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.

New Beginnings

I am coming near the end of my first project at work. I have really enjoyed this project and look forward to seeing what my next project will be. I should hear sometime late this week. I was pleased at the options and would honestly be happy with any of them. My top three all deal with public health, access to care, and issues of poverty. From my experience with my current project, the topic is less important than the team you are working with. And luckily, I have had a great team. I can only hope my next team gets along as well and is able to have a fun working environment. My current project showed me that while having subject matter expertise is helpful, the type of work we do is different enough that we have the opportunity to come up to speed on an unfamiliar topic under the guidance of more senior analysts.

I have really enjoyed the opportunity to work on a topic I had no familiarity with. I have been amazed at how much I have learned and how far the team has come in understanding the ins-and-outs of a complex project. It will be nice to bring the project to a close and release the report publicly. It is nice that each project ends in something high-quality and tangible that indicates the amount of hard work that goes into each engagement.

We are currently at the part of the project where we are identifying what we will say in the actual report and trying to figure out the best and most clear way of laying out that information. Some people can get bogged down in the editing process but I find it interesting and enjoy that a variety of stakeholders have a chance to weigh in and improve the product. It is interesting to see how different readers see something different and having to figure out ways to make it more clear to people with no familiarity with the topic.

Suffice to say, I am still really enjoying my new career and can imagine being in it for a while. I only hope that my next engagement can be half as fun as my current and that things will continue to be great.

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,
America!

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
Today-
To strike your face.

Utah

We have been back from Utah for a week. The whole trip went quite well. We were able to see our loved ones and also eat at nearly all of the restaurants we wanted to. Having not been back to Utah in nearly a year, it was nice to see everyone and have a relaxing vacation. I was surprised that Logan had not changed more in the year since I last visited. It felt much the same, but it was nice to be there with a certainty about where we were going. Last time we were there Heather and I had no idea if D.C. would work out, or if we would end up going someplace completely different to find careers.

We ended up going to Bear Lake as well, which was really fun. Whenever I think of swimming in Bear Lake I instantly feel like I am freezing to death. However, on this trip the water was surprisingly warm. Well, not warm, but not as cold as usual; where simply going in waste deep is an exercise in masochism.

Matt's (Heather's brother) wedding went really well and was a fun time. Heather played the piano which was really nice and the ceremony was well done. It was also nice to me Dai Li (Matt's fiancee) and get to know her more. Heather and the rest of the family had met her before, but this was my first time.

And the food. I still can't believe Logan and Salt Lake City have as many great restaurants as they do. Mazza was top notch with the freshest potatoes harra I have had in years. At Trio the asparagus and mushroom cannelloni with champagne cream sauce almost made me consider moving back to SLC. El Toro and Callaway's both lived up to their usual excellence. Tandoori Oven had been renovated and looked amazing. The food was spectacular as always, and because we went at the lunch buffet we all nearly burst as we walked out. It was also nice because the owners were so excited to see us. Logan Burgers and Sandwiches was also excellent. Finally, and certainly not least, the only place we hit up twice was Cafe Rio; which was as amazing as always and filled our hearts with remorse that it is so far away...

While the food was great it was also especially nice to spend time with family and friends. We had a great time with Heather's siblings and developed many new extremely inappropriate inside jokes. It was nice to discuss world affairs and weighty subject matters as well. We also got great book recommendations and had a good time hanging out and drinking strawberry daiquiris. Overall, it was a very nice trip and I look forward to going back there again. While there isn't always a ton to do in Logan, it is the people and memories that keep us coming back.

Heading to Utah

This Friday Heather and I head to Utah for Heather's brother's wedding. It will be my first big break from work (and my first time using a whole chunk of my annual leave). I am really looking forward to it. Heather has been able to go out and visit Utah a couple times since we have been out here, but this will be my first time since last August when we stayed there for almost a month after grad school. It will be really nice to see family and friends and to eat at our favorite restaurants. It will be nice to meet Matt's fiance, Dai Li, as she sounds really nice. It will also be nice to go drinkin with Davis, as he always holds a special place (for alcohol) in my heart. It will be fun to see Holly and Davis's apartment, near where I used to live in Logan. It will be nice to talk politics with Kayla, and conspiracy theories and politics with Denise. Another thing I look forward to, surprisingly, is running into some of the Logan locals we always happen to bump into while we are out there. It will be nice to go up to USU and drop in on some of our favorite professors while we are there. Though we will be out there a little more than a week, I know it will go by in a flash.

I thought by this point in the job I would feel like I needed a break. I really haven't gotten that feeling yet; looking forward, I think that means that I am in a good spot. I still really enjoy my first career position and can imagine myself working at GAO for awhile.

Back to Utah, if only to clear my head and have a reference of the places we need to go:

Crumb Brothers (mmmmmmmmmmmmmm cinnamon pull-a-parts....)

El Toro Viejo (some of the best Mexican food ever and ludicrously strong margaritas)

Callaway's (I have been going to this place since it was a one room restaurant with a handful of tables and like 3 staff members)

Cafe Rio (One of the best fast-fresh restaurants in the country... If only they would open one in my bedroom)

Firehouse (Amazing foccacia and where the ranch flows down like water)

Mazza (SO EXCITED, this place has been a staple of our SLC trips since I was a sophomore in high school and Mazza was serving on Styrofoam plates)

Cafe Trio (amazing New American/Italian fusion food, with desserts that bring tears to my eyes)

Taco Time (I know, not that crazy, but the one in Logan makes a mean bean chimichanga. And there aren't any Taco Times out here)

Logan Burgers and Sandwiches (Great family run joint with probably the most expansive vegetarian menu in Logan)

Indian Oven and Tandoori Oven (Amazing Indian food at both, though our loyalties lie with Tandoori oven. However, we may end up going to both)

Casper's (Amazing shake and ice cream place - one of Kayla's many attempts to give Heather and I diabetes)

That list makes our plate look pretty full (both literally and figuratively) but we also hope to squeeze in time with family and friends and pets.

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.

Thales

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.

Criminology

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.

Something to Consider

I came across this quote from I.F. Stone in The Nation a couple weeks ago:

"If you're going to be a newspaperman, you are either going to be honest or consistent. If you are really doing your job as an observer... it's more important to say what you see than to worry about inconsistency. If you are worried about that, then you stop looking. And if you stop looking, you are not a real reporter anymore. I have no inhibitions about changing my mind."

While I think the quote should be read daily by anyone in charge of informing the public (or hourly at Faux News), I think it can also be applied more widely. I am sure by now most people are aware of the psychological term 'cognitive dissonance', where people filter the information they receive to make it fit their current worldview, instead of letting their perspective evolve in light of new information.

It is a grave error to believe that anyone ever has all the facts or a monopoly on the ability to analyze information. I find that the most uninteresting people to talk with are the ones that have lost all curiosity and stick to ossified opinions that are out of touch with reality. I understand that we all have different backgrounds and are exposed to vastly different sources of information, both in terms of quantity and quality. This gives rise to the diversity of perspectives and opinions, many of which I cannot fathom. While I don't think we have to give credence to all opinions and perspectives, we must be aware that at some level a given person has built a world view that is at least somewhat internally reinforcing. Expecting people to change their mind over a core belief or an opinion that is central to that belief takes time and cognitive effort.

And, as one of my favorite professors said, "Everyone has the right to be a hypocrite."