A Composite Healthcare Program

The “public option”, which appeared dead only a month ago, is now gaining momentum among the public. The latest polls show Democrats in favor by 65 – 35%, while even Republicans prefer that option by a small margin. “Blue-dog” Democrats are running scared for opposing reform while their constituency favors it by a wide margin. Even still, Democrats from states like Nebraska (huge insurance industry) are opposing it. This is the worst of politics!

First, there are actually two distinct issues: health insurance reform, and healthcare reform. Fortunately, the president has at last begun to defuse the “health” issue by addressing his focus as “insurance reform”.

The insurance issue is easier to unravel. The “public-option”, which is gaining traction, is ultimately the only sensible way to go. This is not the scary thing that right-wingers portray---with all their slogans about government bureaucrats and “socialism”. The public option is merely an extension of Medicare, an extremely successful and popular program. True, it costs money, but the alternative, and the system we have now is much more odious and probably more expensive.

Medicare could be systematically expanded by lowering the eligibility age over time to eventually include everyone. As a concessionary alternative, the public option could be added to the present system, available to all, for a price. This would be OK, in that it would hold the insurance companies’ feet to the fire over prices and benefits.

Any plan that does not include a “public option” is a complete concession to insurance companies and the status quo. Right now we’re hearing of “mandates” to purchase health insurance. This would be the worst of all plans, leaving the insurance companies in control---leaving the fox in charge of the henhouse.

The best option, in our opinion, is the total public option---like in Canada or Britain. Proponents of the status quo roll out spokespeople to decry these systems, but ultimately these negative testimonials appear to be straight lies or from the cherry-picked disgruntled. Our national health care should be a public utility; it’s too valuable to leave to the wiles of insurance executives and greedy stockholders.

The next issue, the cost, gets a bit stickier. There are many ways that our system produces out-of-control costs. One of the most egregious is the “multiple-test” scenario, in which doctors prescribe multiple tests to patients to cover their legal vulnerability. As long as insurance companies pay for the tests, the doctors prescribe more, running up their bills as well as those of the laboratories. This also brings more profit to the insurance companies, as a percentage of the total cost, all eventually covered by increased premiums. Another result of this scenario is an increase in the exposure of ill people to healthcare facilities, which are dangerous places for sick people! --- So these multiple, random, sometimes exotic tests run up everybody’s bills, covering the doctors’ liability, but have a negative impact on patients’ recovery. The government can control doctors’ liability through the plan, as they do in Medicare.

Another area generating enormous expense is the “final days” treatment for the very ill. There are a number of ways to handle this. The easiest is to pursue the so-called “death panel” approach (as described by Sarah Palin and other right-wing fear mongers) which really is only an avenue to allow people to prescribe how they wish their own care to be rationed in their final days.

Another way to manage this expense is to allow everyone to pre-determine his own level of “heroic measures” for their final days. There can be 2 or 3 different levels of procedures (and expense) available to everyone based upon their own decision made at some age---say 40 to 45. An individual would then pay a premium starting at that age to pay for their expanded level of coverage---the lower the age at commencement, the lower the premium. In this case, it would be important for all to know, including family members, what their relatives have chosen for their coverage.

Between a rational course of medical testing and a drastic reduction in the cost of keeping the very sick alive, a great deal of money can be saved. Further savings can easily be realized by cutting drug costs, as covered in a previous essay. Drug advertising on TV should be stopped, as it is outlawed almost everywhere else in the world. This alone would save billions. The existing prescription drug plan is designed to maximize drug company profits.

The most compelling piece of this puzzle, and perhaps the most difficult to unravel, is the issue of responsibility. Here we see the greatest possibility for savings. Who, after all, is responsible for our health? Is it our doctors? Insurance companies, the government? It is we, ourselves, who must shoulder the primary load of this responsibility. Can we ask society to take care of us when we don’t take care of ourselves? Yes, but not in good conscience.

The paradox of the “nanny state” is that while our government is proposing to insure our health, at the same time its policies now promote ill health. This hypocrisy must end. Then yes, government can definitely help us on the road to better health.

This begins with diet. Nutritious food must be available at an affordable price. Perhaps the most intractable problem is our ubiquitous junk food, so inexpensive that many are driven to eat it out of budgetary necessity. A lot of money can be saved by ending subsidies on the greatest culprits: beef and corn. Beyond, that, high enough taxes should be levied upon junk food to make it more expensive than good food. In this category we find candy, pastries, cookies, soda pop, chips, “twinkies” (processed foods), and fast-food restaurants.

This matter has actually appeared on the table. We saw a commercial on television in the last week with a shopping housewife, desperate over the possibility of a tax on her soda pop. One might think her children had to have this to stay healthy!

We need to face the consequences of unhealthy lifestyles. “Free” healthcare might be moderated by a “fat tax”, through which people assume responsibility for life-style choices (which cost the public dearly) by paying initially small insurance premiums for being overweight. These “taxes” should mount for those who continue to gain weight. A person 50 pounds over established weight standards may be asked to pay $50 per month---$100 for a hundred pounds, etc.

The beauty of such a system is that it serves itself. That is, the generation of income to pay for healthcare would come from these various (voluntary) taxes, which would “encourage” us to improve our health. This would presumably result in better health, lower health care costs, and bring the system to pay for itself.

Easy enough? Yes, but in addition to the Republican Party, considerable political forces are arrayed to oppose change from our present system. Write to your representatives.

Abortion and Politics

by Jackson Dave

At a luncheon meeting last week with our editorial staff, a charming lady of past acquaintance, a recent GOP dropout, expressed doubts over supporting the Democratic Party because of its pro-abortion position. In response to this sentiment, Robbinsense will step forward to tackle just another difficult cultural issue.

As we perceive it, the Democratic Party does not promote or even endorse abortion. The Democratic Party endorses “choice”. In contrast, the Republican Party, which wails over government intrusion into our lives, tells us that for this matter, government knows best (as long as they run the government) and should step into our lives by removing our right to determine our family.

GOP nostrums over “morality” are specious at best. Abortion is not a moral issue---it’s a spiritual issue. Slogans about “murdering babies” are just inflammatory rhetoric. A zealot’s passion does not bestow truth or legitimacy on any matter. “Murder” is “unlawful killing”; abortion is legal. A fetus is NOT a baby…one need look in a dictionary to confirm these definitions.

But defining terms, or "framing the issue" seems to be the field where Republicans have found mastery; and "death" stirs. We have "death tax" for estate tax, "death panel" for a frank discussion with ones doctor about end-of-life consideration, and "killing babies" for the voluntary termination of pregnancy. This works!

But beyond the rhetoric, does the party really oppose abortion? From 1990 through 2000, the number of legal, induced abortions in this country gradually declined. Considering that abortion only became legal in 1974, these are significant statistics, at least implying that the policies of the Clinton Administration, following 12 years of Republican rule, led to a decrease in the abortion rate. Statistics for subsequent years are difficult to assess considering the intensity of forces opposing abortion. Aside from political “noise”, there is a stream of legislation requiring parental notification among other things, direct intimidation at clinics, outright killing of doctors and the closure of clinics all over the country, making it ever more difficult to find these services.

For political perspective, over the years since American soldiers liberated the Northern Marianas, tens of thousands of people, primarily Chinese and mostly women, have been lured to the main island, Saipan, told they were coming to a job in America. All the flights arrived in the middle of the night. It's scary for the workers; they had no understanding of where they were going to end up. Most of them, in the late ‘90s, were paying huge recruitment fees.

They soon discovered they were essentially indentured servants, thousands of dollars in debt to the company men who had recruited them and often forced to sign secret "shadow contracts." They agreed they wouldn't date, they wouldn't go to churches. If they got pregnant, they'd have an abortion.

The factories, many owned by the Chinese Communist government, manufactured clothing for some of the biggest retailers in America - from the Gap to Jones New York - and legally labeled them "Made in the USA." But workers were paid a pittance. It was a very sweet deal made possible because Congress had exempted the territory from U.S. minimum wage and immigration laws. It was just understood that if a worker filed a complaint against her employer, she would be deported.

The owners had a tremendous amount of control over these workers. They lived behind barbed wire in squalid shacks; the Interior Department called them "labor camps." Forced to work twelve hours a day, often seven days a week, their pay was barely half the U.S. minimum wage. Many were paid with checks that could not be cashed. There was no opportunity to just "walk out", essentially no escape.

Republican Senator Frank Murkowski, then Chairman of the Committee with Oversight of U.S. Territories, traveled to Saipan with Allen Stayman to investigate. But when pressure began to mount to challenge conditions in the islands, the owners hired Jack Abramoff to correct their image. Abramoff set out to paint a different picture, promoting the Marianas to conservatives as a free-market Eden for maximizing profits. He began running all-expense paid tropical junkets for lawmakers, their staff, and conservative activists and journalists.

Abramoff's marquee guest was Tom DeLay. When DeLay, his wife, and daughter and Ed Buckham arrived in 1998, DeLay praised Abramoff as "one of my closest and dearest friends." DeLay later told a Texas newspaper that contrary to reports that workers were being sexually exploited, he had interviewed them one-on-one and found no such evidence. "It's a beautiful island with beautiful people who are happy," he said.

Their first night, Abramoff and DeLay were hosted at a party thrown by Willie Tan, a Chinese textile tycoon who had already paid the largest labor fine in U.S. history - $9 million for sweatshop conditions in his factories. Delay told Tan, “You represent everything that is good about what we are trying to do in America - and in leading the world in the free market system...” After attending a cockfight with him, he called the Marianas a "petri dish of capitalism" and denounced efforts to enforce U.S. laws.

Turning the Marianas into a conservative cause was crucial if Abramoff was to block the growing bipartisan consensus in Congress that U.S. minimum wage and immigration laws should be enforced in the islands. Were these “conservatives” worried about the forced abortions?

In the rare inside look at big time lobbying, Abramoff bragged he would work his Congressional connections "to impeach Allen Stayman" and "either defund or severely restrict" Stayman's activities at the Interior Department. According to Interior Secretary, Bruce Babbitt, “Mr. Stayman has been subjected to a massive campaign of intimidation, much of which is being orchestrated by the paid lobbyists for the government of the Northern Marianas.”

Sen. Frank Murkowski's reform bill passed the Senate by unanimous consent. But that's as far as it went. The bill died in the House. “We passed it again, and still nothing was done.”

Nothing was done because Jack Abramoff - and the Marianas' garment industry - had Tom DeLay in their pockets. When Willie Tan met with a human rights activist posing as a clothing buyer from New York, a hidden camera recorded their conversation. Tan was confident he had nothing to worry about.

Tan: “…because Tom DeLay will never let it go.

You're sure?

Tan: Sure. You know what Tom told me? He said, "Willie, if they elect me the majority whip, I'll make the schedule of the Congress. And I'm not going to put it on the schedule." So Tom told me, "Forget it, Willie. No chance."

Willie Tan would contribute $650,000 to DeLay's "favorite non-profit," the U.S. Family Network, with its stated mission of restoring America's “moral fitness”. Furthermore, the Abramoff team persuaded the Bush White House in 2001 to intervene and fire Allen Stayman, who had advocated reforms in the Northern Mariana Islands that Mr. Abramoff opposed.

"We pulled the plug on him," announced one White House email. They got rid of Allen Stayman, and those workers in the Marianas remained at the mercy of Willie Tan and his ilk. No high-level Republicans raised the issue of forced abortions imposed on these exploited women.

There are those who would argue that DeLay, among the many high Republican mucky-mucks who traveled to this island, was ignorant of the conditions of the indentured women, who were being sexually exploited by their “jailers”. But really, who in that position of power could be so naïve as to not suspect that this situation was enforced? And with anti-abortion as the lynchpin of the Republican Party agenda, why was this not pursued?

The real Republican hierarchy has no more inclination than Tom DeLay to oppose abortion. The GOP uses anti-abortion as a “wedge issue” to motivate passionate foot soldiers to their cause. Anybody who believes that Rush Limbaugh, Glenn Beck, Newt Gingrich or Ralph Reed, for that matter, cares about abortion probably also believes in fairies---or that Sarah Palin sits at home at night, stewing over unwed, teenage mothers. While preaching “pro-life” and churning up as much anger and demagoguery as possible, they know that overturning Roe-vs-Wade would destroy the Party.

For those who would impose “morality” into the issue (their morality, always), consider that Christians don’t bother to claim that abortion violates the teachings of Jesus. Somehow they seem to “just know that it’s wrong.” From a moral consideration how could any person or group impose forced carriage to term of a baby born to a poor, teen-aged mother from the ghetto, likely to bear a “crack baby”, requiring enormous, perhaps life-long public services? The only “moral” position a non-hypocrite who denied abortion to this woman would take is to assume personal, perhaps lifetime financial responsibility for the child. Instead, these crusaders deny poor women birth control and family planning options (“just say no”), then insist that public services in the form of long-term welfare be denied to these needy people. Good Christians? That’s a bad joke.

Hence, to our concerned friend, we say that actually both parties appear to be concerned over reducing unwanted pregnancies. The Democrats’ plan focuses on women’s issues: equal rights, health services, education, birth control and family planning. The Republicans use deprivation of services, along with sanctimony, intimidation and fear…oh yes, “Just say ‘No’”.

Ironically, GOP focus on the religious aspect of the issue harkens back to the earlier roots of Christianity when people were motivated by guilt and fear, fear of God and fear of judgment. Now we are to fear bands of aroused Republicans.

Jackson Dave is a staff writer for Robbinsense