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George, On June 14, I was at table with two members of the LaRouche organization. The man, whom I’ll call M, is close to “Lyn” LaRouche. He turned conversation to the health care reform proposals inching their way toward Congress. “We are going to bring this bill down,” he said. Bring down? Why on earth, I asked. His answer was involved, having to do with Tom Daschle’s apparent support of a Comparative Effectiveness Review (CER) board based on the British National Institute for Clinical Excellence (NICE), their technology assessment agency. I had read something about this discussion, though not from M’s point of view. He was livid and also, frightened, his eyes wide. He said, If we were to adopt this British model, it would lead to a Nazi-like review of who could live and who would die. He brought up Dr. Ezekiel Emanuel, referred to a paper he had written, and claimed that his — Emanuel’s — position would lead to euthanasia as an approved policy. I know a little about the British health care system and had had informal discussions about comparative national systems while at Cambridge University last autumn; I had heard about Dr. Emanuel’s paper, but not this rather wild interpretation. (The paper has since been widely circulated; it cannot be interpreted this way; and Dr. Emanuel has categorically denied this interpretation.) I asked M in what way would any commission which reviewed effective techniques and technology possibly have anything to do with Nazis? (I have known this man for many years and have continually been amazed at the sloppy quality of his thinking, which does come straight from the standard line of his organization. LaRouche seems to believe--M says this--that the British Empire still exists and means to rule the world again. I can’t follow the logic, but know enough of the historical grounding of the argument to see that it is badly twisted, rather as paranoics construct narratives based on a few facts strung together oddly and amplified by their worst fears.) Sharply, I said that it was certainly possible to have an informed argument about whether CERs were a good thing, but to bring in the incredible, false comparison to the Nazis was simply demagoguery. The Nazis intended to exterminate people. It didn’t happen because of bureaucratic slippage or bureaucratic rigidity. They killed people on purpose. His response: This is a desperate situation. “We have to scare people, so that they can see how bad this might be.” He said “we” had been talking to Sen. Grassley and he was on their side. I said again, this was demagoguery and completely disgusting. I cannot remember more of the conversation; indeed, had forgotten it. But last week, I was made aware that what M promised--or threatened--did indeed come about. It seems the LaRouchites have haunted Congress and public meetings with elected representatives, shouting their “Nazism” charges. Curiously, I have seen no references to NICE or CERs or any of the serious, complicated proposals that so frightened M. Rather, the use of fear, instigated by him and his fellow believers, has caused the public discussion to metastasize into an older, uglier form of American know-nothingism, that deep strain in our history of ill-informed citizens goaded by fear and their anxieties to imagine the worst. Let me say again, I think there was--earlier--some basis for serious, informed discussion of real differences of analysis and judgment (not mere opinion). But that’s gone. Instead, demagoguery and fear, used as political weapons, seem to be working. I am afraid they will, indeed, succeed. I am very concerned that President Obama’s serious, thoughtful, important recognition that our health care system is badly flawed, and that cost and delivery must be changed if we are not, collectively, going to sink under an unaffordable burden, has been defeated. His was no radical proposal, as I think sensible people would agree. The suggestion of a public option--a sort of medicare-for-all, government-based, optional insurance program--seems to have been taken as an affront by insurance companies, and other for-profit agents of the health care industry, who could not compete. This is beyond irony. At Cambridge, in the informal discussions about national health care systems, a friend and colleague pointed out that the three major countries with serious health-care-delivery problems --the U.S., Britain, and Ireland (all are in serious trouble, each in its own way)--are products of neoliberal capitalism. We don’t use the word neoliberal in this country, but I am sure readers know its history and meaning, that is, our all-but-unregulated finance capitalism, in contrast to the various social market-based capitalisms of the rest of the European Union. I cannot explain--because I cannot comprehend it myself --to European friends why so many of our own people are uninsured, and why health and well-being are commodified in our country. Paul Krugman, in a recent NY Times column, wrote: “ ‘We have always known that heedless self-interest was bad morals,’ said Franklin Delano Roosevelt in 1937. ‘We know now that it is bad economics.’ And last year we learned that lesson all over again. Or did we?” My points are related: the use of fear and demagoguery to defeat a proposal,
because the political agents responsible do not trust the electorate and
mean to have their way at any cost; and the savagery of the existing system
of health care organizations that make profits from the needs of people
who depend upon their assistance. The I cannot explain any of this to my friends and colleagues in other lands. A last word. I was speaking with M because we are connected by marriage, through his wife, herself also a believing LaRouchite. I am fond of her, and she and I never, ever discussed politics. We three had met because she has been diagnosed with early-onset Alzheimer’s; she is 58. The news was, for me, a thunderbolt. M, speaking of what might happen if we did borrow from the British system, looked terrified and said, “It will be hell.” I do believe he was speaking of what he might be facing in the present situation as he and his wife go into her long night. Katherine McNamara (Electronic mail, August 27, 2009)
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