Hillary Clinton

Sexism, Hillary Clinton, and Presidential politics

This has been an interesting political season especially with the rise of Donald Trump. We now have a matchup between Hillary Clinton and Donald Trump. What has been disconcerting is the way that some of my friends create a false equivalency between the two candidates. They say both candidates would be equally terrible for the nation. Certain people have asserted that Clinton would be worse than Trump. Others have exclaimed that a Trump presidency would not be as bad as people say or for others a Trump presidency would be so apocalyptic that it would prompt a progressive revolution. I do not understand such sentiments at all.

I supported Hillary Clinton in 2008. I thought she had the experience and competence to be President especially following the incompetence of George W Bush who will probably go down as the worst or one of the worst Presidents of all-time. During the primary between Barack Obama and Hillary Clinton, there was not too many substantive policy differences between the two candidates. The differences came in style. I admit that I consider myself more of a realist than an idealist over time. I was much more of an idealist when I was in college. In the 2000 Democratic primary, I supported and campaigned for insurgent candidate Bill Bradley over Vice President Al Gore. In Bradley, I saw possibilities of what could be with a progressive platform. Bradley came to the University of Washington and held a rally on Red Square trying to inspire young people to vote. However, when it came time to vote, Gore demolished Bradley winning every single primary and caucus that calendar year including trouncing him in the Washington state primary. After Bradley bowed out of the campaign and endorsed Gore, I quickly supported and campaigned for Al Gore. However, I had people around me who wanted to have a protest vote and voted for Ralph Nader. Fast forward to election night and Florida flips from Al Gore to George W Bush and it is discovered that through a terrible ballot design, many voters in Palm Beach County, Florida who had intended to vote for Al Gore ended up accidentally voting for Pat Buchanan. Through the shenanigans of the Supreme Court, Governor Jeb Bush of Florida, and Florida Secretary of State Katherine Harris, the election was stolen and given to George W Bush. He was certified the winner of Florida by 537 votes. If a few hundred Nader protest voters had voted for Gore, we would have had a different result. What did we get? We got the worst President of my lifetime and the most vulnerable among us suffered the greatest!

Idealism has its place. However, we have a huge threat in Donald Trump who promises to be an even worse and scary president than George W Bush. His vitriolic rhetoric has given permission to racists to speak up and express their hateful language. The people who will suffer the most under a Trump presidency will be people of color. Some white progressives say its better to either vote for Trump or to vote for a third party as a way to protest. They claim that a Trump presidency wouldn’t be as bad as some people are making it out to be and that a Clinton presidency would somehow be worse. Of course, this is undeniably untrue. However, the privilege that some of these white progressives like Susan Sarandon who would be shielded from a Trump presidency through her wealth and whiteness have no sense of the fear and anxiety that people of color like myself feel about a Trump presidency. I will not be a martyr to some magical hope of a political revolution by white progressives that materializes from the terror of a Trump presidency.

My last point is that Hillary Clinton and Barack Obama do not differ much on policy. Many people praise President Obama for what he’s done but then denigrate Hillary Clinton when their policy positions are virtually the same. President Obama’s health care plan is basically what Hillary Clinton advocated in 2008 with the individual mandate which at the time, Barack Obama objected to. I wonder if one reason that Hillary Clinton gets such criticism and vitriol has to do with sexism. I’m not saying everyone who disagrees with Hillary Clinton is sexist. However, the attacks both from some Donald Trump and Bernie Sanders supporters definitely attack her in a way that a man wouldn’t. The use of sexist slurs like b**** and c*** have no place in political discourse. So if Hillary Clinton is extremely qualified and has similar policy positions as Barack Obama, then why is he affirmed and why is she maligned by the same people? Could sexism be the reason? I think it has something to do with it though I would never claim that it’s the main or only reason. Moreover, she voted with Bernie Sanders 93% of the time in the US Senate and yet you would think listening to some of the Bernie Bros that she is some kind of extreme right wing conservative which of course is ridiculous. Also, it’s unfortunate that Bernie Sanders has not mentioned the historic nature of the first female candidate to be the Presidential nominee for a major political party in US history. No matter what you think about her, this is a major historic moment in our nation’s history.

When supporting a presidential candidate, I am not looking for a messiah who will miraculously solve our nation’s problems overnight. Unlike some of my friends who support Bernie Sanders, I can acknowledge Hillary Clinton’s fault. She is definitely far from perfect. I don’t agree with every policy position that she has. However, she is someone that I truly believe is qualified and competent to do this job. I’m not looking for her to magically solve our nation’s problems by herself. Real change in our current system comes from down ballot candidates including the Congress, governors, and state legislatures. President Obama has shown that an obstinate Congress can halt the governing process. So if you want real change, tearing down Hillary Clinton is not really going to do anything but to ensure a Donald Trump presidency. Yes please keep Hillary Clinton accountable. However, do not think for a second if you are rational that Hillary Clinton is just as terrible or even worse than Donald Trump. Let’s not believe in this false equivalency propagated by Trump and Sanders supporters.

The force of the Hillary Effect

The Boston Globe; by Derrick Z. Jackson; October 18, 2008

Londonberry, N.H.

THE BRADLEY EFFECT is fading into the Hillary Effect.

The former is the phenomenon that the polls overestimate how much white voters will support a black candidate. The latter was in full force Thursday at Barack Obama’s first rally of the homestretch of the presidential campaign. Huge numbers of women from New Hampshire and Massachusetts who breathed fire into Hillary Clinton’s campaign after Clinton was stunned in Iowa by Obama cheered jubilantly with the original Obama believers.

Until recently, polls indicated that a quarter of Clinton voters were so steamed over her elimination that they threatened to vote for Republican John McCain. A month ago, McCain had a slight lead in two polls in New Hampshire. Obama now leads by 10 percentage points in Real Clear Politics averaging of the last state polls. From listening to former Clinton voters, you know why.

“It took two to three weeks for it to all settle down,” said Sue Martin, 68, social studies textbook editor from Atkinson, N.H. She was a Clinton volunteer in the Salem office. “Back then, I thought he was way too young. But he’s grown a lot.”

“Up until the last month, I was going to write in Hillary,” said Janice Keene, a 58-year-old retired elementary school teacher from Londonderry. “I was quite disappointed. But our country needs change, especially the middle class.”

“I still feel Hillary was robbed,” said Geraldine Sanders, 68, of Candia, who assists Alzheimer’s patients at a residential treatment center. “You might say that, politically, I grew up with Hillary. She is a very strong woman. But my mother was a great Democrat and I can’t forget that.”

Whatever hope McCain had of peeling off white women voters is evaporating. According to Real Clear Politics averages, Obama is up 14 points in Pennsylvania and 8 points in New Mexico, states Clinton won. Obama is up 10 points in Michigan, where Clinton ran unopposed. Obama has small leads in Ohio, Florida, and Nevada, where Clinton won or ran virtually unopposed. President Bush won Ohio, Florida, Nevada, and New Mexico for the Republicans in 2004.

New Hampshire, while having only four electoral votes, is a final state McCain hopes to keep in play on Election Day. His running mate, Alaska Governor Sarah Palin, campaigned here this week. McCain clearly hoped that having a woman on the ticket would sway Clinton voters. But Clinton voters here said Palin is beyond the pale. In many cases her very selection accelerated their support of Obama.

Carol Kunz, a 42-year-old attorney from Manchester, said, “To compare the two women is insulting to women everywhere.”

Christine Hines, a 43-year-old homemaker from North Andover, said, “Palin’s right-wing politics curl my hair. How could any Hillary voter align herself with Palin?”

Carol Crowell of Haverhill, a 46-year-old executive editor in educational publishing, said, “My husband voted for Hillary too. But the idea that Hillary supporters would support someone the political polar opposite from Hillary on healthcare, education, and ending the war just because they’re women is crazy.”

The Hillary Effect is so much in play that Karen Fronterotta, a 50-year-old telecom sales representative from Kingston, N.H., is listed on the Obama campaign website as hosting a “Women for Truth and Change” party the Sunday before the election. She wants to get 30 women to pledge to get at least five of their friends to the polls for Obama. Sue Martin has switched from working for Clinton’s Salem office to working out of Obama’s Salem office.

“For me, it’s about changing the Supreme Court,” Martin said.

Lise Ragan, 56, joked about herself as “Jill the Publisher,” a play on McCain’s use of Joe the Plumber in the last debate. Ragan is an educational textbook publisher in Haverhill, Mass. She said the Palin ploy and the plumber play landed with a thud to her political ears. “You’re talking to the Hillary demographic here,” Ragan said. “I know that there might be tax repercussions in running a small business. But for me and most Hillary voters, the greater issue is the future of the planet.”

Equal Treatment for the Uninsured? Don’t Count on It.

Lack of Compensation Can Tempt Doctors to Tailor Their Care to a Patient’s Coverage

The Washington Post; by Manoj Jain; October 14, 2008 

When I walked into the hospital room of a 19-year-old woman, a foul smell all but overwhelmed me. I called a nurse to assist me and saw her, too, catch her breath.

When we examined the young woman we found a chronic infection of her pelvis so painful that she resisted our slightest touch.

How long had she been living like this, I wanted to know. Through tears, my patient hesitantly began an explanation that told me as much about our diseased medical system as about her illness: She’d had diabetes since she was a child, she said. On her 18th birthday, she lost her insurance and had been able to afford insulin only occasionally. She worked two jobs, she said, but neither offered insurance. Uncontrolled, her diabetes had let the infection develop and fester.

As I left her room, I realized I’d already grown accustomed to the rank odor. That, I think, is what happens when we learn that 47 million people in the United States are uninsured. At first, we find it shocking. But over time, most of us learn to ignore it.

What’s in Your Wallet?

That experience sparked a conversation with a friend, a primary care physician who told me that about 20 percent of the patients he treats at the hospital are uninsured, and he is not compensated for treating them. (As physicians sometimes say, “No other professionals — lawyers, plumbers, accountants — provide uncompensated service to one-fifth of their clients.”)

Although the uninsured look like any other patients, it’s easy to spot them: Their charts have places for their address, emergency contact and insurance information; an empty insurance box is a telltale sign. Some doctors examine this sheet before examining the patient — a practice we refer to as a wallet biopsy.

The 1986 Emergency Medical Treatment and Active Labor Act declares that hospitals cannot refuse care to critically ill patients and that the physician on call must treat them. Internists with privileges at a hospital (like my friend) are usually part of the on-call rotation for the emergency room.

“I used to get angry every time the emergency room admitted an uninsured patient,” he said. “I would try to spend less time with them — 20 minutes instead of 30 — and try to get them out of the hospital quickly and hope they would not come to my clinic.”

It’s not uncommon for patients with no insurance or poor insurance to receive different treatment. A 2006 study of 25 primary care private practices in the Washington area showed that in nearly one in four encounters, physicians reported adjusting their clinical management based on a patient’s insurance status; nearly 90 percent of physicians admitted to making such adjustments. For patients with no insurance, alterations occurred 43 percent of the time; and for the privately insured, just 19 percent.

Some of these adjustments make little difference: Uninsured patients received more generic drugs and multiple drugs. A doctor might prescribe two generic pills for high blood pressure — an ACE inhibitor and a diuretic, which together would cost $20 for a given period — instead of a combined brand-name pill, which would cost $241.

The impact of other decisions is more worrying. A heart surgeon told me he operates on uninsured patients but schedules them for the end of the day; if other cases take longer than expected, the uninsured get bumped. Some gastroenterologists are quick to perform endoscopies or colonoscopies on insured patients; not so for the uninsured.

Some uninsured patients forgo tests or treatment. According to a 2003 study, participation in screening tests for breast cancer, prostate cancer or high cholesterol was 30 percentage points higher in some instances among people with insurance than among those without. Once the uninsured become eligible for Medicare, that gap shrinks.

Although the uninsured can be guaranteed care by coming to an emergency room, not all care is available there. Nor should it be. Estimates suggest that an ER visit is six times more expensive than a clinic visit.

Take the story I heard of an uninsured 31-year-old man who came to the emergency room complaining of pain in his groin. A CT scan revealed enlarged lymph nodes and what looked like a tumor above his left kidney. This was not the kind of problem that the ER would take care of; nor was the patient so ill that he required admission. So the ER doctor referred the patient to the urologist on call for a follow-up office visit.

The patient never went. A year and a half later, he showed up in the ER, with worse pain. The tumor had spread to his testicles, which were surgically removed a couple of months ago. A new urologist discovered that the patient had an endocrine tumor, which could have been managed with medication.

That patient’s experience is reflected in research. A 2007 study by the American Cancer Society showed that patients with no insurance have lower survival rates for breast and colorectal cancer than insured patients. Similarly, a 2004 report in Health Affairs showed that people ages 51 to 61 with diabetes, hypertension or heart disease had a mortality rate of 12.5 percent over eight years if they had insurance and 18.8 percent if they had no insurance.

There may be a few among the uninsured who prefer to buy $149.99 sneakers than health insurance. Far more common are stories of preexisting conditions that make insurance unaffordable or jobs that offer none. My primary care friend told me about a patient who had left a boil untreated until it needed surgical drainage and intravenous antibiotics. When asked why didn’t have insurance, the man said he had lost his job and was recently divorced. Stories like that helped my friend realize what injustices the uninsured face.

Makeshift Solutions

At the hospital, I avoid looking upfront at the patient’s insurance status. In my office, my receptionist asks uninsured patients to bring a deposit of $50 to $75 and offers a payment plan. Some surgeons expect a $500 down payment before an operation.

I do not discriminate at an individual level, but many doctors, including myself, discriminate more broadly by moving our clinics to wealthier parts of the city, for example. To compensate for the cost of treating uninsured patients (about 10 percent of my practice), I inflate my charges for all patients, thus increasing my income from commercial insurance. According to a Kaiser Commission report, uncompensated care for the uninsured cost $41 billion in 2004 , the majority of which was paid by the government.

In my city, Memphis, as in many other cities, doctors are applying their own makeshift bandages to our hemorrhaging system often in collaboration with faith-based institutions. One Memphis doctor — who is also a Methodist minister — founded the Church Health Center, which cares for more than 50,000 patients. The city’s Muslim community has a clinic alongside the mosque where my partner volunteers. At the Hindu temple clinic where my wife and I volunteer, I counsel patients on vaccines and infections.

And as that foul odor wafts through my consciousness, I advise them on how they should try to get health insurance.