Saturday, June 27, 2009

A Must Read For Everyone

I just finished Mirrors: Stories of Almost Everyone by Eduardo Galeano. I am amazed at how much I learned from the book and how lyrical and engaging the entries were. Galeano takes on all of human history, and even a little pre-history, through short entries that engage with anything and everything: major events in human history, famous (and infamous) historical figures, great people whose names are now lost to history, etc. His populist approach and keen sense of history create a rich and engaging view of how things have changed over time but how discrimination, hate, and violence have always marred our actions. Heather and I were lucky enough to attend his reading the week the book came out a month or so ago. I have never seen the bookstore, Politics and Prose, so packed full of people (and they bring in some huge names for readings). Some excerpts from the book:

Brief History of Civilization

And we tired of wandering through the forest and along the banks of rivers.
And we began settling. We invented villages and community life, turned bone into needle and thorn into spike. Tools elongated our hands, and the hand multiplied the strength of the ax, the hoe, and the knife.
We grew rice, barley, wheat, and corn, we put sheep and goats into corrals, we learned to store grain to keep from starving in bad times.
And in the fields of our labor we worshipped goddesses of fertility, women of fast hips and generous breasts. But with the passage of time they were displaced by the harsh gods of war. And we sang hymns of praise to the glory of kings, warrior chiefs, and high priests.
We discovered the words "yours" and "mine," land became owned, and women became property of men and fathers the owners of children.
Left far behind were the times when we drifted without home or destination.
The results of civilization were suprising: our lives became more secure but less free, and we worked a lot harder.


Two thousand six hundred years ago in the city of Miletus, an absentminded genius named Thales liked to go for a stroll at night to gaze at the stars, and as a result he frequently fell into the ditch.
Perhaps by asking the stars, Thales discovered that death is not an end but a transformation, and that water is the origin and meaning of all life. Not gods, water. Earthquakes happen because the sea moves and disturbs the land, not becasue of Poseidon's tantrums. The eye sees not by divine grace, but by reflecting reality the way the river reflects the bushes on its banks. And eclipses occur, not because the sun hides from the wrath of Olympus, but because the moon covers the sun.
Thales, who had learned to think in Egypt, accurately predicted eclipses, measured with precision the distance of approaching ships on the high seas, and calculated the exact height of the Keops Pyramid by the shadow that it cast. One of the most famous theorems is attributed to him, as well as four more, and it is even said that he discovered electricity.
But perhaps his greatest feat was of a different kind: to live godless, naked of any religious comfort, never giving an inch.

The Loser

He preached in the desert and died alone.
Simón Rodríguez, who had been Bolívar's teacher, spent half a century roving Latin America on the back of a mule, founding schools, and saying what no one wanted to hear.
A fire took nearly all his papers. Here are a few of the words that survived.
  • On independence:
We are independent but not free. Something must be done for these poor people, who have become less free than before. Before, they had a shepherd king who did not eat them until they were dead. Now the first to show up eats them alive.
  • On colonialism of the mind:
Europe's know-how and the prosperity of the United States are for our America two enemies of freedom of thought. The new republics are unwilling to adopt anything that does not have their stamp of approval... If you are going to imitate everything, imitate orgininality!
  • On colonialist trade:
Some think prosperity is seeing their ports filled with ships - foreign ships and their homes turned into storerooms for goods - foreign goods. Every day brings another load of manufactured clothes, down to the caps the Indians wear. Soon we shall see little golden packages bearing the royal coat of arms containing 'newly processed' clay for children accustomed to eating dirt.
  • On popular education:
To make students recite by rote what they do not understand is like training parrots. Teach children to be curious so they learn to obey their own minds rather than obeying authorities the way the narrow-minded do, or obeying custom the way the stupid do. He who knows nothing, anyone can fool. He who has nothing, anyone can buy.


Every year, chemical pesticides kill no fewer than three million farmers.
Every day, workplace accidents kill no fewer than ten thousand workers.
Every minute, poverty kills no fewer than ten children.
These crimes do not show up on the news. They are, like wars, normal acts of cannibalism.
The criminals are on the loose. No prisons are built for those who rip the guts out of thousands. Prisons are built as public housing for the poor.
More than two centuries ago, Thomas Paine wondered:
"Why is it that scarcely any are executed but the poor?"
Texas, twenty-first century: the last supper sheds light on the cellblock's clientele. Nobody chooses lobster or filet mignon, even though those dishes figure on the farewell menu. The condemned men prefer to say goodbye to the world with the usual: burgers and fries.

Saturday, June 20, 2009

Health Care is a Human Right

With all the discussion of health and health reform, some key facts have been overlooked and, for the most part, insufficiently examined in the debates. While there has been some acknowledgement of the high cost of treating chronic diseases, rarely is it raised that treatment of these diseases accounts for 75 cents of every dollar spent on health care in the U.S. This fact helps us understand that while coverage for everyone is a crucial and fundamental right, the goal of keeping down costs requires more acute awareness of where the money is actually spent.

Another key fact that is discussed infrequently is the high concentration of health care expenditures in a small population. A recent study found that five percent of Americans are responsible for nearly HALF of all health spending in a given year. An earlier study found that it was over half. Also, almost half of the U.S. incurs little to no health care costs and thus the other 50 percent make up about 95% plus of the health care spending. This concentration is interesting at other levels as well. The top 30 percent of spenders make up 90% of health spending; while the top 10 percent make up nearly 70%.

These statistics speak the need for a more holistic view of reform. Increasing quality, decreasing costs, and expanding coverage all are worthy goals but they cannot be goals divorced from the social reality of health care needs. Both studies find that the elderly are more likely to bear the burden of high expenditures. Also, they found that people with chronic conditions had much higher out-of-pocket expenses than average. Better, more cost-effective treatment is needed for these folks. Often their situation is compounded by the fact that they may reach their lifetime spending cap and lose coverage. In turn, due to pre-existing conditions clauses, they may have an extremely difficult time getting other coverage, and if they do it will be exhorbitantly expensive until they are so drained of money they can qualify for Medicaid.

All these factors indicate the importance of having a coherent, nationally focused health care reform. The reform must be tailored to meet the needs of different populations and levels of care. However, everyone should have to have insurance; at the very least, catastrophic coverage. It is in the best interest of the long term health of the American people and in the best interest of our financial well-being, both individually and as a society. People without insurance coverage that require medical treatment incur higher costs and are much more likely to face bankruptcy as a result. Of course, there must be subsidies to help those who would not be able to afford coverage themselves.

During the current health care reform I have continually been dismayed by the process and how easily many of those involved lose sight of the overall goals and the purpose reform serves. We don't need reform for the sake of reform. Sure the system is broken, but a patchwork solution will only push the need for a more significant reform off the radar for another decade or two. We have hard decisions to make. Until we face those decisions with a sense of history and an eye to the future, we will continue to create policy that only serves to line the pockets of those who are currently abusing the system.