August 12th, 2009


Poem: "The Activist After Death"

This was the most popular of the $10 poems in the poll, with 6 votes. (I'm intrigued by how some polls have a tremendously clear winner, while others spread out or even tie votes. It might be interesting at some point to test this with a batch of poems: is your anticipated favorite your actual favorite after you've read them all?) This poem came out of the August 4, 2009 Poetry Fishbowl and was inspired by a prompt from minor_architect. Also worth noting is that it's a match for "Life Beyond Life" -- and could be considered a prequel for it, or an opposite.

The Activist After Death

You’ve spent your whole life
taking care of people and causes.
You’ve shepherded siblings and peers
past the potholes of adolescence.
You’ve survived parenting,
and heaved a feather-scattering sigh
over your empty nest.
Through it all, you’ve maintained
your contacts in activism,
penned a long line of protest letters,
attended rallies in the rain.

But then you die and reach the Other Side
and none of it, oh, nothing
compares to the sublime panic
the first time they hand you a planet you can’t hand back
when you get tired of it crying.

Poem: "A Night's Courage"

Here is the second-ranking of the $10 poems; it won 4 votes. This poem came out of the August 4, 2009 Poetry Fishbowl. It was inspired by prompts from wyld_dandelyon and newroticgirl.

A Night’s Courage

The first act of courage
often goes unnoticed
but is the most significant –

the time when you turn off the night light
because you have come to believe
that the monsters under the bed are not real.

It is belief, at first, and not knowledge,
a fragile thing in its early hours
as the shadows fill the room

but in time it gains solidity
and you no longer need the night light
because what lights the room is your own mind.

The "Tweet Wire" Form

Recently minor_architect and I were discussing Twitter poetry. I wound up devising a form specifically for Twitter, and I have nascent ideas for others too. This first example I passed to minor_architect to tweet ... and someone retweeted it, so that was cool. You-all are welcome to share it likewise, as long as you include my byline and a link back here. Other folks are also welcome to experiment with writing poems in this form.

– a Tweet Wire

My friends
my own.

* * *
The Tweet Wire form consists of 10 lines, each no longer than 14 characters, to fit Twitter’s 140 character limit for tweets. If the lines are a little under the limit, there will be room to include the title in the same tweet; otherwise it will need to be announced separately. The main focus is the verse.

End-of-Life Counseling in Health Care Reform

My partner Doug tipped me to this article:

Is the Government Going to Euthanize your Grandmother? An Interview With Sen. Johnny Isakson.
Sarah Palin's belief that the House health-care reform bill would create "death panels" might be particularly extreme, but she's hardly the only person to wildly misunderstand thesection of the bill ordering Medicare to cover voluntary end-of-life counseling sessions between doctors and their patients.

This part particularly caught my attention:
It seems to me we're having trouble conducting an adult conversation about death. We pay a lot of money not to face these questions.
Therein lie two crucial and dangerous truths. 1) Americans have a terrible relationship with death. 2) Americans use money to avoid important responsibilities. One result of this is that the #1 death nobody wants -- dying alone in a medical facility -- is the one that almost everyone gets. Because when you aren't on speaking terms with Death, you aren't able to make a comfortable arrangement to be picked up when the party of your body is over, and Death has to come throw you over his shoulder and carry you out. And when you aren't able to speak about death, other people wind up having to make decisions that you should've made yourself, and it tends to add a great deal of extra misery to what is a challenging time already.

We can do better. In this case, I recommend Mexico as an example of a country that has a healthy relationship with death. Their health care system may not be terrific, but they get the concepts that Death can be a gentleman (or a pesky lecher...) and that being dead doesn't remove a person from the family.

The Search for Middle Ground in Health Care

This cartoon summarizes the health care debate.

Two reasons I think we should have pushed hard for single-payer care (aside from the fact that other countries have working models more effective than our current system) are: 1) the Republican party, insurance agencies, and drug companies are against reform and will attempt to block any effort; there is no point trying to devise something they'll consider acceptable because they consider the fundamental premise unacceptable; and 2) in bargaining, always start by asking for more than you will accept as a minimum, so you have room to back down without losing everything.

Alternatives to Universal Health Care

haikujaguar tipped me to an interesting article which proposes alternatives to the kind of universal health care currently debated in Washington.

The Whole Foods Alternative to ObamaCare
"The problem with socialism is that eventually you run out of other people's money." —Margaret Thatcher

With a projected $1.8 trillion deficit for 2009, several trillions more in deficits projected over the next decade, and with both Medicare and Social Security entitlement spending about to ratchet up several notches over the next 15 years as Baby Boomers become eligible for both, we are rapidly running out of other people's money. These deficits are simply not sustainable. They are either going to result in unprecedented new taxes and inflation, or they will bankrupt us.

While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:

That opening quote is hilarious, and I should point out that it's equally true of the government budget in general, which is raised from taxes.

Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs).

This might be advisable, though it should be examined closely first. The main problems with HD plans is that people often buy them because they can't afford (or can't qualify for) anything else, when those plans are not suitable for them; and that people often cannot afford a savings account to cover what the policy won't cover. Before taking steps to expand HD plans, steps should be taken to address those problems. However, HD plans are very useful to people who rarely need medical attention, so should be available for that purpose.

Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.

I strongly agree with this.

Repeal all state laws which prevent insurance companies from competing across state lines.

This is probably a good idea, since the current system cuts down competition in ways that favor insurance companies over consumers. However, I'd want to investigate why those laws were created in the first place; if they're intended to stop specific problems, that needs to be addressed.

Repeal government mandates regarding what insurance companies must cover.

I disagree with this. In my experience, companies often make choices for their own benefit at the expense of their customers. I believe that removing these mandates would allow insurance companies more freedom to cheat people of medical care they need.

Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.

I'm ambivalent about this. Ruinous lawsuits are certainly a problem, and certainly contributing to high costs of health care. America's legal system is turning into about as much of a disaster as its health care system. However, it is equally true that medical mistakes injure and kill thousands of people per year; those people deserve recompense for their loss. I'm not sure whether more laws would improve this situation. Other methods might be more effective. Finally, a key reason for medical lawsuits is that some people have no other way to afford care. Removing that pressure would be more effective than new laws.

Make costs transparent so that consumers understand what health-care treatments cost.

I agree very strongly with this. It's difficult or impossible to make good decisions without accurate, complete information. I would add that we also need access to studies that show how effective (or not) various treatments are.

Enact Medicare reform.

This is probably a good idea, although I suspect we might differ on the details.

Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid or the State Children's Health Insurance Program.

I strongly agree with this also.

There's a basic activist principle that you should team up based on common ground. Work with whomever agrees with you on a given point to promote that. Then switch partners if needed for the next round. I wish our politicians would do that, because some of these points would gain much wider support than the mass package they're currently trying to shove through. Also, it's easier to work on the hard stuff if you have several easier successes behind you.

In this regard, if there are petitions or other support options for the above points that I agree with, I'd be happy to see those. I don't actually like or trust the government, I just think that things are so terrible that even the government might manage to suck less. If some other solution could be made to work better, I would prefer that.

Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?

In fact, I believe that people have a right to food and shelter too. Why? We are guaranteed an inalienable right to life. If that does not include the basic means needed to sustain life (food, water, shelter, clothing, health care) then it is meaningless, because depriving people of those things tends to reduce or remove their life. In ancient times, people had access to territories from which to gather what they needed to survive, which cost nothing but the time and effort to gather them. Modern society no longer allows people to do that, for the most part, so it is obliged to provide an alternative minimum support. Otherwise, people suffer and die, which undermines the health of the society, impairs its function, and causes other societies to criticize it.

Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.

It would certainly be a great idea to work on prevention instead of cure, and to make people healthier. The problem is that we're unhealthy because we've designed a society and infrastructure that makes it easy to do the wrong things and hard to do the right things. People are extremely resistant to many changes that would help. Outlawing tobacco would help; the tobacco companies are rich enough to prevent that, so far. Rezoning unhealthy types of fast food to the edges of town rather than the center would help; the business sector is against that. Banning high-fructose corn syrup as a food additive would be a huge help in reducing both weight and diabetes; the food and farming industries are against that. Reducing cancer risks would be really hard, because we've surrounded ourselves with carcinogens in our foods, homes, and products of all kinds. We could start banning all sorts of known carcinogens, but almost all businesses use them and scream hysterically when even one is threatened -- as witness the recent resistance to banning bisphenols from baby bottles. Ensuring that all urban areas have sidewalks and bike paths would improve fitness; that costs money and people don't want to spend it. Urban design for walkability would have similar benefits; businesses have spent decades fleeing in the opposite direction. It is the responsibility of individuals to live as healthy a lifestyle as they can, but it is the responsibility of society to create circumstances that support this. It is unfair, stupid, and wicked of society to set up unhealthy conditions and then blame individuals when most of them become unhealthy. That's like blaming the animals in a factory farm for getting sick.

We need more than health care reform, really. We need social reform -- and most people simply do not want to do that, and fight against it.

On a related note, I've observed that many people arguing against "socialized medicine" do not ackowledge (or perhaps realize) that we already have multiple versions of it in play. Congress has a lovely health care plan paid for by taxpayers. Elders have Medicare. Military personnel have medical services through the military both during active service and afterwards through the VA. For those people who oppose a health care system that provides for everyone: Are you also against the socialized medicine systems we already have? If so, what would you do to replace them? If not, why is socialized medicine okay for some people but not for everyone?