Hyde Park Urbanist

Hubris is the Curse of Hegemony: Health Insurance Co-ops as National Policy

A friend from Singapore sent me this link from the Asia Times.  I wish I disagreed with more than a couple of the author's assertions concerning the health insurance debate we're having in this country.  I advised my friend to tell his fellow Singaporeans that there are huge downsides to hegemony, most notably the accompanying hubris, which sent young soldiers to die in Vietnam & Iraq and today stands in the way of our adopting a wise national health insurance plan.

No politician, not even a Democrat, is willing to pitch universal coverage based on a foreign plan, even though Britain and Canada and France and Germany all deliver similar health care outcomes at a substantially better price.  Health care costs in Britain come in at under $3,000 per year per capita, while we pay over $7200 per year per capita.  That's insanely cheap.  What might the average family of four do with an extra $16K per year?  (The other three nations come in at roughly 65% of our per capita costs.)

What's wrong with us that we won't even consider stealing other countries' ideas and applying them here?  I blame hegemony.  We've conditioned ourselves to think that our military might means we're the best at everything.  To believe otherwise implies weakness, it seems.

And that brings us to this notion of health insurance co-ops instead of a public option.  Ezra Klein reports:

In early June, Max Baucus asked Kent Conrad to solve this argument. Conrad came up with the co-op proposal. And I literally mean "came up" with it. Conrad told me that the idea emerged "out of conversations in my office after we were asked to see if we couldn't come up with some way of bridging this chasm."

Instead of figuring out which tried & true foreign system could best fit the United States, these senators from two very small states decided to reinvent the wheel.  This is not a solution based on objectivity or empirical research or anything bankable.

Sen. Conrad states that the votes aren't there for a public option.  But the co-op plan is favored by only himself.  The Republicans have no interest in it and minority party leadership will not compromise:

"I am negotiating for Republicans," (Sen. Grassley) said. "If I can't negotiate something that gets more than four Republicans, I'm not a good negotiator."

When NBC's Chuck Todd, in a follow-up question on the show, asked the Iowa Republican if he'd vote against what Grassley might consider to be a "good deal" -- i.e., gets everything he asks for from Senate Finance Chairman Max Baucus (D) -- Grassley replied, "It isn't a good deal if I can't sell my product to more Republicans."

Sen. Grassley, in other words, would vote against a bill that he believes would be in the best interests of the United States or even just in the interests of his home state of Iowa simply because his fellow Republican senators are against the bill.  These people are terrorists and there's no point negotiating with them.

Nate Silver believes the public option has about 43 votes in the Senate right now with another five very likely.  Out of those other twelve Democrats, it's likely that we could get another couple votes at crunchtime.  No other reform option has that many votes.  The status quo doesn't even have that many votes.  The Democrats in the Senate need to take the reigns back from Sen. Conrad and give them to someone else.

Hyde Park (HPKCC) Used Book Sale

It takes a fair amount of work to get from pic-left to pic-right for the Columbus Day weekend Hyde Park Used Book Sale. Fortunately, that work is kinda fun and you're welcome to join in.  Contact info for volunteers is here, but I'll be sorting books on Monday evenings from 6pm until we run out of work-- usually about 8pm, I'd guess-- and you can just show up and help if you want.

If you can't sort books, be sure to stop in on Columbus Day weekend and buy some.  And if you have books to donate to us, that's wonderful.  Just throw them into the bin depicted above, located in the basement of Treasure Island, who's once again treating us very generously by donating space.  Proceeds go to the Hyde Park-Kenwood Community Conference, where I've been a board member for most of the last five years.

Obama & the Public Option

Much is being made of Health & Human Services Secretary Kathleen Sebelius's remarks over the weekend concerning the public option, but the truth is that there's no change in White House policy here.  As spokeswoman Linda Douglass stated on Sunday:

The President has always said that what is essential is that health-insurance reform must lower costs, ensure that there are affordable options for all Americans and increase choice and competition in the health-insurance market. He believes the public option is the best way to achieve those goals.

Right.  That's stewardship in action.  He outlines the goals and lets Congress figure out how to get there.  It's a perfectly acceptable relationship for the executive branch to have with the legislative branch.  

What we don't want to have happen is for President Obama to abandon those goals or even compromise on those goals.  It's fair & advisable for progressives to evaluate the plans moving around Congress and determine for themselves whether those proposals meet the president's goals.  If the president ends up trying to pretend that a milquetoast health insurance reform plan meets those goals when it really doesn't, then progressive Americans should turn their backs on this White House and on the Democratic Party.

High Speed Rail

Rick Harnish from the Midwest High Speed Rail Association sent out a mass e-mail this morning drawing attention to his organization's new improved website.  You can sign up for his e-mail news list here.

High speed rail has done very well in Washington this year due to President Obama's support.  The Midwestern states have been on the ball to coordinate a regional plan and it's likely that federal largesse will find its way to our region.  Chicago is an obvious location for a high speed rail central hub, with routes to Detroit, Milwaukee/Madison and St. Louis fine choices for immediate improvement.

Democrats & Republican politicians in Illinois have generally found common ground on building infrastructure.  Transportation proposals rarely devolve into partisan fights here.  In fact, Governor Ryan was much more forward-thinking than Governor Blagojevich on infrastructure, with Pat Quinn providing important leadership on high speed rail.

Recently, an amendment was introduced in the U.S. House of Representatives to cut $3 billion from federal funding for high speed rail.  The amendment failed.  Almost all Democrats voted against the cut and they were joined by quite a few Republicans.  In Illinois, all Democrats (except Danny Davis, who was absent) voted against the cut.  Of the seven Illinois Republican congressmen, one was absent, four opposed the cut and two favored the cut, meaning that Illinois supported high speed rail 15-2 on this vote.

The two Republicans voting to cut high speed rail were Peter Roskam and Mark Kirk.  They not only voted against local interests, but did so despite the wishes of a majority of the Republicans in their state's congressional delegation.  Mark Kirk is running for the Senate in 2010 and will try to position himself as a relatively moderate Republican, but on this issue he was on the fringe of his party.

ADA

From Time Magazine's photo blog, this depicts an audience member taking a picture at a recent ceremony on the anniversary of the Americans with Disabilities Act.

If people knew how expensive ADA regulations were, their jaws would drop.   But we look at scenes like this and we feel the money is well-spent, even wonder if the regulations go far enough.

Third World Health Insurance

Remote Area Medical Volunteer Corps is a non-profit, apolitical organization that provides free health, dental and eye care to people in remote areas around the world.  Their two largest efforts have taken place in that medical third-world-for-some-people commonly knows as the United States, specifically in Wise, West Virginia, last year and this week in Inglewood, California.

Inside an aging sports arena, where rows of dental chairs and a hospital smell have replaced the former Los Angeles Lakers basketball court, thousands of Americans are seeking free healthcare.

Hundreds were turned away just on Tuesday, the first day of a weeklong clinic run by the nonprofit Remote Area Medical Volunteer Corp as part of its mission to provide free health, dental and eye care in needy spots around the world.

It marks the first time in RAM's 25 years that it has gone to a major U.S. metropolitan area -- a reminder that even in Los Angeles, with world-class doctors and hospitals, many do not have access to affordable healthcare.

If this were happening in Britain or France, you can imagine what the right wing would be saying about their national systems.  It's simply a disgrace that people have to camp out all night in a parking lot to get basic medical care in the most powerful country on earth.

And yet moderate Democrats are still dithering.  Iowa Congressman Leonard Boswell still hasn't committed to voting for the health insurance bill likely to pass in the House.  Lucky for us, we have a leader who's knees are buckling:

"The president (said), 'I'm not going to kick the can down the road.' And he said that and I (Boswell) said, 'Well, that's something I'm kind of used to from southern Iowa, you know.  I know about kicking the can down the road.' And he said, 'No, if it makes me a one-term president, I'm going to, we're going to take it on because the country is in need of us taking this on.' I respected that very much."

If the Democrats can't get a decent health insurance bill out of Congress, we should indeed kick some cans down the road, the cans of moderate Democrats.

Begin the Begin: Relocating the Gitmo Detainees

The people of Standish, Michigan, are proving immune to this plague of cowardice that's gripped our country since 9/11.  Unlike wusses across the rest of America, the very people who would have to guard detainees relocated from Guantanamo are asking that the Feds send them to Standish.  Granted, jobs are on the line and the risk of unemployment may be strengthening their backbone, but times are tough in plenty of places and, as far as I know, only Standish has stepped forth. 

The insurgency began and you missed it
I looked for it and I found it
miles Standish proud

Special recognition should be extended to Sen. Carl Levin and Rep. Dale Kildee on this issue for their support.  But Standish City Manager Michael J. Moran III (pic-right) provided my favorite quote. "If anybody did escape, they'd have a surprise," (Moran) said. "We're a community of hunters. Just about everybody has guns."

TPM's Letter from the UK about the National Health Service

Talkingpointsmemo published a letter this afternoon from an American who works in London.  I have no way of verifying the claims in the letter, but will pass it along in its entirety:

I am an middle aged, white male American who lives in the UK working for a medium sized US company. The following is a true story about my many years experience of the NHS (National Health Service) in the UK, only the names have been changed to protect the identity of my family.

I live with my wife and son just outside of London. When our son Leo was due to be born, like virtually every family in the UK (rich or poor), we went to our local NHS hospital for the delivery. An unpredictable chain of events resulted in unforeseeable complications during his birth. Leo was born in very poor health and was immediately transferred to a SCBU (Special Care Birth Unit) in another hospital. Because of the severity of Leo's condition we were transferred to the most advanced SCBU in the region.

Leo spent the next three weeks in the SCBU being cared for 24/7 by highly trained nursing staff using the latest technology and a team was formed with about a dozen specialists from around the country working together to ensure Leo's many complex problems were dealt with using the best medical knowledge available. As parents we stayed with Leo in the parents residence just down the hall from the SCBU. Our room was basic, but it had cable TV and we got clean bedding and towels as well as three meals a day for three weeks. How much did all of this cost? I will never know because as a UK resident and taxpayer it was provided as a public service.

By the time Leo was three months old it was obvious he was experiencing many very difficult problems. Leo was referred to one of the top specialists in Europe, a professor consultant in neonatal neurology. The professor determined Leo needed a MRI scan, but because of Leo's small size and constant abnormal movement, no existing scanner could safely be used. It was decided the newest and fastest scanner in the country would be modified to accommodate Leo's situation. When we arrived for the scan we were greeted not only by the professor and her team but by a team of technicians and scientists from the manufacturer. The MRI magnets were partially dismantled and recalibrated and a frame for Leo was built on the spot so he could safely undergo the scanning procedure. How much did all of this cost? I will never know because as a UK resident and taxpayer it was provided as a public service.

The scan showed that Leo had received a profound brain injury before birth. He had many different tests to determine the extent of his disabilities including EEG, X-ray, video fluoroscopy, endoscopy, sight tests, hearing tests, and others. Leo was referred to eight different specialists to deal with his problems and underwent surgery to implant a portal in his stomach so he can be fed directly by tube, without danger of food being "swallowed" into his lungs. Leo's dietary requirements are very special and all food, as well as the daily feeding kits and the pump needed to deliver the feed are provided by the NHS. Leo is on about a dozen different medications and all meds, syringes and other daily disposable equipment are provided by the NHS. Leo has a wheelchair, sitting frame, standing frame, sleep system, leg and hand splints and other equipment, all designed for him and all replaced or adjusted every few months because he is a growing boy. All equipment as well as the technicians who maintain the equipment are provided by the NHS. How much does all of this cost? I will never know because as a UK resident and taxpayer it was provided as a public service.

Is the NHS perfect? Far from it! Can it be more bureaucratic and slower than I would like at times? Of course! Has there ever been an issue about Leo not receiving care because he is profoundly disabled? Never! Have we ever had to stand before a "Death Panel" and justify the vast ongoing expense of Leo's care, even though he will never be a productive member of society? NO! When surveys ask people what is the single thing they are proudest about the UK, the winner is The National Health Service.

Yep.  And the right-wing American attacks on the NHS have even inspired a British Twitter feed called welovetheNHS.

At a recent town hall meeting in Pennsylvania, a constituent yelled at Sen. Arlen Specter:

"One day, God's gonna stand before you.  And he's gonna judge you and the rest of your damn cronies up on the Hill -- and the rest of your damn cronies up on the hill -- and then you can get your just desserts."

Did you ever notice in the gospels how Jesus spends so much of his time healing the sick? I was raised to believe that the two most important outward manifestations of Christian faith were caring for the sick and caring for the poor.  Those intersect as public policy with universal coverage.  No amount of yelling is going to make me forget what I read in the Gospels.  I'll go to my grave believing that advocating for universal coverage will mitigate, at least a little bit, God's justified wrath for the rest of my sins.

How will God judge the nations of the world?  I don't know for sure (or even if He will).  But, on one hand, He'd look at our nation, as wealthy as any, and see the pain of parents who worry about their children's medical expenses.  On the other hand, there's Britain, caring for an immigrant's child, and, like Jesus, healing the sick free of charge.

The Grid Plan Emanates from Our Weaknesses

I watched the documentary "The Cruise" for the first time last night.  The film depicts Timothy "Speed" Levitch on and off his job as a Gray Line cruise narrator in New York City, which he loves with all his heart.

I can't embed this clip, but you should check out Levitch's rant about the grid plan.

Burnham Pavilion, Shopping

Beth & I hit Grant Park last night for the outdoor showing of Born Yesterday (1950), then happened upon the new Burnham Pavilion (pic-left).  This morning the Trib devoted a photo gallery to it, including construction shots.  To just chance upon it on our way home was pretty enchanting and a fine way to top off a day of shopping.

I can happily report that the Unique Thrift at 51st & Kedzie is even more awesome than before.  Tidier now & with dressing rooms, it always gets me for about $40, which is a lot of clothes.  There's a panaderia and tamale shop on the walk back to the 55 bus.  And, State Street has become quite the shoes shopping destination with Foot Locker, Aldo's and Skechers supplementing the Filene's/TJMaxx outlet.  Plus, there's Macy's and Carson Pirie Scott and Sears, which I always browse thru because I've found some surprising deals there.