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Monday, November 20, 2017

MEDICARE FOR ALL-HARD HEADED ECONOMICS, SOFT HEARTED POLICY



                                       


We’ve all seen it: You walk into a convenience store and there on the counter, taped to a jar, is the photo of a child. Scrawled on the picture is an appeal to leave your change to finance a bone marrow transplant or some other treatment the child’s family cannot afford. Or maybe you can help the victim of a fire or accident by buying a pizza on the night that one dollar per sale goes to her medical expenses.  Do you feel good about being able to help, or are you outraged that these families have to beg for desperately needed assistance?

If you don’t feel guilty passing up such chances to help, perhaps it is because you realize the ultimate futility of such appeals. But if you don’t support doing something about it, you should feel guilty. These are neighbors in need. We can turn away from them now, but what happens when we need medical care we cannot afford?

Chances are, you don’t have enough insurance to keep from going bankrupt if you get an illness or injury requiring expensive treatment. 60% of bankruptcies are due to medical bills, and 75% of those undergoing medical bankruptcy are insured.  In other words, simply having insurance isn’t enough if you can’t afford to use it, or if you use it and go broke anyway.  Medical bankruptcies are unheard of in other developed countries. There, risk sharing through universal health care prevents the unlucky families who most need help from having financial ruin added to their burden. Everyone contributes to the system so that none need go without care when it is needed.

Aside from the humanitarian issue of having nearly 30 million Americans uninsured, most of whom are the working poor, there are many practical advantages to universal health care. When access to care is not tied to employment, it is much easier to change jobs. People are free to work where they want instead of keeping a job with medical benefits that doesn’t otherwise fit their needs. If they want to start their own business, they don’t have to worry about losing it due to unexpected illness or injury. Businesses are more competitive with overseas competitors when they do not have to pay extortionate rates for insurance and instead, have predictable costs.  These costs are significantly less in countries with universal health care than they are in the American system of access through for-profit medical insurance.

The financial benefits of universal health care are well known, but since some continue to claim that we cannot afford it in the US, it bears repeating: Other countries provide universal, comprehensive care for as little as half the amount per person that we pay in the US for care that is full of gaps even for the insured.  While it’s not estimated that we will save that much under the plan recently introduced in Congress by Bernie Sanders, his proposal for an improved system of Medicare for All would provide comprehensive care to every American at less cost than the current system.

Such as system would have built-in cost controls lacking in the Affordable Care Act. Without such constraints, the system will ultimately become unsustainable due to the familiar “death spiral” of medical insurance:  As costs rise, fewer can afford it, leading to premium increases to maintain profits, which leads to fewer being able to afford it, thus causing a new cycle of price increases. Ultimately, most of us will not be able to afford insurance without the subsidies offered under Obamacare. These subsidies amount to a bailout of Wall Street investors in the insurance industry for the sole purpose of maintaining their profits. They add nothing of value to the system to justify their siphoning 30 cents out of every health care dollar, when Medicare overhead is less than a tenth of that.

When you understand the economics of universal health care, it is hard to argue that we cannot afford it. The question then becomes, do we really want to pay more for less care for ourselves and our loved ones, just to deny it to those we think may not be worthy?



This article first appeared in the News-Review (Roseburg, OR) on November 17, 2017.

Thursday, July 13, 2017

ALL WE NEED IS LOVE




                                           


When I was asked to speak to my local Unitarian Universalist congregation on a topic of my choosing, I opted to speak about how we are morally obligated to resist injustice in general and war  in particular. Since this blogsite is a political one, it may seem inappropriate to some that I am choosing to publish a sermon here, but I do not apologize. Anyone who objects to the invocation of a higher power in the universe is welcome to skip past such references here, but the message is otherwise universal and entirely consistent with the stated aims of Soldiers For Peace International. I hope that it will provide some thought for those who battle for justice out of anger, and who forget that anger is but a response to the pain we feel when we see the powerful prey on the meek.


In his first inaugural address, with the nation on the brink of civil war, Lincoln called on the nation to remember that regardless of our differences, we are all bound by common ideals. Pointing out that we had a choice to resolve our differences peacefully, he concluded with an appeal to listen to “the better angels of our nature.”  That’s a beautiful metaphor, but what does it imply?

I believe it refers to the fact that Man has two natures that are often in conflict: spiritual and animal. When we decide to act in a situation with moral implications, we always face a choice between satisfying our physical and psychological desires or acting according to the greater good. Lincoln was pointing out that the coming war was not inevitable. War is always a choice.

In deciding on our actions, most of us try to balance the two types of motivation, animal and spiritual. We want to serve our own interests, but not at the expense of doing harm. But how deeply do we consider the effects of our actions and just as importantly, our decisions not to act? We can’t all be saints, but I believe if our needs are met it is a moral imperative that we do what we can to align with our spiritual side. That requires consistent effort. While accepting our limitations, we must constantly strive to improve. We are all creatures of habit, but the absence of change is death. Therefore, we must make it a habit to question our actions as a means of growth.

This starts with questioning our motivations. The difference between the two forms of motivation, spiritual and animal, is not always clear. Rationalization is powerful and universal. For example, we may strongly believe that character is built by being self-reliant. Does this mean that caring for others actually harms them? Some say yes. Are they just justifying their desire to avoid paying taxes to provide a social safety net? After all, most would feel differently if someone close to them is afflicted. Until the question affects them personally, such people suppress their innate compassion. I believe that this community supports the right of each of us to health care, but how many of us are standing up for the innocent victims of war. What interest does turning away serve?

Rationalization is an unconscious process, so how do we decide what our motivation is and whose interest our actions or inaction serves? The key is to honestly consider where our self-interest lies, and put it aside when it conflicts with what is best for all.   Perhaps we avoid confronting the evil of war because its horror is too overwhelming. That would serve to ease our anxiety and avoid a sense of helplessness, but at the cost of our spiritual well-being.

Animal nature is not inherently bad.  It enables us to survive as individuals in hostile physical environments. However, it is our spiritual side that connects us to the wider universe, including that which is not seen. God, however we choose to define it, is within us as well as outside of us. I believe that though we often forget it, love is what connects us to each other and to the wider universe. We can call this universal, all-pervasive love the Holy Spirit.

Love is not physical, yet nothing is more powerful. Love is the one thing that could exist without its opposite, which is not hate but apathy. Unlike darkness, which cannot exist without light, universal love fills the emptiness of space. I believe that this is because it emanates from the Source of all creation. It is our substance, in the most elemental sense.  We cannot ever separate ourselves from that Source or from each other, though we can become insensible of the connection. That is what apathy is, willful blindness to our innate compassion.

Our beliefs do not define us. Our actions do. What we think we believe is self-identity, but it is what we do establishes the identity that others see. When our actions follow our beliefs, we are said to have integrity. If we never examine our beliefs, we do not see inconsistency between our various beliefs or between our beliefs and our actions. But we cannot honestly say we believe in something if we are acting contrary to that belief. For example, “Christians” who claim that life is sacred but support the death penalty clearly do not believe what they profess.

We choose what we want to believe, often without thinking. In a very real sense, we construct our own reality. That is why we have become divided by our belief systems. We must strive to remember that in truth, we are one even with those who seem to have nothing in common with us. We should try to persuade others in a loving manner, not in one that promotes anger and conflict.  Our goal should be to create a common reality that is true to the loving nature of our spiritual selves.

So, if we want to become more the person we want to be, we have to make decisions by looking at all choices, understanding our motivations, and deciding to act according to the beliefs we wish to define us, such as thinking that we are empathetic, engaged and altruistic.

We cannot allow superficial beliefs to guide us, if they conflict with our core beliefs. For example, many of us believe that capitalism is literally God’s gift to Man. That’s fine as far as it goes, but if we allow that belief to justify acting in ways that do not reflect our spiritual beliefs, we have to challenge those inconsistent beliefs. Again, only when we develop a coherent system of spiritual beliefs and allow them to determine our actions can we become the persons we want truly want to be.

If we consider ourselves spiritual and virtuous, how do our actions show it? Are individual acts of kindness enough? If so, then what of the suffering of those who are victims of the powerful?  The working poor in America have no access to affordable health care. Innocent civilians in targeted nations in the Mideast and throughout the world are victims of US aggression cloaked as “humanitarian” intervention in the name of liberty and security. These problems and many others are not unconnected. They result from moral choices that we make as individuals and as a society. As Franklin pointed out, if you sacrifice liberty for security, you will have neither. If we believe in the principle of self-rule, we have a duty to demand that our government serve the cause of liberty and justice for all.

We fought a war that was ultimately about ending the institution of legal slavery. Now we face the task of stopping our government from enslaving the human race through war and economic coercion. We are all paying the price for allowing our government to serve the selfish interests of the powerful. Whether we are victims of austerity measures at home or of endless war abroad; whether we are suffering from compassion overload or have become numb to our innate compassion, none of us are spared. 

Those of us who are comfortable have a duty to those who are not, both poor Americans and victims of US aggression around the world. Doing nothing is a choice, but those who make this choice should not try to excuse it by saying that they cannot make a difference. It is only their efforts that can. Good intentions are not enough. We cannot honestly call ourselves spiritual if we do not face the evil that our government is perpetrating in the name of “freedom” and “security” and demand justice.  Standing up for what is right often takes courage and sometimes requires sacrifice, but the only hope for humanity in these dark times is for those of us who understand that we are all part of an interdependent web of existence, bound inextricably together only as strongly as our love for each other.