Trust Us!

The more I read about the health insurance reform going on in Congress the more confused and worried I get. This isn't supposed to be the way it works -- like in the public service annoucement, its supposed to be The More You Know.
This process is so complex its no wonder nothing has ever passed. In addition, in the current environment, there is no trust that the people's interest is what is driving the compromises. Incremental progress is now a Republican concept to derail health reform. I'm really concerned that whatever comes out of Congress is going to make things worse rather than better, both politically and about health care. As I read the bills in both the Senate and House, there seems to be some good things in them. And after reading them, or summaries, I generally thought this would work. But then upon reading criiques of them and the Massachusetts bill and seeing the cost to a middle class American family, I'm astonished that some of this is being proposed. I'm talking especially about the individual mandate coupled with the skimpy subsidies.

The Congress seems to be unwilling to take back the windfalls to the rich from the tax breaks earlier in the decade to help pay for this. These windfalls resulted in some of the most revolting excess of conspicuous consumption witnessed since the Gilded Age and by some of the same types of people who were called Robber Barons in the late 19th Century. The filthy rich involved in Enron, World Com, Tyco and plenty of other dot coms earlier this decade have been replaced by the filthy rich from AIG, Citigroup, Goldman Sachs, Morgan Stanley, B of A, among the survivors; and, Countrywide, Wachovia, Washington Mutual, Bear Sterns and Lehman Brothers among those who did not. Whether the people who reaped the benefits from the demise of any these organizations landed on their feet hasn't bee analyzed in any depth as far as I know, but in their heydays, they walked away with billions.

Because of this unwillingness to tax any of this "wealth", the individual mandate may end up costing a family of four $9K or more for a health insurance policy. And given that it costs over $13K for many policies one wonders if they will get even minimal protection for that price. If one cannot or does not wish to pay this amount [unless the government agrees with a hardship exemption] the family will be fined up to $3800 for not having insurance. There is also no employer mandate and this may result in either poor quality choices from an employer or incentives to dump employees into the Excange Market. These provisions are in the Baucus bill which is currently the media favorite for passing the Senate. A question was posed on the Sunday talk shows to Obama about whether this was a tax. He denied that it was because we know "tax" is a four letter word in politics. However, it is hard to see how someone with a family making $66000 would refuse to pay for insurance if it was what they considered affordable. They likely uninsured because they consider the premiums unaffordable given the many demands on a family budget. Many people just don't have that much available for something they can do without if they are lucky. Yet, this bill will require they pay these sums to private companies who have been denigrated in this battle for being anti-patient and greedy, uncaring behemoths who owe their allegiance to the bottom line and their stockholders. It is unlikely that these companies will lower their premiums without some outside force. Yet that outside force, if available is about as capable of exercising any pressure as an ant facing an anteater. This bill would also set up a mechanism for enforcing this mandate, further siphoning off government dollars that would be better spent for health care or deficit reduction.

The Massachusetts experiment provides a picture of just how difficult this process is. While the program has dropped the level of uninsured to less than 3%, it has substantially smaller penalties and higher subsidies than the Baucus bill. And yet, there are many anomalies of coverage such as a 40% dropout rate on some policies after 5 months. Enforcement has not been easy and premiums and penalties are increasing as costs balloon out of control. Can the federal government do any better? Are the enforcement mechanisms against the insurance companies for keeping their part of the bargain as good as those against individuals through the tax code.

This is also just one example of why the bills are so long and complex. Each item they take up brings forth all kinds of permutations that have to be addressed less they create loopholes which imperil the bill's purposes. Reading the bills seldom explains anything in clear language because so much is an amendment of an existing law or a change to a procedure or regulation in another Title or section.

All of this is being done in an atmosphere of severe distrust of our leaders that has seldom been so evident. It is also being done without the transparency that was promised in the campaign. Every "deal" behind the scenes with the medical industry raised scepticism as to who's benefit these are done, since medical industry contributions and lobbyists are at an all time high. People who have been burned by other government reform efforts are feeling very unsure about this one as well. With 80% of the people insured through their employer and only uneasy about its potential loss, any bill that does not make things better could be viewed as a disaster for those who are insured.

All these concerns I have are juxtaposed against a personal desire to finally see us commit to making health care a basic right in this country. Do we throw the baby out with the bathwater or do we wake up to find the baby was poisoned to death by the bath water? I know legislating is ugly and difficult. I know compromise is the only way to pass something, but I fear the Democrats is their efforts to compromise the heart of the effort away may be setting themselves up for a terrible backlash. And the Republicans who have opposed any reform may end up being the winners because their names won't be on any legislation when the bills for premiums or penalties, and the complaints about problems with the bills start rolling in.

Brothers in Murder

On Sunday night, I watched a Dateline piece on Alex and Derrick King, two brothers who, when they were 12 and 13, killed their father with a baseball bat and set fire to their home. I have since read a couple of articles and the comments to a HuffPo piece. The comments are divided between those who think that they should have been locked away for good or executed and those who support the apparent rehabilitation of the boys, now young men, by people caring about them while they were in prison. I tend to the latter as I cannot understand how a country who will not trust the judgment of an 18 year old to drink would put a 12 or 13 year old on trial as an adult. I also know that few people ever come out of our adult prison system better than they went in. The men seem to have made an exceptional adjustment to life on the outside and have a tremendous support system that may bode well for their full re-entry into society. I certainly hope so.

I had not planned on watching Dateline as I find it often lurid and showy. I watched an excellent piece on a woman in Pakistan and stayed to watch this. After watching, I am struck by several feelings. One is why these men were willing to go on national TV and thereby subject themselves to millions of people knowing who they are now and thereby unleashing the kind of vitriol I saw in so many of the comments. The interview provided no insight into the crime and was basically a waste of my time. However, I was struck by their absolute lack of acceptance of the enormity of their crime and the need to acknowledge what they did before they can move forward. They were oddly calm and reserved about their past and were at a loss to even explain what they had been imprisoned for. They were upbeat and looking forward to moving on. They were in a supportive adopted family with other strangers who had become friends after having rallied around them after the crime. All this gives one great hope that they in fact can put this behind them.

However, I am still bothered by this fairly innocuous and partly uplifting interview, because there was a feeling that the rage that had been unleashed the night they killed their father has not been vanquished but fully repressed. The piece provided no information on their life in Florida juvenile facilities, except one mention of the younger Alex's attempt to escape for which he fortunately escaped severe punishment. The piece said his adopted Mother has not discussed the murder with Alex and everyone seems content to pretend the past never happened. Alex, at the urging of Depak Chopra, is speaking to children about the evils of violence at a variety of events. When one was filmed, the student asked Alex why he had been in prison and he replied that he had made some bad decisions. I hardly think murder of your father and arson qualifies as just bad decisions.

Almost all serial killers were physically and mentally abused as children. Most pedophiles are repeating the crime that was done against them. These children were in foster homes from a very early age, abandoned by their mother, and perhaps abused by a father who was apparently pushed to take them in, when a foster home sent Derrick away because of his behavior. The father was a low wage worker who apparently was strict and unavailable emotionally and could provide little in the way of material goods the boys wanted. He allowed a convicted sex offender to befriend the boys and become a very important force in their lives. Alex was abused by this man; and its never been stated whether Derrick was or was not. These events in their lives do not mean they should have been thrown away in an adult prison for life, but they do suggest that these children needed extensive counseling. Growing up in a detention center has to be an emotionally difficult process even without their history. Since Florida has a criminal justice system which promotes law and order over everything else, I can't imagine they received the type of help they most likely needed. Perhaps I'm wrong and I hope I am.

The caring that the people who came to their side while they were in prison is a wonderful statement about how people can behave and how love can make a difference in people's lives; but it doesn't erase the scars that were created by their lives up to and including prison. I admire the woman who took Alex in and is now helping Derrick establish himself. Perhaps if I knew them I would feel more sanguine. But I hope this incredible act of charity [St. Paul's definition] doesn't come back to haunt them.

The interview left many questions and few answers.

Two Realities

I started this post a week or so ago and then decided not to write it. I'm back to try and sort through the feelings that prompted it so I can get on with my life. I feel I live in two worlds. One is the news world where so much is at risk, there seems to be so little progress and people are generally unkind or unforgiving or angry. The other is the everyday world inhabited by most of my friends and the rest of the world. It's the mundane, everyday life that most of us share. We sleep, work, read, travel or whatever suits us. Days pass and life goes on. Many people see no conflict with these two worlds, primarily by spending little time in the first. I find the two almost opposite in nature and find I need to choose one or the other. I hope I'm wrong.

The News Reality: I read a variety of articles, mostly on the internet - NYT, WAPO, blogs, and local news. I've been drawn in by the Health Care "debate"; the financial meltdown; global warming; extinction of species; in Afganistan and Iraq; humanitarian crises in Darfur, Congo, Pakistan, Somalia, New Orleans among others; and the extreme partisanship and anger in the country. I feel this stuff passionately and personally but feel powerless in its face. I'm impressed by those who move forward in little steps to save a child, a school, a refugee population, or those hit by a natural disaster, among many things. But for me, I feel little steps are too small and big steps are beyond me. The bad news paralizes. A friend tells me I get too upset - that the world has gone on for eons and it will go on. I find that the only way to come even close to that equanimity is to ignore the news completely, almost like an alcoholic refraining from alcohol.

The Real World Reality: The withdrawal from news works wonders for this world and it makes me realize why so many people decline to be activists. My life isn't exciting, I go through it without much awareness of days and weeks passing until another milestone appears and I realize another year has gone. I claim that in this world my mantra is "Do no harm". I try to contribute to charity, live a fairly green life, try to be polite to strangers and kind to friends and acquaintances. I don't know if I succeed but I do try. The only problem is I feel guilty. I feel like I have contributed nothing to the world. I used to repeat a quotation that 99% of the people were born to fill graves and I didn't want to be one of them. I can't find any references to that quotation so now, I'm not even sure it exists. Perhaps that is a sign that it is alright to move on and become one with the 99%.