Friday, July 29, 2011

Not Even the Right Hand Knows What the Right Hand is Doing

As I write this, the federal government is only a few short days from defaulting on its loans, a first in US history. Soon, officials of all stripe are going to have to start turning out their office lights any time someone drives down the street, and shunting all incoming calls to the Congressional Cleaning Department. "No, no, Senior Paul no eez here. This housekeeping. We need more Lemon Pledge." All hopes of a sensible and balanced debt reduction package have been consistently gutted by House Republicans, and their sound bites about how it was actually the fault of everyone else are masterworks in Doublespeak so clever that I full suspect that had congressional staffers spent half the time on the actual bill that they spent planning their boss's camera time, we wouldn’t have to worry about the deficit for another decade. One would hope that the millions of people who voted with their adrenal glands and their fists instead of their cerebral cortices in the 2010 elections would now at least have the decency to feel some sort of shame or blame for the way things have turned out, but I haven’t actually heard anything approximating either over all of the whining and hand-wringing. What did you people expect? You got exactly what the Tea Party sold you: rabid, far-right reactionaries with zero experience in governance or logic and precisely zero lucid economic theories about the free market. That a significant portion of the Republican Party interprets the word "compromise" to be symptoms of heresy and decay is largely your fault. Stupid people usually can’t help it, and we usually give them the space to live out their delusions in peace, so long as they keep their vacuous tendencies to themselves. Then their ideas start to spread, we may feel a momentary sense of amusement on the nature of the folie á deux, until the deux becomes a crowd. Then we are all responsible for our complacency, and this is precisely what we should all be feeling at present. I've said this before: in a democracy, you get the government you deserve. We all deserve this mess, so stop kidding yourselves about blaming Washington. It's as broken as YOU allowed it to be. We did this. Now live with it.

Examples of the disastrous 2010 election cycle will be familiar to all. If you are a worker, you have probably seen your rights eroded or outright dynamited, all so that multi-national corporations can churn a slightly larger profit (and then not hire any additional workers). If you have a child in this nation, it is a certainty that in the 2011-2012 school year, they will receive a worse education than they did a year ago, thanks to the billions of dollars that Repubs slashed from state budgets (all instead of increasing taxes on rich people and oil companies, who can definitely afford it). I don’t suppose the fascists really care, since most of them send their kids to religious and private schools, but you should care enough to have known better. Environmental regulations designed to protect the earth for future generations are being eviscerated in favor of "increased economic activities", which, again, translates to big business crunching up the little guy so that some people at the top can have yet another million dollars to go with all of the rest. The wealth gap between rich and poor is now as wide as it has ever been - and it's still growing at a healthy clip. People, you can have a democracy, or you can have a nation where 5% of the population controls 70% of the wealth, but you cannot have both. As much as I dislike Repubs in general, John Boenher is starting to look downright reasonable to me of late. Too bad Eric Cantor and the rest of the American Taliban have stuck enough knives in his back to start a silverware business.

Convicts in Texas are never immune from Republican social engineering. We live in the society that the right dreams of turning the rest of the nation into. In every election cycle, we get to star as the great foil which right-wingers use to drive their campaigns: ok, sure, I don’t know anything about economics or ecology or science or even basic math, but I sure hates me some lawbreakers, and I promise to punish them mercilessly! Kiss the baby, strike a patriotic pose, and begin planning how to start bilking the public. They do this because it works: fear can always be counted on to motivate the shallow and the weak. We once had this governor here in Texas - maybe you remember him? - named George W Bush. During his campaign for the most powerful office in the State of Yee-haw, he promised to shut off all of the air conditioners in the TDCJ, a promise he fulfilled and which is still in effect, and for which several convicts ultimately lose their lives over each summer in the 130 degree dorms (including one 30 year old this very week). One of his good buddies named Alberto Gonzales - perhaps you recall that name, as well? - was his primary hitman in the attorney general's office of Texas, and was such a dedicated execution-assistant and lackey that he ended up getting a new job when the GW circus rolled into Washington. Remember how well that turned out? Quite simply, reputations are made by scaring people about crime so that they forget to think with their heads and opt instead for their "hearts." Your heart is for beating. Maybe you ought to stop taking orders from an organ that hangs out with a pair of windbags.

The fascists had a super-majority in both houses of the Texas Capitol this year, plus, of course, good old I'm-not-running-for-President-but-we-all-know-that's-a-crock-of-Texas-sized-horseshit Perry. So we pretty much all expected a rancid ball of redneck insanity to begin rolling down the hill in Austin aimed square at Huntsville. Fortunately for us, if there is one thing you can count on with the right, it is their inability to ·get much of anything done. They get elected complaining about how government doesn’t work, and then spend the majority of their time in office proving exactly that. Even with their overwhelming numbers, King Perry I had to call a special session just to get his main priorities completed. Thousands of decent bills died in committee or on the House floor, and if you were a backer or follower of one of these, what did you expect? You deserve this, when you vote for the GOP

One bill that did manage to survive the Darwinian not-Darwinian-because-evolution-is-a-liberal-lie-just-see-the~new-Texas-science-schoolbooks-for-proof jungle of the Lege was HB 26, created by Rep. Jerry Madden, R-Plano. HB26 contained the brilliant idea to begin charging Texas prison inmates 100 dollars a year for medical coverage. It is planned to work like this: for inmates with more than 200 dollars in their trust fund account, the full 100 dollars will be removed in one fell swoop. For inmates with less than that, 50 dollars will be removed at once, and the other 50 dollars will be taken out of each incoming deposit, in 50% increments. For people with no money at all, 50% of all deposits will be taken until the full 100 dollars is covered. Since most inmates in this system come from families in the lower rungs of the socio-economic ladder, it has been noted by many that this bill ultimately amounts -to a 100 dollar fee on the poor. I wont argue with that though, again, you should probably be used to that sort of thing by now if you live in this state.

The sad thing is, even if you ignore the fact that this bill is doomed to failure, it is only supposed to bring in 9.9 million dollars over two years. Sounds like a large amount until you learn that the Lege apportioned 900 million for prisoner healthcare in the 2010-2011 biennium. On top of that, costs ran over an additional 70 million, and that is a conservative estimate, pardon the pun. So, instead of lawmakers actually facing the failure of the prison system they created, they paraded out a bill designed to enflame hatred of inmates that was never intended to even cover 1% of the costs of inmate care. Ladies and gents, I give you the Texas Legislature.

Of course, like I said, the bill will never work as intended.

Since the right like nothing better than Big Business privatization, medical care inside of the TDCJ is handled by the University of Texas Medical Branch. I know someone who works for this organization, and she is a fine woman. I also know that UTMB does run some very decent hospitals in the freeworld, including the #1 cancer research hospital in the nation, MD Anderson. All of that makes it difficult for me to understand how the Corrections division has been mismanaged into the calamitous muddle that it is today. In the end, the issue at hand is oversight: when a doctor screws up in your world, there are avenues for you to take to address this. As a result, doctors and the departments built around them know the standard of care that they are required to give. When there is no path for grievance or redress, few people are capable of bringing their “A” game for very long. The worst soon learn they barely need to show up at all. What we end up receiving are the dregs of the medical world: doctors and nurses with too many Texas Medical Board complaints to work with customers in the freeworld. The best doctors we ever see are those men and women who are waiting on their immigration paperwork to be finalized; the current doctor here at the Polunsky Unit is one Syed-Saleem Shamsee, an excellent man of character who hates this place so much that he will be gone for greener pastures the second he is allowed to work in a real hospital. As for the pill techs and administrators, well, if they could work anywhere else, they would. That's not my assessment, by the way. That is a direct quote from several of the techs themselves. They say this as if it were a joke, but the strained look in their eyes always belies the truth.

In the past, when one wanted to see a doctor (or the Physician's Assistant, as in many cases there is no actual MD present), one had to wade through a labyrinth of nurses and forms. When one finally reached the inner sanctum and saw a physician, a three dollar co-pay charge would be deducted from your trust fund. You usually didn’t get three dollars worth of treatment, but I always considered the co-pay to be mostly fair. I actually don’t have any issue with paying for care; everyone else in the world does, and it seems irresponsible for me to expect something for nothing. I would prefer to be given a job where I could earn a few cents an hour and then pay for my treatment like everyone else, but I understand and recognize that it will be another 5 or 6 decades before Texas copies other states in this practice. My objection to HB 26 deals not with the cost, but rather with how short-sighted the lawmakers are who created and then passed it. I expect better from government. Even Republican government, from which I expect almost nothing.

There are basically going to be two consequences to this bill, and both were predictable enough to have given said lawmakers pause, had they bothered to stop salivating over the opportunity to attack illegal immigrants Arizona-style (read: pander to the base, which in this instance has the happy benefit of fitting both definitions of that word) long enough to chat with a single prison activist. For men who receive very little money from friends and family over the course of a year, these fees are going to produce a class of men who are forced to avoid UTMB at any cost. Arnold, is amongst this group. So long as he doesn’t submit a single sick call all year, he will not be charged this co-pay. To his view, his family is not wealthy, and he sees no reason why the state should get half of what they labor to give him. I see his point but this is very morally troubling, Healthcare is, to my way of thinking, not a luxury but a universal human right. Science has progressed far enough to grant that right to even the poorest of convicts. People get sick back here. They get cancer and diabetes and they get old. Some sicknesses are communicable, and since they warehouse us here like lab rats, when one person gets sick it can quickly become an epidemic. Being so poor that one feels he must refuse medical care creates unnecessary suffering, and this is a gift that keeps giving. Medications must be renewed in person once a year, so this bill also means that anyone who opts out of receiving doctor visits also opts out of any and all medicine. You ever been around a schizophrenic without his Haloperidol, his Fluphenazine, his Chlorpromazine? It is enough to make you want a shot of Litihium yourself. Or a shot of 12-gauge buckshot right in the face.

Quite a few of the men around me are talking about attempting this tactic. I suspect that this is exactly what Rep Madden and his cohorts had in mind, as immoral a hope as that is. Sadly (for them), their master plan is going to end up crashing and burning, and very quickly, too. A year is a long time, and at some point a tooth is going to start aching, or someone in the kitchen will come to work with the flu or the norovirus, or the lack of sanitation in the dayrooms will spur an outbreak of staph infections, and people will fold. They will resign themselves to the cost, and the poverty. And therein we find the problem with this bill, the stinking, festering, house-of-mirrors heart of it that proves nobody bothers to test concepts out in the real world before enacting them into legislation. Because once the 100 bucks is as good as spent, every single person in the TDCJ (155,000 and counting) is going to make damned sure that they get their moneys worth.

This tends to require some serious effort, as the care we receive is atrocious. I have mentioned this before, so I will be brief: in 2007, the metal tube inserted into my right humerus snapped, cracking the bone with it. This ultimately required two major operations to repair, the second being needed because the surgeons in the first were replaced with students (without my knowledge) who bungled the job. That I was given either surgery dealt entirely with my hard head and knowledge of §1983 suits and nothing to do with the Hippocratic oath. Even after X-rays confirmed a massive shattering of the humerus, Dr Porras refused me care, claiming "no acute injury." (He's since been "released.") Immediately after the nearly two years it took me to resolve this mess, I started taking calcium pills I bought off the commissary, thinking that I would speed up the healing process. I didn’t know any better, and in any case, there wasn’t anyone available to ask: aside from the one visit to the nurse to remove the 51 surgical staples from my arm, I never once saw a single doctor about postoperative care, or given any form of pain medicine for the wound. (The doctor at the time was one Dr Zond, also since "released.") Turns out, you can take too much calcium, as it builds up in the kidneys and produces stones. I don’t know why anyone calls them that. They should be called Satan's Cockleburrs of Agony and Much Cursing. I had no idea what was going on in my gut, as I had never felt anything like this before. I suspected that my appendix had gone thermonuclear, and it is a good thing that this was not the problem as it took a nurse almost 9 hours to make it to my cell. By this point I was urinating blood. She took one look at me through the metal door, and decided that I had a "stomach virus", for which I was given an antacid, Diotame. I was told not to worry about the blood in the toilet, as I "would make more of it." I eventually figured out what the culprit was when the bloody bastard came out of me and the pain switched off like a switch, but I was actually contemplating the merits of sticking a pencil through my brain for several hours there.

Basically, what I am saying is this: before the bill, if you wanted decent healthcare, you had to demand it with vigor. Many people were not willing to do this, due to the effort required. But the general attitude of the men post-bill is that, if they are going to lose that much money, they are going to demand adequate care for every single thing that ails them. No more generic Tylenol for the flu. No more diagnoses of arthritis or the gout for every single illness in the book. And since real care costs a lot more than 100 bucks, UTMB is going to end up losing money, and losing it in large amounts. Lawmakers would have known about this, had they bothered to talk to a unit level doctor or CO. I keep harping about, this point, but it bears repeating as we all know about the disconnect that exists between the real world and people who spend their lives in places like Plano. When UTMB starts to panic and begins denying care on a massive level, people who would not have been sufficiently motivated to file a lawsuit in the past will find their spark. After all, they paid for this. And, by a simple and pleasant coincidence, a certain inmate has arranged for thirty copies of The Jailhouse Lawyers Handbook to be sent to inmates here on death row, to confront this wave of denials head on. Titter, titter. (The JLH can be obtained for free from The Center for Constitutional Rights at

I heard about HB 26 months ago, when it was first a fledgling bill in the House Jurisprudence Committee. I knew it would pass, as all such bills always pass in this state. I have never been pleased with the level of care here, but my displeasure deepened when I realized that I was going to be 100 bucks poorer. For instance, I have been having problems with acid reflux for years. They refused initially to write me a script for Prilosec, which would have taken care of the problem entirely. Instead, they put me on the much cheaper generic of Xantac, which simply does not work very well, to the extent that I paid an additional 50 dollars over the course of the last year for antacids from the commissary. Now, Prilosec does actually carry an over the counter version of their drug, and I have mentioned before that the state could save a lot of money by simply stocking this for inmates to purchase. But since no one ever listens to me, and since I was paying for it, I put on my armor and went through the tasks necessary to get my prescription changed. I am now on the generic for Prilosec. I have also had issues with hypertension for the last several years, but resisted medication because I did not see the point in making taxpayers cover the cost for drugs when the state was going to be injecting me with another series shortly that will have the opposite effect. Still, HB 26 swayed me, and now I am on Metoprolol for high blood pressure. I don’t know what all of that costs, but I am quite certain that UTMB is losing money on me.

And they are going to lose it on everyone else, as well. Once people realize that the money is spent, they will fall in line. This could very well 'break the system. UTMB has been wanting out of their contract for years. Not too long ago, the head of the Correctional Division of UTMB admitted in a board meeting that they were straddling the line on unconstitutionality in regards to level of care. For the head quack to admit this in a public hearing pretty much tells you that in reality they crossed that line so long ago that they now couldn’t find it with a map and a GPS device. If UTMB folds, the state will have to take over care, as it is unlikely that anyone else will want to try to fix what UTMB so completely destroyed. I know that many of you are yawning to yourselves, thinking, well, why the hell, should I care? Because if the state is forced to tackle this issue instead of foisting the responsibility off on a third party, then you are going to be paying for their incompetence. The state wouldn’t have any more luck running a medical branch than they do running anything else, and the level of care will quickly drop below the levels cited in the case law as violations of the 8th Amendment. I don’t want to sound like a jerk when I say this, but we writ writers are watching. We are not always successful, but we are here and we have the knowledge and the empathy, and when some physician claims that the tumor sitting on your lung is "just a little fluid," we're on that. When a person is seriously diabetic and cannot seem to get his insulin in a timely manner, we're on that, too. (Those are both true stories, actually; the latter was filed last summer in federal court by yours truly.) The money that is ultimately paid out in damages comes from taxes, which means you. Now, you could get angry with those “damned inmates abusing the courts," or you could go after the source and demand that the state quit screwing up. That is ultimately your call, but I think I have proven my point that you have a vested interest in seeing that our care is legal and adequate, and I am not even going to bother mentioning the moral dimensions of this argument.

I keep showing you in these articles how my world is not disconnected from your own, no matter how high they build these walls. You pretend that it is, because crime and punishment are troubling conundrums of society, but when the system keeps some human being in a cage for decades and then paroles him to the streets with zero vocational training or psychological assistance, the fact that he then goes out and shoots someone becomes the fault of all of us. All the money that is wasted on holding tens of thousands of non-violent marijuana offenders could have been spent on avoiding all of these cuts to infrastructure or education. What is more important to you: keeping some guy who likes a joint at the end of a day's work in prison, or lab equipment for your daughter's chemistry class? In the midst of all of these budget woes, many states closed multiple prisons. New York has been closing them for years, redirecting men and women into treatment centers. And guess what? Their crime rate keeps dropping, and so does their recidivism rate, Texas, on the other hand, closed ONE prison, the Central Unit, and only because it was A) small, and B) sitting smack in the middle of Sugar Land, so the property value was off the charts. Many experts recommended closing ten to fifteen, but Governor Goodhair and his cronies know their ticket to reelection, and know that we in white can always be counted on to punch it for them. I keep waiting on middle America to get it: when you pick up a pitchfork and a torch and march off to the voting booths, you aren’t hunting for a monster. You are becoming one.

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© Copyright 2011 by Thomas Bartlett Whitaker. All rights reserved

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