Lion in State

The name Ted Kennedy triggers an immediate response in most Americans, a response either very positive or very negative. But from those who knew him, the response is overwhelmingly positive. Even his most powerful political foes speak highly of him, highlighting his willingness to work across party lines and his commitment to helping people everywhere he went.

Although he was a Senator from Massachusetts, he often represented the disenfranchised across the country. His home state is among the smallest in the nation, but his vision stretched from one coast to the other. He cared deeply about the big issues that affect us all, whether we’re in Texas or Maine.

Civil rights. Education. Gay rights. Universal health care.

He was a leader on all those fronts, and many more.

His personal life often distracted from his political accomplishments, but in the end, it will be his 47 years in the Senate that defines how history views him. And I think it will do so kindly.

He had a family name that he leveraged every chance he got. He didn’t talk much about being a Kennedy, but he used the power of that name to achieve more than either Jack or Bobby did. He took longer, but most of his fights were long-term projects. They would have taken longer than a presidential tenure.

In the end, the country is better off that he never became president. Instead of 8 years to pursue his goals, he had 47. Like Martin Luther King, he didn’t live to see all his dreams realized, but like MLK, he got a lot done.

He’s lying in state tonight at his big brother’s library and museum, and people have been lining up since the early hours to pay their respects. Thousands lined the roads along the route of the motorcade that took him there. It’s the kind of response one would expect for a president.

That he commanded the respect and affection of his opponents as well as his supporters paints the full picture of the man. And that in spite of his personal foibles.

No man is perfect. None will ever be. But some are more perfect than others when it matters. He was a horribly-flawed human being, as most of us are. But he never lost sight of the world he wanted to help create.

One that was better, fairer and more just than the one he inherited. And that will be his legacy, one earned over decades of relentless work.

He was called "the lion of the Senate" for good reason, and I will miss his roar deeply and profoundly.

We loved him well. He was not ours to keep.

Fear Factor

When Sarah Palin goes out stumping and using the phrase "death panel" to try and re-define end of life care and counseling, my stomach turns. I can't imagine what her motivations are, other than a pure and unadulterated attempt to stoke fear in the far right wing of her party. It amounts to nothing more than pandering, and it's in very poor taste.

I have dealt with more than one of her "death panels", and they have been composed of health-care professionals who wanted to give everyone involved the information they needed to determine treatment for the person they loved. They were straight-forward and painfully honest. They told us things we didn't want to hear, but they did so honestly.

That's what end-of-life counseling boils down to: having the right information to make the right decision, whether it is the patient or the family making those painful decisions.

The way the radical right has framed this debate, I would be a murderer for asking that treatment be withdrawn from a terminally ill patient because I knew what was going on and what the outcomes would almost certainly be.

If you follow this debate to its natural end from the Palin point of view, I should not have been informed or had the opportunity to withdraw care. And no doctor or nurse should have been able to give me the information I needed to make the right choices, much less mention that it was available. That the right to counseling on this most difficult issue shouldn't exist.

It is pandering on an obscene degree that belies a gross lack of conscience or sense of moral justice.

Terminally ill people deserve the right to good medical counsel. They need to know the possible outcomes and the implications of them. And so do patient's families.

That anyone would question this centrally important part of health care leaves me walking around with my hands in the air saying "What? What? She didn't really say that, did she? Oh, my God. She did."

Campaigning on a platform of restricting end-of-life care (and she's campaigning-you betcha') should give every voter pause. Apart from restrictions on free speech and professional practice, it's just plain old wrong.

Limiting health-care providers' speech in those situations is not only immoral: it's irresponsible and unethical. It would leave the provider in the position of violating the law or violating the oath they took as a licensed professional.

Given all the problems we have with health-care right now, this is one more thing that should not be politicized or bastardized. And it has been.

When people are dieing, they deserve the ability to determine their futures. And when they can't make those decisions, their family needs to be able to do the same with the best information possible.

As a people, we should not let our cultural reticence to talk about death infect the debate about health care reform that is decades over-due. And politicians who use blatantly false statements to exploit that fear do their constituents a great disservice. All Americans would be better served by a healthy and honest debate about the issue.

Mouthy Redux

What follows is a letter I sent to the Austin American-Statesman. They require letters to the editor to be short (150 words) and to the point. So this is the condensed version of my opinions about health care. For a more complete version, go here. For Daniel Gross's insight go here.


Rationed Health Care and Why We Aleady Have It

Its time to set the record straight about rationed health care: we already have it. I am insured and can see a GP almost any time I want. But I usually have to wait 2-3 months to see a specialist. With a very good plan.

I watched a friend with similar coverage grow sicker with cancer as his doctor battled the HMO for the best care and not the cheapest. Weeks after diagnosis of an aggressive and fast-growing tumor, his insurance company finally let him get the treatment his doctor had first recommended.

It was too late. He died a few months later.

My partner has coverage through the VA, and, yes, they ration health care. But not to any degree larger than my private insurer does. He gets high-quality health care that is as good as what costs over $600/month for me.

Rationed health care is a moot point. Its already here. And its spelled HMO.

Bite Me

I am sick to death of hearing about “death panels”. I wish someone would put either me or Sarah Palin out my misery. She’s taken one of the most sacred trusts anyone of us hold, that to care for a loved-one when they can’t care for themselves, and perverted it into nothing less than a blatant political tool. For someone who has experienced end-of-life counseling more than once, it makes me nauseous to see what has been a part of quality health care since professional, trained doctors have existed singled out and labeled a “death panel”.

If you’re lucky, you will have a doctor or a panel of doctors assemble to tell you or those responsible for your care the truth that you may not want to hear but need to know. How does one make a decision without knowing the facts? The options? The probabilities?

That’s what end-of-life care has always been, and it continues to be one of the most important components of health care. Withdrawing care is never easy, but withdrawing care without adequate information is unconscionable.

I’ve never had to do that and hope I’m never faced with that situation.

I doubt that doctors will cease the practice, whether they’re paid for it or not. It’s part of being a doctor. Or a good one, at least. Most private insurance would pay for it.

When Daddy died a little over two years ago, the team of doctors that was treating him assembled to talk to us about the grim prospects and what our options were. They provided information and described what can only be called cascading organ failure: his liver had failed, causing his kidneys to fail, causing his blood to thin, causing his heart to require medication to function. His eyes were bleeding and he was hemorrhaging under the skin all over his body. He could not be stabilized to the degree required for a liver transplant, even if one were available.

They gave us all the God-awful truth, but we made the decisions. The hard ones. The ones we didn’t want to make.

That is what end-of-life counseling is, and also what Sarah Palin is calling a “death panel”. Such rhetoric is ingenuous at best and appalling in general. It ignores the simple but obvious truth that end-of-life care is called that for a reason. It seeks to politicize what is often the hardest thing someone ever has to do. It cheapens the grief of those who have made hard decisions after getting the information they need to make those decisions.

Life and death should never be political footballs.

Mrs. Palin apparently doesn’t realize this. She created the concept of “death panels” out of whole cloth. And then got the media to report it. Never mind that not even the semblance of truth has come out of her mouth in the last several weeks.

No doubt, she will continue to contort, distort and generally misrepresent any proposals for health care reform. She will continue pandering to the extreme right wing of the Republican party rather than being sensible or even honest.

I think she might very well put herself out of her own misery (and mine, too) by imploding on a national stage. She’s made some pretty big claims that she can’t substantiate with real evidence, and the press is getting closer and closer to biting her Alaskan fanny real hard.

If only I could.