Random Thoughts on Health Care Reform

The one thing clear about the passage last night of the Obama-Democratic health care reform bill in the lower house of Congress is that a political Rubicon has been crossed.  It my have passed by only three votes but let me remind you that George W Bush was elected and served as President in the 2000 election by an even slimmer margin of electoral votes. And since the Democrats were going to be blamed anyway for trying to pass reform, they at least now have the advantage of actually having it signed into law.  

Now thing I know about the country I  am fortunate to live in: Americans in general  love people that can get a job done, and don't give up and make excuses and quit. The newest Gallup Poll shows that President Obama's approval ratings have done back up to 50 percent favor ability again and will likely increase. This is because Obama and Speaker Nancy Pelosi got something major they set out to do and got it passed. 

 Many people objected to Ronald Reagan draconian politics on welfare recipients, cutting school lunch programs  and practicing the politics of excessive-individuality,  but he always won grudging admiration for sticking to his guns.       

 This is nothing less than a new era in dealing with a private-treatment system that has put profits over caring for indigent sick people.  Health care insurers like Wellpoint and Blue Cross are now on notice---the days of desperate sick people showing up at a public clinic with few resources or a overcrowded emergency room  for care because they aren't good customers for their stock-holders and CEOs is soon going to be over. 

Yes, health care reform is controversial and the Democrats who voted for this are not all going to be reelected.  But many of these legislators were already targeted by the Republicans and conservative and right-radical groups because  they were in traditionally Republican districts anyway!  Elections matter as we in the  Democratic camp have been reminded over and over again by conservatives since Nixon's landslide victory in 1972 and all through the Reagan-Bush years.  We were told to give up and adapt to a new conservative mantra of less regulation and more  free markets as a way to solve everything from health care to banking regulations (or non-regulation)  of fighting foreign wars.  

Well, we've been taught  the lesson--and now it finally appears that our elected Representatives in the current Senate and House are finally ready to teach the class to the masters.    

Sure, there will be charges of unconstitutionally and all the usual back and forth of those who see change and are threatened by it. But I think in the end most of this bill will be set and standard law in a few years... and more and more of the public will accept this law not because its about bigger government but because its about a greater fairness and protections for working and middle-class families.  Over sixty percent of bankruptcies are now caused by excessive health care billings.  No other developed nation in the world allows parents to deal with a sick child, for instance, and also the loss of a family home.We Americans need to get with the modern world!    

Paul Krugman in the New York Times pointed out the latest part of this year-long battle and the Republican agony:  

" 'Yes, a few conservative policy intellectuals, after making a show of thinking hard about the issues, claimed to be disturbed by reform’s fiscal implications (but were strangely unmoved by the clean bill of fiscal health from the Congressional Budget Office) or to want stronger action on costs (even though this reform does more to tackle health care costs than any previous legislation). For the most part, however, opponents of reform didn’t even pretend to engage with the reality either of the existing health care system or of the moderate, centrist plan — very close in outline to the reform Mitt Romney introduced in Massachusetts — that Democrats were proposing.

"Instead, the emotional core of opposition to reform was blatant fear-mongering, unconstrained either by the facts or by any sense of decency.

"It wasn’t just the death panel smear. It was racial hate-mongering, like a piece in Investor’s Business Daily declaring that health reform is “affirmative action on steroids, deciding everything from who becomes a doctor to who gets treatment on the basis of skin color.” It was wild claims about abortion funding. It was the insistence that there is something tyrannical about giving young working Americans the assurance that health care will be available when they need it, an assurance that older Americans have enjoyed ever since Lyndon Johnson — whom Mr. Gingrich considers a failed president — pushed Medicare through over the howls of conservatives.' "

Medicare, passed in 1965, was supposed to be "the end of freedom", as Reagan put it when he was entering national politics. The same was said of Social Security thirty years earlier by the proto-Reagans like Herbert Hoover, William Randolph Hearst  and Father Coughlin (a radio pundit much like Rush Limbaugh). 

  Instead of the crack of doom happening, Medicare and Social Security are programs that has helped eliminate much of the poverty that haunted  older people.  They are settled programs that are seen as part and parcel of the structure of the political landscape.

There are many flaws to this bill of course---much of the paying for it has been put off and some of the benefits for 32 million uninsured people are not going into effect for three or four years.  But, what may I ask, was so good about the status quo?  How many more incremental and anemic changes were we going to make in health care without confronting the need to  reduce costs and bring more people into the preventive care system?       

 Unless you make $250,000 dollars a year or have a "Cadillac Health Plan" provided by a union or a corporation, this new bill will not add a significant increase to anyone's taxes. Far from being "socialism", this, for better or worse is simply American pragmatism---we have a problem that has lasted for decades.  We are finally on the first steps to correct the massive medical industry and put matters on a more humane track.     

Mary Travers of "Peter Paul and Mary" dies at 72

Mary Travers was one of the great folk-singers of the 1960's and beyond. She died today of complications from chemotherapy for her advanced leukemia. 

This was the first folk group I was aware of as a kid. I had a crush on this lovely lady before I knew what a crush was! She and her two partners (Noel Paul Stookey and Peter Yarrow)  were not only into making beautiful music, but in  promoting awareness of issues like  Civil Rights, an end to the Vietnam War, nuclear arms control, progressive politics  and plain tolerance.

I offer these two examples of the music I think made her special. The first one is my favorite of theirs, "If I Had a Hammer", originally written and recorded by folk legend Pete Seeger. It's also one of the most "covered" songs ever. 

 

Peter Yarrow, commenting on his friend's death on the group's official site summed up their contribution this way. "The trio's growth, our creativity, our ability to emerge over the years completely accepting of one another, warts and all, was a miracle...When we performed together, we gave the best to each other and to the audiences who came to hear us."      

This trio represented a sound that spoke of a  faith that the America of the future would be a more inclusive  society. And they also did songs like"Puff, the Magic Dragon", which were plain fun. Their first album, pictured above, was  on the Billboard Magazine Top 100 chart for over three years. The group split up in 1971, but reunited a few years later.   Mary released five solo albums, but none captured an audience like her work with Peter and Paul. 

 

From Yahoo News:

Their beatnik look — a tall blonde flanked by a pair of goateed guitarists — was a part of their initial appeal. As The New York Times critic Robert Shelton put it not long afterward, "Sex appeal as a keystone for a folk-song group was the idea of the group's manager, Albert Grossman ... who searched for months for `the girl' until he decided on Miss Travers."

The trio mingled their music with liberal politics, both onstage and off. Their version of "If I Had a Hammer" became an anthem for racial equality. Other hits included "Lemon Tree," "Leaving on a Jet Plane" and "Puff (The Magic Dragon.)"

They were early champions of Dylan and performed his "Blowin' in the Wind" at the August 1963 March on Washington.

And they were vehement in their opposition to the Vietnam War, managing to stay true to their liberal beliefs while creating music that resonated in the American mainstream.

The group collected five Grammy Awards for their three-part harmony on enduring songs like "Leaving on a Jet Plane," "Puff (The Magic Dragon)" and "Blowin' in the Wind."

At one point in 1963, three of their albums were in the top six Billboard best-selling LPs as they became the biggest stars of the folk revival movement.

It was heady stuff for a trio that had formed in the early 1960s in Greenwich Village, running through simple tunes like "Mary Had a Little Lamb."

Their debut album came out in 1962, and immediately scored a pair of hits with their versions of "If I Had a Hammer" and "Lemon Tree." The former won them Grammys for best folk recording, and best performance by a vocal group.

"Moving" was the follow-up, including the hit tale of innocence lost, "Puff (The Magic Dragon)" — which reached No. 2 on the charts, and generated since-discounted reports that it was an ode to marijuana.

Album No. 3, "In the Wind," featured three songs by the 22-year-old Dylan. "Don't Think Twice, It's Alright" and "Blowin' in the Wind" both reached the top 10, bringing Dylan's material to a massive audience; the latter shipped 300,000 copies during one two-week period.

 

 

 

This is Mary singing sans Peter and Paul  from a 1969 Television Special with Mama Cass Elliot of "The Mamas and the Papas".  

Reinhold Niebuhr, The Health Care Fight and The "Immoral Society"

"...a 'laissez-faire' economic theory is maintained in an industrial era through the ignorant belief that the general welfare is best served by placing the least possible political constraints upon economic activity.   The history of the last hundred years is a refutation of this theory...It's survival is due to the ignorance of those who suffer  injustice from the application of this theory to modern industrial life but fail to attribute their difficulties to the social anarchy and political irresponsibility that the theory sanctions."

--Reinhold Niebuhr, "Moral Man and Immoral Society, A Study in Ethics and Politics" (1932).  

Reinhold Niebuhr (1891-1971), pictured on the left in a TIME magazine cover from the early 1950's, was considered the one of the foremost American Protestant theologians of pre and post World War II America. He wrote many books and articles about politics and ethics and was the Professor of Christian Ethics at the Union Theological Seminary in New York State from 1928 to 1960.  Prior to that he served as a pastor for thirteen years at a church in Detroit, Michigan.   Another important work of his is the book "The Irony of American History", a book that explores the conflicts between "the hopes of the founding fathers and the reality of the present situation" (i.e, America in the dawn of The Cold War.)  He has been cited as one of Barack Obama's favorite philosophers. 

After World War II, he co-founded the leftist but non-Marxist group "Americans For Democratic Action", which is still an active and leading independent progressive organization which, among other activities, watchdogs the voting records of Congressional members in both the House of Representatives and The Senate. 

Professor Niebuhr's book on morality in public life by groups and individuals seems relevant to me today not only because both Barack Obama and John Mccain cited him favorably during last year's Presidential Election, but because of the health care debate in the USA which is raging at the moment.    The current struggle can be summed up  in two competing philosophies. The first is the traditional view that nothing the government does in the domestic sphere can be of benefit to the average person.  Change from Washington or the State Houses is simply incompetence at best and a collectivist power grab at worst.  These views are all over the editorial pages of the "liberal media" newspapers, and there is a plethora of examples.  I will spare you the cacophony of those who feel the status quo in having 40-50 million uninsured Americans is only worthy of modest reform and cite just one advocate, Michael Tanner of the conservative Cato Institute, writing recently in The Los Angeles Times:

"Everyone agrees that far too many Americans lack health insurance. But covering the uninsured comes about as a byproduct of getting other things right. The real danger is that our national obsession with universal coverage will lead us to neglect reforms -- such as enacting a standard health insurance deduction, expanding health savings accounts and deregulating insurance markets -- that could truly expand coverage, improve quality and make care more affordable."

  

Herein is the usual argument: to Mr. Tanner, health care is a commodity like an automobile, dog food or a latte coffee creation for someone's morning caffeine fix.  Just let the "free market" take care of all this, add a tax cut to sweeten to pie, and all will be well.  

Such thinking did not serve the America that Professor Niebuhr's wrote about during The Great Depression.  Unregulated markets and speculation run wild had crashed the economy.  And now we face a similar era of recovery from the sins of ignorance. 

Health is most decidedly NOT simply a commodity. By it's nature it is often too expensive to purchase for those without the social protection of  decent job.  And the dangers of underinsured Americans means that 40-45 million Americans are not entitled to any primary care at all, unless it is under-borne by small-scale clinics which are underfunded.  In addition those who fail to get primary care have to resort to the emergency room to get treatment, often for conditions that are long neglected.  The result makes for sicker patients and higher bills. Today, more Americans file bankruptcy and lose their homes because of medical bills they can't pay than for any other reason.  

One of the things Niebuhr wrote about in "Moral Man..." was the need to go beyond appealing to moral principles to create a change.  Entrenched interests like the health care lobby will always try to show that their position of power is in the best interests of the country.  They will protect that.  Change can only come if enough people demand it, demand something that is so "radical" that all nations in Europe and Canada that elect governments already have some form of it--a public health care system with regulated costs and open access.  Otherwise, we will be left with the status quo, which traps people in jobs, and makes a mockery of a "free" society :

     

Gonzo:The Life and Work of Hunter S. Thompson (2008)

Rating:	★★★★
Category:	Movies
Genre:	Documentary

This documentary explores the life of American political and cultural journalist Hunter S. Thompson (1937-2005) , the former avaunt-garde writer for "Sports Illustrated", Washington correspondent for "Rolling Stone" magazine during the dark days of the Nixon Era, and a sometime columnist for "The San Francisco Examiner" in his later days when th booze and pills would permit him to meet the newspaper's deadline.

He is also the man rightly credited with inventing "gonzo" journalism--a form which allows a reporter to cover a story using his imagination and making insights that go beyond the surface of a political campaign or a scandal to get at a deeper , often bitter, core truth about the events he/she is covering.

His books include my favorite work of American political campaigns, "Fear And Loathing On the Campaign Trail: 1972"; "Fear and Loathing in Las Vegas", "The Hell's Angels" (a book that grew out of his spending months with the most dangerous of the West Coast outlaw motorcycle clubs) and an anthology of his essays and articles called 'The Great Shark Hunt". Many of these books come with illustrations by Ralph Steadman, an inspired artist of twisted imagery in the spirit of the Wiemar-Era German master, George Groz.

This film is a fascinating glimpse into his life and those who loved and cared about him as a colleague. The saddest part of the story is how, after the mid-Seventies, he began a long decline and was almost swallowed up by his own legend.

Hunter Thompson, you see, was the consummate outsider looking in--and he was also a damn funny writer, as well, which makes me sad to think he's not around to give us his takes on the world for the ease of a pundit's chair. He was an original, a patriot, a bit of a kook, a genius with words when he was on his game, a gun nut, a bit paranoid, a romantic, a cynic, a dangerous man to drive in a car with, a passionate seeker and...did I mentioned he was damn funny?

Studs Terkel 's America: 'The Big Boys Are Not That Bright'

I ran across an  article about the late Studs Terkel from AARP magazine.  It features one of the last interviews  by the great American oral historian and activist  who died  this October , aged 96.  A frequent guest on television and radio programs, Mr. Terkel wrote two of the best books on 20th Century American history I've ever come across:  "The Good War" (1984) a Pulitzer Prize winning book about dozens of ordinary Americans telling the stories of their lives during the Second World War and "Hard Times: An Oral History of the Great  Depression".    

His final thoughts on collapsing economic conditions then and now,  recorded by Alan Horowitz, encapsulate for me an excellent contrast of the Great Depression and the latest financial panic calls out of New York and Washington for  taxpayer bailouts.  These calls for help come from those corporate hounchos who fought tooth and nail against regulation and financial transparency and fair-dealing.  They successfully neutered, through campaign contributions to both political parties agencies, the Securities and Exchange Commission.  They kept the hedge fund industry from being regulated altogether.  And much of the money from the mortgage crisis was lost because the people making those loans knew they wouldn't have to make the loans accountable to real market values and the consumers ability to pay and hold the properties. All this chicanery: and now we all reap the whirlwind.

 Now perhaps the  United States, after some thirty years of massive deregulation since the election of Ronald Reagan, can return to a mature regulated economy. I hope it is not too late.   This latest financial meltdown and the loss of so many fortunes through bad investments have made true believers out of a lot of folks who had been living off the notion that people in speculative businesses by nature are more knowledgeable and honest than the average Joe or Jane, and that personal greediness will make us all better off.   

The latest debacle in the news has been the world-wide Ponzi/Pyramid schemes of hedge fund titan  Bernard L Madoff, who bilked a reported 50 billion dollars out of investors.  He fooled some very bright people.  And no one paid attentio nto the early whistle blowers.  It was, as one columnist put it, only when the tide went out that people could see how many people were left swimming naked.    

It reminds us all that as individuals we can be fooled by the experts, many of whom are not as expert as the so-called ordinary person.  That's why we need regulation.  The Reagan Era is (at last) really and truly over. A balance might be restored (again, if it is not too late) between the desire of individuals to make money and the needs of the commonwealth to make sure they do it honestly. 

Mr. Terkel's remarks are below.          

 

"So here we are at a crossroads. In a strange way, I’m hopeful. Franklin D. Roosevelt sums up how I think about tomorrow. When asked a tough question once, he said, “That’s an iffy question.” I think if we don’t remember what happened in the past and if we don’t remember there was a way out, it’ll be an iffy question as to which way we go. During the Depression people believed that the man behind the desk was a better man. They’d think, “I’m here with hat in hand. He knows more than I do.” We’ll have less of that kind of thinking now because so many of us have been through the Civil Rights Movement and the ’60s. In the Depression they didn’t have that as a preface. We do. That’s the big change. We’ve seen what activism does.

"The Great Depression. I was about 17 years old. Hoover was still president. People had been living high off the hog. And then, boom, comes the Crash. It was so sudden. Guys jumped out of windows. They didn’t know what to do. The wise men ran around, and then they cried out after Roosevelt for the government to help them out. Regulation. They asked for it. They cried for it. The wise men were lost, just as they are today. The free market fell on its fanny. We learned nothing. It’s exactly the same today.

"My mother ran a hotel, the Wells-Grand Hotel, for men, just outside Chicago’s skid row. Skilled workers. Mechanics. Guys with jobs here and there. Some retired. It was fine. The lobby in the hotel was empty in the daytime. It was just a little room, and at night they’d come play hearts and pinochle. Then came 1929. Suddenly they’re not working. Or those guys who retired, suddenly their pensions are gone. Now they’re in the lobby in the daytime. They don’t know what the hell to do. So they drank more. And played the horses more. And there were fights. What were the fights over? Their own self-respect. I mean, they had nothing to do. They were furious. Who do you blame? Who do you hit? You hit each other. That was sort of a metaphor for what happened to the country. They blamed themselves. Yet I met these people who weathered it one way or the other, some just by lending a hand.

The lessons of the Great Depression? Don’t blame yourself. Turn to others. The big boys are not that bright.”

For a brief biography on Studs Terkel, check out this link: http://www.spartacus.schoolnet.co.uk/USAterkel.htm 

The Central Asia Institute: Fighting Terrorists Without Bombs and Guns

"When it is dark, you can see the stars."--

Persian Proverb

 The Central Asia Institute  is a non-profit, non-governmental organization.  It was  started by Greg Mortenson, a one-time child of Christian missionary parents (sent to Tanzania for much of his youth).  He later enlisted in the military and became a medic, and later a trauma nurse by profession and a skilled mountain climber.  He was trying to climb the infamous "K2" mountain in the Himalayas when disaster struck his party about 800 meters from the summit.  He barely made it down the mountain alive and was nursed back to help by Muslim villagers in an isolated mountain town.

Thanks to the generosity of these strangers, Mortenson made a vow: he would return to the village and build the people there a school for their children.   The efforts to get funding for the endeavor (and the beginnings of the Central Asia Institute's main efforts to promote female literacy in Pakistan and later Afghanistan) were outlined in a July 2008 column by   Nicholas Kristof of the New York Times (excerpt below) 

  "Scrounging the money was a nightmare — his 580 fund-raising letters to prominent people generated one check, from Tom Brokaw — and Mr. Mortenson ended up selling his beloved climbing equipment and car. But when the school was built, he kept going. Now his aid group, the Central Asia Institute, has 74 schools in operation. His focus is educating girls.

"To get a school, villagers must provide the land and the labor to assure a local “buy-in,” and so far the Taliban have not bothered his schools. One anti-American mob rampaged through Baharak, Afghanistan, attacking aid groups — but stopped at the school that local people had just built with Mr. Mortenson. “This is our school,” the mob leaders decided, and they left it intact.

"Mr. Mortenson has had setbacks, including being kidnapped for eight days in Pakistan’s wild Waziristan region. It would be naïve to think that a few dozen schools will turn the tide in Afghanistan or Pakistan.

"Still, he notes that the Taliban recruits the poor and illiterate, and he also argues that when women are educated they are more likely to restrain their sons. Five of his teachers are former Taliban, and he says it was their mothers who persuaded them to leave the Taliban; that is one reason he is passionate about educating girls.

"So I have this fantasy: Suppose that the United States focused less on blowing things up in Pakistan’s tribal areas and more on working through local aid groups to build schools, simultaneously cutting tariffs on Pakistani and Afghan manufactured exports. There would be no immediate payback, but a better-educated and more economically vibrant Pakistan would probably be more resistant to extremism.

“Schools are a much more effective bang for the buck than missiles or chasing some Taliban around the country,” says Mr. Mortenson, who is an Army veteran.

"Each Tomahawk missile that the United States fires in Afghanistan costs at least $500,000. That’s enough for local aid groups to build more than 20 schools, and in the long run those schools probably do more to destroy the Taliban."

 

   Mr Mortgenson's is also the  co-author of a bestselling book about his experiences called "Three Cups of Tea" which has been on the best-seller lists in the USA for 90 weeks, despite not having a major publisher initially to promote it.  It was mainly by word of mouth. It was through my wife that I first heard of this amazing organization and these efforts to help children, particularly in promoting education for girls in isolated mountain villages around the old Northwest Frontier of Central Asia.  His organization also promotes the training of teachers from within the local communities themselves. www.threecupsoftea.com

(above) Here a camera crew visits a school and interviews Farhat, an eighth-level scholarship student, at a village school in the Pakistani part of Kashmir.  

 

  One of the mottos of the organization is "educate girls and save the world".  It is estimated by the Council on Foreign Relations that this is a key to break the cycle of poverty that afflicts this area, the overwhelming number of whose victims are women.  

For more on Greg Mortenson and the work of CAI, here is a clip from an interview from Borders Books television: