Sick politics make us sicker
Expanded from the Sunday, 10-31-2004, Daily
Sparks, Nev., Tribune
"To tell the naked truth might make no appeal. It may be necessary to fool people for their own good. Doctors, and even preachers, know that and practice it. Average intelligence is surprisingly low. It is so much more effectively guided by its subconscious impulses and instincts than by its reason." (From "Critical Condition," pages 201, 233)
That statement did not come from Karl Rove, although it explains the continuing closeness of the presidential race in the face of a mountain of damning facts. The above was uttered by a 1930s advertising executive talking about new ways to peddle snake oil.
"Politicians love to say that the United States has the best health care in the world. In truth, it doesn't come close."
"Critical Condition," page 3
Once people have had their emotions tweaked, facts dont matter. For various reasons, about 48 percent of voters have decided to make a leap of faith that their president has their best interests at heart and won't listen to anything bad about daddy.
Regular readers know that I've decried the hijacking of the health care system many times, especially the privatization of public hospitals in Reno, Carson City and Elko.
In 1985, through control of information and political corruption, our county hospital was privatized with the promise that the new non-profit entity, now known as Washoe Health System, would forever indemnify the county against the cost of health care for those who could not pay. Never happened.
That promise made it into press releases but not into the final contract which gave away a $120 million asset for 30 pieces of silver, a puny $3 million. Washoe Med's new owners also promised to lower health care costs, but instead plowed the money into building what is perhaps the largest business empire in the region.
The Washoe Med lesson was nothing if not a lesson in high-powered PR. A group of high-level hospital execs stated that Washoe County would soon go broke paying for indigent health care. Although Washoe Medical Center had always made money, their dark warnings were echoed by community leaders, some of whom stood to profit handsomely by the privatization.
Their coup was complete when Ed Dannan, now a judge, removed the indigent care provision from the final contract. Years later, all the skulduggery was detailed in a Washoe County grand jury report, but the damage was done and no one was ever prosecuted for grand theft hospital.
During that same period, Carson City enacted a law to limit health care costs. It worked but was allowed to sunset a few years later. We once really did have a handle on a system which is today spinning out of control.
If modern medicine leaves a bad taste in your mouth, blame Listerine. That ghastly mouthwash was sold as a way to make sure you did not fall from social grace because of "halitosis" or bad breath. The depression-era Listerine campaign actually coined the phrase with which sportsfans everywhere save Boston will identify: "often a bridesmaid, never a bride."
"Much of the turmoil is a direct result of a national policy to run much of health care like a business, a misguided notion promoted by Washington over the last two decades that the free market and for-profit health care would restrain costs and bring high-quality care to all. On both counts, the experiment has failed miserably."
"Critical Condition," page 4
Two-time Pulitzer Prize winners Donald Barlett and James Steele tell that story in their new book "Critical Condition: How Health Care in America Became Big Business and Bad Medicine." It traces how a necessity became a profit-making commodity and we are all the worse for it.
As it now stands, Nevada consumers will wake up Wednesday morning half-naked. Should you become a victim of medical malpractice, you will find it extremely difficult to find a good lawyer.
New contribution reports reveal that insurance companies and medical lobbies have raised $3.7 million to the legal profession's $1.3 million in the initiative wars. When post-election reports come in, my spies report that the insurance/MD/HMO alphabet soup will have spent upwards of $6 million convincing us that we can "keep our doctors in Nevada" with just one vote at the polls.
The facts are otherwise. The state board of medical examiners reports that the number of Nevada doctors in all disciplines has consistently increased and never dropped. Las Vegas physicians cleverly went on strike in 2002 as part of a very expensive PR campaign unfairly blaming trial attorneys.
Led by the right-wing Las Vegas Review-Journal, Gov. Dudley Do-Right felt compelled to call a special session of the legislature to solve the "malpractice insurance crisis." A compromise was reached which included capping pain and suffering damages at $350,000. The current limit may be waived only if a judge finds truly grotesque incompetence, such as the woman who suffered an unnecessary double mastectomy.
The likely passage of Question 3 this Tuesday leaves those like her out in the cold. The legislative compromise has not had time enough to work. Insurance companies actually raised rates after the 2002 "reforms" passed. The malpractice insurance hikes which caused the so-called crisis were fueled by insurer stock market speculation. They gouged their medical clients to cover Wall Street losses.
The compromise was not good enough for the insurance lobby and thus was born Question 3. If your baby loses eyesight or a leg due to malpractice, you get $350,000, tops for life. California bought the same snake oil and imposed such a cap 30 years ago. Worth just $71,000 in today's dollars, our neighbor nonetheless suffers some of the highest health care costs in the nation.
Still wanting more, the Nevada insurance-medical complex is now circulating another petition to drastically reduce lawyers' fees which will already erode dramatically under Q-3.
Lawyers have countered with Questions 4 and 5, both of which are underfunded, trailing in the polls and cannot go into effect until 2006 after another vote. Q-3 takes hold immediately upon passage. When you vote Tuesday, keep in mind my recommendation of last week that 4 and 5 merit support as an insurance policy against Q-3. You may hate lawyers all you want until you need one. As our legal system continues to devolve into a poor copy of Texas, I hope you never do.
Q-3 addresses a problem which does not exist. Don't take my word for it. Listen to the best investigative reporters in the country. (Bob Woodward lost his title after becoming embedded and thus co-opted by the Karl Rove klan earlier this year.)
Barlett and Steele identify the major problems of the health care system: mistakes, malpractice and prescription drugs not lawyers. (Page 243)
They advocate stepping away from the greed-driven system which puts patients behind the priority of profit and which turns doctors into victims, too.
Barlett and Steele propose common sense solutions such as "creation of a single information technology system that links all health care players." It would cause "a reduction in medical mistakes (which) would lead to a fall-off in serious malpractice claims With fewer errors and thus fewer deaths, lawsuits would decline In a less hostile environment, doctors could stop practicing defensive medicine The situation has become so grim under the profit-driven system that many doctors view their patients as adversaries and practice medicine accordingly. This is not only bad medicine, but also incredibly expensive. Yet the proposed solution placing a maximum cap of $250,000 on damage awards is hardly equitable Is it fair for an infant with severe birth defects as a result of a delivery mistake to receive no more than $14 a day over 50 years? Would you consider those sums to be fair if the mistakes involved you or members of your family? Yet that's Congress' idea of malpractice equity," Barlett and Steele note. (Pages 243-44)
Never troubled by pesky statistics, that president beloved of the factually challenged smirkingly blames trial lawyers for high health care costs and thereby excuses his failure to heed warnings about the flu vaccine shortage.
With a major cap on damages, you will be asked to front all legal costs, which can run into six figures. The average family will not be able to afford to sue, which is the whole idea. The average lawyer who takes any such case will be impelled to settle for pennies.
"At the uttering of 'see my lawyer,' heavy troubles are lifted from aching and tired shoulders and transferred to the stronger ones of those more eager to bear them, those who cannot have troubles of their own, the lawyers," the late, great litigator Melvin Belli wrote years ago.
Alas and alack, it appears that as of Nov. 3, the old Nevada mining camp advice will once again rule the High Desert Outback of the American Dream: If you live here, don't get sick. Go vote anyway.
Three Nevada newspapers have written in-depth articles which show that the crisis is one of PR, just like Listerine's marketing of halitosis to insecure young debutantes. You may access those and much more along with a few surprises before Tuesday in the web edition at Barbwire.info.
See you Wednesday with postmortems on statewide Nevada Newsmakers (12:30 p.m. KRNV TV-4; 9:28 p.m. on Charter cable channel 12 in northwestern Nevada; various other times in Gomorrah South) and Sunday, Oct. 7 at 6:00 p.m. on KNPB TV-5. [UPDATE 5:59 p.m. PST November 2, 2004 : READY FOR PRIME TIME after, lo, these many years I'll be doing postmortems with the body politic still warm, in the 9:00 p.m. hour election night on KRNV TV-4 in Reno. If I wasn't afraid they'd charge me rent, I'd bring a razor and shaving cream and sleep there. Tune in, turn on and tell a friend.]
Be well. Raise hell.
Junk Lawsuits How journalism in Nevada and elsewhere
invented the litigation "crisis"
Dennis Myers' cover story in the 10-21-2004 Reno News & Review
Front page news roundup by Frank X. Mullen
Reno Gazette-Journal, 10-31-2004
Patients caught in crossfire as doctors and lawyers do battle
over insurance issues on Nov. 2 ballot
Las Vegas Review-Journal 10-24-2004
Please consider voting NO on Q-3, Yes on Q-4 and Q-5.
Send me your comments and personal stories.
Barbwire Ballot Question Analysis
A Blow Against the Secrecy State: Federal government
didn't even want to produce its photo ID law
Las Vegas Review-Journal Editorial 9-17-2004
ORDER "Taking the Risk Out of Democracy"
Corporate Propaganda versus Freedom and Liberty
By Alex Carey
Edited by Andrew Lohrey
Foreword by Noam Chomsky
University of Illinois Press
BEEN THERE, DONE THAT
The 1994 Labor Day Barbwire introduces Alex Carey
A brief history of neo-con PR and the roots of corporate propaganda
Copyright © 1982-2004 Andrew Barbano
Andrew Barbano is a 35-year Nevadan, a member Communications Workers of America Local 9413 and editor of NevadaLabor.com and JoeNeal.org. Barbwire by Barbano has originated in the Daily Sparks (Nev.) Tribune since 1988.
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