Shifting Tides of American Politic Rock Healthcare Boat

The tension is in the air. It is between friends. It is in the workplace. It is in the grocery store. We have a jobless economic recovery in our front window and a nasty ideological debate on health care going on in this country rattling all the other windows in our glass houses. Plus we have the latent and aging racists and monarchists in our society bubbling over the top of the kettle throwing scare tactics, guns, Fox News pundits, and labels around like the circus has come to town. Plus the media is ducking responsibility for any worthy journalism on the topic hoping to fend off being the next cartel in line after the insurance industry gets spanked.

None of the above, by itself, is my biggest worry though. I'm always a survivor. I crave a good challenge. But the above are simply symptomatic of the change afoot in the American current. The waterfall is just coming into view and I am not so sure I want to think about what lies ahead. However, what I figure I can't survive is the changing politic in America.

My biggest worry is that America has lost touch with those who struggle in ways those with wealth rarely experience. American institutions have such vast markets that these institutions and the supporting businesses do not have any need or real incentive to cover the lower end of market spectrum. There is plenty of profit to be had by carving up the middle and upper class and developing new markets around the world. Hence needs go unmet if you are on the lower end of the market.

The American economy has done a great job of covering the most people's needs during the 20th century. But now it finds itself, albeit the consequence of too much wealth and population expansion, rather than too little capital, in a parallel situation to third world countries. Stagnated economies or underdeveloped nations have long sufferred their citizens on the lower end of the economic stratum being clobbered by those above. Basically it is a consequence that few "above" care, or need to care, because their cash needs are being met without caring. This is self interested capitalism at its best. Couple, this cash based disconnect, with government stepping out of the arena and either removing or looking the other way on almost all economic regulation between the players under the proclomation of the free market and "government is never a good thing". The resulting consequence is the smoldering embers of standard discontent in a society become open flames.

Furthermore, I will argue, that emotional or intellectual needs in modern American society can mostly be purchased with enough cash so these societal checks and balances have also been substantially eroded. Just ask yourself the question how many families or neighbors you know would approve of their son or daughter currying favor in their job or relationship for monetary gain? There isn't a lot of need to look over the backyard fence at how the neighbors are doing anymore unless their McMansion casts a shadow on yours.

Instead of being pushed to perform in this society I simply feel obligated to produce cash. For myself and for others. There aren't really any ethics or scope of morality attached to the production of that cash just as long as the cash gets produced. This has become the ethereal societal expectation from my fellow citizens. Basically I can, and they can, do as they please as long as they don't harm any little children and as long as they are making money for others as well as their own good. If one is simply making money mostly for their nepotistic "own" that can be a little sketchy too. Especially if caught. Just ask Bernie Madoff.

Now maybe I grew up in the wrong household but as a child I was raised with the expectation that I would be a productive human being. That demand was inclusive of nurturing my own well being and paying my own bills and also giving to others whenever possible so that, together, we all could be safe, healthy, and potentially happy. Hard work was simply an expectation in my working class family. It was how you lived. Whether it produced a lot of cash or just enough to live on--if you did your job well and with integrity then you had met your societal obligation. My father may have been a raging abusive alcoholic but he got up every morning and put in a very effective eighteen-hour weekday six days a week. He helped make the owners of the company very wealthy over a number of years.

As an adult I have learned that people are raised with many variant expectations of their own contribution to society dependent on cultural, familial, and even geographical factors. I guess I just never assumed that this nation would turn its back on people who struggle every day to do their best but don't acquire a lot of wealth mostly because capitalism doesn't value their skills, or what they have to give, as much as they do the person's next door. We pay our sports heroes and bankers mega-millions yet we pay the people who still can dig a ditch, pick up our trash, or take care of our loved ones only enough to meet minimal needs.

First insurance became a response to disaster. Ben Franklin got it right. If your home burned down the potential for replacing the shelter was improbable in times when there was minimal capital in a community. Your neighbors meant everything in a disaster not simply for the immediate response but to stabilize your future. Insurance made a lot of sense to pool the collective capital and lower the risk.

Then insurance became a need generalized to other necessities and larger investments. It at least made a little bit of sense that if you had something worth protecting you wanted it protected. Especially so from those with nothing to protect who might be a little less careful about their approach on life. It also still serviced those caught unaware by natural or man-made disasters.

Then insurance became an institution. A distinguishing and stablizing concept especially rewarding and productive for the middle class. A requirement in many states to be held up by legislation created by those with secure housing, food and water supplies, and a good education. Many legislators simply members of the "Lucy Sperm Club" themselves. By far our legislators and representatives reflect people in our society who have been equipped, mostly by birth, with the assets that open doors to success and stability. The rest of us have to clear a path to the doors and earn our keys to the locks.

Once institutionalized insurance companies have been kissing home plate. The government stepped in to cover 9/11 victims, the vast majority already well healed, to augment and supersede their insurance companies from taking them to court, where it would be plainly pointed out that most those insurance contracts, now required, put a clause in regarding "acts of war" and, too frequently, acts of Mother Nature. The nation stood by watching the misfortunes of families in Katrina. Those of lesser economic means were left without the cash to hire effective attorneys. We stood by and watched while the Katrina victims' insurance companies twisted previous promises like writhing knotted snakes to get out of fulfilling those obligations.

A century ago American media made stars out of those who worked hard and struggled to overcome adversity. As the struggle of life became less and less a standard and the wealth accumulated in families to be passed on to the generations that followed our taste for common heroes rising through the ranks fell to the wayside. The national focus tended more to those whose status came with birth or had already been achieved. The process was not the point of interest any longer. The cool factor became less about the struggle and more about the glitz and glam of the perceived treasures. The glorification of the process and struggle of obtaining status faded as Americans began to live vicariously through the society and entertainment pages.

We drive the media and we become our media. It tends to be a closed ecosystem.

I, personally, cannot think of a group that emulates, in the majority, this modern American representation of paper made icons better than Congress itself. Our for-profit media has not missed out on following the societal trends for opportunistic gains as much as for public information. It has followed these political leaders and icons for decades and held them up for emulation. House and Garden, GQ, Money, INC., Lives of the Rich and Famous, People Magazine, and so on.

Now health care, hopping into bed with its sugar-daddy, has become an extension of the institution of insurance. The idea that people, when sick, should be tended and looked after to be made well again simply because they are a fellow human being has fallen by the wayside. Senator Max Baucus' finance bill wanted every person who could not pay for health care insurance to pay $3,800. as a fine for not participating in the good enrichment of society. The moral assumption reads "If you can't pay to stay alive then obviously your not worth keeping around."

Prisoners on death row get public paid health care. People who get minimum wage get the death sentence. Great idea Senator Baucus. When people are allowed to go homestead a piece of land, cut down their own trees, plant their own vegetables, and not be fined for doing so then maybe, just maybe, it makes sense to force people with little economic means in the first place to pay to participate in the great Baucus society twisted out of the one LBJ once stood over. At least they won't have to lose their homes or go without groceries to make you feel secure in your gilded mansions at night. Or is the general idea here to enslave or outlaw people without means? Can we make the ugliness we don't like to look at go away like the unwanted bags under our eyes? Can we simply pay for someone to make everything look good on the surface and ignore the reality of the situation?

This is what frightens me the most about present day America. Watching the powerful in the Congress and the Obama Administration who seemingly think that coming up with $3,800 is within every person's means. What happens to a nation when its leaders become so out of touch with the workers that actually make the infrastructure of the system go round?

In my world Senator Baucus should have been embarrassed to even whisper such a proposal behind closed doors. We take out public servants who admit to canoodling with lobbyists in the bedroom but we leave in those who would loosen the Hound of the Baskervilles onto the throats of good honest hard working people with less accumulated wealth. We care about the boundaries and civilities of sex and marriage but not ALL the people those marriages produce. Simply because the poor are asking to have a stake and share in the essentials that society demands BEFORE a person can be a fully fledged participant in the economy we are to be fined.

Of course that is only if President Obama manages to get his way and there is some type of viable public option. Which is what the Senate Finance bill is looking to ensure doesn't happen. Senator Baucus is going to make absolute sure that the unworthy, meaning those without accumulated wealth, will suffer some type of second class citizenship if the "Have's" will be footing any part of the bill.

Suddenly I don't need to be walking inside a Castle in the Rhineland to get a feel for what it was like to be medieval peasantry. I can get it all right here in America in 2009. If health care has become a requirement to participate in the education system, to get a decent job, to be allowed to board public transportation, and just to be treated civil in society then society needs to make health care readily available to everyone they expect to participate. If not then the poor should be allowed to stake out a living space where ever they please without fines and stigma. A street corner, under bridges, in tent cities, where ever they can survive. Participation in society is already not an option. Does it also have to come with a fine for not being able to afford membership dues when a person is being actively excluded on many levels from full participation? It doesn't make sense unless we go back to an agrarian society where Senator Baucus can have his own fiefdom.

The only marker of a decent man or woman is not the property he or she owns Senator.

As an alternative we could just put every one making less than a living wage in America on a bus and send them to Canada. It would make governing so much easier for the insurance-controlled Congressional elite. At least Canada has a sense of humanity toward their own even if they would turn the buses away. America used to be the champion of humanitarianism throughout the world. How low we have sunk that we can't even champion our own.

A poor person cannot create their own economy of scale to lower costs. Nor can individuals without many collective resources easily organize political power for their own benefit. Poor people have little representation in Congress because they cannot pay to purchase their senator and representatives ears or their integrity. And often, strangely enough, the lower economic classes suffer from roadblocks on the way to polling. Not to mention that Congress, the Senate the House Richie-Rich built, is heavily invested in the industries which make a lot of their wealth from the backs of labor. Businesses, banks especially, earn a large bulk of their wealth and profit by charging the poor excessive fees, surcharges, and usury interest rates.

Good credit has also become a need for survival. Try having a health care crisis and keeping your stellar credit rating. It has brought more than one middle class Joe into the sewers with the unwashed masses. In many jobs there are so many qualified applicants that the employers screen out those with health care issues and those with poor credit. The public education system has been repeatedly raped by financial conservatives over the past three decades so it can produce only the minimal cloned workers from the masses entering the system. Higher education has become increasingly more and more difficult to access.

In short, the competition for the higher status in society, is being systematically eliminated. Capitalism is all about competition and so is the innate shadow self of humankind. Check-mate goes to the wealthy elite and the others in this country whom they have managed to convince that government is never a good thing and thus compel these citizens in many cases to vote against their own true self-interest.

Left unchecked, both of these mechanisms, bring out cycles of destruction which the world has seen before. Let's just hope we are not doomed to repeat our mistakes of ego.

President Obama is right to make health care a moral argument. The problem still remains that he needs to let us know which side of the moral ideology he is keeping tune with rather than vaguely chastizing both ends of the spectrum. One end has all the power Mr. President and the other end has most of the day to day burdens and consequences.

If the Senate Finance Committee doesn't come up with a plan for all the people please don't just send them back to their room without dinner Mr. President. Publically expose their strategic posturing for what it really is--grotesque, devisive, and a fuedal elitism designed to reappoint and legitimize through the hands of government a second class citizenship for the peasants in America and a ruling first-class citizenship for the insurance industry, corporate monopolies, and the blue blood. Let them hang for social canoodling regardless whether a Republican, a Democrat, or a Republican in Democratic fuedal drag.

Let's just hope he gets a bill in front of him that can knit this nation of opposing forces and ideologies together for another two hundred years. Then President Obama will have done his job well, in my view, and delivered full value on his own obligation to society.

Health Care Cooperatives--Not Good Enough Mr. President

President Obama is from a big town. In a town like Chicago, big and cosmopolitan, the idea of health cooperatives meeting the public need for health care might look sane. President Obama is already on record as having said as much.

The Senate Finance Committee, where this health care plan for cooperatives is rooted, basically shows how completely out of touch with the needs of the average American the Senate has become. The Senate is made of millionaires. Even if one happened to land out of their mother's womb in a small town to begin with it is obvious they have no memory of it now. Perhaps, given this scheme, they may have landed on their heads. Why else would Congress promote a design which essentially leaves the insurance industry still in power over the public's health care needs. The idea of nonprofit health care cooperatives serving the public need is a shell game. It is a cloak over the public's eyes at the behest of the insurance company profiteers and the medical elite.

I say don't play the game and don't believe it. This "option" is not an alternative to the public option or the single payer system. It is a way for the insurance and private health company executives to retain control of the health care market and have it their way.

Here's why.

First and foremost any nonprofit, especially a membership based nonprofit, is like driving a bus. Whereas a private forprofit business is a zippy little red sports car. Well funded private business, like you find in the insurance and health industry, goes even further and resembles the famed Italian Maserati. They are sleek organizations, designed to hug the road, expensive, and represent loads of capital (cash).

President Obama has said he feels that the nonprofit cooperatives should have to compete for that capital. I like President Obama and empathize the heft of his burden but he is more the attorney and politician here and less the nonprofit business man.

In a nonprofit cooperative there is a board of directors. This board, although there are no definitive guidelines put out yet, most likely will be elected by the members of the cooperative. There are specific regulations which provide the directors with the structure for governance in a nonprofit. These have distinct differences compared to a forprofit organization.

The people who run for nonprofit board positions will be similar to the same people who run for local school boards and housing cooperatives. In private corporate business the board of directors are appointed more often than not. Directors receive nice annual stipends, pay, and perks for giving advice in their special areas of expertise or using their influence to get favorable legislation. It is a nice job in the forprofit world and someone wealthy with clout and experience lands the role and holds onto it--until death, or dementia, do us part. Meanwhile, back at the nonprofit, the assets of the nonprofit belong to the public and therefore the public representatives are assigned to watch over those assets on behalf of the membership of the cooperative. How many board directors, what regional representations might be assigned, how long their term of service, all has to be established in the nonprofit charter. Any remuneration will likely be limited and contained to expenses incurred while being a public community servant.

In this spirit, allow me to metaphorically introduce you, the person needing health insurance reform, to your new bus driver--your neighbor Joe the Plumber. Or perhaps Suzy the Secretary, Gary the Mechanic, Jenny the Accountant, and/or Carol the Hairdresser.

Basically the cooperative board of directors will be made up of people from your cooperative's community.

Now if you live in the community of Chicago the pool of potential nonprofit board candidates is bigger. The select educated elite and various professional backgrounds are naturally more diverse and better candidates can be drawn upon to serve. Your Chicago Cooperative might end up with Karen the Physician and Sam the Surgical Nurse for example. These options would, presumably, be better trained leadership for a health care cooperative. Lucky you--the Public Citizen.

At least for a while.

Then Karen and Sam's term of service will be up and new board members will come on. New board members who have never driven this particular bus before. New board members unfamiliar with the history of the bus, the patients riding the bus, and the mechanic's tinkering with the bus. Never having stuck their heads under the engine of the bus and never having kicked the tires of the bus these new board members will be seated. Not to mention these new board members, "drivers of the bus", will even have to become familiar with what road the bus is going down.

And there are a lot of bumps, cracks, and potholes in the road.

This, Public Citizen to whom I write, is who will be in charge of your health care in lieu of the government. A gamble at best. A tragedy in the making at worst. Because (play close attention to where the pea lands underneath the shell) while nonprofit cooperatives may be designed to be in lieu of the government being in charge of your health care they are not in lieu of the insurance company executives remaining in power. They, the insurance executives, are just scurrying under the new shell Congress has designed to maintain the status quo for the elites.

In the meantime, the insurance company executive will be driving on ahead of the bus, happy in the newly lightened and speedy Maserati. A few small tow lines attached to the Public Citizen bus at the initial camera-op, all for show, without any long lasting effects for the Maserati driver.

In fact, is that a smile I see on the Maserati driver's face?

Of course it is, since the Public Citizen bus will be full of riders that the insurance company executives don't want in their zippy little sport car. Public Citizens add weight and cost money in gas and repairs. Plus, the evil public riders tend to complain when they get dumped out on their heads in the middle of the road. It will take a little more conniving to get around President Obama's legislation on patient dumping--but with the Senate Blue Dogs on their side, no problem. So onto the bus with you!

A private forprofit organization can make quick stealth-like decisions. It can plan a long time in advance since it has a relatively stable market. It can control, to a great degree, how much supply it wants to give in order to meet demand. The forprofit insurance company is going to set, because it can and the industry is allowed to collude, how much profit it wants to put in the hands of its executives and investors. And the profiteering will always come first because that is what the company is designed to do, and it is what the executives get paid the big bucks for... doing what is best for the company.

Is there a great new technology on the market people are dying to pay for? Great let's adopt it and charge a 200% markup. Better yet let's buy up that company and roll it into our portfolio! Full speed ahead. The zippy little red Maserati doesn't even slow down for the turns or the bumps in the road--it generates enough money to negotiate successfully all the curves and bends in the road. And when it needs repairs it just charges anyone riding along more money.

Ah, the perfect life. Neck scarf blowing in the breeze and the Senate pumping gas into the tank.

Meanwhile, the Public Citizen bus is back here trying to figure out which way to turn next. The driver has stopped and is waiting to hear from all the passengers (members). The driver has to unfasten his seat belt and walk up and down the aisles of the bus to get every rider's ideas and thoughts on which way to go next. Then there is the time spent to show that process is being done and to take these thoughts into consideration. Next compare the new ideas with the old map, explain to everyone why that might be the wrong way to go, get the board to draw a new line on the map, and then finally he can get back in the driver's seat and go forward to make the turn in the road ahead.

Needless to say, if Public Citizen, wants to get anywhere soon he or she isn't going to get there quickly by riding that nonprofit cooperative health care bus.

Could you buy a better bus or a better trained driver or mechanic? Not likely. The nonprofit will never be able to, without the government's backing, outbid the private forprofit competition for the best doctor's, nurses, administrators, and technology. Even if the, ever-changing, board can get it together to understand the strategic need and are willing to work, being semi-paid, full time to raise capital. The forprofit insurance industry will have every reason to work around any regulations and to take shortcuts to ensure it stays ahead of the bus. Effectively undercutting any strategic advantage the nonprofit cooperatives may develop.

Just ask Fannie and Freddie--they essentially got into competition with the for-profit mortgage sector. It is a slippery slope leading to the eventual abyss.

Yet some buses might be better than others--true. Big polished city buses might have bigger gas tanks and better drivers than rural or small city ones--but they still will never be able to catch up to that tasty little red Maserati ahead. There are individual health care nonprofits that are bound to be rolled out as examples. An individual does not an industry make. Overall if the bus breaks down along the way and needs more gas, private gas stations are going to give their best supply to the Maserati owner because the Maserati owner obviously can always pay more. The Public Citizen will get the dregs of the tank and the mechanics straight from medical skid row. Running on dregs never makes for a good ride--for anyone.

Even more poetically or poignantly, however you want to look at it, the Maserati driver will get to dine at the White House with all the Senators long before the Public Citizen bus limps in. All the prime rib, shrimp, and organic greens will long be gone. Congress and the Maserati driver will be snuggled into the study smoking a few handrolled cigars and sipping cognac by the time the bus pulls in. In fact, the Maserati drivers may even, if they are clever enough, be able to arrange it so that the Public Citizen gets to the White House just in time to done a servant's outfit and wait upon the Blue Dog Senators and Maserati drivers in their cloistered study.

Guess who will get the bill.

Finally, after every one else has left, pockets stuffed full of goodies for the drive home, the Public Citizens can pick at the crumbs spilt on their uniforms before heading home to wait for that call from the Grim Reaper.

Yes, Virginia, this is a class war and Santa Claus doesn't really visit the little people in America any more. Not even for Show and Tell.

Let's just hope President Obama is playing chess with Congress rather than MouseTrap.