DONALD K. SWITZER BA, JD

Free-Lance Essayist

                            E-Mail: DLDSwitzer@Cox.Net              2739 White Oak Drive                        T el.: (479) 936-8893

                               Rogers, Arkansas  72758                            

    WWW.PoliticsandWhimsey.Com

 

September 13, 2009

 

Mr. Dedrick Dahlander

Herenstrat 1207, 3

Hilversum, The Netherlands 1200 (31)

 

Re:  The State of the American Psyche:

Turmoil Over Healthcare

 

Dear Dedrick,

 

          It has been too long, my friend.  I must soon return to your beautiful land and, as we Americans say with a longing towards rest and repose, “smell the roses.”  (I know tulips are the flower of “Holland,” but the roses smell much better!)

 

          Thank you so much for your letter of September 1, but particularly for the photographs of the family.   Little Lela is no longer so “little”; but still as pretty as ever.  You must tell Ulrika, again, that YOU were NOT the better “catch.”  I would have been!!!  Linda and I truly miss all of you.

 

          Sadly, I feel right now that I have to share with you the feelings that I have regarding one of the most traumatic times, during this very “moment” of our lives, that the United States has ever gone through.  Your first thought might well be, “What?  Is Don going to rant some more about that cursed war again?”  No, Dedrick, but that is kind of wrapped up in the point…indirectly.  No matter now stupid and destructive the invasion of Iraq was, and no matter how many lives have been senselessly tossed aside to bolster the ego of a truly sick and dysfunctional “band of brothers” in our White House and Pentagon, the War in Iraq (and Afghanistan) are not even on the “front page” here anymore.  These wars, or “the” war (however categorized) are/is on page two now, as the more important first and third pages (literally every day) are taken up with charges and counter charges on the pending revision (which is not a “done deal” by any means) of our laws regarding: i.) honesty and fair practices in health insurance–about which I could write an entire book; ii.) unconscionable billing practices by medical-device and other ancillary service providers (especially to Medicare); iii.) some possible changes in our medical malpractice laws because of all of the extra and unnecessary expense that type of law practice leads to; and iv.) assuring more equitable access to heath care to all citizens of our beloved country, regardless of social or economic standing. 

 

          I have been caught up in this healthcare mess since it became an issue back during the early portion of President Clinton’s term of office, beginning in January 1992.  His effort hit a Republican “brick wall” that controlled the debate (even though they were even then considerably out-numbered in our Congress–as now).  Coming out of the most recent Congressional Recess, which took up the entire month of August, the Republicans again jumped in front in the critical battle for public opinion with some of the most venomous political activities in any living person’s memory.  These vile Republican attacks upon our President and his proposals equaled in intensity and scope, if not actual physical violence, even the attacks of the early Twentieth Century by Big Business upon the fledgling Labor movement in America.  Details are not necessary, as I know you are well-schooled upon the labor movement around the entire world.  But it was, I assure you, exceptionally awful–giving much credence to Secretary of State Clinton’s tired and well-worn allegation about the existence of a “vast right wing conspiracy.”  You might have to have actually lived through that time as well as in the current time, as I have  and am, to fully appreciate it…and to know that it truly does exist. 

 

          I do not see much point in discussing further with you or with anyone else the particulars of anyone’s “plan”, for in the legislative sense, the road ahead is a still a long and twisted one.  As I see it, however, the factions behind the push for reform are, generally speaking, the very, very Upper Class (I mean old, old money!), and the well-educated members of the Middle Class with an egalitarian bent.  These are the “actors” or the “pushers” that try to make certain that important things get accomplished; but in this strange circumstance there is almost no help from many, if not most, of the people that most urgently need the help and the protection of universal or near universal health access.  That is because so many of the working poor and the homeless, or the truly “lost”, as well as those of our younger persons who believe themselves “invincible,” are fully disassociated from politics and are not even registered to vote. 

 

          The opposition to any change (and I really do mean any change) is coordinated by the Republican Party, and, in particular, the “public face” of the opposition which has consisted of a group of tried and true “naysayers” by the name of Newt Gingrich, a former Speaker of our House of Representatives; Dick Armey, a former Republican Majority Leader in the House–but whose conservative organization “FreedomWorks” orchestrated the disruptions of the August recess at various of the “Town Hall” meetings held by Democratic congresspersons; Sarah Palin, former Governor of Alaska and former candidate on the Republican ticket for Vice President of the United States; any number of rabid “commentators” of the Fox News Network (owned by Rupert Murdock) and perhaps the most important person, because of the vast audience he reaches, Mr. Rush Limbaugh. 

 

          It is very important that I describe Mr. Limbaugh to you because I assume that very few Europeans have ever heard of him, and, too, he is clearly one of the most important factors affecting almost any political issue in the United States.  He is a former disc jockey and current talk show host who is an admitted prescription drug addict, and, yet, he has such a huge following that his view on any issue persuades enormous numbers of people.  I believe, personally, that he is nothing more than an opportunistic, glib  fool, but he is obviously a wise fool who draws to his side of things, by lies, actual on-the-air screaming and irrational rants, many of the lesser educated persons in our country.  That includes i.) those who are afraid of any change; ii.) those who are (without knowing it) perhaps just one pay check away from unemployment; iii.) and those people, though intelligent, who are without an emotional  “anchor” as we as a Nation enter this unexplored and tumultuous sea of change–when they feel as thought they personally are wrapped in a secure blanket!  Other groups, such as small business owners, who are being told that they will be forced into bankruptcy by the new law’s mandate to “cover” employees, which is a knowing, blatant lie because of the way each version of the currently pending bills are drawn, are lining up against its passage.    

 

          The money behind the opposition, of course, comes from the big business interests of the health insurance industry, medical practitioners, attorneys, and pharmaceutical companies who are spending hundreds of millions of dollars upon media advertising and have organized that proven, most intrusive and effective tool of all, the Internet.   The Internet is literally filled with misrepresentation about the proposed changes and even with attacks upon the President that are clearly racial in tone. In the recent “town hall meetings” some of the haters even carried automatic weapons outside the buildings where the meetings were held to call attention to themselves and to frighten Democrats and moderates away–and to get fifteen seconds of “fame” on television.  You see, in many states of the United States, unlike in Western Europe, it is actually legal for persons to openly wear or carry weapons of any kind in public–except sawed off shotguns.  There has been a persistent rumor, based on a vote against the carrying of firearms years ago by President Obama, that he plans to take away all of the firearms of private citizens so that he and his friends, using the army, can “take over” the Country while depriving “ordinary citizens” the right to defend themselves!  It is truly no wonder, Dedrick, that in any comparison of standardized tests of academic accomplishment comparing American schoolchildren or university students against the remainder of the developed world, the U.S. scores at or near the bottom.   These particular persons are, tragically, total fools. 

 

          The truly fascinating thing about the opposition is not really the Republican and big business backing, no matter how well-funded, self-interested and vile in execution.  Rather, it is all of the good-hearted, well-meaning and intelligent people who have, I truly believe, been fooled and taken in by the Republican and Neo-Conservative tactics.  I am speaking of bright, well-meaning and honest types of persons who have in all of this admitted morass of information and misinformation found reason to fear change and to ignore the dangerous actual state of healthcare in this Country at present.

 

          Only because I know that healthcare is not your field and it has been mine for many, many years, I will take the dare and the risk of boring you with just a few facts–not arguments, just the proved, unassailable actual facts that the groups promoting change, as well as the President and his Administration, seize upon.  In no other country in the industrialized world do twenty thousand people die each year because of their inability to access medical care.  I am speaking of the finest countries and societies–and we rank last!  Our costs of providing healthcare to those who can afford the insurance have increased by one hundred fifty per cent over the last ten years, above the rate of inflation for the rest of the economy by over fifty per cent.  The United States has the highest infant mortality rate of any society in the industrialized world, and most significantly, perhaps, is the fact that in a survey performed in these same countries, each and every one of them has reached the conclusion that the government has a moral duty to provide, regardless of ability to pay, each and every one of its citizens access to healthcare.

 

          And since all of this has been occurring in a Country which has the second highest standard of living in the world, the greatest scientists, the best medical facilities, and the best physicians in the entire world, it is obvious that something very, very wrong, something systemic, is clearly causing the entire system to fall apart…and possibly take the rest of the Country with it.  Many of the “naysayers” have openly said they know this, but have said they believe it is worth the price (of economic collapse) just to destroy the Obama Administration! 

 

 

          There are many problems which have resulted in these horrible truths not bashing their way into the consciousness of those opposing the changes necessary to bring us up to even near the level of the rest of the “developed” world in delivery of healthcare.  First of all, and I believe the very most important, is the fact that President Obama made this healthcare improvement attempt to do the right thing the “centerpiece” of his campaign for President (as it was the country’s second largest problem, behind only the misbegotten war in Iraq and those necessary attacks and other necessary steps to help achieve security against radical Islamist Terrorism–two separate issues), only to be met with the beginnings of an economic recession second only to the Great Depression of the 1930’s.  Ironically, it was caused in major part by a deliberate move by “Wall Street,” President Bush and the Republican Congress in 2000 to make legal a practice of the securities industry which had been illegal since the 1930’s!  

 

          All of the politicians acted upon the sworn assurance of the lobbyists (is that an oxymoron?) that there is nothing better than unfettered capitalism to build up the wealth of the Country (and I would agree…if that were the sole issue).  The problem is that what Congress and the President did was to repeal one little provision of The Securities Exchange Act of 1934 which had made illegal the sale and trading of “derivatives,” i.e., third party trading with “bucket shop brokerages“–entities which took third party “bets” (there is no other word) as to whether bundled sub-prime mortgages sold as securities would or would not fail or become insolvent!   Obviously, when the sub-prime mortgage market failed in 2008, along with the bursting of the housing “bubble,” it took down several huge Wall Street firms, banks faced huge liquidity issues and could not make loans to small businesses, and, as a result, it destroyed the fortunes of many small businesses across the entire and created a spiraling unemployment problem.  For the first time in eight decades the most anticipated economic news issued by the Government each month became not what the quarterly or annualized GDP would be, but, rather, what the next unemployment rate would be.  It is officially reported now in “double digits”, i.e., just over ten per cent; but eveyone knows the actual, “real world” rate is between sixteen and twenty per cent once those who have run out of unemployment compensation and have given up looking for work are added back in.

 

          American International Group’s Exotic Markets Division (in London and separate from its insurance company) (”A.I.G.”) bought the largest share of these derivatives covering down side of the bets and lost billions–resulting in the need for a capital infusion by the Bush Administration of, I believe, something in the range of thirty billion dollars.  This was accepted by almost everyone in the financial sector as necessary to keep it and the entire financial system afloat…at least for a while.  Interestingly, the massive financial infusion to A.I.G. was to the very company which had issued guarantees to the brokerage firm of Goldman, Sachs which would have lost tens of billions of dollars on the bundled sub-prime packages it guaranteed, the very firm from which then President Bush’s Treasury Security (Henry Paulson) had come.   It made it possible for Mr. Paulson to personally receive many millions of dollars in bonuses from Goldman, Sachs!

 

          Beginning in mid-2007, Bear, Stearns, the notorious “black sheep” of Wall Street securities trading firms, began to show serious capitalization problems.  First, it lost its access to overnight lending resources that it had been relying upon for years for all of its in-house investment cash, because of concerns over the quality and value of its collateral.  Things began going downhill from there.  After the principals of Bear Sterns first thought they had a deal with JPMorgan for a merger, JPMorgan backed out when they examined Bear, Stearns’ assets and found them grossly over-valued.  The only way out, as far as the Federal Reserve and the New York Fed were concerned, would be to merge with JPMorgan as planned but with BS’s stock valued at mere pennies on the dollar and a guaranty by the Federal Reserve to JPMorgan against any losses it might suffer because of the “garbage” real estate derivative assets of Bear.  Eventually, this–the first of many–merger eventually closed with the BS stock valued at ten dollars per share.   

 

          Within the last few weeks of the Bush Administration, General Motors, Ford and Chrysler officially made public what everyone else had known for decades, i.e., they could not compete with Japanese, Korean and German automobile manufacturers.  Nothing could be done before the end of Bush’s term, so the resolution of whatever was going to happen had to be orchestrated by the Obama Administration.  But, of course, all of the stock market problems and the failure of American Automobile companies was somehow turned around by the Republicans, and the truth was that they, the Bush Administration laissez faire policies which had made it all possilbe if not probable, laid it all at the feet of the Obama Administration. And much of the Public has bought it!!!  Not the U.S. cars.  The lie.

 

          Ford eventually backed away from asking for financial help, but General Motors and Chrysler were in much worse shape and absolutely needed assistance.  Chrysler ended up going through a quick bankruptcy, selling off divisions and a smaller Chrysler emerged.  It ultimately merged with Fiat with a large segment of its own stock held by its own union employees–which had the very largest debt against the Company in deferred benefits.   General Motors went into a reorganization type of bankruptcy rather than liquidation, sold off divisions (one to Penske, the international racing team owned by Roger Penske), scrapped some, and received tens of billions of loans from the Federal Reserve secured by non-diluted common stock of the company–which a successful General Motors has the right to buy back.  

 

          Yet, it has been the ownership of stock in private business, which has never been done before, which has given impetus to the screams of the “nut jobs” that the government is promoting socialism and is taking over the country!  They do not understand (or profess not to understand) the difference between:

 

          i.)”social policy” which takes on tasks which no other entity is large enough or equipped to handle (such as in building roads, bridges, airports, regulating insurance practices, regulating medical practices, regulating securities and banking practices and prosecuting fraud therein), and

 

          ii.) “socialism” which is the ownership and management of the distribution of all production of all businesses in a given Nation–which has been proved time and time again to be a philosophy of government that simply does not work to the benefit of the People.    

 

          I remember that you roomed for at least one year with Charlie Patch from Nashville when we were all at Dartmouth.  You will recall that while Charlie helped us get into some clubs back then since he was older–with his prior military career and all–but that also means that he has been retired now for almost twenty years instead of the three to five years that we have.  Well, Charlie happened to send me an article last week which really frightened me.  It was written by a man named Harold E. Meyer entitled simply “Revolution;” and I say “sadly,” because Charlie, in his “obstructionist” state of mind (I joke of course) would give you the impression that Mr. Meyer speaks for America.  Charlie Patch is a great friend of mine as well as yours, but Charlie tends sometimes to be too readily “taken in” by ideologues such as Mr. Meyer.  In being as charitable as I can, I have to describe Mr. Meyer as a reactionary writer, former staff member under President Reagan, and Central Intelligence Agency operative who is clearly more prolific than even I, but certainly of the highly paranoid “doom and gloom” cast.  He has no problem with changing or ignoring facts which disprove each and every one of his reactionary propositions–and for that reason I gave up reading his missives years ago since he is an intellectually dishonest, but I suppose still dangerous, propagandist.  I did closely study his paper called “Revolution”; and it was of the same “stripe” and the same tripe.

 

          I had been in a very deep “funk” for over six weeks, ever since our National Congress went into recess, as I alluded to above.  This, traditionally a time when the various Senators and Representatives meet and “press the flesh” with their constituents, was on this occasion a vile portrait of just how dirty politics can sometimes become.  With merely a broad brush and no energy reserves remaining to go into the myriad of details, I will simply describe for you what happened.  The first point is that the Republican Party in the United States is for the first time in a generation, without a true leader. (Some say it’s really the Rush Limbaugh character I described above!)  But, as a consequence of a lack of leadership and focus, they have had not one new idea in quite some time and their party is at a tremulous, frightening and pivotal time in its history. 

 

          To my mind, as a group, the Republican Party must determine whether it is going to re-organize (and perhaps change its name) by expanding its true conservative base of the newly rich and the “wannabes,” or simply hang around for a few more years as a group of quite wealthy and still powerful “naysayers” seeking only to protect their fortunes and opportunities.  There certainly is nothing wrong with being monetarily successful, having a vacation home or two spread around the Globe, since in our system of government and our capitalist economy, innovation, genius, and great talent and skills of all kinds are encouraged, highly valued and necessary–and always will be.  But when its agenda as a political party becomes nothing more than deluding those whom they can with specious argument and otherwise simply playing the role of obstructionist to score political points, they become something other than a true political party.  Precisely what that means it has now converted transferred itself into, I don’t really know…but perhaps you will have a good Dutch or German word to describe, or “label,” this strange phenomenon.

 

          No one, not even the President, knows where this is all going.  What has been made clear, however, is that there is no intention by anyone that the doctor/patient relationship be infringed with some bureaucrat sitting in the examining room deciding courses of treatment.  That is, in fact, one of the problems that we currently have in this Country that angers President Obama and which he is determined to “remove from the face of the earth.”   What angers him is what has angered me for many years–the role of the insurance company in dictating what procedures it will and will not pay for and thus, since the cost of care is so enormous, it determines exactly what care will be given.  And it kills people!

 

          Before I retired from practice, I had a case brought to me by one of my cousins, whose wife was ill from some severe abdominal problem which required a very delicate (and expensive) bit of surgery.  As is the case with all surgeries under these health policies, the insurer will not reimburse the patient or policyholder unless it has pre-certified the procedure.  The particular procedure (a laborious laparoscopic removal of something and repair of another something) was deemed by the insurer–on a private list kept only by the insurer–if it really existed, as “experimental.”  The policy, of course, had an exception in it for all “experimental” procedures and the pre-approval request was declined.  My cousin was forced to take out a second mortgage on his home to pay for the operation in advance, and the surgery was, in fact, performed successfully.  But the insurer still refused to reimburse my cousin.

 

          So, finally, my cousin called me for help.  He told me the story.  I immediately recognized the issue and the answer (I had been down the same road many times), and I took over the task of getting his reimbursement.  The fact that my cousin works for one of the Country’s largest energy companies made the resolution of this particular problem extremely easy.  I obtained the name and telephone number of the President, and I set up a meeting of just he and myself in Little Rock.  (I had met the gentleman socially on a couple of occasions, so he was more than willing to listen to my possible solution.) 

 

          You see, health insurers have an Achilles’ Heel: greed.  I know from my years in the business that many of them, certainly not a majority, really do follow the pattern of always denying the large claims–knowing that only very few claimants will eventually go to a lawyer to take over the case.  That, in effect, places the lives and fortunes of so many insureds in America in the uneducated and inexperienced hands of twenty-one year claims clerks!!!!  So, long story made short, I told the President that what the insurer said was “experimental” did not control the matter; what actually controlled was the fact of whether it was truly “experimental.”  And that was determined by a list of procedures published by the American Academy of Surgery–which demonstrated that the procedure in question to had been taken off of the “experimental list several years earlier.  So, armed with this and a little coaching from me, the President called the President of the insurer, threatened to take this huge group health policy elsewhere, and the forty thousand dollar reimbursement was made the following week!

 

          So, that was simply a little bit of “hard ball” that resolved that case.  The problem is that anyone has to play “hard ball” in any instance.  And that is one of the major focuses of the present healthcare proposals.  Under the new laws we hope are passed, insurers could not require pre-certification–and could not require that only THEIR doctors be used.       

 

          Dedrick, there are so many issues, so many problems and so many adversaries–many of them friends–that I despair of a solution…in at least the near future.  It is so bad that one lowly representative from South Carolina named Joe Wilson (the “red neck from Hell” type of fellow) that on National television during a speech by the President to Congress and the Nation last week yelled out from the floor of the House of Representatives that the President was a “Liar.”  The very next day, since this move made Mr. Wilson a hero to many of his South Carolina constituents, Mr. Wilson’s campaign fund received One Million Dollars in contributions!

 

          At least this little war is not over; and the “good guys” have not lost.  But if anything, this war shows me more starkly than anything ever has how natural allies and even friends and relatives may be made into political enemies by wily liars preying upon ignorance or innocence.  My Aunt Doll had it right sixty years ago when she “dictated” that when we were at the dinner table no one would ever discuss religion OR politics.  That was wise counsel.

 

          Please give my best to Ulrika; I think she is a wonderful lady.  And, seriously, you were the best choice for her.  And Linda tells me that I was chosen by her SINCE I WAS THE BEST…, but I would swear I proposed to her and it was not the other way around! 

 

                                                   Sincerely,

 

 

                                                    -Don