The Terri Schiavo Case Once Again Exploited – This Time By The Left.

Posted on | December 3, 2023 | No Comments

Mike Magee

The case spanned 15 years, and was rejected by the Supreme Court for a hearing four times. Hijacked from doctors and patients by political opportunists and Right-to-Life activists, it rode the poor health and disability of one unfortunate woman literally into her grave with devastating consequences for all concerned.
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Having lived it, known some of the primary players, taught it in classes on medical journalism, medical history and medical ethics, the name Terri Schiavo understandably triggers something close to PTSD. She certainly has earned the right to “rest in peace.”

And yet, this past weekend, MSNBC Films ran “Between Life & Death,” an NBC News Studios production. As the promo stated “The documentary retraces the tragic story of Terri Schiavo from the 1990s and early 2000s, going beyond the headlines of the national debate over her life that reverberates in today’s culture wars. Watch Between Life & Death: Terri Schiavo’s Story.”

It would be easy to attribute this to “Florida-man” culture and the state’s peculiar predilection for right wing campaigns. After all, this is the state that Paul Weyrich and Jerry Falwell chose for the Moral Majority driven, Anita Bryant “Save Our Children” anti-gay campaign. That supported marches and speeches and book banning from 1977 to 1980 before burning itself out.

And now, as Gov. DeSantis’s culture wars have fallen flat in his home state, and his presidential prospects appear dim, the Scihavo case once again has been surfaced (this time by the left), and its advertising trailer (not surprisingly) completes the loop. The 60 second promo ends with these words delivered somberly by a legalistic male voice, “Reproductive Health and the Right to Die. It’s two sides of the same coin.”

Recent history has indeed “flipped the coin.” On June 24, 2023, the Justices on the Supreme Court allowed the government to “muscle out” the patient-physician relationship in the Mississippi abortion case (Dobbs v. Jackson Women’s Health Organization). “What possibly could go wrong if we remove doctors from delicate life and death decisions?”, I asked (fictitiously) at the time. The answer for Republicans arrived a few months later in the 2022 Midterm elections as multiple states abandoned the party to support women’s autonomy over their own medical decisions.

We’ll see how many viewers decided to tune in this past weekend. But in the meantime, for context and historic accuracy, here is a summary of the Schiavo case from my Fall, 2021 course, “The Right to Health Care and the U.S. Constitution” at the President’s College of the University of Hartford.

Schiavo Case: Summary and Timeline

•Theresa Marie Schindler was born in a Philadelphia suburb on December 3, 1963. She and her bother Richard and sister Suzanne attended local schools. Terri struggled with weight and had an eating disorder.

•Terri married her husband, Michael in 1984 and moved to Florida to be close to her parents. Terri apparently continued to struggle with her eating disorder, a condition left undiscovered when she sought evaluation for infertility.

•On February 25, 1990, she collapsed in the lobby of their apartment in St. Petersburg, Florida. She was 26 years old. She was resuscitated, and taken to the local hospital, Humana Northside, where she was determined to have had a cardiac arrest brought on by a cardiac arrhythmia caused by hypokalemia with a blood potassium of 2.0 mEq’L (normal 3.5 – 5.0 mEq/L).

•Michael received a court order on June 18, 1990 making him legal guardian and director of future medical decisions related to his wife. Two physicians independently declared her in a “permanent vegetative state.” A gastric feeding tube was surgically placed to provide regular nutritional feedings.

•When she developed a urinary tract infection in mid-1993, he signed a Do Not Resuscitate (DNR) order on her behalf.

•In May, 1998, Michael filed a petition to remove the feeding tube, providing some evidence that his wife would not have wanted to continue to live this way. He refused her parents request that he divorce his wife and hand over decisions, and money garnered from a successful malpractice suit for ongoing care of Terri.

•The parents challenged the removal of the feeding tube that her doctors supported. The case went to Court and a decision to remove the tube was upheld in Florida Second District Court of Appeal in February 2000. After multiple legal maneuvers, the tube was finally removed on April 24, 2001. Terri was now 37 years old.

•The Schindler’s charged Michael Schiavo with perjury, and a judge ordered the tube reinserted 2 days later.

•Claims and counter-claims ate up two more years. On September 17, 2003, as Terri approached her 40th birthday, a frustrated presiding Judge George Greer declared the actions of the Schindler parents was “an attempt to re-litigate the entire case”, and ordered the feeding tube to be removed for a second time, which it was on October 15, 2003.

•With encouragement from Republican operatives in Florida, the Schindler’s joined by their son, Bobby, engaged anti-abortion Operation Rescue/Right to Life extremist Randall Terry in a very public campaign with daily demonstrations at the care facility.

•The Florida legislature in emergency session granted then Gov. Jeb Bush (filled with Presidential aspirations), the authority to intervene in the case. Citing the new “Terri’s Law”, Bush ordered the feeding tube surgically reinserted for the third time.

• In the meantime the ACLU lined up with Terri’s husband. On May 5, 2004, “Terri’s Law” was declared unconstitutional.

•Senator Mel Martinez’s (R-FL) political career was damaged irreparably when he called for federal government intervention in the case. His top aide, Brian Darling’s memo was leaked to the public. It read, “This is an important moral issue, and the pro-life base will be excited…This is a great political issue, because Senator Nelson of Florida has already refused to become a co-sponsor and this is a tough issue for Democrats.”

•A second Republican casualty was the future political career of doctor turned politician, Senator Bill Frist, who had Presidential aspirations but couldn’t resist weighing in as a physician. Breaking a well accepted medical media code of ethics for the medical profession, without every seeing the patient, he challenged the decision to remove Terri’s feeding tube, proclaiming on the floor of the Senate on March 17, 2005, “I question it based on a review of the video footage which I spent an hour or so looking at last night in my office.”

•The United States Congress held hearings on the case, and then President George W. Bush brokered a compromise transferring the case to Federal Courts. The Federal Court agreed with prior State Court Appeals.

•Terri Schiavo’s feeding tube was removed a final time on March 24, 2005. She died at a Pinellas Park hospice on March 31, 2005.

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“AI god Tells Medical-Industrial Complex: ‘Your Health Care System Is Perfect!’”

Posted on | December 1, 2023 | No Comments

Mike Magee

One of the top ten headlines of all time created by the satirical geniuses at The Onion was published 25 years ago this December. It read, “God Answers Prayers Of Paralyzed Little Boy. ‘No,’ Says God.”

The first paragraph of that column introduced us to Timmy Yu, an optimistic 7-year old, who despite the failures of the health system had held on to his “precious dream.” As the article explained, “From the bottom of his heart, he has hoped against hope that God would someday hear his prayer to walk again. Though many thought Timmy’s heavenly plea would never be answered, his dream finally came true Monday, when the Lord personally responded to the wheelchair-bound boy’s prayer with a resounding no.”

But with a faith that rivals the chieftains of today’s American health care system who continue to insist this is “the best health care in the world,” this Timmy remained undeterred. As The Onion recorded the imagined conversation, “‘I knew that if I just prayed hard enough, God would hear me,’ said the joyful Timmy,., as he sat in the wheelchair to which he will be confined for the rest of his life. ‘And now my prayer has been answered. I haven’t been this happy since before the accident, when I could walk and play with the other children like a normal boy.’”

According to the article, the child did mildly protest the decision, but God held the line, suggesting other alternatives. “God strongly suggested that Timmy consider praying to one of the other intercessionary agents of Divine power, like Jesus, Mary or maybe even a top saint,” Timmy’s personal physician, Dr. William Luttrell, said. ‘The Lord stressed to Timmy that it was a long shot, but He said he might have better luck with one of them.’”

It didn’t take a wild leap of faith to be thrust back into the present this week. Transported by a headline to Rochester, Minnesota, the banner read, “Mayo Clinic to spend $5 billion on tech-heavy redesign of its Minnesota campus.” The “reinvention” is intended “to present a 21st-century vision of clinical care” robust enough to fill 2.4 million square feet of space.

The Mayo Clinic’s faith in this vision is apparently as strong as little “Timmy’s”, and their “God” goes by the initials AI. Only six months earlier, they announced a 10-year collaboration with Google to create an “AI factory” described as “an assembly line of AI solutions that are developed at scale and incorporated into clinical workflows.” They added that they are “looking beyond foundational development.”

Cris Ross, CIO of Mayo Clinic, imagines crowded hallways. He says, “I think it’s really wonderful that Google will have access and be able to walk the halls with some of our clinicians, to meet with them and discuss what we can do together in the medical context.” No small dreamer, Ross sees bright skies ahead – “an assembly line of AI breakthroughs… being able to do the kinds of things that people are doing in little bits all over the planet, to be able to do the same kinds of things but at scale and repeatedly.”

Luckily, the “AI god” will provide management infrastructure in the form of the new Mayo Clinic Platform, a group of digital and long-distance health care initiatives under the direction of physician executive missionary, John Halamka MD. As a fully registered Medical Industrial Complex (MIC) professional, he has touched all the bases – graduate of hallowed Stanford University, member NAM, wrote econometrics software for Milton Friedman, medical informatics at MIT and Harvard, birthed the software startup Ibis Research Labs, CIO at Beth Israel Deaconess, and influencer on multiple government panels.

The venture he directs will not rely on spirit alone. Venture capital dollars have helped launch two joint ventures – one intended to collect deindentified clinical data from patients far and wide, and the second “to commercialize algorithms for the early detection of disease.”

The “AI god” is wise enough not to reinvent the wheel. His/Her plan comes directly from the MIC playbook, originally designed in 1950 by Arthur Sackler. Create an integrated career ladder for academic medical scientists that will seamlessly carry them from Medicine to Industry to Government and back again, reward all parties with exclusive patents and hidden incentives, and trust that the little “Timmy’s” of the world will find some way to survive.

Of course, the “AI god”, to reach this level of power so quickly, has had to make certain sacrifices, notably replacing one of the two bedrock commandments that have served to guide human behavior for several thousand years:

The first – “Love the Lord your God with all your heart and with all your soul and with all your mind” – can stand, as we transfer loyalty to an over-arching artificial intelligence.

But we must toss the second, “Love your neighbor as yourself.” And embrace instead, “Love technology as yourself”, and all the riches will follow.

And for the patients? Have faith that when science and technology finally “defeats disease,” your health will follow.

Category: Uncategorized
Tags: AI > AI god > arthur sackler > artificial intelligence > Cris Ross > John Halamka > mayo clinic > The Onion

Giving Thanks to Women, and Children, and Lives Filled With Promise.

Posted on | November 20, 2023 | No Comments

Mike Magee

As Thanksgiving Day approaches, let’s give thanks for women, and children, and lives filled with promise.

One President who understood the power of promise more than many others was FDR. When he structured up “a series of programs, public work projects, financial reforms and regulations…”, he memorably packaged the plan under the label, “The New Deal.”

With a heavy dose of humility and learned wisdom, he rose again eleven years later, on January 11, 1944, fifteen months before his death, and delivered the State of the Union Address as a Fireside Chat from the Oval Office in the White House.

His words once again were clear and ever lasting. He stated that the original Bill of Rights was “inadequate to assure us equality in the pursuit of happiness.” One of the missing elements, he affirmed was a national health care system.

“Necessitous men are not free men.” The nation needed, he said, “a second Bill of Rights under which a new basis of security and prosperity can be established for all—regardless of station, race, or creed.”

Harvard-trained moral philosopher Susan Neiman PhD recalled those words recently in calling for “a commitment to universalism over tribalism, a firm distinction between justice and power, and a belief in the possibility of progress.”

She also recalled the work product of Eleanor Roosevelt who guided the creation of the UN’s “Universal Declaration of Human Rights” which she herself admits is to this day “a declaration that remains aspirational.” Signed by 150 nations, it remains the most translated document in the world.

Embedded in the declaration is a broad and inclusive definition of health. It reads “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

The Roosevelts’ definition of “health” continues to guide the work of the March of Dimes , whose latest report on maternal and childhood health in America is disturbing, and sends an arrow through the heart of Article 25 in the Declaration which reads:

“Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.”

As the March of Dimes reported, “the U.S. remains among the most dangerous developed nations for childbirth with early data from the CDC showing a 3% increase in infant mortality in 2022.” 10.4% of babies last year were born prematurely before 37 weeks gestation. Compare that with the U.K. (7.6%), Italy (6.8%), or Japan (5%). To make matters worse, U.S. numbers reveal remarkable racial disparity with 14.6% of Black babies born prematurely compared to 9.4% of White babies.

As for mothers health in the post-Dobbs era, the report states that “maternal deaths are on the rise, with the rate doubling between 2018 to 2021 from 17.4 to 32.9 deaths per 100,000 live births.”

Susan Neiman sees the problem as deeply embedded in America’s culture and politics where guideposts and philosophical values are being dismantled. Cast in this light, the failed U.S. health care system is systematically broken and highly discriminatory at best.

For Neiman, the vacuum left by an erosion of justice is always filled with power – and specifically, power over someone. As the March of Dimes report so well illustrates, the targets of this power play are clear. They are women, children, and people of color in America. They deserve more than our thanks this Thanksgiving. They deserve unimpeded and complete access to health services, and to their doctors and nurses throughout the land.

Category: Uncategorized
Tags: Eleanor Roosevelt > FDR > march of dimes > susan neimen > universal health care

The True Color of Tribalism – an orange sash, a green flag, a red MAGA hat…and a fragmented health care system.

Posted on | November 17, 2023 | Comments Off on The True Color of Tribalism – an orange sash, a green flag, a red MAGA hat…and a fragmented health care system.

Mike Magee

As Thanksgiving Day approaches, let’s give thanks for the study of history, in part because it reminds us that Trumpian words like “vermin” have been used before and serve to alert the human race that we have entered the danger zone.

One President who understood the power of words more than many others was FDR. When he structured up “a series of programs, public work projects, financial reforms and regulations…to provide support for farmers, the unemployed, youth and the elderly”, he memorably packaged the plan under the label, “The New Deal.”

Seizing alliteration in 1933, he further defined his new policies as the “3 R’s – Relief, Recovery, Reform”, promising “…action, and action now.”

“Necessitous men are not free men. People who are hungry and out of a job are the stuff of which dictatorships are made,” he said, proposing “a second Bill of Rights under which a new basis of security and prosperity can be established for all—regardless of station, race, or creed.” Those were FDR’s words that day.

In proposing this radical cultural shift, he was forecasting the words of Harvard-trained philosopher Susan Neiman PhD in her recent book, “Left Is Not Woke” celebrating a democracy that valued “a commitment to universalism over tribalism, a firm distinction between justice and power, and a belief in the possibility of progress.” Adding, “All these ideas are connected.”

It is not surprising that Dr. Neiman highlights the work product of Eleanor Roosevelt who guided the creation of the UN’s “Universal Declaration of Human Rights” which she herself admits is to this day “a declaration that remains aspirational.” Signed by 150 nations, and the most translated document in the world, not a single country has created a society that assures all the rights enumerated.

This Thanksgiving Day, I will encourage my children, and grandchildren and guests to read aloud the 30 short Articles in the Declaration. Embedded in the declaration is a broad and inclusive definition of health. It reads “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

I am motivated to take this action, not simple because the health of our democracy and others around the globe are under attack by Trump, and Putin, and their followers; nor only for the intentionally destructive behaviors of some of our elected officials; nor just as a reaction to the willingness of some leaders to undercut women’s autonomy and their rightful access to health professionals when medical danger is knocking at their doors.

Rather, I am driven to this action by last week’s March of Dimes report on maternal fetal health in America, and its incongruity with the second paragraph of Article 25 in the Declaration which reads:

“Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.”

As for mothers heath in the post Dobbs era, the report states that “maternal deaths are on the rise, with the rate doubling between 2018 to 2021 from 17.4 to 32.9 deaths per 100,000 live births.”

Fintan O’Toole, the Leonard L. Milberg Professor of Irish Letters at Princeton, in a recent review of Susan Neiman’s book, suggested that results such as these are “rather intimate catastrophes” … and “the starkest manifestation of a tribalized society.”

Such societies, and by inference our own, go well beyond “political partisanship.” As O’Toole explains, “Tribalism spills beyond the strictly political arena into parallel assumptions about history, geography, economics, and, of course, religion… neither side in this (typically binary) contest truly accepts the legitimacy of an electoral defeat. Being outvoted is understood not as a disappointment but as an existential threat.”

O’Toole, as an expert on “The Troubles” in Northern Ireland, knows the landscape, and is raising alarms. “The throwback now feels like a foretelling,” he says. As he sees it, “the Troubles are now—and not in a good way—everybody’s trouble. There are, in the United States and Europe, powerful forms of mass political identity that do not ‘adequately manifest’ themselves in loyalty to the institutions, laws, and values that make a democratic state possible…. suffering deepens the sense of victimhood… Self-harm and self-pity form a feedback loop of endlessly renewable political energy. And this perpetual motion machine is also driven by revenge.”

“The true colors of a community’s life may be a dazzling mosaic, but tribalism makes them monochrome: an orange sash, a green flag, a red MAGA hat.”

As a moral philosopher, Susan Neiman clearly channels an earlier Eleanor Roosevelt when she highlights the abandonment of philosophical values including “a commitment to universalism over tribalism, a firm distinction between justice and power, and a belief in the possibility of progress.” Cast in this light, the failed U.S. health care system is easily cast as “tribalistic” at best.

Of course, as O’Toole points out, tribalism is also accompanied by heavy doses of self-victimization. Trump’s White Nationalist followers believe they are being “tyrannized by poor immigrants and nonwhite people demanding to be treated as equals.” But as O’Toole points out, “The power of self-pity is that it does not require actual oppression—if you always travel first-class, being stuck in economy will make you feel very sorry for yourself.”

Neiman’s major point is that the vacuum left by an erosion of justice is always filled with power – and specifically, power over someone. As the March of Dimes report so well illustrates, that “someone” for Trump and followers, for whom (as O’Toole suggests) “the only truth is the eternal binary of friend and enemy,” and “politics, like war is a matter of the most extreme and intense antagonisms,” the enemies are clear. They are women and people of color in America.

Category: Uncategorized
Tags: 2023 march of dimes report > Eleanor Roosevelt > FDR > Fintan O'Toole > ledft is not woke > nazi language > Susan neiman > the new deal > tribalized society > trump > universal declaration of human rights > vermin

The Way Men Ought To Behave – According to TikToc.

Posted on | November 14, 2023 | 2 Comments

Mike Magee

The juxtapositioning of Tuesday’s New York Times headlines was disturbing. The first “Why Does This Bride Look So Mad?”, was followed by “An ‘Unsettling’ Drop in Life Expectancy in Men.”

The “reluctant bride” referred to in the first article is (by now) an estimated 175 years old if the intended bride was 18 in the painting. The painting itself was the work of artist, Auguste Toulmouche, in 1866. The original title was “The Hesitant Fiancee.” Its’ current fame has a much shorter timeline – 2 weeks to be exact. That’s when it began to appear on TikTok, hosted as a statement of disgust and outrage by mostly young females in opposition to “sexist scolding.”

The painting displays a soon-to-be bride, attended by three friends, all well appointed in opulent dress, with obvious emotional distress. The bride’s face is frozen somewhere between disgust and outrage. Two supplicants are attempting to calm her, with limited success, by hand-holding and kisses on the forehead. The third is distracted, examining her own image in a mirror.

Temple University Art Professor, Theresa Dolan, PhD, offered this description to The New York Times Style and Pop Culture reporter Callie Holtermann: “You don’t often get this in 19th-century painting — this kind of independent streak. She’s actually showing the emotion of not wanting to get married to the person that her obviously wealthy family has picked out. What Toulmouche does so successfully is get into the psyche of the woman.”

Since its recent appearance on social media, modern women have been setting the image to music (“a dramatic section of Giuseppe Verdi’s Requiem”). and adding their own captions, including: “Literally me when I’m right,”“You’re overreacting,” “You should smile more,” “Ugh, do I really have to go through with this,” “Don’t be mean,” and “Mean wasn’t even in the room with us but I can go get him and bring him in.”

Turning the page, the second article feels somehow connected to the first, and not in a good way. It’s written by the Times Sex, Gender, and Science reporter Azeen Ghorayshi, and begins with, “The gap in life expectancy between men and women in the United States grew to its widest in nearly 30 years, driven mainly by more men dying of Covid and drug overdoses, according to a new study in the journal JAMA Internal Medicine.”

The facts are clear: Life expectancy of men at birth is now approximately six years less than women. This reinforces a several decades old trend, and one that is gaining steam. General life expectancy, independent of gender, has declined from 78.8 years in 2019 to 76.1 in 2022. Placed in perspective, most developed nations like the UK, Japan, Korea, and Italy are above 80 years. Our women come close to that at 79.1 years, but they are dragged down by men who now register a depressing 73.2 years. That’s a 5.9 year gender gap.

Dr. Brandon Yan was the lead in this Harvard School gf Public Health Study, and his explanation for the results are discomforting. He identifies Covid-19 as one “preventable cause,” and adds that “The opioid epidemic, mental health, and chronic metabolic disease are certainly front and center in the data.”

But taking a systematic long range view, he speaks directly to policy makers with these words:

“We have a health care system that is very advanced in treating illnesses and advanced disease. But for the most part … it is not very good when it comes to preventative care…There’s a substantial socio-cultural norms component to this data as well in terms of the ways that society views masculinity and the way that men ought to behave. That has profound effects on care-seeking behaviors.”

“The way men ought to behave.” Hummm…sounds like a caption for a TikToK painting.

Category: Uncategorized
Tags: Auguste Toulmouche > Azeen Ghorayshi > Brandon Yan > Callie Holtermann > Harvard School of Public Health > Life Expectanct in US > The Hesitant Fiancee > Theresa Dolan > TikToK painting

Courage Has A Face. Her Name Is Hadley.

Posted on | November 8, 2023 | Comments Off on Courage Has A Face. Her Name Is Hadley.

Mike Magee

“Don’t call me a saint,” said founder of the early 1930’s Catholic Workers Movement, Dorothy Day. “I don’t want to be dismissed that easily.” Oddly enough, says Jesuit writer, James Martin, “That quote is probably the biggest obstacle to her canonization…Given that quote, would Dorothy really want to be canonized?”

Today’s election results were a sliver of bright light in what has been a rather dark period. But it is at times like this that quiet heroes emerge. If courage has a face, this morning, as results across the land show a sweeping victory for Democrats, and specifically those advancing the cause of women’s autonomy in managing their own health decisions with their doctors, it belongs to a young woman from Kentucky named Hadley.

In the final weeks of the Kentucky governor’s race, as Politico reported, Andy Beshear gave voice to the woman who directly addressed his opponent on camera. “Anyone who believes there should be no exceptions for rape and incest could never understand what it’s like to stand in my shoes. This is to you, Daniel Cameron. To tell a 12-year-old girl she must have the baby of her stepfather who raped her is unthinkable.”

Absorbing the results of yesterday’s elections with the rest of us are Governor Chris Christie, Governor Ron DeSantis, Ambassador Nikki Haley, Vivek Ramaswamy, and Senator Tim Scott who will take the stage this evening in Miami at the 3rd Republican Primary Debate. No doubt they are surrounded this morning by consultants trying to figure out how best to spin this issue. As Dobbs has played out in states like Kansas, Ohio, Kentucky, Wisconsin and beyond, political scientists are likely reminding their students that in politics, “Sometimes when you win, you lose.”

Court packing on a federal level, and even more importantly by Republican leaders on the state level, has tipped the power of our nation toward minority rule, allowing repugnant leaders to seize control of our legal system. That power has been used over the past decade to allow passage of laws that attack existing rights such as women’s power and autonomy over their own bodies, or construct barriers that obstruct the popular will of the people. Examples include promoting extreme gerrymandering and voter suppression, dead ending the Dream Act, or allowing citizen access to weapons of war and a permitless gun-carry law in Florida.

Understandably, citizens have wondered, “Will our Democracy die?” Hadley’s courageous decision reflects a stubborn and determined stance, by her and many others throughout this land, assuring the answer is, “No. Not on my watch!”

Her image and words will be lasting for three major reasons. They prove that:

A healthy Democracy requires participation and engagement of citizens.
Freedom and autonomy, including access to health professionals, is sacred and personal.
Women will not accept second class citizenship.

Trump no doubt remains unaware that he has lost everything. Many of his most ardent supporters, including Leonard Leo, the mastermind behind the court packing scheme that brought us the Dobbs decision, remain firmly in a state of denial. But even they must admit this morning, as they stare into Hadley’s eyes, and listen to her steady voice, that they have met their match. And she is a young woman who’s message is clear, “Enough is enough!”

Likely channeling another woman’s spirit from a century ago, Hadley’s courage (listen here) was more human than super-human. As Dorothy Day quietly proclaimed, “Don’t call me a saint. I don’t want to be dismissed that easily.”

Category: Uncategorized
Tags: Andy Beshear > democratic victory > Dorothy Dasy > Hadley > Kansas > kentucky > Leonard Leo > ohio > republican 3rd debate > trump > wisconsin > womens autonomy > Womens Rights

Picking Up The “Single Payer” Baton From Ady Barkan.

Posted on | November 2, 2023 | 2 Comments

Mike Magee

The Politico headline in 2019 declared dramatically, “The Most Powerful Activist in America is Dying.” This week, 4 1/2 years later, their prophecy came true, as activist Ady Barkan succumbed at age 39 to ALS leaving behind his vibrant wife, English professor, Rachael King, and two small children, Carl, 8, and Willow,4.

His journey, as one of the nation’s leading activists for a single-payer health care system began, not coincidentally, with his diagnosis of A.L.S. in 2016, 4 months after the birth of his first child. His address at the 2020 Democratic National Convention fully exposed his condition to a national audience.

His mechanized words that day were direct, “Hello, America. My name is Ady Barkan, and I am speaking to you through this computer voice because I have been paralyzed by a mysterious illness called A.L.S. Like so many of you, I have experienced the ways our health care system is fundamentally broken: enormous costs, denied claims, dehumanizing treatment when we are most in need.”

With remarkable self-awareness, he told New York Times reporter, Tim Arango, “That’s the paradox of my situation. As my voice has gotten weaker, more people have heard my message. As I lost the ability to walk, more people have followed in my footsteps.”

His was a shared sacrifice, laced with stubborn and very public persistence, under the banner, “Be A Hero.” His passing on November 1, 2023, was bracketed that day by a piece by veteran Healthy Policy guru, and columnist for KFF Health News, Julie Rovner, that certainly would have made Ady smile. In the Washington Post newsletter, Health 202, it read, “The AMA flirts with a big change: Embracing single payer health care.”

The commentary that followed included this, “That leftward shift in political outlook is showing up not just in the AMA, but in medicine as a whole. As the physician population has become younger, more female and less White, doctors (and other college graduates in medicine) have moved from being a reliable Republican constituency to a more reliable Democratic one.”

Ironically, the AMA’s lead journal, JAMA, last week reinforced the need for simplification with an article by luminary KFF health policy pros, Larry Levitt and Drew Altman, titled “Complexity in the US Health Care System Is the Enemy of Access and Affordability.” They wrote, “Health care simplification does not necessarily resonate in the same way as rallying cries for universal coverage or lower health care prices, but simplifying the system would address a problem that is frustrating for patients and is a barrier to accessible and affordable care.”

My friend and colleague at The Health Care Blog, THCB, Kim Bellard took off on the article, writing, “Health insurance is the target in this case, and it is a fair target, but I’d argue that you could pick almost any part of the healthcare system with similar results. Our healthcare system is perfect example of a Rube Goldberg machine, which Merriam Webster defines as ‘accomplishing by complex means what seemingly could be done simply.’ Boy howdy.”

A bit further on, Kim comments, “If we had a magic wand, we could remake our healthcare system into something much simpler, much more effective, and much less expensive. Unfortunately, we not only don’t have such a magic wand, we don’t even agree on what that system should look like. We’ve gotten so used to the complex that we can no longer see the simple.”

As Kim suggests, status quo is hard to crack. But change has been in the air for some time. A KFF supported 2017 survey of 1,033 US physicians by Merritt Hawkins revealed a plurality of physicians favored moving on to a single payer system. Why? The survey suggested four factors:

1. Physicians are seeking “clarity and stability”. They believe “single payer” will reduce “distractions.”

2. There is a generational shift underway. “Younger doctors are more accepting.”

3. Physicians have become resigned that “we are drifting toward a single payer system” – so let’s get on with it.

4. There is a philosophical change occurring that increasingly embraces the societal value of universal coverage.

Around the same time American Public Health Association published a proposal drafted by the Physicians for a National Health Program which currently boasts more than 25,000 physician and medical student members. That proposal echoed some of the five points – universality, single administration, local delivery, health planning, and inclusive transparency – I advanced in 2019 in CODE BLUE: Inside America’s Medical Industrial Complex.

Kim, Julie, Larry, and Drew are right in pointing a finger at complexity. But what Ady understood, more perhaps than any others having waged the good activist fight as a progressive soldier, was that the challenge was greater than that. The challenge was cultural.

That realization was what drove the military’s decision under the Marshall Plan. In the re-build of Germany and Japan, we elected to start with a health plan – in part because we recognized that all other social determinants – housing, nutrition, education, clean air and water, safety and security – would be enhanced in the process leading to a tradition that could support stable democracies. This is essentially the same challenge we as a country (having wandered so far off course as to elect Trump) are facing today.

Changing culture, as health professionals know, is a tall order. It is about compassion, understanding and partnerships. It is about healing, providing health, and keeping individuals, families and communities whole. And – most importantly – it is about managing population-wide fear, worry and anxiety.

What we are asking of the people, and the people caring for the people, is to change their historic culture (one built on self-interest, hyper-competitiveness, and distrust of good government). This is a tall order – something that parents, pastors, politicians and physicians equally recognize. Things evolve, and difficult things take time.

Ady Barkan has run out of time. He has left it to us to complete the task of achieving health care for all through a single payor system.