Friday, August 21, 2009

Truly Surreal Patriotism

The word surreal comes into play a lot these days, at least for me, and it generally comes into play when I observe other people's inexplicable one-sidedness in the pursuit of the right to express themselves politically. I'll grant that I'm exercising the same right, and that I support the right to do so unilaterally and without condition. However, I find myself amazed at times like this, when I realize just how many have formed fierce opinions with nothing to back them except the spurious claims of hired pundits and spokespersons. It's one thing to have a fierce opinion built on a principle that has served you a lifetime and which, after careful thought, merits ferocity, it's another thing altogether when a person rushes to judgement based on the patently manufactured outrage of a hired political pundit that hands you a string of catch phrases to repeat.

This behavior isn't limited to one party or philosphy, to one region or religion, but can be observed everywhere, and provides a great source of interesting news clips and sound bites for the media grist mills that pass as news in the US. At the moment, the ball has fallen into the court of the aggrieved, out-of-power GOP, and we find ourselves treated to a spectacle that harkens back to the worst moments of the 1960's and 1970's. The reactionaries in our new era are largely comprised of lower middle class whites, but the single-minded determination to ignore inconvenient facts is shockingly familiar.

I sympathize greatly with every person who is sickened by political inaction, misinformation, thinly veiled lies and deliberate obfuscation...BUT, I find an alarming number of people focusing on a single party, just as the left and many Democrats did for the last eight years. The same one-sidedness and careful avoidance of information that might conflict with a dearly held view is in place, this time for the right. I challenge this way of thinking almost daily, because I too am a person frustrated by politics in the United States, but I am ALWAYS striving to question the information I take in, and to weigh what can be trusted and what cannot. My beliefs don't come from a limited number of trusted sources, and are not dictated to me by friendly televised faces, and I strongly believe that others should accept the hard task of constantly examining their media, their beliefs and the potential consequences of their actions. For the most part, this is the high price of adulthood in a democratic republic. It is your responsibility to sift fact from fiction, instead of depending on others to do it for you.

I can afford a certain freedom to criticize without hypocrisy, because I have a critical view of both major parties, no lasting political alliance to any organization or persons thereof, am financed by no one, and I withhold my criticism from no one. The most unbearably common technique of the informed political hack, when faced with critical questions about the point of view or representative they champion, is to dodge the issue at hand by shouting about the perfidy of the other party. This is irreverant and ignorant conduct. It simply proves beyond doubt that a person possesses no credible defense for the actions of their party or its leaders, and that they have no choice but to scurry to a different topic rather than facing the harsh and unpleasant possibility that a treasured faith in a party or person may be unwarranted.

This stands for Democrat and Republican, conservative and liberal alike. Where was the psuedo-left and the DNC during the Clinton era? Mostly applauding loudly or defending every inept or inadequate decision. The same held true for eight years of the Bush administration, with stolid, traditional Republicans keeping a tight lipped silence and marching in lockstep instead of demanding accountability from their own party. This brings us to the current day, in an era where tension is rising fast and tempers are fraying, with one party paralyzed by internal wrangling for lobby dollars and another descending into pandering to paranoiacs and lunatics.

When I hear the screams from barely articulate right-wing hacks about the erosion of our personal liberties and the certain doom of our way of life and the freedoms enshrined in our constitution...well, mostly, I want to vomit explosively to vent that bile and incredulity that comes from hearing concentrated idiocy. What forms in my mind after the urge to hurl has passed is a single shining question: WHERE THE HELL WERE YOU A YEAR AGO? OR FIVE YEARS AGO? OR TEN YEARS AGO? OR FIFTEEN? OR THIRTY?

Were these people living in a cave for the last decade? Did they not notice the multiple power-grabs by the executive branch that dominated the past few decades? The court stacking and gerrymandering? The fraud and graft and collusion by both parties? Did they just now FINALLY notice that, since the president isn't an elderly white man, that the infringement of government into our personal lives is at an all-time high?

Here's a free clue, just for those who might need it. If you paid your taxes without complaint for eight years while the federal deficit skyrocketed, but proudly "teabagged" the minute the other party was in office, before any changes were even made to our system of taxation by the new administration, you are the person who needs to wake up and think about your role in a democratic process. If you feel that you have no voice, it's because you didn't use it until the slime that passes for today's pundits told you to start feeling that outrage.

For every person who spent eight years in silence or loudly defending the corrupt and inept Bush administration, here's your new marching orders. March home. Go to the woodshed. Beat yourselves silly for being so damned permissive about your party's behavior that you allowed it to acquire greater and greater heights of executive authority, which now rests in the hands of another party, because the rest of the country reacted in horror and disgust at your party's excesses and chose to elect anyone other than the status quo. Then shut up and sit down...we don't need you if you can't educate yourself sufficiently to make rational judgments about your own party's conduct.

For every person who maintained radio silence during the Clinton years, but suddenly had the heart to speak up about the wicked nature of the GOP as soon as George W. entered office, here's a new set of marching orders for you. Find a VW Bug with flowers on it to the hospital...then walk in and have a doctor to examine the contents of your skull. Then go home and stay stoned and quiet long enough for another generation to take over. Your silent complicity and refusal to hold the DNC's feet to the fire is the precise reason that wind up wondering why you never get the results you want. We are better off without you.

The people who herd you on command are not afraid of you (as they rightly OUGHT to be). They expect and receive your cooperation every single time they come calling. Your outrage exists for one party only, and you have the nerve to call yourself patriots because you are surrounded only by voices that agree with you utterly and won't challenge you to think or question. When you run across a contrary opinion, it's more likely than not that it's a person from the 'other side', your natural enemy, and they are just as poorly equipped and as sadly misinformed (and comfortable with it) as you are.

Nothing can be solved or even marginally changed by brain dead herds of rabid followers spewing the same empty phrases from the same collection of talking heads. That isn't debate...that's sports...and at least in sports something is actually decide based on visible, recorded, measured performance. In politics we're down to people just lying and saying that something was accomplished, and with enough blind suppoprt from partisans they make it true in the history books, even while nothing tangible changes.

I freely call this stupidity. Engaging in that kind of conduct is antithetical to patriotism. It is what patriots should oppose at every turn. Let me share a beloved quote that has guided my political thoughts like an unerring rudder for almost two decades now.

"The deadliest enemies of nations are not their foreign foes; they always dwell within their borders.... The nation blessed above all nations is she in whom the civic genius of the people does the saving day by day, by acts without external picturesqueness; by speaking writing, voting reasonably; by smiting corruption swiftly; by good temper between parties; by the people knowing true men when they see them, and preferring them as leaders to rabid partisans or empty quacks." -William James

So here is my most reasonable request. If you are uninclined to bring accountability to anyone save the side that opposes your own, if you cannot speak and respect the right of others to speak, if you cannot abide that sometimes your chosen side will find itself in the minority, if you cannot bring yourself to listen, even momentarily, to an opinion that contradicts your own, and if you cannot conduct yourself in a civil manner because the absence of genuine facts must be compensated for by the weight of your ire...stop voting. Now and forever. Just stop and stay away from even the simplest of debates.

Get out of politics entirely, and leave it to people who are willing to endure the discomfort of hard questions and cautious consideration. You are the plague of locusts and the rain of frogs that warn the rest of us of ill times to come. You are the embodiment of all that chokes the life from good government. You are the problem because, allegorically speaking, we are struggling to repair something delicate, and you are wielding the axe that broke that delicate thing in the first place.

Let me say in parting only this: should you find yourself questioning your own party loudly, should you realize that only by demanding the highest levels of accountability and transparency from all parties and persons can we hope to regain control of runamuck leaders, then by all means join us in the long struggle to put this country back together, so that we might rebuild a little of the greatness of spirit this nation once proudly cherished, and which our children deserve to inherit.

Tuesday, August 18, 2009

Bad Medicine

Don't be fooled by the thoughts on health care in the U.S. can't be easily pigeon-holed into a convenient slot...and in truth, most people's thoughts on the subject are the same...hard to classify, but that's not the impression we draw from the current news storm that drenches us daily with platitudes and misinformation.

I'll admit plainly that I oppose most of what is being proposed on Capitol Hill, not because I oppose the concept of health care reform, but because the choices being laid out before Congress today are largely toothless, hideously expensive and will likely only help a sparse few persons at a cost that most cannot afford.

To be brutally honest, if I thought that we were being presented with a choice that would make a large scale difference in the quality of care that America's working poor receive, I would support the effort and applaud it loudly, but like most people who fall into the category of independant voters, I feel a wave of suspicion creep over me when I hear the actual reform plans being discussed.

And let me be specific...I do not fear 'death panels', which are a genuinely pathetic twisting of words to misrepresent an actually useful initiative proposed by a Republican, transforming it into a scare tactic used by the lowest intellects in the GOP and believed by the lowest intellects everywhere else. Neither do I fear seeing private insurance forbidden to those who can afford it. This is another fiction that makes the GOP look foolish and inadequate as guardians of common sense and fiscal sanity. Given that the insurance lobbies are piling dollars into influencing both sides of the debate, it seems extremely unlikely that any bill that emerges will do anything more harmful than offering them a state sponsored opportunity to enroll millions of new customers who can look forward to the abuse the rest of already endure when trying to get a claim paid.

This is where my real distrust lies. Based on the partisan wrangling that passes for debate now, it's easy to draw the impression that anything useful, thoughtful or helpful will almost certainly be snuffed out of existence long before it could reach the Oval Office. What we'll likely be left with is a patchwork quilt woven from pure pork, transforming billions of tax dollars into a minimal service boondoggle that leaves millions underinsured. This isn't that different from what we have today...but it will cost oh so much more.

This in no way defends our current system, which amounts to a philosophy of "pay now or go die". For all the screams for the fringe that health care reform will result in poorer quality care for a majority of Americans, the irony is in their silence regarding the inequities of the system we have now. Medical debts are a staggering burden, since even fairly common treatments cost more here than in other developed nations. It is disgusting to watch relatives and friends pour hours of labor into getting a claim paid, stressed to the limit of their ability to cope WHILE dealing with illness as well. Our 'system' of health care is broken...badly...and just because the solutions being offered are ineffective half-measures, it doesn't mean that we don't have a problem.

Our spiraling costs for health care may have their roots in the dawn of nuisance-based malpractice suits, and while litigation and insurance to protect against it are costly, they are not the end all and be all of expenses. Stripping the right to sue for legitimate redress of grievances from all but the wealthiest of clients is not the answer, because wasteful litigation is a matter better handled by careful scrutiny of proposed cases, not the elimination of the right to sue. On this matter, left leaning lobbies (not surprisingly featuring many lawyers) favor suing the pants off of anyone who even looks like they might deserve it, and those lobbied by industry favor being made immune to any scrutiny or accountability for malfeasance; both wrong, both ultimately horrible extremes, both unworthy of being taken seriously. This is exactly why I wind up finding myself in the middle...and like it there.

More influential in the advance of high costs for health care was the switch from non-profit service mode to for-profit service mode. The fundamental philosophy behind administration of a hospital has shifted radically in just a few decades. We are living (and dying) with the effects of that change. No matter what people may claim, for-profit health care corporations unfailingly find themselves in the position of answering to shareholders...not patients. Sagging profits and share prices eventually add up to leadership necks on the chopping block and fresh new faces at the helm. To avert this, every half decent executive will labor to shear away costs and bolster share value. "Commitment to Quality Care" is a great phrase...but phrases mean nothing. Profit means a lot more than any string of syllables ever will. The patient has become the customer, and the customer is really just a source of income. With medicine there are always other customers, and every one of them is expendable. This is not a recipe for great care.

For decades, employer sponsored insurance has been the gold standard, but as costs rise and numbers of retirees grow, each requiring longer, more expensive care than ever before, even basic coverage has become incredibly burdensome for business, small and large alike. Just a few generations ago it wasn't an unreasonable expectation to demand solid, comprehensive insurance in exchange for a comparatively small contribution, organized and managed through one's employer. Unfortunately, margins are leaner these days, contributions have grown larger and larger and the coverage that smaller business can afford to offer is very nearly not worth the cost for the average lower wage employee.

Wages have also taken their toll on the concept of health care. Specialists are costly, and medicine is no longer practiced as a general body of knowledge, but rather as a collection of niche markets, each commanding a higher wage per hour than in days gone by. This isn't to say that demanding work that requires extensive education and training doesn't deserve higher pay, but when the luxury and elective specialists earn noticeably more than men and women who save lives daily, we've moved toward a system that prioritizes all the wrong things. To reduce staffing costs, nurses, physician's assistants, LPN's, CNA's and MA's are becoming overtaxed substitutes expected to work outside their purview in exchange for lower wages. This is one of the root causes of strikes that plague corporate hospitals today, and the solution is more staff, but that inevitably drives prices up and profits down. Where is the answer? Honestly, I don't have one either, but acknowledging that health care is subject to unique needs that aren't easily answered in a purely for-profit system is a good start.

Now we come to drug costs, which are a racket that easily puts running numbers to shame. Speaking for those who have seen production cost vs. sale price comparisons, most businesses only WISH they could mark up their product like that and get away with it! Can you imagine a drop-forged hammer, made (theoretically) for a dollar, and selling for $30, $300, or even $3,000? And what are we getting for these exorbitant prices? A list of side effects that take up so much space that flyers have to be attached to every bottle! Prescription drug deaths, intentional and unintentional, are becoming a rising problem, both in terms of lost lives and in terms of malpractice and class action suits that wouldn't even be necessary if drugs weren't so poorly regulated and heavily prescribed. Again, lobbies from either side of the political spectrum, industrial or public safety-minded, overstep with answers too extreme for easy compromise, and we remain at an impasse, unable to navigate our way toward safe and affordable care.

That brings us to the middlemen who help cushion the cost of these high priced curatives...the insurers and co-ops and HMO's who make up the industry that adds yet another layer of staff and associated costs to an already mind-frying situation. One shining truth exists: you get what you pay for, and this basic truth is seen here like nowhere else. You can get coverage cheaply in this country, right now, even without a health care reform package passed by Congress. There's only one catch...that coverage will SUCK beyond anyone's ability to adequately describe. It's not entirely unlike calling a newspaper 'coverage' when you're outdoors, January.

Insurance doesn't exist to help. It exists to collect money by offering to spread the costs around to a wide pool of people who all contribute at one rate or another. If you don't mind paying the exorbitant rates that aren't too troublesome for high income brackets, you can enjoy knowing that you won't often run into situations where large checks have to be doled out to cover the remaining balance. If you aren't from one of those higher income brackets...well, you might very well be better off keeping those dollars for a rainy day rather than spending them on a plan that might cover the comparatively inexpensive doctor visit or prescription, but almost none of the tests, specialists or follow ups...which is where the bills begin piling up. This is at the root of the working uninsured. That money can't be wasted on a boondoggle that barely covers the start of serious health care, so people do without and allow their personal health to deteriorate until care is required and becomes much more complicated and expensive.

Like many other industries, insurers jumped on the Wall Street bandwagon and owe their allegiance not to customers, but to board members and share holders. This isn't a statement about right or's just an honest fact about doing large scale business. Profits must always increase if possible. Costs must always be driven lower. When the margin is in danger, cut, cut, cut to the bone. This isn't an environment that fosters a sense of responsibility for providing comprehensive coverage. It just isn't. Not because it's "evil" or "good", but because good or evil are irrelevant measurements compared to "profitable" or "not profitable".

To sum up, these are the questions that we aren't asking loudly enough: can ANY purely for-profit system ever deliver the goods to a reasonable majority of Americans, and if it can, what can we do to ensure its profitability and long term survival? Are employers genuinely no longer able to keep up with the rising costs? Is the institutional concept of the insurance company even trustworthy as a component of a system for delivering health care? Can cost reductions be enacted that could make our existing system viable again, or would that only stall for time, pushing the question back to become another generation's struggle? Is a national health care program even viable while we retain so many elements of our existing system? Would greater transparency in the political process allow us a window into how and where the misinformation and confusing numbers come

These are great questions, but the answers won't be found while waving guns outside of town halls. They won't be found by buying into panic-inducing rhetoric from the people on the receiving end of lobby and think tank dollars or by listening to shock jocks peddling anxiety and fear for a quick buck. If answers are ever going to be found, they will be found by careful examination of each issue, by weighing observable facts and by discussing them rationally. There is room for passion in this debate, but there is no room for hysteria or deliberate fraud. If you want answers, they are born of thought and reason, not through howled recriminations and shaking fists. It isn't as fun as shrieking incoherently and muddying the waters with references to totalitarians of bygone eras, but it's a hell of a lot more effective.

By Way Of Introduction

After some lengthy delays and false starts that bogged this process down, here I am at last, starting what should have begun last year, when many relevant issues were only beginning to unfold. Recreated here is the opening blog that was used on the original account, soon to be followed by more serious articles as time allows. Please enjoy.

It only seems appropriate to open this with both something in the way of a proper introduction, as well as a disclaimer. I write because I write, and acclaim is the least of my interests. We live in a complicated time, like many before us, and there are things that well deserve discussion and consideration, politics chief among them. We are fortunate enough to live in an era of unprecedented communication, where many can exchange thoughts and beliefs with relative freedom, and because of this, I choose to blog. Not so much because my opinion is better or worse than anyone elses, but because with so many hats in the ring, mine has just as much right to be there as any other.I might be no more than a white, male, middle-aged, blue collar worker with a penchant for writing and a passion for reading, but it isn't my background that matters as much as my desire to push questions into the forefront of people's minds. More questions, and better questions, ultimately lead to better answers, and in this difficult time many good questions go unasked, and thus unanswered. If I contribute but a single better question to the vast traffic of communication, then I have done as well as I could have hoped.

So, having said a little of myself but not too much, we move to the disclaimer, which is completely called for on a blog that will be dominated by thoughts and opinions on social and political problems.The articles that follow may be controversial, to one group or person or to another, but they are merely opinions, possibilities and notions, and in voicing them I exercise the same right I acknowledge and respect in others, including you. I am largely non-partisan, having grown cynical enough to place faith in almost no one involved in politics, and nothing has yet convinced me that I was wrong to adopt that cynicism. I reject political correctness, but not as an excuse to exercise deliberate acts of hate. I reject the idea that someone who differs in opinion from me is inherently bad, just because they disagree. I reject the notion that there are taboo subjects, because trouble brews in shadows, and turning a bright light to any topic strips it of its power to to sway us through fear. I reject censorship and the restriction of speech and expression, because they are weapons that steal from people of all parties and beliefs the power to speak their mind freely and participate in the governance of their nation.

I am a walking contradiction, a blend of left and right and moderate, conservative and liberal, yesterday and today and tomorrow, and really just a man who thinks too much for his own good. Please don't take any of this too personally, and remember that your opinions have the same value to me, even if I disagree with them. To paraphrase Voltaire, "I may not believe in what you say, but I will defend unto my death your right to say it."