Archive for the ‘health care’ Category

Unemployment and Dependency

April 9, 2010

In some ways, working the desk in the computer lab of the library seems something like the stereotype of work as a bartender. We get quite a number of the down-and-out, and they frequently turn to us to share their frustrations.

A broad-shouldered man in his forties, slightly frayed and worn, came to me for assistance. He was confused by the instructions on how to submit his resume for a job listing on Craigslist. I helped him to read the instructions, and guided him in the process of attaching his file to an email. Afterwards, he spent several minutes expressing his frustrations. For the past three years he had been unemployed. He had previously worked for years in a respectable blue-collar job which provided him a modest but sufficient income, a job in which he was proud of his work. But changing economic conditions had caused layoffs in his profession, and he had found little demand for his skills. He tried to be inventive and branch out into new fields, but with plenty of applicants with specific training and skills in those fields, nothing had come of his efforts. He was obviously ill-prepared to enter into fields requiring computer skills, which severely limited his options. He was interested in re-training, but routine bills and his medical expenses drained all his available funds—most coming from government welfare programs. If it weren’t for those, he would likely be out on the street.

“I just want a job,” He mourned. “But I can’t catch a break.”

This patron was hardly alone. A large number of requests for help at the desk have something to do with looking for work: writing resumes, sending or uploading resumes, using online job boards, using the library’s computers to learn to type, learning other computer skills.

All my life I’ve heard conservatives insist that welfare corrupts self-reliance and personal industry, encouraging laziness, idleness, and indolence, turning good people into “loafers.” Tom Delay even recently went so far as to avow that people want to be unemployed, that “unemployment benefits keeps people from going and finding jobs.” When unemployment benefits are proffered, goes the theory, it prolongs unemployment because the recipients have less incentive to find work.

Seems a pretty dismal view of humanity, and I don’t buy it. Oh, I’m sure there are always some who abuse the system, but the extent and level is exaggerated. I see far too many people who want work, who want to be able to provide and to feel the sense of self-worth which comes with being self-sufficient. They may lack the background which has helped enable many of us to find a place in the modern economy. They may have some extra obstacles, and lack some of the skills or training which are prized in today’s job market. But they don’t aspire to be leeches and loafers. Welfare doesn’t extend some life of luxury, it extends their survival while they struggle to succeed or deal with the challenges which have prevented their ability to be self-reliant thus far. They may depend on government assistance to keep them housed or fed right now, but they don’t relish the notion of relying on their meager welfare checks indefinitely to support idleness.

The data shows that the conservative complaint is superficially correct. Unemployment welfare does prolong unemployment. However, an Economic Policy Institute analysis shows that a deeper look reveals a story missed by the critics: unemployment insurance allows the recipients the time and resources to find work suited to their abilities or to develop the skills necessary to be more effective in the modern workplace. This makes those individuals more productive and more economically secure in the long run—a valuable investment if we want the members of our society to be more self-sufficient. In the short run, If people are having difficulty finding work, it may have less to do with some supposedly welfare-facilitated loafing than with an economy which has been persistently hemorrhaging jobs for some time now. To assume that jobs will suddenly open up if we just cut off aid to the poor in order to prevent dependency and “loafing,” that everyone will be self-reliant and “independent” is naive, and the results could be disastrous for the poor in society—most of whom are like you and I, and “just want to work.”

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Bob Aagard: Canada Scares and a Personal Story About Health Care Reform

August 7, 2009

All sorts of horror stories are going around the conservative media and blogosphere right now. Bob on The World According to Me shares his own experience with US health care, which adds a little context to the topic.

Overtreated: The Case for Single-Payer Healthcare

December 13, 2007

Steve Olsen, one of the most lucid writers in the Utah blogosphere, has written a nice post on Shannon Brownlee’s book Overtreated.

Brownlee’s (and Olsen’s) points are very relevant. It very much makes sense that in a free-market system where the ultimate goal is maximization of profits, health-care institutions would be less interested in curing illness efficiently. It is only rational (if amoral) that they would be more focused on keeping a catheter to your wallet.

For those who insist that the U.S. healthcare system is not a truly free-market system: you’re right. But it is a whole lot closer than the European systems which routinely provide more efficient care (not to mention the “socialized” VA system).

And yet still free-market apologists complain; most perplexingly about “undiscriminating” overuse (or abuse) of our health-care system, a complaint which I’ve addressed before. I would really like to know who these people are who “abuse” our health care system. How many people are making the regular, routine visits to their physician recommended to maintain optimal health? Just how many people are seeking professional medical advice at the first signs of developing problems? I’m betting the numbers are low. I suspect that to improve overall health in the U.S, we should be encouraging more use of the health care system (albeit use dictated by patient need rather than industry profit as mentioned in Overtreated) not less. The conservative attitude that we should just “walk it off” when our body warns us about health problems and only seek medical attention when things get serious courts disaster.

Social Justice III: The Libertarian Criticism of Social Justice

August 27, 2007

It is a bit misleading to describe this post as “The Libertarian Criticism of Social Justice,” as the libertarian argument itself actually makes no case for or against social justice per se, only the use of governmental power to promote social justice. The libertarian criticism posits that individual freedom is the highest priority in this as well as all other social issues, and that government activity in social justice amounts to coercion regarding the individual’s private property. As a matter of public ideology, it ignores virtually all other moral concerns.

Frankly, the argument is compelling. Much of the animus behind the Revolutionary War was the desire among the revolutionaries for the freedom to make economic and moral decisions. That urge for freedom has remained a huge part of the national character. Moreover, the most fundamental principle of the Gospel is similarly that of free will (2 Nephi 2:27). It is that free will (or “free agency” in the parlance of Mormon culture) for which we battled in Heaven, according to LDS theology, and which we expect from our governments (D&C 134:1-5).

But the libertarian argument is not the sole word on governance. There are other concerns to balance. While we respect the freedom of individuals regarding their private property, we also recognize that we have entered into a social contract in choosing to unite as a nation, a compact in which we have surrendered some of that freedom for the greater good. We all provide from our private property for the defense of the entire nation, whether or not our individual communities or homes may or may not threatened. We provide for public infrastructure at all levels of government, regardless of whether we ourselves will personally be accessing those particular roads, rails, public transit, water systems, trash collection, etc, because it benefits the community and nation as a whole. We provide for emergency services whether or not we ourselves expect to need them. Again and again, we seem to have found it acceptable to surrender a portion of our private property for, as referred to in the Preamble and Section 8 of Article 1 of the Constitution, the “general welfare.”

Does social justice promote the general welfare? History shows that disease ferments within the homeless and impoverished community, eventually breaking out to ravage the mainstream society. The greater the disparity of wealth within a society, the more likely crime and civil unrest will rise. The general welfare is threatened when large segments of the population are underserved. Not only do we have a moral imperative to promote social compassion, but it is just as much a part of the public interest and within the scope of government, at whatever level, to promote social justice as it is to promote the defense or functional infrastructure.

The libertarian perspective insists that private efforts are inherently more efficient and effective than government efforts in virtually all areas. For them, social justice is no exception—indeed, for them it may be the most brazen example of this maxim. One acquaintance of mine once suggested, in denouncing the principle of government social spending, that the people instead needed to again stretch their charity muscles if they want to help the poor, because government shouldn’t be involved and couldn’t perform as well as we as private citizens could, were we to again take up the cause.

Theoretically, it may be so. But I prefer to look at practical reality than the theory. And in reality, there is no evidence that “the people” the U.S. have never advanced social justice as well as the government welfare system which had its birth in the New Deal and was further developed during the liberal programs in following decades. I do not suggest that there was no charitable work prior to the liberal welfare programs of the prior century. At the turn of the last century and in the years leading up to and opening the Great Depression, there were various religious charities, mutual aid societies, and individuals attempting to alleviate the problems of rampant poverty. Those efforts were valiant and noble. But for every person they fed, many hundreds went hungry. For every one educated or housed, scores were left illiterate and homeless. People by the thousands died of disease brought on by their living conditions in the slums, even disease treatable by the medicinal practices of the day, despite the best efforts of conscientious doctors and organizations striving to provide care for those who could not pay.

Government welfare programs have hardly been perfect either. There are far too many who slip through the cracks. But government welfare has provided for the basic necessities to a far greater proportion of the population than the combined efforts, however heroic, of the various private entities ever did. Even the LDS church welfare program, as vast and impressive as it is, could not step into the breach were government social programs to be eradicated.

Opponents of social programs, including several people commenting on this blog, have accused liberals of shifting their responsibility for personal action in social justice causes onto government essentially shirking their obligations. Of course, they have no evidence for this specious charge. Liberals across the country are contributing time and money to help solve the social ills that plague our nation. We believe strongly in grassroots mobilization and personal participation. To claim that liberals do not engage in charitable activities is as ignorant and disingenuous as for us to claim that conservatives do not participate in charitable work. We simply recognize that government action is also valid and apparently crucial (judging from historical observation) to maintaining a minimum standard of social justice when government works alongside private social efforts.

Though their argument itself has merit, I am troubled by the fact that the public ideology of those who uphold the libertarian position is so limited in scope. ideology is more than just politics; it is how a person views life. While their stand on government social justice actions is ethical, their public ideology ignores the needs of social justice. For example, I respect many of the positions of libertarian Ron Paul, and while I certainly do not agree with all of them, I do believe he is a highly principled man and politician—something of which neither major party has enough. I greatly admire that in his private profession, he has been willing to make a number of sacrifices to help serve the less fortunate. But his private deeds are not enough; the advocacy of public figures among the libertarian cause is necessary for their public ideology to be complete. Those who object to government solutions must then advocate private actions, or their ideology is hollow. To my knowledge, neither he nor other libertarian enthusiasts like the late Harry Browne, nor the Cato institute, nor the Libertarian party, nor the Republican “small government” pretender, nor any other prominent libertarian voice makes private mobilization against social ills a primary part of their ideological agenda. I do not see them imploring their listeners to make social compassion and charity a high priority in life. I hear none among those who use the libertarian criticism of (government) social justice saying “Government is not the best solution for lifting up the downtrodden. How sad that we failed to address those concerns through private action, so that those concerned about the poor felt they had no recourse but to seek government action to solve the problem! We can do better. Here is a plan by which we can through private means better provide adequate health-care / housing / education / nutrition /etc. If we all work together, if everyone sacrifices and makes this a priority, we will be able to see the blight of poverty reduced further than ever before, and no longer need those government efforts! ”

No, at best I hear those bearing the libertarian criticism mention as a footnote to their denunciations of government that we should be charitable as individuals (important but insufficient); and at worst, they display an idolatry of the market, promoting the free-market fundamentalist falsehood that an unhindered market will somehow magically eradicate poverty.

Because I recognize the inherent logic and virtue of the libertarian criticism, I agree with the need to try minimize the involvement of government as much as possible while ensuring social justice is sufficiently addressed. And, as I have said before, I acknowledge the need to minimize the abuse of the programs—while insisting that if we should err, we must err on the side of mercy. I will avidly lend my personal effort to helping the poor and promote private efforts to attack the causes and results of poverty. I don’t believe many liberals would disagree with those propositions. But until the naysayers provide practical solutions by which the private sector can better tend to any given social justice issue than the government, I will stridently defend government redress of social justice.

Previously:

Jim Wallis Tangles with Socialized Medicine

August 13, 2007

If you listen to the right-wing pundits, you might think that socialized health care, such as found in Canada, Britain, and lets see…virtually the entire developed world, is nothing more than dark concrete dungeons, months of waiting for either the simplest or most urgent procedures; rusting, antiquated tools; and unresponsive, indifferent staff.

Doubtlessly every one of those nationalized health-care systems have their share of problems. But I’ve little reason to believe any of these foreboding scenarios are remotely accurate. After all, notwithstanding Walter Reed, evidence suggests that the VA provides a higher quality health care than the civilian, private health care (and it is worth considering that the problems at Walter Reed might well be attributed to the extended and apparently unforeseen foreign occupation which our military is performing, for which this sort of planning and preparation was botched).

Despite the dire warnings of the conservative talking heads, I hear plenty of positive remarks from those who use the socialized health care of other nations—and no more complaints than I hear about our system.

Jim Wallis himself recently had the opportunity to avail himself of the British health-care system.

“What do you need from me?” I asked hesitantly. “Just your name and address,” she replied with another smile. “Oh…OK.” She told me it would be about 10 minutes to see the nurse. “Yeah right,” I thought to myself…

…It was five minutes before the nurse called me in to a little office adjacent to the waiting area, which seemed to be an intake room. She was pleasant and professional as she asked me what was wrong, and how long I had felt the soreness. She gently examined my foot and then told me I would be called in to see a doctor in about 10 minutes. “Sure thing,” I thought. So I went back out to the waiting room and settled in again to read my novel.

It was five minutes before a young woman appeared and called my name, “Mr. Wallis?” She was a young Asian doctor named Dr. Gillian Kyei. She was also very pleasant and professional, taking time to ask me lots of questions about how I might have hurt my foot, etc. She examined the injured foot carefully, told me that it didn’t necessarily look broken, but that we should get an X-ray to make sure. I waited in her examining room for a couple of minutes while she called down to the X-ray department to say that I was on the way. Then she came back and escorted me herself.

When I got to X-Ray, I checked in by just saying my name and took a seat in the waiting area. Finally, I was going to get to read my book! But five minutes later, the technician came out to bring me in. She took her time with me, taking several different angles of my foot. When I was done, she sent me back to my young doctor, with another smile.

This time the wait was a full ten minutes because, I later learned, Dr. Kyei was reading the results of my X-ray, which had already been sent to her computer. She showed me what looked to her like a fracture of my fourth metatarsal bone, but said she wanted to consult with the orthopedic specialist. I waited about ten minutes more while she did that and so got a few more pages read.

Dr. Kyei then came back with the definitive diagnosis—my fourth metatarsal bone was indeed fractured. She went over their preferred treatments and my options with me…I chose the boot and she told me she would be back in a minute.

It was actually about two minutes before she got back, and I was getting nowhere with this novel!

…“How can I call a cab?” I asked. “Oh, I’ll do that for you,” she said. “Just take a seat over their and the cab will be here in about 10 minutes.” As I sat there, I realized something. Nobody had ever asked me to pay. Everything was FREE, including my nice new boot. How about that? They think health care is a right for all citizens, and even foreign visitors like me. Amazing (“My Encounter with [Insert Scary Music]…Socialized Medicine!”).

It may not be perfect, but it just may be that socialized health care isn’t the nightmare conservatives would have us believe.

Shouldn’t the Farm Bill Help Farms?

August 10, 2007

Just over a week ago, the House of Representatives passed the new Farm Bill. Instituted during the New Deal to protect the public interest by helping to ensure that the vast population of small farmers could maintain their livelihood and provide the nation with a quality food supply.

three-quarters of a century later, the Farm Bill has become twisted. Billions of dollars flow into the coffers of corporate agribusiness, which then turns those subsidies into processed, chemically fertilized, protected, and “enhanced” processed foodstuffs. The small family farmer is often left on the short end of the stick, unable to sustain themselves on their vocation. We spent the last weekend at my in-laws’ rural home, and my wife and mother-in-law mourned the fact that so many of the farms were hanging up their plows and milkers. Farmers are being forced to sell their family plots, some having been passed down for generations, to developers who immediately begin laying down sprawling subdivisions and golf courses (four in one development!) on the good farmland.

Not only is this corporate welfare bad economic and social policy, it is bad health policy. I have a hunch that the nature and artificially low cost of the predominant (malnutritious) foodstuffs in our nation contributes to the declining national health.

While it would be ideal if no government support was necessary for any part of the agricultural sector of our economy. But the reality is that in our current economy, traditional farming is simply not viable. So it is imperative that we provide help. Wouldn’t a better, moral Farm Bill help protect the viability of the small farmer; the yeoman who was the backbone of Jefferson’s vision of America? To support the diversified, organic production of natural whole foods which will promote better health and reduce the demand on our health-care system rather than the corporate monoculture commodity farming?

This latest Farm Bill takes some small steps in the right direction. But the emphasis on corporate welfare remains.

In “The Farm Bill and the Common Good,” Adam Taylor of Sojourners has taken the Democratic congress to task for failing to stand up to corporate agribusiness, and makes the moral case for revitalizing the Farm Bill so that it can fulfill its original mandate.

This outcome in the House illustrates the brokenness of a political process in which corporate interests too often drown out the voices of faith-based and civic advocates. It also demonstrates the urgent need to reclaim our democracy on behalf of the common good.

Prophets such as Amos, Isaiah, and Ezekiel didn’t mince words or withhold prophetic judgment when leaders advanced the interests of the strong over the welfare of the weak. With our pastoral side we can sympathize with elected officials who are trying to do the right thing—balancing the interests of multiple stakeholders while facing real and perceived constraints around what’s politically possible. However, our prophetic vocation calls us to hold elected officials to a higher standard and change the very parameters within which these policy decisions are made, one that privileges and protects the interests of the weak and dispossessed—in this case, small farmers at home and abroad.

If we can create a culture in which the small farmer can flourish and in which all people have greater access to wisely grown foods, we will all benefit.

See also:

  • Clever curmudgeon Jim Hightower takes his stand on the Farm Bill in “A Farm Bill in the Public Interest.”

    …this massive subsidy program has become a total perversion of what it was meant to be – and should become again. The New Deal concept (still valid today) was to support the public interest in having an abundance of good food produced by healthy small farms that, in turn, strengthen rural communities…the central focus of the program should shift to helping small farmers make the transition to organic and sustainable production, sell directly to local markets, form marketing co-ops, convert to energy and water-efficient systems, conserve land and natural habitats, and develop locally-owned processing businesses.

  • Morning EditionFarm Bill: Beauty for Biz, Beast for Environment?
  • Talk of the NationHow the Farm Bill Affects What We Eat.” A great panel discussion on all the ramifications of the farm bill.

Utah Politicians on Health Care

August 10, 2007

(I posted this last year on OneUtah.org, on which I was active at the time. It was a follow-up to my post “The Value of the Working Poor,” which had I cross-posted there. At the time I chose not to cross-post this one here, but have now reconsidered.)

I received several comments to my previous post on the working poor. Emily Hollingshead shared a recent experience she had at a meeting which was attended by many Utah politicians. One line in particular caught my attention. I hope Emily does not mind if I quote her.

I was shocked to hear some of our legislators talk about the “lazy people” who use medicare, and who “abuse the system” and who “make lifestyle choices” that put them in the hospital in the first place. The most shocking comment came from a gentleman running for the county commission who said the people who use medicare or medicade “use it all the time” because it is available to them and they have unending access to it. (Paraphrasing).

Interesting. I am not familiar with the situations about which this potential county commissioner is speaking. But it seems an odd perspective on health care.

Please correct me if I’m wrong; but isn’t a quality health care system one in which the patrons are able to make frequent and regular use of the system? Where frequent check-ups are the norm, so that potential health issues can be detected and prevented before they become catastrophes or expensive emergencies? “An ounce of prevention is worth a pound of cure,” I’d been led to believe. Is that only true for those wealthy enough to afford health care?

Are we supposed to turn away those whose lifestyle choices lead to health problems? How charitable.

I shudder to think what that would mean for the increasingly sedentary population, whose diet consists of increasing amounts of sugars, salt, and fats. The LDS community may not drink or smoke, but they are certainly vulnerable to a number of lifestyle choices which can put them in the hospital.

There may be more effective ways to accomodate their health-care needs, but the objections of these Utah politicians are completely off-base.

Jim Hightower on Bush’s Ideological Snake Oil

August 9, 2007

Populist/liberal Jim Hightower has a great barbed wit, and today posted a great commentary skewering the administration’s attitude towards health care reform.

…But Bush the dogmatist even disputes reality. In a July speech to the Cleveland chamber of commerce, he assured the audience that the lack of health coverage really isn’t such a big deal: “I mean, people have access to health care in America,” George informed them. “After all, you just go to an emergency room.”

He’s not the quickest bunny in the litter, is he?

Read his column, “Bush’s Ideological Snake Oil.”

Are you feeling well?

May 2, 2006

News that isn’t shocking news:

Americans are significantly less healthy than their counterparts in the UK.

(Read the article from the Journal of the American Medical Association)

Actually, Americans are significantly less healthy than a couple dozen of the other leading industrial nations.

How is it that ill-health can be so widespread in the wealthiest nation on the earth? We’re not just talking about the poor living in poor health while the wealthy are in the pink. According to the report, the rich in America are about as healthy as the poor in the UK.

Why?

How in the world can we possibly claim that for-profit, capitalist-based healthcare provides the best and most efficient healthcare, when we spend twice as much on healthcare and are much less healthy than those who rely on nationalized health care systems?

Are we seriously to believe the dogma that our American economic system (whether you call it corporate capitalism, free-market economics, plain ol’ capitalism, whatever) maximizes benefits and provides the greatest good to the greatest number when the healthcare system which that economic system supports (not to mention the lifestyle that system encourages) leads to epidemic obesity, skyrocketing diseases like diabetes, and general poor health among the population?

Time to wake up to reality and look beyond the dogma.