HEALTH CARE/Joan Retsinas

The Decency Chronicles

A chapter from the Decency Chronicles.

Attorney Joseph Welch launched these Chronicles. During Sen. Joe McCarthy’s hunt for Communists buried in American society, Welch asked, “Have you no sense of decency?”

That question spurred Americans to reconsider their fascination with a demagogue.

Here are cascading examples from today, 62 years later, when the sense of decency remains elusive.

This November we have the chance to elect a new crop of solons. In the spirit of Welch, let me propose a Decency Test for candidates.

Flint, Michigan

When General Motors workers noticed that the water was rusting engines, the company switched their water from the city’s new supplier, the Flint River, back to Lake Huron.

The investigators did not know that the culprit was the absence of a chemical to clean the water, but knew that something was amiss. The company alerted the city. People in charge assured residents that the water was safe for drinking, bathing, cooking.

Fast forward through a few more investigations, more months: lead was contaminating this water. Fast forward to more investigations, more months. The details mounted: budget woes prompted the city to switch water suppliers. In a cost-cutting move, the city had opted for a cheaper supplier. But the city didn’t add a crucial chemical to clean the water. And they lagged on “fixing” the problem, endangering residents.

More investigations prompted the arrests of mid-level bureaucrats, as though they were pulling the levers, in charge of the decisions, from how much to tax to how much to spend. Will the people who hired the people now held responsible be themselves held responsible? Will this chapter in the Decency Chronicles fade?

The Decency Test: Every candidate proposing to abolish the Environmental Protection Agency, to put the safety of air, water, and earth into the hands of local officials — the ones who understand how to save taxpayers’ money — should spend a week, with family and staff, drinking water from the untreated Flint River.

Veterans Administration Health System

As we read the current transcripts from Congressional hearings into the Veterans Administration healthcare system, we might ask – not just of the system’s administrators, but, more importantly, the people in charge of the people in charge – “Have you no sense of decency?”

Years ago, when reports of long wait-times, delays, and visits never scheduled emerged, the brouhaha was loud and earnest. Our solons were clear: this could not continue. Heads, figuratively, would roll. Fast forward: a few heads rolled. But the long wait times, the delays, and the log of untreated patients continue.

Defenders of the system point to the many hospitals and clinics that serve veterans well; the outliers should not blemish the entire system. But those outliers serve thousands of veterans – the ones who have returned from wars they didn’t understand – was it regime change that would later spur civil war? Was it hidden weapons of mass destruction that weren’t there? Was it oil that we no longer need?

These veterans deserve more than “call waiting” when they seek care. Indeed, although some politicians call for abolishing the Veterans Health System, putting veterans into the general syste­­­m, our veterans deserve better care, the best we can summon up. The first explanation for the bureaucratic ineptitude is bureaucratic ineptitude; beyond that is money. But for conservatives preaching fiscal austerity, “more money” is opprobrium.

The Decency Test: All candidates should spend a month in the Veterans Health System, waiting for an appointment. And all candidates preaching strategies that would put eventually put more boots on the ground – a strafing of deserts in the Middle East? A no-fly zone over Syria? – should do the same, because every hawkish move will generate more patients waiting in queues at our Veterans Administration hospitals.

Tough-on-Addicts Governors

The nation has an addiction problem. We can debate the causes ad nauseum. Too many prescriptions from Dr. Feel-Goods? Too much malaise? (The statistical bump in women’s suicides suggests a deep dismay.) Too few police officers patrolling the narcotics? Too much easy-to-grab stuff? Whatever the cause, as many as 44,000 people (from The Centers for Disease Control and Prevention) died from an overdose last year.

We don’t have a sure-fire cure for the addiction.

We can, though, stem the deaths. Naloxone, an opioid agonist, if given soon enough, will save the addict’s life. But naloxone is a “controlled substance” that only physicians can prescribe and administer.

To date, most states have passed “naloxone access” legislation, letting other professionals (including pharmacists) as well as friends and families in some states, administer naloxone. Addicts have a chance to survive past the overdose in those states.

Good Samaritan laws are trickier. Not surprisingly, the friend who saves his addict-friend may have drugs in his possession, or be using drugs – a felony. Good Samaritan laws will give that life-saving person immunity from the drug possession charge. Twenty-two states have passed these laws; 13 of those states go further, giving the life-saver immunity from other drug charges. Politicians in most states have resisted these laws. They have adopted a politically popular tough-on-drugs stance, as though unleashing Good Samaritans into the body politick will unleash a flow of heroin, a horde of addicts.

The Decency Test: Legislators should attend the funerals of the addicts who overdosed, grieving with their families and friends.

Maybe these Decency Tests will inspire candidates to put decency above demagoguery.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, June 1, 2016


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