Bush is classic 'dry drunk'

By Ellen Ratner
I often wear two hats, one as a reporter who covers Washington and the White House and as an opinion journalist who makes her living giving opinions. I am often asked why a politician responds in a certain way, ways that often make no sense to the general public.



The radio stations I report for range from conservative to liberal, with most leaning on the conservative side. Most weeks, the questions are related to why so-and-so are not in the presidential race or why someone took a particular position on a bill. This week, the questions were related to the president and the attorney general. The radio hosts, conservative and liberal alike, wanted to know why the president was hanging onto the attorney general.

There really can only be three answers. The first is that Attorney General Gonzales knows something about the president and the White House that would lead to impeachment of the president for something he did that was blatantly unconstitutional, or even criminal. Though many of my friends are convinced the president's actions regarding the war are impeachable offenses, there is no evidence that the attorney general is hiding information about the war. I can't believe that Gonzales really has anything on President Bush that we don't already know about.

The second reason is that the president has only 18 months in his term, and a nomination fight in the Senate would bring all of the dysfunction of the Justice Department, as well as failed policies, front and center in the evening news. The "parade of horribles" would include spying on Americans, high staff turnover and how polices are made at Main Justice. Not exactly what the Bush administration would like to have sitting in front of Joe and Sally America.

The third is that the president has a real personality flaw. I ascribe to this theory. Given the week's events and the testimony of the attorney general before the Senate Judiciary committee, there is no senior manager I know who would hold on to him. Gonzales's testimony was completely contradicted by FBI director Robert Mueller. Mueller said it was about the terrorist surveillance program, and the attorney general said there was no departmental disagreement. This is on top of hours and hours of evasive testimony concerning the scandal on the firings of the U.S. attorneys. Then we have the midnight visit to the former attorney general in his hospital room and the lies he told about that. If that was not enough for the president to send a pink slip to Gonzales, then how about the huge staff turnover at Main Justice? Liar or lousy manager, he just doesn't belong there.

So why does the president hang on? It can only be his personality structure. Many people LOVE this about the president. He means what he says and says what he means. He won't back down etc. etc. This is what got him elected but makes him a poor president. There are many theories as to why he is like this, and historians and psychologists will be arguing for years to come about President Bush's personality. My summation is that he is a classic dry drunk – someone who is an untreated, but dry, alcoholic often referred to in Alcoholic's Anonymous as "white knuckle sobriety". Basically, someone whose obsessive compulsive personality kept him drinking, denying reality, seeing the world in a very rigid manner and often thinking in a grandiose fashion. There are a few other characteristics of this kind of sobriety, and one of them is extreme rationalization.

Looking at the attorney general situation and meshing that with the president's personality, it becomes clear that even in the face of opposition in his own party, even in the face of facts of bad management, the president holds on. He is denying reality, holding on to his appointed choice for the job with a rigidity rarely seen in politics or business management. He believes in a very grandiose fashion that, as president, he can thumb his nose at the will of Congress. Had the president received treatment for alcoholism 20 years ago, he would have been introduced to the ways and means of the Serenity Prayer. "God grant me the serenity to accept the things I cannot change; courage to change the things I can and wisdom to know the difference." With Congress calling for a special prosecutor for the nation's top cop and an impending Constitutional battle, we could all be saved from this mess. If only the president had courage to change and the wisdom that went along with it.

Word of the week is 'al-Qaida'

By Ellen Ratner
This week I traveled with President Bush to my hometown, Cleveland, Ohio, where he had a lengthy town meeting. Later in the week, I attended a press conference in the brand new press room. The president did well in both venues, exhibiting a command of the issues and a good sense of humor that most don't get to see on sound-bite oriented television. He also was very quick to use the al-Qaida name. By my count, he mentioned al-Qaida 37 times in the Cleveland town meeting and 38 times in the press conference. Neither the timing of the public appearances, nor the excessive use of the name al-Qaida were by chance.


The White House chose to go to Cleveland just five days before the visit. They invited themselves. The White House called "Cleveland +," an organization similar to the chamber of commerce, and asked it to put together the town meeting. The White House had a reason for these two presidential "messaging opportunities." It wanted to plant an idea firmly in the American public's mind – re-invigorating the link between Iraq and al-Qaida – the missing link before and during the war. It is emerging as the president's last ditch effort to justify American boots on the Iraq civil war-torn ground.
Why now all of this al-Qaida? With the president's popularity ratings continuing at an all time low, and with members of the Republican Party beginning to question the wisdom of staying in Iraq at the present troop strength, he needs to do something. Enter the one thing everyone agrees is bad, bad, bad for America – al-Qaida. It has been a coordinated "word of the week" with Homeland Security Secretary Chertoff saying he had a "gut feeling" of a terror attack this summer. It was passed off as a slip of the tongue but "gut feelings" can't be subpoenaed in Congress. So, he was in safe territory by saying it.
President Bush wants to stay in Iraq, and even he has to have reasons to do so. He has become like Pravda in the old Soviet days, and no one believes him. So, the White House planners, headed up by the "architect," Karl Rove, saddled up with the president and headed to Cleveland. They resurrected the one issue every American has a genuine fear of – al-Qaida.
But like any law student learns, when the facts are with you, pound the facts. And when the facts are against you, pound the table. Well, the facts are against him, and he is pounding the table. Bush wants to make the reason for staying in Iraq the fight against al-Qaida, but military experts, whose careers are not dependent on the commander in chief's favor, are saying otherwise. Twice in the last month, Colin Powell has talked about the Iraqi civil war. On June 10, he said, "I have characterized it as a civil war even though the administration does not call it that. And the reason I call it a civil war is that allows you to see clearly what we're facing." Last week at the Aspen Ideas Festival, Powell said, "It (Iraqi conflict) is not a civil war that can be put down or solved by the armed forces of the United States."
There is no doubt that al-Qaida operates in Iraq. There is no doubt that foreign fighters make up some of the resistance. Officials estimate that al-Qaida numbers 5,000 in Iraq. Most of the fighting taking place in Iraq is, however, between the various factions of a "country" that was designed out of the needs of British Colonialism. The New York Times quotes military sources who say that the membership of the resistance in Iraq is primarily Iraqi and that their main interest is in ending the occupation.
Many of these foreign fighters are either coming from, or financed by, Iran and now believe that the Shiite area of southern Iraq is really an extension of Iran. According to L.A. Times reporter Ned Parker, 45 percent of all foreign militants targeting U.S. troops are from Saudi Arabia. Although the government of Saudi Arabia does not dispute the numbers, it denies any direct involvement. Others have questioned where the Sunni Iraqis are getting their financing if it is not directly from the Saudis.
The bottom line: This is a complicated civil war being fueled with arms from oil-rich nations, and citizens of oil-rich nations mixed in, with a cult of people who hate the West. Al-Qaida is quite adept at taking advantage of a very fluid and messy situation. So long as America is in Iraq, al-Qaida will be in Iraq. The American people deserve to know the facts; they deserve to know who our American men and women are really fighting and who exactly they are keeping the peace for. The American people need a more sophisticated explanation as to why President Bush is pushing to keep us fighting in Iraq. Mentioning al-Qaida 75 times in 48 hours just doesn't cut it as a reason to stay.

'Sicko' exposes wounded health care system

By Ellen Ratner
Like many Americans I went to see "Sicko" this weekend, the second-highest-first-weekend-grossing documentary of all time. Sicko brought in $4.5 million in just three days. Yes, there were some major stretches of the truth such as the waiting times for certain procedures in Canada, but the point is clear: Even if you have health insurance, a medical issue can put you at the edge of bankruptcy.



About two hours after seeing "Sicko," I called my friend Christian to check in on her. She recently had a second mastectomy for three cancerous tumors in her breast. This was followed by a hysterectomy to prevent overproduction of estrogen which "fed" her cancers. Christian has her own business and has health insurance, but because her first breast cancer was diagnosed when she was 32, she cannot purchase disability insurance. She has not been able to work since March and is rapidly depleting her savings. She has a 20 percent copayment for her surgeries and had just finished paying off her chemotherapy and surgeries from 11 years ago when she was hit with the second mastectomy. Christian is the type of person most Americans would love to have as their friend or neighbor. She helps care for the children of a single parent, raises money for a local children's charity, volunteers her time and while recovering on her living room couch from these two recent surgeries, managed to get her many visiting friends to play bingo and raised $350 for our project in Gulf Coast of Mississippi.

Christian was upset when I called. She received another bill and had no idea how she was going to pay it. Her wonderful friends have chipped in to help with some expenses, but Christian is not a person who likes to ask for things. She simply wants health care to be affordable so she doesn't have to go to bed at night contemplating bankruptcy. I don't think that is too much to ask from someone who, as Bill Clinton says, "works hard and plays by the rules."

There is a solution to helping Christian and other Americans. Extend Medicare to all and allow people the option to purchase Medicare Supplemental Insurance. Medicare does not cover every cost, and many seniors purchase additional coverage, but it is easy to obtain and doesn't break the bank. For those that rail about fraud, waste and abuse in government programs, keep in mind that Medicare spends about 3 percent on administrative costs, while private insurers spend about 13 percent of every dollar on administrative costs.

In recent years, the health care industry has become very, very profitable. Doctors and nurses are making less, but the industry is flush with cash. Within the last few years, Health Maintenance Organizations, or HMO's, doubled profits and made $10 billion. I worked in a health care organization in the late 1980s where managers were given bonuses based on how high they hiked up the ancillaries, (blood tests, psychological testing etc). The amount spent on lobbying Congress from the health care industry could pay for those administrative costs incurred by providing access to a Medicare like single payer insurance system.

One recent poll taken by ABC News and the Washington Post a year and a half ago shows that 62 percent of Americans support government-run universal health care insurance; the numbers drop sharply if there is a waiting list or limits on physician choice. But, with Medicare there is neither. Why isn't there more support for universal health care? Simple, the profit motive and fear of oversight by the federal government. Former Majority Leader Bill Frist's company, HCA Inc., had to pay millions back to the federal government for Medicare fraud. Fear by money-grubbing companies and drug companies who don't want the federal government negotiating lower drug prices is no reason to deny insurance and, therefore, universal health care to Americans.

As the only Western society without guaranteed health care, we all deserve better and so does my hard-working and very charitable friend Christian. Michael Moore may be prone to exaggeration, but his primary diagnosis is correct: We have a very sick health care system.

Cost of Iraq war is much too high

By Ellen Ratner
As I write this column, the cost of the Iraq War is about $439 billion. By the time we reach the five year mark, we will have spent $500 billion. We can debate the "surge," the reasons for the war, if it is indeed a civil war, but we can't debate the costs. The billions of dollars spent is set down in black and white in the budget, and the various war supplemental funding bills have been passed by Congress and signed into law by the president.



Other continuous wars such as the Korean "conflict" have added lots of red ink to our national budget. Republican presidential candidate Ron Paul recently said that Korea has cost us more than one trillion dollars in more than 55 years, and we still have a big problem with North Korea.

As human beings in a complex society, we ask ourselves on a daily basis if we are spending our money wisely. Rich or poor, it is a question that comes up with almost every purchase. Is the car I buy worth the money? Is the education I have saved for going to help my child make it in the world? Is the charity I give to going to use the money wisely? Those same questions need to be asked about our spending on the war.

Some believe our foreign aid is simply a waste of money, while others believe it is not only a moral imperative, but it is also vital to our national interests because that money enables us to win the hearts and minds of those who may have been future enemies. Others conjecture that the foreign aid we give is necessary to prevent disease from traveling across the seas and causing more deaths than a thousand Sept. 11s.

I am sure I will hear from many of you that every penny of the war is worth it. We need it to combat terrorism. There are, however, many uses that money could be spent on, and here are just a few proposals:

New Orleans: Turning headlines into action

By Ellen Ratner
"New Orleans deaths up 47 percent" was the USA Today above-the-fold headline in last Friday's paper. The number 47 percent is one number. We could add to that number to the 182 percent increase in the murder rate in the past year recently reported or two-fold increase in suicides. So what can we do about it? The headlines can be manipulated to mean a variety of things, depending on the lens with which the reader reads them.



Like in the immediate aftermath of Katrina, some blame the ongoing human crises in New Orleans on the local government, the governor of Louisiana, residents themselves or all of the above. Others blame the federal government, George W. Bush, FEMA or all of the above. We can agree that there is plenty of blame to go around, but none of this blame serves those in need. There are those who talk and those who do. And if any good has come from Katrina, it is the good that has been created by the vast number citizens and ad hoc nonprofit organization volunteers who have been brave, and perhaps naive enough, to put on their rubber boots and wade through the sea of dysfunction and misery.

One such organization was formed to immediately stem the healthcare crisis. It is a small clinic called the Lower Ninth Ward Health Clinic. Most homes located in the neighborhood of the clinic had water over the roof. One of those homes has been rebuilt and is a clinic for the people of the Ninth Ward and surrounding area. There is such high demand for medical services that people from other Parishes with other economic and racial makeup cross previous divides to access critical services. I learned of this clinic through my work in the Gulf Coast in Mississippi. I was seeking funding for our project to build a public swimming pool and resource center when I was introduced to the staff of this wonderful clinic.

The clinic currently runs on the nurse-practitioner model. Nurse practitioners are able to write prescriptions. The clinic has one health care professional and serves 20 to 25 patients per day. They have five examination rooms but lack the staff to fully utilize those rooms. For example, they could double their services with an added nurse practitioner ($100,000 per year salary including benefits).

There are less than half a dozen small clinics in the New Orleans area. I am told that one of these small clinics, Operation Blessing, is closing due to lack of funding. Another small clinic is operated out of an abandoned mosque. These clinics may be the bubble gum holding the dam together in the wake of the health care shortage, which according to the same USA Today article, New Orleans lost, "seven of 22 hospitals and half of the city's hospital beds. More than 4,486 doctors were displaced from three New Orleans Parishes."

I'm sure there is some community development plan to rebuild health care in New Orleans, like there is one to rebuild housing and schools and levees, but these plans remain on paper, plans unrealized, while the existing emergency rooms and hospitals are stressed to break point. Patients don't need to go the ER if they can access health care prior to the state of an emergency.

Most of the deaths mentioned in the USA Today article were unnecessary, and the care for these victims was likely several times that required had they had access to routine medical services such as those provided by nurse practitioners at clinics like the Lower Ninth Ward Clinic. "The lack of primary care, of mental care and of long waits in emergency rooms all have (worsened) people's normally controllable chronic diseases – diabetes, respiratory disease and hypertension – all are killers, especially when they're not dealt with," says Jullette Saussy, director of New Orleans EMS.

While nonprofit organizations are lean, flexible and responsive, they lack the long-term revenue inflow that public or for-profit ventures enjoy. The Lower Ninth Ward Health Clinic, for example, relies on in-kind donations as well as small grants from a patchwork quilt of funding sources – sources that may dry up as Katrina falls out of view of the nation's rearview mirror. I often focus on politics and engage in the blame game myself in this column, but today I would encourage the readers to look for opportunities to give a hand up to those on the front lines of what is still an enormous human crisis in our own backyard.