Sunday, July 26, 2009

Health Care Reform Blues

With reform unlikely to happen before the August recess, the likelihood of reform becomes less clear. After swings in momentum both for and against reform over the past few months, it has been interesting to see how quickly some ideas have fallen away under pressure, and how others continue to be recycled and brought back to the fore. It seems likely that we will have some sort of "reform" at this point, in that a bill will likely be passed by both the House and the Senate and signed by Obama. The question is will there be any actual valuable reform to a problematic and burdensome system or will it merely push off necessary reforms for another decade or so.

I think one of the most interesting developments has been that the Republicans in both the House and the Senate have decided to drop developing their own bill, after promising to do so since the beginning of the reform effort. While I can understand the desire to focus all of their attention on the current resolution being discussed, it seems that they are only falling into the trap of being the "party of 'no'" label which has been wielded against them expertly during the current Congress.

I also think it is dangerous for the Republicans to place so much hope on the Blue Dog Democrats. While allies on some issues, they are, at the end of the day, still Democrats. They know they can only push so far before they overstep their power and incur undesirable repercussions (such as the bill being moved to the floor without a committee vote). The Blue Dogs may claim that they are the beacon of fiscal conservatives and small business, but there are many ways to allay their fears and still have a bill that will be faced with obstructionism by Republicans.

I am often surprised that the current bill, even in its most liberal versions, is itself a comprise; not necessarily a good one. Many Americans, rightly in my view, favor an even more robust public system than is currently written into any of the House or Senate versions of the bill being floated around. The high costs of care (as I have discussed in previous posts) are not simply due to the high-cost treatments or expenditure disparities. They are in large part due to the cost of "doing business" under a for-profit system of health care. One of the key advantages of a single-payer system is the sense of solidarity that it brings amongst those involved. When people are all paying into the same system, there is an acknowledgement that while some are paying more, it is often for the greater good.

One final point about perceptions of U.S. health care. It is often stated, without any support, that America has the best health care in the world and that people from other countries flock here due to long wait times elsewhere. However, both these characterizations are false; but more importantly, they indicate that the debate is simply focused on the wrong sets of issues. Even if the U.S. had the best health care in the world and people did come for care unavailable in their homelands, simply stated, the U.S. health care system is unsustainable. Right now our costs continue to rise much faster than either the economy or costs of living. As health care continues to eat up revenue, we will be forced to cut other programs to pay for the bloated and overpriced care we provide, while still having worse health outcomes (and worse quality of care, in many cases) than countries with cheaper, more sustainable systems. To pretend that the problem is only quality and access fails to address that it is the costs that will become increasingly prohibitive and untenable.

Sunday, July 19, 2009

Political Poetry

I have been becoming more interested in political poetry as of late. I never had much interest in poetry but had come across a few poems in my undergrad that I had really enjoyed but never really followed up on. Some of my favorite authors have poetry but I never really dug into it. Lately, I have found that poetry can tell of human suffering and crushing inequalities in a way regular writing just cannot. Here are some highlights.

The Nobodies by Eduardo Galeano

Fleas dream of buying themselves a dog, and nobodies dream
of escaping poverty: that one magical day good luck will
suddenly rain down on them- will rain down in buckets. But
good luck doesn't even fall in a fine drizzle, no matter
how hard the nobodies summon it, even if their left hand is
tickling, or if they begin the new day with their right foot, or
start the new year with a change of brooms.
The nobodies: nobody's children, owners of nothing. The
nobodies: the no ones, the nobodied, running like rabbits,
dying through life, screwed every which way.
Who don't speak languages, but dialects.
Who don't have religions, but superstitions.
Who don't create art, but handicrafts.
Who don't have culture, but folklore.
Who are not human beings, but human resources.
Who do not have names, but numbers.
Who do not appear in the history of the world, but in the
police blotter of the local paper.
The nobodies, who are not worth the bullet that kills them

Let American Be America Again by Langston Hughes

Let America be America again.

Let it be the dream it used to be.
Let it be the pioneer on the plain
Seeking a home where he himself is free.

(America never was America to me.)

Let America be the dream the dreamers dreamed-
Let it be that great strong land of love
Where never kings connive nor tyrants scheme
That any man be crushed by one above.

(It never was America to me.)

O, let my land be a land where Liberty
Is crowned with no false patriotic wreath,
But opportunity is real, and life is free,
Equality is in the air we breathe.

(There's never been equality for me,
Nor freedom in this "homeland of the free.")

Say, who are you that mumbles in the dark?
And who are you that draws your veil across the stars?

I am the poor white, fooled and pushed apart,
I am the Negro bearing slavery's scars.
I am the red man driven from the land,
I am the immigrant clutching the hope I seek-
And finding only the same old stupid plan
Of dog eat dog, of mighty crush the weak.

I am the young man, full of strength and hope,
Tangled in that ancient endless chain
Of profit, power, gain, of grab the land!
Of grab the gold! Of grab the ways of satisfying need!
Of work the men! Of take the pay!
Of owning everything for one's own greed!

I am the farmer, bondsman to the soil.
I am the worker sold to the machine.
I am the Negro, servant to you all.
I am the people, humble, hungry, mean-
Hungry yet today despite the dream.
Beaten yet today-O, Pioneers!
I am the man who never got ahead,
The poorest worker bartered through the years.

Yet I'm the one who dreamt our basic dream
In the Old World while still a serf of kings,
Who dreamt a dream so strong, so brave, so true,
That even yet its mighty daring sings
In every brick and stone, in every furrow turned
That's made America the land it has become.
O, I'm the man who sailed those early seas
In search of what I meant to be my home-
For I'm the one who left dark Ireland's shore,
And Poland's plain, and England's grassy lea,
And torn from Black Africa's strand I came
To build a "homeland of the free."

The free?

Who said the free? Not me?
Surely not me? The millions on relief today?
The millions shot down when we strike?
The millions who have nothing for our pay?
For all the dreams we've dreamed
And all the songs we've sung
And all the hopes we've held
And all the flags we've hung,
The millions who have nothing for our pay-
Except the dream that's almost dead today.

O, let America be America again-
The land that never has been yet-
And yet must be--the land where every man is free.
The land that's mine--the poor man's, Indian's, Negro's, ME-
Who made America,
Whose sweat and blood, whose faith and pain,
Whose hand at the foundry, whose plow in the rain,
Must bring back our mighty dream again.

Sure, call me any ugly name you choose-
The steel of freedom does not stain.
From those who live like leeches on the people's lives,
We must take back our land again,

O, yes,
I say it plain,
America never was America to me,
And yet I swear this oath-
America will be!

Out of the rack and ruin of our gangster death,
The rape and rot of graft, and stealth, and lies,
We, the people, must redeem
The land, the mines, the plants, the rivers.
The mountains and the endless plain-
All, all the stretch of these great green states-
And make America again!

United Fruit Co. by Pablo Neruda

When the trumpet blared everything

on earth was prepared
and Jehovah distributed the world
to Coca-Cola Inc., Anaconda,
Ford Motors, and other entities:
United Fruit Inc.
reserved for itself the juiciest,
the central seaboard of my land,
America's sweet waist.
It rebaptized its lands
the "Banana Republics,"
and upon the slumbering corpses,
upon the restless heroes
who conquered renown,
freedom, and flags,
it established the comic opera:
it alienated self-destiny,
regaled Caesar's crowns,
unsheathed envy, drew
the dictatorship of flies:
Trujillo flies, Tacho flies,
Carías flies, Martínez flies,
Ubico flies, flies soaked
in humble blood and jam,
drunk flies that drone
over the common graves,
circus flies, clever flies
versed in tyranny.

Among the bloodthirsty flies
the Fruit Co. disembarks,
ravaging coffee and fruits
for its ships that spirit away
our submerged lands' treasures
like serving trays.

Meanwhile, in the seaports'
sugary abysses,
Indians collapsed, buried
in the morning mist:
a body rolls down, a nameless
thing, a fallen number,
a bunch of lifeless fruit
dumped into the rubbish heap.

(Translation by Jack Schmitt)

Militant by Langston Hughes

Let all who will
Eat quietly the bread of shame.
I cannot,
Without complaining loud and long.
Tasting its bitterness in my throat,
And feeling to my very soul
It's wrong.
For honest work
You proffer me poor pay,
for honest dreams
Your spit is in my face,
And so my fist is clenched
To strike your face.