Friday, August 28, 2009

Health Care Reform: A Pandemic of Ignorance and Fear

I have just finishing reading "Naples in the Time of Cholera 1884-1911." It is a masterful historical look at the spread of cholera in Naples, Italy during the late cholera pandemics that swept large parts of the world in the 19th and 20th centuries. The parallels between today's vocal citizen opposition to change in our problem-plagued American health care system and the frightened ignorance of fist-shaking citizens in Naples 125 years ago are worth a few words.

In Naples, filth and squalid living conditions as well as medical ignorance of just what caused cholera made for a deadly combination. This was worsened by politics, class distinctions and long a standing public distrust of authority in 1884. Italy had just been unified in 1871, with Rome as its capital, into a single republic. Naples had been under the domination of so many other countries and powers since its founding by the Greeks in about 430BC that its citizens didn't trust politicians for a moment. And with good reason, with the hapless poor and elderly always the first to get the short end of any political stick.

The USA, just an upstart of a country compared to the ancient grand old former empires of Europe, nonetheless shares the commonality of basic human nature with Italy and certainly Naples when it comes to anger generated from ignorance and fear of change. And we also share with Naples the existence of conniving politicians, greedy business interests, a medical elite fighting amongst itself, and organized religion attempting to influence legislation.

Putting things into this kind of a time comparison, the 70 years we have been trying to get affordable access to health care for all Americans doesn't seem very long compared to how long old world countries have had to wait for things to happen.

As cholera spread throughout the slums and packed tenement houses of Naples, widespread anger fed by wild rumors and misinformation resulted from the heavy-handed treatment and cavalier approach by government to dealing with massive death and spread of the disease.

Rumor became fact in the minds of the non-elite sufferers that the rich were poisoning them "by spreading arsenic on their buildings at night" as a way to get rid of them. In both France and Italy the clerical right fanned the flames of the Vatican's prejudice to further stir up trouble for regimes they deeply disliked. The Jesuits called cholera "the chastisement of heaven' for those who strayed from toeing a strict Catholic line.

Involvement of religion here in the USA is most loudly heard through faith-based interpretation of when life begins and how that belief impacts health care for believers as well as non-believers. This line in the religious sand focuses most fiercely upon abortion rights. Obliquely, recent misinformation from conservatives includes nonsense and twisted interpretations warning of President Obama's "death panels" that would decide who lives and dies ... sort of a modern day rumor akin to government poisoning the poor in Naples to get rid of them.

The human nature parallels between health care based fear and public demonstrations here in the USA and those in bella Napoli more than a century ago are not hard to see. Lines can be drawn between the socio economic and educational levels of the loudest and angriest of those in Naples in the 1800's and the many frightened and ignorant fist shakers at the hot summer 'Town Hall' meetings across America in recent weeks.

The misinformation and rumors could have been a lot worse in Naples had there been access to email and TV.

In Naples there was no fact-checking to counter misinformation, so the wildest and most improbable fear-mongering flashed like a wildfire through the disease ridden quarters of the old city.

Today we do have impartial fact checking and the Annenberg Public Policy Center's just posted results of their non-partisan research into recent falsehoods and manipulation by those with lots to lose from a more level health care insurance playing field:

Twenty-six Lies About H.R. 3200
"A notorious analysis of the House health care bill contains 48 claims.
Twenty-six of them are false and the rest mostly misleading. Only four are true."

It is worth a quick CLICK ON THE LINK to see this dispassionate debunking of chain e-mail and blathering talking head nonsense.

The irony of my Naples comparison is that Italy ranks near the top of the list of countries with the most equitable and highest level of quality health care today, while the USA is pitifully way down the list ... and it is America's world-recognized low standing that current health care reform seeks to finally remedy.

graphic by Larry Ray
"Naples in the Time of Cholera 1884-1911" by Frank M. Snowden

Thursday, August 13, 2009

Town Hall Crazies : Too Nuts for Jerry Springer?

Out of Control Town Hall mobs:
Probably too much
even for Jerry Springer!

It would not surprise me if former politician and TV show host, Jerry Springer, would even ban some raving and ranting health care town hall meeting audience members from his show. Springer, known for the raucous and outrageous behavior of his show's guests is a former Mayor of Cincinnati and knows the politics of stage-managed dissent. Many recent summer break town hall meetings televised on cable TV and the evening news look very much like the Jerry Springer show . . . complete with beefy security guards hauling off screaming, threatening audience members.

News and opinion columns are full of reasons why rude sign-toting mobs are shouting down their U.S. Senators and Congressmen at town hall meetings across the nation. Common findings about this rage and nastiness show much of it has to do with more than constructive health care debate. Almost all the red-faced, loud, finger-pointing folks are up in arms over totally incorrect or out of context information they believe to be true. Many also erupt over things to do with immigration and topics other than health care. And the meetings may also be serving as a pop-off valve for racial hatred in some instances.

Senator Arlen Specter was assailed by 59 year old Craig Anthony Miller who did not like the seating plan for the meeting. He bellowed at Specter, ""One day, God is going to stand before you and he's going to judge you!" Then he walked out of the meeting. Later Specter noted, "There is more anger in America today than any time I can remember."

Much of this disinformation is fed by mindlessness opportunists like Sarah Palin and her Twittered warning of Obama "Death Panels," and from endless talking-point emails loaded with falsehoods and half-truths.

I was recently emailed "20 Questions for your Congressman . . . what to ask at a Town Hall Meeting." The list is the work of Robert Tracinski, and distributed by the right-wing "TIA Daily." I looked up Tracinski and remembered his ultra-conservative ravings from the presidential campaign. He was opposed to McCain for president for not being a true conservative and was a Rudy Guliani champion. In January 2008 wrote:
  • So how is he (McCain) supposed to stand up to the Democrats on any part of their socialized medicine agenda? In addition to fighting the Democrats on socialized medicine, a Republican president would also have to fight in Congress for the extension of President Bush's tax cuts, which are set to begin expiring in 2009 and 2010.
Tracinski's talking-point list is full of total fiction and fear mongering. Here's an example:
  • When the government starting(sic) portraying people in the financial industry as villains and started limiting their pay and subjecting them to more regulations, banks reported a "brain drain" as smart and well-educated people left the industry or went overseas looking for better pay and less stress. But the term "brain drain" was originally coined in the 1960s when doctors and medical researchers left Britain to escape socialized medicine. Aren't you afraid we might see the same kind of brain drain from the medical profession here in America?
That simply is not true at all, but is typical of chauvinistic claims ignorant Americans love to make about "foreign countries" they know nothing about. Tired of hearing their National Health Service, England's cheap, efficient and universal health-care system smeared in the American debate, the Brits have started responding to them with a lively Twitter forum, ""welovetheNHS."

A serious example of chauvinistic ignorance is the conservative Los Angeles, California based, "Investor's Business Daily" which asserted in an editorial, "People such as scientist Stephen Hawking wouldn't have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless."

This prompted a quick counter response from London's "Guardian," by Hugh Muir an editorial columnist for the paper. Muir, contacted the internationally famous, wheelchair-bound Prof. Hawking for comment which was easy to do since Muir and Hawking are both UK citizens, a fact the LA IBD clearly did not know. Muir reported on his contact with Professor Hawking:
  • We say his life is far from worthless, as they do at Addenbrooke's hospital, Cambridge, where Professor Hawking, who has motor neurone disease, was treated for chest problems in April. As indeed does he. "I wouldn't be here today if it were not for the NHS," he told us. "I have received a large amount of high-quality treatment without which I would not have survived." Something here is worthless. And it's not him. Investor's Business Daily, incidentally, has now deleted the offending line from their editorial and published a correction. "This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK," reads the addendum.

    But that's not a correction at all. IBD never claimed that Hawking didn't live in the UK. It claimed that the NHS would judge him worthless and leave him to die. That was what was wrong. And that has not been corrected by the IBD -- which says a lot about how much trust readers should place in their work. Instead, it has been corrected by Hawking himself.
This kind of calculated misinformation easily leads to anger and violence. Fortunately this unforgivable US editorial garbage was called to task. All too many Americans still repeat the old saw that America has "the best health care in the world," which of course has not been true for decades when looked at in detail. America, indeed, has some of the very best physicians and surgeons in the world and amazing medical technology. But when you look at the overall health care provided to our citizens, we are failing miserably. The statistics are nothing to be proud of:

US expenditure for health care (2008) was $2.4 trillion, and estimated to be $4.3 trillion by 2017. 46 million uninsured and another 25 million underinsured. 18% of US citizens can’t pay for medicines or health care their family needed in last 12 months (April, 2009).

A telling and truly sad confirmation of this lack of health care for all Americans was published in The New York Times last night, August 12th. The story's headline is "Thousands Line Up for Promise of Free Health Care."

Hundreds of volunteer doctors, dentists, optometrists, nurses and others have set up a huge M*A*S*H unit in an arena just outside Los Angeles. For eight days they hope to help more than 8,000 people. "Remote Area Medical" is offering basic medical exams, mammograms, eye exams and glasses as well as dental services, all offered for free from medical professionals who understand the huge problem too many Americans face.

Of the thousands standing in lines for hours, many have some sort of insurance but it does not cover all their needs. Most still cannot afford a dentist, preventive medical tests or the cost of an eye exam and glasses.

It is extremely generous for individual physicians, nurses and others to make this all possible a few times a year. But this Tennessee based group is now spending more time helping the under served in America than in rural India where they have helped for years.

You would never see such a pitiful band-aid approach to health care anywhere in Europe, Japan, and other modern societies where all citizens are guaranteed quality universal health coverage. The USA is a singular holdout, not placing a high value on guaranteed quality health care for all its citizens.

Shouts of "socialized medicine" by conservatives clearly mean that they feel many Americans actually do not deserve quality health care. Shouting down this obvious need for universal health care, especially if the rich and powerful are urging frightened people to do the shouting, may appeal to Jerry Springer fans but for most reasonable Americans it is a disgusting show.

graphic by Larry Ray with Apologies to Jerry Springer

Monday, August 3, 2009

Beneath Naples, Italy via Radio New Zealand!

The reach of the internet continues to amaze me. I have long had a fascination with the "Parallel City" beneath Naples, Italy since the early 1960's when I lived there. Called the "sottosuolo," it is a maze of giant cavities, tunnels, aqueducts, passageways, ancient Greek tombs, WWII air raid shelters and more.

Stationed in Naples many years ago, I became fascinated with the mysterious network below the city, which few locals knew much about at all. For many years I regularly returned to Naples to see friends and pursue exploration of the wonders below the city. In recent years I have translated articles into English on a wonderful web site operated by my urban speleologist friends in Naples.

The English Language version has resulted in a much wider knowledge of the marvels beneath the city including attracting the interest of regular visitors from around the world, National Geographic who did a great article with stunning photos, a travel article in The New York Times a couple of months ago, and a phone call a couple of weeks ago from Radio New Zealand wanting to do an interview with me for their popular "Nights" program.

That interview was broadcast August 3, down under in New Zealand and is now available in streaming form at the link below through the marvel of the internet. Imagine the improbability of Radio New Zealand interviewing an old guy in Gulfport, Mississippi about a secret world beneath Naples, Italy!

I believe you will enjoy the interview. Chris Whitta, the program host, is personable and asked great questions. So take a few minutes and come enjoy the mysterious "Sottosuolo" of Naples.


Graphic by Larry Ray - RNZ Logo©