Filed under: Politics, Public Policy | Tags: compromise, Congress, conservative, Democrat, gridlock, ideology, liberal, moderate, polarized, political science, progressive, regressive, Republican, Tea Party
Today’s political dialogue is framed in terms of progressive politics versus conservative politics. Is this really the case? Multiple studies and surveys have demonstrated that Americans have become more polarized, politically, over the past two decades. This has become exceedingly apparent through the observations of the last two Congresses. Members on both sides have been promoting legislation that the opposing side will not support in an effort to score points with their own political base. The net effect is gridlock in Washington and in state legislatures across the country where elected leaders fail their constituents in an effort to maximize their abilities to reflect the vocal minorities of their base voters in an effort to become reelected.
While both of the main political parties, Republican and Democrat, are guilty of this, there are a number of underlying issues that need to be recognized and addressed. While the numbers of Americans who identify as either Republican or Democrat is relatively unchanged since the 1950’s, those who identify as moderate Democrats or moderate Republicans has declined since the 1970’s. The biggest changes of note are the loss of moderate voices in either party since the 1980’s which has intensified since 2000. This has been much more pronounced in the Republican Party especially since the election of President Barack Obama and the rise of the Tea Party after 2008.
Two underlying factors have been associated with increased levels of political polarization throughout history. These include immigration policy and income inequality. These factors were in play during the first part of the 20th century and are currently at the center of our current polarization crisis. Recent research has shown that the current polarization effect evidenced in state and federal elections is more significantly rooted in conservatives moving even further to the right on important policy issues while progressive politicians have not shifted much further to the left. The current shift means that it is so-called conservative political positions have veered into more extreme territory while traditional progressive policy positions have not demonstrated a similar dramatic shift further to the left.
Today’s arguments are not so much a difference between progressive and conservative ideas. The greatness of the United States has always been its embrace of change and forward advancements. The United States, for nearly two centuries, was the powerhouse of innovation and creation in technology and knowledge. Traditionally, both conservatives and progressives believed, and pursued change. Conservative thought and progressive thought agreed on one defining thing. The best days of America lay before her and each side promoted ideas and goals that would further this vision. While the more liberal voices promoted grand, sweeping changes, conservatives were often a voice of reason, of caution, pursuing these objectives over a slower, longer timeframe. This is one of the reasons that, for most of our history, politicians found the ability to work with their peers on the other side of the aisle to accomplish the things that would serve to benefit all Americans, and, American society. Conservatives and progressives did not disagree so much on change, per se, but on the rate of change or how sweeping such change would be.
In the last century, Democratic and Republican politicians came together to establish Social Security, the Interstate Highway System, Medicare, Medicaid, public works projects, the Environmental Protection Agency, the National Parks System, public university and college systems, the Civil Rights Act, the Voting Rights Act, FEMA, FDA, NIH, the defeat of Nazi Germany, the atomic bomb, the Arsenal of Democracy, the Hill-Burton Act which led to the building of hospitals to improve access to care, and many more great achievements.
Today, there are a number of voices within the Republican Party, as well as many voices outside of the party, who, while claiming to be conservative, are, in reality, regressive. These regressive voices see America as a place whose greatest accomplishments reside in the past and would seek to return us to an era where Jim Crow laws ruled the land, where abortion was still illegal, where there was no income protection for senior citizens or the disabled, and where segregation was still completely acceptable. These voices seek to overturn discrimination protections, access to health insurance, sensible gun regulation, and the foundation of every great society, our public education system.
Within the last decade, we have seen a surge in the number of white-supremacist groups, of so-called Patriot groups, and other hate-groups that actively challenge the legitimate authority of government agencies by threatening force and insurrection. This weekend marked the 20th Anniversary of the deadliest homegrown terrorist act on American soil, the bombing of the federal building in Oklahoma City that killed 168 Americans, including 20+ children. These are the voices that are being reflected in the increasingly regressive candidates running as Republican candidates for elected office.
It is not a matter of progressive ideas and conservative ideas being in conflict with each other. This is an issue of progressive, and according to many polls, mainstream, ideas clashing with a regressive ideology that renders compromise impossible. We are nearing a dangerous tipping point in our nation’s history. The trustworthiness of our elected officials is at its lowest point in recorded history, the favorability ratings of Congress are lower than certain types of insects, and while favorability ratings for both Democrat and Republican elected officials have fallen, the Republicans have fallen harder and faster. Election results from the past several election cycles have consistently demonstrated that more people have voted for the Democratic, or progressive, candidate than voted for the Republican, or conservative candidate. Gerrymandered election districts have ensured that candidates from either party cannot be readily challenged on the field of ideas in the way these districts are drawn. This causes frustration among the electorate.
When you hear a political candidate talking about how he or she is the conservative candidate, simply know that they are most likely a regressive candidate. True conservatives can work with progressives to get things done. Until we balance, and reverse, this polarization that we are witnessing today, elected officials are not going to accomplish much in the way of benefiting the American people.
Filed under: Health and Medicine, Legal, Politics | Tags: 1st Amendment, Birth Control, HIV, HIV Stigma, Hobby Lobby, Justice Alito, PEP, PrEP, Religious Freedom, Religious Liberty, Reproductive Health, Stigma, Supreme Court, US Constitution, USSC
This past Monday’s decision by the US Supreme Court regarding Hobby Lobby, et al., has been widely misinterpreted as both a sweeping victory for Christian businesses and a slap at the Obama Administration and the Affordable Care Act, as well as, a total annihilation of reproductive rights and reproductive healthcare in the United States. Both of these extremes are flawed and completely miss the mark.
While I do believe the opinion, penned by Associate Justice Samuel Alito, is flawed, it was not a broad sweeping opinion and it attempted to narrowly relate to the facts presented in the case. The ruling’s major flaws include its attempt to insert the Supreme Court into the role of determining, what is a legitimate religious liberty and, recognizing a corporate entity as having the legitimacy of personhood. Other flaws associated with the ruling are more covert and may not be recognized for a period of time.
While many have been quick to claim the Justices voting in favor of the Hobby Lobby decision acted out of a political, or ideological, motivation, they miss the fact that the government failed to provide enough proof for the Court to rule otherwise. The attorneys representing Hobby Lobby, Conestoga, etc., brought a case that expressed their clients’ opposition to four specific types of contraceptives that, to one extent or another, prevent the implantation of a fertilized egg into the wall of the uterus. These drugs, referred to by Hobby Lobby, et al., attorneys as abortifacients, prevent the fertilized egg from implanting into the uterine wall. They did not present evidence opposing forms of contraception that prevented the fertilization of the egg claiming only that their clients believed, as a matter of religious teaching that life begins at fertilization. The government failed to counter these claims with satisfactory evidence otherwise including any rationale that may exist, demonstrating improved safety, cost-efficiency, or beneficence for women.
The Court did not address, nor did the Hobby Lobby group claim, more invasive forms of contraception, including vasectomy or tubal ligation, violated their sincerely held religious beliefs. Nor did the Court address forms of contraception that prevent the fertilization of an egg. This is what narrows this particular ruling. One flaw in narrowing the ruling is that the Court failed to recognize medical and scientific consensus that life can only be recognized as beginning when the egg implants into the wall of the uterus and begins to divide. The Court relied on the Religious Freedom and Restoration Act (RFRA) to determine that the owner of a business does not sever their religious faith simply by entering into a contractual structure as in incorporating a business.
It should be noted that an egg that does not implant in the uterine wall, but rather begins to divide anywhere else is referred to as ectopic and may often require the surgical excision of a dividing embryo. This condition, an ectopic pregnancy, and the consequent surgical intervention associated with terminating this pregnancy would appear to also violate the religious beliefs of the Hobby Lobby participants in this case. This demonstrates the convoluted rational the Court used in reaching its 5 to 4 decision.
While the ruling did note that future court cases seeking religious exemptions for vaccinations and blood transfusions may result in a different opinion than what was rendered here, it is important for those of us concerned about reproductive health, that there are implications for pre-exposure prophylaxis (PrEP) to be discussed.
Because the Court did not address other forms of contraception, including vasectomy and tubal ligation, they also did not, more broadly address other forms of reproductive healthcare including vaccination against the Human Papiloma Virus (HPV), post-exposure prophylaxis (PEP), or PrEP. It is reasonable to anticipate that another corporate entity may elect to seek exemptions from requirements for other forms of reproductive healthcare. For example, an employer may suggest that sex outside of traditional marriage between a man and a woman violates their sincerely held religious beliefs, therefore requiring them to provide insurance coverage for PrEP or PEP is a Constitutional violation of their religious liberties. Notwithstanding the fact that there are male/female married couples that currently use PrEP as a part of their reproductive health, the Court’s failure to recognize legitimate scientific and medical consensus in the Hobby Lobby case should give us a reason to be concerned about how the current Court might rule when faced with such a case.
The Court erred in attempting to determine what constitutes a legitimate, and sincerely held, religious belief deserving of Constitutional protection which is troubling. The US Constitution ensures that each of us, as individuals has a right to believe as we so choose. The Supreme Court has now made itself the arbiter of what religious beliefs can be imposed by employers on employees which should be a concern for each of us.
Filed under: Politics | Tags: Affordable Care Act, AIDS, American Airlines, civil rights, Dave Agema, discrimination, HIV, HIV Discrimination, Human Rights, intolerance, Marriage Equality, MILive, Republican, The Herald-Palladium, traditional values, Until There's A Cure
Recent comments made by a former state legislator regarding gay people have been mutedly condemned by folks, mostly from the state of Michigan, who basically tsk-tsk his statements to a group of Republicans at a Berrien County event. Notwithstanding the gross inaccuracy of his statements to this conservative group, his comments are extremely troublesome for a party that is desperately trying to appear to become more inclusive and more tolerant of groups in which the Republican Party has to make significant inroads if it intends to survive as a viable alternative to progressive voices in the political realm.
According to an article in MILive written by, Jonathon Oosting on December 10, 2013:
“Some American Airlines employees, he claimed, would tell the company that a person with AIDS was their lover in order to help them get medical benefits.
“Folks, they (gay people) want free medical because they’re dying (when they’re) between 30 and 44 years old,” Agema said. “To me, it’s a moral issue. It’s a Biblical issue. Traditional marriage is where it should be and it’s in our platform. Those in our party who oppose traditional marriage are wrong.”
Agema’s comments were part of a larger speech calling for unity between various Republican factions under the party’s official platform.”
According to, Louise Wrege, of The Herald-Palladium in southwestern Michigan, the event Mr. Agema was addressing was the Berrien County Republican Holiday Party where he also addressed how he believed it was wrong for American Airlines to extend health benefits to same-sex partners and that he,
“saw firsthand what happens when benefits are extended to gay people.
He said American Airlines workers would say a person with AIDS was their lover so that person could get medical benefits.
‘Folks, they (gay people) want free medical because they’re dying (when they’re) between 30 and 44 years old,” he said. “To me, it’s a moral issue. It’s a Biblical issue. Traditional marriage is where it should be and it’s in our platform. Those in our party who oppose traditional marriage are wrong.’”
He has come under fire on multiple occasions for his statements opposing marriage equality. In response to his most recent comments, Republican leaders in the state have offered perfunctory statements distancing themselves from his comments but failing to condemn his intolerance or demand his resignation as a Republican National Committee member. He was elected to this position in 2012 after defeating incumbent Saul Anuzis.
Also, in The Herald-Palladium article,
“He said he accepted the position as the state representative to the Republican National Committee so he could help get conservatives like himself elected.
“It’s very important that you get involved with your politicians at a grass roots level and make sure that politician you’re trying to get elected fits certain criteria,” he said. “They must be a fiscal conservative. They must be a moral conservative. And they must be a Constitutional conservative or I won’t endorse them.”
While he was a representative in Lansing, he said he would not vote for a bill if it increased taxes, fines or fees.”
Mr. Agema’s comments are not about conservative values. They are about his personal hatred of gay people and his repeated comments confirm this. More importantly, they underscore the attitude and direction of today’s Republican Party. His opposition to extending domestic partner benefits to same-sex couples in the 1990’s is consistent with current Republican actions that would continue to let health insurance companies discriminate against individuals with pre-existing conditions. His claims that gay people acted fraudulently in attempting to obtain health insurance benefits for their partner’s is reprehensible and not supported by the facts. He has claimed that the city of San Francisco essentially black-mailed his employer, American Airlines into providing such benefits which is also patently false. While the City of San Francisco did pass such legislation it was partially struck down by the Courts and therefore, did not force American Airlines, or any national company, to abide by it. American Airlines, as did many other large companies, decided later to implement such benefits as a strictly business decision.
In the 1980’s and early-1990’s, the AIDS epidemic did, in fact, claim the lives of a great many people. While the great majority of those who died in the United States were gay men, by the late-1980’s, and certainly by the early-1990’s, it was well known that AIDS was not simply a disease of gay men. That is certainly the case today. The opposition to affordable health insurance then most assuredly led to the untimely demise of many people in the prime years of their lives. The current opposition to affordable health insurance for all people will absolutely lead to the untimely demise of many people and not just those affected by HIV and AIDS. As Ebenezer Scrooge was visited by three ghosts during the Christmas season, I wonder if Mr. Agema sees the ghosts of those who have died as a result of his hatred and intolerance?
If the Republican Party is going to continue to permit hatred, lies and intolerance to guide its selection of leaders, the Party will collapse. This would truly be a tragedy for fiscally-conservative values. Statements like those made by Mr. Agema must be soundly condemned by the leadership of the Republican Party. “The only thing necessary for the triumph of evil is for good men to do nothing.” (Edmund Burke) Are there any good men in the Republican Party?
Filed under: Health and Medicine, Personal, Politics | Tags: activism, ADAP, AIDS, ART, Dab the AIDS Bear, education, HIV, HIV Discrimination, HIV law, PrEP, World AIDS Day
December 1, 2012 marked another World AIDS Day. Once again, I had the opportunity to participate in events over the past week relating to WAD. Each year, I pause to remember those I have known who have lost their valiant battles with this disease. Since 2002, World AIDS Day has had a special significance as in January of 2002, I tested positive and was diagnosed with AIDS. I am one of the fortunate ones. I have a loving and supportive family and wonderful group of friends. I am also a beneficiary of the tremendous scientific advancements that have served to save and extend my life.
This year, I attended the International AIDS Conference in Washington DC. I met many incredible people who are true leaders and advocates in the fight against HIV and AIDS. This year was the first IAC to be held in the United States since 1990! The event was remarkable because it was the first time a person who has been cured of HIV was introduced. The event also highlighted other great strides that give hope and promise that HIV will become a chronic, manageable condition instead of the virtual death sentence that was the case in the first 10 to 15 years of the epidemic. Also, evidence was presented about the benefits of pre-exposure prophylaxis (PrEP) and that people with suppressed HIV viral loads have a greatly reduced risk of transmitting the virus.
In contrast to all of the hopeful information that was shared at the IAC, some troubling issues were raised. One person is infected with HIV in the US every nine-and-a-half minutes. One-in-five people, or 20% of those infected, are unaware of their HIV status. Among Americans who are diagnosed with HIV only one-quarter have their viral load suppressed. The AIDS Drug Assistance Program (ADAP) still has people on waiting lists for financial support for HIV medications. A number of states have reduced an individual’s income level required to be eligible for ADAP support. Criminalization and stigma continue to have a negative impact on HIV testing and prevention efforts.
Secretary of State, Hillary Clinton, has stated a goal of achieving zero new HIV infections by 2015. In order for these goals to be realized there must be improvements made to the issues identified above. We currently have the tools necessary to eliminate new infections and we need to generate the interest in implementing proven strategies to make this happen.
This brings me to this year’s WAD events that I participated in. This year I noticed that at various events, a minority of participants were actually HIV positive. A similar, relatively small, number were gay men. Considering the impact that HIV has among men who have sex with men, I was disappointed. If we are going to reduce the rates of HIV infection in this population to be consistent with the goals of Secretary Clinton, a significant ramp-up of education and prevention efforts will have to occur in order for this to happen.
I know this will require folks, like me, who have been living with HIV, to stand up and speak out. It requires people to have personal courage and a desire to erase the stigma associated with HIV. It will require people to get tested for HIV and to be adherent to medications that will suppress the virus. It will require pharmaceutical companies and the government to ensure that these medications are made available to everyone who needs them and that they will be affordable. It will require the repeal of criminal statutes that penalize those who are known to be infected with HIV. It will require a commitment from policy-makers, patients, people who are at high-risk for HIV infection, educators, activists, healthcare workers and business leaders to make this happen.
In the 1980’s, as this new epidemic was unfolding, it was activists who demanded changes to the status quo. The time has come for these activists, along with a new generation of activists and allies, to come together and demand the changes necessary to make HIV and AIDS a thing that is discussed in history textbooks. It can happen. It must happen. HIV will lose. But, only if we, as a nation, come together and commit to an end of AIDS!
Filed under: Health and Medicine, Legal, Politics | Tags: ACA, Affordable Care Act, health, healthcare reform, individual mandate, Law, Medicaid, Medicare, medicine, Supreme Court, USSC
Within the next two weeks the United States Supreme Court will issue its ruling on the Affordable Care Act (ACA). There is much speculation as to what the Court has decided (yes, the case has already been decided) when it issues its ruling on the Constitutional questions raised by the Affordable Care Act. Some think it will be completely struck down while others (you have to love dreamers) believe it will be completely upheld. Most of us who have actually read the Act, believe it is quite likely that the Justices have decided that parts of it fail to pass Constitutional muster and must be struck down while leaving large portions of the ACA intact. In any event, the ruling of the nine men and women who comprise the highest court in our land, will have far reaching effects on the lives of everyday Americans. Not only will their decision(s) affect average folks, the impact will be felt by healthcare providers, insurance companies, pharmaceutical companies, and medical device manufacturers.
For the President, the ideal situation would be for the Justices to decide that the entire Act is Constitutional, thus bouncing any attempts to modify or repeal all, or part, of it to Congress which is unlikely to muster the support for doing so. I, personally, think this scenario is unlikely for two reasons. First, I can see a lack of Constitutional backing for the individual mandate that is a key provision of the Act. Second, given the current make-up of the Court, I do not see a majority of its respected members agreeing that this provision is Constitutional. Certain members of the Court are not especially keen on having the Government require individuals to do certain things. In many ways, this is a very good thing.
For Congressional Republicans, an ideal scenario would be for the Court to strike down the entire Act. This would allow them to put forth legislation addressing the provisions of the Act that a majority of Americans have repeatedly identified are quite acceptable to them. This would allow Republicans, with very broad bipartisan support, claim they support meaningful healthcare reform. I also do not believe this scenario is very likely because precedent shows that the Court has supported the right of Congress to enact laws that address interstate commerce. The issue the Court must grapple with here is that there is no specific severability clause that would permit the Justices to only strike portions of the Act. Not that there is no precedent for allowing this, it is, however, interesting that no such clause was included in the final legislation that was sent to the President in March of 2010.
Personally, I am inclined to believe that the Justices have decided that the Act can survive with the removal of the individual mandate. It is not up to the Court to decide that the hardship forced on corporations resulting from a loss of revenue as this is not a question posed by this case. So, what happens if the individual mandate is struck down and the remainder of the Act survives intact?
Medical insurances companies will, initially, face the greatest financial burden. They will (continue to) be forced to provide coverage to anyone regardless of medical condition. Further, they will (still) not be able to drop people when they become ill. These are both extremely important issues for individuals who, inevitably, will require healthcare services at some point in their lives. Pharmaceutical companies are also on the hook for reducing the cost of medications to some groups and this would not change with or without the individual mandate. Hospitals and other healthcare providers will be hurt with the loss of an individual mandate as Medicare and Medicaid reimbursement rates are slated to be kept under a tight rein under provisions of the Act. With otherwise healthy folks showing up in Emergency Rooms, reduced reimbursement and increased volume will make it a challenge to continue to provide high-quality care.
The impact on businesses and individual purchasers of health insurance will become very noticeable without an individual mandate. These folks can expect their premiums for health insurance to rise significantly especially for those who have pre-existing conditions or who work in inherently dangerous fields. Without the guarantee of a large, relatively low-risk, pool of people purchasing insurance, companies that sell insurance will be forced to raise rates on everyone who does buy in order to maintain a healthy profit-margin and in light of the fact that individuals cannot be denied insurance. Businesses and corporations will likely decide that it may be cheaper to self-insure thus drawing even more customers out of the health insurance marketplace. As this begins to happen health insurance providers will begin to go into bankruptcy leaving millions with insurance policies that are worthless. This is the worst case scenario, however, it is what will ultimately lead to something I have recommended for more than a decade. As insurers fail, healthcare providers become sucked in by a staggering loss of revenue, and they, too become bankrupt. The Government, belatedly, recognizing that healthcare is not a commodity that cannot be satisfied by the traditional laws of supply and demand, will have to take action and a form of Universal Healthcare will be implemented.
Could this be avoided? Not likely. America has the greatest medical technology in the world. The healthcare industry in the United States makes up about 1/6 of our Gross Domestic Product (GDP). The costs associated with the development of new drugs and medical devices that are designed to improve the quantity, or quality, of life are, well, quite costly. Healthcare in this country is, literally and figuratively, too big to fail. Unfortunately, finding a way to pay for this is an issue. For far too long America and its leaders have acted as though healthcare, and access to it, is a commodity that is to be financed based on free-market principles alone with very limited regulation. American citizens have become so insulated from the actual costs associated with healthcare through employer-provided insurance benefits. We have come to expect the very best in medical innovation even though it is not always necessary. We demand the newest drugs. We know we will receive tests performed on the latest diagnostic machines and that a robotic system can be used for almost every surgical procedure. This is neither cost-effective nor wise. However, when the Affordable Care Act was introduced, critics called attempts to look at the feasibility or appropriateness of care, people balked and critics derided this, quite incorrectly, as the implementation of, “death panels.”
Instead of implementing a Universal Healthcare system, or at least the framework of such a system, when they had the opportunity, Congress attempted to circumvent the inevitable. Healthcare has become a major burden on businesses and individuals. A uniquely American model based on the healthcare systems of every other industrialized, and a significant number of developing, nations should have been seriously discussed and implemented. We had the chance to do this in 2009 (and a number of times in the century prior) and we failed. We were provided legislation that, despite its length, failed to ensure that every citizen had insurance. The final bill failed to provide sufficient cost-containment mechanisms. The expansion portions of the bill were challenged by Attorneys’ General, allegedly, acting in the best interests of their citizens. And this is why we eagerly, and anxiously, await the opinion of nine folks in black robes.
One other prediction. Whatever the ruling(s) that are presented, they will be nearly unanimous. The Court will have considered its own integrity and, realizing the view of the Court in recent years as more in lockstep with their Presidential nominator’s political affiliations, will make sure that whatever conclusion has been reached is supported by a near-unanimous Court.
Filed under: Politics
Congratulations to Scott Walker of Wisconsin who was able to survive a recall election and remain Governor of the Badger state. The pundits will debate about this means for Republican governors across the country who wish to implement drastic reforms in order to address structural budget deficits while attempting to erode the collective bargaining rights of workers. They will also debate the implications for President Obama and for Democrats in general. I will leave these debates to the talking heads on radio and TV.
Personally, I am more concerned about the price of Governor Walker’s victory and how it was obtained. The recall election is the first major election following the US Supreme Court ruling in Citizens United. I believe it is important for all of us, as Americans, to pay attention to what happened in the great state of Wisconsin. Wisconsin, for many years, was a leader on progressive issues from worker protection to non-discrimination. Since 2010, however, and the election of Governor Walker, legislative behavior has taken on a decidedly regressive tack. The Governor has significantly rolled back collective bargaining rights and scrapped equal pay provisions for women. Anti-abortion provisions are percolating through the Republican-controlled legislature and the Governor has indicated he would like to implement major corporate tax cuts which will have to be balanced on workers. He has slashed education budgets for both K-12 and higher education and has consistently spoken about how public teachers are to blame for everything that ails the public education system.
After draconian legislation curtailing the ability of workers to bargain collectively was signed into law, a recall effort was initiated that garnered enough signatures to proceed. This effort was, primarily, a grassroots effort. It coincided with massive protests at the state capitol that were viewed throughout the nation as a symbol of what happens when you tread on the working men and women who have made our nation so great. More than a million signatures were presented and validated. More than enough to warrant a special election.
And, then, the money started rolling in. Billionaire financial backers of Scott Walker’s agenda poured money into his campaign to hold onto his office. Labor unions and working class individuals tried to finance the campaign of Mr. Walker’s challenger, the Mayor of Milwaukee, but the flood of money from outside sources, including the Koch brothers, proved, in the end to be too much. Granted, Mr. Walker did lead in every reputable poll against his opponent. It should be noted, however, that Mr. Walker’s team spent almost a whopping $27 million dollars more than his opponent in this election! This was the most expensive election in Wisconsin state history! This should serve as a warning to all patriotic Americans that the wealthy elites are able to, essentially, purchase an elected office. The question every American should ask is, “What is the quid pro quo for the office?” Are those with the greatest wealth acting out of a sense of altruism that by electing a particular person every citizen will benefit? I am strongly disinclined to believe this. Instead, I believe the intent is to ensure an elected official is in office who will serve to protect their personal interests and, more importantly, act to preserve or increase the benefactor’s personal wealth.
In light of the Citizens United ruling, any wealthy individual (or group) can privately fund a candidate for elected office. This is, most definitely, not the intention of our founders. It was intended, at our nation’s founding, that each person should have an equal voice in selecting our representatives. Instead, it is the most wealthy among us (and, perhaps, even from other countries) that are selecting the people’s representatives. This should make us each pause and consider, what is the price of victory?
45 to 47 million Americans are currently without health insurance. This is not to say that anyone is, technically, without healthcare. For the individuals and families who comprise the number, it means that all healthcare costs will be billed directly to them. For a simple Doctor’s office visit, they may be able to pay the total cost out of their pocket. For a visit to the Emergency Room, they may ultimately face financial ruin and bankruptcy. Of course, most physicians offices do not accept patients who do not have private insurance.
It has been said that the true measure of a society lies in how it takes care of those most in need. In the United States, far too often, we have fallen short. America has always been the leader among nations and is still the country of choice for many who strive to get here through both legal and illegal means. Citizens from other nations have not come here because the healthcare system is so great, but for the opportunity that America has always provided to the people who live here. While the greatness of our nation has shown in manufacturing, technology, diplomacy, efficiency, and military might, we have not demonstrated as much success in the areas of poverty, education or healthcare. Why is this the case?
Hospitals and Physicians offices throughout the country are blessed with the latest technology available to diagnose, treat and heal the sick and injured. Yet, our lifespan ranks below almost every other industrialized nation and a number of developing nations. It is not a lack of money or a lack of spending money that produces these statistics. America spends trillions of dollars on healthcare. Yes, trillions, with a T!
According to the Centers for Medicaid and Medicare Services (CMS), 2.2 trillion dollars was spent on healthcare in 2007. A 6.1% increase over 2006. Averaging out to $7,421 per person in the United States! Healthcare spending in the US makes up over 16% of our gross domestic product (GDP).
All this spending must make America the greatest place for healthcare in the world, right? Not quite. In fact, not even close. The only measures in which the United States ranks at the top of the list? Latest technology, healthcare spending per person, and healthcare spending as a part of GDP.
Life expectancy at birth? We rank 24th
Infant mortality? We rank 19th
Overall level of health? We rank 72nd
Healthcare as % of GDP? We rank 1st
According to the World Health Organization (WHO) when they did a global survey of overall healthcare delivery in 2000 ranked the United States 37th right behind the Dominican Republic and Costa Rica and just ahead of Slovenia and Cuba! That is out of 193 United Nations member nations. The top 25 included all of our European allies and Japan. The top 30 included Canada, Saudi Arabia, the United Arab Emirates, and Israel. At least we made it in the top 50 along with Poland, Bahrain, Qatar and Croatia.
What is the matter here? Having worked in healthcare for all of my adult life, I know this is a problem that can be addressed and resolved for the benefit of our nation. The American people must first stand up and demand a change in the business-as-usual method of healthcare delivery.
First, however, people need to ask a fundamental question. Is healthcare a “right” or is it a “privilege?” My personal belief is that it is a basic, fundamental right, as is education, national defense, public safety and infrastructure serve as such. Quality health of the individual is critical to the pursuit of success in life and vital to the continued success of the society. As the basic knowledge and skills that are supposed to be imparted by the K-12 public educational system and as the police and fire-fighters that stand ready to assist us in our need demonstrate, healthcare must be available and provided for all people in this country. Each of these things, and to some extent already, healthcare too, is funded by tax revenue. Everyone laments having to pay taxes, however, the critical support systems of a society cannot stand without the financial support of all who may possibly require these services at some point.
If, as I believe, healthcare is a basic right, the question becomes, “Who should pay for it and how?” This is where each of us must participate to determine how to create a viable system that is available for all.
Think about that!!
Ken's Take on the World 