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I am suffering from brain block. My brain block started with the desire to write something super comprehensive and well-informed about health care. But that isn’t possible right now.
So instead, here is what I’ve figured out so far: a) I support a public plan (But it does matter what the details are. There are a lot of ways a public plan could go wrong and then it would be worse to have one than not to have one) for exactly the reason its enemies are against it. A public plan could get us closer to single payer.
Unfortunately, a public plan is probably off the table, politically speaking. Single Payer (my true ideal) is definitely off the table. (If single payer scares you, consider that–as others have pointed out–Medicare, for all its warts and it has them!, is a public plan where the government is the single payer. Consider where our elderly population was before Medicare. Do you want to rewind? I don’t.)
So–
Despite current political realities (single payer and public plan being on hold), I still believe we must do something about health care and soon. But if the number crunchers who studied the plan currently on the table in Congress are trustworthy, and there really is no cost savings (!) from the plan they’ve been considering, then we can’t go with that plan. No cost savings = disaster. We can’t move forward until we figure out how to pay for this. We need to cut health care costs and find additional sources of revenue to pay for it.
I’m not sure what we should do instead of what is currently on the table given that there is no public appetite for the best fixes. The health care coops might work–depending on the details, of course.
So, I am still reading and thinking about health care and probably will be for a long time.
Health Care Reading Recommendation: I found the material on health care at FreshThinking.org super helpful. I especially appreciated their links to the articles on Why Tie Health Insurance to a Job? in the Wall Street Journal and the article in the Washington Post on the 5 Myths about our Ailing Health Care System.
It is time for every American citizen to tune in to the healthcare debate. Inform yourself and then seek to inform and persuade others. The issue is huge and the outcome is unclear. Millions of our neighbors have no health insurance. Healthcare costs rise every year and there is no end in sight. Bankruptcy through medical catastrophe is commonplace. The rising cost of care means that fewer people get jobs and fewer people with jobs get insurance.
President Obama is right. We cannot do nothing. As scary as change is, and as problem-fraught as some of the proposals for change are, we simply cannot stay with the status quo. We have an obligation to those with whom we share our soil, and if we are wise, even those of us who now have good insurance realize that our own security hangs in the balance.
Unfortunately, fixing our broken system will not be easy. It certainly isn’t as easy as electing the right person. It doesn’t matter if that person is Obama or McCain or Max Baucus or Mitt Romney, or fill in any name you like. Providing healthcare for those who need it is a difficult and complex problem. Solutions will not be cheap, they will not come without sacrifice, and they will not always be comfortable.
The progress medicine has made in the past fifty years is miraculous. Consider heart surgery. Consider the cholesterol-lowering (and very expensive) statin drugs. But getting heart surgery or getting statins [now] costs a lot more than visiting a doctor’s office and hearing of your (quite limited) treatment options [then]. Medicine costs more than it has ever cost because it can do more than it ever could. That doesn’t mean that we can afford to pay for everything we know how to do. That’s the ugly truth. Every compassionate soul would like to see statins in the pocket of everyone who needs them and a transplanted heart in the chest of everyone who requires one. But we can’t pay for it all.
Realistically, what we can pay for is excellent preventative and routine care. We can ensure that non-emergency care is not handled in the emergency room. We can ensure that doctors make an excellent (yet not extreme) wage to ensure that we all have access to a good doctor when we need one. We can pay for medical school for those willing to be general practitioners and for those willing to serve in underserved communities. We can mandate evidence-based medicine and offer the drugs and other types of care that have proven to be cost effective.
We will have to have a two-tier system. Universal healthcare will necessarily be basic. Those with greater resources will have to be allowed to pursue greater care. We can tax them to help support those who are less fortunate. We can also tax the wealthy and healthy. But when President Obama claims that healthcare for all Americans can come without sacrifice to most of us, we need to laugh. Providing for our neighbors and ourselves will cost us, but we should do it anyway. Remember, doing nothing guarantees disaster. With so much wrong, we can surely hope for something better.
As I have followed coverage of Iran’s swinging political pendulum over the past couple of weeks, I have been thinking about the other moments during which I have felt tremendous optimism and terrible pessimism regarding world events. Ever an observer, I can’t predict or change outcomes. But this doesn’t keep me from hope and fear, doubt and anticipation.
I was a child in a world where many thought the Iron Curtain was impenetrable. Yes, it was simplistic, but for many there was East Germany and the USSR and shoe pounding dictators on one side, and freedom and the USA and people who wanted good things for the world on the other.
Then, during the fall of 1989, the wall came down and the world changed. I had the opportunity to live in Leipzig (former East Germany not too far from Berlin) during the summer of 1994. It was exciting to hear how the movement that preceded the fall of the wall had grown, meeting at the very church where we enjoyed such wonderful organ concerts. However, most of the former DDR residents I met hadn’t necessarily been campaigners for freedom (perhaps most of the campaigners lived in the West by then?). In fact, I grew to realize that they were part of the “them” that I had always opposed to my “us.” But the people I knew were ordinary. Not evil, not seeking world nuclear annihilation, just trying to figure out how to live a happy life under the constraints that they had–as we all do.
Of course, 1989 was also the year of the Tiananmen Square protests in China. Wikipedia says one million people were on the square. I grew up in a small town. A football stadium’s worth of people still impresses me. I can’t imagine what it would be like to stand with a million others calling for freedom. In any case, in China, a million was not enough. The protesters were dispersed–there were injuries and deaths. The desired change didn’t come.
During the past week, there have been times when hundreds of thousands of protesters were on the streets of Iran. I admit that I do not have a nuanced enough view of this area of the world to understand completely what is going on. I do know that as with the world before the wall fell, it is too easy to simplify, to point fingers at good guys and bad guys, good parts of the world and bad. On the other hand, it is true that some guys are good and some are bad. It was a good thing when the wall came down. It was a good thing when East Germany’s secret state police were disbanded and their secrets weren’t secret any more. It was a bad thing when the East German people didn’t have the freedom to travel.
From what I understand, Mir Hussein Moussavi, the opposition candidate who allegedly lost the election, isn’t the pro-American pacifist we dream of, the one who would completely end our nuclear Iran fears. Until recently, he wasn’t part of the opposition, he was part of the establishment.
On the other hand, the enemy of my enemy is my friend. Unfortunately, Ahmadinejad has worked hard to put himself in the enemy category. And when I see the people, especially the women, chanting for Moussavi, I want to join them. I want to wear green and stand in the street and chant, Mou-sa-vee, Mou-sa-vee, Mou-sa-vee. I want to be brave and stand up to the Basij, the robocops, and the tear gas. I want to dare them to spill my blood and see whether it makes their grip on power stronger or weaker. Perhaps it is easier to feel these desires in full force from the comfort of my computer chair. I admire those who feel it when they see the riot police out in force.
Moussavi announced this past week that he was ready to become a martyr. I am not sure whether he is worth dying or being beaten and teargassed for, but the freedom that so many of these Iranians desire probably is.
Recently, we saw Valkyrie. I liked it. Is it possible to watch that movie and not desire to be a von Stauffenberg (the German officer plotting to assassinate Hitler) in one’s own life? To have that courage, that integrity, and to be willing to sacrifice everything for what one believes? To have that sort of clarity and confidence that what one believes is worth the sacrifice?
Anyway, back to Tehran. Or more accurately, to my computer, surfing to see the latest in Tehran. Again, an observer. Pessimism and fear. Hope and anticipation. Waiting, watching, hoping.
I am relieved that Mr. Daschle withdrew his name for consideration as Health and Human Services Cabinet Secretary. I don’t know if some of the things that others have said about him are true–that he’s a decent person, that it was an honest mistake, that he was the best person for the job, or that he’s about the only person for the job. I do know that his nomination, considered in tandem with the other nominations (principally Holder and Geithner), was starting to make me nervous.
I woke up this morning with that feeling of waking from a dream. The dim memory of something wonderful fading, a too bright sunlight arresting my reverie and calling me to the reality of the day. What happened? Was it real? Is it over? Will it last?
Oh, yes. Barack Obama was inaugurated as our 44th president yesterday. Four years ago, I heard his voice for the first time; it was exciting, but he was an unknown. Two years later he announced his candidacy; he was promising, but was he prepared? Yesterday he became my president. Oddly, I find that my misgivings related to his lack of experience have dropped away. After two years of watching him, my confidence in his ability to handle himself and to represent me has grown. My trust in his capacities is signficant. And yet—will his capacities be sufficient? Am I right about who he is and how he will behave?
This was originally meant to be part of my Preparing for the Inauguration post, but it seemed distracting so I moved it here. I thought about deleting it, but my blog was on hiatus during the general election, and my earlier political posts didn’t reflect the later shift in my views. I wanted to go on the record, so here I go:
I voted for Obama. Of course I have reservations about him. I would have much rather voted for someone who shared my views on abortion (pro-life), and Supreme Court judges (I thought John Roberts was an ideal nominee, Obama didn’t). I would have preferred someone who didn’t show such an obvious anti-corporate bias. Additionally, I worry that Obama’s views on free trade will take us backwards. However, the ideal candidate is never available and I saw a lot about Obama to admire and appreciate: I look forward to having a president who is an inspirational and eloquent speaker. As the (several greats) granddaughter both of those who opposed slavery and those who held slaves, I know my legacy. I am so thankful for the opportunity to support an African American president, someone who can tell our youth that what they become is up to them. Also, Obama gives us the chance to start over with the world, and we desperately need that. I hope that his peace-oriented approach, his openness and desire for dialogue will bear fruit.
I spoke with Amelia’s principal today. He told me that Amelia will be in the class of the teacher who we had requested. That is a huge relief. I actually had a nightmare this week about which school Amelia would be going to. The situation is that I have heard such negative things about one of the other possible teachers that I actually considered putting her at another school for a year in order to avoid that classroom.
I feel a bit guilty about being successful in my class placement request. I would prefer not to make a request at all. It seems inegalitarian. What about the kids whose parents are tuned out? On the other hand it doesn’t seem like the fact that some parents are tuned out is a good reason for me to tune out–not to actively seek what I believe to be best for my daughter. Read more
I waited for over an hour. Democratic privileges.
I have long been interested in the presidential campaign. As more primaries and caucuses occur, and as candidates drop out and the race narrows, I get even more interested. It seems to me that it really does make a difference who our president is. I do believe that where we are today is different than where we would have been with a different president–both for good and for ill.
One reason many people do not vote is because they believe all of the candidates are deeply flawed. I wish more satisfactory candidates were available. However, I think this isn’t a reason for not being involved, because flawed as they are, the candidates do offer very different choices. Read more
I am thankful that my sister was willing to come and help with Amelia’s Kool Klay project. (BTW: Koolaid does color playdough pleasingly, but the scent is not as strong as would be desirable). Her help made all the difference. It is funny to see how amazing Amelia thinks Sis is. I guess that’s related to the fact that she got all the talents I lack. Of course, as she explained to Amelia, she can sew because she took lessons. She can do origami because she works at it. She kneads well, because she has made hundreds of loaves of bread, etc. I know that I need to adopt more of a “You have the talent for it because you practice it mentality,” but I’m just not there yet. Notice that I heft 18 lb. Kate around all day. Yet, Sis, who does nothing of the sort, has unquestionably stronger arms. Practice doesn’t fix everything!
I am thankful that I am not the only person with “issues.” : ) I find it comforting to realize that my family of origin family members struggle with many of the same flaws that I do. It is comforting, because I realize that it is not just me, eccentric and alone, but somehow some of these things are just hardwired in. Now this isn’t to say that I have reason not to attempt change. Change would make me a calmer, happier person. So, I want change. But it is to realize that just as some are born as alcoholics, others are born as meddling OC control freaks (well, born, or maybe raised that way so that when they are 35, they struggle to see other ways). If I work, I can recover. ButI still I like knowing that it’s not just some weird evil awful eccentricity about me. I come by it quite naturally. Also, I find it helpful to spend time with similarly struggling family members, because it’s as though they hold up a mirror to myself and I can see better what it is I need to fix.
I hope all of this makes sense. I’m not trying to disparage family members, I’m trying to say that they make me feel that I’m not alone, and help me recognize how I still need to change.
I want to say more about how I’m thankful for Pdad and I’m thankful for being able to reason through things–we’ve been going over the voucher issue for hours–as things stand, our votes will cancel. It’s frustrating, but it’s nice too. It’s seldom the case that you get to follow out such an extended argument. I’ve enjoyed it. But I do wish I could sway him. I don’t like people I love believing things I think are wrong! I still don’t believe we’ve gotten down to the agree-to-disagree bottom of it. I still have more reasons, not just some inexplicable preference for my position.
Well, Kate is stirring, and it’s 3 a.m., so I have to go.