Peacefully, and no, not as a result of assisted suicide.
He was right to shed light on the issue of how America prolongs the suffering of the dying. He was right that people have a right to end their own lives. He was right that there should not be a stigma attached to that act.
I don’t know if physicians should be involved in that act. I hope he never convinced any of his patients to do something they otherwise would not have done.
The bigger picture than assisted suicide is the way America treats the dying. For moral and financial (which are also moral) reasons, terminally ill people are treated far worse than dying dogs and horses – poked, prodded, and hooked up to machines in a sterile, soulless, frightening hospital environment. When possible – and often it is – people should die at home with their families.
Here is a highly informative 60 Minutes report about the issue. In addition to its big picture analysis, it follows an elderly woman in her last days subjected to test after tests, even pap smears, at great cost to future taxpayers, since current taxpayers have decided not to pay our own bills.
Freed from the constraints of a possible presidential run, Gov. Mike Huckabee made a number of candid statements – about the national debt, about the nature of politics, and about the Republican Party – during a speech at the Clinton School of Public Service Wednesday in Little Rock.
Asked how to explain to voters the seriousness of the country’s current fiscal situation, he said this:
“I’m not sure that the political election process is the environment in which it can be told because our election environment is becoming incredibly toxic to the point that I’m not sure that the country is presently governable. I know that’s a very bold statement, but I’m telling you now, that it is becoming where it is impossible to actually govern. Not just because the other side is going to take you on because of everything that you say and parse every word and bring nuances to everything that’s said, but because your own party will do that. One of the processes that I was going through in deciding whether or not to run for president this election cycle was whether or not the environment in the Republican Party was really about moving toward where we had pragmatic solutions to governing the country or whether it was all about, ‘Can we poke out the eyes of the other guy before they poke out our eyes?’ And I’ll be honest with you, I’m right now convinced that it’s all about poking out each other’s eyes. It’s not about solving real problems. And until we change that, and when I say, ‘we change,’ we as a culture, as a country, have to utterly reject the idea tht one party is always right and the other party is always wrong. That’s nonsense.”
Huckabee talked about the importance of strong families and decried the national debt, which he blamed on both Democrats and Republicans. He compared the Greatest Generation’s sacrifices so their children could live better lives to today’s electorate, which seems on the way to doing the opposite. He said that Ronald Reagan might not get nominated, much less elected, today because he worked within the political system, made deals and even raised taxes. He called for an end to corporate taxes in order to better compete with China – taxing consumption instead of productivity.
He said he wouldn’t completely rule out running for president in 2016 or even in 2012, saying, “I honestly thought I was going to run this time.” He said he didn’t run for several reasons, including spiritual ones, and the fact that, since 1868, only once – in 1980 after Jimmy Carter’s first term – has a party been turned out after only one term. Next year, he said, President Obama will have a billion dollars in the bank. By contrast, he said, “It’s not going to be an easy path for whoever the Republican is. Whoever it is is going to come out of a bloody primary, broke and battered, because I anticipate the Republicans will do what they typically do and they’ll have a demolition derby, a circular firing squad and load up with bullets and start shooting and then by the time somebody comes out of this thing in let’s say April or May, they have very little little time to recover, they’ll never be able to come up with the amount of cash that the incumbent is going to have, and plus he’s an incumbent president which means the advantages of flying in on Air Force One and being presidential is very different than being the challenger.”
He also said that “Q and A” stands for “Questions and Avoidance” and then joked that his goal was to “avoid a career-ending response.” Which led him to say this:
“Although I will say that I have a little bit of a liberation in that the decision that I’m not going to be seeking the Republican nomination gives me a freedom that maybe I wouldn’t have had otherwise.
“And in part, I would say that’s the shame of our political system today. We say we want candor, but we don’t. We say we want people who run for office to be blunt, but if they are, then we crucify them for their candor. We say that we want people to give straightforward answers. But straightforward answers are usually what gets a person from being able to hold office, not what propels him into it. And so in many ways, I feel like there is a great need in our culture for us to come to the place where we actually want an honest, intellectually upright discussion of issues that we are challenged by in this country.”
My column this week is about Act 1209, a law passed during this past Arkansas legislative session that created the Teacher Excellence and Support System, a process statewide for schools to evaluate teachers.
The law requires evaluators to sit through at least 75 percent of a class period (as opposed to sticking their head in the door) and to counsel teachers afterwards based on that visit as well as on other external measurements. That includes student test scores when considered as part of what the law calls “trend data” and not a single exam.
Just as important as the law is the way it was passed. Instead of rushing through the process, as happens with some of the other 1,241 laws passed this session, the law’s sponsor, Rep. Johnnie Roebuck, D-Arkadelphia, engaged a diverse group of people who often don’t agree with each other. That included business-oriented school reform groups, the Arkansas Education Association (the closest thing the state has to a teacher’s union), the Arkansas School Boards Association, the Arkansas Educational Administrators Association, and the Department of Education. Over the course of several months, the groups hashed out their differences in sometimes passionate negotiations and eventually came up with a bill they all liked.
Isn’t working together and coming up with a consensus a far better way of writing legislation than picking sides, drawing lines in the sand, issuing press releases, and calling people “nazis” and “socialists” through the media? If it can be done in Little Rock, it can be done in Washington, D.C.
Arkansas’ four congressmen today voted against H.R. 1954, the bill that would raise the country’s debt ceiling past its current $14.3 trillion limit. The bill failed with not a single Republican voting for it.
This does not mean the debt ceiling won’t be raised. There is still plenty of time before the country runs up against the time limit and begins to fail to make good on its obligations. The press releases I have received – from Reps. Ross, Griffin and Womack – indicate that the congressmen voted against the bill because it included no structural spending reforms.
I’m fine with that. For a long time, deficits in Washington have been all-too-business as usual. Ultimately, Congress will have to vote to raise the ceiling – and it will, despite all the saber-rattling. Let’s hope the congressmen get what they want and that the bill includes spending reforms.
Here are the statements released by the three congressmen, in the order that I received them. I have not yet heard from Rep. Rick Crawford from the First District.
ROSS – “I voted against raising the nation’s debt ceiling today because we’ve got to send a strong message that it’s past time to stop the out-of-control spending in Washington. Before I can support any increase in the debt ceiling, it must include meaningful spending cuts that will actually reduce our deficits without punishing America’s working families and seniors.
“The debt ceiling isn’t about new spending; it’s about meeting the debts and obligations we’ve already committed. It has been increased 36 times over the last 30 years, with President Reagan signing 17 debt limit increases into law and President Obama signing three so far. The debt ceiling problem isn’t new, but it’s reached a level that is unsustainable. Congress needs to stop the partisan bickering and start working together to draft a commonsense compromise that preserves America’s standing in the global economy, cuts spending and reduces our deficit.
“Instead of playing games with the debt limit, we should instead focus on how to get our nation’s fiscal house back in order. That’s why I have worked hard as co-chair of the fiscally conservative Democratic Blue Dog Coalition to pass components of our Blueprint for Fiscal Reform, cosponsoring 15 deficit or debt reducing bills, many of which have become law. This Congress, I’ve also voted to cut $38 billion from the 2011 budget and am working hard to build support for the Blue Dog Benchmarks for Fiscal Reform, which aims to cut the deficit by $4 trillion over the next decade. Reducing our deficit is and will continue to be my focus in Congress as a fiscal conservative and as a Representative from Arkansas.”
GRIFFIN – “Tonight, I voted ‘No’ to raising the national debt limit and will remain opposed to raising it without serious structural spending reform. Neither the President nor Senator Reid has a plan to deal with the federal government’s out-of-control spending, but the House does. They should adopt the House’s reforms to save Medicare, reduce spending and encourage private-sector job creation. I understand the gravity of what is at stake and addressing the root cause of the debt—out-of-control spending—is the only way forward.”
WOMACK – “I have said all along that the fiscal situation facing our nation is among our highest priorities in Congress. It is unconscionable to consider an increase in the debt ceiling without significant and guaranteed limits on federal spending.
“We cannot continue to add to the burden of future generations by ignoring our obligation to control spending.”
The overhaul of the state’s Medicaid system will move a little more slowly than earlier anticipated, but it’s still moving.
That was one of the takeaways from a question and answer session in Little Rock attended by hundreds of medical providers and led by State DHS Director John Selig, Medicaid Director Dr. Joe Thompson, Medicaid Medical Director Dr. Bill Golden, and Steve Spaulding, vice president of enterprise networks for Blue Cross.
DHS and the Beebe administration have proposed replacing the state’s fee for service system, in which Medicaid keeps paying as long as doctors keep treating, with concepts such as “bundled payments” for “episodic care.” The state has gotten a waiver from the federal Department of Health and Human Services to try to implement the idea as a pilot project.
In other words, the state would pay a certain amount to all the providers (bundled payments) for an episode, such as an appendectomy, and no more. The idea is to give medical providers a financial incentive to provide only necessary care.
How that system will work is a topic of big concern and debate in the medical community. As originally planned, providers would decide how to divide the money for each patient. That’s still being talked about, though Selig did indicate to one questioner that Medicaid could be the decision maker. Still, it could be a mess. As David Wroten, director of the Arkansas Medical Society told me, a state is a pretty big pilot project.
The plan was to start going into effect in July 2012, and that’s still the timeline, but the presenters said the state may begin by trying to pick low-hanging fruit and roll out the changes over time. For example, an early focus area could be early delivery of babies, which data show is being done too often for convenience instead of medical necessity.
The idea is being considered because the state faces a $200 million shortfall in Medicaid in 2013, with future deficits looking even scarier. Thompson pointed out that a 5 percent savings in Medicaid’s $4 billion budget would equal $200 million.
Medicaid is the program that pays for care for the poor, the disabled, many nursing home residents and others, and you can’t reform health care without it. In Arkansas, 750,000 people are on it, and it pays for 60 percent of all childbirths.
Spaudling said Blue Cross wants to participate so it won’t be at cross purposes with the state. “The whole idea is to share information and find ways that we can both push on the same side of the rock,” he said.
I talked with Selig (above) after the meeting to get his thoughts. I have no idea why his head is so flat in the video. I promise he does not look like that in real life.
