Let Health Care Reformers Listen to Ted Kennedy’s 1980 Speech—and Rally

I still recall Ted Kennedy’s speech at the 1980 Democratic convention. It remains the finest, most inspiring political oration that I have ever heard. This is in part because Kennedy was speaking from a position of defeat. He had just lost the Democratic nomination to Jimmy Carter. And yet this was a full-hearted, rousing speech delivered by a man who realized that in the battle ahead, the issues at stake were far, far more important than his own loss. Intuitively, he knew that the country had reached a turning point.

Many people are talking about that speech today. Instead of substituting my prose for Kennedy’s, I have decided to quote high points from that speech for the many readers who either didn’t hear it– or don’t remember it in all of its richness. This was a speech written long before slippery political strategists had learned to “frame” ideas as bumper-stickers. In its eloquence, it shows great respect for the English language, for ideas, and for its audience. And, I think, it reminds health care reformers that this is not a time to “yield.”

Kennedy began: “Well, things worked out a little different from the way I thought, but let me tell you, I still love New York.

“My fellow Democrats and my fellow Americans, I have come here tonight not to argue as a candidate but to affirm a cause. I'm asking you–I am asking you to renew the commitment of the Democratic Party to economic justice.”

Today, politicians, pundits and even the public seem to see politics as a sport, a horse-race that’s all about personalities and what the polls say about personalities– who’s ahead, who’s behind—what the president could have done, should have done, to keep his poll ratings high..

Meanwhile there is far too little discussion of the ideas and issues at hand. How many Americans know, for instance, what is in the House Bill? Polls tell us that when asked whether they favor the Obama plan for healthcare reform, the majority say “no.” Yet when asked about specific planks in the House Bill (which closely reflect the administration’s priorities), the majority approve of those reforms. This tells us that the media has done a very poor job of conveying the content of the House bill, and a miserable job of correcting the many misrepresentations of Obama’s plan for reform. The press has become too caught up in the inflammatory politics of the debate—and the doubts planted by reform’s opponents– while ignoring the ideas and values at the heart of the debate.

By contrast, Kennedy’s speech focused on issues, drawing a bright red line between a tradition of progressive change that he traced back to FDR and the new conservative ideology expressed by Ronald Reagan, who would be running against Jimmy Carter that fall.

Kennedy talked first about unemployment.

“In this campaign and in this country that we seek to lead, the challenge in 1980 is to give our voice and our vote for these fundamental democratic principles.

“Let us pledge that we will never misuse unemployment, high interest rates, and human misery as false weapons against inflation.”

Here, Kennedy is referring to the conservative argument that unemployment is necessary because it keeps wages low; when wages rise, companies must charge more for their goods, and prices soar. Kennedy took the progressive point of view: unemployment is never good. (Later, the 1990s would prove that it is possible to have low inflation and low unemployment, simultaneously.)

On this issue, Kennedy didn’t waver: “Let us pledge that employment will be the first priority of our economic policy. Let us pledge that there will be security for all those who are now at work, and let us pledge that there will be jobs for all who are out of work; and we will not compromise on the issue of jobs.

“These are not simplistic pledges. Simply put, they are the heart of our tradition, and they have been the soul of our Party across the generations. It is the glory and the greatness of our tradition to speak for those who have no voice, to remember those who are forgotten, to respond to the frustrations and fulfill the aspirations of all Americans seeking a better life in a better land.”

Here, one cannot help but think of today’s immigrants–including the legal immigrants who many conservatives argue should have to wait five long years before being eligible for health benefits.

Kennedy continued: “We must not permit the Republicans to seize and run on the slogans of prosperity.”

I recall the slogans of the Reagan years: the conservatives’ insistence that “growth is good” –that even “greed is good.” For growth and greed lead to prosperity–at least at the very top of society, and the chimera of “trickle-down” prosperity for the rest of us.

Today, conservatives insist that we want health care to continue be a growth industry. They applaud the pharmaceutical industry’s double-digit profits – unless profits grow, how will drug-makers produce more new drugs? They want more hospitals, more surgical centers, more diagnostic testing equipment, more diagnostic tests . . . more and more, and more. “Plenty” is never enough. More is always better—whether it’s a bigger car, a bigger home, or more health care.

Progressive healthcare reformers understand that, when it comes to health care, less can be more. Better, safer care is usually less expensive. And, most importantly, progressive reformers realize that if we want “economic justice” in the form of high quality, affordable care for all Americans we need to eliminate the waste in our healthcare system. Granted, someone is profiting from that waste, but as Kennedy observed later in the speech: “Finally, we cannot have a fair prosperity in isolation from a fair society. So I will continue to stand for a national health insurance.” 

Here I would repeat what I have said in the past: only national health insurance—i.e. a public-sector plan—can be trusted to reduce spending without lowering the quality of care. For-profit insurers lack the standing, morally and politically to make these decisions. A public sector plan does not have to worry about shareholders; its only allegiance is to the public good. And, as Kennedy understood, the public good requires that we rein in health care spending:

“We must not surrender to the relentless medical inflation that can bankrupt almost anyone and that may soon break the budgets of government at every level. Let us insist on real control over what doctors and hospitals can charge, and let us resolve that the state of a family's health shall never depend on the size of a family's wealth”

It’s surprising how little the issues have changed in 29 years. In 1980, Ted Kennedy, understood that health care inflation was the inflation to fear most. Looking ahead, he could see that if everyone continued to charge whatever the market would bear—healthcare would soon become unaffordable for many middle-class Americans.

And this, of course, is precisely what has happened.

But Kennedy realized that conservatives were not terribly concerned about the fate of ordinary, middle-class Americans. “The 1980 Republican convention was awash with crocodile tears for our economic distress, but it is by their long record and not their recent words that you shall know them.” He then summed up Ronald Regan’s ideology, and in so doing, offered a glimpse of the future:

“The same Republicans who are talking about the crisis of unemployment have nominated a man who once said, and I quote, ‘Unemployment insurance is a prepaid vacation plan for freeloaders.’ And that nominee is no friend of labor.

“The same Republicans who are talking about the problems of the inner cities have nominated a man who said, and I quote, ‘I have included in my morning and evening prayers every day the prayer that the Federal Government not bail out New York.’ And that nominee is no friend of this city and our great urban centers across this Nation.

“The same Republicans who are talking about security for the elderly have nominated a man who said just four years ago that ‘Participation in social security should be made voluntary.’ And that nominee is no friend of the senior citizens of this Nation.

“The same Republicans who are talking about preserving the environment have nominated a man who last year made the preposterous statement, and I quote, ‘Eighty percent of our air pollution comes from plants and trees.’”

“And that nominee is no friend of the environment.

“And the same Republicans who are invoking Franklin Roosevelt have nominated a man who said in 1976, and these are his exact words, "Fascism was really the basis of the New Deal." And that nominee whose name is Ronald Regan
has no right to quote Franklin Delano Roosevelt.”

The cadence was perfect. The applause, thunderous.

What few in the audience realized at the time is that Ronald Reagan would win the White House.

In 1980, when Regan was elected, everything changed. His victory represented a watershed moment in U.S. history. As a nation, we began to turn our backs on the poor. Single mothers struggling to feed their children were labeled “welfare queens.” (Older readers will remember the outrageous stories Reagan told—later entirely disproved—about African-American women on welfare driving Cadillacs.)  President Johnson’s War on Poverty was successful: By 1975, 15 percent of American children were living in poverty; two years after Reagan took office, the share of children growing up in poverty had climbed to 22%.

Meanwhile, a president who referred to unemployment insurance as a “paid vacation for free-loaders” would break the unions—beginning with the air-traffic controllers who worried that job conditions threatened our safety.

A president who “prayed” that the government would not help New York City when it teetered on the brink of bankruptcy would cut taxes for affluent Americans who lived in our wealthiest suburbs —while ignoring the needs of middle-class and low-income families in our inner cities.

A president who felt Social Security should be voluntary would be the first of a long line of conservatives—ending with George W. Bush—who would do their best to kill Social Security as a public program.

A president who knew so little about the planet we live on that he thought trees and plants created air pollution would oppose government regulations that strove to protect the environment.

But while Kennedy couldn’t know what would happen to the nation following Reagan’s victory, he did understand the deep difference between Reagan’s conservatism and progressive goals: “The great adventures which our opponents offer is a voyage into the past. Progress is our heritage, not theirs. . . .  The commitment I seek is not to outworn views but to old values that will never wear out. Programs may sometimes become obsolete, but the ideal of fairness always endures.

Circumstances may change, but the work of compassion must continue. It is surely correct that we cannot solve problems by throwing money at them, but it is also correct that we dare not throw out our national problems onto a scrap heap of inattention and indifference. The poor may be out of political fashion, but they are not without human needs. The middle class may be angry, but they have not lost the dream that all Americans can advance together.

The demand of our people in 1980 is not for smaller government or bigger government but for better government. Some say that government is always bad and that spending for basic social programs is the root of our economic evils. But we reply: The present inflation and recession cost our economy $200 billion a year. We reply: Inflation and unemployment are the biggest spenders of all.

The task of leadership in 1980 is not to parade scapegoats or to seek refuge in reaction, but to match our power to the possibilities of progress. . . .

. . . We are the party of the New Freedom, the New Deal and the New Frontier. We have always been the party of hope. So this year let us offer new hope, new hope to an America uncertain about the present, but unsurpassed in its potential for the future .

To all those who inhabit our land from California to the New York Island, from the Redwood Forest to the Gulfstream waters, let us provide new hope that prosperity shall not be purchased by poisoning the air, the rivers and the natural resources that are the greatest gift of this continent. . .

The tax cut of our Republican opponents takes the name of tax reform in vain. It is a wonderfully Republican idea that would redistribute income in the wrong direction. It is good news for any of you with incomes over $200,000 a year. For the few of you, it offers a pot of gold worth $14,000. But the Republican tax cut is bad news for the middle income families.”

1980 was just the beginning of “redistributing wealth in the wrong direction.” From 1976 to 2006 the wealthiest 1 percent of all Americans enjoyed 232 percent of the gains in the nation’s wealth while the bottom 90 percent reaped only 10 percent of the benefits. And in recent years, the trend accelerated.  From 2002 to 2006, the share of the nation’s income flowing to the top 1 percent climbed from 15.8 percent to 20.0 percent. Not since 1928, just before the Great Depression, has the top 1 percent held such a large share of the nation’s income.  As I have explained in the past, this is why it is fair to now ask the wealthiest 1.2 percent to pay higher taxes to help seed health care reform.

“The vast majority of Americans cannot afford this panacea from a Republican nominee who has denounced the progressive income tax as the invention of Karl Marx,” Kennedy added.  I am afraid he has confused Karl Marx with Theodore Roosevelt–that obscure Republican president who sought and fought for a tax system based on ability to pay. Theodore Roosevelt was not Karl Marx, and the Republican tax scheme is not tax reform.

Kennedy ended his speech by congratulating his opponent, adding;

“I am confident that the Democratic Party will reunite on the basis of Democratic principles, and that together we will march towards a Democratic victory in 1980.

“And someday, long after this convention, long after the signs come down, and the crowds stop cheering, and the bands stop playing, may it be said of our campaign that we kept the faith. May it be said of our Party in 1980 that we found our faith again.

“And may it be said of us, both in dark passages and in bright days, in the words of Tennyson that my brothers quoted and loved, and that have special meaning for me now:

‘I am a part of all that I have met….
Tho much is taken, much abides….
That which we are, we are–
One equal temper of heroic hearts,
 …strong in will
To strive, to seek, to find, and not to yield.’

“For me, a few hours ago, this campaign came to an end. For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives, and the dream shall never die.”

In 1980, the Democratic contest for the White House was seen, by many, as a bitter fight between two very different candidates. But today, when the vast majority of politicians on both sides of the aisle seem so lacking in compassion, so bereft of the will, Kennedy and Carter stand out, more alike than different.

If we are going to achieve true health reform, we need more men and women with “heroic hearts, strong in will, determined to strive, to seek, to find, and not to yield.”

This is not a time for compromise.

While Senator Kennedy’s death was expected, it still comes as a shock. I hope that shock is sufficient to rally progressives of all stripes, to come together and make an unswerving commitment to true health care reform—reform designed to benefit patients, not those who profit from a money-driven system. 

18 thoughts on “Let Health Care Reformers Listen to Ted Kennedy’s 1980 Speech—and Rally

  1. Listening to this speech and hearing the conservatives talk today about getting rid of government involvement in healthcare and letting patients control their own care, I wonder about the following. Most of these conservatives seem backed or supported at least philosophically by corporate interests such as drug companies and provider related orgs. Over that last 50 years, healthcare has become very lucrative and very very expensive partly because of government tax pooling and employer subsidies that pay these high costs to these types of orgs, and that has partly allowed them to charge so much. What would happen to these high costs and profits if the complaints of the conservative were all of a sudden listen to, so that everyone from now on had to pay their own way for each episode of healthcare OR all insurance pooling was done through private groupings with no employer or government subsidies. No Medicare and no Medicaid either. All charity and free clinic stuff for the poor.
    If we ever let this happen, how long would it be before very few could afford healthcare at today’s cost. Then how long would it be before the providers, provider orgs, and drug companies would stop supporting the conservative mantras we hear today? Shall we try it?

  2. I just wish someone in politics, either liberal of conservative, would mention the quality of the food supply and it’s affect on the health of Americans. The mechanical and chemical technologies developed over the past two centuries have seriously diminished the biological potency of the food supply. To make matters worse, government agencies dispense bad dietary advice which textbook authors, health professionals, advertisers, and journalists use as a reference point. In fact, the public health sectors in at least 70 other countries use the Dietary Guidelines for Americans to formulate public policy.
    Some of us familiar with the scientific data on fat intake and obesity and on saturated fat intake and heart disease would just like the truth to be made known so people will know to avoid 0mega-6 vegetable oils to prevent cancer and limit their sugar intake to prevent heart disease. These simple improvements would drastically reduce the need for medical screening and treatment. This would save taxpayer dollars and also lower the cost of doing business in the USA.

  3. NG–
    You write: “What would happen if from now on, everyone had to pay their own way for each episode of healthcare OR all insurance pooling was done through private groupings with no employer or government subsidies. No Medicare and no Medicaid either. All charity and free clinic stuff for the poor.
    “If we ever let this happen, how long would it be before very few could afford healthcare at today’s cost. Then how long would it be before the providers, provider orgs, and drug companies would stop supporting the conservative mantras we hear today?”
    NG– If course, you’re right
    If employers and gov’t didn’t subsidize our over-priced heatlhcare system–and it had to rely on what middle-class individuals could afford to pay (as most industries do) Pharma could say good-bye to 16 percent profit margins (see upcoming post), non-profit hospitals could say good-bye to the waterfalls, marble lobbies and $5 mill CEO salaries, and the companies makin. exorbitantly expensived diagnostic imaging equipment) could say good-bye to their double-digit profit margins.

  4. Why doesn’t the government just create a Federal Department of Health Insurance and give the stimulus monies to the private insurers, mandating that they cover all Americans?
    Stiff penalties, a Federal watchdog organization overseeing the existing private system and keeping employment and the value of the underlying stocks stable, while we go through a transition of say 5 years…
    While I do agree that we have a healthcare crisis, I do not see our system as being one which can easily be changed, especially quickly, without greatly damaging many other economic factors such as jobs, pension plans and ultimately, doctors and hospitals who may not wish to join or participate with the new public option plans.

  5. I am on the other side of Senator Kennedy’s politics, but I mourn his passing. He was a principled and extraordinary force in American politics. Nevertheless, if nationalized health care, his lifelong passion, were to be instituted, most of us would receive medical care very different from the quality of care the Senator received this past year. http://www.MDWhistleblower.blogspot.com

  6. Michael Kirsch, M.D. wrote:
    “most of us would receive medical care very different from the quality of care the Senator received this past year.”
    How so and with what different endpoint?? Seriously!
    From what I see and looking at the system from an accountable point of view, I believe the American medical system has been pushed and touted into an almost religious experience by advocates who benefit from the status quo. They want to get paid FFS for everything they can think to do on a paying patient whether it has any chance of providing meaningful benefits or not. Kennedy died about one year or so after his diagnosis. How much was spent on him by his luxury care givers, and what did they get for him? Did he live a month longer or two or six?? What would have been considered a good value? Was he given expensive narcotics (joking) for pain that other people would not get? If this is the best the system can do and assuming an enormous amount of money was spent on Kennedy, was that money well spent compared to say kid’s dental care or exercise classes in schools or other public health interventions?
    I ask these tough questions in a constructive spirit at a critical time because I do think this Kennedy medical situation and comment can be used for some constructive dialogue at a critical time.

  7. When I read this post, I was reminded of a saying that I was exposed to decades ago and is attributable, I think, to the writer, James Joyce. That is: “The force of idealism is lost when it fails to recognize the reality of things.”
    In this context, “the reality of things” includes (1) politics is the art of the possible and (2) with federal finances grossly out of kilter, there is no money for new entitlement programs. As desirable a goal it is to bring health insurance coverage to those who currently lack it, it’s not a necessary prerequisite to bending the medical cost growth curve. Conversely, we probably need to bend the cost curve first in order to be able to afford the subsidies that will allow the uninsured to purchase health insurance. The problem is that tackling healthcare costs means taking on powerful interests including doctors and hospitals. Indeed, hospital costs are the fastest growing segment within healthcare while doctors drive virtually all healthcare spending through their decisions to prescribe drugs, order tests, admit patients to the hospital, consult with patients and perform procedures themselves.
    I think it would be considerably easier to win physician cooperation in such areas as quality measurement, pay for performance and utilization control if we passed sensible malpractice reform including robust safe harbor protection from lawsuits based on a failure to diagnose a disease or condition as long as evidence based protocols were followed and taking medical dispute resolution out of the hands of juries and assigning the task to specialized health courts that could bring some consistency and objectivity to the process and give doctors confidence that they are likely to get a fair hearing. Requiring plaintiffs to submit their case to a panel of experts to would grant or deny a certificate of merit before the case could proceed would also be helpful. Of course, for any of this to happen, Democrats would have to take on their trail lawyer friends. I won’t hold my breath waiting for that.
    As for the public option that the left is so insistent on, Medicare already has all the market power and moral authority required to provide leadership in driving coverage and payment reform. If it did so, private insurers would happily follow its lead. We don’t need a public option to serve the under 65 population. If this were jettisoned, there is lots of common ground that both sides could work together on to pass healthcare and health insurance reform that would benefit many millions of people.
    Finally, the idea of ramming through health reform via the reconciliation process is an incredibly bad idea. We’re talking about reforms that will impact one-sixth of our economy. It needs to be bipartisan. If it isn’t, it would probably be quickly dismantled under the next Republican president.
    Senator Kennedy built a well deserved reputation for legislative accomplishment and the ability to work with the other side to achieve positive results. That’s the part of his legacy we should focus on, not his 1980 convention speech.

  8. Barry-
    Barry–In this post, I intended to draw attention to the values Ted Kennedy stood for in 1980–and throughout his career in Congress.
    It seems to me inappropriate to use a thread about Ted Kennedy’s death as a platform to advocate, once again, for malpractice reform.

  9. The ‘Lion’ of the Senate, Ted Kennedy championed many noble issues throughout his storied career, but none was more consistently his passion than health care. His commitment to bringing affordable, high quality health care within the grasp of every citizen is worthy of our praise, and an ideal we must continue to advance in his honor. Americans of all backgrounds and political persuasions should pause in respectful recognition that a great man has left the world stage, and remember that his legacy will surely live on in the health of our nation.

  10. Dr. Lewin–
    Thank you, very much.
    I agree–Ted Kennedy championed noble issue, even when some of those issues were no longer popular,while enduring the tragedies that hit his family, and his own health problems.
    A lesser man would have retired from Congress long ago, and played golf, traveled . . . whatever.
    The fact that Ted Kennedy hung in, not only for so many decades–but during this last very difficult year– is a sign of his courage and commitment to affordable, sustainable healthcare for all. I suspect that gave him a will to live during the final months.

  11. Thank you for making this available to us, both the original speech and your insights as to how it relates to today’s challenges.
    I find it deeply saddening that Ted Kennedy’s words spoken in 1980 have such a powerful resonance today due to the many severe injustices that continue to pervade American society. We have been letting each other down as Americans, and as global citizens, for so many years. I should say on a more upbeat note, that this feeling has lessened somewhat since late last year — starting on November 4, 2008, to be precise. I think Teddy would agree.
    Amidst the sadness of our loss is the belief that this year, is a crucial time for rededicating ourselves to the many causes of justice–justice in healthcare, in employment, in education, and in protecting our environment, to name but a few.
    The Alliance to Defend Health Care, a health reform group that I volunteer with, has a tiny office located in the Boston neighborhood of Mission Hill, directly across the street from the church where Teddy’s Funeral will take place tomorrow on 8/29/09. Our motto from the time we were founded in 1997 (by Dr. Bernard Lown and 5 others) is “For Our Patients, Not For Profit–A Call To Action”.
    I think Ted Kennedy might have felt discouraged these past few years in his quest for a just health care system in America. As many reform-minded advocates know all too well, fundamental and meaningful health system reform is a tough road to travel with many fierce and well-funded opponents. I find solace and also a source of renewed inspiration in many of the words from Teddy’s 1980 speech, especially those that I want to end with below. Thank you again, Maggie.
    “Finally, we cannot have a fair prosperity in isolation from a fair society. So I will continue to stand for a national health insurance.”
    ‘To strive, to seek, to find, and not to yield.’
    “For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives, and the dream shall never die.”
    Let us carry on.

  12. I’ve been following the health care debate closely and have been appalled by all that I have read and seen (especially on Bill Moyers Journal). But the one thing I never hear is what can I do about it? How can I help bring about change? I’ve written my congressmen but it seems I have no real voice in this whole mess. And have no choice as to whether or not I participate in this country’s health care system.

  13. Jennifer – what you can do is become active with one or more groups, either nationally or in your congressional district, that are well-organized and working for the kind of health reform that you believe in.
    Two major and very effective advocacy organizations that exist in almost every state in the U.S. are Health Care For America Now and Health Care Now. You can learn more about them here:
    Two excellent sources of policy and political analysis as well as advocacy tools to influence the outcome are Campaign For America’s Future and the Center For Policy Analysis. I’m active with all of them!

  14. Ted Kennedy and Michael Jackson, Faraha Fawcett, Anna Nicole, Suzanne Sommers, Brooke Shields are undiagnosed Celiac people where gluten destroys the intestines so you don’t absorb vitamins and then a health issue will kick is due to the cells being too low in nutrients and the immune system goes down. Half of America is Celiac and you can be the richest person and not get the help since doctors are not trained in it and blood tests and biposies don’t work half of the time. http://www.enterolab.com stool sample and cheek genetic test can usually diagnose it. MS is from Celiac and and if Celiac people were helped they would not go onto have mental/emotional/physical health issues from it. Why is cancer, Attention deficient, bipolar, depression spreading…it is because Celiac is spreading in the Family trees. You give a cancer person Chemo and radiation…you wreck their intestines more, but Celiac help (no dairy/ gluten), LDN, vitamins and good oils can stop it. Health care reform could be Alternative medicine, Celiac help and outlaw bad food in grocery stores…not paying for high priced Conventional medicine that is overpriced and doesn’t work. The FDA is blocking the use of Amour thyroid…millions of Americans will suffer and their health will go down hill since they need the T3 in Amour medicine. If they die…only healthy people will be left over…Survival of the fittest will happen…Less people will be easy for the government to handle. Sad.

  15. I have a theoretical question that may indicate what the different political mindsets may have to consider. Actually, this conundrum may be consciously or unconsciously the basis of a lot of what is going on now in the healthcare debate. Here is the theoretical question:
    Let us imagine that in the future, medical science can/could develop extremely expensive processes that could cure terminal illnesses and maybe extend the QUALITY human lifespan by a factor of 2 or more! There would be no way that we could afford to give this technology to everyone as they got ill. If this technology was possible, how should the healthcare system and society handle this:
    –Don’t allow this technology to be developed in the first place to avoid this terrible issue?
    –Develop social rules not based in income to determine who get this technology?
    –Give or really sell this technology only to those who can afford to pay for it by themselves.
    I believe the way we approach this question will/should help guide our current view of reforming the system, even though many do not want to elevate the discussion to this level.

  16. NG, Jennifer,Ann,NG, Michael, Steve
    NG–We really don’t have to worry about what we will do if someone discovers something that could double human life-span.
    First, we now have quite a bit of evidence that, as a species we have pushed the envelope as far as we can.
    After eliminating many of the deaths by infecton, deaths during childrbirth, deaths due to heart diseaes, some deaths due to cancer, etc. geriatricians find that at a certain point, people die “of old age.”
    The body deteriorates, and there is a distinct limit to how many body parts can be replaced.
    Finally, and most tragically, the mind deteriorates.
    Today, many people who manage to “beat” heart disease by taking good care of themselvs, eating right and exercising, are going to die of Alzheimers or another form of senile dementia.
    Not only are we very far away from finding cures for these diseases, it is, I think, unlikely that we will ever completely conquer them. Becuause we only have the human mind with which to study the human mind.
    I doubt that artificial intelligence will crack the problem.
    We’re looking at a stand-off as the mind investigates the mind. (I certainly hope we will find a way to slow Alzheimers, or reduce the suffering–perhaps by allowing people to write advance directives saying that if they are suffering from Alzheimer’s, can no longer recognize friends, or family, etc., they are requesting a physicain-assisted suicide.)
    But in terms of curing all diseases that afflict the mind, I can only think of what the poet Wallace STevens wrote:
    “The mind is the terriblest force in the world . . ./
    Because, in chief, it only, can defend/
    Against itself. At its mercy, we depend/
    Upon it.
    Finally, I think we would do much better to focus on improving the qualtiy of life for everyone so that a great many more people can live 85 or 90 or 95 quality years.
    Jennifer– See Ann’s reply. Also on the film’s website http://www.moneydrivenmedicine.orgyou‘ll find suggestions for how you can set up a screening (even a small screening in your home) and use the film to focus a discussion on a number of topics. (See http://www.moneydrivenmedicine.org/user-resources
    Ann- Thank you.
    Yes, I think recent years must have been very discouraging for Kennedy.
    I admire the way he persisted. But there were fewer and fewer people that he could find “common ground” with.
    At the same time, I agree that he saw Barack Obama’s election as a watershed moment, much like 1980.
    In 2008, the pendulum swang once again. Voters repudiated a conservative government, and elected a decided progressive candidate.
    I’m very glad that Kennedy lived to see that moment.
    Much of the up-to-date intenseive and aggresisve care that Kennedy received is what anyone of us might have receive if we had good insurance– or Medicare —
    The surgery at Duke was cutting edge–but it wasn’t meant to save him, just buy some time.
    Half of all patinets with the type of brain tumor he had survive a year– a he survived 15 months.
    So his experience was not atypical–for someone who has good insurance or Medicare.
    Michael–thank you for your tribute to Kennedy. I value it particualrly because it’s coming from
    someone who did not share his politics.
    But I disagree about National Health Insurance. Medicare is a form of National Health Insurance.
    Under Medicare, many patients with this type of brain tumor might well undergo surgery, chemo and radiation.
    As I note above, 50%
    survive for a year.
    I am assuming that a public section option would be at least as good as Medicare–and one woudl hope, as good as a reformed, more efficient Medicare that pays doctors for quality, and avoids paying for ineffective tests and treatments.
    His treatment was effective–he lived 15 months and was able to function during much of that time. Originally the pronosis was that he might live just a few months.
    Our experience with for-profit insurers has not been good.
    They have not been able to contain costs. When they tried to in the 1990s, they looked at cost rather than qualty of the proposed treatment and were just as likely to deny needed care as they were to deny ineffective care.
    Since then–for the last 10 years–they have let healthcare spending spiral by 8% a year and passed the cost along in the form of higher premiums.
    We have tried to regulate them, but their lawyere are always finding loopholes–someimtes illegal loopholes.
    This is why so many insurers have had to pay big fines–but then they go back to doing the same old thing.
    It is very difficult to regulate such a huge industry. But asking them co compete with a public plan that doesn’t have to worry about pleasing shareholders automatically forces them to focus on trying to provide the highest quality care possible at the lowest cost possible.
    Medigap providers co-exist along side Medicare; there is no reason private insurers could not co-exist along side a public plan–as long as they do a good job.