Friday, July 24, 2009

The Obama Healthcare Reform Plan

At the forefront of American politics at the present time is Obama’s plan to reform the healthcare system in this country. Healthcare reform was one of his biggest platforms during the election, and he is following through with his promise to make it a priority during his presidency.

There are a lot of rumors and unsubstantiated accusations flying around the media, the internet, and the water cooler in regards to this new plan, so I decided it was time to add my two cents into the mix in the hopes of clearing up some confusion for the 1½ people who follow my blog.

Among the most common misconceptions about Obama’s healthcare plan involve catchphrases like “socialized medicine” and “the government takeover of healthcare,” and include the idea that if Obama’s plan is passed, our general welfare and ability to receive good healthcare will dramatically decrease, while at the same time our country will be thrown toward the brink of economic meltdown due to cost.

In this article, I want to specifically address those issues, look at Obama’s plan and compare it to other similar plans around the world, and demonstrate why those concerns are not legitimate, but instead are functioning as fear-mongering political spin aimed at defeating anything Obama brings to the table.

I realize most people have not actually read or studied the legislation that is currently being discussed in Washington. Lucky for you, I have read and studied it. I accessed it through links on the website of the House of Representatives. It is over 1000 pages. Fortunately, there are links summarizing what is contained in each section.

AMERICA’S AFFORDABLE HEALTH CHOICES ACT

This is the title of the new plan being discussed in Congress. As I noted above, the bill is over 1000 pages in length, and seeks to make healthcare more accessible and more affordable for all Americans. It is not a “socialized medicine” healthcare reform bill. I’m not even sure what “socialized medicine” means, but presumably it gives the impression of the government taking control of everyone’s healthcare choices. You pay thousands of dollars a year for health insurance, get bogged down in government bureaucracy, can’t get the treatment you need because some government official decides you don’t need it, you wait for weeks to see a doctor about a cold, months or years for major surgery, your doctors are all haggard government employees who hate their jobs, and you end up dying of government-induced cancer at age 43.

Sound silly? Ask the roughly 273 billion Americans who seem to believe it’s true.

There is nothing in the current proposal that is in any way related to the government taking over American healthcare. The bill is aimed at passing laws that improve healthcare, make healthcare more accessible and more affordable for all Americans, and improve competition among insurance companies. If such efforts represent a “government takeover,” then the same argument would apply to any laws passed by government to control the free market. Does anyone, for instance, have a problem with anti-trust laws – those laws dictating what corporations can and can’t do in the public market? Of course not. We all benefit from laws like that.

The healthcare reform bill is similar. It passes laws that control what insurance companies can and can’t do in the free market; like anti-trust laws that protect investors, the healthcare reform bill passes laws that protect healthcare investors – that is, patients.

It does not establish government-mandated and government-controlled healthcare. It does not eliminate the for-profit nature of the health insurance industry or establish a single government program for everyone. It does not establish precedents that will make going to the doctor similar to standing in line at the DMV or the Social Security office. It’s not a government-run program like Welfare or Social Security. It is a government-protected program like the free market.

KEY POINTS IN THE BILL

There are a number of important reforms to the healthcare industry contained in this bill. I will list the major points and provide commentary.

1. Protects and guarantees private health insurance plans. Private health insurance carriers – like Blue Cross, Humana, etc., will continue on a wide scale, as they do today. Anyone who wants and can afford a private health insurance plan is entitled to enroll in such a plan. No one is required to take a government-funded plan. Those of us with private health insurance that we are happy with will not be forced to change anything.

2. Establishes a “Healthcare Exchange.” Think for a moment of those commercials for LendingTree.com that assert “when banks compete, you win.” That’s what the Healthcare Exchange is like – insurers coming together to compete for business. The Healthcare Exchange will be an organization that allows those who do not have private health insurance plans to find a plan that fits their needs and is affordable. Among the plans on the Healthcare Exchange will be a government-funded public plan.

3. Establishes a Government-funded Public Plan. The public plan will simply be one of dozens that are available to those who do not have private insurance. The public plan will be required to conform to the same standards as private insurance plans. For those who cannot afford the normal premiums of this plan, the premiums will be cut on a sliding scale, based on income. The lower the income, the lower the premium. Even this public plan is not just a free lunch for lazy people – there are premiums associated with it.

4. Maintains Medicare and Medicaid. Sweeping changes to the way money is allocated and spent within Medicare and Medicaid will provide most of the funding for the new healthcare system. However, those two government programs will continue as they have before. Medicaid, for instance, will still be the option for those below a certain income level. That is, if someone is not able to afford the public plan offered on the Health Exchange, even at the reduced rates based on income, then they will be eligible for Medicaid, as they would be now. This would represent, however, only a fraction of the general population.

5. Guarantees coverage. Insurance companies, including the public plan, will no longer be allowed to discriminate based on pre-existing conditions, put a limit on how much they will pay, or rescind coverage for any reason other than fraud. Penalties for fraud, on the other hand, are increased. Additionally, insurance companies will no longer determine what treatment a patient can and cannot receive, or what treatments will and won’t be covered. Doctors and patients will now make that decision, not insurance companies, and not the government. This is a vitally important point, because it is one that is often misrepresented by opponents of healthcare reform.

6. Increases training and incentives for healthcare workers. The bill aims at putting more healthcare workers into the field by providing for more attractive loans and grants for healthcare students, better training programs, and more lucrative careers. This includes healthcare workers from doctors to nurses, dentists and dental hygienists.

7. Establishes an agency to analyze the program’s benefits and weaknesses. This agency will analyze how the program works, and seek to strengthen it when weaknesses appear. This provision helps ensure that the program is self-correcting.

OPPONENTS OF HEALTHCARE REFORM

Some health insurance carriers oppose this legislation because of fears that it will reduce their profits. They have long been able to more or less name their own price and determine their own enormous profit margins, all at the expense of patients – you and me. This bill will put an end to that. It’s not difficult to understand, then, why some health insurance carriers are opposed to it. They will now be forced to price their services competitively based on the free market; power is, in effect, being taken from their hands and given to the market.

Some have argued that this plan will hurt healthcare workers. Doctors and nurses and other healthcare professionals won’t have as much job security and won’t be able to afford to keep practicing. This is simply not supported by the facts or the content of the bill. It’s simple fear-mongering. The American Medical Association and the American Nurses Association both endorse this new bill, and the reason is because they see that it will help, not hinder, medical professionals. As outlined above, it contains specific provisions to encourage better training and better benefits for doctors, nurses, and others in the industry. Doctors who now enjoy 6-figure salaries are in no way threatened by this legislation. Instead, this legislation is aimed at ensuring that doctors and hospitals get paid for the work they do. Presently, millions of dollars are absorbed every year by hospitals because of uninsured patients who cannot afford to pay their medical bills. That will be all but eliminated under the new plan, making hospitals – and their doctors, nurses, and other professionals, better protected and better compensated.

Many conservatives in Washington are opposed to this healthcare reform bill. For instance, a writer for the Cato Institute – a public policy research foundation in Washington D.C. – wrote that opposing Obama’s healthcare plan was key for maintaining support in the Republican Party. The writer noted that if a universal healthcare plan is passed, many middle-class Republicans who benefit from it may be more likely to vote for Obama and the Democrats in later elections. He pointed to a similar trend in the UK after universal healthcare was passed.

Senator Jim DeMint, of South Carolina, recently argued that it was necessary to delay a vote on the bill until after the August recess, in order to “break” Obama and make healthcare his “Waterloo” – Waterloo, of course, being a reference to the major battle lost by Napoleon that spelled the end of his reign of power. He describes the bill as a “government takeover” of healthcare and a jeopardy to American freedom. Clearly, he agrees with the writer from the Cato Institute – just as passing this bill may lose the Republicans some support, defeating the bill will “break” Obama and the Democrats.

It is easy to see from these stories that opposition to healthcare reform isn’t actually about healthcare; it’s about political ideology and power. “We can’t permit Obama to win, because it may undermine our power,” these sorts of arguments are saying between the lines. So they use distortions, misrepresentations, “spin doctoring,” false analogies, and slippery slope fear-mongering to twist perceptions. And they succeed because they know most Americans don’t actually have a clue what the healthcare reform bill contains. It’s easy to fool people when those people’s only source of information is you. Confirmation biases reign supreme. If I am a Republican, and the Republicans tell me that Obama’s plan is “socialized medicine,” then I accept that on face value and viciously oppose Obama’s plan.

One of the ways opponents of the healthcare reform bill have waged their attack is through “personal testimonies” of people in other countries. I recently saw an ad with a woman in Canada talking about how terrible their “government” healthcare is, and how she would have died of a brain tumor if not for the fact that she was able to travel to the U.S. for treatment. The Canadian healthcare system, she asserts, was going to make her wait 6 months for surgery.

In addition to being full of political spin and unsubstantiated attacks, and in addition to ignoring the millions of Canadians who are happy with their health insurance, it has come to light that the woman in the commercial didn’t even have a brain tumor. She had a benign pituitary cyst that was not life-threatening. That is why she had to wait for treatment. Immediate treatment for her took a backseat to those people who did need immediate treatment.

Still, the woman’s misrepresentation about her condition aside, isn’t “waiting” for health services one of the primary arguments of the opposition? If I had even a benign brain cyst, I certainly wouldn’t want to wait 6 months to get treatment.

The problem, of course, is that Canada’s healthcare program is, in fact, a state-run program. All Canadians have one health insurance carrier – the Canadian government. That is not what the current bill in our Congress is proposing, as I have already argued. A public plan is only one of many available to Americans to choose from. It is simply one of the competitors, competing with private health insurance companies, within the free market. Furthermore, as I have already noted, the current bill denies insurance carriers – including the public plan – to determine who gets treatment and when. Doctors and patients determine that.

The bill currently before Congress is not in any way related to these sorts of fear-mongering, politically-motivated advertisements. They are complete and total misrepresentations of reality. Again, confirmation bias reigns supreme.

A poll on Facebook right now asks if the respondent supports a “government run healthcare plan.” Something like 90% have said no. Well of course not! I don’t support a government run plan either!

Referring to this plan as “government run” is misleading political spin. This plan establishes protocols for interactions between health insurance carriers – of which the public plan will be one – and patients, just as anti-trust laws establish protocols for interactions between publically-traded companies and their investors and clientele. The reason those anti-trust laws exist is to protect Americans and the American economy. The healthcare reform bill seeks to do the same thing in regards to our suffering healthcare system, which is rife with discrepancies, soaring costs, income gaps, and inefficiencies.

WHY WE NEED HEALTHCARE REFORM

This is a section that I shouldn’t even need to write about. Unless you live under a rock, you should be aware that our healthcare system is broken. 50 million Americans live without any health insurance at all. Many who do have health insurance would still be in dire straits should a serious illness arise, because their insurance would only cover a fraction of the cost.

In the last 9 years, employer-based health insurance premiums have increased at four times the rate of wages. They have literally doubled in that period of time. According to one report cited by the Obama administration, nearly half of all personal bankruptcies in America are caused at least in part by healthcare costs. Another report says that in 2007, 60% of personal bankruptcies were related to medical costs. To put that in perspective, about a 1.5 million personal bankruptcies are filed every year. That means medical expenses cause a bankruptcy in America every single minute.

I ask my readers to consider the following scenario. Imagine you have lost your job and have no health insurance. Perhaps you don’t even have to imagine it; it may be a present reality. Now imagine that tomorrow you find out you have a terrible disease that will take months and perhaps years of treatment to control or cure. The ultimate cost will be somewhere in the range of 80,000 to 100,000 dollars. A month from now, you get a new job, which offers health insurance. But the insurance company will not cover your condition because it is pre-existing. Would your bank account cover those costs, or would you end up in bankruptcy like so many others, with the economy at large absorbing your medical costs?

We are the only major industrialized country in the world with no public healthcare option. We are also the only major industrialized country in the world with a verifiable “healthcare crisis” on our hands. Will we continue to let healthcare drain our economy, or will we tackle it head on to strengthen our economy and make people healthier?

The current bill does not propose to copy government-run programs like what are present in Canada and Europe – even though those programs, by all accounts, work very well and are strongly supported by the people. Instead, it supports the American free market and maintains private insurance carriers as for-profit businesses, while seeking to make the system better by forcing insurance companies to compete and by laying the groundwork to end exploitation of patients and healthcare workers by the system. It takes the power out of the hands of the insurance companies and puts it into the hands of the patients. It guarantees affordable coverage for everyone. It eliminates personal bankruptcies due to medical bills, eliminates the need for hospitals and healthcare workers to absorb the costs of those millions who are uninsured, and promises to not only protect our health, but also to strengthen our economy.

A BRIEF COMMENT ABOUT THE COST

The cost of this new healthcare bill is a concern for a lot of people. A large part of the present bill seeks to tighten the reigns of expenditures in Medicare, providing up to 66% of the cost of the program from smarter spending itself. A full two-thirds of the cost will be taken care of right there, without the need of a single penny spent by anyone.

The other portion of the program will be paid by a healthcare surcharge on the wealthiest 1% of Americans. Specifically, families with joint incomes over $350,000 per year, or individuals with incomes over $280,000 per year, will pay a 1% surcharge on their income to cover healthcare costs. For those over $500,000, the surcharge will be 1.5%. That, of course, is a trifle compared to how much they already make. And it is justified by the fact that these wealthiest of Americans also benefited disproportionately from tax cuts enacted over the last eight years. That 1% of Americans has experienced far more growth in their personal wealth over the last decade than the remaining 99% of us. Despite that, the program provides for lowering the surcharge if cost goals are maintained. The percentages could drop as low as 0.1% - or a few hundred dollars on a $350,000 salary.

CONCLUSION

It’s time to put an end to the political spin-doctoring from conservatives over the healthcare reform bill. It’s time to stop lying about what the bill contains, knowing that it will fool many Americans who only get their information from like-minded politicians, commercials, and slanted media outlets.

If you don’t like the healthcare reform bill, state why you don’t like it, and provide evidence for why your perspective should be taken seriously. Don’t just sit back and say it’s “socialized medicine” and assert that we’ll all be spending $1600 a month to stand in line for 8 hours to get cold medicine, like some pathetic 1960’s Communist toilet paper line.

Otherwise, you are just buying and selling oceanfront property in Arizona.

Saturday, July 18, 2009

Christianity and Giving Money to Beggars

In modern society, beggars are generally not regarded with much respect. Among the religious and non-religious alike, we tend to frown upon begging. Get a job, we might say. Beggars might even present a threat to us, because what if begging turns to mugging?

I've talked before to Christians about giving money/food to beggars. In my experience, most Christians are supportive of giving food to beggars, but not money. What if they use it for drugs/sex/alcohol, etc? I've also had Christians say that even food should be given discriminately, because many beggars are just lazy and would rather sit and beg than go get a job. I've heard this said in specific reference to "familiar" beggars at sporting events, the local intersection, etc.

I've made the argument that, as Christians, we are not instructed to discriminate in that way. The Bible doesn't say "Give to the poor as long as you think they'll use your charity wisely." It just says give.

I wanted to reassert this point with one of the most widely attested sayings attributed to Jesus in the entire canon of Christian literature. I'll provide the saying in all its various forms among the texts that attest it.

Shepherd of Hermas (circa 100 C.E.) - Do good, and of all your toil which God gives you, give in simplicity to all who need, not doubting to whom you shall give and to whom not: give to all, for to all God wishes gifts to be made of his own bounties.

Luke (circa 90 C.E.) - Give to everyone who begs from you; and if anyone takes away your goods, do not ask for them again.

Matthew (circa 85 C.E.) - Give to everyone who begs from you, and do not refuse anyone who wants to borrow from you.

Gospel of Thomas (circa 60 C.E.) - Jesus said, "If you have money, do not lend it at interest. Rather, give it to someone from whom you will not get it back.

Didache/Teaching of the Twelve Apostles (circa 50 C.E.) - If someone takes from you your goods, do not reclaim them, for you are not able to do so; give to every person who asks anything of you and do not make any counter-demands.

The dates of those texts, of course, are up for debate, but one thing most scholars agree on is that they are all independent of one another. Luke and Matthew's version came from the Q Gospel - an otherwise non-extant source that is imbedded in those two texts; the Q Gospel, Gospel of Thomas, and Didache all drew the saying from the Common Sayings Tradition, which is the earliest oral tradition of Jesus' teachings, going back to the very earliest days of Christianity. The Shepherd of Hermas also probably comes from oral tradition, though it may have used Matthew and/or Luke.

It is for this reason that most Jesus scholars affirm very strongly that this teaching - to give indiscriminately and without expecting anything in return, most definitely goes back to Jesus himself.

Considering that, should we - as Christians - not take it very seriously, and stop giving discriminately to only those poor who we think deserve it and/or will use it wisely?

Wednesday, July 01, 2009

The Infernova

You may have noticed (or probably not) a new blog link on the left side of the page called "Alenthony's Inferno." That's a blog site kept by one of my good friends, and I recommend it to you heartily.

Alenthony has recently published his first book, a work of epic poetry that satirizes Dante's Inferno. It's called "The Infernova."



I read it in about 24 hours. It's not long, but I couldn't put the book down. It's written in rhyming verse, and that had me nervous at first because I've read very little epic poetry in my life, and never rhyming epic poetry.

And yet, shockingly, he pulled it off. It flowed like a Homerian epic, and I mean that sincerely. As I told him, I'm no expert poet, but I do dabble in it now and then and have published some of my own poetry - and I could never pull off what he pulled off. The style fits the symbolic, dream-like state of the story, and the rhyme scheme is authentic and clean; it never distracts from the plot. I was genuinely impressed and I had no problem reading and understanding what was being said.

The book, as I said, is an epic poem that creates a symbolic satire of Dante's Inferno in reverse: instead of gays and Jews and adulterers in this new hell, it's scam artists and conspiracy theorists and scheming politicians and televangelists (among others). It's written as a sort of symbolic dream in a computerized future, so everything seen is not real, but a computer simulation. This is how Alenthony gets around the problem of sounding like a hell-fire and damnation preacher. It's only a symbolic hell, not a real hell. The narrator's guide through hell is none other than Mark Twain, which I thought was a really clever twist.

I would be lying if I described it as anything other than "atheist" fiction. In fact, the small publishing company that my friend set up to publish the book states, on its website, that it caters to: "...freethinkers, atheists, agnostics, pantheists, and humanists."

There is no love lost for religious thinking in this book, though I would describe the book in general as more of an apologetic for rationalism and intellectual honesty than a polemic against religion. Still, traditional believers would find much to offend them, no doubt, in this book. Alenthony doesn't pull any punches in regards to his perception of how religion has affected and continues to affect the world.

Of course, I don't agree with all the ideologies present in the story. I'm not an atheist, after all. I pointed out a few problems to him, in fact. Some of the gods and prophets in his symbolic hell are really just parodies of the original, and he seemed eager to "punish" people in his hell even if they, themselves, were okay but their ideas and teachings got used by others for evil. Be that as it may, most of his ideology is pretty well on target, and it's important to remember that this is epic poetry and satire, not biography.

The punishments he contrives for the various intellectual "crimes" match the real-world crime perfectly in dream-world symbolism. For instance, conspiracy theorists are broken down into pulp inside a paper mill, and their bodies become the tabloids they previously had published, written for, and circulated. Similarly, televangelists are encased inside tombs where they must shout and preach for eternity, and their "hot air" heats the interior of their tombs to hellish proportions.

Alenthony's "hell," like Dante's, is composed of 9 levels, with each level populated by increasingly more horrific sinners against intellect and rationalism. Some notable figures - some surprising and some not-so-surprising - show up: Nostrodamus and Joseph Smith, for instance, but also great scientists like Newton, Faraday, and even Albert Einstein.

As for ideology in specific, there were a few things that I stringently disagreed with. I have already noted how some of his prophets and gods are really just parodies of the original and how he lumps basically "good" religious people into his hell. As I said to him, one would have to wonder if Ghandi, Schweitzer, and MLK Jr. (though they are not named specifically) were also in this vision of hell, since they certainly taught and worked from within a specific religious worldview, albeit a very humanist one.

I also disagreed with his depiction (though not a caustic one) of Jesus. Jesus basically takes the fall because so many people for so many centuries have misused his teachings for evil. That doesn't seem fair.

My belief is that the historical Jesus was a radical ethicist, who certainly would have couched his beliefs in divine language, but whose primary message was one of breaking down social barriers, negating the systemic evil of the world around him, and preaching a new vision of a world without physical and emotional and cultural oppression. In that sense, he is relevant not only for his own ancient, patriarchal and imperial time period, but also for the modern world. Again, that he has been frequently misused by 2000 years of theology is not his own personal fault, nor the fault of his own vision/theology.

There was a specific comment in the text, pg 151, that I found fault with: "We've always had sadistic villains, but to cause benign and otherwise good people to be bad requires organized religion." That seems like an ad hoc fallacy.

Was it organized religion, or systemic evil and fear, that made complicit criminals out of so many Germans involved in the Holocaust? Hitler's actions can be explained as the evil of a madman - but it took thousands of regular joes to carry out the Holocaust. What led them to be complicit in that? Anti-Semitism was certainly rife within Lutheran Christianity, but even Luther himself never suggested genocide. You can think Jews are Christ-killers without actually wanting to go kill Jews. I think it was systemic evil and fear that led to the Holocaust, not organized religion.

Evil does not require religion. And mass evil also doesn't require religion. In addition to the Holocaust, consider Communist Russia and the countless leaders and military personnel complicit in Stalin's reign of terror. Clearly organized religion in that atheist government was not behind their mass complicity in systemic evil.

These really are minor quibbles with the book, however. Again, it is epic poetry with symbolic meaning, not biography or objective history. All in all, I thought the book was absolutely excellent. It was brilliantly composed with a literary style equal to any great writer; it's structure and development was clever and meaningful; and within an atheist worldview, it's ideology was consistent and poignant.

I highly recommend "The Infernova" to anyone who fancies themselves a progressive or freethinker, or any atheist, agnostic, or secular humanist who enjoys and appreciates good literature with a meaningful plot.

Here are a few links:

Blackburnian Press, my friend's small publishing company.

"The Infernova" on Barnes & Noble's website.

"The Infernova" on Amazon.

Serene Musings Books of the Year, 2005-2015