Anatomy of a Liberal

No actually I don't consider myself a liberal, though in some camps non-compliance to core beliefs can get you that label. No I would consider myself a progressive that respects conservative values but appreciates many "liberal" goals... though not all. I called it "anatomy of a liberal" to point out why I have become disillusioned with some of the conservative pundits and think-tanks.

I used to be quite enamored with the conservative view. My family has been long-time Republicans. I had many good friends, including a former pastor, who were staunchly conservative. I voted for Nixon mostly out of family tradition, then for Jimmy Carter due him being a Christian, and then for Reagan. Then in 1988 I became active for Pat Robertson and even went to the county convention. I guess that is a mixed record, but I always considered myself a conservative with a liberal heart.

In the 90's there were multiple things going on. My sister was married in 1991 to a man who was a very wealthy and a committed environmentalist. As a result, I started to look at environmental concerns more closely. Secondly I remember listening to Rush Limbaugh and cheering in the Republican revolution. It was a little surreal that I become a government contractor about the time that Newt et al were decrying government contractors, but hey the overall ideas sounded good. Contract for America seemed to bring promise of fiscal conservatism and good sense. Nonetheless the die was cast to ask too many questions.

I began to look into the easy pronouncements of my once heroes at the Heritage Foundation and the American Enterprise Institute. It really started with some of the overstatements and positions on environmental affairs. I began to question the easy answers that I heard on Rush Limbaugh and in the encyclicals of these two groups.

As an example I read recently an article from AEI that took issue with raising efficiency standards for appliances. The article was written in 2006, yet is still gave an example of report on problems with front loader washers from 1999. I had just bought one, so I knew that there problems at first, but they had significantly improved. It seemed to be a false condemnation to use outdated issues to condemn a mainstream technology. It is even more pertinent to point out that no one was suggesting making front loaders a standard, but simply raising the minimum as even top loaders are so much more efficient these days. The point is that they simply opposed any government appliance-efficiency standards on philosophical grounds and were using any possible argument to stop them.

The most recent example of excess came as I began to wonder about poverty in the US. I know that there are many very poor nations, and than in general we are very blessed in the US. That does not mean that there are no serious problems.

As I searched the net for good articles, I ran across "The Extent of Material Hardship and Poverty in the United States" http://www.heritage.org/Research/Welfare/wm187.cfm. If you read it, you will find that they argue that poverty has been eliminated in the US. They come to this conclusion by defining poverty as the issues that we see in the poorest nations. So everything is just fine and any problems are the people's own fault.

The thing that struck me is that the article never conceded any points on the other side. I have read articles from other sources that point out that the US does not fare well in comparison to other wealthy nations. See "Poor People in Rich Nations: the United States in comparative perspective" http://www-cpr.maxwell.syr.edu/faculty/smeeding/pdf/JEP%20V5_2006.pdf. So are these other articles all liars? Are they just deceived liberals? I don't think so.

What I have noticed about many of the publications of these conservative think-tanks is that they take no prisoners. They act like lawyers who present only the positive evidence for their client. So their "client" seems to be their philosophical conclusions and opposition to government programs. The assumption seems to be that the other side is lying or at least twisting the truth. So if "we exaggerate a little bit, we are just trying to balance out the liberal majority".

The problem is that people in conservative circles believe these conclusions word-for-word. It is not a balance. For them, these are the facts and the right perspective. Do "liberals" and mainstream media do that? Of course! However, my observation is that there is a greater sense of fairness in the mainstream media or "liberal media" as these conservative groups label all outlets but their own.

Now don't get me wrong. I love to listen to programs where representatives from these conservative think-tanks discuss issues along side of equally well versed experts from a "liberal" or "moderate" perspective. They keep each other honest, at least with a forum designed for that purpose. Here I am speaking of NPR, for example, versus say Fox or CNN where one expert tries to shout the other one down. It is not perfect, but it is harder to exaggerate when an equally knowledgeable person can catch you on it.

I also enjoy reading the more analytical articles. You can tell the earmarks. The best articles state their perspective, then list the relevant facts on each side, and then summarizes. If it is possible to argue for the other side based on the facts, presented, I feel like it is probably fair. I also give them high marks if they active concede points against them. With complex issues, it is rarely simple. So to summarize, I want to highlight how one-sided the conservative think tanks are in their analysis, which at minimum means they are a not a reliable summary of the issue. They are one side of the issue and wrong if not read after reading the other points of view. Tragically many well-meaning people take this as THE truth. Personally I would prefer that they at least attempt to be unbiased. I think I am bothered that they don't seem to even try. It is "winner take all" but frankly they lost me.

John McCain's Radical Agenda

A recent article by Bob Herbert in the NY Times titled "John McCain's Radical Agenda" raised dire warnings about the impact of the John McCain's proposed tax reform for health insurance:
http://www.nytimes.com/2008/09/16/opinion/16herbert.html?th&emc=th

In a nutshell, the McCain campaign proposes dramatic changes in the deductibility of health insurance. For too long, individuals and small business owners have not been able to deduct the full cost of health insurance from their taxes. In contrast, large employers are able to deduct the full cost.

John McCain would level the playing field. Basically the deductions would be the same for all. They would be limited to a refundable tax credit — $2,500 for a single worker and $5,000 per family — to be used “to help pay for your health care.” This may not be fully adequate, so the likelihood is that many working for corporations will pay more in taxes.

In many respects this makes a lot of sense. The problem is that it will drive many people into the private health care market which has many problems. There are little to no protections to prevent insurers from ejecting and charging huge premiums for individuals with health care issues. It is a real problem. The following is an excellent discussion of the implications "Ask the Experts: Tax Subsidies and Health Insurance":
http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2536

The bottom line is that significant reform will be needed in order for this to not be a disaster for many people. It could be a good thing, but not at the current state of private insurance. One key question to ask when considering this policy and who to vote for is whether they are prepared to do all that is needed? To put it plainly would the McCain campaign be willing to support the needed regulation in order to make this a good thing and prevent disaster? If they don't plan to implement regulations at the federal level, how do they plan to ensure that all of the states will properly address this potential disaster?

Ray

Healthcare - The Facts

One of the problems with many discussions of health care policy is lack of a good information.  Tragically many conversations are based on hearsay, laced by philosophical statements and generally lack solid analysis and facts.  Many say that we have the best health care in the world.  Others decry the lack of coverage and point to a looming health care crisis due to rising costs.  I will try to lay out the current facts about health care in the US.

The fact is that it is true that the US leads the world in the technology of health care.  We have the most sophisticated treatments, the best trained specialists and are often the first to offer new treatments such as open heart surgery.  If having the most sophisticated technology is the mark of success, then the US is the most successful. 

The first problem is that we have the most expensive health care in the world.  In general we spend twice what the rest of the world spends as percentage of GNP.  Health care costs in the US are enormous at 16% of GNP (gross national product) and are expected to reach 20% of GNP by 2016.  In contrast, most of the rest of the world spends half or less of that amount. For example, France spends 9.5% of GNP, Canada spends 9.7% and Germany spends 10.7%.  More facts can be obtained at:

http://www.nchc.org/facts/cost.shtml

So the second question is what do we get for all of that money?  Is our care better than the rest of world? Sadly the fact is that many of our outcomes are actually worse than a number of these leading countries.   Here are a few of the facts that can be found at http://www.nchc.org/facts/quality.shtml :

• The U.S. is 33 percent worse than the best country on mortality from conditions amenable to health care - that is, deaths that could have been prevented with timely and effective care.
  
• The infant mortality rate in the U.S. is 7.0 deaths per 1,000 live births, compared with 2.7 in the top three countries.
  
• Recent studies show that only a little more one-half (54.9 percent) of adult patients receive recommended care. The level of performance is similar whether it is for chronic, acute, or preventive care and across all spectrums of medical care -- screening, diagnosis, treatment, and follow-up.
  
• Underuse of care is sometimes a greater problem than overuse. Patients do not receive recommended care (as prescribed in national medical specialty guidelines) about 46 percent of the time. Another 11 percent of patients receive care that is not recommended and potentially harmful, according to practice guidelines.

Further our coverage problems are significant and were alluded to in post on "Healthcare - The Problem".   The facts is that we do not have the best health care in the world when it comes to the actual health and care of those in the US.   The point is that if we look at what other systems have accomplished, it is clear that we can do better... much better.  Equally more critical is that the costs of health care threaten to destroy our economy if not addressed. 

The point is that we cannot afford to do nothing or to be complacent.  The question is what can we do.  In the next posts, I will go over some of the options and proposals.

Healthcare - The problems

I remember quite well January 15, 2002.  It was the day that my son Jonathan, age 18, was diagnosed with leukemia and had a few weeks to a month to live without treatment.  It was my personal 911.  My total focus became what to do for him; his treatment, support and care.  The treatment was extremely rough but gratefully was successful.  In our joy and reflection for the future, I began to see healthcare in a different light.  We had good coverage though my employer, Cisco.  Because of the large pool and government regulations, the insurance company could not change more rates or reject me in the future.  I realized that my son would have a different fate.  It is possible that he could never get an affordable insurance policy outside of a group.

There actually are a number of challenges and problems with US healthcare but coverage is the one that most transfixed me after this experience.  I realized that those with any type of catastrophic or chronic health care are often excluded from future coverage.  You can pay in for years, yet have a single incident that raises your risk and suddenly you are rejected.

Many well-meaning people do not realize how bad it can get.  Younger people with good health or anyone without serious issues working for a large company such as Cisco can get quite good care at affordable prices.    The problem is that many do have such good options (see http://www.nchc.org/facts/coverage.shtml):

• Nearly 47 million Americans, or 16 percent of the population, were without health insurance in 2005, the latest government data available.1
  
• The number of uninsured rose 2.2 million between 2005 and 2006 and has increased by almost 9 million people since 2000.1
  
• The large majority of the uninsured (80 percent) are native or naturalized citizens.2
  
• The increase in the number of uninsured in 2006 was focused among working age adults. The percentage of working adults (18 to 64) who had no health coverage climbed from 19.7 percent in 2005 to 20.2 percent in 2006.1 Nearly 1.3 million full-time workers lost their health insurance in 2006.
  
• Nearly 90 million people - about one-third of the population below the age of 65 spent a portion of either 2006 or 2007 without health coverage.3
  
• Over 8 in 10 uninsured people come from working families - almost 70 percent from families with one or more full-time workers and 11 percent from families with part-time workers.2
  
• The percentage of people (workers and dependents) with employment-based health insurance has dropped from 70 percent in 1987 to 59 percent in 2006. This is the lowest level of employment-based insurance coverage in more than a decade.4, 5
  
• In 2005, nearly 15 percent of employees had no employer-sponsored health coverage available to them, either through their own job or through a family member.6
  
• In 2006, 37.7 million workers were uninsured because not all businesses offer health benefits, not all workers qualify for coverage and many employees cannot afford their share of the health insurance premium even when coverage is at their fingertips.1
  
• The number of uninsured children in 2006 was 8.7 million - or 11.7 percent of all children in the U.S.1 The number of children who are uninsured increased by nearly 610,000 in 2006, the second year that the number of uninsured children increased.
  
• Young adults (18-to-24 years old) remained the least likely of any age group to have health insurance in 2005 - 29.3 percent of this group did not have health insurance.1
  
• The percentage and the number of uninsured Hispanics increased to 34.1 percent and 15.3 million in 2006.1
  
• Nearly 40 percent of the uninsured population reside in households that earn $50,000 or more.1 A growing number of middle-income families cannot afford health insurance payments even when coverage is offered by their employers.

So it is easy to ignore the problem until you face it personally.  The election 2008 is an opportunity to explore and diligently examine the issues of health care in the US.  Sure there are other issues such as cost and quality.  There is also the issues of personal freedom and individual responsiblity.  I will try to explore some of the issues and facts in further posts to this blog.  Keep posted.

 

What is socialism?

In my mind, one of the most abused words in politics in socialism. "Socialism refers to the goal of a socio-economic system in which essential industries, social services, property and the distribution of wealth are publically and cooperatively owned and democratically controlled with a view to equal opportunity and equal benefit for all." I don't think you will find a better definition of socialism. I also don't know too many real socialists in US politics, though I am sure there are some. Have you heard of anyone who believes that all essential industries and services, etc. should be owned and controlled? There are a likely still a few Marxists but if the commentators are honest, there are essentially none in mainstream US politics.

So what is this "socialism" that some use in their criticisms? That is more difficult to pin down. It is apparently tied to those who want to apply controls to some industries and services or have the government own some of them. On the extreme opposite end of the scale are those who want Army, police and perhaps some emergency services only. This is the libertarian edge of US politics. Do they really want to eliminate all government programs? Are all regulations to be repealed? What about child labor laws? Should Medicaid be dissolved along with social security? Most don't go that far, though the reality is that socialism has no single definition. It is normally defined as someone wanting more or different government controls or wanting more or different ownership of certain services than I do!! It is a very personal definition, and, in my opinion, useless and subject to extreme abuse.. and abused it is!!!

It becomes a proxy for what I dislike, yet it allows for no conversation since it is so individually defined. It requires a lengthy conversation with the individual to understand. For that reason, I will not use the word, even where I disagree with a proposed level of regulation or disagree with some extension of government owned services. For me it is a matter of principle and good communication to avoid that term.

So how would a political conversation be better handled and served? Let's take the claim that Obama is a socialist and zero in on the area of health care policy. Medicare is the closest to true socialism that we have. Even there, it is really a government based insurance program rather than true socialized medicine. Does the government own the Medicaid clinics? Does the government pay the workers directly? The answer is no for Medicaid though there are socialized medical services in the Armed Services and at the state or county level in some cases. Is it socialism to NOT want to dissolve the Medicaid insurance program? What about NOT dissolving the state or country clinics Is it socialism to have Army doctors or should they all be civilian private contractors, except on the field of battle? No the reality is that in most cases, people are not calling for a total dissolution of Medicaid, state or country clinics. Most are not calling California or Massachusetts governors socialists for their experiment in extending health care. Socialism often becomes any attempt at the Federal level to extend controls, services or even insurance regulation. Would it not better to be specific, articulate and descriptive of what is opposed and what is proposed? Why should we tolerate the use of the word socialism that so poorly serves communication or the democratic process.. though it does serve the problematic side of politics. Would not specific criticism better serve everyone?

Now don't get me wrong. I believe the time is now for a national approach to health care reform. The experts say that extending coverage is the easiest thing to do, but that addressing costs is the hardest. This includes John McCain's advisors.. I can give you details and references if you like.... Politically though a national approach to extending coverage, even through insurance and market reform is the hardest. Republicans are basically saying that they want no national solution to health care, and that anything else is "socialism". Unfortunately that is never clearly spelled out. It is possible that a national standard and perhaps some infrastructure to support medical records might be supported. I suspect that even there it might fail among Republicans due to deep fears about "the mark of the beast" and Big Brother. So, though I am glad for specific proof of proposals say by John McCain to the contrary, I don't believe he has any proposals for federal solutions to the health care crisis, much less a comprehensive plan. If a national approach to healthcare is socialism, then I support socialized medicine of that sort....but again what is support is far from classic socialism or the single payer system as is in Canada (most of the rest have a hybrid.. Canada is unique in that private medical care for traditional medicine is illegal.. oh I guess Cuba is also in that camp). I support a national program. If someone doesn't, I suggest they should say so specifically and not say "I don't want socialized medicine".

I should end by bringing up another area of "socialism". I think any of us who have raised children are concerned about the secular nature of public school education, especially though of us whose children did attend public schools. I also admire those such as our pastor's family who successfully homeschooled bright, generally well-adjusted children. Nonetheless it may or may not surprise you to know that they are a number of Christians who are hoping for the total and tragic collapse of the public school system. I guess this is socialism to them, though they seem to use different terms. I will leave this one for your own analysis. Personally I would rather pray for, support ministries to and support believers teaching in the public school system.

Ray