Time to consolidate US health care

Today in the US we have:

  • Medicare for seniors
  • Medicaid for the poor
  • The VA for veterans
  • Private insurance for most other Americans
  • No insurance for the rest

Does this make sense? Of course not — and the current scandal at the VA finally brings it home.

While I don’t necessarily agree that the VA couldn’t be a more workable system if it had the resources to serve the millions of vets who are enrolled, I do think it makes far more sense to have a single health-care system to serve ALL Americans. Everyone would have the same insurance card, with VA-eligible veterans exempt from premiums and co-pays according to the current formula.

In some ways the VA as it now exists would serve as a model for a universal health-care system, just as clinics like the Mayo and Cleveland do — and in the past I’ve expressed this opinion. But the weight of patient demands has become too great for the VA in its current form and is yet another sign that the solution for all US health-care problems is consolidation into a single system — Medicare for all.

In the interim, vets should be issued cards to allow them to access care in the civilian sector on the VA’s dime.

I like the VA, and I think it does a good job with what it has to work with. But I’m the first to admit that I don’t know any better. I went so long without health care that I don’t remember what it’s like to go to the doctor in the real world. On the one hand I like that everything is under one roof, that I don’t have to drive 20+ miles for appointments with specialists and imaging. I like that blood test results are ready in an hour, not a few days, and I like being able to renew prescriptions through a secure website and receive them at my door. What I wish is that the VA wasn’t 12 miles away while there are primary care physicians right here in town, that I could call in the morning and be squeezed in that afternoon, that appointments with specialists following referrals didn’t have to be so far off.

I like the VA because without it I’d be dead now, and signing up when I learned I was eligible was probably the smartest thing I’ve ever done. I have found myself wishing that all Americans could have access to health care as I do, but over the last few weeks I’ve come to the conclusion that the best way to achieve that is Medicare for all — including veterans.

Not much has changed in US schools

In the early 1890s, educator and author Joseph Mayer Rice toured schools of the United States “not only to learn what methods of instruction were commonly followed . . . and the general condition of our schools, but also to investigate the manner in which the schools of different cities were managed.” On this tour, Rice “hoped to discover the causes of the marked variation in the general degree of excellence of the schools of various localities . . .” [Italics mine.]

Rice reported on his survey in his book entitled The Public-school System of the United States, first published in 1892 by the Forum Publishing Company. Rice visited a cross-section of cities and school districts ranging from New York to Minneapolis, and while I won’t attempt to summarize his findings here I will say that anyone who reads this book might be shocked by how little things have changed: innovation was usually rewarded with good outcomes; teachers were generally more than competent but administrators often weren’t; and school boards often got in the way of progressive education.

Educators and political leaders really serious about reform would benefit from reading this book, if for no other reason than to see that what was true in education in the 1890s is still true today. In 1892 someone might have asked, “If students excelled in one system because an innovation worked, why not adopt that innovation in other schools?”

One could ask the same question in 2014.

 

One more time

I’ve been on this earth since the 1940s, and for most of the years since then gay marriage was never something people talked about. Generally if people don’t talk about something, they don’t think about something — unless it directly affects them, that is.

So it wasn’t until recently that people started talking about gay marriage, and that happened because people who are gay started wondering out loud, “Why can’t I get married?”

And that’s when I started thinking about it. All of a sudden it was all over the news, and before other people could start wondering why gay people couldn’t get married, a panicked Congress passed the Defense of Marriage Act. I guess the idea was to settle the question before too many people asked it.

But it didn’t work with me. When I asked myself about it, my mind went immediately to the Constitution, specifically the 14th Amendment’s Equal Protection Clause, which essentially prohibits states from denying to any person within its jurisdiction “the equal protection of the laws.” And interpreting this is oh, so easy . . . so easy in fact that a child can understand it. What it means basically is that a state can’t deny a right to someone that it has granted to someone else.

The plain fact is, states everywhere should be throwing out their unconstitutional marriage laws without waiting for court challenges — or (especially) without calling for referendums. How foolish it is to think something like interpreting the Constitution should be left up to the people. That, folks, is what courts do.

Like it or not, states have only one legitimate interest in deciding who can and cannot get married — whether or not those applying for marriage licenses are consenting adults. It may be possible to define narrower interests regarding polygamy and incest, but those aren’t at issue here.

Figuring out that gay marriage had all the constitutional protection it needed was easy for me — and when courts have the opportunity afforded by challenges to review the laws, for the most part they agree. It’s politicians who can’t all be persuaded, apparently in some cases despite legal backgrounds themselves. Take the Arkansas attorney general, for example — Dustin McDaniel — who decided to appeal a court decision to throw out laws prohibiting same-sex marriages. Yikes — did McDaniel sleep through his Constitutional Law classes? Surely if a layman like me can understand the 14th Amendment, so can an attorney.

It’s official: We’re an oligarchy

According to a Princeton Study, the US is no longer an actual democracy. Surprised? Don’t be. Authors of the study conclude that it’s more accurate to call America an oligarchy, where “wealthy elites wield most power.”

We’ve seen it coming — some of us have even called it, and the study makes it official. The transformation that has been underway for decades was codified when SCOTUS Inc. ruled that corporations are people, effectively and officially giving the wealthy few the right to drown out the overwhelming majority of the people.

Of course people without minds of their own won’t care. They made it possible in the first place by electing candidates who put shareholders ahead of workers, guns ahead of children. Now there’s a tell for you — the general disdain for humans as symbolized by the worship of guns. And to those who elected such candidates — the conservative base — the only right that matters is the “right” to own a gun, or a dozen.

When I was born, over 400,000 young Americans were giving their lives to save democracy and to restore it to as much of the world as possible. I hate to think that after 70 years, what these lives bought was only temporary. But that’s where we’re going. No — check that. It’s where we are.

What arms do we have a right to bear?

You can read the Second Amendment backwards and forwards, all day and all night, inside out if you want, but you will not find the word “gun.” Here — see for yourself:

“A well regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed.”

See? Not there. No — it says “arms.” So what does that mean? Well, when the Amendment was drafted and ratified, “arms” were flintlock pistols, rifles, and cannons, and not much more. And while private citizens generally didn’t own cannons, well regulated local militias often did.

Today “arms” range from flick knives and .22 caliber revolvers  to M-60 tanks and F-16s, with a lot in between. So does the Second Amendment protect our right to bear all of them? Or does the amendment allow for government to regulate the sale and distribution of any arms?

If you can’t figure out the answer, then you’re not as smart as you think you are about the right to bear arms. In point of fact, the authority to regulate the overwhelming majority of arms has never been rationally contested — even if people don’t understand what “well regulated militia” means.

What’s particularly stunning to me is that the five “wise” Supreme Court conservatives don’t take this into account when they render decisions on gun rights.

Student debt is a symptom

The obscene student loan debt in the US, estimated to be about a trillion dollars by the Consumer Financial Protection Bureau, screams that there’s something seriously wrong with not just the American university system but our entire education system. But while it’s the debt that provides the headlines on various news programs, it’s just one symptom of a problem that may be stunting America’s growth.

First and foremost, we have to get away from the notion that the ticket to everyone’s future is a university degree. In the natural order of things, human beings have a variety of aptitudes, and not all of them can or must be nurtured and developed in a university setting. Since it’s fairly easy to spot aptitudes and interests in children as young as middle-school age, this is the time to begin providing them career guidance, becoming increasingly specific as they move upward through the grades.

There was a time when many high schools prepared students for trades, and we should return to this model on a national level. Students with mechanical and technical aptitudes can be guided into such programs, while those showing skills requiring advanced instruction can be guided toward community colleges. Those showing the necessary aptitude and interest in one of the professions should aim for a university. Opportunities for those who want to learn just for the sake of learning should be provided, perhaps on a scholarship basis.

More scholarships should be available, too — especially in careers for which there is a high demand. Scholarships can be funded by the federal government; after all, what’s more critical to national security than a well-educated population. Teachers, nurses, and primary care physicians, meanwhile, should never have to pay for a higher education, although they should be contractually obliged to work in the career for which they were trained for a minimum of five years. Where they have an interest, corporations can fund some scholarships as well. The bottom line: no student should have to incur a debt that would take more than ten years to pay off at a fixed percentage of their income.

We’ve been arguing about how to fix the education for as long as I can remember, and according to what I read the debate is well over 100 years old. Doubtless there are more and better ideas on how to solve the variety of problems with the system out there, but let’s not keep them a secret.

Anti-unionism is anti-democracy

It seems politically incorrect these days to accuse anyone of fascist leanings, or to even mention the F word. I wonder why this is. America gave up a fortune in lives and treasury to defeat fascism in the bloodiest war in history, but has not expended nearly as much energy keeping it at bay as it has communism.

The reason may be that capitalism and fascism enjoy a fruitful symbiosis, and that many American corporatists admire fascism, whether secretly or unwittingly. Indeed, in the years leading up to WWII, many of America’s corporate elite openly admired Adolf Hitler, and a few continued to do business with him during the war.

It’s a matter of historic fact that one of the first things Hitler did when he came to power in 1933 Germany was ban unions because he saw them as a threat to his power over workers. Hatred of unions has been a trait of American conservatism ever since unions appeared on the scene, for essentially the same reason. For this reason, it was completely in character for Senator Bob Corker (R-TN) to campaign against unions in the run-up to the recent election at the Chattanooga VW plant, where workers ultimately rejected the opportunity to unionize. This tactic is especially effective in the South, where despite the fact that workers are among the most exploited in the free world, people have an irrational fear of unions and would rather submit to the control of a corporation like the old Cannon Mills than fight to protect their rights.

I don’t mean to gloss over the corruption that has plagued unions over the decades, but corporations and government have not been immune to corruption over the years. Today unions are relatively corruption-free, and the same probably can’t be said for corporations and government. Indeed, as beholden as he probably is to corporations, it may be fair to argue that Corker is more corrupt than the union he campaigned against.

Thanks to the Supreme Court, the voice of corporations is louder than ever. Unions once put real people on an equal footing with corporations, but alas conservatives are successfully silencing that voice, effectively silencing American workers and preventing them from standing up for their rights. Sadly, the ultimate victim is democracy.

Ya gotta wonder about Mississippi

The stupidity of Mississippi’s Abstinence-Only program was borne out by its failure over a decade. Based on the premise that teaching kids medically accurate information about their bodies would convince them to start having more sex, failure was easy to predict, because historically ignorance has never inhibited people from having intercourse — and having babies. Meanwhile, knowledge of how babies are conceived can and often does, which has always been viewed as an important reason to provide comprehensive sex education.

The result of this ill-conceived social experiment is an entire generation of young Mississippians denied the education they needed to help them live safe childhoods and function as responsible adults. The irony is, many of the poorer young people who wound up having unwanted children will also be denied assistance for the care and feeding they and their babies need because Mississippi is also unsympathetic to safety-net programs.

Mississippi’s anti-social attitude toward crucial social safety-net programs is typical of predominantly conservative red-state America, where religion is preached but seldom practiced. Denial of sex education is not only foolish in its own right, it helps create an entire class of people dependent on the programs they are loathe to provide. Are the words “We screwed up” echoing in the halls of the Mississippi State Capitol in Jackson?

I doubt it.

Thank you for choosing AT&T

If you’re like me, you have more important stuff to do than to waste time trying to get your internet service provider to get something done. Now I don’t want to hurt AT&T’s feelings, but dealing with them has  been a royal pain in the ass. Here’s a timeline for this particular nightmare:

Oct. 24 — I had AT&T U-verse installed. On departure, the technician gave me his number and told me to call if I had questions or a problem. He also gave me his boss’s number.

Oct. 28 — I experience two problems — Internet service drops periodically, and WiFi fails — and I began trying to contact the tech.

Feb. 8 — AT&T finally sends a technician who seems interested in getting to the bottom of the problem. Outside, he finds that the phone line to the house needs to be replaced, and inside he reconfigured the gateway. In the intervening three months-plus since, I made countless calls, spent hours emailing a special customer service person, and had two visits from a technician.

AT&T thanks me for choosing them, but I didn’t. I originally chose Bell South, but AT&T absorbed them without asking me. What are my options? AT&T and cable. Some choices. Neither is beloved by consumers. And if I can’t easily take my business elsewhere, what incentive do they have to promptly resolve a customer complaint?