3 posts categorized "lead"

October 12, 2011

New Site Design!

As of October 12, 2011, the url "http://www.frameshopisopen.com" will no longer link to the Typepad version for Frameshop, but will link to an upgraded version of the site at Wordpress.com.

The new Wordpress format was chosen to better serve the growing number of readers who interact with Frameshop via smartphones and tablet computers, and to make sure that the site emphasis on legibility and ease of sharing keeps pace with changes in social media.

The new site theme is from my favorite web designer: Khoi Vinh.  When I first started frameshop, I contacted Khoi and asked him if he would design the site for me.  As it happens, he was a little busy becoming a leading figure in his industry.  Fast forward six years--Khoi's original grid-system layout blog template is now available for Wordpress clients.  Game, set, match.

It will take some time to move all posts over accurately from Typepad to the Wordpress system. Also, given the way Google indexing works, I want to avoid the problem of ghost pages in Google searches (pages that show up in Google, but then lead to a dead end because the original site is no longer online).

For those of you with bookmarks, the new wordpress url is: http://jeffreyfeldman1.wordpress.com

Also:  the new site offers two different page styles for users reading from smartphones--as well as the option to use a "flip" format when viewing from a tablet. Both formats are intuitive, easy to use, and optimized for small/touch screens.  And you can easily switch back and forth to standard web view.

This will give on-the-hoof Frameshop readers more options. 

Finally: ads are gone. Over the past year, ads have no longer brought in enough revenue to justify the design clutter they dropped on the site. Ergo: so long, ads--thanks for all the fish.

Anybody who is still wishes to sponsor Frameshop--a decision I endorse with gusto--drop me an email and we'll work something out that fits elegently and effectively into the new site.

March 28, 2010

Conspiracy Tea Served Up As Constitutionalism

Probably the most oft-heard refrain from the Tea Party adherents is a vague, undefined notion that by dressing up in costumes, shouting and spitting at members of Congress, they are somehow acting in defense of the United States Constitution. Glenn Beck and Sarah Palin (de facto prom king and queen of the Tea Party) are forever claiming that their protestations against "big government" and taxes hail from a deep reverence for the Constitution, which they say has been victimized--indeed, mortally assaulted by Democrats under the guise of economic reform.

Is the Tea Party movement "constitutional" or is it something else?

Are we really supposed to believe, for example, that Glenn Beck (a shock jock with no legal training whatsoever) and Sarah Palin (a celebrity-cum-failed-politician known for celebrating her own ignorance of U.S. history and civics) somehow have an understanding of those aspects of the U.S. Constitution that, say, would come into play when the mandate to purchase health insurance was extended to the States in 2014?

To even ask that question is to immediately grasp how ridiculous the claim is that the Tea Party movement is somehow defending the Constitution.

Tossing aside the word "Constitution," a much better word to describe Tea Party politics would be "conspiratorial."

If we take this word "conspiracy" and we hold onto it while we look at the latest coverage of the Tea Party rallies in Searchlight, Nevada or Washington, DC, we begin to see more clearly what holds together this movement.

What Tea Partier's share is not an understanding of the founding document defining the form and function of our system of government. What they share is an embodied sense that the United States government has been "taken over" by a conspiratorial movement. Where other Americans still a government operating within the framework of the Constitution, the Tea Party activists see a government whose every lever has been gripped by the many hands of conspiracy. To be a Tea Party activist filled with enough rage to lean back and spit in the face of an elected official is to know in your bones that "Constitution" has been displaced by "conspiracy"--and your job is to kick the conspiracy out and put the "Constitution" back in place.

If you ask: which aspects of the Constitution have been compromised, Tea Party members inevitably respond with the word "Taxes." But if you point out that the Constitution Clause of the U.S. Constitution allows for exactly the kind of economic reforms the government has enacted during the Obama administration--indeed it allows for reforms even stronger--the TEa Partier inevitably responds with another word: "lies."

To talk about the Constitution in any detail with a Tea Party member results, in fact, with little more than an accusation that you (or I) are part of the conspiracy, part of the lies. Tea Party activists are convinced at a deep emotional level that the conspiracy now running the government has been perpetrated by tyranny, masked as justice--evil, masked as good.

There is, in other words, a circular and nonsensical kind of argument that is characteristic of the Tea Party: either you believe the conspiracy exists--or you are part of it.

"Conspiracy" and "Constitution."

It would be fascinating, for example, if a journalist were to put Sarah Palin in a position of having to explain which aspects of the Commerce Clause she felt the recent health insurance regulation bill violated. If Sarah Palin claims to be the leader of a Constitutional movement, she should have no trouble explaining her position on the Commerce Clause.

Here, for example, is a law professor Mark Hall explaining why the Commerce Clause of the U.S. Constitution, as well as the Constitutional power of Congress to tax income, easily allows for the health insurance mandate:

Constitutional attacks fall into two basic categories: (1) lack of federal power (Congress simply lacks any power to do this under the main body of the Constitution); and (2) violation of individual rights protected by the “Bill of Rights.” Considering (1), Congress has ample power and precedent through the Constitution’s “Commerce Clause” to regulate just about any aspect of the national economy. Health insurance is quintessentially an economic good. The only possible objection is that mandating its purchase is not the same as “regulating” its purchase, but a mandate is just a stronger form of regulation. When Congressional power exists, nothing in law says that stronger actions are less supported than weaker ones. An insurance mandate would be enforced through income tax laws, so even if a simple mandate were not a valid “regulation,” it still could fall easily within Congress’s plenary power to tax or not tax income. (http://bit.ly/9P483O)

Some individuals may not agree with the mandate, but the Constitution allows for this kind of regulation, such that arguments to the contrary certainly will not stand up to Judicial scrutiny.

As you might have guessed, though: if you so much as try to make this argument to a Tea Party activist, they will respond that you and Prof. Hall are both part of the conspiracy.

This leads to an interesting conclusion about the nature and makeup of the average Tea Party activists: if a deep understanding and reference for the U.S. Constitution is not what draws them to the streets, what does? The answer seems to be: a tendency among certain Americans, often deeply ingrained, to buy into the idea that the world is run by hidden cabals.

Is it any wonder, then, that these Tea Party events have drawn in people whose lives are steeped in other conspiracy theories besides the most recent health care taxation plot?

Other conspiracy theorists at Tea Party events include gun rights conspiracists (who think the government is conspiring to take away their guns), anti-Semitic conspiracy theorists (who think Jews are conspiring to take over the world financial system), racist conspiracy theorists (who think blacks are conspiring to take over white America), Christian conspiracy theorists (who think non-Christians are conspiring to destroy Christianity)--and so on.

The racism and outbursts of violent rhetoric at Tea Party rallies that has shocked Americans has been a product of all these various forms of conspiracy theory merging into one cacophonous mass of screaming voices. Some of these conspiracy theorists are drawn in by the vague talk about defending the Constitution, but many more are just there because they find a common way of speaking about nefarious plots threatening the world.

The sad reality is, however, that conspiracy theory makes for good TV, which means it is very unlikely that anyone in the mainstream media will ever sit people like Sarah Palin and Glenn Beck down and force them to answer questions about the Constitution they claim to be defending. Beck and Palin have become experts at stoking people's sense that the conspiracy is not just out there, but that it is just minutes away from breaking down the door and dragging us all off to the gulag. And for those whose lives are saturated with conspiracy theories, consuming the rhetoric of Palin and Beck is not unlike an alcoholic slipping into a bottle of gin: it consumes them.

How to stop all this?

At every step, the media and elected officials need to stand up and refute the idea that the Tea Party is about the U.S. Constitution. The Constitution not only allows for economic regulation and taxation, but the health and prosperity of our nation depends on those very aspects of the Constitution being faithfully applied. If we are willing to toss away our faith in the constitution because a bunch of conspiracists are standing on street corners shouting, that would be bitter tea indeed.

February 26, 2010

Do Doctors in America Turn Away the Uninsured?

If President Obama's health care summit revealed anything in the long hours of partisan whining, it was a fundamental difference in the crisis that each side believes is on the table for Congress to solve.  Democrats spoke to a national humanitarian crisis caused by an industry run amok, while Republicans talked of a series of consumer obstacles caused by government meddling in the market place.  Who is correct?

To believe the Republicans, one would be forced to accept the central claim they make over and over and over again:  anyone at anytime can go to a doctor and be treated irrespective of insurance coverage or financial circumstances. 

Is this claim true? Are the uninsured denied care upon going to a doctor? 

The answer is: yes--the uninsured are denied care by doctors all the time.  How this denial of care happens, however, is something that nobody in Congress or the media has bothered to discuss on the public stage, despite the fact that it is one of the most common and banal evils of our democracy.

To see how patients are denied care by doctors, we must begin by exorcising from our heads the Norman Rockwell painting many of us carry around in our heads--the painting of a boy sitting in the office of a country doctor.  For about the past 40 years, "going to the doctor" in America has not had much in common with the nostalgic image of a ruddy-cheeked old man putting his stethoscope on the chest of a nervous teenage boy. That kind of simple and direct interaction between doctor and patient did happen in the past--I vaguely remember it when I was a boy in the early 70s.  But it has been a long, long time since things were that simple.

Nowadays, to get into the room with a doctor, we must first make it past the system each practice sets up to weed out the paying customers from those who cannot pay.  This often humiliating experience begins with a phone call to the front desk of the doctor's office.

The person who works behind that front desk is in charge of two tasks:  (1) ascertaining how the patient is going to pay for the appointment and (2) fitting the patient into the doctor's schedule of appointments--in that order.  Barring some personal connection, nobody in America can get a doctor's appointment without getting past the hurdle of payment maintained by the receptionist in charge of maintaining it.

To determine if we can pay for an appointment, the receptionist asks first for insurance plan information. Even if we have insurance, that may not be enough to see the doctor because at this point we may find out that this doctor's office only accepts patients with certain insurance plans.  If our plan is accepted, we can move forward, if not, we move on to the next hurdle.

If we are uninsured or our insurance plan is not accepted by this clinic, the receptionist then asks for a valid credit card to cover the cost of the appointment.  If we have a valid credit card, we give it to the receptionist and we can move forward.  If not, we move on to the next hurdle.

In the absence of a valid credit card, some medical practices will allow us to pay for the appointment in advance  using cash. If we can pay, we must go to the office and do so, whereupon we can get an appointment.  Many doctor's offices, however, do not allow cash payment because most appointments involve an element of the unknown in terms of final cost.  Because of this, "payment in cash" is often allowed  only if a patient can guarantee the payment with a credit card number: a deal breaker for many people.  Therefore, if we do not have enough money to pay cash in advance and a credit card to back it up, we move on to the next hurdle.

At this point, the receptionist will likely suggest another practice or an emergency room visit. 

We have not been denied care by a doctor, in other words, but we have not really made it anywhere near the doctor, yet, either.  Instead, we must now head down to the local hospital emergency room and get treated there.  Since we cannot pay cash at the emergency room anymore than we could pay at the doctor's office, we will be treated by virtue of laws put in place to recover from state and federal government some of the costs of an unpaid emergency room visit.  We will go home treated, but we will not have established any kind of relationship to a doctor.  Most likely, we will have been treated by an overworked and under-appreciated medical resident 72 hours into a 48-hour shift.

In some cases, a medical practice who determines a patient is unable to pay will allow a patient to talk to the doctor briefly, either in the doctor's office, in the waiting room, or briefly over the phone.   An uninsured and non-paying patient making it into the examination room, however, is possible, although unlikely. 

This is not a comment on the individual character of doctors in America, today. Most doctors are selfless and service-oriented:  good people with a desire to use their skills to improve people's lives no matter what the cost. 

But doctors have a larger concern that most often mitigates their ability to exercise this direct kind of care for any patient who comes their way regardless of financial circumstances.  Doctors, today, erect a  barrier between themselves and their patients because their ability to treat their covered and paying patients depends on their ability to keep the doors of their medical business open.   And so, in order to protect their practice, doctors must look for ways to minimize, if not eliminate altogether, the financial losses to their businesses incurred by treating patients with no means to pay.

Good people, with good  hearts, often build business in which they surround themselves with heartless bureaucrats tasked with guarding the gate and protecting the bottom line.  And that is often the case with doctors.

The receptionist who is paid to keep uninsured and non-paying patients from entering the doctor's examination room is one of those barriers.  Patients, however, also develop internal barriers--psychological hurdles--that keep them away from the doctor.

Americans who lose their health insurance coverage often do not even bother to try to make appointments at the doctor's office out of concern that to do so will risk financial ruin or humiliation. 

Since it is not possible to put a limit on how much a doctor's office can charge to a credit card, patients are often worried that giving a doctor a credit card could result in tens of thousands of dollars in charges, unexpectedly.  Rather than thinking of doctors as people who can and want to help them--the way most doctors see themselves--tens of millions of Americans think of doctors as financial predators to be avoided at all costs.  

Likewise, the pain of having to admit one's own indigent status in the course of making an appointment is often too much for proud Americans to bear. And so they stay away from the doctor.

Is it true, then, as Republicans claim, that nobody has ever been denied care upon going to a doctor?  Is this humanitarian crisis in America really just a political fiction as the Republicans would have us believe?  Experience and logic lead us to conclude otherwise.

American is packed to the gills with the most skilled and selfless doctors in the world--and millions of Americans, each and every day, despite trying, never make it to the examination room to see them.