February 27, 2006

Slater: Why America is Polarized

Filed under: Random Stuff — Bob Gifford @ 9:53 pm

Philip Slater, the former sociology professor, author, playwright and liberal activist, has an article out titled “Why America is Polarized“. In it, he argues that the Red/Blue divide is a clash between two cultures, the Control Culture and the Connecting Culture. We find ourselves at a transition point in history, caught between those clinging to the Control Culture of the past based upon hierarchy, certainty and reductionism, and those creating the Connecting Culture of the future based upon networks, ambiguity and complexity. Slater uses examples from politics, business, technology and science to illustrate the transition from control to connectedness, but those of us comfortable with the blogosphere, social software and open source should readily grasp where he’s going.

What I find interesting is that the Control/Connecting divide, in Slater’s view, isn’t a conservative/liberal divide. Economic libertarians, with their reliance on the bottom-up uncontrolled mechanism of the market, are very much of the Connecting Culture, while old-fashioned big government liberalism epitomizes the Control Culture. Instead of a clash between conservatives and liberals, Slater describes a clash between metaphors: the clockwork universe of the 18th century vs. the biological universe of the 21st. Clockworks are designed (intelligently) to operate perfectly within precise tolerances, while the biological world is messy, wasteful, complex and incredibly rich and vibrant. Small wonder that the evolution vs. intelligent design debate is one of the flash points of contention between these two metaphors.

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More Healthcare Posts from Drum

Filed under: Random Stuff — Bob Gifford @ 8:49 pm

Kevin Drum at Political Animal has a couple posts on healthcare. First, he points to the blog of Malcolm Gladwell of Blink and Tipping Point fame. Six years ago Gladwell argued against the Canadian single-payer system, but he has now completely reversed his position:

Why have I changed my mind? Some of my reasons are in the piece on moral hazard I wrote for the New Yorker last summer.

The bigger reason is simply that I woke up one day and realized what much smarter people than me (Adam Gopnik) realized a long time ago, which is that the idea of employer-based health care is just plain stupid–and only our familiarity with it and sheer inertia prevent us from rising up in rebellion. I always try to think of a suitable analogy and fail. The closest I can come is to imagine if we had employer-based subways in New York. You could ride the subway if you had a job. But if you lost your job, you would either have to walk or pay a prohibitively expensive subway surcharge. Of course, if you lost your job you would need the subway more than ever, because you couldn’t afford taxis and you would need to travel around looking for work. Right? In any case, what logical connection is there between employment and transporation? If you can answer that question, you can solve the riddle of the U.S. health care system. And maybe I’ll change my mind back.

I hadn’t seen his New Yorker article, so I was grateful for the pointer. An excerpt:

Gina, a hairdresser in Idaho, whose husband worked as a freight manager at a chain store, had “a peculiar mannerism of keeping her mouth closed even when speaking.” It turned out that she hadn’t been able to afford dental care for three years, and one of her front teeth was rotting. Daniel, a construction worker, pulled out his bad teeth with pliers. Then, there was Loretta, who worked nights at a university research center in Mississippi, and was missing most of her teeth. “They’ll break off after a while, and then you just grab a hold of them, and they work their way out,” she explained to Sered and Fernandopulle. “It hurts so bad, because the tooth aches. Then it’s a relief just to get it out of there. The hole closes up itself anyway. So it’s so much better.”

People without health insurance have bad teeth because, if you’re paying for everything out of your own pocket, going to the dentist for a checkup seems like a luxury. It isn’t, of course. […] “Almost every time we asked interviewees what their first priority would be if the president established universal health coverage tomorrow,” Sered and Fernandopulle write, “the immediate answer was ‘my teeth.’ ”

Those of us with good insurance and good jobs take so much for granted. This is a great article that I’ll be quoting from again in a future post.

Next, Drum posts about the sudden end of the malpractice insurance crisis:

The fine folks at Americans for Insurance Reform have tabulated recent increases in malpractice premiums and found that after the big upsurge of a few years ago, rates aren’t going up anymore:

Contrary to the medical and insurance lobbies’ message — that medical malpractice lawsuits and claims were to blame for the increase in insurance rates — the fact is that in 2001, commercial property insurance rates jumped across the board. In other words, rate hikes for doctors were only a small part of a much larger insurance problem that affected homeowners, motorists and all kinds of policyholders.

It turns out that the recent insurance hikes were caused by insurance industry business cycle, and not by higher malpractice damage awards. Tort reform, one of Bush’s proposals to improve access to healthcare, is a solution to a problem that doesn’t exist.

February 26, 2006

Healthcare Pt 4: Progressive Alternatives

Filed under: Random Stuff — Bob Gifford @ 4:44 pm

As I began to research single-payer health systems, I came across a great organization — The American Medical Student Association. They have a very helpful site with various primers on universal health care, which I am going to paraphrase liberally below, but I recommend their reports if you’re interested in learning more.

So first, some definitions:

  • Universal Health Care: Any healthcare system that provides access to medical care to all residents, regardless of how this outcome is achieved.
  • Single-Payer: A method of financing healthcare in which the government pays for all care, although it doesn’t necessarily deliver any healthcare. The government, whether at the county, state or federal level, takes over the role that health insurance companies and HMOs play in the U.S. E.g. Canada
  • Multi-Payer: An alternative financing arrangement in which healthcare is paid for by a combination private health insurance companies and the government. E.g. Germany, Japan
  • Nationalized Healthcare: A healthcare system in which the government is not only the sole payer, but is also responsible for the delivery of healthcare, owns the hospitals and clinics, and employs the physicians and nursing staff. E.g. United Kingdom
  • Employer Mandates: A legal requirement that employers provide healthcare benefits to employees.
  • Individual Mandates: A legal requirement that individuals obtain health insurance, whether from their employer, an individual health insurance policy, or a government program.

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February 21, 2006

Healthcare Pt 3: Bush's Health Savings Accounts

Filed under: Random Stuff — Bob Gifford @ 6:02 pm

Let’s take a look at President Bush’s proposals for improving the U.S. healthcare system. In his 2006 State of the Union address, Bush said regarding healthcare:

Keeping America competitive requires affordable health care. (Applause.) Our government has a responsibility to provide health care for the poor and the elderly, and we are meeting that responsibility. (Applause.) For all Americans — for all Americans, we must confront the rising cost of care, strengthen the doctor-patient relationship, and help people afford the insurance coverage they need. (Applause.)

We will make wider use of electronic records and other health information technology, to help control costs and reduce dangerous medical errors. We will strengthen health savings accounts — making sure individuals and small business employees can buy insurance with the same advantages that people working for big businesses now get. (Applause.) We will do more to make this coverage portable, so workers can switch jobs without having to worry about losing their health insurance. (Applause.) And because lawsuits are driving many good doctors out of practice — leaving women in nearly 1,500 American counties without a single OB/GYN — I ask the Congress to pass medical liability reform this year. (Applause.)

In statements since the SotU, Bush has made it clear that health savings accounts (HSAs) are the centerpiece of his healthcare agenda. So what are they and what would they do?
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February 16, 2006

What Kind of a Soul Are You?

Filed under: Random Stuff — Bob Gifford @ 8:17 pm

You Are a Seeker Soul

You are on a quest for knowledge and life challenges.
You love to be curious and ask a ton of questions.
Since you know so much, you make for an interesting conversationalist.
Mentally alert, you can outwit almost anyone (and have fun doing it!).

Very introspective, you can be silently critical of others.
And your quiet nature makes it difficult for people to get to know you.
You see yourself as a philosopher, and you take everything philosophically.
Your main talent is expressing and communicating ideas.

Souls you are most compatible with: Hunter Soul and Visionary Soul

What Kind of Soul Are You?

February 14, 2006

Sullivan: "Principled Conservatives and Sane Liberals"

Filed under: Random Stuff — Bob Gifford @ 8:16 pm

Here’s another reason why Andrew Sullivan is my favorite conservative:

Many Republicans have found the appeal of an unbending faith – Protestant fundamentalism – more emotionally satisfying than the challenge of rational and questioning belief. Others still have responded to the empty center of liberalism by flocking to a new cult of the leader who can do no wrong – Bush. Others still are so blinded by partisan loyalty they can call torture – torture! – by another name, and vie with one another to extend the reach and power of government. But there are many sane liberals and principled conservatives prepared to confront modernity’s empty center with skepticism, private faith, public moderation, and a commitment to limited government. They are becoming the real opposition to the muddle of fundamentalisms, passivity and hero-worship that now pass for establishment conservatism and post-modern leftism. And I have a feeling we have only just begun to hear from them. [Emphasis mine]

I may disagree regularly with Sullivan, but I always find it easy to understand and appreciate his arguments, unlike those of most conservatives. Maybe it’s because of Sullivan’s years editing The New Republic — he had to learn to speak “liberal”. Andrew Sullivan is certainly a “principled conservative” (and I’d like to think that I’m a “sane liberal”), and I’d be happy to join with conservatives of his stripe where we can find common ground.

Too bad he’s now taking shots from his own side.

Why Did Jesus Heal?

Filed under: Random Stuff — Bob Gifford @ 2:52 pm

This past Sunday, the lectionary included the story from the first chapter of Mark of Jesus healing the leper:

A leper came to him begging him, and kneeling he said to him, ‘If you choose, you can make me clean.’ Moved with pity, Jesus stretched out his hand and touched him, and said to him, ‘I do choose. Be made clean!’ Immediately the leprosy left him, and he was made clean. After sternly warning him he sent him away at once, saying to him, ‘See that you say nothing to anyone; but go, show yourself to the priest, and offer for your cleansing what Moses commanded, as a testimony to them.’ But he went out and began to proclaim it freely, and to spread the word, so that Jesus could no longer go into a town openly, but stayed out in the country; and people came to him from every quarter.

But Jesus didn’t come to heal, he came to proclaim the good news. Just before the account above, Jesus says to his disciples “Let us go on to the neighboring towns, so that I may proclaim the message there also; for that is what I came out to do.” So why did he spend so much of his time healing?

The first thought that occurs to me is that it was good marketing. As soon as word of his healing got around, people flocked to Jesus. They came to be healed, but ended up being saved. Is this Jesus’s bait and switch — promise them healing, give them salvation? But of course Jesus tries to avoid this result by telling the leper to “say nothing to anyone”. Jesus isn’t trying to attract the crowds by healing — he’s trying to avoid being mobbed by crowds looking to be healed instead of saved.

So why did he heal? As Pr. T mentioned to me, we can’t separate his words from his actions. He is not only preaching compassion, he is modeling it for us. Jesus can’t cure all people, everywhere and throughout all time, so he tells us that we are to care for the sick in his place. His healings then are just an extension of his teaching — he shows us what compassion looks like. We may not have the power to heal as he did, but we have the power to be compassionate as Jesus is, and to do what is within our God-given power to care for the sick.

So Jesus’s healings may have brought the crowds, inspite of his admonition to the leper, but it’s not why he healed, nor why he came. He came to proclaim the immanence of the kingdom of heaven, and to tell us and show us what the kingdom looks like. And it looks like compassion, which leads us to care for the sick.

February 9, 2006

Healthcare Pt 2: A Flawed System

Filed under: Random Stuff — Bob Gifford @ 10:29 pm

U.S. healthcare is a paradox: we spend more and get less for it than anywhere else in the world.

Americans are spending a growing portion of their incomes on healthcare. Healthcare expenditures have been growing 2.5% faster than income, a trend that could lead to healthcare consuming a third of household incomes by the year 2030. The U.S. spends dramatically more per capita on healthcare than any other developed nation. In 2000, the U.S. spent $4,500 per capita on healthcare, while the second highest spender, Switzerland, spent only $3,300, 71% as much as the U.S.

Yet U.S. life expectancy ranks 27th in the world, below countries spending half what we spend on healthcare. In 2004, almost 46 million Americans, or 18% of those under 65, were uninsured. Most of the uninsured are families where one or more members work full-time. As the cost of health insurance increased by almost 60% for a family of four between 2000 and 2004, the number of uninsured grew by 6 million. While the uninsured are able to receive free or heavily discounted healthcare, typically from hospital emergency rooms, on average they receive half as much health care as the insured, with a resulting 10-15% increase in average mortality, and as high as a 70% increase in mortality for some illnesses.

How can things have gotten so screwed up?
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February 7, 2006

U.S. Healthcare Fun Facts!

Filed under: Random Stuff — Bob Gifford @ 9:28 pm

Share these fun facts with your friends and family!

  • Close to 46 million people under 65 did not have health insurance in 2004, an increase of over 6 million people since 2000. This represents 18% of the under-65 population, or about 1 out of six Americans not covered by Medicare.
  • Employer-sponsored healthcare covered 66% of the nonelderly in 2000, but only 61% in 2004.
  • Mortality rates for those covered by health insurance are 10-15% lower than for those without insurance.
  • Employees’ share of employer-sponsored healthcare costs for a family of four rose $1,000 between 2000 and 2004, to $2,713.
  • 70% of the uninsured come from families with one or more full-time workers, and another 13% from families with part-time workers.
  • Patients with colorectal cancer without insurance are 70% more likely to die than patients with private insurance.
  • 29% of American adults report that someone in their household skipped medical treatment, cut pills, or didn’t fill a prescription in the past year because of cost.
  • 40% of Americans are “very worried” they won’t be able to afford medical care when they are elderly, and 37% are “very worried” they won’t be able to afford medical care in the event of a serious illness.
  • Healthcare costs have been growing 2.5% faster than incomes in the U.S. for decades.
  • Healthcare consumed 5% of U.S. GDP in 1960, 16% in 2005, and at current trends will consume more than one-third of GDP in 2030.
  • The U.S. spent more than twice as much as the U.K. per capita on healthcare, but had a lower average life expectancy.

Sources: Kaiser Family Foundation, the University of California Santa Cruz Atlas of Gobal Inequality, and the Brookings Institution.

February 3, 2006

Healthcare Pt 1: Scriptural Foundations

Filed under: Random Stuff — Bob Gifford @ 2:15 pm

So where to start in discerning a Christian view towards health care? With Scripture, of course, and we don’t have to perform any hermeneutic acrobatics to tease out what the Bible has to say about it. From Matthew:

All the nations will be gathered before him, and he will separate people one from another as a shepherd separates the sheep from the goats, and he will put the sheep at his right hand and the goats at the left. Then the king will say to those at his right hand, ‘Come, you that are blessed by my Father, inherit the kingdom prepared for you from the foundation of the world; for I was hungry and you gave me food, I was thirsty and you gave me something to drink, I was a stranger and you welcomed me, I was naked and you gave me clothing, I was sick and you took care of me, I was in prison and you visited me.’ Then the righteous will answer him, ‘Lord, when was it that we saw you hungry and gave you food, or thirsty and gave you something to drink? And when was it that we saw you a stranger and welcomed you, or naked and gave you clothing? And when was it that we saw you sick or in prison and visited you?’ And the king will answer them, ‘Truly I tell you, just as you did it to one of the least of these who are members of my family, you did it to me.’

Then he will say to those at his left hand, ‘You that are accursed, depart from me into the eternal fire prepared for the devil and his angels; for I was hungry and you gave me no food, I was thirsty and you gave me nothing to drink, I was a stranger and you did not welcome me, naked and you did not give me clothing, sick and in prison and you did not visit me.’ Then they also will answer, ‘Lord, when was it that we saw you hungry or thirsty or a stranger or naked or sick or in prison, and did not take care of you?’ Then he will answer them, ‘Truly I tell you, just as you did not do it to one of the least of these, you did not do it to me.’ And these will go away into eternal punishment, but the righteous into eternal life.”

In this parable, Jesus is giving us a commandment. There is no wiggle room. Both inerrantists and theological progressives can agree that there is no subtle meaning here: we are to care for the needy, including the sick. In fact, this parable stands out for its lack of grace. Those who obey will be given eternal life, and those who don’t will receive eternal punishment.
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