Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts

Friday, June 24, 2022

Backsliding

Everyone knew it was coming, of course.  That didn’t make the news any easier to accept. 

The U.S. Supreme Court has formally handed down its decision in Dobbs v. Jackson Women’s Health Organization, nearly two months after Justice Samuel Alito’s draft majority opinion was leaked to the public.  The resulting backlash notwithstanding, it appears the final draft is identical or nearly so to the preview.  There is no longer a nationally recognized right to abortion.  

The extent to which a woman enjoys reproductive freedom now depends upon the state where she lives.  In my own state, little or nothing will change in the wake of Dobbs.  There has been talk of making our state a sanctuary for women seeking safe terminations.  But even then, measures elsewhere such as the Texas snitch law may thwart this particular haven unless the woman doesn’t return home. 

Emboldened by their right-wing supermajority, there is already talk of harsher actions to come.  Clarence Thomas has publicly said it may be time to consider limiting access to contraception. Rights such as same-sex marriage may also be at risk now that SCOTUS has issued a total reversal of what was once considered settled law. 

Despite having won, the right is nevertheless taking refuge in their perennial claims of persecution by a malevolent “woke” left.  Congressional wingnuts are already conjuring specters of a violent backlash to further entrench the hysterical tendencies of the base.  Republican Sen. Mike Lee of Utah (where else?) warned of a potential “constitutional crisis” resulting from a rumored “invasion” of the Supreme Court by the “pro-abortion left.”  (Sorry, Mikey, inciting mob violence is your party’s brand.)  

The decades-long assault on reproductive rights is deeply disturbing to me on a visceral level.  This may read counterintuitively considering men can’t get pregnant (except in emojis).  But the two things I value most are my privacy and my autonomy.  If I insist upon these for myself, then it is only right that I want them for you as well.  Anti-abortion and anti-contraceptive policies limit privacy and autonomy for women of childbearing age, and that is wrong.  

Dobbs is a landmark on the backsliding route our country is traveling.  It is also a warning.  We have arrived at a place where a moderate majority are increasingly subjected to the superstitious fanaticism of right-wing leaders and their legions of scruffy devotees.  It’s sickeningly awful to witness them fouling our nest while our freedoms erode and life in America becomes harder to bear.  We face more grim days such as this.  The darkness is gathering fast.

 

© 2022 The Unassuming Scholar

Friday, May 29, 2020

Alone Together


The past months have been instructive as we endure an unforeseen emergency which has yet to show any sign of letting up.  If we believe the more pessimistic predictions, the future will be permanently altered and not for the better.

This is the third major crisis the country has faced in less than twenty years.  First there was 9/11, which itself came on the heels of the tech meltdown.  Next was the bursting of the housing bubble.  Now it’s the wide swath cut by an unseen killer bearing the awkward moniker SARS-CoV-2.

Being slightly north of fifty, I’m alarmed at the increasing frequency of these calamities.  Life in America has never been entirely secure for average people, but the worst thing I witnessed in my first three and a half decades were the stagflation and oil shocks of the 1970s.  Even if you throw in the domestic turmoil over Vietnam and Watergate, the difficulties of that era seem positively quaint in retrospect.

A sense of unity is essential for a society to meet extraordinary challenges.  What that means is a matter of one’s personal worldview, however.  For me, the closest example that comes to mind is Britain during the Second World War.  Confronted with an existential threat and living through years of material hardship, the British people met the challenge with plucky cheerfulness. 

A quick glance at your newsfeed or cable news will show instead that the fissures plaguing us before coronavirus have only deepened.  This should be surprising to no one.  The cultural and economic wars experienced by the past two or three generations have left us so divided the divisions may be irreparable.

Material satiety has done a lot to paper over these differences, but this has become less feasible as time has passed.  After the attacks on New York and Washington, George W.’s advice was to go shopping and visit Disney World.  We did, and the downturn quickly passed.  If you stayed employed through the Great Recession you probably came out okay; many of those who didn’t had yet to fully recover before the COVID-19 anvil landed on them.

Economic pressures are indisputably a factor driving the reopening controversy on the part of laid off workers and small business owners who abruptly lost their incomes.  But the great cultural divide in American life overshadows the coronavirus response as it does everything else.

A closer look at the news since March brings this conclusion into 20/20 focus.  Three and a half years of “fake” news accusations and “alternative facts” has made the discourse (if you can call it that) a bit unreal.  A local news channel interviewed churchgoers defying a closure order a couple of weeks ago.  One worshipper said he wasn’t concerned about the pandemic since for him it signaled the beginning of the End Times.  Another said he wasn’t worried because God would shield him.  Neither wore face masks.

Face masks have become an unlikely bone of contention of late.  If the opinion pieces I’ve read are any indication (and the President’s own statements echo this) it’s that being required to cover one’s face is a sign of weakness.  It is a form of forced submission, and so to go without a mask is an expression of one’s manhood.

Asinine?  Emphatically yes.  But there may be an added dimension to the pushback over masks.  An article in The Atlantic proposes that the reason so many white males on the Right reject masking is that it makes “vice signaling” difficult for them.  Put differently, covering their faces makes it less likely for them to receive credit for any public mischief they commit.

Vice signaling, as you’ve probably surmised, is the flipside of the conservative snarl phrase “virtue signaling.”  The MAGA contingent wants the world to witness its bad behavior and dares us to do something.  In the social media age, however, this can entail blowback as we have seen on recent two occasions.  Sadly, but unsurprisingly, both involve the deaths of black men.

The stalking and murder of Ahmaud Arbery is notable in that the perpetrators were so sure they would suffer no consequences that one of them recorded it on his phone for posterity.  The death of George Floyd at the hands (or, more precisely, knee) of a Minneapolis police officer this week was caught on camera by several onlookers.  One would think that the nauseating procession of public violence against people of color over the years would inhibit would-be race warriors and law-and-order thugs, but no.  Not only have they been emboldened, but they want the notoriety of going viral.

The Arbery and Floyd killings perversely demonstrate that while so much of our world has been upended some things do not change.  But as horrific as these deaths are, the extent to which the pandemic has disproportionately harmed minorities demands even more attention.  Not only are they more likely than whites to have the kind of underlying health issues making them vulnerable to COVID-19, they are less likely to have health insurance and are more likely to work in the essential jobs necessary to keep the country’s head above water.  The soft violence of social inequality will do far more harm to people of color over the pandemic than any random attacks on their young men. 

Throughout it all, I’ve been hunkered down at home.  I am one of the fortunate ones whose bosses have commanded to work from home.  I have ventured out twice since early March, once to the supermarket (before dumping my shopping needs upon gig workers via Instacart) and once to the bank.  Each time the world looked normal albeit with lighter traffic.  Everyone I interact with, few as they are and mostly limited to neighbors and the aforementioned delivery drivers, has been normal and even pleasant. My risk of infection is very low.  By all rights my only enemy should be boredom.

Yet, I continue to look at the world with trepidation. The antics of the Trump administration, its disingenuous minions, and its unhinged supporters have become less amusing and more appalling as this year’s election draws near.  I’ve assuaged my frustration with and distaste for daily life with occasional travel abroad, the future prospects for which are now remote.  Weeks of confinement, while tolerable, has also heightened a state of anxiety that sometimes drifts to the edges of paranoia. 

I thought I was immune to this; who knew?  I can’t be alone.  It’s our new normal.


© 2020 The Unassuming Scholar


Sunday, January 20, 2013

Generation Gap

My HMO recently assigned me a new doctor.  Well, he actually wasn’t a doctor; he was a physician’s assistant.  This fact wasn’t a problem in itself.  But being a careful consumer of healthcare services in the information age, I researched his professional background online.  What I learned gave me pause.

It turns out that my primary care manager, to describe his role in insurance speak, was born in 1987.  I would be placing my health in the inexperienced hands and technology addled mind of a Millennial, and that would not do.  I called my HMO, told the customer service drone on the other end I wanted a new doc, and to my pleasant surprise I got my way.  My new “PCM” is an actual MD, and she was born in 1961.  Her professional record is substantial and, as far as I was able to find, unblemished.

Problem solved, at least for the time being.  I know that this conundrum will recur as the years progress.  Eventually, the professionals of my generation or earlier will have retired and my only choices for doctors, lawyers, and accountants will come from today’s young’uns.  I am dreading the prospect.

I never thought I would feel this way.  After all, I’ve worked with young people throughout my professional life as well as in my community service activities.  More importantly, I’m a little disappointed in my own kneejerk judgments in light of my own youthful frustrations with what I saw as my elders’ misperceptions of my Generation X peers.

If you look at media depictions of Gen X from the Eighties and Nineties, you would have trembled for the future.  Personally, I was a little mystified by them.  Even relatively sympathetic pop culture depictions of Xers, such as the movies Reality Bites, Clerks, or just about any of the early work of Richard Linklatter failed to reflect my subjective experiences as a teen and twentysomething.  Nor did the literary emanations of Chuck Palahnuik or even Douglas Coupland, who did the most to popularize the moniker “Generation X,” fully resonate with me even though I enjoyed them on their own merits. 

I suppose it was because by my late twenties, I was a married homeowner with a couple of kids and a middle management job I’d held since graduating college several years earlier.  I was neither a slacker nor a techie.  I wasn’t financially dependent on my parents as I tried to make my breakthrough as a—fill in the blank—poet, musician, film producer, artist, or dancer.  I suspect the majority of people my age didn’t have these experiences either, any more than the typical Baby Boomer was a hippie other than perhaps in the sartorial sense.

But as I contend with increasingly callow groups of kids each semester, my resentment waxes while my hopes for the future wane.  Official expectations don’t help matters.  The executive dean at my small campus suffers from a case of youth worship bordering at times on ephebophilia.  (The semi-fictional Dean Kimpossible who occasionally haunts my posts is an all-too-slight exaggeration of an all-too-real person.)  My job security as a non-tenured prof consequently demands that I cater to the shallow intelligence and short attention spans of my young charges.  Standing on principle can lead to unemployment in academia just as easily as it can anywhere else in this economy.  I may be craven, but I’m employed.

What I find so hard to grasp is not so much their dependence on technology, but the way in which they use it.  I was inspired by the role of social media—Facebook, Twitter, YouTube, et al.—in organizing and publicizing protest during the Arab Spring.  By contrast, Millennials at home use it to ceaselessly document the minutiae of their daily lives.  The outcome is that, to a larger degree than any generation before them, the present youth cohort exists within a self-referential bubble nearly impossible to burst.  Collective narcissism, if you will.  Already driven to distraction by their toys, our Millennials have had their self-esteem propped up by parents and the educational system to the point where failure really isn’t an option; accordingly, it has all but been eliminated as a possibility.

So, why did I refuse the boy-PA as my primary care doc?  Was it necessarily his youth that made me ask for someone else?  Well, let’s just say it was a matter of premonition and a desire to avert the inevitable just a little bit longer.  Many of my students are self-declared nursing majors or they plan to go into some other healthcare field.  A few of them have told me they’re pre-med.  I guess someone has to do it.  And while I know that the rigors of training will pull the bullshit card on a few of them, I also know that many will get through nonetheless.  (There’s also the possibility that the medical and nursing schools will eventually have their own versions of Dean Kimpossible, in which case we’re all screwed.  I try to push those thoughts aside for the sake of my own fragile peace of mind.)     
I have this recurring scenario which runs through my head whenever I think of the day when I must entrust my health to today’s youth.  It goes something like this: I’m undergoing a major procedure, let’s say open heart surgery.  My life depends upon a successful outcome.  And the next-oldest person in the OR is twenty years my junior…


Scene: The Operating Room. 

Time: The not-so-distant future. 

The PATIENT is already prepped and on the table.  Enter DR. CHELSEA, DR. TIFFANY, DR. TODD, NURSE BRITNEY, and NURSE JOSH.


DR. CHELSEA

Dr. Todd, is the patient anaesthetized and ready?


DR. TODD

Yeah, we good.

DR. TIFFANY

 Wait…Chelsea, have you, like, ever done this procedure before?  Do you even know what to do?


DR. CHELSEA

(Scoffs)

Huh, yeah!  I totally looked it up on Wikipedia!


 DR. TIFFANY

Oh, wow! That’s such a great idea!  I’m so doing that next time!


DR. CHELSEA

(Smugly)


Yeah, well, that’s why I was first in my medical school class!

 (Turns to NURSE BRITNEY)


Scalpel, please. 


(NURSE BRITNEY seems distracted as she hands DR. CHELSEA the scalpel.)


 What’s wrong, Britney?


 NURSE BRITNEY

(Tearfully, her voice quavering…)


It’s Dr. Jared.  He…he…unfriended me on Facebook!  I…I…just don’t know what to d-d-do…


(NURSE BRITNEY’s voice trails off into a sob.  She buries her face in her hands.  DR. CHELSEA, overcome with shock, suddenly drops the scalpel.  It lands with a clatter on the instrument tray.)


DR. CHELSEA and DR. TIFFANY

(In unison…)


Oh…my…god!!!  What a jerk!


DR. TODD

(Scoffing)

Huh, Jared!  What a pantload!  You could do way better.


NURSE BRITNEY

 (Sniffles, smiles behind her facemask)


Thanks, guys!


NURSE JOSH

(Abruptly, in an alarmed tone)


Aw, dude!  Check it out!  The patient’s vitals are slipping!


 DR.  CHELSEA

(She is clearly annoyed by the interruption)


Josh, WTF!  Can’t you see Britney’s upset?  Stop being such an asshole, okay?


 NURSE JOSH


I’m just sayin’…


 DR. TIFFANY


Yeah, well, save it for later.  The patient’s not going anywhere.  And Britney’s hurting now!


(There is a loud, steady tone as the PATIENT suddenly flatlines.  DR. CHELSEA turns around, clearly agitated.)


 DR. CHELSEA


What now? Can’t this guy leave us the hell alone for two seconds?


 NURSE JOSH


Aw, weak!  He’s dead!


DR. TODD


What a dick!  He could’ve at least waited a coupla minutes before bailin’ on us.  Epic fail!!!


DR. TIFFANY


Hey, wait, this means we’re done for the day!  Let’s go out tonight!


 DR.  CHELSEA


Omigod, that’s great!  I just bought a low-cut dress that totally shows off my new tattoo!


(DRS. CHELSEA and TIFFANY grasp each other by both hands.  They jump up and down in unison)


Omigod!  Omigod!  Omigod!  A-i-i-i-e-e-e-e-e!


NURSE BRITNEY


And let’s go to the beach tomorrow!  I just got a new thong and a bikini wax!  I am so ready to forget Jared and meet some new guys!


(DRS. CHELSEA and TIFFANY begin jumping and squealing again.  NURSE BRITNEY joins in)


DR. TODD

(Jerks his thumb toward the now deceased PATIENT)


Uh, what about this choad over here?


 DR. CHELSEA

(Sighs disgustedly, snapping off her surgical gloves)

Oh, him.  I don’t know…just call it, already.


(Exit DRS. CHELSEA and TIFFANY and NURSE BRITNEY, shaking their heads in annoyance at having been inconvenienced)


 DR. TODD

(Motions toward NURSE JOSH)


Dude, like, cover him up or something!


(NURSE JOSH carelessly throws the sheet over the PATIENT’S head)


So, like, what’re you doin’ tonight?


 NURSE JOSH


I’m goin’ to a rager over at my cousin’s place.  He’s got this DJ playin’ there, name’s DJ Spazzz.


 DR. TODD


Yeh-yeh-yeh!  I heard of him! 


 NURSE JOSH


Yeh-yeh-yeh!  This dude’s, like, off the chain, yo!  You comin’?


 DR. TODD


Ai’ight!


 NURSE JOSH


S-w-e-e-e-t!  We outta here!

(DR. TODD and NURSE JOSH pull out their phones and begin texting intently as they amble towards the door.  Exeunt.  Fade to black…)


Fade to black, indeed…

© 2013 The Unassuming Scholar




Friday, June 29, 2012

Healthcare, Anyone?

I have mixed emotions about the news that the Supreme Court has upheld most of the Patient Protection and Affordable Care Act, commonly referred to even by the administration’s supporters as “Obamacare.”

My ambivalence comes from misgivings over the law’s provenance.  The individual mandate, the controversial key provision upheld by SCOTUS, is its best-worst aspect.  Despite its allegedly socialistic origins it creates a captive market for private insurers and was the result of intensive lobbying by America’s Health Care Plans, PhRMA, and other industry groups.  The bill that passed in the spring of 2010 is a Frankenstein’s monster of special interest and pork barrel provisions that illustrate the darkest facets of our political system.  (PBS Frontline presented an excellent documentary on the bill’s journey through Congress and the Obama administration’s frustrated efforts to enact a comprehensive reform.)     

Republican politicians, led by John Boehner, have already stirred an outcry from the right.   To be sure, the GOP faithful and a flagging Tea Party movement will get a lot of mileage out of the Supreme Court’s decision in the months leading up to the November general election.  It helps that many Americans, and not just those in “red” states, have a rather distorted idea of what the healthcare law does and its constitutional implications.

Bring on the cynical pols, the pissed off seniors raving about “death panels,” and the crackpots in tricorn hats…




Wednesday, April 25, 2012

Your Freedom or Your Life

A news item has made the rounds this week: A woman in Illinois was jailed for failing to pay a medical bill arising from cancer treatments.  The amount?  $280.

Since we’re bringing back debtors’ prisons, maybe we should dig up Charles Dickens while we’re at it…