Wednesday, September 16, 2009

What if it is broke?

One of my favorite sayings, one which reflects America’s pride in being a practical people, is “If it ain’t broke, don’t fix it.”

The corrolary is implied. If it is broke, then do fix it.

The health care battle raging in Congress and around the nation is bringing home the fact that not only is our health care system broken, but so, quite evidently, is American democracy. And fixing health care, alas, doesn’t appear to be in the cards at the moment. Nor do we seem to have much chance of fixing American democracy.

In Obama’s address to Congress the other night, now forever marked by Joe Wilson’s “You lie” outburst, Obama put out the good news that the Senate was coming up with a health care plan in a week’s time.

Well, it’s out. The Max Baucus proposal, aka “Obama’s blueprint” is on the table.

And sometimes you just want to throw up.

This joker who has collected almost four million dollars in contributions from the insurance industry since 1989 comes up with what? A proposal to enrich the insurance companies. Wow. I wonder how that happened.

And Max Baucus is a democrat. One of us.

Yeah. Right.

If this were not absurd enough, despite the fact Max Baucus’ Finance Committee has a bipartisan face, the Republicans, with the possible exception of Olympia Snow, are all expected to vote against it. Which means this is the friggin' DEMOCRATIC plan!!! The one we’re going to ram through despite Republican opposition.

Man, if you ever want an example of a broken democracy, I don’t know where you’ll find one better than this.

Look at this roadkill of a plan. It asks American families to pay 13.5% of their income in monthly payments. Oh, yeah. And then co-payments. Oh, yeah. And then there will be the usual deductables. It will extend health care to 30 million uninsured citizens. Whoopee. And the other 17 million? They’re supposed to get on their knees and praise the Lord for saving us from socialism?

Because this proposal would require all Americans to sign on, it would bring in additional billions in new business to insurance companies. Quite a windfall. Billions for the insurance companies that could have gone into a pool, if we had national health care, to lower the costs considerably more and pay for the seventeen million left out in the cold with this plan. As the Los Angeles Times reports, there’s joy in the boardrooms tonight.

Reminds me – just a quick aside here – of the time The Onion had a ball last year with the $700 billion payout plan:
Three thousand guests were reportedly flown on 750 separate private jets to the Caribbean, where they commemorated the last-minute financial aid package—which saved their companies from the subprime mortgage crisis that has left thousands of Americans without homes—with 4-tons of Beluga caviar, $250,000 bottles of vintage Dom Pérignon served over precious gems, a 36-hour fireworks display, an additional loan of $200 billion to cover the costs of the gala, and a private concert for each attendee with rock legend Rod Stewart.
And is it really supposed to be 13.5% across the board? If somebody grosses $100,000 a year, he or she can afford a reduction to $86,500. But imagine your income at $40,000. That means it drops to $35,000. That missing $5000 smarts a whole lot more than the missing $13,500 for the first guy. Countries with national health plans don’t tax the less affluent at the same rate as the more affluent. But this is the U.S., and Congress runs the country for the wealthy, so this will not surprise anybody.

And while you avoid seeing a doctor for fear of the deductibles and co-pays, your employer still pays through the nose. Money you might have access to, if your employer were not saddled with the obligation to pay for health care.

But is this the best Obama can do? Shuffle the deck chairs on the Titanic? Shovel more business to the insurance companies, with their 20% + administrative costs instead of copying the national health care systems around the world with their 5%?

77% of Americans want a public option. Hell, even 73% of American doctors, once thought of as the self-serving bad guys along with corporate America, want some sort of public option. Instead we have representatives of 3% of the population come up with a plan we’re calling the Obama blueprint – which excludes the public option. If you’re not ashamed of that fact, shame on you.

Senators earn $174,000 a year. If they claim D.C. as home, they pay premiums of $336.03 every two weeks for health benefits. The government then reimburses $252.02 of this. (Click on non-postal federal employees for the full data state by state). Rates vary according to state, but they are all in this ball park. Think about this. They have access to a health care plan that requires them to pay about $672.06 a month. But the government reimburses them for $504.04 of this. They end up paying $168.02 a month. On $14,500 a month income. And then they come up with plans like this for the rest of us? This is representative democracy?

In eleven U.S. states the uninsured number more than one in five. In three states, Florida, New Mexico and Texas, they number more than one in four. Yet look at how these people are represented. Texas, with 28% of the population uninsured, is represented by Senators Cornyn and Hutchinson. Cornyn doesn’t like the Baucus bill because he worries it’s really about Washington handing out more “entitlements”. (Top Story as of today – this may change on his website). Hutchinson, pictured today speaking behind a “Free Our Health Care Now” no-public-option poster, is unhappy that the Baucus bill is not bipartisan.

To be fair, the figures for uninsured Americans are highly contested. Many Americans could be insured if they would only sign up, we hear. Many of the uninsured are only temporarily uninsured. But despite it all, we’re arguing about details, not about the fact we have millions of Americans without health insurance, no matter how you cut it.

And, the citizens of these fourteen states aside (and all states have uninsured in the double digits), as the government was originally conceived, each Representative was to represent his or her constituency, but each Senator was supposed to represent the nation at large. When you see how the Senate votes, you see that bubble burst a long time ago. Partisanship and self-interest are a stark reality. Put that fact together with the fact that the Finance Committee consists of three democrats and three Republicans – 40% of the Senate, but 50% of this committee in other words. And then combine that with the fact that together they represent about 3% of the population, and you can see the cracks in the system.

For me, the bitterest pill of all was thinking about Joe Wilson. We’ve satisfied ourselves that this guy is a lout. Jimmy Carter called him a racist. His wife and kids insist he’s a peach of a guy, never mind that he wanted to fly the Confederate flag over South Carolina not too long ago, and defended his racist boss Strom Thurmond, referring to his illegitimate black daughter's revelation of her origins as "unseemly." Name calling aside, the House, for the first time in memory, censured him for his outburst, and one hopes that might lead somehow to greater civility in the body politic. I continue to place great hope in Obama, but he’s wrong. Joe Wilson choice of "liar" is nasty - all politicians slant their stories. And his style may be "unseemly." But Obama lied by omission. He claims that the bill excludes illegal aliens. And it does. But they will go to emergency rooms and be paid for by taxpayer money. We can't demand IDs in emergency rooms – too many people, many of them citizens without birth certificates, would die.

We’ll figure out one day how to keep illegals from entering the country, but who wants to live in a country that tells people having a heart attack to do it on the steps of the hospital. And who send little kids with contagious diseases back to school to infect the rest of the population, rather than treat the disease under a public health policy.

We don’t hear much about that because the Obama supporters among us are trying too hard to disassociate ourselves from the Baucus blue dog democrats and the entire wretched Republican spoiler party and we feel we have to defend Obama right or wrong.

That makes us part of the problem of brokenness.

Shame.

Shame all around.

Monday, September 14, 2009

All you need is time

Yesterday, I forwarded copies to friends of an exchange I had with my friend, Dov, which included a description of the Australian health care system known as Medicare. He wrote in response to my forwarding a description of the German health care system. In this morning’s New York Times, for those interested in these international comparisons, is Roger Cohen’s attempt to put right some of the misconceptions over the French system.

It’s a fascinating time for the exchange of information on health care. Unfortunately, there are two pretty severe stumbling blocks – one, along with the information comes a ton of misinformation. And two, it’s only information if people actually read it and discuss it.

America, alas, has an awful lot of folk waving signs and marching on Washington, calling into talk shows and watching Fox news, who don’t.

Another good source of information on health care reform is Bill Moyers. He’s been running one program after another on Bill Moyers Journal on various aspects of the problem.

This week he had Dr. Jim Yong Kim on.

Just as I was wallowing with Dov in despair over the fact that Americans don’t read, don’t think, don’t bother to check their facts before speaking, this interview with Kim comes across my screen, reminding me (he’s an anthropologist as well as a medical doctor) of what Margaret Meade once said:
Never doubt the capacity of a small group of committed souls to change the world. In fact, that's the only thing that ever has.
Maybe we can do it even despite the tea-baggers.



P.S. Margaret Mead also said:
I was brought up to believe that the only thing worth doing was to add to the sum of accurate information in the world.

P.P.S. Sorry to continue to repeat the obvious, but anyone who wants to can even take a course at MIT on comparative health care! No kidding. Online at: http://ocw.mit.edu/OcwWeb/Political-Science/17-315Fall-2004/CourseHome/

All you need is time.

P.P.P.S. All one ever needs is time.




Tuesday, September 8, 2009

Campillo, Sí Quiero (Campillo, I Do)

When you’ve finished cleaning your sock drawer and have some time to practice your Icelandic, go to: http://www.youtube.com/watch?v=haByWjOXdKQ and listen carefully. They’re talking about a Spanish documentary, Campillo, Sí Quiero, which is about a village in Castille called Campillo de Ranas (Littlefield of Frogs).

Or you can skip all that and read about the village in the New York Times.

Get in your car in Madrid, head north on the A-1 for about 70 km., take Exit 76 toward Avenida de la Venta de Méa, take the M-137 about eleven km. till you get to Prádena del Rincón, where you turn right onto M-130. Go about 7-8 km till you rejoin the M-137 again. Be sure to take the right turn and go north and not the left turn which would take you back to where you started on M-137. Follow that for about 8 km, till you get to the GU-187. Stay on that about 5 km. till you get to GU-181. Turn right and continue on about three and a half km. till you get to GU-194. Turn left onto the highway to Corralejo (Carretera a Corralejo) (GU-194) and go about 8 km. till you get to GU-186 (Ctra a Majaelrayo). Take that about half a kilometer, turn left toward Calle Cuesta about half a kilometer and there you are in Little Field of Frogs, the gay marriage capital of Spain. If you make all the right turns it shouldn’t take you more than two hours from Callao in downtown Madrid, about 128 km. in all.

Probably best to go when there’s a wedding you’re invited to. Or arrange one of your own, gay or non-gay. Takes about 45 days to clear the paper work, I understand, so get cracking. Besides the wild boar, there are only 50 or 60 inhabitants, but there are apparently lots of B&Bs and restaurants in villages nearby.

You can see the mayor (and local beekeeper) of Campillo de Ranas, Francisco Maroto, interviewed by Teresa Viejo on the Castillian TV program Tal Como Somos (Such as We Are). People are coming from all over the place (Peru, the U.S., Eastern Europe) to get married in his town, since he decided (he’s gay himself) to take advantage of the fact that Spain approved same-sex marriage in June of 2005. The marriage featured on the program is one done in medieval costume where everybody, including the alcalde gets all dressed up in medieval drag. When Lord of the Rings fans got married, Maroto got dressed up as Gandalf. Whatever it takes, says Mayor Maroto.

This is one clever dude in the body of a cozy teddy bear. He’s stopped the exodus to the cities, the school has opened again with eleven kids after being closed for 32 years, and the old folks are rallying round their mayor in case there might be anybody who would wish him harm.

The interviewer puts him on the spot. She asks him if he’s married himself and he says no. She then tries to interview his partner, Quique Rodriguez (the local justice of the peace), sitting in the audience, but the partner refuses. Mayor says they’re not interested in getting married. Interviewer says, well if you change your mind… A real marriage-maker, this one.

She then interviews a straight couple he married some time ago with their four-month-old daughter who want to thank him for his efforts in marrying them. Most of the folk who come there now to marry are straight. They just like the place.

Seriously – you can skip the Icelandic interview since it’s just talking heads – unless, of course, you like to hear Nordics make those delicious sounds with their mouths. But watch the mayor’s interview, even if your Spanish isn’t up to snuff. The warmth of the guy, of the interviewer, the warmth of Spain comes through.

Where, I ask you, in all this, is the view that gays are a threat to the institution of marriage?