Tag: Capitalist

Anti-capitalist Meetup: “Separate but Equal” Shuts Down Women’s Health Care by TPau

This week has a certain nostalgia for me. I am working the last four shifts in my home, Humboldt County. Nestled between pristine redwoods and dramatic cliffs overlooking the west coast of California, I want to stay here, but cannot. I am feeling the full force of the United States health care crisis. In the four years I have worked here eight of ten obstetricians in the southern half of the county have left, and now I find I am one of them.

Two obstetricians, far apart geographically and serving two different hospitals, are all that is left to serve an area once supporting 10 obstetricians. Both doctors are men over 60, who have a tough future ahead of them. Without outside help there is no way they can see all the patients that will need them. They have to remain within 30 minutes of the hospital and can be told to come to work any time of the day or night. They can never have a moment off, a full night’s sleep, a drink of alcohol to ring in the New Year. Watching a full length movie, or having a nice dinner with the spouse without interruption is a thing of the past. Neither of the remaining doctors can get sick or injured. This is really asking them to be super human and there is no cavalry on their horizon. In fact, if Catholic Health Systems is successful at closing one of the two hospitals, only one physician will remain.

As a young person, I wanted to take my medical skills to a disadvantaged third world nation. Looks like I got my wish-right here in the US. How did we get here?

A Necessary Evil, or Just Evil? by T’Pau (T. P. Alexanders)

We are told we need the law. We need a million rules to ensure everyone has a fair shake,  a level playing field we rely on as we move through life. But if you are lesbian or gay, the majority have recently passed laws giving  people who prefer heterosexual coupling an advantage. The federal government has done nothing to come to this minority’s assistance. These laws are just the latest in a long litany of discriminatory laws.

We are told we need the law to define culture, to give the boundaries of permissible behavior. Yet, do you think you are aware of every law you live under? In every jurisdiction, outdated laws remain on the books. You are likely to have broken some of them without even knowing. In fact, most new endeavors begin with consultation of a lawyer. Legal professionals research for hours to ensure their clients won’t inadvertently break some little known law. Many of these laws unduly invade our private lives to restrict trivial actions, like putting a window in a wall of your home, so the state or some industry can make money.

We are told without the law, our society would crumble into brutish chaos. To me, the image of John Pike, dressed like an SS officer, strutting around a circle of passive students shaking a can of pepper spray, meant to be used at distance on an advancing crowd, is the image of brutish chaos.

Pepper Spray Police

Or perhaps those words conjure up the image of an octogenarian pepper sprayed in the eyes for speaking out against a government that coddles the rich and abuses the poor.

Or the Berkley students night-sticked in the bread basket to discourage peaceful assembly:

Yet, surely our teachers and parents are right. Surely we need the rule of law to guide society. We need some rules.

Or not.

Today we crawl outside one of our deepest and oldest mental boxes to consider the unthinkable—that changes in the law cannot cure society’s ills, because the law, itself,  is part of the problem. Today we take a walk on the wild side in a lawless society.  

A Necessary Evil, or Just Evil?

We are told we need the law. We need a million rules to ensure everyone has a fair shake,  a level playing field we rely on as we move through life. But if you are lesbian or gay, the majority have recently passed laws giving  people who prefer heterosexual coupling an advantage. The federal government has done nothing to come to this minority’s assistance. These laws are just the latest in a long litany of discriminatory laws.

We are told we need the law to define culture, to give the boundaries of permissible behavior. Yet, do you think you are aware of every law you live under? In every jurisdiction, outdated laws remain on the books. You are likely to have broken some of them without even knowing. In fact, most new endeavors begin with consultation of a lawyer. Legal professionals research for hours to ensure their clients won’t inadvertently break some little known law. Many of these laws unduly invade our private lives to restrict trivial actions, like putting a window in a wall of your home, so the state or some industry can make money.

We are told without the law, our society would crumble into brutish chaos. To me, the image of John Pike, dressed like an SS officer, strutting around a circle of passive students shaking a can of pepper spray, meant to be used at distance on an advancing crowd, is the image of brutish chaos.

Pepper Spray Police

Or perhaps those words conjure up the image of an octogenarian pepper sprayed in the eyes for speaking out against a government that coddles the rich and abuses the poor.

Or the Berkley students night-sticked in the bread basket to discourage peaceful assembly:

Yet, surely our teachers and parents are right. Surely we need the rule of law to guide society. We need some rules.

Or not.

Today we crawl outside one of our deepest and oldest mental boxes to consider the unthinkable—that changes in the law cannot cure society’s ills, because the law, itself,  is part of the problem. Today we take a walk on the wild side in a lawless society.  

Pelt the President with the Pill

[The conversations represented here took place over the last week and are compressed for your reading pleasure. My husband and I are real people and said the things represented here. The rest of the dialogue is provided by intentionally fictionalized characters that are not meant to represent any one person. All sentiments and facts expressed here are genuine to the best of my recollection, but the characters saying them were selected by drawing names from a hat. I, alone, am responsible for this content.]

The Quickening

“They canceled Andrianna’s tubals yesterday,” I inform Steve in the hall outside the conference room. “They didn’t even give her a whole day’s notice so she could talk to her patients before they did it.”

“I got virtually no notice either when they canceled mine on Monday,” he replies.

“Really?” I am shocked by this. I have never heard of a hospital canceling cases so abruptly without involving the surgeon. “Who ordered the cancellations like that?”

“Don’t know. We’re only told the surgery scheduler, but someone gave her the order.”

We enter the conference room to find Norm waiting for us. The other gynecologists filter into the room. Both the hospitals the Sisters of Orange own are represented: the hospital in my town, St. Joseph’s, and the one south of us, Redwood Memorial.

“We had hoped this would blow over but the sisters feel backed into a corner.” Norm starts. “They have no choice but to get tough on this issue.”

“What brought all this on?” Steve asks.

“The edict came down from the new Bishop in Santa Rosa,” Norm says, “but we got targeted when they pulled the diagnosis codes for the hospital. It was obvious we were doing more sterilizations than they were in Southern California.”

“In Southern California you can go down the street from any Catholic institution and run into a secular hospital.” I try to defend us. “The Catholic Church bought almost all the hospitals in this area. For the last six years they’ve been trying to drive the last secular hospital under.”

“Never the less, we were doing a lot of tubals for ‛psychological’ reasons.”

“We were hardly doing a lot of sterilizations,” I say. “Other hospitals preform far more tubals a year. The stigma the Church gives the procedure already curtails many woman from asking for sterilization.”

“So what’s the plan?” Steve says, rescuing the meeting from disintegrating into complaints about the Church.

“Nothing.” Norm states. “This is a game we can’t win. The more public pressure the Catholics face, the more they will dig in. We have to keep quiet and wait. That will take the pressure off the nuns. When you’re approached by the media, and you will be approached, my advise is to refer them to the CMO. That’s what he gets paid for. Don’t talk to the media, or write letters to the editor. Don’t talk to your patients about it. We need to keep the lid on this to stop it from blowing up.”

“Too late. The patients already know.” I inform him. We all know there was an article in the local alternative paper, The Journal. The “real” paper in town, the Times Standard, has been silent on the issue. “I spent half an hour at a Pap smear today with an irate woman who vented the whole time about how this was unreasonable and unfair.”

“I wouldn’t encourage her. And don’t talk to your staff about this either,” Norm says.

“How am I going to do that? I’m taking my patients to Mad River. They all know why I stopped operating at St. Jo’s.”

“What do you say to the patients?” Steve wants to know.

“The truth. I don’t think it’s fair to deny all the women in an entire county a procedure on religious grounds. And the patients agree with me. I have an eighty year old woman who lives as far south in the county as you can go. I told her why I was taking my patients north, but seeing where she lived and considering her age I told her I would make an exception for her and operate on her at St. Jo’s. She told me, ‛Don’t you dare. I don’t want to support that any more than you do.’ This octogenarian wants to drive past the two hospitals the Sisters own to have her surgery at Mad River Hospital.”

“This hospital is facing hard times right now.We’re barely holding on ourselves. We can’t afford to lose any patients. We don’t want to lose patients or doctors.” Norm seems genuinely alarmed.

“Great. Go back to the way it was, and I’ll bring my surgeries back to St. Jo’s.” I feel for Norm, but I will not be moved.

“Look, if they made us take all the hysterectomies to ethics committee, the way they threatened to, then I would do the same thing.” Wendy said. “But it’s just the tubals.”

“The only reason they didn’t is because they found out the insurance companies already reviewed all our hysterectomies and would not pay without an adequate medical diagnosis.” I tell her. “They weren’t being magnanimous. They just didn’t want to duplicate the work.”

“You can’t take your surgeries to Mad River.” Quinn, always the practical one, tells me. “I’ve looked at the labor numbers. St. Jo’s is hemorrhaging money in Obstetrics. The hospital will take the Laborist program away. The only reason you came here was for that program. You don’t want to see it die, do you?”

“I don’t.” Everything he says is true. Medicaid doesn’t even cover the cost of deliveries for most hospitals. The one wing devoted exclusively to women is a loss leader for most hospitals in the nation. Obstetricians get treated like the red-headed-step-children of the family of physicians because we don’t make the hospital any money. Having a Laborist program is a rare luxury. It meant I could sleep through the night for the first time in years, watch a whole movie in a theater, have a conversation with my husband–uninterrupted by the other woman…one with vaginal discharge. I do desperately want to keep that indulgence. “It’s not just about what I want. If they take the Laborist program, there’s little reason for me to be at St. Jo’s at all. I’ll not just take surgery to Mad River, I’ll take my labor patients as well.”

“If we don’t support the hospital it won’t be there to care for us.” Wendy says. “I for one want a hospital here when I retire.”

“Not taking care of the needs of half of the population is not caring for us.” I can feel my control slipping. “If they are unwilling to serve half the population’s health care needs, what are they doing in the business in the first place? They should sell the hospital-preferably back to the community to be run cooperatively.”

“This happens every seven years or so.” Elroy, the oldest member of our tribe, says. “The last time it was a new nun sent to take over the hospital. She had all the tubals canceled too.”

“How did that get resolved?” I ask.

“She died and it got forgotten.”

“So we’re waiting for the Bishop to die? Or just waiting for him to change his mind?” I say with more than a little heat. “The Bishop isn’t the only one with strong feelings on this.”

“The hospital can make it hard for you.” Adrianna has arrived late to the party due to her patients. “Remember Tony? He got in that spat with the hospital and started talking to people-even people in the Foundation. It got back to the Board of Trustees and they dragged him into Medical Executive Committee. Now he has that mark on his record forever.”

I know she is trying to warn me. I’m no stranger to this tactic. Though I have not seen it used at St Jo’s, I’ve seen it used elsewhere to strike fear into doctors. A hospital will use its power to remove incompetent doctors on a doctor who is medically competent but has a disagreement with the hospital. They sacrifice one physician, ending his or her career, to scare the other physicians into compliant silence. There are even courses for hospital administrators instructing them how to do this effectively. I’ve avoided such abuses of power so far, but I’ve seen it used time and again on colleagues.

“Look, it’s not just our patients. I was already scheduled to talk about this subject on a national level. I can’t act like it’s not happening to me on a personal level as well. You see, I’m an editor of this blog…”

Reclaiming Our Democracy (Part 2 of 2): Nullification

“Timid men prefer the calm of despotism to the tempestuous sea of Liberty.”
— Thomas Jefferson

What is Government?

Why do we submit to the law?

We can’t run very fast. We have no sharp teeth or claws. Long ago it became obvious that it was in humanity’s self interest to ban together for our mutual security. We each give up a small amount of personal freedom, for the greater good of the whole. That is the basis of the social contract.

As citizens, our responsibility is to uphold the laws of government. The government, in turn, also has obligations. The bare minimum of those obligations are to protect the majority of people from enemies both foreign and domestic. What enemies do we wish to protect ourselves from? At the very least hunger, disease, invasion by hostile forces (external security), and threats to our self-governance (internal security).

So how are we doing in that respect? Lousy.

We all but wiped out hunger in the US shortly after the Kennedy administration (ended 1963), but the government intentionally reintroduced it in the Reagan administration to drive down worker wages. What is left of our health care system is sowing the seeds of its own destruction. Foreign NGO’s have been invited by the Supreme Court to financially manipulate campaigns and thus our government. Internal threats to self-governance are too numerous to recount here, and in any case the Supreme Court has abandoned all pretense that this was a democracy and officially ruled the US a plutocracy.

We are in essence living in a failed state. Just because I am writing about the US, don’t think your country is doing any better. Most of the Western world is in the same boat.

Other articles have detailed the complex road we took to get here. That is not the purpose of this series. This series discusses how we get out.

Specifically, how to tell our government “No!”

Anti-Capitalist Meet-Up: Reclaiming Our Democracy (Part I of II): Miliary Democracy

“Duck House”:

I sit on the floor of the Duck House with thirty others, brainstorming for the January action. Neither men nor women dominate the group. We are young, and surprisingly old. Counter-culture and conservatively clad. We question whether it is nobler to seek permits or just show up unannounced. We speak of banners, flyers and street theater-anything to educate the public about our goal.

Even when I still lived in Arizona, I had heard of this place. Democracy Unlimited Humboldt County (DUHC) or “Duck” was on the forefront of the war against corporate power. In 1998, they helped pass a ballot initiative establishing the Democracy and Corporations standing committee in Arcata’s city council here in California.

The Committee’s primary functions are: to research and present to the Council options for controlling the growth of “pattern restaurants” in the community; to cooperate with other communities working on socially responsible investing and procurement policies; to make recommendations to the Council, and/or with the Council’s approval, provide educational opportunities to promote “fair trade”; to inform citizens of corporations with negative social and environmental impact; and to provide advice on ways to foster sustained locally-owned businesses, publicly or locally owned services and worker-owned cooperatives and collectives.–City of Arcata

The committee was hailed by Howard Zinn, Noam Chomsky, and Jim Hightower. Ralph Nader commented, “I look forward to Arcata being a luminous star in the rising crescendo of democracy in our country.”

Embolden by this success, they passed Measure T in 2004. It forbid nonlocal corporations from contributing to local political campaigns. Two corporations immediately challenged the initiative as unconstitutional. Before the case could be decided by the courts, Humboldt’s Board of Supervisors succumbed to corporate pressure and declared this popularly elected law nullified.

DUHC learned from this experience. They won’t be going it alone, this time. They are but one small seed of democracy, but they are amassing with others to change the political landscape in America. They have joined Move to Amend in a miliary campaign, and this time their aim is not a city ordinance in some far off town on the edge of America, but changing the highest law in the land.