A viscious lie

What the Republicans are doing now with regard to the health bill is a classic tactic used by scum everywhere through history. It is the big lie and the vicious lie. Hitler used this tactic over and over again in gaining power in the third Reich. And the real truth is beautifully described by NICHOLAS D. KRISTOF in the New York Times.

This is a personal issue to me and thus makes me particularly angry. When my poor mother finally turned the tide for the worse in her battle with Ovarian cancer, she was diagnosed at the Hutch in Seattle. I had to fight, almost physically, to get her out of a hospital 3,000 miles from her beloved apartment in NYC and back home to the apartment where she wanted to end her days. I almost had to medivac her before she recovered just enough to get her discharged and onto a wheelchair and thus onto a plane back to NYC. Once in NYC, I brought her into Sloan Kettering Memorial Hospital which had treated her well while treatment worked, but once it was clear that all options had ended and she only had a couple of months left, they and the current medical system left her and us terribly adrift. They basically sent an old lady away to die and confront fear and pain without any offer whatsoever of home help. They gave her a complicated regime for the painkillers and other meds that even the visiting nurses of NY (who were saints) couldn’t administer and Sloan offered no help in finding the “High Tech” nurses we required for my mothers care. We went through fear, pain and panic for the next couple of days trying to help her follow the meds regime they had given us on discharge which it turned out, even the visiting nurses of NY (saints!) couldn’t follow. I finally found some along with the help of an extraordinary friend of my mothers who had been an ICU nurse and we managed for the next 2 months until her last few days when she chose to go into a hospice. But the modern health care system tried hard to have her die in the hospital at a cost of 1,000’s of dollars a day when all she wanted was to be at home, pain-free, among friends. For that, not a penny. Her hospital never even called to see how she was doing.  And this is what the Republicans are trying to protect – this soulless cruel heartless vicious system. They should be ashamed. I am ashamed of them.

26 Responses to A viscious lie

  1. Christian Romney says:

    I stopped reading at “Hitler”. And I’m *for* health care reform. If you want to influence people with your words, you need to choose them better.

    Adam >> I’m sorry you stopped reading. It happens that I was a history major and when I see a trend to create a social movement through the consistent repetition of a an untruth it reminds me as when this happened in the past. To be honest, I don’t write the blog to “influence people” but merely to speak from the heart. In this arena, because of the fear and pain that my mother went through unnecessarily, it is a deeply passionate and emotional subject for me. And so my words reflect that.

  2. M.C. says:

    My Adam Bosworth respect-o-meter just slipped from a high number to a very low one.

    >> Adam – I say what I feel from the heart. I think that’s my job. Not to say what is popular, but what seems to me to be true. And my mother and I went through anguish, fear and pain due to the lack of help from the current system when end of life is approaching. Ignoring the incredible waste of the system in this regard, why should I not speak up when I feel so strongly about something and see it being used to falsely attack a plan which at most would have given us choices?

  3. C.B says:

    Why are there some words like “hitler” “holocaust” “nazi” “communism” etc that everyone is so afraid of using that they discredit anyone else when they use it when speaking of modern day politics??? He is right regarding Hitler, sure I wouldn’t go that far to compare the Republican Party to Hitler especially about healthcare as it is extreme BUT I do worry that if we aren’t even allowed to reflect on how one government went about things the very wrong way, can we make sure we aren’t going to do it again? Don’t say Hitler until there’s another genocide? Yes some words are painful and I feel for all who ever had to endure unjust persecution by any form of government, however, the words exist and they are powerful. Maybe using those words reminds us of governmental behavior we should be suspect of and not tolerate today… lying, fear tactics… doesn’t sound like we are too far off from at least something that doesn’t represent the people very well.

    • adambosworth says:

      Clearly, this did upset people and I regret it because they seem to have stopped reading before getting to the point I was making which was that what is being said to discredit reform is both untrue and hides the fact that the current situation where end of life issues are handled terribly by the system.

  4. All I will say is that the Nazi Party is categorized as a fascist party – which is an extreme right wing party. Extreme right wing parties will use similar techniques no matter what country they are in. And in the US, these are the same extreme right wingers who hounded the Democratic president in the 1990’s.

    There are certain places where you can go right now in the US where you will find Confederate and Nazi flags hung up on walls inside of people’s homes.

    I’m looking forward to Obama’s upcoming senate speech where if he’s smart he’ll return public opinion to where it belongs as he counters the fear with the promise of security.

  5. Michael McCormick says:

    This is a recent and insightful article discussing both incentive issues and electronic records.

    http://www.theatlantic.com/doc/200909/health-care

  6. Murray S says:

    What if you agree with the need for reform – but just don’t agree with how the Dems are going about it? I think many Republicans are like this. So to tar them as “Nazis” – just because they don’t like the ill-conceived half-baked ideas the Dems are trotting out under the umbrella of “reform” – seems to me to smack of hypocrisy. I’m all for change – but to something better – not something less efficient, more bureaucratic, more complex and ultimately less humane. I think we would all agree to that sentiment – what we disagree about is some of the practicalities – and maybe some of the principles.

    • adambosworth says:

      Agreed and I didn’t mean to target all Republicans as Nazi’s. What I was addressing was a specific claim being made about the “Death Plans. One of the tragedies of our health care is how cruelly and badly it provides help for people finally facing end of life. As I said in my post, my mother faced this challenge and when an attempt to help is smeared like this, I feel a need to speak up. And the support for this claim of “death plans” has largely been partisan.

  7. Christian Romney says:

    The thing is the amount of hyperbole in the debate drowns out all reason. References to Nazis and Hitler really have no place in this debate whatsoever. It’s turning out to be a giant proof of Godwin’s Law. And I’m *for* health care reform, so imagine how turned off someone who’s not for this set of reforms might react.

    I understand the frustration, believe me. But the best way to make the case for health care is to debunk the propagandists’ lies, not by adding fuel to the fire. It’s sad that in American politics a great many of us have forgotten how to have reasoned debate and civil discourse. The media is an enormous factor, but we’re all accountable for what comes out of our mouths – and what we write online.

  8. cmarz01 says:

    Classic liberal post: irrational, unfounded, misguided, devoid of fact, ignorant of truth, and completely driven by emotion.

    • adambosworth says:

      Amusing to see. I was a long-time Libertarian, long-time Republican and in general some one who is deeply skeptical about government solutions. What I was calling out was the dangers of Government telling lies and in fact, wasn’t driven by emotion but by looking at the bills and experience.

  9. Randy H says:

    Your words were appropriate and honest–they deal with issues that transcend political affiliations. It is sad indeed that many of your readers are crippled by shortsightedness.

    The truth is that when given a diagnosis of cancer, the biggest thing that patients lose is not years of life, but rather autonomy. They are required to make clinical decisions while still reeling from the diagnosis.

    Technology is a great tool, but needs to be used in concert with compassion, reality, and respect for the patient’s decisions and needs. You honor your mom’s memory through your work in this important area.

  10. Mark M says:

    The most amazing guy I’ve ever met in the health care field — a celiac disease researcher — is also one of the most passionate people I’ve ever met. He and like-minded colleagues and moms of celiac kids everywhere are *rapidly* transforming this part of the world. I don’t think he’s known for mincing his words either. Yeah, you’ve got to be careful how you expend energy. But please don’t ever stop being passionate about this stuff.

  11. Michael Lunzer says:

    I can appreciate your passion Adam. My 17 year old niece died of a brain tumor last year and once she was out of the hospital home care was non-existant unless her family agreed to hospice which meant no more chemo. Watching someone you love struggle through this experience when they should get support from their health providers can generate a lot of energy to change things. Keep on telling it like you see it. Politics should not get in the way of help for people that need it.

  12. Paul Ambrose says:

    I love it. If the “big lie” is that government has no ability whatsoever
    to effectively run healthcare, then I fear hearing what your idea of “truth” is.
    If the government is in charge of healthcare and resources are limited (as
    they always are), then in fact the government will be put in the position of
    deciding who lives and dies. Exactly where is the lie in that statement?

    Your personal history and *emotion* (which in this case is a convenient
    excuse to ignore logic and fact and instead engage in idiotic Hitler attacks),
    adds zero to the discussion of healthcare.

    • adambosworth says:

      But that wasn’t the proposal. The “death” discussion of Sarah’s came out of a much simpler issue which was around patients getting to decide how they wanted to be treated when they had reached a point where there was no curative option. And speaking both for myself and many others who share my opinion, at that point, the current health care system gives us even less options than you suggest the government will do. It will pay for someone to spend months lingering tied up in a hospital bed filled with tubes and unnecessary procedures to add maybe a month or two to their lives, but not pay for them to go home and be treated there and attended with dignity even though it is a fraction of the cost. This is a classic argument tactic. Attribute to someone something they didn’t say and then shoot at it. I wasn’t arguing that people shouldn’t have the right to get private care and nor was the bill in question.

      • Paul Ambrose says:

        No, in fact, the “death panel” charge was made in the context of
        the overall bill and whether unelected, nameless, faceless
        government bureaucrats would be making decisions about
        who gets care and who does not. Her second time around
        with the comment was in the context of her Down’s child,
        which has nothing whatsoever to do with terminal care.

        Terminal care coverage is a insurance carrier/policy-specific issue.
        There is no “blanket” policy in the current healthcare system
        for end of life care.

        As for your straw man charge, I find it remarkable that the same
        guy who is calling people scum, liars, and Hitler-like because they
        dare disagree with him, is lecturing *anyone* about argument tactics.
        And if you want a fine example of a lie, reread your comment
        about what “Republicans are trying to protect.” In a word: pathetic.

  13. Christian Romney says:

    There are a few problems with the last commentator’s arguments. Starting with the easy one: essentially FUD. The argument is putting a bureaucrat “in charge” of medical decisions will get people killed or at the very least result in poor care. Presumably the reason is budget constraints would influence medical decisions. I agree, that sounds outrageous. But here’s my question to you: given that the current system is precisely the same – simply substitute insurance company bureaucrat for government one – where is your outrage at the status quo? How do you propose to fix it? If you don’t have the same issue with say HMOs then you’re bordering on hypocrisy. Or is your argument that insurance bureaucrats are inherently more virtuous and compassionate? How do you counter the argument that insurance companies are worse (for the patient) because they have the additional influence of profit disincentivizing the approval of claims?

    • Paul Ambrose says:

      There is *zero* uncertainty or doubt about the incompetence and fecklessness
      of government bureaucracy. Are insurance companies bureaucratic nightmares?
      Of course. But suggesting they are the same is ridiculous. In the current
      environment, I have my choice of who I want to do business with. If I do not
      like the way I am being treated, I find another carrier. In a world where the
      government is the only game in town, there is no choice. (And dear God,
      please do not suggest that the government will just be another choice. )

      The current legislation has nothing to do with improving healthcare. Its goal is
      to empower a particular political party, drive millions of people to being
      dependent on the government and kill our prosperity. If the goal were to
      actually improve the affordability of healthcare, then you would see serious tort
      reform (there is none), elimination of restrictions on cross-state insurance
      purchases, and an effort to decouple healthcare from employment.

  14. sal says:

    Blimey!….

    Let me give you an outsider’s perspective. I’m a Brit and live in the land of the National Health Service (the NHS). I’ve also spent a number of years living in the US, working in medical research (I’m a PhD fluid mechanics engineer).

    I’ve lived and worked under both systems. Which one would I prefer? The NHS, the NHS and again the NHS.

    Why?

    Personal experience of living with sick elderly relatives. My father-in-law died a few years back of pulmonary fibrosis. His last few years were awful. I don’t care what system you live under pulmonary fibrosis is a terrible disease. My father-in-law had the good fortune to retire in the UK (after a lifetime of living in the US and Africa). His treatment was superb. Nothing was too much trouble for the local docs. Oxygen was delivered, almost daily in the end, drugs were delivered and administered, and the horrible disease was made as painless as possible. Total monetary cost to him, his wife and our family? Nothing. Other than the tax we gladly pay to support such a splendid system.

    Compare and contrast with a dear friend of my father-in-law’s, who had the misfortune to contract the same horrible ailment and live in the US. Again, excellent care and the kind attention of the local docs in the small town in the mid-West where he lived did what they could to alleviate the horror. Total cost to him and his wife? Bankruptcy. Selling the house. ‘Begging’ from relatives. And he had insurance.

    Both men were well looked after. No ‘straw men’ arguments about NHS being closet commies or the American health care system being run by money grabbing Nazis. In both cases the care was excellent. In one case the family was left bankrupt, in the other they weren’t.

    If this happened to you where would you rather live?

    I’ve heard the scare stories about ‘socialized’ medicine (seemingly a word right up there with ‘Hitler’) and I’ve seen Michael Moore’s ‘Sicko’. Both, in my experience, are caricatures. There are good people in both systems and bad people in both systems.

    But socialized medicine is just plain more *civilised*. It’s the way I want to be treated and it’s the way I want to treat others.

    An aside: I’m always intrigued by the American fear of ‘government’ as an unalloyed bad thing. I struggle to understand this (just like I struggle to understand your gun laws or the German insistence on being able to drive at 200mph on a public road). Your health system costs twice what ours does and fails a significant proportion of the population. How is that defensible? If you don’t like the NHS model look at any other European country, or Australia (indeed, any civilised country in the world apart from yourselves..).

  15. Christian Romney says:

    Simply stating that there is *zero* uncertainty about something doesn’t necessarily make it so. In fact, medicare is a huge government run health insurance program which seniors seem to be pretty satisfied with. I’m sorry to point this out, but most of your arguments begin with wording designed to shutdown debate and don’t advance your central point. I’m a little confused about the suggestion that a government option won’t just be another choice. One argument against the public option says the system will be terrible. Another argument is that it will put private companies out of business. How are these suppositions logically compatible? People are going to abandon their wonderful private insurance plans for a terrible government plan in such massive numbers as to make the private insurance industry unsustainable? There’s a fundamental contradiction there that doesn’t make sense to me.

    You mentioned killing prosperity. That’s already the case. We spend a disproportionate amount of our incomes on healthcare today. Honestly, your arguments sound like a massive conspiracy theory – the dems don’t want to improve healthcare only to empower themselves and drive millions of people to be dependent on government? This is the problem with political discourse in this country. We all start from a supposition that the other party is a malevolent entity that hell-bent on destroying the country. Why must every policy debate devolve into an exchange of apocalyptic nightmare scenarios?

    • Paul Ambrose says:

      Suggesting medicare is a successful government program is about as credible as Bill Clinton speaking out against sexual predators or Nancy Pelosi speaking out on the virtues of aging naturally. Medicare has unfunded liabilities in the trillions — it is bankrupt, it is a financial disaster. Maybe you could suggest social security? Damn, that is also bankrupt. How about Fanny Mae or Freddy Mac? Doh!, bankrupt. How about the war on poverty? Nope, not a good example. War on drugs? No. Protecting our borders? Hardly. VA hospitals? No, better not go there. How about Bureau of Indian Affairs? Keep going. I have it — education. Hardly a success story. Sorry I cannot help you out.

      This might shed some light on what the goal of ObamaCare is:

    • Paul Ambrose says:

      You can clearly see the lack of a profit motive insures efficiency and stunning competence:

      http://news.yahoo.com/s/ap/20091114/ap_on_bi_ge/us_medicare_fraud

      Just think how great it would be to have 300M people on medicare.

      • adambosworth says:

        The basic point that this set of acerbic posts of yours miss is that the current system for private industry is completely broken. There is no model of payment for value in the private system either. The private system pays for procedures based on the complexity/difficultly of the procedure. It is therefore, a system fundamentally designed to encourage waiting for the patient to get sick. It has no motivation to keep people from getting sick or even to deliver cost-efficient care which is why there are so many unnecessary stents, MRI’s, back surgeries, and so on. That’s where the money from the private sector is going. And it is also worth noting that the private sector is currently paying almost twice per capita what the dreaded government systems in countries like France pay and with much worse overall outcomes. We need a system that has an incentive to pay for value, for best most cost-effective outcome. Kaiser comes much closer (as does Geisinger – http://www.geisinger.org/) because they both are on the hook for the costs. So they actually have an incentive to deliver health efficiently. This entire jeremiad is targeted at a red herring. The real issue isn’t government or not. It is fixing the payment model and the care delivery model and the latter will happen automatically if the former occurs.

  16. Christian Romney says:

    Not only that, there isn’t an argument in sight. Even the link posted about Medicare fraud is fraught with problems that are trivial to spot if one reads beyond the headline. A couple of paragraphs in there’s a statement about how no one knows if it actually rose since they are now looking more closely. Furthermore, even assuming there were $47B in fraud, it takes an enormous mental leap to conclude The Medicare model is a bad one. If anything, it makes a case for reform and oversight. If we were to discover voter fraud would we do away with free elections? Also, there’s no acknowledgement or attempt to refute the central point: that Medicare patients are very satisfied with their government-run insurance coverage and are not driven into bankruptcy by illness. I’d love to have some earnest and honest intellectual debate about the issue rather than just swapping sensational headlines and witty quips about government inefficiency.

  17. [...] rally supporting this movement. I’m happy and proud to do so. As I wrote in one of my most contentious posts, once my mother was diagnosed as being terminal after a valiant 4 year battle with Ovarian cancer, [...]

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