Tuesday, March 23, 2010

The Genie is Out of the Bottle

On Sunday night I was one of the many millions of people doing something rarely done, watching our Congress in action, live, during and just prior to the House vote on health care. In the course of the “debate” portion (an absurd misnomer for sure), one of the Republican speakers (I don’t recall which) used a 1964 quote from Ronald Reagan, which I found interesting. He used the quote both to inject the name Ronald Reagan, which has deity status with the Conservative Right, and to argue that even in 1964 Reagan was shooting bull’s-eyes on the subject of health care. What Reagan was attacking at that time with his predictions of lost freedom and lost liberty was Medicare. It was Reagan’s first political issue delivered on a national stage which he began to preach in 1961, the same year he was dropped as spokesman for General Electric and changed his party affiliation from Democrat to Republican. In fact, he did little else during those years other than campaign against Medicare, ending with his famous keynote speech at the nomination of Barry Goldwater.

I couldn’t help but wonder how many Republicans in last Sunday's “debate” would openly demonstrate their devotion to Reagan’s “insight” by advocating the dismantling of Medicare (& Medicaid) along with stopping any attempt to make health care realistically available to the general population. John Boehner, the House minority leader and a champion of the if you say a lie with enough conviction and repetition it’s as good as true philosophy, screamed how shameful the House was in not carrying out the “will of the people”. Perhaps he felt the specter of Ronald Reagan behind him breathing sweet sound bites in his ears since Medicare never polled anything close to a 51% majority prior to its adoption into law. Nah…because the fact of the matter is that Reagan ended up as most Republicans are today, as stalwart defenders of Medicare, at least in any public setting.

The true opposition to the newly passed Health Care Reform bill (which is really more accurately a health care insurance reform bill) had little to do with health care. Every politically ambitious Republican I’ve seen interviewed since the passing of the bill is now putting emphasis on the righteousness of Health care reform and the injustice of their plans not being included (the 200 plus Republican articles contained not withstanding). The fact that the Republicans had control of the House for 15 of the past 23 years and never introduced any comprehensive health reform (but did manage to kill reform during 2 of the years they were out of power) makes their postulating a comedy, albeit a dark one. Why would they? They would never never never originate health reform because it would be contrary to the interests of their constituents. Not the duped tea party crowd I assure you, rather those powerful interests that are on the nipple end of our $1.7 trillion transfer of wealth: funds transferred from the health care consumers, taxpayers, and debtors to the for-profit health care industry. Whether you believe it or not, it’s the only thing that makes any sense.

The stark evidence of this could be seen in the days and hours before the vote. With Republican leaders holding signs from the Capital porticos egging protestors below to amplify their rage; protestors who held pictures of Obama portrayed as Hitler (as if fascism played a role?), signs with guns portrayed as a solution to meddling proponents, “activists” hurling homophobic slurs at Congressman Frank, and “patriotic” Americans outside and in the halls of the Capitol Building spitting on and calling out “nigger” to distinguished black Congressmen, including Congressman Lewis. The lunatic fringe that performed such acts may have been only the tip of an iceberg, but it was all the same iceberg. It is the sad result of unleashed profiteering zealots like Limbaugh and Beck, and political leaders like Boehner and Cantor, totally focused on their political ambitions, who have mastered the use of such meaningless generalizations as “government takeover”, “will destroy America”, “Socialism”, “rob you of your freedom”, “enslave your children”, “lose your job”, “lose your coverage”, and this Limbaugh predictive threat (which I think says it all): “lose your right to fish”!! None of it had anything to do with health care reform, let alone health care insurance reform. It only prays on ignorance and it undermines the moral integrity of a nation for the benefit of a small minority.

Ronald Reagan used the following phrase as a mantra in his election and re-election: government is not the solution to the problem, government is the problem. It resonated because it was combined with a conservative axiom that taxation is fundamentally evil, even if it’s necessary. The Reagan administration and the two Bush Administration then began to dismantle government regulations even as they expanded government and government debt exponentially (note that debt is just deferred taxation). Only in the Clinton “pay as you go” administration was debt accumulation temporarily paused. Republicans will now argue that “government” is the cause of all health care short comings, that “government” (currently with a distorted likeness of Obama) is poised to rob you of your wealth and happiness, and “government” can only be contained by, as Limbaugh announced yesterday, “ridding ourselves of those bastards”. They'll claim this even as they claw and scratch to be elected to (dare I say it)...government.

But on this one the genie is out of the bottle. They can’t go back, any more than they could on Medicare. The greater question is whether those who just succeeded can continue to turn an imperfect but necessary beginning into a workable future, in spite of the distortion and self interest.

Thursday, March 11, 2010

What is So Special About People Over 65?

One of the great ironies attached to our national health care debate is the avid support that individuals over the age of 65 (seniors) have for the status quo. I don’t mean to suggest that all seniors think alike, even on national issues, but as a group they fall pretty solidly with the Conservative message on health care - that things are better left unchanged instead of embarking onto something as demonic as Government supported health care. Anecdotally, it has been my experience in talking with many seniors that the vast majority do abhor the idea of change, even as many criticize their personal experience within our current system (interestingly, they don’t necessarily fault the System; rather they’re more likely to blame the insensitivities of subsequent generations). The irony, of course, is that they are already active and satisfied recipients of what they argue so vehemently against expanding– Medicare.

Why should they support change? I can’t think of any good reason - even the truth - as long as self interest prevails. They are one of two sets of beneficiaries in our flawed system (the other beneficiaries are those on the receiving end of the $1.7 trillion transfer that takes place every year in the United States). How did this happen? What makes Americans over 65 so special, that their health and well being is somehow more important than say children 16 and under, or pregnant women, or perhaps young adults with multiple sclerosis? Like most things, you have to go back to the beginning:

What we fondly and simply know as Social Security began as our nation was just rising in 1935 out of the first major dip in the Great Depression. After experiencing the inhumanity caused by failed financial systems, the concept was simple; provide a base line of income to a class of citizens who, as a result of age, no longer had the capacity to earn income. Like insurance, the cost would be borne by all working people in order to contain cost, but unlike free market insurance (as with annuities) participation could not be an option. However, in order to pass the legislation with the votes of those who raised the specter of Socialism, the taxes and benefits would be restricted to working Americans. Of course, as it gained in popularity and, therefore, became politically attractive, it began to grow in complexity and benefits. Even as the projected benefits began to outweigh the projected “assets”, and even as the “assets” were in the form of purchased US Debt (Treasuries) during periods of overall deficits (a bit like an individual who puts $1 into savings for every $3 he puts on his credit card), the reality of Social Security became sacrosanct to Conservative politicians (Republican or Democrat). None…I repeat none would openly argue against it today. Why? Because, even with it's flaws, the nation sees it's value. Enter Medicare.

The Social Security Act of 1965 was the first (and really the last) attempt in dealing with the problem of health care in the US. Other major laws since, such as the Balanced Budget Act of 1997 which included Medicare Advantage, or the Medicare Prescription Drug (et al) Act of 2006 were attempts at fine tuning (often for votes) and whose primary beneficiaries ended up being the Medical Insurance Industry and the Pharmaceutical Industry. The idea of the Medicare law of 1965 (which included state controlled Medicaid for the indigent) was to address the growing need to provide nationally guaranteed health care beginning with those most vulnerable to the costs (those with fixed incomes), and it had a vehicle to use – the Social Security System. It was fought vigorously by Conservatives. Ronald Reagan claimed it would rob us of our freedom, George H.W. Bush, while running for the Senate in 1964, echoed it as “Socialized Medicine”. Those who supported it openly saw it as a first step toward bringing health care to the US in line with what had already happened throughout the world.

In the post WW2 years, the developed democracies, other than the US, figured out that in a new free world, where there was a desperate overall need for health care by people rising from devastation, the overall cost had to be borne by everyone in order to make it work. Universal Health Care, or as often described now as a Single Payer System, either through direct payment or manditory public insurance, became the law of the land in these democracies. This was especially (and interestingly) true of the two nations for which the United States took the primary role in rebuilding, namely Japan and Germany. Only Canada, the other major Western ally whose homeland was physically untouched by war, did not adopt a true single payer system, but they offered public health insurance immediately after the War, which evolved into full universal coverage in 1984. The United States, the great engine of free enterprise, alone chose the road of a for-profit health care system, a system that now costs multiples of what the rest of the world pays and is rife with gross and tragic inequities, discouraging patients and medical providers alike.

Even so, going back to the beginning of that post-war period, such “radical liberals” as Harry Truman saw the need to create the means by which all citizens could have access to health care and that the key to access was cost. They and others understood the obvious, that health care is a commodity that does not fit ordinary economic models. In economic terms, the demand is inelastic; it does not decline when the price increases. Therefore, in the absence of a system which includes everyone, and with an exponentially rising population, they saw that the Government (Federal, State, and Local) would become the de facto payer of last resort, and there was absolutely nothing to restrain costs from rising by those benefiting from that revenue.

The need for Universal Health Coverage was advocated during the Roosevelt administration, but attempting to create law really started during the Truman administration. Truman, for his efforts, was given the honor to sign up as the first participant in the new Medicare program in 1965. The widespread belief at that time was that an expanded version of Medicare provided to the entire American populous was only a matter of time. Of course, few foresaw the huge industry that would balloon as a result of stratospheric revenues, and how that industry would fight to keep that cash flowing. It was aided by tax law which allowed companies providing health insurance benefits to bury the costs (borne by their employees) out of their worker’s sight.

Still, Medicare/Medicaid made it under the wire, and although it is an imperfect public insurance program it pretty much accomplishes what the supporters wanted – universal health coverage for the participants funded through general payroll taxation. What it never did nor could ever do was impact general health care costs, because it controlled less than 15% of all Americans (albeit a larger percentage of cost). Which is why Medicare is now essentially funded through debt. The participants don’t care, they’re not paying, and all in all they’ve been pretty happy with the result; ergo you won’t hear a Republican advocate the dissolution of Medicare - even as they deride the idea of Medicare expanded to the rest of the population as socialistic mania.

There is nothing special about the 36 million Americans over age 65 (74 million by 2050), at least not when it comes to health care. In less than 5 years I will be 65 and be invited under that protective umbrella. If the Republicans, Conservative Democrats, and the financial recipients of the largest transfer of wealth any nation has ever seen succeed in thwarting any changes, then I will be forced to watch my children and grandchildren suffer under this system, even as I benefit. I can’t call that a benefit.

My gut winces a little each time I hear a Republican or Conservative Democratic politician announce that we have “the best health care (system) in the world” as I heard Rep. John Boehner (R-Ohio) recently said at the March 2010 “Health Summit”, shrouding his obstructionism in patriotism. I feel that way because I know many believe him, just as they believe the rhetorical lie that describes attempts to reform health care as a “government takeover”.

We do not have the best health care system in the world, or even the best health care for that matter (by published international standards), although we pay many times what everyone else does. If we just reduced our per capital spending on health care to that of Germany’s, the second most expensive nation, we would save enough money in ONE YEAR to pay the current health care costs for the 3 billion people in China, India, Russia, and Indonesia for the NEXT FIVE YEARS!!! We do not have the best health care system in the world, but we may have the worst. Why? Because it is a system in which the above statement on cost does not resonate at all with those who, contrary to their own best interest, have been manipulated to oppose health reform, including those contented senior beneficiaries who already enjoy guaranteed health care. In a world where access is inextricably and inversely depended on cost, what kind of vile system is that?

Thursday, March 4, 2010

The Most Evil Man in America

I know I know…I write a title like that and most everyone can conjure up a quick image of the individual they believe fits the bill - and then may read on with curiosity to see why their choice isn’t the same as mine. Besides, the word evil itself is more closely aligned with comics or soap operas than real life. If I were to let my first image surface it would, of course, be Dick Cheney, the Darth Vader of American politics. With the news of Cheney’s most recent coronary I had an immediate picture in my head of Lucifer sitting in his fiery office, leaning back in a smoking overstuffed desk chair, and on the phone saying “…okay Dick, this is the fifth one I’ve bailed you out on. Now you either start a new war or I’ll be out of town when the Man hits you with the sixth.” But to really determine who most exemplifies the personification of villainy in America one must really define what evil is.

If evil were merely a relative concept, then for those who see Dick Cheney as a John Wayne understudy, he is hardly evil. They are right…but then, is anyone wrong? Despite the distain I harbor for Cheney (by the boatload), I actually think he is no more evil than most anyone else’s oxen you feel deserves to be gored. That’s because evil is not relative. Cheney participates in our national drama through his own self interest and lust for recognition in a manner which reflects his constituency. If he wasn’t feeding off public attitude Cheney would fall off our collective radar like a bronze medal winner. But is that evil? I think not. Maybe one might find what he does appalling, perhaps maniacal, or maybe even criminal…but not evil. He really doesn’t create opinion, he merely uses it.

Evil should not be misconstrued with its fruit. When one is told to think of an apple tree they naturally envision the apple itself and not the nature or description of the tree which bears it. There is a pervasive evil which has been growing in our country for long enough now that I, for one, have to concentrate back a while to realize that it didn’t always exist in my lifetime. It is an imbalance in the collective identity of our nation, which has permitted us to hate ourselves.

So who do I believe is the most evil man in America, and why? I give that honor to Rush Limbaugh III. Seriously…I consider the master of Conservative talk radio to be the dean, the linchpin, the standard by which a considerable handful of mostly conservative and some liberal commentators/entertainers/writers have watered the tree of divisiveness in our country, without which its fruit might not have found itself on practically every kitchen table in America. His influence has been extraordinary, or even greater than extraordinary based on Limbaugh’s own swagger. You have to go back to when it started, which some might find was not so long ago.

To say Limbaugh is smart would be a debate unto itself. I for one give the word “smart” a colloquial meaning which includes positive ethics. However, there is no doubt that Limbaugh has innate abilities that make him uniquely qualified for the roll he fell upon. His intelligence is validated by his pedigree. Father, siblings, grandfather, uncle, cousins are all jurists of note. A giggle of irony escapes me when I think that they are now all known primarily as the relative of Rush the radio guy. Rush III was an anomaly to the group. He was a bad student, his mother quoted to say “he flunked everything”. He managed his way into a lesser know state university in time to drop out almost immediately. He had to have been a black spot on the family refrigerator.

To his credit he focused early on a career in radio working a standard circuit of DJ jobs around the country and apparently, along the way, discovered his talent for glibness. I suspect that Limbaugh, a man with an ego the size of Montana, also discovered that in his chosen venue he could compete with his accomplished and certified family members at their own conservative game. Good luck, Rush. I’d guess that ultimately all his money, his influence, and his buffoonery never allowed him into the inner circle of Conservative lawyers and judges that is his family tree - just a guess, consistent with prescription drug abuse, and lawyers generally.

By the late 80’s his style of commentary had hit a cord. Freed by the repeal of the FCC Fairness Doctrine in 1987 (after being law for 38 years) he was one of the first to exploit bias as a form of entertainment. However, the use of a target as a means of gathering listenership had not yet gelled. During the administration of George HW Bush the Republicans had their problems even as they still rode the Reagan tsunami. His attraction was more his style and comedy which he intermixed with home spun commentary, a counter to the likes of Howard Stern. Although his reach through the number of participating stations was significant, his market was still not that large and actually pulled from a wider political segment which enjoyed his antics and clowning.

It was the election of Bill Clinton that changed everything. It was the 9/11 for Rush and the true beginning of his crafting the vilification of anyone not Conservative. As his listeners, comprised primarily of disappointed Conservative Republicans, began to expand exponentially, he saw the writing on the wall (and bank statement). The tone of his commentary notably changed. He was now selling fear wrapped in patriotism and he sold it well. So well in fact that for many today he has made the Clinton years of prosperity, surpluses, growth, and security a time of national shame, and the Bush years of preemptive war, terror, lost civil rights, political stagnation, colossal deficits, and near economic collapse a period of national pride. Can it get any more bizarre?

In the process of making himself a household name he also made a couple hundred million dollars, by some accounts. He certainly became in less than 15 years one of the richest men in America, simply by talking on a microphone. Incredibly, polling after the last presidential election also had him named as the Conservative Republican standard bearer, over everyone else…in America!!

His financial and influential success did not go unnoticed by others in the field. Such “commentators” as Glenn Beck, Mark Levin, and Sean Hannity jumped aboard the H&F (Hate & Fear) Gravy Train. They saw that by making “Liberals” the true enemies of “patriotic” America they could tap the kind of enthusiasm usually engendered by invasions. No wonder Sarah Palin recently got on board. Mark Levin, who renamed Liberals “Statists” because he thought the word “liberal” sounded too much like “liberty”, wrote the following in his best selling ($$) book Liberty and Tyranny:

"The Conservative must accept that the Statist does not share his passion for liberty and all the good that flows from it. The Statist does not acknowledge the tremendous benefits to society from the individual pursuits of tens of millions of others. The Statist rejects the Founder's idea of the dignity of the individual, who can flourish through ordered liberty, for one rooted in unpredictability, irrationality and, ultimately, tyranny." pp15

That kind of wholesale categorizing of people is the kind of dehumanization that can be found in Hitler’s Mein Kampf and his description of the Jews. That was a best seller too.

So just what is the Evil that I associate so closely with Rush Limbaugh and his disciples? It is what now pervades our nation, but more importantly our individual neighborhoods and even families. It is the new distain that we have for each other without the necessity of recognizing our humanity.

I remember hearing a Catholic priest once say in a lecture that if Satin could do only one thing to solidify his malevolence throughout mankind he would make us hate our bodies. He was suggesting that self deprecation of that which is the most basic and natural to us in this life was the surest way to abandon that which we revere in God. Rush has given this a socialogical twist.

As a nation and a society we have, since inception, had ideological conflict which has manifested itself into periods of tragedy and suffering. Students of the Civil War could successfully argue that period as the most obvious and poignant. At each such time there has been an imbalance caused by the demands of ideology requiring a dehumanization of those who don’t agree, essentially managing to get us to hate ourselves. Within the current health care debate there is so much hate that people virtually cannot see the problem to the point that they will actively work against their own self interest. Could anything make the devil smile more?

We are experiencing a civil war right now…and it is obvious. It began with people like Rush Limbaugh and has spread to the far left end of the spectrum in a vain attempt to create balance. It is aggravated by the nature of our political system which has currently become a manic struggle for power without substance and job security for its participants. This chapter in our history was made possible by a new age of communication, a new message of hate and fear, and was brought to you by the embodiment of the most evil man in America – Rush Limbaugh.