Judevine Mountain Emailite 47

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from our friend, Harriette Greene out in Marin County, California comes . . .

CANADIANS have voted Tommy Douglas, known as the father of the Canadian Medicare system, the greatest Canadian of all time. Canadians may complain, but they love their system, which provides lifelong medical care for everyone. There are private clinics but everyone pays Medicare taxes.

I am a Canadian and I had breast cancer while living in Montreal. Last year, while living in California, the cancer recurred. Where do we get these myths about Canadian health care?

In Canada I was able to choose my surgeon, oncologist and radiologist from all the doctors in Montreal. I also chose a McGill University hospital for my surgery. After the operation, my oncologist prescribed all the needed tests, including a bone scan and an MRI, which were all done immediately.

I then started chemotherapy. At every appointment I had blood tests, my tumor markers were monitored, I saw my oncologist and had a breast exam. I saw my surgeon every three months. Throughout, my treatment was orchestrated by all the doctors who worked consistently as a team. After chemo I had a PET scan. Results were good, and I continued to see my oncologist and surgeon yearly.

Because my team thought ultrasounds the best diagnostic tool for my dense breasts, I had those every six months as well as annual mammogram and breast MRI. The radiologist also examined me at every imaging appointment.

Here, we are covered by Kaiser. Tumor markers are not routinely followed at Kaiser, but my oncologist did agree to test them last year. They were high. I continued to have tests every six months. The markers kept rising and I requested a PET scan. My oncologist said he could not justify it. Not justify it! This was a phrase I had never heard in Canada.

Finally, I broke a rib and that was enough to justify a PET scan. It revealed boney metastases and I got radiation therapy. I am now on a drug treatment regime recommended by my Canadian doctor, to which my Kaiser doctor has agreed.

My markers are low and I am feeling very well. But Kaiser has refused to do ultrasounds or MRIs. I get a mammogram every two years. I have never seen the radiologist who has decided mammograms provide adequate testing. My oncologist, whom I see regularly, has not examined my breast in 18 months.

Where is the rationing? I never had to argue to get treatment in Canada. I never had to know so much about my illness or to be such an advocate for my own case. I used to get calls, from my physicians in Canada, suggesting treatment. Not here.

I worked almost 40 years as a physical therapist in Montreal. I have treated thousands of patients with hip and knee replacements. There is no rationing, by age or anything else, and anyone who needs a joint replacement gets it. The medical team makes the decision. The waiting period, in Quebec, for a hip and knees is now three months. Furthermore, ceramic hips are considered the most durable kind of prosthesis and they are used regularly in Canada. My son is an orthopaedist in Iowa and bemoans the fact that ceramic, total hip replacements are not available in the USA.

I have had good care here, but the care in Quebec was better. Everything was done to get me healthy. And here, the out of pocket cost is much higher than the Medicare taxes I was paying in Canada.

There, when I was earning a high salary I paid high taxes. When I became ill and could not work, I paid nothing. Here, as I get older and sicker, my costs rise.

What an unconscionable system, completely counter to what one expects of a civilized society. Civil society means caring for one another, the healthy caring for the sick and the young for the old. How did this idea get lost in the USA?

I’ve been pulling my hair out, banging my head against the wall––all those clichés of frustration––as I listen to the wildly misinformed health reform protestors and the outright lies of Republican legislators. It’s so disheartening to see this intense politicization of an issue that should transcend partisanship: good health care as a fundamental right for all Americans, regardless of income.

Should we have expected anything different, even with a charismatic President? The industry players are mightily influential and the legislature bogged down by inertia. The Senate has become an institution hampered by minority rule with the elevation of the once-rare filibuster to standard practice.

But even so, we are now further in the reform process than ever before; even if Congress doesn’t pass a public option with the bill, we can welcome what will surely be in it: the expansion of Medicaid, the end of lifetime caps on healthcare spending, the expansion of insurance with subsidies for millions of people who don’t currently have it, the end of pre-existing conditions exclusions.

This can be seen as just incremental, but it’s a move in the right direction, and one we should support and applaud.

. . . and for more from our friend Altoon:

ALTOON SULTAN ON NPR

NPR's Weekend Edition aired a letter of her's on August 22nd. To listen to Altoon's letter go to: http://www.npr.org/templates/story/story.php?storyId=112134932

For those of you who have not yet seen this clip of a news conference where Barney Frank responds to a questioner who calls the Obama health care plan "Nazi" . . . go to:

The tension between individual rights and community well being is as old as the story of America. From the time the Puritans arrived on our country’s shores, we have struggled over how to strike a balance. Our best moments have come when we put the good of the whole ahead of the interests of the individual – the Civil War, the Homestead Act, child labor and meat inspection legislation during the Progressive Era, Social Security during the New Deal, the fight against fascism in World War II, the civil rights revolution and Medicare during the Great Society. Now the issue is before us once again with the issue of health care. How can we make the tension between individual and communal well being a source of strength rather than have it become a debilitating weakness.

Perhaps it is worth going back to the heart of John Winthrop’s vision for America as a “city upon a hill.” When he delivered his sermon, “A Modell of Christian Charity” aboard the Arabella as the Puritans arrived in Massachuestts Bay, he envisioned a new kind of society. The task of the settlers, Winthrop declared, was to embrace a covenant with God that would create a beloved community. “We must strengthen, defend, preserve, and comfort each other,” he said. “We must bear one another’s burdens, . . . make others’ conditions our own. We must rejoice together, mourn together, labor and suffer together, always having before our eyes [that we are] members of the same body.

Through much of its early history, Massachusetts witnessed the evolving tension between the common good and individual liberty. The notion of “just prices” (no one should seek excess profits) and regulated social behavior (no flashy clothes) competed with a growing capitalist economy and the rise of laissez-faire individualism. Nothing better illustrated the dialectic between these competing values than the nation’s Declaration of Independence 135 years after Winthrop’s sermon. “We hold these truths to be self-evident,” Thomas Jefferson wrote, “that all men are created equal, endowed by their Creator with certain inalienable rights, among them life, liberty and the pursuit of happiness.” “Equal opportunity” parsed the tension between individual rights and the common good. Every person should have the same chance (a communal right) to distinguish themselves from their peers (individual freedom).

Finding the right balance was never easy. But the debate generated interesting crises, and creative legislative responses. Thus in the 1860s Congress passed the Homestead Act that opened up millions of acres of public lands so that individuals could migrate to the West and begin a new life as independent yeoman farmers. Then as manufacturing plants swept across the nation and spread their hold over the steel, railroad and meatpacking industries, Congress passed laws regulating the power of individual corporations to control the nation’s social and economic life. Theodore Roosevelt became the political personification of the common good, arguing that government should be a moral arbiter striking the balance between individual greed and communal well being. Franklin Roosevelt, his nephew, carried the same message to a new level during the Great Depression with Social Security, a commitment to help that “one-third of a nation that is ill-housed, ill-clothed, and ill-fed,” and a raft of legislation to protect those most helpless against the ravages of the Great Depression – a movement brought to its culmination in Lyndon Johnson’s Great Society during the 1960s, including a Medicare bill that slashed dramatically the rate of poverty among senior citizens.

Now, once again, the debate between these competing values has crystallized in a moment of political and economic crisis. Do we care about the common good? Are we willing to have one sixth of a nation denied the chance for regular check-ups and preventive health care? Is there really a conflict between individuals being able to retain their own insurance packages, and others having access to a publicly funded option? Can we sustain a vibrant democracy “of the people, by the people and for the people” when 50 million of us are denied the “equal opportunity” to enjoy decent medical care?

Yes, the size of the deficit does matter. Yes, individual choices must be protected. But if the history of this centuries old debate teaches us anything, it is that we reach our greatest moments as a nation when we act on behalf of the common wealth. Or as John Winthrop said, if we wish to become a “city upon a hill” that others can look up to, “we must bear one another’s burdens [and] make others’ conditions our own.”

The liberals and progressives, radicals and left-wingers, even Paul Krugman--surprise, surprise--are all now complaining about the wimpy nature of Obama's fight for health care, which is, as Peter Suderman, in The Atlantic's "The Daily Dish" for 21 August, says, is "particularly unrealistic given that Obama didn't run as a progressive cage-fighter, but as a calm, pragmatic leader--with progressive sympathies . . . .

And don't forget, as our friend Altoon says, "That's why we all voted for him."

Suderman continues: What did progressives expect? That Obama could simply roll into Washington and ignore the myriad forces arrayed against a liberal agenda? That conservatives, Republicans, moderate Democrats, and interested industry groups would simply go away or shut up? That Obama, through force of will and liberal coolness, could use his awesome rhetorical jujitsu skills to flip the opposition and defeat nutty right-wingers and conservative politicians forever? Unless you're a character in an Aaron Sorkin show, that's just not how national politics work.

James Wagner is an almost-daily art and politics blogger, http://jameswagner.com, who lives on Manhattan Island in the Chelsea section of the West Side.

David Kreuter is a computer guy and avant garde jazz fan who lives in Thornhill, Ontario, Canada.

Miriam Schubert lives in San Rafael, California. She was a lifelong resident of Quebec until she married an American and moved to the U.S. three years ago.

Barney Frank is the gay, Jewish--not to mention fabulous--member of the House of Representatives from a district in Massachusetts.

THE JUDEVINE MOUNTAIN EMAILITE: A Cyberzine
An On-line and On-going Journal of Politics and Opinion
#47
14 September 2009

In This Issue:

THE JUDEVINE MOUNTAIN EMAILITE: A Cyberzine An On-line and On-going Journal of Politics and Opinion #47 14 September 2009

In This Issue:

THE JUDEVINE MOUNTAIN EMAILITE: A Cyberzine
An On-line and On-going Journal of Politics and Opinion
#47
14 September 2009