Monday, August 1, 2011

Farewell, Democrats

Writing in the Sunday New York Times (7/31/11), Stanley Greenberg, a pollster, noted "There is popular support for the policies of the Democratic Party, but little trust in its ability to execute them."

This brings to mind a conversation I had with a patient the other day, a man who is a roofer, who has a health insurance policy which costs him $100 a month and it has a $6,000 deductible. He had resisted getting some lab work I wanted because his prior lab bill was $490, all of which he had to pay. And this guy is a roofer; that was big money to him.

I asked if he was going to benefit from the recent health care legislation the Democrats had passed.

He said, without hesitation, "No. I will probably be even worse."

I cannot say for sure, but I'd be surprised if he had read through that massive law, all 2,000 pages. I know I haven't. But his prejudice was no law borne of government would help him.

Had I pressed him, I suspect he would have said what I hear all the time in New Hampshire: Government is good for nothing. Nothing good comes out of the government. Government is not the solution; it is the problem.

When you press people about, well what about Medicare, Social Security, the roads, the bridges, the internet, the armed forces, the air traffic control system, the FBI, the CIA, the fire fighters, the police, the rescue squad, the public school system, they have complaints about all of them.

If they have been steady listeners to Rush and Glenn and Sean, they will tell you all these things would be better run and would work if only they were private companies.

Personally, I don't buy that sentiment. I think government is for what we cannot do better for ourselves and what is done worse if there is a profit motive driving it--like health care.

People will tell you if government ran the healthcare system, you'd have doctors and nurses sitting around, unwilling to see patients because they get paid whether or not they see patients, so they fight adding patients to their schedules and the waiting lists grow into year long affairs and nothing happens. If you want customer service, you need the fire in the belly only private enterprise gets you.

But consider this: Somewhere in the range of 88% of all practicing physicians in the USA have become employees. This is a slippery number but it sure fits with what I've seen. Doctors are voting with their feet in a huge stampede away from hanging up a shingle and doing private practice and they are looking for a W-2 form, not a series of 1099's.

Ask them why and they'll tell you they are sick to death of thinking about money all the time, about money before patient care. They may have hustlted to get out to see that patient in the waiting room a bit faster when they first started practice, but once they got established, got busy, they were running away from patients, the old incentive of an extra few bucks for an extra few patients disappeared.

As for private insurance, ask any 50 year old whether or not he'd rather have Medicare or Aetna or Blue Cross, and you'll see a flood of people who would prefer the government poison to the private sector poison any day.

But, have the Democrats managed to sell this proposition?: "The problem is not government; the problem is not even Big Government; the problem is bad governement. And bad government, or no government (in the case of the Tea Party) is what Republicans are all about."


President Obama accepted a budget without forcing the Republicans to cave on taxing the rich, closing loop holes for corporate jets, for second and third homes, for yachts and for corporate luxury boxes at stadiums

Paul Ryan handed Obama and the Democrats a loaded gun with which they could have blown away the Republican bandits. They passed a law which would have killed Medicare and put in its place Coupon Care.

And what did the Democrats do? I can't remember. All I can remember is seeing Harry Reid, with that whispery little voice of his and that stooped shoulder Casper Milquetoast look, saying the Republicans are not playing nice.

That is the really disturbing part of this. The world will always have bullies and people who try to suck in every bit of wealth and largess they can-- the rest of the world be damned. The disgusting part is when the champions of the people just let these Orwellian pigs win.

If you have a dragon, you need a knight to slay it.

Clearly, sadly, Obama ain't that.

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