Tag Archives: Obama

Republicans are listening… The Dems should pay attention too…

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Trey Radel is possibly the future of the Republican party. He is a conservative Congressman from Florida who is under 40 and therefore able to still able to evolve a bit with respect to his political stances.  He has the capacity to connect to a younger generation of voters. He’s a good looking guy and has no problem being appropriately aggressive with liberal reporters and has been an advocate of bipartisanship to get things done in Washington.  Congressman Radel is more comfortable with playful appropriate confrontation in the media in a cool frat boy sort of way and he’s only been in office all of 3 months. While he did engage in some questionable decision making during his run for office, he managed to pull through all of that and maintain the support of his party and obtain a respective majority of the vote. These are the things that most parties look for in future leaders and candidate, one either is or isn’t “that”.  Congressman Radel appears to be “that”.

Radel is the type of politician that Democrats need to watch. Careful. He is likable and unlike Marco Rubio, he seems more sincere when making quips about Lil’ Wayne and other mainstream musicians. Radel seems as comfortable talking to people of color as much as he does with his base constituency. He also is an early supporter of former Governor Jeb Bush for President in 2016 and Bush appreciates the support. This is significant because Bush has been clear in several recent speeches that if Republicans keeps losing presidential elections, the Republican agenda will be lost. He’s right. Neither men are interested in the fringe groups of the party, they are cultivating a new Republican identity. They will hold true to their conservative roots while playing moderate and center…

The Democrats should be mindful of this and respond accordingly. We do not have the next Obama in the Democratic party. And Democrats are pining their hopes on the current leadership – Hillary Clinton in 2016, but if she isn’t willing, who do the Dems have?  The Republicans took their whupping and now, they are retooling. The Democrats should pay attention, and plan accordingly.

Marco Rubio is the GOP Saviour – Only Not So Much…

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In 2011, a young Latino from Florida was elected to the US Senate.  His name was Marco Rubio. Rubio rode into prominence on the backs of and with the support of the Tea Party movement; he was the extreme right’s response to Obama. He was young, good looking, articulate, and… Brown.  A perfect poster boy for the Tea Party’s rebuttals to any claims of racism. You could almost hear it –  Surely we cannot be as racist as the rest of the country believes we are if we own support this guy, Marco Rubio!

Over the last three years, Rubio has worked diligently to separate himself from the more extreme factions of the Tea Party party while maintaining his GOP conservative principles and credentials.  More recently, he was recognized in Time magazine as The Republican Savior to which the Senator promptly and “modestly” responded via Twitter (and I paraphrase) that Jesus is the only Saviour.  That said, he’s relished the spotlight and has played up to the notion that he can turn the party’s image.

The GOP has had high hopes for Rubio. He is now the poster boy for GOP diversity, a son of  Latino immigrants, coming from a family of modest means, and having benefited from student loans and government programs for his educational attainment and subsequent success. His own mother is a current recipient of Medicare.  All government sponsored programs based on policies that Rubio would oppose based on a fiscally conservative GOP agenda.  While I am loathe to call him a hypocrite, I would argue a level of inconsistency and hypocrisy in Rubio’s positions over the last several years.  He’s done a bit of the Romney flip flop enough to lead us to wonder what his real positions are.

In his rebuttal to President Obama’s State of the Union (SOTU) speech, Rubio proceeded to crash and burn… horribly.  Now I will stipulate (as have others) that is not easy to follow the SOTU, especially when that person’s last name is Clinton or Obama.  But if you accept the task and are seen as the second coming of the GOP (and we all know the GOP needs a major shift), you better be able to handle it when the cameras come on and its time to speak.  I felt awkward FOR Rubio. It was uncomfortable and an important moment for the GOP fell apart.  If Rubio is supposed to the be the new face of the hip cool conservative who knows who Tupac is (and allegedly listens to him a la Paul Ryan’s playbook) and this was supposed to be a bi-partisan introduction akin to a blind date, then we were introduced to a sweaty, nervous, shaky, and uncomfortable disaster.  And the chemistry was off. And it was a let down.

First impressions mean a lot.  They matter. Especially to someone who doesn’t really know you.

Let’s look at Rubio’s response to the SOTU. He noted that his parents immigrated to the US, yet his original position on immigration reform was decidedly anti-immigrant, until recently, and it’s still questionable. Rubio benefited from many of the government programs that made him the “successful” person he has become, only now, he would like to cut many of those programs that offer opportunities for low and middle class people coming up behind him.  Rubio offered JFK and Ronald Reagan up as supporters of free enterprise as a means of growing the middle class arguing Obama is opposed to the notion.  Only it is VERY obvious that Obama has more in common fiscally with Reagan than any current sitting Republican member of  Congress, in fact, given an introspection of the Reagan’s policies of the 80’s relative to today’s current GOP climate, he never would have made it out of California much less to the presidency (you can thank Republican Jeb Bush for that bit of insight).

So what now?

It is time for the GOP to seriously reflect on who they are as a party.  This really is a historical time for the party to consider who they wish to be, what they wish to represent, and how they plan to get there for the long haul.  Its not that difficult.  There is a strong history of reform in the Republican party until they decided to be the party of old, white, and privileged.  Putting forward members of the party who have more pigment will not help the party.  Re-establishing itself as a more moderate and sane party would go a long way for attracting a more diverse group of people.

The Democrats managed to do this successfully during Clinton’s years in spite of the fact that some of Clinton’s policies were decidedly unhelpful to many people of color.  Yet, their perception of Reagan/Bush played a huge role in how the two parties were viewed among African Americans and Latinos in this country.  So Democrats were able to enact welfare reform legislation under Clinton that hurt more than helped the poor and communities of color who were impacted.

So Republicans, Rubio is not your saviour, he doesn’t even come close. You will have to find a more sincere way of revamping and retooling your image, by actually doing it.  You will have to align more with the middle, you will have to take a page from Meagan McCain’s book, you will have to made some hard decisions. You will have to get rid of the Tea Party/GOP image.  You will have to become more bipartisan and not because you feel that you have no choice, but rather because democracy and accountability calls for it.

Rubio can be helpful to the GOP, he can be a leader in the GOP, but as far as being its saviour? Mmm, not so much….

Aside

I am no expert in health care policy but I do know what it cost to be fat and sick. I know that if I did not have health insurance it would cost a lot more and I would be in much worse shape than I am now.  I think that healthcare policy requires a more comprehensive common sense approach only made complicated by the lobbyist for this industry.

I also know that in this country there is less emphasis on  preventative care and a major emphasis on medicinal maintenance when someone becomes ill.  There is a pill (and profit) connected to every conceivable condition – conditions that by and large can be avoided if we had a different relationship to food and health.  In 2009, health care accounted for 16% of America’s Gross Domestic Product (GDP) with the expectation that this will increase by nearly 10% by 2025.  We have a population that is living longer with chronic conditions driving up overall costs associated with health care.  Overall, we have a more obese and less healthy overall population in this country.  And the health care lobbying efforts have ensured that our leaders continue health care policy to place emphasis on maintenance rather than prevention.  

Prevention advocates argue that using such an approach in the context of healthcare policy would result in reigning in increasing healthcare costs and creating a more healthy society.  “The Trust for America’s Health reported that prevention programs could save the country more than $16 billion annually within five years, a return of $5.60 per dollar invested.  The Commonwealth Fund estimated that reduced tobacco use and decline in obesity would lower national health expenditures by $474 billion over ten years.” At a time where we are talking about reducing deficits and spending, this is an opportune time to really focus on this issue.


Unfortunately, though many Americans are indoctrinated to eat and drink to excess the wrong things, the real problem is that our policies and national leaders protect the very companies that benefit financially from our illnesses; this means the capacity to advocate for a sensible approach to health care policy against these powerful corporations is more than difficult.  For example, according to the Center for Responsive Politics, in 2005 there were 535 members of Congress compared to 2,084 health care lobbyist; this means for every member of Congress, there was approximately 3.8 lobbyist lobbying them on behalf of various drug and health insurance companies.  Further, according to OurFuture.org, in 2004 the health industry was credited with giving approximately $14M to 11 members of Congress who were created with negotiating the Bush Medicare Plan

So what are the costs associated with chronic disease in America?  Let’s take my personal favorite chronic illness, diabetes.

Diabetes

There are a total of 25.8 million children and adults in the United States which means that 8.3% of the population has diabetes with approximately 7 million undiagnosed.  As of 2010,  1.9 million new cases of diabetes were diagnosed in people 20 and over.  This is part of the reason why there has been a substantive increase in the number of diabetes related advertising and why we’ve begun to experience a sense of “normalcy” relative to diabetes.  Rather than focus on preventing Type 2 which is largely tied to weight, we are being socialized to learn to live with it.  There are approximately 79 million pre-diabetics in the United States; for diabetes drug companies and companies that produce lancets, blood glucose readers, and diabetes related products, that’s a lot of potential customers and money.

 After adjusting for population age differences, a 2007-2009 national survey data for people diagnosed with diabetes, age 20 years or older showed that 7.1% were non-Hispanic Whites, 8.4% were Asian Americans, while non-Hispanic Blacks and Hispanics made up 12.6% and 11.8% respectively of those diagnosed.

There are a host of other related conditions associated with diabetes including:

Heart disease and stroke

  • In 2004, heart disease was noted on 68% of diabetes-related death certificates among people 65 years or older.
  • In 2004, stroke was noted on 16% of diabetes-related death certificates among people 65 years or older.
  • Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
  • The risk for stroke is 2 to 4 times higher among people with diabetes.

High Blood Pressure

  • In 2005-2008, of adults aged 20 years or older with self-reported diabetes, 67% had blood pressure greater than or equal to 140/90 mmHg or used prescription medications for hypertension.

Blindness

  • Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years.
  • In 2005-2008, 4.2 million (28.5%) people with diabetes 40 years or older had diabetic retinopathy, and of these, almost 7 million (4.4% of those with diabetes) had advanced diabetic retinopathy that could lead to severe vision loss.

Kidney Disease

  • Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2008.
  • In 2008, 48,374 people with diabetes began treatment for end-stage kidney disease in the United States.
  • In 2008, a total of 202,290 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant in the United States.

Neuropathy

  • About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage.

Amputation

  • More than 60% of nontraumatic lower-limb amputations occur in people with diabetes.
  • In 2006, about 65,700 nontraumatic lower-limb amputations were performed in people with diabetes.

Morbidity and Mortality associated with diabetes:

In 2007, diabetes was listed as the underlying cause on 71,382 death certificates and was listed as a contributing factor on an additional 160,022 death certificates. This means that diabetes contributed to a total of 231,404 deaths.

Cost of Diabetes

The total cost of diagnosed diabetes in the United States in 2007 was $174 billion, with $116 billion for direct medical costs, and $58 billion for indirect costs (disability, work loss, premature mortality). After adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2.3 times higher than what expenditures would be in the absence of diabetes.  Does anyone see the economic benefit for prevention here?

The American Diabetes Association created a Diabetes Cost Calculator that takes the national cost of diabetes data and provides estimates at the state and congressional district level.  Factoring in the additional costs of undiagnosed diabetes, prediabetes, and gestational diabetes brings the total cost of diabetes in the United States in 2007 to $218 billion.  In my lovely borough of Brooklyn, in the 11th Congressional district where I live, the total cost of diabetes for people in Congressional District 11 in 2006 is estimated at $551,100,000. This estimate includes excess medical costs of $376,200,000 attributed to diabetes, and lost productivity valued at $174,900,000.  For the entire state of New York in 2006, the cost is estimated at $12,860,000,000. This estimate includes excess medical costs of $8,676,000,000 attributed to diabetes, and lost productivity valued at $4,188,000,000.  So clearly, this is a chronic disease that can wreck havoc on someone physically if they aren’t maintaining it, but the costs associated with this disease is astronomical.

I could have used cancer, heart disease, or some other chronic diseases in the same vein to prove what should be obvious to everyone.  It cost so much more to our government and our society to be chronically ill than to take a comprehensive policy approach to preventative healthcare in this country.  The Obamas have worked hard to create an awareness of this through Mrs. Obama’s “Let’s Move” initiative, but we have to do more as leaders.  As Americans we need to change our mindset and relationship to food and we need to demand that our leaders on both sides of the aisle engage in real leadership by reforming how health care policy is done in America.

2013: Prevention as a Healthcare Policy in America