Health reform: Are we there yet?

Nancy Pelosi is known around San Francisco — and in a few other spots — as one tough politician. She likes being Speaker of the House, and she doesn’t much like losing. So this week’s do-or-die health reform bill is going to get all the muscle she can manage. It is, Pelosi has declared, “a moral and political imperative.”

Okay, it’s not what we hoped, it’s too complicated and too fraught, it’s going to be full of little gifties given to get votes. If we don’t get something America will be stuck with a non-functional system and millions will remain without health care at all. So I for one am on Pelosi’s side.

The plan is for the House to pass the Senate version and send it to Obama for his signature and enactment. Certain fixes the House is demanding for passage of the more conservative Senate bill will be included in a separate, special measure that will go to the Senate for an up-or-down vote that avoids a filibuster.

But once the House passes the base legislation and Obama signs it, the measure becomes law regardless of what the Senate does.

Democrats do not yet have the votes in hand and Pelosi will not call a vote until they do. Liberal lawmakers have deep reservations about the Senate bill, and fights over abortion and immigration have yet to be resolved. But Pelosi has set the legislative train in motion, even as Republicans have publicly begun to express doubt that they can stop it.

Pelosi laid down the law to wavering Democrats who are threatening to bolt. “It’s not about abortion, it’s not about immigration,” she said. “The only reason, therefore, to oppose the bill is that you do not support health care reform.”

A lot of people don’t support health care reform. The Republicans, the insurance industry, the anti-abortion folks and the anti-immigration folks and more than a few people who feel pretty much okay with what they’ve got and frankly don’t care a lot about what others don’t have.

But health care reform is a moral imperative.

Pelosi: Dems will have votes to OK health care.

Gay Rights, Abortion Lose – – Meanness Wins. Is this the 50s?

The New York State Senate‘s rejection of a bill that would have allowed marriage between two people who love each other — but happen to be gay — is just the most recent in a string of set-backs in the area of gay rights. Other set-backs have been occurring, or are currently looming, in women’s rights, specifically reproductive rights. One wonders about the mood of this country.

This particular one wonders if anyone else is harking back, with more than a little sadness, to the 1950s. If you weren’t around then, I can tell you it was a strange decade. Great optimism for the future — well, there’s not much of that today — while simultaneously there was terrible meanness behind the McCarthy witch hunts and the denial of women’s rights, plus a certain amount of smugness embedded into a bland, national complacency.

At ladies’ bridge parties there were small china ashtrays on each corner of the table and the conversation usually drifted toward those lovely wonder drugs emerging to give instant relief for any problem. The conversation never drifted toward back-alley abortions, unless someone had recently died and the others knew how it had happened. Those of us who had jobs — running a house, entertaining for the husband’s business, raising children; those were not considered jobs — usually had male counterparts doing the exact same thing for twice the salary. One did not complain. If one were middle class white, and involved in any sort of civil rights work, one never brought that up at the bridge table.  It was a strange decade.

Today’s New York Times story quotes senators who voted against the same-sex marriage bill as saying “the public is gripped by economic anxiety and remain(s) uneasy about changing the state’s definition of marriage.” The San Francisco Chronicle article includes a comment from sponsoring Senator Thomas Duane, “I wasn’t expecting betrayal.” I’m sure those are both accurate reports. Whatever its underlying economic, political or social fears, the public seems also to harbor a degree of meanness in discounting the rights of others.

If you substitute a measure of cynicism or hopelessness about the future for the complacency of a half-century ago, and throw in the self-righteousness of those who for religious or political reasons justify the denial of rights to their fellow citizens, it’s easy to draw parallels between this decade and that one long ago.

In the fifties the groundwork was being laid for civil rights, for women’s liberation, for Roe v Wade and the upheavals that eventually led to progress, by courageous and energetic people of all sorts. I wish I could list myself in that number; I was at the bridge table trying to pretend normalcy in a life gone amok.  Today there are others working just as hard for the rights of their fellow men and women.

I hope they can keep the faith.

End-of-life counseling stays in health care bill

Here’s a piece of very good news just in from Associated Press reporter Ricardo Alonzo-Zaldivar:

It’s alive. The Medicare end-of-life planning provision that 2008 Republican vice presidential nominee Sarah Palin said was tantamount to “death panels” for seniors is staying in the latest Democratic health care bill unveiled Thursday. The provision allows Medicare to pay for voluntary counseling to help beneficiaries deal with the complex and painful decisions families face when a loved one is approaching death.

The business of thinking ahead toward end-of-life decisions and making  one’s own wishes known through legal documents such as advance directives has long been encouraged by federal policies. But when coverage for talking things over with one’s doctor was incorporated into health reform it was quickly distorted by Republicans.  Sen.Charles Grassley led the successful campaign to strike it from the Senate bills. But saner heads have prevailed in the House.

“There is nothing more basic than giving someone the option of speaking with their doctor about how they want to be treated in the case of an emergency,” said Rep. Earl Blumenauer, D-OR. “I think the outrageous and vindictive attacks may have backfired to help raise awareness about this problem, which is why it’s been kept in the bill.” The legislation would allow Medicare to pay for a counseling session with a doctor or clinical professional once every five years. The bill calls for such sessions to be “completely” voluntary, and prohibits the encouragement or promotion of suicide or assisted suicide.

The counseling provision is supported by doctors’ groups and AARP, the seniors’ lobby. It was not included in health care bills passed by two Senate committees.

It’s alive! End-of-life counseling in health bill.