The Right to Choose

Never Again(image found here)

So there’s all of this fuss right now about Todd Akin’s asinine comment about how if a woman were ‘legitimately raped’ (vs. what, date raped? Raped by her husband? Asshat.), her body would put up its defenses, making pregnancy impossible, and thus, no need to feel badly for the poor woman who might be coming in for an abortion, because, clearly, she is a slut and needs to honor the life of the unborn child before her own. She was not raped. At least, not legitimately. This is a strawman that covers the main issue. The main issue is, can I get an abortion if I want one.

Make no mistake…that is the issue at hand. And we need to stop tiptoeing around it. We should stop saying, “If a woman gets pregnant because her birth control fails her, or she wasn’t using any, it’s all her fault, and she therefore doesn’t have the right to decide whether to have a baby or not, which she will then either have to give up for adoption or raise herself …because abortion is murder of an innocent life.  HOWEVER, if she had no say in the matter, if she were raped, then suddenly, it’s NOT the taking of an innocent life.” That’s bull. I say, make up your mind, and ignore idiots like Akin, who want to pull us into these side issues.

Either a woman has the right to decide to continue her pregnancy, no matter how it was conceived, or she doesn’t. For those who say she doesn’t, for those who see that abortion as murder plain and simple, then I don’t see why there should be exceptions. All in or all out. Me, I’m all out. I do admit, sadly, that abortion is the end of a life. Murder if you want to use that term. It’s just that we have to decide…whose rights are paramount?  Those of the unborn child, or those of the pregnant mother. To a woman who is faced with an unintended pregnancy, I cannot say, “Too bad, you had sex, have a baby. Too bad if you aren’t ready. Too bad if you have 5 children already. Too bad if the father is a guy you DO.NOT.WANT. in your life forever.” There are so many different reasons that people go through this. None of them are easy and pretty. In a perfect world, these women would be able to transfer their babies over into the body of a woman who wants one. But they’re not. I honestly do not believe that anyone should have to go through pregnancy if they don’t want to. It’s horrid. Or at least, it’s difficult.

Anyway, to get back to the meat of it…we have to decide…are we pro-choice, or not? If so, then it doesn’t matter how the baby got there. If not, then it doesn’t matter how the baby got there. Either way, rape isn’t the issue. It’s ugly and horrid and monstrous, and rapists should go to Hell (said the atheist who doesn’t believe in Hell), but it’s not a factor in abortion rights. Or at least, it shouldn’t be.

Friday Randomness ~ 11/11/11

First off, let’s take a moment to thank all of the Veterans this Veterans’ Day, for their patriotism and service.  There is a sad, lovely poem written during the First World War, by Lieutenant Colonel John McCrae, a Canadian soldier and surgeon, after he witnessed the death of a friend.  Lieutenant Colonel McCrae died of pneumonia during the war, in 1918.

“In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie,
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.”

The picture is my Great Grandfather, Percy Herndon, in his WWI uniform.  This is before he married my Great-Grandmother, and the woman in the picture is his sister, my Great Aunt Julia, for whom I was named.  Aunt Julia died before I was born, but she was a large and important presence in my mother’s life.  My Great-Grandfather served in Russia, and came home safely.  He married my great grandmother, and they had 5 children, 3 of whom lived to adulthood, and all 3 of whom are still alive today.  (My Grandma and Great Aunt, who live together in Stockton, and my other Great Aunt, who lives a bit north of Sacramento.) I didn’t know him growing up, as he died right after we moved back to California from Alaska. But I know him through stories, and I wish I had known him better.

Next is Happy Birthday to Little One, my friend Chrissy’s daughter, who is 3 years old today.  Little One was born 3 months premature, and her first few months outside of her mommy were harrowing indeed.   But now she’s a gorgeous, healthy, strong, opinionated, sweet little girl.   I hope you’re having a great celebration, Chrissy, John, and Little One!

Now I wonder if any of you have any tips for getting a stubborn old dog to take her medicine?  Poor Gen is on so many pills now, and she hates them.  HATES them.  Two days this week, she took them easily, just wrapped in salami.  I felt like I had won the lottery, it was so easy.  Seriously, I should have gone and bought a ticket.  Yesterday she refused, and I had to shove them down her throat, which I’ve done with cats before, but Gen is bigger and stronger than a cat.  It worked in the morning, but when it came time for her evening pill, she clamped her jaw shut on my finger.  She’s been bragging about how fierce she is, that she bit Medium Boss, but really, she was just trying to not take her pill, and she didn’t even draw blood.  Not as fierce as she likes to pretend.  So Maya and I figured out that if we packed the pill in grated cheese, and gave her a treat RIGHT AFTER, she would eat the pill and not spit it out.  That worked last night, and again this morning, but our experience thus far has been that she’ll take the pills well once or twice, and then get a taste of one (one particularly is VERY bitter), and refuse that method from then on.  So I’ve tried mixing the powdered pill into sugar water, which she liked a little bit but not enough.  Peanut butter, cream cheese, salami, all worked for a little while, but not consistently.   Any sure fire tips out there?

Tomorrow I’m going to get my hair done.  Always an adventure, since I go to a beauty school to save money.  They do a decent job, but sometimes my hair comes home a different color than I intended.  That’s happened at the expensive salon too, come to think of it, so whatever.

The whole Penn State scandal got me pretty riled up.  I think everyone involved should have been fired, and I cannot for the life of me understand the reaction of the students who rioted in protest.  These men think they’re above the law, and that their football team and department are more important than the lives of disadvantaged boys.  It’s disgusting.  And how much more damage have they done to the department and school than if they had called the police when they first learned of the crimes?  Ugh.  It makes me sick.  Some people need a lesson in ethics.

Thanks to Nance for the link to this article, explaining the anger of Occupy Wall Street.  The problem isn’t that the poor and middle class hate the rich, or are envious.  The problem is that we’re pissed off at the fact that the Wall Street folks gamed the system, they cheated, and they don’t think there’s a darn thing wrong with that.  They think they were smart to think of it, and they’re busy planning how to do it again. And again.  And as long as people make money at it, if their 401(k) goes up and the value of their house rises, they don’t care that it’s not sustainable.  That’s the problem, and it’s not just Wall Street.  Some of it is Main Street as well.  We need to get angry and stop trusting these a-holes.  That’s what the Occupy movement is about.

I guess that’s it.  I could start in on what an idiot I think Herman Cain is, and how I wish he’s just go away, and that I think he’s a lech and he still thinks he can get away with it, but I’ll leave that for another day.

Happy Friday, everyone.

How Progressive Taxation works

(click the tax tables to enlarge)

I’ve been hearing a lot about a proposal to simplify the tax code lately, using a flat tax, which would tax everyone at the same flat rate. Cain says 9%, and would add a Federal sales tax to the mix. Perry says 20%, but doesn’t mention a sales tax. The idea is that we should all be taxed the same rate, because it’s more fair, and that having one tax rate would simplify things. Well, before you fire your accountant (job killers!), remember that it’s not the withholding tables that make things complicated. It’s the exemptions and deductions and credits. So really, in order to eliminate confusion, the government could eliminate all of these deductions and credits, and treat us all the same in that way. Own or rent, married or single, kids or no kids, business expenses or not, health care expenses or not, all of that just goes away. They could then adjust the tables so that people’s taxes didn’t double because they just lost all of their deductions.

It occurred to me that I don’t think many people understand how taxation really works. I’ve been working in payroll for awhile now, so I thought I’d give you a quick tutorial. See that tax table up there? Those are the Federal withholding tables for 2011.  And they’re progressive, meaning that as you earn more money, you pay a higher percentage.  But the thing that’s confusing is that many people think (as I used to) that if you earn the amount in one bracket, you’re taxed on that bracket, and that’s it.  Not true.  If you look at the Single side there, you see that for people earning under $2,100 a year, no taxes are withheld.  But really, none of us pay taxes on that first $2,100.  So if you earn $75,000 a year, you pay zero on the first $2,100, 10% on the next $8,500 ($10,600 – $2,100), 15% on the next $26,000 ($36,600 – $10,600), and 25% on the last $38,400 (your $75,000 salary – $36,600).  And everyone else is paying those same rates, within those same brackets, until they get to the top bracket.  For those who earn $400,000, they pay all of the brackets…and only pay the 35% on the amount OVER $381,250.  The $110,016.50 that you see is the culmination of all of those other tax rates, building up to the top rate of 35%.  If they were truly taxed at 35%, they would be paying $133,437.50 on that $381,250.

In other words, Bill Gates pays the same income tax as I do, and the same amount you do, on the same amount of income.  He pays more on the amounts he earns above what we make.

Another thing to think about is that while the top earners pay a higher percentage of their wages in income taxes, low and middle income earners pay a much higher percentage of their wages on sales tax, property tax, and Social Security taxes.

Sales tax, because they spend a higher percentage of their income than the top wage earners, who have more available for savings, 401(k), etc.  If I earn $1,000 a week, it’s more likely that it will all get eaten up by medical insurance, rent or mortgage, food, gas, clothing, and so on, than someone who earns $8,000 a week.

Property tax is the same..it’s a set amount, based on the cost of your house, not on your income.  So if I make less, it takes a bigger percentage of income to pay the bill.

Social Security tax is a flat tax with a wage limit.  For 2012, the wage base will be $110,100.  Which means that for the first $110,100 of income, everyone pays the same flat rate.  But the tax stops at $110,100.  For the majority of wage earners, we pay that percentage on 100% of our wages.  It is only those making over $110,100 that pay a lower percentage.  That lucky person making $400,000 a year pays Social Security taxes on 27.525% of their income.  And the people who make the very most in this country, the people making millions, or (gasp) billions a year?  They pay almost nothing towards Social Security.  One could rightly argue that those at the top won’t get as much at the end, because they will have put in far more than they ever have a chance of withdrawing.  To that I say, we need a safety net in this country.  The problem of poverty in the aged has gone down markedly since the implementation of Social Security.  It seems a small price to pay for everyone to pay this tax on 100% of their wages, and just accept it as a cost of living in our society.

So, my answers to the complicated tax regulations?  Get rid of exemptions and deductions.  Then it’s simple.  Add more tax brackets at higher levels, so that a surgeon making $500,000 a year isn’t taxed at the same rate as a CEO making $2,000,000 a year.  And eliminate the wage base limits on Social Security and Medicare.

Body Image for Girls

Starshine wrote a post a little while ago about the hyper-sexualized advertising she sees at the local mall, and brought up her concerns about raising her sons to be respectful of women and not objectify them, when they are surrounded by these images. She brings up a good point, and it’s important to raise our boys to understand that this is just advertising, and that the majority of women and girls do not go around in their underwear, with ‘come get me’ looks permanently on their faces, bent into unnatural positions. It’s a fantasy, and not even one that’s very interesting or original.

As the mother of a daughter, my mind travels to what these ads teach our girls. There is SO much focus on how a girl looks, as if that’s the only important thing a girl can do. Look good. And as if the only way a girl can look good is to wear revealing clothes and be available to guys all the time. It’s important to teach our children, boys and girls, that they have a lot to offer the world, a lot more than their looks and charms. For some reason my mind goes to a pretty innocent movie, “Back to the Future”, where Marty is telling Doc Brown that he wants to get back to 1985 because his girlfriend is there. Doc’s first words? “Is she pretty?” And she is, and she isn’t much more, since the story isn’t about her or their relationship, so all the actress has to work with is being pretty. But what about the plain girls in the world? Are they not deserving of love and attention, of respect and acclaim? What if he had had an amazingly caring and smart girlfriend, or a talented and funny girlfriend, but one who wasn’t society’s idea of ‘pretty’. What then?  Shouldn’t he still be interested in getting back to her, and to his life in general?

And what of the constant pressure to have a ‘perfect body’?  What does that do to a girl’s self esteem?  How much energy and time are lost by girls obsessing about how their thighs look?  I remember two separate articles on Yahoo that covered this issue.

Running in Skorts

One was a girls’ track team in Washington DC, where the coach noticed that the team members seemed to be spending a lot of effort obsessing about how they look.  Since high school is the age when women’s bodies start changing, and some girls are more likely to get cellulite than others (even runners), I’m sure they were worried about their butts and thighs, and did they look OK.  His solution was to have a runners skort designed that would allow a full range of motion for the girls, and yet still cover them up enough that they felt more comfortable and could focus on their running. The result?  A marked improvement in their running times.  They’re kicking butt.

Cheerleaders

The second story, from last fall, was about cheerleaders in Connecticut, who were embarrassed because they couldn’t raise their arms without their midriffs showing while wearing their uniforms.  Perhaps some of the girls were fine with letting it all hang out, but others were not, and didn’t want to feel self conscious when standing up to do their cheers.  There’s a perception out there that high school girls are hyper sexualized and want to wear sexy clothes, tight sweaters and short skirts, and certainly, that is how some girls explore this age and their sexuality.  But not all girls feel this way, and putting them in sexy outfits as cheerleaders makes things more difficult for them.  The solution was to buy them body suits to wear under their uniforms.   I hope they have new uniforms this year, because the last thing you want to add to your uniform on a hot fall afternoon is a black body suit.  Maybe they don’t have hot weather in Connecticut at the beginning of the football season, but I remember last year when Maya was cheering, there were some games that were up in the mid to high 90s.

The answer, I suspect, is to treat children like children.  I know that a teenager is not the same as a child, and yet, a 17 year old senior is not the same as a 14 year old freshman in so many ways.  But if we can just understand that kids mature and grow up at different rates, and that not all of us want our butts or tummies hanging out while we’re trying to perform a sport like cheer or running races or whatever, then maybe we can stop pushing our daughters and sons into becoming adults far before they’re ready.  And we need to understand the pressure that this idea of a perfect body is doing to our children.  It is almost unattainable, and the struggle is heart wrenching.   And hell, even kids who are born with that ‘perfect body’  have their problems in the world as well.  No one has a perfect life.  So this pressure, every time you turn around, to have a diet plan, count your steps and calories, watch the fat content in your milk, and try to figure out how many minutes of cardio you have to do to to counteract the sandwich you had for lunch.  It’s exhausting, a waste of time, and horrific.  I’m not saying that all of the ads at the mall have to be prudish, or that girls can’t wear a short skirt if they want to.  But I wish that there were more ads at the mall and in magazines that didn’t show under aged women waiting breathlessly for the opportunity to have sex, and that uniforms didn’t make girls feel uncomfortable about the shape of their legs or their stomachs.

Who Put the Labor in Labor Day?

We did, that’s who.

When I think of labor day, my mind first thinks of the end of summer…the crisp fall weather on the horizon, the cool weather clothes, school starting up again, the return of the good TV shows…

Then there are the Labor Day celebrations…one last bbq of summer, maybe a trip to the beach, the lake, or the shore…

For some people it is a chance to get caught up with some chores around the house, to enjoy a 3-day weekend by sleeping in one extra day, maybe see some friends.

I agree with all of these things. Not a thing wrong with any of them. But at the same time, it’s a good time to remember what the heck Labor Day is…unlike our other holidays, like Veterans Day or Memorial Day, it doesn’t commemorate war or those who fought for our freedoms. Unlike Christmas, Hanukkah, Diwali, and Easter, it doesn’t commemorate any religious significance. Unlike Thanksgiving, it doesn’t commemorate a coming together or the fall harvest, or the brief friendship between the pilgrims and the Native Americans.

Instead, Labor Day commemorates us…it commemorates the worker. People who get up every day and go to work, jobs that we love as well as jobs that we hate. Jobs that we do so that we can gain fulfillment, to make the world a better place, to provide a needed service, to simply pay the bills.

Labor day was created by the labor movement, and is dedicated to you and me, American workers. I know that many people have issues with the labor movement, do not like unions and what they represent. They claim that unions are corrupt and do very little to benefit workers, or that they make doing business too expensive for the employer. I would beg you to dig a little deeper, and look at what labor unions have given our country:

  • Eight-Hour Work Day
  • Five-Day Workweek
  • Health Insurance
  • Good Pensions
  • Paid Sick Leave
  • Fair Treatment for Women, People of Color and Workers with Disabilities
  • Higher Wages
  • Overtime Pay
  • Job Safety
  • Paid Holidays
  • Job Security
  • Severance Pay
  • Paid Vacations
  • Family and Medical Leave

So even if you have never belonged to a union in your life (I haven’t), let’s please stop for a moment this weekend, and thank the unions for what they have given to our country. Also, take a moment to recognize the strength and character of the American worker, upon whose back our economy and democracy rests.

And if, looking at that list, you see some items that don’t apply to you, like a 40-hour work week, a pension, or fair treatment, remember that the labor movement is made up of people who have fought for these things, things that don’t come easily, things that can easily be taken away from us. Fight for these things. Fight for what you believe in, and to make our country stronger.

Happy Labor Day, everyone!

*Repeat…originally posted on my blog September 2, 2006, reposted in September of 2008.

Revolution in Egypt!

Egyptian Celebrations
Like so many, we’ve been watching the events in Egypt unfold these last few weeks. What the future holds for the region, it’s too soon to say. For now, I say, we all celebrate the power of the people to bring down a dictator, and the hope of more freedom and democracy in the Middle East. Look at the joy on the faces in this picture, cribbed from the AP.

And, on a more personal level, and in honor of the amazing revolution currently occurring in Egypt, (and the overthrow of the dictator in Tunisia a few weeks ago) I decided to change our dinner plans tonight from burgers and fries, to spiced burgers and couscous, from Real Simple magazine. Amazing. Truly amazing events taking place. To the people of Egypt, we stand with you! Celebrate!

Spiced Mini Burgers

Spiced Mini Burgers with Couscous Salad
Ingredients

  • 1 10-ounce box couscous (1 1/2 cups)
  • 1 pound ground beef
  • 1 1/2 teaspoons ground cumin
  • 1 1/2 tablespoons dried oregano
  • kosher salt and black pepper
  • 4 tablespoons extra-virgin olive oil
  • 6 scallions, sliced
  • 4 plum tomatoes, quartered
  • 1 seedless cucumber, cut into half-moons
  • 3 tablespoons fresh lemon juice
  • 1 8-ounce container hummus (optional)

Directions

  1. Place the couscous in a large bowl and pour 1½ cups hot tap water over the top. Cover and let stand for 5 minutes; fluff with a fork.
  2. Form the beef into 12 small ½-inch-thick patties. Sprinkle with the cumin, oregano, 1 teaspoon salt, and ¼ teaspoon pepper.
  3. Heat 1 tablespoon of the oil in a large skillet over medium heat. Add the patties and cook to the desired doneness, 4 minutes per side for medium.
  4. Toss the couscous with the scallions, tomatoes, cucumber, lemon juice, remaining oil, 1¼ teaspoons salt, and ¼ teaspoon pepper.
  5. Serve with the burgers and hummus, if using.

Tip

Give this dinner a Mediterranean accent by using ground lamb for the patties and stirring ¼ cup crumbled Feta into the couscous salad.

Three Cups of Tea

Three Cups of Tea

A small group of thoughtful people could change the world. Indeed, it’s the only thing that ever has.  ~ Margaret Mead

In 1993 Greg Mortenson was the exhausted survivor of a failed attempt to ascend K2, an American climbing bum wandering emaciated and lost through Pakistan’s Karakoram Himalaya. After he was taken in and nursed back to health by the people of an impoverished Pakistani village, Mortenson promised to return one day and build them a school. From that rash, earnest promise grew one of the most incredible humanitarian campaigns of our time — Greg Mortenson’s one-man mission to counteract extremism by building schools, especially for girls, throughout the breeding ground of the Taliban.

Award-winning journalist David Oliver Relin has collaborated on this spellbinding account of Mortenson’s incredible accomplishments in a region where Americans are often feared and hated. In pursuit of his goal, Mortenson has survived kidnapping, fatwas issued by enraged mullahs, repeated death threats, and wrenching separations from his wife and children. But his success speaks for itself. At last count, his Central Asia Institute had built fifty-five schools.  Three Cups of Tea is at once an unforgettable adventure and the inspiring true story of how one man really is changing the world — one school at a time.

(From the publisher, cribbed from the Powell’s Books page)

I received this book twice for Christmas in 2007, once from my friend Neva, who had Greg Mortenson as a keynote speaker at a conference on Epilepsy (she is the Executive Director of the Epilepsy Foundation of Northern California.  His sister had Epilepsy.), and once from my step-mother.  I don’t remember her connection to the story…if it was just that she read it and loved it, or if there was more.  That was sickmas, and memories are dim.  Anyway, receiving it twice, I figured I should read it, though non-fiction normally isn’t my bag, baby.

I’m not sure how much of the writing is Relin’s, and how much is Mortenson’s, but I found it clunky and sometimes difficult to get through.  But the story is such a hopeful one of doggedness and faith in humanity, that you forgive the writing and want to find out what is coming next.  I mean, you know to an extent, but as the story goes from the mid-90s, with Mortenson alone and living in his car, selling his possessions to save money for that first school, to September 11th and beyond, I found I wanted to know how he got from point A to point Z, and the steps in between.  While I don’t recommend this book for the writing necessarily, I highly recommend it for the story, and for the hope it puts in your heart about what is possible, and what a difference one person can make in the lives of others.

It’s also really interesting to read about Mortenson’s understanding of the sometimes extreme Muslim culture of the Pakistan/Afghanistan border, how he understands these people far more than most westerners.  He sees the mistakes we are making in our handling of the wars in the region, and has some interesting ideas on solutions.  This is the part of the book that most gripped me, so I’m interested to read the follow-up book, Stones Into Schools.

Greg Mortenson is the founder of the nonprofit organization, Central Asia Institute, which funds the building of the schools.  He also founded Pennies for Peace, which is a charity allowing children to donate their pennies to help build schools for schools in Pakistan and Afghanistan.

Here’s a very interesting interview he did for Bill Moyers Journal.   It’s not short, but it’s worth viewing.  Especially his views on why it is especially important toward bringing peace to the world, that girls receive an education.  Rather than fighting terrorism, his view is to promote peace.

Strange Fruit


Strange Fruit

Southern trees bear strange fruit,
Blood on the leaves and blood at the root,
Black body swinging in the Southern breeze,
Strange fruit hanging from the poplar trees.

Pastoral scene of the gallant South,
The bulging eyes and the twisted mouth,
Scent of magnolia sweet and fresh,
Then the sudden smell of burning flesh!

Here is fruit for the crows to pluck,
For the rain to gather, for the wind to suck,
For the sun to rot, for the trees to drop,
Here is a strange and bitter crop.

I had never heard this song before, nor did I know the story behind it. I was listening to ‘Talk of the Nation‘ on the radio today, and they were talking about Billie Holiday, amongst other things, and brought up this song. It’s chilling.

You can read about the history of the song, and its inspiration in the famous picture of Thomas Shipp and Abram Smith, two black men lynched in Marion, IN, in 1930.

Health Care food for thought…

I have a Facebook friend who I sort of knew via High School.  He was a really great guy, and we had several friends in common, but he was a few years ahead of me, and he graduated before I started HS.  Anyway, through common friends, we became Facebook buddies.  He’s been talking once in awhile about the Health Care issue, one that he clearly feels passionately about, as do many people on both sides of the argument.  I’ve made my admittedly emotional points already, but since A doesn’t have a blog, I thought I’d let him guest post here.  He sent me several emails full of his thoughts on the matter, and I’m copying and pasting them here for your thoughtful consideration.  There are quite a few links included, and I recommend clicking them if you have time.  It’s a serious issue that deserves thoughtful consideration, on both sides. So, here’s guest blogger A, who has asked to remain anonymous because he doesn’t blog:

Recently I had a brief conversation with someone in which I mentioned the US’s poor health care system, and he asked “if our system is so bad, why do people from all over the world come here for treatment?” It’s a fair question. His implication was that we indeed do have an excellent system. He’s a smart, well-educated guy and his reply mirrors what I thought for quite a while. I think this is a hugely important topic for our nation, so I’m sharing this with you. My earnest desire is to not spread misinformation so if you see any factual errors please don’t hesitate to let me know. Also, I know this is a long email but please click the various hyperlinks I’ve included. Even if you don’t read the full articles, at least briefly skim them.

I want to address 3 questions:

1.      How does American health care stack up when compared to other nations?

2.      Are our costs in line with other nations?

3.      Can the problem, if one exists, be solved by mandating insurance for everyone?

Let me start with an important distinction: I’m not talking about the health care you can get here, which is indisputably the best in the world, I’m talking about our national health care system in which an increasing percentage of the population has no coverage at all, costs as a percentage of GDP are the highest in the world, insurance costs are increasing at an unsustainable average of 7% a year, and people with pre-existing conditions like diabetes have no chance of getting insurance if they leave their job. We’re also the only major nation in which you can be bankrupted by a health crisis. Out of the 1.5 million bankruptcies in the US expected in the US this year, more than 60% will be caused by health care costs. Out of those 900K medical-driven bankruptcies, 78% of them will have insurance but have coverage gaps. (Scary!) In other advanced nations no one goes bankrupt due to medical costs, but it happens regularly in the world’s richest nation.

So how does America’s system stack up overall? Measuring all the aspects of a nation’s health care system is complex. Fortunately there are think tanks, NGOs and academic studies that analyze and report on this issue. For example, in 2000 when the World Health Organization ranked national health systems the US was #37, just below Costa Rica, and just above Slovenia. In 2008 the Commonwealth Fund sponsored a study that analyzed 37 metrics of national health care in 19 countries, the US came in dead last. I’ll be happy to read any study you can point me to that ranks the US as having the best health care system in the world. I certainly haven’t been able to find one. The primary reason we come out so low on these studies is that other nations have figured out how to provide affordable universal coverage. In our country, an increasingly large percentage of the population has no health insurance and that drags all the numbers down. For example, our infant mortality rate is the nearly the worst of any industrialized nation (we beat Latvia though!) primarily because in many uninsured families the mother gets no pre-birth care or education.

Perhaps you have insurance and you’re thinking “I feel bad for the folks who don’t have coverage but I don’t want to change the system because I like my insurance.” The problem here is that the costs of health insurance continue to climb faster than inflation. Your employer may cover you now, but the increasing costs are not sustainable. In 1987 70% of workers had employer-provided health insurance. By 2007 that number had fallen to 62%. Not a good trend. This is an issue everyone should be concerned about, currently insured or not.

The bottom line is we spend the most (not just a lot, but literally the most) but get poor results when measured across our entire population. Go click that link in the previous sentence. Check out how much of GDP Germany and France pay for their health care. Americans like to ridicule France, that high tax society that is seemingly run by powerful unions. How is it that we spend 1/3 more than France while getting worse results? Did you realize that France does not have socialized medicine (as I always assumed it did)? Could it be their system is better than we think it is?

The answer is not simply to expand coverage to our entire population and declare the problem solved. The two problems here are access and cost. If you only address access by mandating coverage but do nothing about cost control you get a mess like Massachusetts has. In this the Republicans and blue dog Democrats are absolutely right. The problem is that most of them aren’t proposing meaningful cost reduction measures; that would mean taking on the insurance lobby, the pharmaceuticals lobby, and the AMA. They’re just complaining that the cost controls in the current plan aren’t sufficient without proposing real solutions. But it’s not as if methods of reducing cost are a mystery. Countries all over the world with a myriad of different systems have shown different ways to do it. Even in this country the VHA is a shining example of a turnaround, going from the butt of jokes to a system that delivers very good results. Why are politicians not talking about the lessons this government-run bureaucracy can teach us?

For example, most of our doctors get paid via a fee-for-service system (podcast version here). This doesn’t reward them for health outcomes, it rewards them for doing procedures, tests, and having office visits. How much of a difference does this make? The Mayo clinic, world-renowned for the quality of its care, is one of the lowest cost providers in the US. All its doctors are on salary. That frees them from thinking of how to maximize revenue and shifts them to thinking about how to maximize health. The first link I included in this paragraph is particularly interesting because it highlights that there are actual health detriments to the fee-for-service model, not just high costs.

And because I haven’t inundated you with enough links, here is a recent discussion (podcast version here) with a Nobel Prize-winning liberal economist and a conservative policy specialist from a think tank on funding health reform. I especially like it because it’s an actual discussion, not a typical cable TV shouting match.

My conclusions:

1. Though we spend more than any other nation, the US has a health care system that consistently ranks low when compared to other industrialized nations primarily due to our large number of uninsured.
2. There are examples around the world and here in the US for us to learn from that will enable us to expand coverage and reduce costs.
3. Any reform proposal that expands coverage without comprehensive cost reduction measures is doomed to fail.

~A

PS

Many of us have seen that ad featuring Shona Holmes in which she said she had a brain tumor that would kill her but the Canadian system refused to pay so she came here for treatment. That ad scared and angered me, but digging deeper it proves to be classic insurance industry scare tactics. I resent being manipulated so I want to talk about this ad even though it’s not central to this discussion. First, no Congressional plan is proposing a Canadian single-payer system despite what the commercial asserts, which makes her entire story irrelevant. She’s also lying about having had a life-threatening brain tumor. “But Andy,” I hear you saying, “even if the details were wrong surely her story is a cautionary tale illustrating the horrific care that Canadians receive!” The Canadian system certainly has its problems, but Canadians live longer than Americans, have lower infant mortality, etc., and their system costs a little over half what ours does per capita while covering everyone, and no one goes bankrupt from medical expenses. Sounds like a nightmare, doesn’t it? The bottom line: if you see a commercial on TV that appears designed to scare you, don’t take it at face value. Do some research and decide for yourself.

Then another friend wrote back to A, and he replied with some more points:

I had someone reply to me and I made a few additional points in my reply that I wanted to send to some of you:

For some of us, it’s practically a statement of faith that “government involvement is always costly and ineffective.” But the existence of various government plans around the world proves that they can be effective and affordable. Remember “government plan” does not automatically equate to “socialized medicine.” Germany, France, and Australia all have government options but also have private insurance.

Another public/private comparison: how many private US insurers have lower overhead than Medicare? As far as I can tell, there aren’t any. This seems to fly in the face of conventional wisdom because they’re lean mean private companies competing against big government. And in this case the cards are stacked against Medicare because it deals with the absolute most costly segment of the population in terms of health care. Let me stress I’m not saying that we should change our health care into a single payer system. What I am saying is that it’s a mistake to dismiss out of hand any solution that involves government as a provider. Just look at the example of the VHA that I linked to in my previous email. That went from being an example of “government can’t do it right” to “government is doing it better than the vast majority of private systems.”

Why is it that market forces work so well in other areas of our lives to drive down costs and increase efficiency but that is not happening in health care? Some economists assert that market forces are ineffective in this area. That is not a universally held belief but it can’t be dismissed either.

One easily proven fact is that market forces don’t work in any system in which costs are externalized, the classic case being pollution. If you make widgets in your factory, and I make competing widgets in my factory but if mine are cheaper even though I use a process that emits horrid noxious pollutants I will beat you in the market place. While my pollution has a cost to society as a whole, it’s externalized in the case of my widgets competing against your widgets. This is why government has to step in to curb pollution. In the case of externalized costs, market forces will NEVER work “correctly”.

Of course, there are dumb government solutions and there are smart ones. A dumb solution would be for government to step in and mandate a specific solution. A smart government solution can use market forces to change an externalized cost into an explicit cost. Then market forces work as efficiently as ever! That’s how they fixed the acid rain problem in real life—this isn’t hypothetical, it really worked. They created a market in which companies could trade pollutant allowances. It’s a great example of government involvement spurring the very best aspects of the private sector.

Given the concept of externalities, reforms should aim to turn externalities into explicit costs in order to provide the societal benefits we’re all striving for. Here’s concrete example: hospital readmission rates. They’re higher here than any other advanced country because we’re pretty bad at something called “transitional care”. In a nutshell, you get ejected from the hospital and you’re on your own. In other countries if you have high risk of complications post-release you get a nurse or health aid helping you and making sure you get back on your feet. Here, usually not. Therefore some people end up back in the hospital within a month of being released and many of these would be avoided with better transitional care. But look at this from the hospital’s point of view: they make money every time you’re admitted. Where’s their financial incentive to provide transitional care? The cost to society of the readmission is completely external from the hospital’s point of view. What if you changed the system such that reimbursements would be less or fines would be applied if a readmission was deemed to be avoidable? Then you’d instantly have aggressive transitional care. The result is better health outcome and a net decrease in spending.

~A

Love is the Answer

Love is the Answer
(graphic found here)

Nobody has ever measured, not even poets, how much the heart can hold.
~ Zelda Fitzgerald

Ted and I watched a very interesting episode of Bill Moyers Journal (you can watch the entire episode by following the link…it’s about an hour) the other day, one which dealt with Faith and Social Justice. The panelists were Cornel West, Serene Jones, and Gary Dorrien, three heavy hitting scholars and members of the social gospel movement.  They were discussing what our ethics and values say about our society, most specifically how our system encourages greed and immoral conduct, and the culture of indifference in which we find ourselves.

They argued that the moral imperative is to look out, during a time of catastrophe, for those on the margins of society, those who need our help more than others.  Instead, they said, our society is currently more focused on how the economic catastrophe affects the Wall Street elite.  They argued that the important questions, for Christians and non-Christians alike, are, “How do we get people to rediscover love?  Can love conquer the problems of capitalism?  Can it conquer the gospel of prosperity?”  In other words, how do we get people to stop focusing on increasing their own personal wealth, and instead focus on our society as a whole, and encouraging social justice for all.  One answer, they said, is love.  Love not only for the people that you know and care about in life, not only for God if you’re religious, but love for truth and true justice for all.

Love is not a small thing…it is people loving justice and each other enough that they are willing to fight for the rights of workers, the rights of women and gays and black people, the rights of children.  Love for our fellow man is what makes us care enough to desire to contribute to the general welfare, rather than doing so only because of a sense of guilt or obligation.  Love is what holds you in the struggle when the struggle seems endless and always uphill.

The thing is to recraft the idea of want, so that people are excited and motivated toward helping one another, rather than excited and motivated merely to own more and improve our own personal standards of living.  We fight so hard for what we want, and what we want is often based in economics.  What if we could change that passion and desire, so that what we really want and desire is to nurture communities, so that it matters to us that we respect each other, and that we are involved in the collective project of running this world, so there is comfortable room here for all of us.  So that there isn’t such a vast chasm between rich and poor, between have and have-nots.  What if we loved each other enough to recognize the humanity in the most down trodden amongst us, what if we stopped putting the richest amongst us on pedestals.  Further, what if we stopped looking at people with material wealth as necessarily the best off amongst us.  What if, instead, we truly believed that the most fortunate amongst us are those who work to help further social and economic justice?

These ideas are not new ones.  They are not the property of Christians alone.  They are both ancient and universal.  They pre-date Christ and his teachings, and they can be found all over the world.  They are great ideas, ideas that are worthy of revisiting over and over again.  There will never be a perfect world here on Earth, but with courage, we can work every day toward making the world a better place than the one we inherited.  Perhaps we have lost focus.  I suspect the problem is more that we have never had this focus.  Some small minority among us, yes, but not the greater collective.

They had some praise and criticism of President Obama…praise for the challenges that he is taking on, his work on the international stage and wanting to reform our health care system.  Criticism for his failures in economic policy and not being progressive enough, for being held in the pockets of Wall Street and the lobbyists, rather than being courageous enough to listen to those who want to change and fix things.  They said that progressives need to be more vocal and motivated in their passion to bring the voices of the poor and working class to Obama’s ears, rather than allowing him to continue to focus on the voices of the wealthy elite.

Following the discussion panel, the show revisited a story they did in April of 2008 on hunger in America, followed by the sobering news that the food banks they visited then have seen an increase of 45 – 60% in need in just this last year.   The desperation of people trying to feed themselves and their children, people who have always worked hard for a living, but are now pushed to the sidelines by a brutal economy.  When juxtaposed with the obscene amounts of money promised to the financial markets, it seems that we do indeed have some self-reflection ahead, both as individuals and as a society.  Perhaps we cannot let our markets and our banks fail, perhaps the price would be too high.  But at the same time, we should not let our citizens fail either.  We should not marginalize the poor and hungry, the workers who struggle paycheck to paycheck.  We cannot ignore the voices of everyday Americans.  Public opinion powered by moral conviction. This is what is required.

I was inspired by this episode, and found it really interesting and hopeful.  This economic crisis might be a time when we can transform ourselves, re-examine our own values and ideas.  In the words of Mr. West,

“What kind of human being do you want to be, given your move from your mother’s womb to the tomb.  What kind of virtues and values will you try to enact in your life?”

Single Payer Health Care

I happen to think that the best way for the U.S. to go is toward a Single Payer health plan. The idea that people go bankrupt over health care costs, that people die because their insurance will not pay for the treatment that they need, irks the hell out of me. And both have happened within my own family. Also, the limitations of only being able to see doctors within your own health plan (ala Kaiser) is beyond stupid. If everyone in the United States were automatically covered, just by virtue of being a citizen, then I am sure that we could bring costs down, that yes, our taxes would go up, but the bureaucracy of our current system makes insurance premiums sky high anyway, and they just keep going up. At a speed that is impossible to maintain.

Obama wants some sort of compromise plan, where the Government insures those who cannot afford to buy coverage on their own, or who do not have coverage through their employers. But I suspect that many people who will not be eligible for the ‘free’ coverage will still not make enough to buy coverage on their own. I know my mom, impoverished though she was, did not qualify for medicaid or medical, because she had over $2000 in the bank, or something like that. Never mind that she very often wasn’t so ‘rich’, and that $2000 in the bank would not have come close to paying for the services she would have needed had she lived.

But people talk about the horrible bureaucracy, about how having the government will make things much worse, etc. Worse than insurance companies telling you one thing and then doing another, promising to cover procedures and then not doing so. Or perhaps worse than losing coverage because your illness means you cannot afford COBRA coverage, and getting stuck with huge bills. Or worse than having cancer, and fighting with the insurance company about who will pay the bills, and ultimately dying without getting treatment, while you’re waiting for your insurance to step up.

Sorry, I feel strongly about this. All I’m hearing is arguments from people here in the United States, worried that if our system becomes like that in Canada or Europe, we’ll all die miserable slow deaths that could have easily been avoided, or perhaps we’ll all go completely broke because the increase in taxes is so much higher than the average $5,000 or $6,000 per family, per year today (and that’s not counting the employer portion of insurance premiums, which I believe is around $12,000 per family per year).

The issue, in my mind, is money for the insurance companies. A single payer plan would put them out of business, and a lot of very wealthy people would lose their fortunes. Also, a lot of insurance company employees would lose their jobs. Perhaps some of them, or most of them, could get government jobs, administering this single payer health plan.

I’d like to hear from any readers in Canada or Europe, readers who enjoy the benefits of, and/or suffer the issues of, nationalized health care. Is it perfect? I am positive that it is not. But would you happily switch over to a plan like we have in the U.S., if you were given the option?

Nationalizing Risk, Privatizing Wealth

The whole AIG thing is bugging, you know?  I know that it’s important to retain your top talent when you’re a huge company with fingers in every pie in the U.S., such as AIG is.  I do understand that.  If they should fail even worse than they already have, we’re all screwed even farther than we already are.  But it pisses me off that anyone in the WORLD thinks they’re worth this much money, let alone taxpayer money.  No one is worth this much.  No one.  But people who took huge chances that resulted in the collapse of our economy, resulting in this huge loss of jobs, why should they get huge retention bonuses?  Part of me, the knee jerk part, says, they should get a swift kick in the ass.  That’s it.  At very least, these fat cats should refuse the bonuses they agreed to last year.  I know it’s no fun to work at AIG right now.  I know there’s a lot of pressure, and life sucks.  Wah.  Suck it up, asshat.  You want to make a big bonus?  How about you get it AFTER you’ve paid back the U.S. taxpayers AND made us a bit of profit as well.  In a long term, sustainable way, not a short term, digging us in deeper way, K?

AND, I’m tired of hearing about politicians who don’t pay their taxes.  Hell, if they’re Republican, at least they’re consistent with their ideals, right?  “We’re anti-tax, so we’re not paying”.  But if they’re Democrat, they supposedly feel that paying taxes contributes to the greater good, so it’s painful and sucks, but it’s the right thing to do.  Um, not so much, apparently.  Again and again and again, I hear of politicians not paying their stupid taxes.  I know, at some level, that this is a witch hunt.  People, esp. Republicans, are currently LOOKING for problems.  But hell, people, hubris, OK?  Pride goeth before a fall?  Don’t give the other side fodder.  Damn.

</rant>

At Last…

Inauguration

“What the cynics fail to understand is that the ground has shifted beneath them — that the stale political arguments that have consumed us for so long no longer apply. The question we ask today is not whether our government is too big or too small, but whether it works — whether it helps families find jobs at a decent wage, care they can afford, a retirement that is dignified. Where the answer is yes, we intend to move forward. Where the answer is no, programs will end. And those of us who manage the public’s dollars will be held to account — to spend wisely, reform bad habits, and do our business in the light of day — because only then can we restore the vital trust between a people and their government.

Nor is the question before us whether the market is a force for good or ill. Its power to generate wealth and expand freedom is unmatched, but this crisis has reminded us that without a watchful eye, the market can spin out of control — and that a nation cannot prosper long when it favors only the prosperous. The success of our economy has always depended not just on the size of our gross domestic product, but on the reach of our prosperity; on our ability to extend opportunity to every willing heart — not out of charity, but because it is the surest route to our common good.

As for our common defense, we reject as false the choice between our safety and our ideals. Our founding fathers, faced with perils we can scarcely imagine, drafted a charter to assure the rule of law and the rights of man, a charter expanded by the blood of generations. Those ideals still light the world, and we will not give them up for expedience’s sake. And so to all other peoples and governments who are watching today, from the grandest capitals to the small village where my father was born: know that America is a friend of each nation and every man, woman, and child who seeks a future of peace and dignity, and that we are ready to lead once more.

Recall that earlier generations faced down fascism and communism not just with missiles and tanks, but with sturdy alliances and enduring convictions. They understood that our power alone cannot protect us, nor does it entitle us to do as we please. Instead, they knew that our power grows through its prudent use; our security emanates from the justness of our cause, the force of our example, the tempering qualities of humility and restraint.”

~President Barack Obama, January 20, 2009

At last, I feel like I can breathe again.  We again have a President who is smarter than a fence post.   Not only is he smarter than a fence post, he’s SMART.  And he seems to be a kind and compassionate man, two adjectives I would never have used to describe Bush or Cheney, with their smirking evil faces. 

This last 8 years has been really horrible and frustrating.  I’m tired of feeling like no matter what the right thing to do in any given situation is, my Government will do the exact opposite.  I’m tired of being ashamed of my country.  Tired of feeling that the world judges me because of doofus’s behavior.  I hope this next 8 years is different, and that I can again feel some pride in my Government.  I’m ready.

I wish my mom were here to see this.  She would be SO happy today.

Throw One Shoe…

Ted mentioned the other day that our economic situation is so bad, that even if every American man, woman, and child were to chip in $1 or $5, it wouldn’t really help anything.  I thought, but what if every American man, woman, and child were to throw one shoe at George W. Bush?

Heck, even if every man, woman, and child in DC next Tuesday threw a shoe, surely at least one would hit him.  THAT’S a movement I could get behind.  You have at least one extra shoe lying around, don’t you?  That you’d be willing to donate to the cause?

A girl can dream, right?