No System To It

Rob Thomas is the film critic for The Capital Times here in Madison, and I always find his reviews to be informative, insightful, and well written. The one he did last week was no exception. It was a sympathetic interview with Milwaukeean Steve Burrows, director of the HBO documentary Bleed Out, about his decade-long struggle to find justice for his mother, who had been seriously disabled in what should have been a routine medical procedure.

Something about the review nagged at me, however, and I finally realized that it was the use of the term “health care system” in the headline and thruout the article. It perpetuates the mistaken notion that there is such a thing in America.

There is not.

I’ve done a fair amount of systems analysis in my time, and I’ve got a good grasp of what a system is supposed to be. Above all, it’s something that’s been designed, something to serve an intended purpose, with all its parts properly constructed to fit together smoothly to produce the desired result. If that were the case here in the US, we’d actually have proper health care for everybody. But it’s not. It’s stupendously excellent, world-class, cutting-edge health care for the privileged few, occasionally adequate and fitful attention for the bulk of people in the middle of the economic spectrum, sincere wishes of good luck for the people between jobs, bad nutrition and emergency-room visits for the poor, and “suck it up or please die quickly” for the desperate.

No, health care in America is like our measurement system. Not neat, orderly, consistent, and easy to learn and use like the metric system used by 95% of the world’s population. Instead it’s a cobbled-together patchwork of disparate profit centers like hospitals, pharmacies, independent medical practices, X-ray and lab-test providers, insurance companies, employee-benefit plans, lawyers, accountants, marketers, lobbyists, claims deniers, and of course corporate CEOs whose only joy greater than their annual 8-digit bonuses is pissing all over their competitors. The sole purpose of each of those independent components is not health care or patient sympathy but the ability to make a buck. And if there’s no money to be made, there’s no service.

That’s why, for example, you can get mail delivered to your front door 6 days a week for any address in the United States, or flip a switch and be assured that the lights will go on anywhere in America, but good luck if you need an emergency appendectomy in the northwoods of Wisconsin. No money in it, you know.

And that’s Wisconsin. Imagine what it’s like in Appalachia. Or Alaska. Or ranch country in Wyoming. Or Indian reservations in the Southwest. Or even inner-city Los Angeles, with no public transportation.

We can do better than this. Congress needs to buckle down and give us a serious health-care SYSTEM, like every other industrialized democracy on Earth! Sorry to say, they apparently have higher priorities. Instead of health care, they’re focusing on wealth care. But my rant on big money in politics is a topic for another day.


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Health tip: If you can’t afford a doctor, go to an airport. You’ll get a free X-ray and a breast exam. And, if you mention al-Qaeda, they’ll throw in a free colonoscopy.

Mike McCabe, Democrat (?) for Governor

Mike McCabe, Democrat (?) for Governor
Suppose you’re a Democrat wrestling with which of eight candidates you’d like to support for governor, and you’re looking into this McCabe guy. “Why him?”, you might be wondering. “He spent his early career as a legislative aide to Republicans, has never been a dues-paying member of the Democratic Party, and refuses to take a loyalty oath to support the party’s eventual nominee.”

All true, and exactly why he deserves your support. Ask yourself this: “Do you consider yourself a citizen first or a Democrat first?”

Primary elections are dividers, not uniters. They drive the Democrats toward the bluest, most liberal contenders and the Republicans toward the reddest, most conservative ones. Whichever candidates emerge from this process will have the undying devotion of a fourth of the electorate, the unremitting hatred of another quarter, and massive indifference from the half that’s in the moderate middle. No wonder modern American politics leaves us so fractured and divided.

Mike McCabe is a realist. He knows that third-party candidacies are not only futile, they serve to further fractionate us. That’s why he’s running in one of the major parties, but not as a blind loyalist of it. It’s also why he’ll have broad appeal come the general election, and why he’d govern as a cost-conscious, trans-partisan uniter.

Mike’s #1 issue is getting big money out of politics, whether it’s liberal dollars from George Soros or conservative megabucks from the Koch Brothers. His appeal is to those of us in blue jeans.

In this, he’d follow in a noble Wisconsin tradition. Pat Lucey, a highly successful realtor with a healthy respect for the profit motive, ran and governed as a humane Democrat who promoted governmental efficiency. Lee Sherman Dreyfus, a college chancellor from the liberal world of academia, ran as a Republican and surrounded himself with top-quality advisors who weren’t partisan activists. Wisconsin’s longest-serving governor was Tommy Thompson, a self-described “hick from Elroy” who was able to work with urban Democrats on welfare reform, increased school funding, negotiated firmly but fairly with the state employees’ union, and brooked no nonsense from the extremist factions in his own Republican Party.

We need another governor like this today. Fortunately, one’s available. His name is Mike McCabe.


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The question will arise, and arise in your day, ... which shall rule — wealth or men? Which shall lead — money or intellect? Who shall fill public stations — educated and patriotic free men, or the feudal serfs of corporate capital?

— Edward Ryan, Chief Justice, Wisconsin Supreme Court, addressing the UW graduating class of 1873