politics

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Single-payer health care: Why not?

180px-Roma_-_FatebenefratelliI’ve been fortunate to have traveled many places, and to have lived for extended periods in China, Australia, France, and Ireland. During those travels, my family has received health care on many occasions, including for our small children in China and Asutralia, my wife in Scotland, and my 87-year-old mother in Ireland.

This health care has come in a variety of forms, including treatment for my ten-year-old daughter’s eyes at the Hospitaller Order of St. John of God or Fatebenefratelli (see left), located on San Bartolomeo, the only island in the Tiber River in Rome. That hospital was built in 1584 on the site of the Aesculapius temple.

clontarfWe also faced emergency surgery for my mother’s hip at Beaumont Hospital in Dublin, Ireland and subsequent rehab at the Orthopaedic Hospital of Ireland in Clontarf (right). In China, we were served in medical facilities with separate queues for Western medicine (our choice) and traditional Chinese medicine (below left). I donated blood many times at the Hôtel-Dieu de Paris, founded in 651 on the Ile de la Cité (below right). I’ve also observed, though not had to depend upon, health care in Russia and even in economically oppressed places such as Haiti.

beida_hospitalOn the whole, I’ve received excellent care in a variety of conditions. Individual health providers have been courteous, knowledgeable, and dedicated to their professions. For myself and my family, the experience of care did not depend on the setting or language, but rather on the ailment or the specific people providing care.

And yet, one thing stands out: Among the industrialized nations, the United States is the only one without universal health care. All of the others provide health care for all. They also do it primarily through single-payer systems.

The United States operates instead through a complex bureaucracy of insurance policies, doughnut hole prescription drug coverage, forms and regulations galore, massive administration, unnecessary and excessive procedures, complex and confusing tax codes, leading to escalating costs and unfair coverage. The inequity of care actually costs all of us more in the end, because of lack of preventative care, inefficient delivery (e.g., emergency rooms), and lost productivity. Our system costs much more, even double that found in other countries.

hotel_dieuIf we were to find that spending a few dollars more gave us better care, there might be little room for argument. But in comparable economies, people spend much less, yet have longer, healthier lives (American Health Care: A System to Die For: Health Care for All). Why then, is the system that works in Canada, Japan, Europe, Australia, etc., not even under consideration here?

The answer is unfortunately all too obvious: Americans, unlike citizens in other countries, have ceded control of their own health care to profit-making insurance companies, hospitals, clinics, laboratories, pharmaceutical companies, and other entities. The best we can do is an occasional feeble cheer when someone asks why our government can’t even consider a single-payer system. Then we listen to an answer that mostly obfuscates and lays the blame for it back on our own timidity:

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Minority youngsters dying weekly on Chicago’s streets

So far this school year, 36 children and teens have been murdered–more than one a week–and [Rev. Michael] Pfleger at St. Sabina Church] is among a chorus of weary Chicagoans who say the slayings aren’t getting the attention they deserve.

Had 36 kids died of swine flu this year, “there would be this great influx of resources that say, ‘Let’s stop this, lets deal with this,'” Pfleger said.

via Minority youngsters dying weekly on Chicago’s streets – CNN.com.

As Bob Herbert says,

why overlook the humanity of so many others because of their ethnic background or economic circumstances? Surely the slaughter of dozens of Chicago schoolchildren is worthy of wide national coverage. CNN has covered the story, but there has been precious little coverage elsewhere.

via ‘What Color Is That Baby?’, The New York Times, May 11, 2009.

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Blue sea, wilt thou welcome me?

Emily Dickinson’s “My River” tells the comforting tale of the river running to the gracious sea:

My river runs to thee.
Blue sea, wilt thou welcome me?
My river awaits reply.
Oh! sea, look graciously.

I’ll fetch thee brooks
from spotted nooks.
Say, sea, Take me!

But as a recent article in The Economist (Sin aqua non, April 11-17, 2009, pp. 59-61) points out, many rivers no longer reach those welcoming waters:indus

An alarming number of the world’s great rivers no longer reach the sea. They include the Indus [at right], Rio Grande, Colorado, Murray-Darling and Yellow rivers. These are the arteries of the world’s main grain-growing areas.

Along with the rivers being depleted, the Aral Sea drying up. 

Fish stocks in lakes and rivers have fallen roughly 30% since 1970. This is a bigger population fall than that suffered by animals in jungles, temperate forests, savannahs and any other large ecosystem. [Moreover,] half the world’s wetlands…were drained, damaged or destroyed in the 20th century, mainly because, as the volume of fresh water in rivers falls, salt water invades the delta, changing the balance between fresh and salt water.

Of course, the seas won’t disappear. In fact they’re actually rising due to the melting of the Greenland and polar ice caps. Thus, the world will survive, but it may not be one with blue seas and “brooks from spotted nooks.” People may survive, too, but in what kind of world? What will our poetry become when we’ve destroyed the brooks, the rivers, the forests, the fish and other animals,  the plants, and the beauty of the planet?

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Friends don’t let friends suffer: The US must step up for Haiti

haiti-childrenHaiti is experiencing an unprecedented humanitarian crisis. The US must not ignore one of its closest neighbors in a time of need.

Here are some grim facts behind the crisis, reflecting both long-term problems and recent natural catastrophes:

  • Last year, during a one-month period, hurricanes Fay, Gustav, Hanna and Ike devastated the country. Over 1000 people were killed; countless others were reported missing and injured.
  • The hurricane damage was equivalent to 15 percent of Haiti’s gross domestic product (GDP). A recent international donors’ conference raised $324 million in emergency and long-term assistance for Haiti. That was better than nothing, but it’s only a third of what Haiti needs to rebuild.
  • Meanwhile, over 30,000 undocumented Haitians face deportation orders from the US. If carried out, these orders would return Haitians to a country struggling to rebuild and not able to provide the critical social safety nets needed for people to survive. Their return would also diminish remittances, which mean the difference between life and death for Haitians.
  • There is high maternal and infant mortality, as well as unwelcome high rankings on most other indicators of poverty.

haiti_rel99Despite these problems, organizations such as La Fondation Connaissance et Liberté (FOKAL) have made major strides toward sustainable development. External aid now can make the difference between compounding the suffering and building an independent, prosperous, and democratic nation.

What can be done?

  • The World Bank and International Monetary Fund should include Haiti in their Highly Indebted Poor Country initiative, a program to lower debt to manageable levels. Better yet, cancel Haiti’s crippling external debts until the economy can be self-sufficient.
  • US and other international aid to Haiti should be doubled immediately. Foreign aid should be structured as grants, not as loans, which may offer short-term help, but long-term shackles.
  • International aid should be focused on development, not military and police support. Haiti has enough guns already. Aid programs should work with NGO’s as well as government agencies.
  • Stop the deportations. Haitians should be granted Temporary Protected Status (TPS) and the Department of Homeland Security should conduct a thorough review of US policy towards Haiti. Individuals should call the DHS at 202-282-8495 [if unable to get through, call the White House Comment line at 202-456-1111] and urge these actions.
  • The US should extend the Haitian Hemispheric Opportunity through Partnership Encouragement Act (HOPE), which allows Haitian textile manufacturers to export duty-free to the United States. This could generate much-needed jobs in Haiti’s labor-intensive garment industry. The average Haitian garment worker earns $4 a day, while 77 percent of Haitians live on less than $2 a day. As Rep. Charles Rangel, said of the US textile industry concerns, “God should be so good to the people in Haiti that their exports should be a threat to the United States of America. That’s not going to happen.”
  • All Americans need to learn more about our neighbor in need. Explore the resources provided by organizations such as the Latin American Network Information Center (LANIC) – Haiti, the Haiti Information Project, the Haiti Action Committee, and Oxfam, as well as the many books about Haiti, especially those that consider its history.

References

UNICEF (2009). The state of the world’s children: Maternal and newborn health.

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How Europe underdeveloped Africa

how_europe_underdevelopedAmita’s interesting post, Education for Liberation…., and the materials she cites (Challenging White Supremacy workshop), reminded me of a book that had a big influence on me. I read it shortly before the author, Walter Rodney, was assassinated, in 1980, at the age of 38.

The book, How Europe Underdeveloped Africa, is now available online.

Rodney presents a new way of thinking about Africa’s so-called “underdevelopment.” The question was “why are some areas of the world rich and others poor?” I had been taught many reasons for this—that successful countries had better inventions, more adventurous explorers, greater natural resources, geographical advantages, better climate, less corruption, or just good fortune. The implication was that they mostly deserved their status as did the less successful ones. Africa’s underdevelopment was thus to a large extent Africa’s fault. Of course, a generous impulse might lead us to help those less fortunate to develop and share the goods of the world, maybe not to achieve full equality, but at least enough to meet their minimal needs.

Rodney challenges that entire view. He describes an Africa that is more developed than Europe in most ways except military conquest. When Europe fails to compete on even terms with Africa and Asia it turns to war and colonization to take by force what it cannot achieve through fair trade. Africa is then consciously exploited by European imperialists, leading directly to the modern underdevelopment of most of the continent. Thus, “underdeveloped” is an active verb, with an agent who does the underdeveloping; it’s not just a descriptive adjective.

1492Rodney’s thesis was highly influential. James M. Blaut’s works, The Colonizer’s Model of the World: Geographical Diffusionism and Eurocentric History (Guilford, 1993) and 1492: The Debate on Colonialism, Eurocentrism, and History (Africa Research & Publications, 1993) extends the basic thesis, with more detailed economic analyses.

Other writers have criticized aspects of Rodney’s work, but the general idea seems even more salient in an era of neocolonialism. For example, Haiti today struggles under a crushing external debt. Nearly half of that was incurred under the Duvaliers, puppet dictators of the US. The Duvaliers stole the resources of the Haitian people, then assumed debts that oppress their children and grandchildren. Debt service, a burden essentially imposed by the US, makes economic growth nearly impossible. Yet commonplace accounts would say that “they” (the Haitian people) can’t manage finances, don’t know how to protect their natural resources, have a corrupt economy, lack creativity or initiative, or otherwise are to blame for their fate.

For many countries in Africa, for Haiti, and for other colonized areas, the forcible appropriating of indigenous human and natural resources means underdeveloping those areas. When we turn “underdevelop” into a past participle, “underdeveloped,” we make it easy to forget how that happened. Rodney puts it this way:

The question as to who, and what, is responsible for African underdevelopment can be answered at two levels. Firstly, the answer is that the operation of the imperialist system bears major responsibility for African economic retardation by draining African wealth and by making it impossible to develop more rapidly the resources of the continent. Secondly, one has to deal with those who manipulated the system and those who are either agents or unwitting accomplices of the said system. The capitalists of Western Europe were the ones who actively extended their exploitation from inside Europe to cover the whole of Africa. In recent times, they were joined, and to some extent replaced, by the capitalists from the United States; and for many years now even the workers of those metropolitan countries have benefited from the exploitation and underdevelopment of Africa. (§1.2)

Rodney’s account of Africa, written 37 years ago, is still relevant for Africa today. But it extends to other international regions and even to communities within so-called “developed” countries. When we see, and label, communities as underdeveloped, low-resource, impoverished, disadvantaged, economically depressed, troubled, or marginalized, we follow the lead of the 1965 Moynihan report, which described a “tangle of pathology,” locating problems within the community with causes in the distant past.

We should ask not only how these communities compare to privileged ones, or even what useful things we might do to help them. We need to look first at the structures and mechanisms of power that caused these conditions in the first place, and now, continue to maintain them. This means turning from the conceit that underdevelopment just happens, that an appropriate and full response is to “give” to those less fortunate. It requires collaborative struggle in which all participants are willing to examine the roots of oppression and to engage in the practice of freedom.

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End the destructive payroll tax

1192440-4-hands-of-worker1Governments around the world see the need to get people back to work and increase consumer confidence. Knowing that they need to act, they’re bailing out banks, insurance companies, and manufacturing industries, as well as helping high income taxpayers by reducing income taxes.

In the midst of the crisis, they’re ignoring the most effective way to increase jobs and consumer spending: End the destructive payroll tax, thereby helping the unemployed get jobs. When low and middle income families pay only their fair share of taxes, they’ll be able to spend more on the things they value, thus boosting the economy to grow in productive directions. That’s not happening because of the regressive payroll tax scheme.

The US reliance on payroll taxes discourages employers from hiring and workers from working:

  • For most workers payroll taxes amount to 17 percent of salaries (high income workers pay less than that); this represents a huge disincentive to hiring people or to seeking a job,
  • 3/4 of households pay more in payroll taxes than they do in personal income taxes,
  • The taxes are now almost 40 percent of federal revenues; meaning that we’re increasingly running the government on the backs of the lowest income workers.

healthcare_worker_flu_shots_help_patients1Payroll taxes reduce the things we do want: jobs, a healthy economy, individual and family health, spending based on real human needs, social justice. Meanwhile we give a free ride to things we don’t want: pollution, dependence on foreign oil, an unhealthy environment, foolish use of limited resources, increasing income divides.

Why not couple a reduction in payroll taxes with increased taxes on the things we don’t want? Hendrik Hertzberg, writing in the New Yorker (“Not insane”), argues that we need a package approach:

A whole good idea would be to make a payroll-tax holiday the first step in an orderly transition to scrapping the payroll tax altogether and replacing the lost revenue with a package of levies on things that, unlike jobs, we want less rather than more of—things like pollution, carbon emissions, oil imports, inefficient use of energy and natural resources, and excessive consumption. The net tax burden on the economy would be unchanged, but the shift in relative price signals would nudge investment from resource-intensive enterprises toward labor-intensive ones. This wouldn’t be just a tax adjustment. It would be an environmental program, an anti-global-warming program, a youth-employment (and anti-crime) program, and an energy program.

construction_worker_handsThe bipartisan coalition Get America Working! emphasizes the fact that payroll taxes exacerbate the true unemployment of discouraged workers, with its consequent toll on both individuals and society:

America has one giant unused resource, its hidden unemployed. There are tens of millions of capable Americans who might seek employment if the job market was better, but who, believing that is impossible, do not look and therefore do not count as “unemployed”. They include many older Americans, women, young people, people with disabilities, minorities, and other chronically underemployed groups. Much of this lost opportunity is the result of ever-rising payroll taxes forcing up the cost of hiring.

The key to change is lowering the price of labor relative to that of the only other basic inputs in the economy—natural resources such as materials, energy and land. Eliminating the payroll tax alone could produce as many as 20 million new jobs. That would (1) profoundly enrich the lives and health of those who get the jobs; (2) power a sharp increase in the production of goods and services; (3) cut today’s enormous public and private costs of supporting so many dependents; and (4) sharply reduce the costs of many social dysfunctions – ranging from crime/violence/drugs to unmotivated students—caused by today’s massive true unemployment.

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Today, the me nobody knows

me_nobody1I came across the poem, “Today,” in the me nobody knows: children’s voices from the ghetto, by Stephen M. Joseph (Avon, 1969). There are many beautiful, and some heartbreaking, stories and poems in the book, which is an anthology of writings by children in Bedford-Stuyvesant, Harlem, Jamaica, and the lower west and east sides of Manhattan. The year after the book was published, a musical based it, The Me Nobody Knows, premiered in New York.

Joseph, a teacher, invited the children to write, offering three choices: to write using their names, in which case he was willing to meet at lunch or outside of school to talk with them about it; omit their names, but still hand in the writing; or write, but neither sign the paper nor hand it in. But he never forced them to write at all.

The pieces in the book give one picture of life in the inner city, or for that matter, many children everywhere. They invite the question: Are we doing any better for children today, 40 years later?

This poem struck me for its rhythm and the ways that things seem not totally to fit, but do fit all the same.

Today
Cynthia L, Age 15

Today is my day,
Today should be your day,
If it’s your day and my day
It’s everybody’s day.
In your way is my day
Because you made a day that comes all the way.
And two days of a way equal today.
That will never fade away.
In our own way let’s find ways
To make great exciting things happen.
In your ways, make my days,
You made a day that comes all the way,
And two days that are made up of your ways,
Those kind of days will never fade away.

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Happy Pluto Day!

plutolithograph1Image courtesy of Windows to the Universe. “This is an artist’s conception of Pluto and Charon. Pluto is in the background and Charon is in the foreground. Pat Rawlings, Science Applications International”

The Illinois State Senate has redeemed poor Pluto from dwarf planet status to its rightful place in the universe, and established March 13 as Pluto Day. This was done in large part to honor Illinois native Clyde Tombaugh. One justification for this was that Tombaugh was the only American to discover a planet. Another was that there were no real problems left to work on.

There are of course a few problems with the Senate’s idea. Early Native Americans undoubtedly discovered most of the planets in our solar system, even if official histories don’t credit them. Other Americans have discovered many planets outside of our solar system. And what Tombaugh discovered isn’t really a planet, under current definitions.

225px-clydetombaughBut Pluto is now part of our culture. Even if it’s not a planet, do we really want children going around saying “My very educated mother just served us nine”? Nine what? Pluto gives us a reason to add “pizzas,” which might be reason enough to keep it.

Tombaugh did do something. Eric Jakobsson, points out that they should have honored him for “discovering the first of the Kuiper objects (as opposed to the last of the planets). Arguably, that was a more important discovery than another planet, because it added a whole new dimension to our understanding of the solar system.”

Eric’s argument highlights two different conceptions of learning. In one, authority gives us the answer, case closed. In another, ideas become tools for further inquiry. Richard Shaull, puts it this way in the foreword to Paulo Freire’s Pedagogy of the Oppressed (1993):

There is no such thing as a neutral educational process. Education either functions as an instrument to facilitate the integration of the younger generation into the logic of the present system, or it becomes the practice of freedom, the means by which men and women participate in the transformation of their world.

We should remember and honor Tombaugh’s dedication, intelligence, and painstaking studies of photographs. His work on Pluto and asteroids contributed to transforming our scientific understanding of the universe. That was not the social world that Freire means when he says the “practice of freedom,” but in its own way represented a challenge to the “present system.” Unfortunately, the Senate’s rearguard action has become an internet joke that fails to express what Tombaugh really accomplished.

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RiseOut: “Defining Our Own Education”

I’ve been reading the articles on RiseOut, an online “news center focused on deschooling, youth activism, and other related issues concerning the rights of youth in the U.S.” There are entries on deschooling; unschooling; youth media; racism; the Highlander Folk School in New Market, Tennessee; Dr. “Patch” Adams; a review of the book, The Teenage Liberation Handbook, How to quit school and get a real life and education (by Grace Llewellyn); critiques of school segregation (and recent Supreme Court decisions that support it), credentialism, and military conscription.

Most of the articles on RiseOut are well-researched, thoughtful, and provocative. They remind me of the wonderful book, Letter to a teacher by the schoolboys of Barbiana, in which youth in Italy present a searing critique of their education and the unjust society it supports.

Both the Barbiana book and RiseOut address the question that Earl Kelley asks: What is real in education?. Kelley answers that the bedrock reality is the the actual life of youth.

The Obama administration’s proposed “Cradle to Career” education plan, has many good components, but education reform will never accomplish much if schooling continues to be separated from actual life and fails to come to terms with the issues raised in RiseOut.

From the RiseOut site:

We provide a diversity of alternatives to education that are self-directed and decentralized from standardized schooling. We support a young person’s choice in dropping out of school, free of social stereotypes and biases. We aim to provide a plethora of alternatives from a 12-year prison like sentence of state schooling, while staying vigilant of abuses against young people through diagnosing, segregation, ageism, adultism, sexism, and other assholisms.

A message to those who have decided to quit school:

Instead of dropping out, we applaud you for your courage to “riseout” from a nightmarish disposition of compulsory schooling. We hope RiseOut can be a resource for sharing your stories and providing choices towards regaining control over your own education.

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Hidden Her-story: The Top-Secret “Rosies” of World War II

leann_ericksonNorma Scagnoli referred me to a wonderful podcast by LeAnn Erickson, Associate Professor of Film and Media Arts at Temple University. Erickson is an independent video/filmmaker, whose work has appeared on public television, in galleries, and has won national and international awards.

Entitled, Hidden Her-story: The Top-Secret “Rosies” of World War II, it was recorded in January at the EDUCAUSE 2009 Mid-Atlantic Regional Conference in Philadelphia. I expected to listen for a minute and then go on to more pressing things, but after listening a little I decided that those things weren’t so pressing after all. It’s a fascinating story for anyone who has an interest in history, computers, women, education, mathematics, warfare, politics, Philadelphia, science, workplace equity, morality, or life in general.

In 1942, only months after the United States entered World War II, a secret military program was launched to recruit women to the war effort. But unlike recruiting “Rosie” to the factory, this search targeted female mathematicians who would become human “computers” for the U.S. Army. These women worked around-the-clock shifts creating ballistics tables that proved crucial to Allied victory. “Rosie” made the weapons, but the female computers made them accurate. When the first electronic computer (ENIAC) was invented to aid ballistic calculation efforts, six of these women were tapped to become its first programmers. “Top Secret ´Rosies’: The Female ‘Computers’ of WWII” is a documentary project currently in postproduction that will share this untold story of the women and technology that helped win a war and usher in the modern computer age.

Controls for the podcast appear beneath the description on the EDUCAUSE page.