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Tuesday, April 22, 2008

Hillary Clinton's Fight for Relevance

Today is primary day in my former homeland of Pennsylvania. While Hillary Clinton is expected to come away as the victor in this particular contest, going forward she carries on her back the hopes and dreams of a group within the Democratic Party who with each passing day become more and more an irrelevant anachronism.

The Democratic Leadership Council was brought forth in the age of Ronald Reagan as a response to Democratic candidates whose views were seen as too far to the left of the country as a whole. Bill Clinton, Joe Lieberman and others felt it was their collective duty to lead the Democrats to the White House by staking a claim to what they believed was the middle ground that all Americans sought. In 1993, the world was their oyster. Having just taken the White House and holding a majority in both the Senate and the House, it seemed like the DLC way was destined to be the new way forward.

In actuality, the DLC way was doomed from the start. When the differences with Republicans across the aisle appeared to be semantic more than substantive, parts became interchangeable in the eyes of the independent voter. The base of the Democratic Party becomes disinterested in voting for candidates that didn’t share their views. It also didn’t help that the early 90’s saw the ascendancy of right wing talk radio and Newt Gingrich, two entities that were more interested in verbal bomb throwing than responsible governance. In eight short years, Clinton found himself impeached for something far short of a high crime, and George W. Bush, the perfect symbol of all that is wrong with the United States, became the president.

The DLC’s last stand now presents itself in the guise of Hillary Clinton. She stands seemingly as the last great believer in the right-leaning triangulation that propelled her husband to the White House 16 years ago. Facts such as Ross Perot taking 19% of the vote in 1992 and propelling Bill Clinton to the White House with far less than a 50% majority of the vote are conveniently left out of her narrative. For Clinton, she is fighting not just for the presidency, but for future relevance for herself and her brethren.

The DLC is having enough of a hard time without a Clinton loss further kicking sand in their face. The DLC’s current chairman, Harold Ford, endorsed Christopher Shays, a Republican, in his current reelection bid to the House of Representatives. When he’s not endorsing Republicans, he’s sponsoring conventions on the DLC’s behalf that feature a lot of empty chairs. Joe Lieberman, fighting his own ongoing battle with irrelevance, turned in his DLC card years ago.

For Hillary Clinton, she only needs to look across the aisle at her Senate colleague from Massachusetts, Ted Kennedy, for a glimpse into her future as a losing presidential candidate. Ted Kennedy says all the right things nowadays and is a reliable Democrat on a host of issues, but his speeches only serve to recall a time when his personal possibilities, based on his name and his position, seemed less limited. His relevance on a national scale is minimal at best, despite his surname and the power that once summoned.

All of this should be taken into account when you listen to Hillary Clinton trash MoveOn.org, or talk about using nuclear weapons on a sovereign nation, or having her subordinates argue that any states with fewer than 15 electoral votes that she happens to have lost are full of latte-drinking elitists. Hillary Clinton currently gazes into an abyss of future irrelevance, buffeted only by millionaire donors making veiled threats and the hope of getting enough Democratic superdelegates to ignore the popular vote. Maybe she and Ted will get together in the Senate commissary someday and discuss their twin fates, even if by Hillary Clinton’s latest words and deeds they have nothing else in common politically.

Tuesday, April 01, 2008

Help Me Not Be A Drain On Society

"…promote the general welfare…"

I’m not a constitutional scholar, and would never pretend to be, but as an American, whenever I think about the potential of the land of my birth, I go to the preamble to our Constitution. Those 52 words ratified 221 years ago hold great promise, neatly summarizing the goals of a new country.

The first four words of this post affect me more than any other. I’m employed in the healthcare industry. No, I’m not a doctor or other specific caregiver, as that would define me as "useful". I’m on the administrative side. I represent that portion of the American healthcare system that drains much-needed resources from things such as providing timely medical care to patients and educating the public on risks to health.

Without being too specific about my daily job functions (not that I’m hiding; hell my name is right there in my ID), I am a certified medical coder. As briefly as possible, I’ll try to describe what that is. Every medical test, service, procedure and patient condition has a numeric equivalent for governmental reporting and insurance billing. I’ve been trained to determine what numbers go where on which bill for which patient for what service or condition. For this, I make a healthy wage in a recession-proof industry.

I’m going to ask something of you that may come as a shock, but I’ll do it anyway.

As quickly as you can, please put me out of a job.

Though I do not work in a doctor’s office on a daily basis, trust me when I tell you that I’m on the front lines and the American healthcare system is broken. We need single-payer healthcare yesterday.

I started on the insurance side of this industry in 1989. I was a medical claims adjuster for a little over 6 years. The time I spent on that side of the fence gave me incredible insight into the mind of the person adjudicating your medical insurance claims. Specifically, some of these people really get their rocks off denying services. I wasn’t one of them. I can remember an instance where I was forced by the terms of a patient’s insurance policy to deny a $92,000 hospital bill for a 4-year-old girl with lymphoma. I also remember the hangover I had the next morning from trying to drink my guilt away.

"…promote the general welfare…"

I’ve had my share of stops in this industry. I now find myself on the physician side attempting to educate physicians and other practitioners on documentation for services. I feel that this only slightly helps the treatment outcomes for the patients. What I really feel is that I am employed as a defense mechanism against Medicare and insurance regulations designed not to compensate physicians for the fair value of their services. Meanwhile medical mistakes are on the rise in hospital settings, much-needed treatment is being withheld due to cost to insurers and the amount of a typical healthcare dollar spent on jobs like mine keeps going up.

I realize that I can’t speak for everyone in my sphere of the healthcare industry. I can only speak for myself when I tell all of you to put me out of work. I’ll find another job. I’m reasonably intelligent and have the innate survival skills to find something else to do with the 25 years (give or take) I have left in the working world. I can even write and sing a song or two. Who knows where that might lead?

A society that cares about the fate of all of their citizens would have moved to a single-payer healthcare system years ago (some enlightened countries have already). I currently exist as a symbol of everything that’s wrong with America’s approach to its own citizens. Do the country a favor and politely send me packing.