geisinger uses the method that other progressive clinics (like Mayo and the Cleveland Clinic) are beginning to use: exploring and researching patient outcomes, with the ultimate goal of quality of life—and of death.
I couldn’t help but be reminded of my own father’s death two and a half years ago. Klein and his family were faced with the decision of whether or not to insert a feeding tube for his mother, and whether or not to rehydrate his father when his kidneys began to fail. The staff at Geisinger took a realistic approach to such end of life decisions, and gave Klein honest assessments of what was happening. When Klein debated whether or not to add a “do not resuscitate” order to his father’s file, a doctor pointed out that in a recent fall, his father had broken two ribs; if they were to try to resuscitate him, they would probably break all of his ribs. Klein added the DNR order.
A few points here. First, this is a good reminder that our medical technology has sometimes exceeded our realities. In other words, just because we CAN do something, doesn’t mean that we SHOULD. Are we taking whatever means necessary to keep a loved one alive simply because we don’t want to let them go, or are we making the best decision for them? As I said, it made me think about what happened with my Dad. When the doctors were honest with us—like Klein, I really appreciated their honesty—and told us that there was no chance of Dad recovering, I think we all knew that we had to let him go. Trying to keep him hanging on would only be selfish and thinking of our reluctance to say goodbye to him...it wouldn’t be giving him any quality of life.
Second, this is yet another reason why I loathe Sarah Palin (there are so many!). She tried to portray end-of-life counseling as “death panels,” and that couldn’t be further from the truth. It is a way for doctors, patients, and families to talk honestly about their wishes, and how they want decisions to be handled if they are incapable of making them on their own. I urge everyone to have this conversation with their loved ones. I will be forever grateful to my Dad that he had the courage to talk to me about such things, and I’m glad I had the courage to listen. I’d say something like, “Well, we don’t need to worry about that for a long time, because we want you to stick around for a while!” But I was listening, and because he told me that he didn’t want to be hooked up on life support if something were to happen to him, it made it easier to sign the papers with my Mom and my sisters to remove him from life support and let him go. Such decisions are painful enough as it is, and the fact that I had talked about it with both my Dad and Mom made it a tiny bit easier to take. Ken and I have also expressed our wishes to each other, and we have living wills.
So here is a big hearty FUCK YOU to Sarah Palin for perpetuating this horrible lie, and for discouraging people from having these discussions.
Finally, this is one of the reasons I am a firm supporter of the Affordable Care Act. Although they bowed to pressure and unfortunately removed the end-of-life counseling provision, the ACA attempts to move caregivers towards a more outcome-based model rather than a fee-for-service model. Expanded electronic medical records capability—records that travel with a patient—is part of that. I saw duplication of services all the time in the lab. More often than not, it was because the doctors didn’t have easy access to full records, so we’d see multiple computer encounters with cultures duplicated in the same day. If they can’t get their hands on them easily, they’re going to cover all the bases and order another test or culture. The model used by Geisinger and Mayo and others includes case workers who manage the care of patients. They don’t make life or death decisions for them, but they counsel the patient as much as possible and maintain frequent contact with the patient’s family to keep them informed. Knowledge is power, and honesty is a necessity for such decisions.
This sort of outcome-based care saves money, but more importantly, it usually provides a more peaceful end to the life of those we care most about. Shouldn’t that be our ultimate goal?
In his article, KIein writes honestly about the difficulties of losing both of his parents to dementia and other physical ailments last year. It was the often usual progression of a slow decline, with failure to take medications correctly, followed by a rapid descent into frequent medical problems, confusion, and in the case of his father, anger, belligerence, and stubbornness about how much help he needed. It was heartbreaking, and it must have been incredibly hard on Joe and his family.
He also wrote about the care they were able to get, through the Geisinger Medical Center in Pennsylvania. Geisinger uses the method that other progressive clinics (like Mayo and the Cleveland Clinic) are beginning to use: exploring and researching patient outcomes, with the ultimate goal of quality of life—and of death.
I couldn’t help but be reminded of my own father’s death two and a half years ago. Klein and his family were faced with the decision of whether or not to insert a feeding tube for his mother, and whether or not to rehydrate his father when his kidneys began to fail. The staff at Geisinger took a realistic approach to such end of life decisions, and gave Klein honest assessments of what was happening. When Klein debated whether or not to add a “do not resuscitate” order to his father’s file, a doctor pointed out that in a recent fall, his father had broken two ribs; if they were to try to resuscitate him, they would probably break all of his ribs. Klein added the DNR order.
A few points here. First, this is a good reminder that our medical technology has sometimes exceeded our realities. In other words, just because we CAN do something, doesn’t mean that we SHOULD. Are we taking whatever means necessary to keep a loved one alive simply because we don’t want to let them go, or are we making the best decision for them? As I said, it made me think about what happened with my Dad. When the doctors were honest with us—like Klein, I really appreciated their honesty—and told us that there was no chance of Dad recovering, I think we all knew that we had to let him go. Trying to keep him hanging on would only be selfish and thinking of our reluctance to say goodbye to him...it wouldn’t be giving him any quality of life.
Second, this is yet another reason why I loathe Sarah Palin (there are so many!). She tried to portray end-of-life counseling as “death panels,” and that couldn’t be further from the truth. It is a way for doctors, patients, and families to talk honestly about their wishes, and how they want decisions to be handled if they are incapable of making them on their own. I urge everyone to have this conversation with their loved ones. I will be forever grateful to my Dad that he had the courage to talk to me about such things, and I’m glad I had the courage to listen. I’d say something like, “Well, we don’t need to worry about that for a long time, because we want you to stick around for a while!” But I was listening, and because he told me that he didn’t want to be hooked up on life support if something were to happen to him, it made it easier to sign the papers with my Mom and my sisters to remove him from life support and let him go. Such decisions are painful enough as it is, and the fact that I had talked about it with both my Dad and Mom made it a tiny bit easier to take. Ken and I have also expressed our wishes to each other, and we have living wills.
So here is a big hearty FUCK YOU to Sarah Palin for perpetuating this horrible lie, and for discouraging people from having these discussions.
Finally, this is one of the reasons I am a firm supporter of the Affordable Care Act. Although they bowed to pressure and unfortunately removed the end-of-life counseling provision, the ACA attempts to move caregivers towards a more outcome-based model rather than a fee-for-service model. Expanded electronic medical records capability—records that travel with a patient—is part of that. I saw duplication of services all the time in the lab. More often than not, it was because the doctors didn’t have easy access to full records, so we’d see multiple computer encounters with cultures duplicated in the same day. If they can’t get their hands on them easily, they’re going to cover all the bases and order another test or culture. The model used by Geisinger and Mayo and others includes case workers who manage the care of patients. They don’t make life or death decisions for them, but they counsel the patient as much as possible and maintain frequent contact with the patient’s family to keep them informed. Knowledge is power, and honesty is a necessity for such decisions.
This sort of outcome-based care saves money, but more importantly, it usually provides a more peaceful end to the life of those we care most about. Shouldn’t that be our ultimate goal?
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