"911 is a Joke", accountability, and Medicaid

Last night my brother and I went to an 80's party hosted by a fellow resident. The resident and his girlfriend went all out -- there was a glow in the dark mega rubix cube, 3 televisions side-by-side playing a videotape he put together of his favorite scenes from movies from the 80's, poprocks everywhere, bottles of beer with glowsticks in them as decorations around the apartment, and song after song from the 1980's playing in the background. My brother and I weren't sure what to wear to the party -- we totally missed the 80's altogether when we were living in it. The only thing i remember doing that was 80's-ish was pegging my jeans. I'm sure we did embrace more of the 80's while we lived it but we were definitely having some cognitive dissonance (or perhaps some active repression of those memories). So finally we decided -- Nalin (my brother) dressed as George Michael, complete with the Cross earring, and I dressed as Flava Flav from Public Enemy, complete with a bigass clock around my neck (that nalin made), a sweatsuit, and a brim cap with "Flav" written on it. I was just missing the gold spinner teeth (and I was reminded by several at the party about missing them). Others' costumes were most creative. It was my first real 80's party after the 80's, and the partygoers' way of chillin' a bit after some crazy insane long days in the hospital and the crazy insane things going on in the world.

So it's been a while since i've posted. My month on the pediatric intermediate nursery with the newborn babies has finished, and I'm almost nearing the end of my month doing inpatient family medicine. Working with little babies was more fun than I thought it would be, but I was definitely missing interactions with adults after my month in the nursery. So many stories from the wards, I'll share one specific one in an upcoming post. I'm almost 3 months through residency now, but hey who's counting? :> I still feel weird when people call me doctor, i think that feeling will stay on for a while.

It's been rough doing this intense work while things are breaking down all around. The New Orleans (preventable) disaster has really eaten at me. My brother and I have spent countless hours processing it and figuring out our role in the response, however minimal given our location and time constraints. I almost want to forego my vacation to India in a month so I can spend my only 2 weeks of vacation this year in New Orleans helping out. But at the same time, it's been 8 years since i've been to India and my relatives have planned my grandparents' 60th wedding anniversary celebrations around our vacation, and we've spend $2500 on plane tickets. Displaced folks (not "refugees") have made it as far west as Phoenix, perhaps some will make it out to Los Angeles and we may be able to help in that way. Until then, we'll do the donating and figure out how our assistance can be used in the long haul -- clinically, politically, or otherwise -- because it's going to be a hell of a long process in rebuilding lives.

Speaking of rebuilding lives, the disconnect between the national government and the people is striking. I'd like to think there's just incompetence on the part of the goverment, but it's looking more and more like flat out negligence, which is worse. The racism and other -isms against people not wealthy enough to sit at the table with Bush and Co. are overwhelming.

On a health note (and to further show the disconnect between our nation's "leaders" and the American people), Congress is looking at slashing 10 billion bones from the funding of Medicaid, the public health insurance program for low-income Americans. This has been underway for a while, but after the disaster in New Orleans, many Dems and some Republicans have voiced opposition to the cuts in Medicaid. However, many Republicans are defending the cuts by saying the two are not connected. A comment from Senator Kyl (R) in Arizona: "We need to be careful about making a direct relationship between Medicaid cuts and disaster relief," adding, "There may be little or no connection there." So there are thousands of people dying, thousands others displaced, and this catastrophe is reduced to "disaster relief" with no connection to health care? What world does he live in, how disconnected is he from his constituency? But then again, Barbara Bush thought evacuees were better off after the disaster because of all the wonderful hospitality in Texas. No worries about losing their homes and jobs and lives and relatives, because hey they're poor. And Representative Richard Baker (Louisiana) told lobbyists: "We finally cleaned up public housing in New Orleans. We couldn't do it, but God did." Let's fire him. Fire him and Kyl and all the other disconnected money-mongering rich bastards in Congress.

I've already heard several people on a few health related listservs state that we really should be focused on the rescuing and the rebuilding, not on blaming Bush and his cronies for what went wrong. Well it's hard not to blame as Bush has done SO many things wrong on this situation. Isn't it the role of the public in a democracy to hold its leaders accountable? Why do caring citizens get accused of playing a "blame game"? (Scott McClellan mentioned that term 15 times in two press conferences -- the bush press machine is hard at work). More public relations crap as Bush said recently, "We solve problems, we're problem-solvers." What? As Ed Helms reported on the Daily Show (that show ROCKS) - "Bush is often found saying 'We A - B. We're B - A'ers'" (and we just TAKE it). On the accountability tip, Paul Krugman drops science at his editorial in the NYTimes, where he states:

Why did the administration make the same mistakes twice? Because it paid no political price the first time.

Can the administration escape accountability again? Some of the tactics it has used to obscure its failure in Iraq won't be available this time. The reality of the catastrophe was right there on our TV's, although FEMA is now trying to prevent the media from showing pictures of the dead. And people who ask hard questions can't be accused of undermining the troops.

...if the administration isn't held accountable for what just happened, it will keep repeating its mistakes. Michael Brown and Michael Chertoff will receive presidential medals, and the next disaster will be even worse.

Blame or accountability, it's all a matter of how you frame it. Accountability is the damn BEST tool citizens have in a democracy.

But I digress, back to Medicaid. Drop some thoughts to your elected officials on why we shouldn't cut Medicaid of $10 billion in long-term funding. There's a form letter, you can modify it if you want. If a disaster of such proportions happens in New Orleans and we don't stop the slashing of public programs, people in the streets will indeed be singing Public Enemy's "911 is a joke".