Wednesday, August 26, 2009

Healthcare Distortions

What I'm hearing from people against healthcare reform is as follows:
  • They don't want death panels.
  • They don't want rationing of healthcare.
  • They don't want government-funded abortions.
  • They don't want government-funded healthcare for illegal immigrants.
  • They don't want socialism.
  • They want to be able to keep their existing insurance.
There are lots of people debunking this, but here are my thoughts:

"No Death Panels":

There are no death panels being proposed. But if you're against death panels, you should be against private insurance, because that's essentially what they offer now. The insurance company's job is to find ways to not cover people who need medical care, in order to maximize their profits. This is done through several means: denying coverage to people with pre-existing conditions or health risks; denying a claim; and cancelling insurance when somebody falls into a risky category.

"No rationing":

Nobody wants this. My best friend, who is a doctor, says that she believes it'll be necessary, because we just can't afford to give the best possible treatment to everyone, and at some point you have to draw lines and say that if this will cure only 2% of patients and it costs $2,000,000 per patient, maybe it's not worth it as a society, and you can only have it if you have millions to pay for it yourself.

The truth is that this is the kind of system we have today. You can't get the expensive treatments if you don't have the money or the insurance, and you can't get the insurance if you don't have the money or you have the need for insurance. Rationing is going on, it's just in disguise.

Meanwhile, the what the government is proposing doesn't include rationing. My friend may be right, and ultimately it will be needed, but even if it does happen, it will be no worse than what is going on now. I happen to think she's wrong about this, but it is true that when new treatments are discovered and they are expensive and the become the standard of care, then the cost to the system is high. I think that could be offset by taking a slice out of the insurance agencies' profits, and a slice out of the pharmaceutical companies' profits, although I fear this won't happen. I think it could be offset, as well, by becoming a healthier nation, something that might happen if we all had access to preventative medicine and routine care. But even if it doesn't, and the costs rise, and even if taxes rise, then that doesn't mean it's not still the right thing to do.

"No government-funded abortions":

I'm as pro-choice as they come. I believe government-funded abortions would be a good thing. But I also believe that there will not be government-funded abortions under this plan. Obama has said that we have a history in this country of not having abortions paid for by federal dollars, and my understanding is that this would continue to be the case.

And despite the fact that I believe abortion should be safe, legal, and accessible, and that means paid for, I also believe that people should be able to withhold their tax dollars from things they have religious objections to. So I'll tell you what, I'll agree that you shouldn't pay for others' abortions when I don't have to pay for any war. Deal? And, because I'm generous, I'll say that it's okay to give you a religious exemption now, even if you won't do the same. Just because it's not fair to me, doesn't mean I shouldn't do the right thing by you.

Come on, we all know abortion is not going to get covered in this plan. It would be too big a deal-breaker.

"No government-funded healthcare for illegal immigrants":

First of all, this plan would not provide for routine doctor's visits for illegal immigrants.

But what do you think happens now when an illegal immigrant goes to the emergency room, say for an emergency situation? Do you think the doctors don't give him or her care? They do. They're under a moral obligation and professional vow to provide care to those needing it. And how is that care paid for? There are multiple ways it could be paid for, including grants from companies to cover it, including the hospital making provisions for doctors to have a certain percentage of their time unpaid for. But ultimately, all those ways come back to the average consumer through costs being inflated to cover those other, hidden, costs of paying for people, illegal immigrants or American citizens, who don't have healthcare coverage. We who do pay or who have insurance pay all the costs, through insurance rates or the cost of care directly, for those who don't pay for their care.

"No Socialism":

Okay, so no schools, police, fire departments, roads, or Medicare paid for by the government, either. No unemployment, no post office, no army, either.

Basically, sometimes we need the government to pay for something that covers all people--like the police, like the fire department--for the good of society. Private insurance provided by workplaces is a system that doesn't work. It doesn't work because it doesn't cover everybody with something everybody needs. Heck, it doesn't even cover everybody who works.

Socialism: Not the same as Communism. Not the same as Fascism. It is an economic philosophy, like capitalism, not a political philosophy, like democracy. Democratic socialist countries abound. Capitalistic fascist societies can exist, too.

"Keep My Existing Insurance":

I wish you couldn't. I would like a single-payer system which covers the whole country. I would like universal health care. But the fact is, I'm not going to get what I want: you are. You can keep your existing insurance under the plans that are being proposed. Anyone who tells you differently is lying.

In Conclusion:

What is so frustrating to liberals is that the plans as they're being proposed are not everything we've always dreamed of. They don't include abortion, they aren't a single-payer system. They are, in fact, a gigantic compromise, maybe too big of one, already. The truth is that what is being proposed is something that the VAST majority of Americans would find reasonable and good if they understood it. The problem is that there are a lot of lies being spread about it, and those lies are being funded by the people with something to lose, using the radio and news media's talking heads and using some elected officials, as well. And the people with something to lose here have a lot of money, because they are the health insurance agencies. Because the truth is, that if you have good options, you might not want their shoddy services any more.

Lastly, in honor of Senator Ted Kennedy's passing, and because he puts it so eloquently that I was moved to tears:

Thursday, August 20, 2009

The Art of Apologizing

I'm still irate about Jackson County Commissioner Phil Duckham's carrying of a swastika sign to the healthcare rally/protest last week, and his comments to the press comparing Obama to Hitler. Because I am still irate, I am going to choose his latest remarks for my next rant. Reader beware.

Since the statements Duckham made, there has been a press conference about the issue that I attended, and a County Commissioners' meeting that I did not. In the write-up of those two events, the Jackson Citizen Patriot writes:

Reached by phone after the press conference, Duckham said he does not believe an apology is in order. Although his actions at the rally might not have been the best choice, Duckham said, he still stands by his comparisons between Nazi politics and Obama's plans for restructuring America.

"Was it my best choice to carry the sign — no. In hindsight, I wouldn't have done it," Duckham said. "But I will stick to my point that I was trying to make."

At the Jackson County Board of Commissioners meeting Tuesday night Duckham told attendees — some of whom demanded an apology — that the sign did not convey his message properly and misrepresented his views. He said he intends to take more care in expressing his opinions in the future.

"Apologize for my views? Never," Duckham said after the meeting. "But if I offended anyone, I apologize. That was never my intent."

Rant: That is the most nonsensical non-apology I have ever read. Honestly. It begins by saying he'll never apologize but ends with an apology? And "if I offended"??? Clearly he did. So why the "if"? And he stands by the comparison of Obama to Hitler, yet the sign misrepresented his views? Say what you mean, Duckham, and say this:
I believe Obama is like Hitler, but I regret that I said so publicly because it brought me under fire. I do not apologize for what I did, but I regret that you noticed it.
A somewhat more thoughtful analysis:
This is an excellent example of the nonapology. There was an excellent article on apologizing on NPR a while ago that talks about this, as does this blog post on "The Language Guy." The NPR article points to several ways to give a nonapology:
  • Make appropriately contrite noises
  • Point to extenuating circumstances
  • Disclaim any malign intention
  • Minimize the offense
  • Claim to be misinterpreted
  • Express regret over the response to your words
  • Give contingent apologies (if...), to make your apology hypothetical
Duckham's nonapology does many of these. It gives a contingent apology for the response to his words and claims to have no malign intention. IF people are offended, he is sorry for their response to his words, but his words were not apparently offensive. And, most beautifully, he makes it clear that this is a nonapology by saying he will not apologize for his views.

My Healthcare Stories

My blog posts aren't usually so personal about my life as this one is going to be.

I have two main stories about my struggles with and without healthcare insurance that illustrate problems in the system. The first is when I had a major injury--a broken vertebra--when I was not insured. The second is trying to move jobs and switch insurances when pregnant.

The first situation, the broken back, occurred when I was fresh out of college. I graduated and stayed in the Detroit area doing temp work. I quickly found a job through a temporary employment agency, where they placed me in a "permanent temp" position working for Blue Care Network, an HMO of Blue Cross Blue Shield. Now, I don't know about you, but I think one reason companies hire "permanent temps" is so that they don't have to pay benefits, but ironic as it is that a health insurance agency doesn't want to have to provide all their employees with health insurance, that's aside from the point I'm trying to make. Anyway, when I first started working with them, I was still covered under my parents' insurance. That lasted until January of the new year. That was the deal back then--you were carried on your parents' insurance until the January after you graduated from college or the January after you turned 22. I don't remember which exactly was the rule, and I'm not sure how it worked for students today. In January, however, I was offered a full-time job (with benefits) with Blue Care Network, where I would be working directly for them rather than for the temp agency--they would buy out my contract with the temp agency to hire me on directly. The job was to start in early February.

On my first day of work, I slipped and fell in the shower while getting ready for work. I did, basically, a back-flip out of the shower, something I don't recommend. And I broke my first lumbar vertebra, and I ended up in the hospital. I wasn't yet actually an employee of BCN, so I lost the job. I wasn't yet insured (which wouldn't have kicked in for 3 months anyway), either. The hospital social worker worked with me to get some of my costs covered by the government--basically my hospital stay itself. I still had to pay ambulance costs, doctors' costs, and drug costs, which amounted to several thousands of dollars. Hospital stays only last a few days, so despite the fact that I was unable to care for myself, having to lay constantly on my back for a few months to recover, I was sent home to my apartment that I shared with a woman I had known only a few months (I had answered her advertisement looking for a roommate). She quickly asked me to move out, despite the fact that I continued to pay rent--having a roommate who was recovering from injury didn't suit her lifestyle. So here I was, jobless, homeless, uninsured, and still recovering from a broken back. Fortunately, I have parents who were able to take me in and who didn't charge me rent and board, so that I was able to pay off my medical debt with my income after I was able to work again. I had a safety net. But what if you don't have such a safety net? What happens to you then?

I'll finish this first story by saying that while I received immediate hospital care, I think I did not receive the same care as I would have if I had had insurance. I did not get the follow-up care that might have helped me. I got only emergency care. And I continue to suffer from this injury today. That might be true under any circumstances. On the other hand, maybe it would be less if I had received more care then.

What this story illustrates for me is just a few of the ways how the system is broken--full-time workers don't always have health insurance; employers don't stand by their employees once they get sick; if you don't have health insurance, you don't get the best care.

My second story is one that I told in a sermon on universal healthcare in January, 2008. Rather than rewrite the experience, I'll share those words:
At the recent community forum that our church hosts, in conjunction with the library, on healthcare, I shared some of what I, and this church, went through in trying to find healthcare for me when I came here. I assume that the board was informed of some of this, and the search committee of some of it, but that probably most of it was known only to Alice D., Bob L., and myself, as we struggled with the situation. I was, when I started work here, a little less than eight months pregnant. Both the people at church, and myself, I think had not thought it would be as much of a problem to switch healthcares as it turned out to be. I couldn’t just stay with my existing healthcare, because it was a regional plan for Massachusetts, and delivering my baby here would be “out of network.” Every plan we could find here, at first, considered my pregnancy a “pre-existing condition.” We finally found that if we joined as a group, as a business, rather than getting individual coverage I could be covered, but only if my current insurance was part of a group. Fortunately, through sheer luck, it was. I had to go through some work to prove that, we had to switch insurance agents, because one said it couldn’t be done, and in the end I had pretty much continual coverage. To get the healthcare insurance, I had to show proof of ordination—which involved a quick trip to the framers, who had my certificate of ordination for framing at the time, and I had to show my marriage license. I had never had to show my marriage license for any purpose, and, in fact, didn’t have a copy. Fortunately, Chicago will let you order an emergency copy by phone, but at first they had lost the record of our marriage! They found it in the nick of time, and I was able to get our whole family covered.

What did I learn from this? If you have the time and energy, and some good help, and are willing to spend a month hassling with the system pretty much continuously—I spent my entire study leave on this project, while Peter packed boxes—then you can sometimes, with a great deal of luck, work the system. The good news now is that we now have a denominational health plan, so ministers in situations like mine can carry their insurance from church to church—a major bonus for those professional interims, for example.
What does this story mean to me? Again, it shows several ways in which the system is broken: even if you have insurance, if you move or switch jobs, your pre-existing conditions may not be covered; if you have insurance and it's not an employer-provided insurance, if you switch insurances your pre-existing conditions will not be covered; with some insurances, if you go "out of network," you're basically uncovered; if you're covered by insurance but you need to move to providing your own insurance plan that's not employer-based, your pre-existing conditions will not be covered. Basically, in most cases, you cannot lose your job or switch your insurance, or any pre-existing conditions will not be covered. Again, in order to find coverage, I had two volunteers, myself, and two insurance agents working on the situation constantly for over a month.

Lastly, I know my stories are not nearly as horrible as others out there. But having experienced these myself, it is clear to me that we are desperately in need of healthcare reform. I believe we need a "single-payer" system. I will settle for a strong "government option." But leaving it all to private insurances will leave us with a system as immoral and unethical as the one we have now.

Saturday, August 15, 2009

Comparing Obama to Hitler

Jackson County Commissioner Phil Duckham carried a sign with a swastika (with a circle and slash "no symbol around it) on it to the recent healthcare rally in Jackson, and the Jackson Citizen Patriot says in an article about the rally: "This is how Hitler started out," Duckham said. "First, Obama took over the auto industry, then the banking industry. We don't need him to take over the health-care industry."

What follows is my letter to the "Voice of the People" (letters to the editor) of the Jackson Citizen Patriot:
As a person of faith and as a citizen, I am appalled at County Commissioner Phil Duckham’s public actions and statements comparing Obama to Hitler. They were callous and insensitive comparisons. Comparing Obama to Hitler shows ignorance of Hitler’s motivations and actions, and insensitivity to the Holocaust survivors in our own community.

I invite any making such comparisons to do more to inform themselves. Actions I have taken to inform myself that I would recommend to anyone wanting to understand Hitler and the Holocaust include reading Anne Frank, Primo Levi, Elie Wiesel, Viktor Frankl, and our own local Miriam Winter; meeting and listening to Holocaust survivors; going to the excellent Holocaust Memorial Center in Farmington Hills, MI; taking courses on the Holocaust; and visiting Auschwitz.

Arthur Caplan recently wrote for MSNBC, “There is plenty to debate about health reform. But there is nothing to debate about the contemptible introduction of references, direct or oblique, to Nazi Germany. To do so is to engage in Holocaust denial. To do that is, as those Americans of the greatest generation who died or were injured fighting the Nazi menace well understood, inexcusable.”

Rev. Cynthia L. Landrum, Minister
Universalist Unitarian Church of East Liberty

Friday, August 14, 2009

A Rally for Healthcare in Jackson, MI

Today we had a rally for Healthcare reform in Jackson, MI. Somehow, people had gotten word that there was a rally scheduled at 4:30 to protest against healthcare reform, so various local groups got together to state a counter-demonstration in favor of healthcare reform starting at 3:30. I got notified of the event from several different agencies--Organizing for America, the Jackson Democrats, theMichigan UU Social Justice Network, MichUHCAN, andPlanned Parenthood, as well as some church members. After four e-mails in a row popping into my inbox about it, it was clear this was a big deal in Jackson.

My husband and I got there a little after three, and things were already well underway. There was a table registering people, handing out signs for those without (we came prepared), and handing out buttons to locals only and stickers to all. It was being run by Organizing for America personnel. This event was happening at Rep. Mark Schauer's Jackson office, and congressional staff passed out a flyer warmly welcoming everyone to his office, inviting people to come in and sit if they got overheated, use the restrooms if necessary, and help themselves to bottled water provided. It urged people to be peaceful and respectful of local neighbors and businesses.

Near the peak of the event, I asked an Organizing for America worker if he knew the count. He was sure it was over 300 at that point, but they were still tallying based on their sign-in sheets (and they knew at least 40 hadn't signed in). I was proud to see there were at least 14 people of our 92-member church (15%) in attendance, especially since this was during work hours, and many of our most involved social justice advocates I knew couldn't be there. We hadn't organized formally, but we had talked about it at the board meeting the night before (two board members came), and I had listed the event on the church "unofficial" Facebook page. Several members are very involved in the local Democrats, however, and I knew that one had sent out e-mails to a lot of people, including most church people who would be likely to attend.

The group was looping around the front of Rep. Schauer's office when we got there. By that peak time, it was looping in front of the store next door, the parking lot beyond, and a little beyond that, as well. The group mostly chanted ("What do we want? Healthcare. When do we want it? Now?" and "Everybody in; nobody out") as they walked in the circle. There were a few protesters against healthcare reform during the first hour--about five that I saw. Things remained peaceful, although one person from each side did engage in a fairly heated debate, but managed to cool off and go separate ways.

Shortly before the main opposition group arrived, Rep. Schauer addressed the crowd. He stood in front of his office, balanced on top of a chair so people could see him. It was a pretty gutsy move, I thought, as there were opponents there who tried to both shout him down (but were shushed by advocates) and forcibly move their way up to him. He talked about this being a very important time in our history, and about the way the system is broken, and pledged that if the final bill did the things he listed--protected seniors, kept parents from living in fear that their child would get sick and they couldn't go to the hospital, etc.--then he would vote for that bill.

After Rep. Schauer re-entered his office, the opponents to healthcare reform arrived in full. They numbered probably less than 50, from what I could see. The news articles I've seen on TV and internet have not reported this disparity in numbers, so it's important to note. Another thing I saw on the comments to the Citizen Patriot article was someone basically calling it cowardly of Rep. Schauer to not hold a traditional town hall or take questions at this event. To the contrary, I think he's showing courage by speaking publically at all, and common sense by holding the telephone town halls, where disruptions can be managed and civil dialogue can be held. There is absolutely no democratic process occurring when congress representatives are shouted down when holding public forums so that nobody else can be heard but the irate citizen. The purpose of that is to shut down discourse. The virtual town halls are a way of allowing discourse to continue despite such scare tactics. Another piece of misinformation in the comments was someone claiming that basically most of the pro-reform ralliers were bussed in, whereas the con-reform protesters were local. As a local, I can say recognized dozens of people who I know from the area. Obviously, as someone who has lived here only five years, I can't know everyone in town, so it's not surprising for me not to have known more. I spoke to numerous other people, however, and everyone I spoke with was from within Schauer's congressional district. Furthermore, I did not see any busses in the parking lot next to the office. I have no doubt that some people came from further away, but from what I could tell, that would represent a minority of those present.

Among the opponents to healthcare reform was one man holding a sign with a swastika on it with a circle around it and a line through it (a "no" symbol) (Picture from Mlive). The Citizen Patriot article identifies him as Jackson County Commissioner Phil Duckham, and says:
"This is how Hitler started out," Duckham said. "First, Obama took over the auto industry, then the banking industry. We don't need him to take over the health care industry."
This comparison of Obama to Hitler has got to stop. It is inflammatory, inaccurate, misleading, ignorant, and, as I heard someone on NPR say today, it is a denial of the real truth of the Holocaust and what caused it--racism/anti-Semitism. For a government representative, no matter how small the office, to make such a statement, and to be identifying himself as not a private citizen but with his office, is deeply troubling and deeply offensive.

The behavior of the people on the other side stands in stark contrast. The signs I saw in favor of healthcare reform said things like "Democrats = Caring," "Standing Together," "I Love Mark Schauer," and other affirmative messages. (I have to say, I found very sweet and amusing the "I love Schauer" signs. How often do you see that kind of affection towards the government by liberals?)

Unitarian Universalists have a new campaign called "Standing on the Side of Love." What I can say is that the UUs definitely stood on the side of love today.

Some pictures, in which you might see some local Unitarian Universalist faces (and behinds):

Tuesday, August 4, 2009

The Bête Noire of Religiosity

I just received an interesting article from the University of Michigan about a study on the changes in religiosity of students by major. Humanities majors, it seems, are likely to become less religious than they were before the entered college. Science majors remain about the same. Education majors become more religious. The article states:
“Our results suggest that it is postmodernism, not science, that is the bête noir of religiosity. One reason may be that the key ideas of postmodernism are newer than the key scientific ideas that challenge religion. For example, religions have had 150 years to develop resistance or tolerance for the late 19th century idea of evolution, but much less time to develop resistance or tolerance for the key ideas of postmodernism, which gained great strength over the course of the 20th century.”
For some reason, this idea just tickles me. All that work that the religious right is putting in on combating ideas of science, primarily evolution, and their real threat is postmodernism, "a theory that involves a radical reappraisal of modern assumptions about culture, identity, history, or language" (Wikipedia) and, apparently, religion.

Of course this makes sense. Postmodernism is a strong challenge to the idea of absolute truth and absolute good and evil. And we see it creeping into our society in lots of ways. But when one undertakes formal academic study that includes postmodern theory, it definitely challenges religious assumptions.

On another track from the article, it does worry me that education is the haven of the very religious. These are the people going on to teach in our schools, folks. No wonder we're always having religious indoctrination creeping into our schools in defiance of the separation of church and state.