Wednesday, May 24, 2006

Today's Political Thought

Earlier today in this report, ABC News announced that Speaker of the House Dennis Hastert was involved in the Congressional bribery investigation. Hastert's people have denied that he is a target of the investigation and they are demanding a retraction. The Department of Justice has issued a statement stating flatly that "Speaker Hastert is not under investigation by the Justice Department." ABC has since issued this item which in essence stands by its story but suggests that people are reading more into it than is there.

In other maybe-it's-true news, Truthout (an online left-wing news journal) is standing by its story that Karl Rove has already been indicted...this, despite the fact that the timetable in the original story has already been proven wrong, that no one else seems to have any information to this effect, and that it has been categorically denied by Rove's lawyers.

I have no idea what truth (if any) there is to either story. Perhaps there is none, perhaps they're essentially true but wrong in some technicality that allows them to be honestly denied. As usual for this kind of questionable report, people who want to see Rove frog-marched and Hastert hopping along beside him are cautiously hoping it's so...and folks whose politics would be set back a few yards if those things happened are sure they're not so. The latter group may be right but I think most of them are wrong about one thing. Most of them are saying these are deliberate, politically-motivated lies on the parts of the reporters and/or their news agencies.

That's a ridiculous assumption. They may be politically-motivated lies on the part of whoever leaked the stories to the media, but the media — even a fringe outfit like Truthout — doesn't make such things up out of the whole cloth. Somebody told them these accounts and it was probably someone they had reason to believe, albeit by a low or flawed standard of faith. If the stories are wrong, the crime is bad journalism, not intentional lying. One reason there's so much inept reporting out there is that it so rarely gets called what it is, which is incompetence.

• Posted at 9:51 PM · LINK

Life Imitates Cels

There are kinda weird. They're Reality Cartoons.

I could try and explain the concept to you but you'll understand as soon as you see 'em.

• Posted at 9:23 PM · LINK

Today's Video Link

Senator Lloyd Bentsen died the other day so we might as well take another look at the only thing most people remember him for — his putdown of Dan Quayle in the 1988 presidential debate. I'm not sure many people even remember that Bentsen was the running mate to Michael Dukakis that year. They just recall the public slapping.

I watched the debate that night with some folks over at Harlan Ellison's while Harlan ignored his guests and (quite properly) devoted himself to a rabid and frothing deadline. Mothra could have descended on the block and it would not have pried the man away from his manual typewriter and the paper whizzing through it. Still, when Bentsen delivered that line, we gave out a whoop — not necessarily in approval — and Harlan poked his head out of his office to ask what the heck had happened. Someone told him, "Bentsen just made Quayle look like an idiot" and he muttered, "This is news?" and went back to work.

Of course, it was mainly Quayle who made Quayle look bad that night. The reporters kept asking him what he'd do if the president was killed or disabled and it became necessary for him to assume the office. He kept responding like you or I would if we were asked how one goes about performing a large bowel resection. He just looked clueless and tried to ad-lib a response to a topic about which he seemed to have no idea, even though it's the most important thing (and darn near the only thing) a Vice-President of the United States of America might have to do.

He especially looked bad when he had no real answer to Bentsen's unclassy remark. I always thought he wouldn't have become quite the laughingstock he became if he'd fired back with something like, "People underestimated Jack Kennedy when he was in the Senate. I hope someday to have you say the same of me, Senator." Instead, his deer-in-the-headlights response may not have cost his ticket any states but it and a few public gaffes sure cost him any political future after his one term as veep.

Here's the clip. Bentsen, for whom I had little respect, actually made some very good points in that debate and would easily have been hailed as the winner without this line. It was a moment that made me feel both guys deserved to lose.

• Posted at 12:25 AM · LINK

From the E-Mailbag...

William T. Bradley, a physician in Texas, adds the following to our discussion of emergency room care...

To expand slightly on the response you already got, the answer is, of course, money: Hospitals are not traditional businesses. The problem with your analogy is that Starbucks expands to bring in more customers who'll pay 5-10 bucks for 39 cents worth of coffee in a paper cup. In the ER, it's often the reverse. The hospital will be paid little or nothing for most of the people who show up, and will spend lots of money treating them. If Starbucks were forced to provide lattes to anyone who showed up, regardless of their ability to pay, they'd obviously have much less impetus for expansion.

There are theoretically supposed to be mechanisms to pay for some of the care of the indigent, but these often require extensive administrative efforts on the part of the hospitals and patients to access, and the reimbursements are quite small. Exacerbating the problem is that much of what the ER sees are not emergencies, but people who don't have or can't afford a doctor, coming in for minor problems, or sometimes just to get medical refills or a doctor's excuse.

The result is that, from a business standpoint, the ER is a hugely money-losing proposition. Many hospitals maintain them only because they are required to. The waiting times are horrendous, but the hospital simply has no financial incentive to shorten them. Even the most altruistic facility would find it hard to keep the doors open if they expand more than is absolutely necessary.

Your best course of action, as a patient, is to have a physician you can call for help, and who can, if necessary, admit you to the hospital without going through the ER. Assuming your mother is on Medicare, that may be easier said than done. Here in Texas, primary care physicians who can afford to take new Medicare patients are extremely difficult to find, and I imagine it's worse in California. Political pressure on your congresspeople to stop cutting Medicare payments to physicians would of course be beneficial, but that leads us into another complex topic.

I'm sure everything you say is right. The Starbuck analogy was one of those comparisons that's good for about a sentence and a half before it collapses under its own weight.

However, let me add a few anecdotal nuggets into this. When I was hospitalized briefly last February, I was admitted (sort of) by my doctor. Though he works with Cedars-Sinai — his primary office is elsewhere — even he couldn't get me directly into a room. He had to send me to the Emergency Department where I spent four hours in the waiting area...and the time is only part of it. Those are awful places to be, surrounded by people in pain, people with coughs and little germ clouds you can almost see hovering about them, people agonizing over what the hospital costs will do to their lives, etc. During my wait, my doctor came over to the hospital to see patients and stopped off in the E.R. where he arranged for me to bypass much of the admissions process and then explained my medical situation to the appropriate people. He also located and briefed the specialist who was going to be supervising my treatment. He and the specialist then came out to find me in the waiting room and we discussed my case there...and it still took many hours after that for me to get to the moment where someone finally began treating my swollen, crimson calves.

I understand the money part of this. But I took up around six minutes of actual attention in that Emergency Room and they billed about eight thousand dollars to my health insurance for that part of my little stay. It would seem to me there's got to be a way the finance part of this can be made to work. That's worse than the markup on the Starbuck Decaf Komodo Dragon Blend®.

I should add to all this that I've had several trips to hospital emergency rooms with my mother when the problem was not agonizing pain in her foot but something that might have turned out to be a heart attack. Some of these times, I drove her there — I also drove my father in twice when he had what turned out to really be heart attacks — and a couple of times, my mother went in via ambulance. In the ambulance cases, she received immediate treatment at the hospital expanding on what the paramedics had already begun. In the non-ambulance visits, we got in relatively fast, though that may have been in part because I'm rather large and when my mother's health is on the line, quite loud. (Remind me some day to tell the story about how when my father had his first heart attack, he got in quickly because one of the physicians in the E.R. turned out to be a friend of mine from high school — someone I didn't even know had become a doctor.)

In those cases, the Emergency Rooms could not have performed much better. I just don't think they work well for people who aren't experiencing chest pains. There are a lot of things that can kill you and/or yield great agony that aren't chest pains. I saw too many of them last night at that hospital.

• Posted at 12:22 AM · LINK

May 25, 2006 • Current • May 23, 2006