e The New York Times has an interesting article on how physicians’ attitudes, interests, and politics are changing as the profession moves towards becoming more female and more likely to be (high paid) workers rather than self-employed business people. As they report, doctors are now less concerned about tort reform and insurance reimbursement and more concerned about healthcare access and public health. This change could presage an important change in healthcare politics in the country, as physicians come to identify with other workers, not other business people.
As Physicians’ Jobs Change, So Do Their Politics
By Gardiner Harris
AUGUSTA, Me. — With Republicans in complete control of Maine’s state government for the first time since 1962, State Senator Lois A. Snowe-Mello offered a bill in February to limit doctors’ liability that she was sure the powerful doctors’ lobby would cheer. Instead, it asked her to shelve the measure.
“It was like a slap in the face,” said Ms. Snowe-Mello, who describes herself as a conservative Republican. “The doctors in this state are increasingly going left.”
Doctors were once overwhelmingly male and usually owned their own practices. They generally favored lower taxes and regularly fought lawyers to restrict patient lawsuits. Ronald Reagan came to national political prominence in part by railing against “socialized medicine” on doctors’ behalf.
But doctors are changing. They are abandoning their own practices and taking salaried jobs in hospitals, particularly in the North, but increasingly in the South as well. Half of all younger doctors are women, and that share is likely to grow.
There are no national surveys that track doctors’ political leanings, but as more doctors move from business owner to shift worker, their historic alliance with the Republican Party is weakening from Maine as well as South Dakota, Arizona and Oregon, according to doctors’ advocates in those and other states.
That change could have a profound effect on the nation’s health care debate. Indeed, after opposing almost every major health overhaul proposal for nearly a century, the American Medical Association supported President Obama’s legislation last year because the new law would provide health insurance to the vast majority of the nation’s uninsured, improve competition and choice in insurance, and promote prevention and wellness, the group said.
Because so many doctors are no longer in business for themselves, many of the issues that were once priorities for doctors’ groups, like insurance reimbursement, have been displaced by public health and safety concerns, including mandatory seat belt use and chemicals in baby products.
Even the issue of liability, while still important to the A.M.A. and many of its state affiliates, is losing some of its unifying power because malpractice insurance is generally provided when doctors join hospital staffs.
“It was a comfortable fit 30 years ago representing physicians and being an active Republican,” said Gordon H. Smith, executive vice president of the Maine Medical Association. “The fit is considerably less comfortable today.”
Mr. Smith, 59, should know. The child of a prominent Republican family, he canvassed for Barry Goldwater in 1964, led the state’s Youth for Nixon and College Republicans chapters, served on the Republican National Committee and proudly called himself a Reagan Republican — one reason he got the job in 1979 representing the state’s doctors’ group.
But doctors in Maine have abandoned the ownership of practices en masse, and their politics and points of view have shifted dramatically. The Maine doctors’ group once opposed health insurance mandates because they increase costs to employers, but it now supports them, despite Republican opposition, because they help patients.
Three years ago, Mr. Smith found himself leading an effort to preserve a beverage tax — a position anathema to his old allies at the Maine State Chamber of Commerce and the Republican Party but supported by doctors because it paid for a health program. The doctors lost by a wide margin, and the tax was overturned.
Mr. Smith still goes to the State Capitol wearing gray suits, black wingtips and a gold name badge, but he increasingly finds himself among allies far more casually dressed, including the liberal Maine People’s Alliance and labor groups. And while he still greets old Republican friends — he is a lobbyist, after all — he spends much of his time strategizing with Democrats.
Representative Sharon Anglin Treat, a powerful Democrat who was first elected in 1990, said that she and Mr. Smith were once bitter foes. “But Gordon’s become like a consumer activist,” she said with a big smile. “I’ve seen him more times in the last few years than I can count.”
Dr. Nancy Cummings, a 51-year-old orthopedic surgeon in Farmington, is the kind of doctor who has changed Mr. Smith’s life. She trained at Harvard, but after her first son was born she began rethinking 18-hour workdays. “My husband used to drive my son to the hospital so that I could nurse him,” she said. “I decided that I really wanted to be a good surgeon, but also wanted to raise healthy, well-adjusted kids I would actually see.”
So she went to work for a hospital, sees health care as a universal right and believes profit-making businesses should have no role in either insuring people or providing their care. She said she was involved with the Maine Medical Association, for the most part, to increase patients’ access to care.
Dr. Lee Thibodeau, 59, a neurosurgeon from Portland, still calls himself a conservative but says he has changed, too. He used to pay nearly $85,000 a year for malpractice insurance and was among the most politically active doctors in the state on the issue of liability. Then, in 2006, he sold his practice, took a job with a local health care system, stopped paying the insurance premiums and ended his advocacy on the issue.
“It’s not my priority anymore,” Dr. Thibodeau said. “I think Gordon and I are now fighting for all of the same things, and that’s to optimize the patient experience.”
Many of Mr. Smith’s counterparts in other states told similar stories of change.
“When I came here, it was an old boys’ club of conservative Republicans,” said Joanne K. Bryson, the executive director of the Oregon Medical Association since 2004.
Now her group now lobbies for public health issues that it long ignored, like insurance coverage for people with disabilities.
Even in Texas, where three-quarters of doctors said last year that they opposed the new health law, doctors who did not have their own practices were twice as likely as those who owned a practice to support the overhaul, as were female doctors.
Dr. Cecil B. Wilson, the president of the A.M.A., said that changes in doctors’ practice-ownership status do not necessarily lead to changes in their politics. And some leaders of state medical associations predicted that the changes would be fleeting.
Dr. Kevin S. Flanigan, a former president of the Maine Medical Association, described himself as “very conservative” and said he was fighting to bring the group “back to where I think it belongs.” Dr. Flanigan was recently forced to close his own practice, and he now works for a company with hundreds of urgent-care centers. He said that in his experience, conservatives prefer owning their own businesses.
“People who are conservative by nature are not going to go into the profession,” he said, “because medicine is not about running your own shop anymore.”
Aljazeera reports on the mass anti-austerity protests sweeping Spain as part of what protesters call “a global revolution”:
Reuters reports that the protests are spreading to France:
A French group has called for a large demonstration in Paris this weekend to show solidarity with tens of thousands of youth protesters demonstrating against austerity programs in Spain.
Eyes will be on France this week when President Nicolas Sarkozy hosts world leaders in the seaside town of Deauville for a meeting of the Group of Eight industrialized countries. Such meetings are often the target of anti-globalization protests.
In Spain, tens of thousands of demonstrators, angry over unemployment and austerity measures, packed Madrid’s Puerta del Sol square all last week ahead of local elections, overshadowing the last few days of campaigning. The ruling Socialists suffered a major loss at the polls on Sunday. [nLDE74M02A]
Solidarity with “los indignados” (the indignant) in Madrid has already inspired several dozen French youths to spend nights camped out at the Place de la Bastille, the Paris square where a jail was torn down during the 1789 French Revolution.
Protesters say demonstrations spreading this year through the Arab world have crossed the Mediterranean. They describe the fight in Spain as a European struggle against governments who favor the interests of financial institutions.
“They take money, we’ll take the street,” a French group named after the Spanish “Real Democracy Now” movement said on its website. “We’re being strangled by these austerity plans that are multiplying throughout Europe.”
Youth unemployment in France, at about 20 percent, is well below Spain’s level of 45 percent, but opinion polls suggest the French are angry at sliding purchasing power as stagnant wages fail to keep up with inflation.
The Campaign for Peace and Democracy has released the following press release announcing a statement opposing US support for the Bahrain government, currently brutally suppressing its own population with the aid of foreign troops. The statement was signed by Psychologists for Social Responsibility, which is acknowledged in the press release, along with 1,200 individuals, including hundreds of Bahrainis who signed at great personal risk.
If you would like to sign or donate to help publicize the statement, please do so now at the CPD website.
HUNDREDS OF BAHRAINIS JOIN
U.S. CAMPAIGN AGAINST U.S. SUPPORT
FOR THE GOVERNMENT OF BAHRAIN
NEW YORK, N.Y., May 24 2011 – In a response that surprised U.S. organizers of a campaign calling on the United States government to repudiate its partnership with the Al Khalifa regime in Bahrain, hundreds of people from Bahrain joined in signing the Campaign for Peace and Democracy’s launching statement “End U.S. Support for Bahrain’s Repressive Government.”
“The statement was originally circulated for signatures in the United States, but we have been deeply moved by the fact that hundreds of Bahrainis have added their names,” said Joanne Landy, CPD Co-Director. “Given the violent government crackdown in Bahrain, the very act of signing is incredibly courageous. Bahraini signers have implored us to pressure the Obama administration to decisively repudiate its support of their brutal and authoritarian government.”
On May 16, the New York-based Campaign for Peace and Democracy (CPD) began circulating its statement, which has thus far gathered more than 1200 signatures including those of Ed Asner, Medea Benjamin, Noam Chomsky, Martin Duberman, Daniel Ellsberg, Mike Farrell, Chris Hedges, Adam Hochschild, Jan Kavan, Kathy Kelly, Dave Marsh, Frances Fox Piven, Katha Pollitt, Alix Kates Shulman and Cornel West. The statement is below and on the CPD website. Signatures are still being accepted. The statement will be sent to President Obama, Secretary of State Clinton, and key members of Congress, as well as to domestic and international media.
In the United States, Psychologists for Social Responsibility (PsySR) gave organizational endorsement to the statement. Stephen Soldz, PsySR president, stated, “We cannot be silent. Many of our members are health providers. The government of Bahrain has arrested nearly 50 doctors and other health providers, many of whom have been tortured. Their ‘crime’ is refusing to let injured protesters die and informing the world press about the abuses they witnessed.” [See the report by Physicians for Human Rights.]
In the face of mounting complaints against Washington for muting its criticisms of repression in Bahrain, President Obama did say in his May 19 speech on the Middle East, “…we have insisted both publicly and privately that mass arrests and brute force are at odds with the universal rights of Bahrain’s citizens. The only way forward is for the government and oppositi on to engage in a dialogue, and you can’t have a real dialogue when parts of the peaceful opposition are in jail.” However, in the same speech Obama referred to Bahrain as a “friend” and “partner” of the U.S., thus signaling that the massive human rights violations in that country would not stand in the way of continuing U.S. support for the regime or the continuing presence of the U.S. Fifth Fleet, a naval force supporting an interventionist foreign policy.
In words reminiscent of the Administration’s disgracefully neutral stand on the uprisings in Tunisia and Egypt up until the last moment, when the Ben Ali and Mubarak regimes were clearly no longer sustainable, President Obama has called on both the government and the opposition in Bahrain to “engage in dialogue.” What is needed now, however, is not episodic toothless reprimands to Bahrain’s government or pressure on the opposition to engage in dialogue with the regime, but a clear U.S. break with the Al Khalifa government. This would involve:
- An unambiguous statement from Washington that because of the atrocious government repression, Bahrain is not a “partner” or “friend” of the U.S.
- An immediate end to all U.S. aid to Bahrain
- Vigorous condemnation of Saudi Arabia and the United Arab Emirates for sending in forces at the request of Bahrain’s government to back up the repression
CPD has launched this campaign in order to build pressure on Washington to stop propping up the Al Khalifa government. The brave people of Bahrain deserve no less.
THE TEXT OF THE CPD STATEMENT FOLLOWS:
End U.S. Support for Bahrain’s Repressive Government
On Feb. 13, 2011, inspired by the forced resignation of Egyptian President Hosni Mubarak, peaceful democratic protests erupted in Bahrain. Protests grew and, in response, King Hamad bin Isa Al Khalifa invited other Gulf states to send security forces into the country to assist in violently suppressing the demonstrators. The March 15 invasion by Saudi Arabia and the United Arab Emirates brought an intensification of torture, secret trials, demolition of Shia mosques, and repression against human rights activists, journalists, labor, lawyers, medical professionals, students, political figures, and others. On March 18 the regime destroyed the Pearl Monume nt that had served as the protest center.
Like many other autocracies in the region Bahrain has been a key U.S. partner. It has provided a home to the U.S. Navy’s Fifth Fleet, responsible for naval forces in the Persian Gulf, Red Sea, Arabian Sea, and the coast of East Africa as far south as Kenya. This is why Washington’s response to the vicious repression in Bahrain has been so muted and pro-forma, in contrast to forceful denunciations of repression in countries outside the U.S. orbit, such as Iran and Libya.
Richard Sollom from Physicians for Human Rights says health care workers in Bahrain have been targeted on a scale he has never encountered. Government forces have invaded hospitals; doctors have been dragged out of the operating room, abducted and detained for giving care to wounded protestors. The government says it will try 47 medical workers it accuses, incredibly, of causing the deaths of protesters by inflicting additional wounds on them.
Hundreds of workers, including union leaders, have been fired for striking for democratic change. Security forces closed down the General Bahraini Federation of Trade Unions headquarters. The Bahrain Center for Human Rights writes, “Bahrain is currently considered a dangerous zone for the freedom of press and journalists.” On April 3 the government suspended the country’s only independent newspaper, Al Wasat. On May 2 it arrested two politicians belonging to the opposition Al Wefaq party.
Bahrain’s population is 60 percent or more Shia, with the government dominat ed by a Sunni minority. There is systematic discrimination against the Shiite majority in political representation, employment, wages, housing, and other benefits. The government has tried to split the opposition along Shia-Sunni lines, but uprising leaders insist their struggle for democratic rights is non-sectarian.
Zainab Alkhawaja wrote to President Obama after her father, Abdulhadi Alkhawaja, former head of the Bahrain Center for Human Rights, was beaten unconscious in front of his family and arrested by masked men: “if anything happens to my father, my husband, my uncle, my brother-in-law, or to me, I hold you just as responsible as the Al Khalifa regime. Your support for this monarchy makes your government a partner in crime. I still have hope that you will realize that freedom and human rights mean as much to a Bahraini person as it does to an American, Syrian or a Libyan and that regional and political considerations should not be prioritized over liberty and human rights.”
Amnesty International, Human Rights Watch, Physicians for Human Rights, the International Crisis Group and many others have exhaustively documented the brutal terror of Bahrain’s government. No further evidence is needed. As long as the repression continues, the promise to lift the state of emergency is only an empty public relations gesture. The United States should end all aid to Bahrain, condemn the invasion by Saudi Arabia and the United Arab Emirates, and sharply denounceBahrain’s horrific suppression of democratic rights.
As the Arab Spring has swept through North Africa and the Middle East, the role of the United States has been truly shameful.Washington’s rhetoric cannot conceal a deep fear of democracy. Its first instinct was to stand behind its old friends. Only when it became obvious that Ben Ali’s and Mubarak’s days were numbered were they abandoned. As for Saudi Arabia, this ultra-reactionary monarchy, with its appalling treatment of women and religious minorities,is almost never criticized by U.S. officials.
There are those who, while deploring repression in Bahrain, justify continuing U.S. support for that country’s brutal tyranny as “realism”; in a dangerous world, they argue, our security depends on having a Middle Eastern state willing to host the Fifth Fleet. This argument is profoundly mistaken. Interventionist naval forces are part of a foreign policy that, by siding with despots and pitting the United States against the Arab people’s longing for responsible government and a better way of life, guarantees endless terrorism and bloodshed and an even more dangerous world for everyone. For good reason, democratic movements around the world today do not trust the United States, which they see as motivated by imperial interest. That is why the U.S. desperately needs a new foreign policy, one that welcomes democratic forces — not hypocritically, in order to manipulate them and blunt their impact, but to stand in solidarity with their struggles to win political power for the people and achieve social and economic justice.
* * * * * * *
THE CAMPAIGN FOR PEACE AND DEMOCRACY advocates a new, progressive and non-militaristic U.S. foreign policy — one that encourages democratization, justice and social change. The Campaign sees movements for peace, social justice and democratic rights, taken together, as the embryo of an alternative to great power politics and to the domination of society by privileged elites. Founded in 1982, the Campaign opposed the Cold War by promoting “detente from below.” It engaged Western peace activists in the defense of the rights of democratic dissidents in the Soviet Union and Eastern Europe, and enlisted East-bloc human rights activists against anti-democratic U.S. policies in countries like Nicaragua and Chile.
Annalivia is Liz Simmons (vocals), Flynn Cohen (acoustic guitar, vocals), Brendan Carey Block (fiddle), and Emerald Rae (fiddle, vocal, stepdancing). First two filmed at the Peterborough, NH 2009 fall festival.
Tens of thousands of Spaniards angry over joblessness protested for a sixth day on Friday in cities all over the country, and the government looked unlikely to enforce a ban on the demonstrations, fearing clashes.
Dubbed “los indignados” (the indignant), tens of thousands of protesters have filled the main squares of Spain’s cities for six days, in a wave of outrage over economic stagnation and government austerity marking a shift after years of patience.
As Spain’s electoral commission has stated that the demonstrations are now illegal ahead of Sunday’s elections, the protesters refuse to vacate:
“We are not going to budge from here,” said a 44-year-old unemployed man who declined to give his name, during an assembly at Puerta del Sol in central Madrid, where protesters reached an informal consensus to stay in the square despite the ban.
The man was among hundreds who have camped out all week at Puerta del Sol. His wife and daughter join him every day and the crowd swells to thousands every evening. “Our next move is to spread this to the rest of Europe,” he said.
Many protesters told Reuters that they are scared the police will crack down, but analysts said police action against the protesters would be a disaster for the Socialists.
The protesters have called on Spaniards not to vote for the two main parties, the Socialists or the center-right opposition Popular Party.
Spain has struggled to emerge from a recession, and the collapse of the construction sector and a slump in consumer spending have hit the young particularly hard — 45 percent of 18- to 25-year-olds are unemployed.
“They can’t kick us out. The politicians won’t allow it, it’ll make them look bad right before the voting,” said Virginia Braojos, 32, a logistics technician who has come with three friends to the protests every night this week.
Albie Sachs, a former judge on the Constitutional Court of South Africa, recalls being placed in solitary confinement without trial while living under South African apartheid. Sachs describes the experience as worse than the car bomb that took his right arm and left him blind in one eye.