Positive Steps by Memorial Medical Center

Memorial Medical Center appears to be upping its game.

Wednesday MMC held a public board meeting that was mostly comments and criticism from the public. Several folks started with a litany of bad experiences and criticism; Earl Nissen asked about the poor folks with cancer MMC turned away; but MMC gave good answers to many questions (though not Earl’s). When I suggested they hire an ombudsperson, they produced on the spot someone they’d already hired.

I still view with skepticism and concern Apollo Global, the private equity firm that owns Lifepoint, which owns and operates MMC. There’s significant tension between maximizing profits and maximizing patients’ care. Private equity firms sometimes wring hospitals dry. They’re under investigation, and bear watching – by feds, states, cities, and journalists. They’re part of a U.S. health care system that keeps our costs high and our care minimal. Elsewhere, health care is too essential not to be public. Only in the U.S. do medical bills cause 530,000 bankruptcies annually. That’s two-thirds of all U.S. bankruptcies.

Most providers at Memorial are competent and caring. We’ve had consistently good experiences, although some friends haven’t. Two surgeons operated on me this year, Dr. McGuire at Mountainview and Dr. Pinheiro at MMC. Both doctors came highly recommended, impressed me, and did great jobs.

MMC has an unusal situation. Because its predecessor, Memorial General, was a Hill-Burton public hospital, jointly owned by City and County, which still own the land, MMC’s lease and the purchase contract obligate MMC to keep operating certain departments open and fulfill other promises, including reporting requirements. MMC appeared in breach, notably of obligations to treat indigent patients with serious conditions such as cancer.

A public outcry and a national news story helped awaken the City to its oversight responsibilities. The City investigated. The City wrote MMC demanding compliance. The County joined in the demand.

The good news is that MMC is providing requisite information, if perhaps a little more slowly than the City might like, and negotiating issues. Sources at both City and MMC seem optimistic that the negotiations will lead to improvements, without costly litigation. Trusting no one completely, I’ll be interested to see what actually develops.

It’s good news that MMC has switched CEO’s: John Harris, by all accounts, was dictatorial, played favorites, retaliated against folks who pushed for better medical care and raised issues. So the apparent good news comes after a lot of good people got punished and left, or got fired. The AG and others are still investigating possible medicare fraud and other alleged problems.

Dennis Knox, the new CEO, appears a breath of fresh air. He is more responsive to questions and concerns. He speaks of increased transparency. The other guy clammed up and wouldn’t even answer my calls when I investigated MMC for columns. He held Wednesday’s public board-meeting; MMC says it’ll do that once a year, henceforth. (I’d respectfully suggest every six months.) Yeah, the meeting was MMC trying to put on its best face; but no reasonable observer could fail to conclude that that Board includes at least a majority who seriously care about patients and community.

MMC has a lot of caring, competent providers, but it took those news stories, Yoli Diaz’s complaints, and the official investigations to prod Lifepoint into upping MMC’s game. The ultimate owner remains Apollo Global, which has given us reason to stay alert. Thanks, Yoli, Raul, Gretchen Morgenson, and local officials.

                                       – 30 --

 

[This column appeared Sunday, 24 November, 2024, in the Las Cruces Sun-News

and will presently appear on the newspaper’s website and on KRWG’s website, under Local Viewpoints. A shortened and sharpened radio commentary version will air during the week on KRWG (90.1 FM) and on KTAL-LP (101.5 FM, streaming at www.lccommunityradio.org/). For further information on the topic of this column, please go to my blog, https://soledadcanyon.blogspot.com/ .]

[As I say in the column, let’s credit MMC for losing former CEO John Harris and hiring someone who seems a better bet; and for responding reasonably to the City’s notice of breach; and for Wednesday evening’s public board-meeting. These are positive moves. I’m not delighted that MMC is ultimately owned by a private equity firm, Global Assets. However, if MMC is prepared to bring itself into compliance with its contractual obligations, the City [and County] will remain in a kind of partnership.

I did think Wednesday evening’s session showed both why some people are unhappy with MMC’s work and that there are many caring medical professionals on MMC’s board. (I never doubted that most line people we see at MMC are qualified and caring; I’ve doubted whether management does right by them, or by us.) Recent history at MMC, including some reprisals and firings discussed in my columns, and the temporary closure of the mental health ward, are cause for concern, and cost us some very fine medical professionals. But let’s hope that, going forward, Lifepoint/Apollo manage MMC in a way that reflects a healthier balance between profits and topnotch are. I’m guardedly optimistic about that.]

Thoughts on the Recent Disaster

So, what happened?

Yes, we are a stubbornly sexist nation founded on racism. Even macho Mexico has elected a woman president before we have, and Mr. Trump was a bad joke.

But Democrats are barking up the wrong mesquite if they think racism motivated all Trump voters, or even a majority.

Many voters are angry. In 2016, I wrote that people were angry and Trump was yelling angrily, so they kind of liked him. Our inequitable corporation-dominated system provides good reason for anger.

Unfortunately, a huge swath of voters get their information not from our “papers of record” or from fact-based journals that attempt neutrality but from partisan on-line material created, often carelessly, by partisans or Putinists. One Trump voter solemnly told me that Harris had been a high-class prostitute during college and Trump, when younger gave poor Black entrepreneurs low-interest loans and often forgave them. Hunnh?

The Democrats haven’t “abandoned workers,” despite globalism. Most of this century, Democrats supported workers against capital, battled the profit-driven corporate excesses of our huge corporations, and protecting poor folks, various minorities, and [legal] immigrants. Support of LBGTQ folks continues that commitment to protecting the weak and minorities in a closed-minded population. However, it offends some, just as, Democrats’ support of civil rights once alienated some white workers. Republicans used this issue well.

As Blacks need protection from racism, and workers from low pay and unsafe working conditions, and women from abusive partners (and strangers who grope or rape), and the environment from pollution, LBGTQ folks need protection from prejudice and abuse. Allowing LGBTQ folks to live their lives needn’t cost workers anything; letting women flourish (and make choices) needn’t harm men. We are all citizens.

Our capitalist masters have always played us against each other, as southern aristocrats maintained power by playing Blacks and poor Whites against each other. It’s not us poisoning you and ripping you off, it’s the welfare cheats. The pregnant females getting abortions. The immigrants. The socialists.

It was and wasn’t the economy, which has been doing well. There had indeed been inflation initially, and folks recalled the pain of it. They feared high prices, so they rushed to vote for a fellow promising to raise everyone’s prices with tariffs – as if Chinese would kindly decline to raise prices to cover tariff amounts.

There’s also an international trend toward authoritarian governments. We face an axis of dictatorships, and recent right-wing gains in European countries. Democracy is in decline. Is it our human tendency to duck out on freedom and seek a Leader in times of crisis or uncertainty? Marx thought Labor would eventually rebel against capital. Much of our working class has “rebelled” by jumping into Capital’s lap.

In 2016, many voters felt that since the government wasn’t serving them properly, they’d toss Trump into the works. Instead of focusing on understanding folks’ anger, too many political leaders either enabled (or deified) Trump or grew too obsessed with his narcissism. Meanwhile, Democrats compounded their electoral challenges through Biden’s long delay in withdrawing from the race.

Trump’s defects seem obvious: but if you want to weaken the country, who cares? To weaken the country, a guy appointing wholly unqualified people to high positions is fine. Imagine President Kamala Harris naming Hunter Biden Attorney-General and Travis Kelce Defense Secretary.

Voters wanted fairer and more efficient government. Instead, they’ll watch it get dismantled. Vladimir Putin is laughing.

                                -- 30 –

 

[This column appeared Sunday, 17 November, 2024, in the Las Cruces Sun-News

and will presently appear on the newspaper’s website and on KRWG’s website, under Local Viewpoints. A shortened and sharpened radio commentary version will air during the week on KRWG (90.1 FM) and on KTAL-LP (101.5 FM, streaming at www.lccommunityradio.org/). For further information on the topic of this column, please go to my blog, https://soledadcanyon.blogspot.com/ .]

[Two major points I don’t mention: inflation and the Middle East. It’s very tough for an incumbent president to win-election when the country is suffering inlation. Meanwhile, around October 7 of last year, when Hamas butcherred 1,000 Israeli civilians, in addition to being sorry to hear of the attack and sympathizing with victims and there families, I told a friend “There goes the election,” meaning the U.S. Presidential Election. Obviously Israel would overreact, as Hamas had intended for Israel to do, and the U.S. would be involved supporting Israel, and the Democratic President (Biden, I assumed then) would be brought down by the conflict. I think the conflict did hurt Harris, particularly in Michigan; but it wasn’t the deciding factor.]

[Unless something surprising happens, I hope my next several Sunday columns won’t mention the national political scene. There’s a lot to discuss locally.  I am very glad to live in New Mexico! ]

 

Surviving Trump -- and Helping the Republic Do So

Friends ask, “If anyone has any advice on how to survive this, please share it.”

This is both familiar territory and not.

In 1952, just five, I wore a sandwich sign urging a vote for Adlai Stevenson. My father, a Stevensonian Democrat, won a minor local office in that election. But General Eisenhower beat Adlai. Both were decent, competent men serving their country.

In 1964. a college freshman, I campaigned for Lyndon Baines Johnson, whom I soon came to loathe as he escalated the inexcusably stupid Viet Nam War.

1968 I cast my first presidential vote – for Black Panther ex-con Eldridge Cleaver. A college dropout, I asked passengers entering my New York City cab, “Which of the three little pigs are you voting for?” Richard Nixon, Hubert Humphrey, and segregationist George Wallace all seemed unacceptable -- as some now equate Trump and Harris, because of Palestine. When Chicago police beat antiwar demonstrators outside the Democratic Convention, I listened on radio, late at night, concluding that the only course for a person of conscience was to begin assassinating high U.S. officials, killing as many as possible before being killed. [I didn’t!] Four years later, during Nixon’s re-election, marked by Watergate, I was the kind of young dissenter Nixon wanted to destroy.

In 2000, we elected Al Gore but five supreme court justices gave us George Bush.

I believed Richard Nixon would continue the Viet Nam War [despite his “secret peace plan”] and break laws to punish us; I believed Bush was a wholly unqualified fellow who’d be the tool of right-wingers, and disbelieved his silly excuses for starting two wars. I was right. But Trump is different: he’s not only wrong on policies, he abhors our democracy.

In 2016, in Democrats’ local headquarters on Election Night, we were shocked and dismayed, believing Mr. Trump was an incompetent narcissist, somewhat spiteful and lacking in compassion or judgment, all of which proved true. In 2020, Mr. Biden wasn’t my first choice for nominee, but he was a decent and competent gent who prevailed. If only he’d stuck to his promise to stay one term then let younger folks take over!

For more than five weeks, although a civilized nation re-electing Mr. Trump, who promised to be even worse this time seemed unthinkable, I thought it was probably about to happen. It has.

Two questions: will what we have of democracy survive? And will progressives?

First, Mr. Trump, disgusted that his Attorneys-General, VP Pence, and others chose patriotism over licking Trump’s golf shoes, will appoint worse flunkeys this time. He and his advisors have announced plans to challenge our Democratic system. Smarter folks than Trump have detailed plans. He and allies have weakened a lot of the guard-rails we once relied on; but people of good will acting lawfully and non-violently, might just manage to thwart his effort and save the republic. Stay loyal – but watchful.

Individually, we must face this directly without letting it eat us up inside. As Buddhists say about getting others’ criticism, meanness, or bad acts, they’ve handed you a chalice of poison. You alone decide whether or not you drink it, by choosing to take that anger and hatred inside you. Hating Trump does nothing to control his excesses, but weakens you, when our country might need you. And you’ve a life!

Also, recall that many Trump voters are much better people than he. They’re our neighbors, too.

                                       – 30 --

 

[This column appeared Sunday, 10 November, 2024, in the Las Cruces Sun-News

and will presently appear on the newspaper’s website and on KRWG’s website, under Local Viewpoints. A shortened and sharpened radio commentary version will air during the week on KRWG (90.1 FM) and on KTAL-LP (101.5 FM, streaming at www.lccommunityradio.org/). For further information on the topic of this column, please go to my blog, https://soledadcanyon.blogspot.com/ .]

As far as surviving this personally, try not to let it poison everything! That’s hard, at times; but the better we do at it, the more we enjoy our personal lives and the stronger we are to do what little we can do. We’re all that hummingbird in the old tribal legend: as all the animals flee the huge forest fire, the leopard sees the humming bird repeatedly flying toward the fire, then away again, and asks why. The hummer explains that the forest has sustained it all its life, and, in gratitude, it is flying to the river to drink, then dropping water on the fire; and to the leopard’s comment that the fire is too big to be controlled that way, the hummer says that doing what it can beats the alternatives, and if everyone does what s/he can, who knows?

I’d also recommend a glance at Nicholas Kristof’s Manifesto for Despairing Democrats in the New York Times. One on his list that I work on is: “5. I will try to understand why so many Americans disagree with me. Too many Democrats reflexively assume that any person backing Trump must be a bigot or an idiot. But let’s beware of invidious stereotypes, for finger-wagging condescension alienates centrist voters; it’s difficult to win support from people you’re calling idiots and racists. Many working-class Americans have been left behind economically and have reason to feel angry. And Democrats aren’t going to win elections as long as they seethe at a majority of voters. ”

As far as our democracy, in a previous column [A Grim Direction We Might Take], ’ve made clear how this could go, and why, as best I could within the 570-word Sun-News limit.

Will it?

Mr. Trump’s own actions and words suggest that his Presidency will be an assault on our democracy in the sense that it will further weaken the “guardrails” and be dominated by Mr. Trump’s personal/political interest.

Where will that leave us? Friends who assert the traditional protections will save our democracy are unreasonably optimistic. Friends who say that there’s no chance we can save democracy are too pessimistic. We have some chance. Our greatest hope is Mr. Trump’s own incompetence.

Another factor is Trump’s health. His mind appears to be softening toward dementia – but how fast is anyone’s guess. He’s a fat slob of advanced years, which is not ideal for continuing good health.

Normally, one would figure that if Trump screws up badly or overreaches in obvious ways, popular opinion will punish him politically. However: so far, the conservative sources many people read or watch are doing a great job of presenting inaccuaracies; while some Trump voters aknowledge this but vote for him anyway, others believe and repeat wildly inaccurate facts Neither is a hopeful sign.

A Grim Direction We Might Take

Here’s some nuts & bolts of why recovering democracy might be tough if a dictatorial president and his associates overstepped traditional boundaries and chose to retain power permanently.

We can’t be sure either constitutional and traditional guardrails or public opposition would save us.

Our democracy is limited: the Senate and the Electoral College give less populous states disproportionate power. If we ever started a Constitutional Convention, the skew would be even worse.

Republicans controlling “swing state” legislatures have been busily changing the rules, purging voter rolls to decrease poor and minority voters, and increasing legislative control over voters’ decisions. There’s even a crazy argument that a legislature could legislate that it, not citizens voting, would choose presidential electors.

We’ve nearly lost the Supreme Court as a principle-based check on presidential power. Trump’s three appointments, Republican senatorial chicanery during Obama’s Presidency, and recent judicial longevity created a nine-member court with five extreme conservatives. And counting.

Thus, executive overreaching, legislative “adjustments” curbing traditional voting rights, and bad corporate conduct would likely all be found “constitutional.” They might even let legislatures usurp citizens’ rights to vote for presidential electors.

Meanwhile, Trumpian legislation would weaken the “non-partisan” civil service. Once, a newly-elected mayor appointed a whole new police department, loyal to him, helping at his rallies and harassing his critics. Presidents appoint top “political” officials but a core civil service has some expertise and non-partisan interest in just collecting the garbage, inspecting drugs or food, etc. A key Trump agenda item is to weaken that protection, letting Trump appoint lackeys, regardless of ability. We’d get non-evidence-based decision-making, elections could disrupt the whole government, and career civil servants who’d developed real skills and expertise could be fired at a presidential whim.

One hopes that abusing immigrants and maybe ethnic minorities, and curbing personal freedoms of speech and choice, would trigger a wave of negative public opinion. Well, look at Brave New World or Putin’s Russia. Citizens don’t stand up to Putin because (a) he’ll kill them and (b) his tight media control few even know the facts.

Large newspapers owned by zillionaires just copped out on editorializing about the Presidency. Newspapers were already in decline. Meanwhile, a Wall-Street Journal study showed that someone signing onto X to discuss chess or basket-weaving, not seeking political discussion, will be buffeted with pro-Trump messages, courtesy of Elon Musk. How might a coalition of reasonable people seeking a return to democracy ever form, and communicate? Musk could buy Facebook, too. After an innocuous post or two, we’d get one saying Kamala was a college prostitute or Trump spent years rescuing dogs. What if Wikipedia were “acquired” by some Trumpist billionaire? What if universities’ scientific research was funded based on companies’ and scientists’ obeisance to right-wing ideology?

What if every federal clerk reviewing your tax or medical issue decides based on your Trump-friendliness? As was surely true in Nazi Germany. Terrible; but with no press left to write about it and no Supreme Court requiring fairness and justice, well, live with it!

It could happen. We don’t wear some magic shield. As in Russia, they perhaps could gain and hold dictatorial power; but (as in Russia) they’d severely weaken the country. When political loyalty trumps merit, your science, your education, your health, and your military security all deteriorate. Look at Russia!

And, as always, the wealthy interests cheating and poisoning us have great ploys to make us blame each other.

                                              – 30 – 

 

[This column appeared Sunday, 3 November, 2024, in the Las Cruces Sun-News and on the newspaper's website, and on KRWG’s website, under Local Viewpoints. A shortened and sharpened radio commentary version will air during the week on KRWG (90.1 FM) and on KTAL-LP (101.5 FM, streaming at www.lccommunityradio.org/). For further information on the topic of this column, please go to my blog, https://soledadcanyon.blogspot.com/ .]

[Yeah, the column paints a grim picture, but a sufficiently plausible one that it’s worth some serious effort to avoid. Do I think Donald Trump will be elected President again? This morning, I don’t. But for a month I’ve been pretty pessimistic. I kept thinking, “It’s unthinkable that in the 21^st Century a reasonably educated and successful nation could actually elect this guy again,” but feeling pretty sure that we would do so. Obviously, we very well may.

If we do, resistance to the kind of anti-democratic efforts described in the column would be the order of the day. (It was soberting, and helped generate this column, to read [in a recent New Yorker] some of Alexei Navalny’s writing from prison. He was a good and courageous man and died in prison for opposing dicatorship in Russian – reminding me that even our partial democracy is a hell of a privilege in this world.)]

[However, whatever happens, we need to soften this hyperparisanship. We means “we all” there.” We [progressives, skeptics, people of good faith, humanists – whatever you and I are] have a more specific task: to recognize that alhough, yeah, some of Mr. Trump’s most dedicated supporters are racists and haters, many who will vote for him are NOT. I play pickleball with a bunch of ‘em. Some, including people from ethnic minorities, are not being well served by our system [or feel that they’re not] and dislike politicians generally.

What remains important for each of us to do, I think, is to engage with our neighbors. To understand that they are not demented fucks who idolize that huckster, but decent folks – who pet their dogs and make their children laugh just as we do – who, like us, are being cheated, poisoned, and otherwise mistreated by a corporate economic system that has convinced them that in fact, it’s the asylum seekers and illegal immigrants, the people on welfare, the people whose colors, faiths, language, genders and conduct are different.

Underneath, we are allies: we would all like a saner, safer world in which individuals had more of a chance and more personal freedom.

Whether “we” [progressives] win this election and bask in victory or lose it, and feel we’re in danger, finding common ground with our neighbors is an urgent need.

Because while Donald Trump is an incompetent narcissist, the schism that leads nearly half our country’s “adults” to vote for him is a continuing danger; and even the party we’re supporting is too kind to big corporations, too sluggish about dealing meaningfully with climate change, supportive of what many now call genocide, and resistant to doing the normal stuff other modern democracies do, such as taxing excessive wealth, making health available to everyone, etc. ]

[So, I’d say: vote for Kamala and Tim’ and drive someone to the polls who might not otherwise get there; but, whichever side wins, be a skeptic, a critic, a watchdog. Being a pain in the ass to power is an obligation of all citizens.]