#103 – Bob Barkley: The Evils of Commerce

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Everything that is discovered – whether an idea or a scene – that can earn a buck will be exploited and then ruined.  That is the way of commerce in the unregulated capitalistic scheme of things.  Only the people, through their government, can control this.  And when the commercial interests themselves control the government, hope is lost. We are getting very close to that point.
Ambrose Bierce in his Devil’s Dictionary defines commerce thusly: “A kind of transaction in which A plunders from B the goods of C, and for compensation B picks the pocket of D of money belonging to E.” I suspect the “E” in this formula is we the people.
It is extremely hard to be objective about a system that for the most part has served many of us quite well – and still does in many instances.  It is hard to have significant investments that are doing well and at the same time criticize that which seems to be working in one’s self-interest.
But failure to do so means being blind to the inevitable collapse of a system of greed and collusion amongst commercial interests.  As 18th century’s Scotsman Adam Smith observed, in reflecting upon the evils of monopolies, “People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the publick, or some contrivance to raise prices.” Then he added, “The proposal of any new law or regulation of commerce (that arises from the merchant class) ought always to be listened to with great precaution.” Amen! As in health care maybe?
It is not that profit is wrong or that hard work and innovation should go un-rewarded.  It is that the “general welfare” (Check our Constitution’s Preamble.) and the nation’s founders all too familiar term, ‘the common good,’ are being ignored in such an unconstrained system.
As Scotsman Adam Smith apparently felt from his study of the Greeks, wisdom was the avoidance of excess in all things. Thus, it can be concluded that wise government does indeed guard against excesses – whether it be in poverty or profit.
All of the above paints many of us with a broad brush.  It implies that those who have invested their lives in the financial system, the insurance system, the health care system (At least in the US.), and in many well-intentioned (at least initially) endeavors are somehow evil.  That is not the case, but it speaks to the blinders our current system places on most of us.  We seek employment and well-being and for the most part no one chastises those in such businesses. But it’s the system stupid, as they say, and it is a system that must be roped in – soon and strongly – for I am convinced that it cannot prevail much longer and shouldn’t.
Most of us are in denial on this topic.  In Reality Isn’t What It Used To Be, author Walter Truett Anderson tells us, “Faced with information, the believer becomes either a constructivist or a fundamentalist; the former takes stories lightly, changes them, or abandons them entirely when it becomes necessary; the latter deals with troublesome information through psychological denial and/or political repression.” I believe we’re seeing both at play all the time regarding today’s commercial capitalist system. Anderson goes on to point out that all explanations of reality are tainted by this psychology.  In my words, we see what we wish to see and hear what we wish to hear based largely upon how it makes us feel about ourselves.
In that context, our ability to be rational requires that we step outside our context and look down on the picture.  It requires that we go to 20,000 feet and ponder what is beneath us – absent our direct relationship to it.  That is when the truth is both easier to see and to bear. And when I attempt to do that, the picture relative to our commercial system is not pretty – and yet it controls us ever more in our unrestrained ‘crapitalistic’ society.

#99 – Dick Bernard: "Capitalism: a Love Story"

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(As you see this film, I’d like your comments to add, here.)
October 8, 2009:  We saw “Capitalism: A Love Story”, this afternoon.  It is well worth the time, and it’s messages will be conveyed in a later post.  Even if you think that Capitalism is all there is, this film will cause you to wonder….
October 3, 2009: We were planning to go to Michael Moore’s latest film, “Capitalism: a Love Story“, today, but scheduling problems (even retired people have scheduling problems!) interfered.
So, we don’t have bragging rights to having seen the film on its first day of release, or even the second.   The people who watched the film in over 1,000 theaters across the country can see it first.  There’ll be plenty of time.  Maybe early next week….
I’m a creature of Capitalism. Everyone of us in the U.S. are.  Even those who loathe Capitalism and live in the U.S. are in Capitalism’s clutches.  It surrounds us; it’s what we grew up with; it’s likely what we’ll die with, perhaps not a normal death.
(As I was writing the previous paragraph, an e-mail came in from Michael Moore’s mailing list, captioned “A Great Opening Night – – Do Not Put Off Seeing “Capitalism: A Love Story“.  Michael Moore’s take at #mce_temp_url#)
Capitalism is and has always been great for the serious Capitalists, the people who make the financial killing from business as usual.
What has always been a source of curiosity for me is why the foot-soldiers in behalf of Capitalism are ultimately its intended victims: the middle class types (like me) who are exhorted to spend what they don’t have on things that they don’t need to put cash in the hands of the people who will lay them off on a moments notice to help prop up a sagging profit and loss statement.
There are many ways that this nefarious goal is accomplished:  fear and loathing is an obvious one.  People, at Capitalism’s encouragement, rail on against the evils of “socialism” without even knowing what it is, except as defined by the Capitalist.  (We are a surprisingly “socialist” nation as it is…and we value the many socialist elements of our daily life.  Yet we’re supposed to despise socialism…and almost by rote, we do.)
Most working people are in effect “chained” to a corporate work station.  They are free to leave, yes, but terrified to do so, especially at this down time in the economy.  Capitalism generally abhors things like labor unions, and convinces the people who might benefit by labor unions to rail against them.
Or it can be seen at really great events, like Sunday’s Twin Cities Marathon, where the corporate face is very, very positive, and tens of thousands of people participate, and watch, an outstanding event largely run by volunteers (and, of course, the runners are “volunteers” as well.)  In the end analysis, though, it is the corporate sponsors, and the winners in the competition, who get the payoff.  Everyone else simply contributes to the corporate greater good.
The stories go on and on.
But, yes, we are all part of Capitalism.
In the end, I think that Capitalism will succeed only in killing itself*, in a final, slow but certain, act of self-immolation.  It won’t take a movie like 2012 to do us in.  We literally can’t survive living in as unbalanced a way as we currently continue to live.  It’s only a matter of time.  The only unknown is how much time….
By the time the Capitalists figure this out it will be too late.
Watch Michael Moore’s film, get in a lather (including against him, if you like – but the film is highly rated), and go to work for deep change.  You won’t get rid of Capitalism, but you can help get it reformed.
* – an older story: a friend of mine, a history buff, recalled reading an apparently true account of an old-time Capitalist venture that went severely awry.  Seems a group of European businessmen, in business to make money, saw an opportunity to make a bundle by selling armaments to a neighboring country.  They struck a deal, made their pile…and their country was promptly overrun by their newly well armed enemy.
I’d name the countries, but won’t.  Most any self-respecting Capitalist would do the same stupid thing if opportunity knocked….
Update October 6, 2009:  We’ll likely go to the film tomorrow.  In the interim, I’ll simply add some comments that have come to mind since my initial scribblings, above.
In the U.S. we’re immersed in Capitalism.  It’s ubiquitous, impossible to avoid.  Sunday I was over at the Twin Cities Marathon – first at the starting line at the Metrodome; then at the Finish Line (no, not as a runner!).
Everything about the marathon was a commercial event, from major sponsors, frequently named, company names on all products dispensed, probable tax write-offs for their “contributions” to the community.  Such events are marketing bonanzas for the corporate world.
But when I think of Capitalists, as a group, I mostly think of the really fat cats that make the really, really big bucks off the rest of the population.  These folks used to be called by terms like “Robber Baron”, “Captain of Industry” and the like.  In the present day you can see them in local, regional, national and international folks who are extremely wealthy (or appear to be so, till they’re busted for fraud, as has happened to some big operators in my area recently.)
These truly “rich” folks, as defined by almost anyone, are today’s Capitalists.  They are only the most recent in a long, long line of people whose god is money, and who exercise power against all the rest of us.
Most of them are probably “good” people.  But if it comes to accumulating power and money (synonymous terms, in my opinion), they can be pretty ruthless.

#92 – Peter Barus: "Out of the loop"

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From Moderator: Peter Barus is a great friend, going back a half dozen years or so.  When first I knew him, he was an out-east big city guy, a computer specialist, an excellent trainer and all around good guy.  Two or three years ago or so he and his spouse moved into the very rural northeast U.S., to a farm, and here begins his story….
I have been out of the loop for a couple of weeks or more.
And it strikes me now that this is more than burnout or just an upsurge in activity around here  I’ve really had a change in lifestyle.
I used to be plugged in all the time, writing back to everybody, reading everything that came in within minutes or hours of arrival.
What’s happened?  For one thing, I moved to a farm without electricity, with wood heat, and spent two years living as if I hadn’t.  This year, instead of paying over a thousand dollars for enough wood to stay alive til spring, I decided to go get it myself.  after all, this is a 186-acre forest.
There was a big ice storm last winter that knocked the tops out of about a quarter of the big trees at the edges of the fields and along the roadsides.  The plan was to clean up the mess where its close to home, like the cluster of maples that fell on the old tent platform just up the hill beyond the garden; then go out along the roadsides where the Town crew left major trees for us, before the less scrupulous among our neighbros scarfed it up.  And we had some big chunks out of the logging operation from last winter that a neighbor kindly hauled out of the swamp and left me several truckloads in the front yard.
Lots of people around here rent a splitter and spend about two weeks making their winter pile.  I like splitting by hand.  But first I had to go cut up the trunks and load them in the truck and bring them home.  Then I set up a big stump about waist-high and got out the old maul.  This is like the child of an ax and a sledge hammer.
I got to where I’ve been able to stack about five cords so far; seven is comfortable; a dozen would be nice, cause we can just carry it over into next year.
But it hurts!  My hands are all gnarly and knotted and other words that sound like “nnggg!”  All my joints ache.  I’m not complaining!  I’m strong as an ox now, at age 61.  But how many more seasons can I keep this up?
I think the secret is pacing.  A few strokes a day, rather than a crash-and-burn, all-out, heroic effort.
In between all this, clean the chimneys with the long handled brushes, finish re-shingling the roof, host a family reunion, etc.
We live in the previous centruy, or the one before that, now.  sleep when it gets dark, and up with the first hint of a sunrise.  Life here is a direct struggle with nature, and nature is changing fast too.  Weather like nobody’s seen before, changes in soil, habitats, flora and fauna.
Well, as I say, a change in lifestyle.  By the time I get to the Town Library and hook up to the local wi-fi, I ain’t got much to say, somehow.
But keep ’em coming.  I’ll get to it.
Love,
Peter

#86 – Dick Bernard: Two sides of "entitlement"

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Saturday, during President Obama’s time in Minneapolis, a friend of mine did a little experiment with the protestors outside.
Bruce explains it best: “At the Obama rally on Saturday, I approached several anti-reformers as a panhandler asking for a handout to help me pay my lapsing health insurance premiums,  Some told me to ask the people standing in line to see Obama.  Some said get on Medicaid (ironically, a government program).  Some stuck their hands in their pockets and asked me how much I needed and gave me $5 and $10.  I had the money in my hand and gave it back saying “I can’t take your money, you are a good person, and you put your money where your mouth is.”  Many of the anti-reformers are caring and generous people who truly believe what they are against, a government incursion on their freedom and liberty.  They should be taken for real, as people with substantive concerns.  The problem is how we bridge this gap and ease the fear of our fellow human beings so they can help ease ours.”
There is a lot of wisdom in what Bruce has to say.  At the same time, it reminded me of the simple distinction between “charity” and “justice”.  The people who gave the money to Bruce knew what he looked like and could judge him worthy or not for their money (charity).  (Bruce is a professional man ‘by day’ and would likely not be able to disguise his ‘responsible’ appearance and actions.  He probably looked like he “deserved” help.)
On the other hand, these same benefactors would likely not want their money to go to someone whose name they don’t know, in some place far away (even the next town), because they can’t personally judge the recipient who might be given the money.  He or she or might use the money, they say, for something they don’t approve. Their giving lacks justice.  Justice, it seems to me, is by its very nature less judgmental.  
Bruce’s comment reminds me of the frequent times when I see a handbill asking to help the family of someone whose house burned down, or one of whose members has a serious injury or disease, and no insurance to cover the costs.  In such circumstances, there is often a community outpouring of compassion and concern and even money, and spaghetti dinners become an important community event to help the afflicted.  But I wonder about what happens after the spaghetti dinner…people may toss a twenty in the kettle once; how about $20 a month for years till the debt is paid?
This is where “society” (a synonym is “government” in my opinion)  has to come in, to spread the risk.  The protestors want a very constricted view of what society is.  At least that’s my opinion.
But there is another side to this as well, not quite as comfortable to contend with.  And I’ll pick on someone who I’ll call “Jan” who runs in the circles that I do.
For awhile, Jan came to meetings of a group that I was part of.  She had no shortage of opinions and complaints.
Our $8 dues (per year) was pretty steep, she felt, but she thought that we should send our newsletters by mail to those who didn’t have e-mail, or take them to the libraries so that people like her could read them close to home.
We tend to empathize with the Jan’s of the world, but sometimes they really challenge our understanding.
Probably the last time I saw her at a meeting, was almost a year ago, after she had done her usual litany of complaints.  She told us she was buying a bus ticket – a couple of hundred dollars – to go to DC for the Presidential inauguration week activities.  As I listened, it didn’t sound like she felt it to be too pricey for her budget.
I couldn’t help think of that too pricey $8 dues she’d complained about, (and never did pay).
We can look outward; but as we look outward, we need to look inward as well.
Thanks, Bruce.
UPDATE from Bruce, after he read the above:
“At first I was disappointed with the compassionate response of those who gave money to me.  I wanted to see them as evil without compassion.  The first responses I received were what I expected, “get in line with the Obama people”.  That made more sense to me.  But after getting the hand in the pocket response a few times, it dawned on me that some of the anti-reformers are serious caring people.  Another side note, the women anti-reformers were the most militant and dismissive of my panhandling.”

#77 – Dick Bernard: The political execution of Van Jones (and a possibility or two)

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Van Jones is now history, at least insofar as an office in the White House is concerned.
I heard Van Jones speak in person twice.  The last time, in March, 2009, was apparently his last public speech before joining the Obama administration.  I bought his book, “The Green Collar Economy: How One Solution Can Fix Our Two Biggest Problems” (HarperOne 2008).  It comes with an all-star list of endorsers.  It’s well worth reading.  He is a phenomenal person.
Of course, Mr. Jones has now been publicly executed, resigning from his post within the Obama administration for what appears to have been two ‘sins’: signing a petition, and using colorful language about Republicans.  I’m quite certain I signed the same petition some time (questioning the truth of 9-11*); and as for colorful language, my guess is that Jones ‘executioners’ were at least equally colorful in their description of him in their private meetings.  But that is now simply history.  Jones would be a distraction if he remained on the White House staff.  Life goes on.
Jones ‘demise’ is just the latest example of a contemporary political reality: anyone aspiring politically is fair game for anything, whether true or not.  There is no such thing as a truly personal life for a political figure.  We are all quite literally surrounded by our past, remembered or not.  This is a matter of consequence for our version of democracy.  We need gifted people in government; many gifted people say “no thanks” to public life, and not only because they can make more money elsewhere.  The ‘costs’ of the job are simply too high.
Van Jones is a gifted speaker and visionary.  That was obvious the first time we heard him in June, 2008, at the National Media Reform Conference, and the second in March, 2009. At the conclusion of the 2009 speech (at the University of Minnesota) we were told that he would likely not be doing more public speaking. There was another assignment in the offing, we were told.  It was not hard to put two and two together.  Not long after we saw him, he appeared on the White House roster.
Now, presumably, Van Jones can again speak as an individual.
But I really hope that persons interested in nurturing and development of a “Green Economy” don’t sit back and expect Van Jones to do the heavy lifting.  There is a real danger that could happen; perhaps it already had.  After all, one can reason, he’s in the White House, we don’t have to do anything more.  Not true.  In fact, the opposite is true.  With the opportunity comes the work.    
What better a development than have a million or more advocates for the change that Van Jones sought doubling their personal efforts to make his dream not only stay alive, but grow more quickly?
Personally, I don’t need to hear him speak again, and I doubt many others do either.
What is needed are “boots on the ground” doing what needs to be done; putting in place the multitude of ideas he so well articulated for the future of this nation.
Perhaps the Republicans have done the movement a favor – if we make it so.
* – This reminded me of a 9-11 project I need to do: check the July 23 posting at this blog for details.  You may wish to participate as well.

#70 – Dick Bernard: Health Care and Government in LaMoure

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Other posts on this topic: July 24,26,27,29,30,31,August 1,2,5,6,7,10
See Update at end of post.
Friday I was in LaMoure (county seat of LaMoure County, ND, pop. 900). 
As is usual on my visits there, I was an early customer for coffee at the gas station on the east edge of town.  I got my coffee, picked up the daily Fargo Forum and the weekly LaMoure Chronicle.  The Forum front page was dominated by a large photo and headline “Conservatives rally in Fargo for ‘Tea Party’.  Speaker Hennen says ‘freedom is under attack’.”  (That phrase,’freedom is under attack’, would be amusing, were it not so tragically wrong.) 
As I paid for my small purchases, I noticed on the counter a newsletter, “Recovery Times”, put out by FEMA, the natural disaster section of the Department of Homeland Security.  A few months earlier LaMoure had indeed been ‘under attack’ by a near catastrophic spring flood, and at that time,  ‘government’ in the form of outside assistance was very, very welcome in LaMoure, North Dakota.  Indeed, Fargo, where the Tea Partiers were conclaving, had also had great need for FEMA in its own disaster a few months earlier. 
When in LaMoure, I always pick up the LaMoure Chronicle because I’m  a fan of publisher Gerald Harris’ Comments column.  He always seems to call it like he sees it, whatever the topic, and I enjoy his passion even though, I would guess, we are not ideological twins.  He seems to have no problem with disagreement, and has printed my letters in response to something or other he’s written.  If I’m correct, I like it that he’s willing to consider and even publicize other ideas.  Maybe, even, he can accept other points of view, and maybe even change his mind…not at all a bad trait.
Harris’ August 12 ‘Comments’ column was on Health Care.  I’ve retyped it in its entirety at the end of this column.  It speaks for itself. 
No question, the Health Care debate has taken on the cast of ‘government’ versus the people…and I always find that odd.  The people are, after all, the government.  Whatever the final results of the Health Care debate, the private sector will continue to reap the benefits.  Even if we went socialist (not a swear word to me), the government would be the health care industries biggest customer.
(Come to think of it, in the area of military expenditures, we are already ‘socialist’ – without huge government expenditures for ‘defense’, the massive defense industry would be treading water.  There’s apparently good socialism and there’s bad socialism, and it’s all around us.  Indeed, little LaMoure has a small operating military facility just outside of town.  It’s a piece of pork that goes way back to the time when a local boy was United States Senator from North Dakota.  There’s an old rocket on display right beside the motel I stay in when I visit….)
So, the Health Care debate rages on, as well it should, given the immense size and complexity of the entire Health care complex.  It is not an easy debate.  A couple of days before LaMoure, I was sitting with a group of 14 “birds of a feather” (Mr. Harris would likely observe we all were like thinkers), but what was striking when we talked about Health Care was that there were, even among ourselves, many points of view about what needed fixing, and how it should be fixed. 
What seems clear is that a fix is desperately needed, and continuing to deny reality is like putting off the operation for a cancer until next year, when we know more about the specific disease.  By then it’s too late for the patient.
What’s needed in this debate is not only ideas, but an ability on all sides to really listen, rather than getting stuck in some ideological cement. 
I appreciate Gerald Harris’ point of view.  I hope he appreciates mine, too.
COMMENTS by Gerald Harris, Aug 12, 2009, LaMoure Chronicle
The health care business is becoming a contentious issue in this country today.  There are those that think health care is a right and there are those that think if you can’t pay for it you have no right to it.  I happen to be one that thinks that children and those incapacitated should be taken care of no matter what parents and others can afford to do.  What I don’t think is a solution is for the federal government or state government stepping in to turn our private health care industry into a government controlled industry.  The thing that will do is take away the incentive to improve health care because there will be no reason to do so.  The reason people keep looking for ways to improve things, whether in the health care field or any other field, is they have a monetary or other incentive that drives them.  There has to be something that a person gains from improving things or they won’t do it.  For the most part people don’t look for better ways to do things just for the fun of it.
This is a nation that spends upwards of $3 trillion a year on medical care and that may indicate that we are a nation of hypochondriacs.  It may also mean that we are becoming an aging population has has never taken good care of itself physically.  There are many reasons for poor health and some can be prevented and some can’t and it is up to us to prevent as much of it through diet, exercise and sleep as we possibly can.  This in itself would lower our health care expenditures.
The problem that we face now is that all of our energy to solve the health care problem is focused on health insurance.  The federal government’s efforts are aimed at getting everyone insured through some sort of health insurance policy whether they can pay for it or not.  As I see it this is entirely the wrong approach.  If government wants to get involved at all, and they sure seem to, they should look at making health care available to all citizens young and old through a two or three tier system.  The Number one effort should be protecting those who can’t protect themselves and that is, for the most part, the young and the mentally and or physically infirm.  The country should see to it that all children age 0-18 have free health care.  The second thing is to leave the private health care industry, including the insurance industry, alone to provide health care as they see fit.  The third thing would be to provide a public health care system by expanding on the Veterans Administration health care system to include all those that can’t or won’t afford the private system paid by insurance or by the individual without using insurance.
Ths would provide competing health care systems that the federal government seems to want and it would provide health care to all.  The details of this could easily be worked out and it would be interesting to see what the general populace would do.
By providing for children we have solved the problem of seeing to it that most of those that have no choices have a chance at growing up healthy.
What the government is proposing will eventually cost a lot more money than it does now and probably be no more effective than what we have now.
**
“As I see it, every day you do one of two things: build health or produce disease in yourself.”  Adelle Davis, 1904-1974.
Moderator Comment:  I certainly don’t carte blanche agree, or disagree, with Mr. Harris.  But the suggestion that the government is the problem brings back the comment about FEMA in LaMoure.  When there was a threatened flood, FEMA was there, even though it may well have been smarter for the town of LaMoure, and particularly the farms in the James River Valley, to be built on higher ground.   Government Health care (i.e. Veterans Administration) IS efficient…probably too efficient…it cuts into profits….
Letter to the editor published in August 19, 2009, LaMoure Chronicle:
I’m in and out of LaMoure from time to time, and when in town I always look for and appreciate Gerald Harris’ Comments in the Chronicle.  They make me think, even though I don’t always agree with them.
The August 12 column on Health Care is no exception.
I have a lot of experience with Health Care over many years; luckily I’ve been pretty health, personally.  Were it as simple as Mr. Harris and others assert.  As currently organized, medicine is extremely complicated and inefficient.
“Government” which seems to be, often, a hate-word, is all of us…not some sinister “them”.  Anyone on Medicare or who has ever been in a VA Hospital or in any way has been visited by catastrophe (your flood a few months ago) knows and appreciates the good side of “government” in Health Care.
The massive middle class – most of us, from lower to higher income – is the group that desperately needs reform of Health Care, and protection from the whims of private enterprise and economic downs.  Ironically, it is that same middle class that is mobilized to defeat the very reform that is needed.
So, you have insurance?  You can lose that job which has the insurance, or the rates or the coverage can change, or you move somewhere else.  What stability is there for the common citizen in our current system?  Precious little, I would submit.
I type this letter on an old computer that needs replacing due to innumerable upgrades, etc., over the years.  It was top of the line when I bought it, but no more.  In many ways, American Health Care policy is like this old computer.  It has patches on top of patches.  It needs, badly, “reform” (replacement).
The bottom line mitigating against reform is, I feel, the preoccupation with profits.  That is the main reason for the blizzard of misinformation about keeping what should be public, private.  There’s lots of money to be made from keeping the current system, and the prime beneficiaries are people living a life style that we cannot imagine.
Thanks, Gerald.  I have my own blog, and have written quite a lot about this topic in the last month. www.thoughtstowardsabetterworld.org is the address.  Start with August 15, where I write about the visit to LaMoure last week.
Dick Bernard

#63 – Jim Reed and Carol Ashley: Comments on the American narrative and the demonization of words

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This is post #7 of 13.  The others: July 24, 26, 27, 29, 30, 31, August 2,5,6,7,10,15.
Moderators note: During the posting of this Health Care Reform series, a number of individuals wrote me on various aspects of the problem.  James Reed and Carol Ashley had two quite different takes on the target (my opinion) of this intense debate: “middle class” American people.  Both Carol and Jim make important points.  The reader can interpret.  Both posts are shared with the writers permission.
James Reed, July 29, 2009:   The greatest obstacle to overcome is the public’s belief in America’s exceptional-ism, the belief that the American version of any endeavor is necessarily the best.  That belief projects America’s military forces as the most capable, its schools and universities the most instructive, its products the most inventive, its sports the most entertaining, its care for the young and old the most comprehensive, its economic system the most fair, its lifestyles the most advanced, and by extension, its health care services the most beneficial.  Those beliefs underlie all the arguments against change and undermine all efforts to introduce change.  Those beliefs allow stories of failures in other health care systems to be accepted without question while stories of America’s failures are dismissed out-of-hand.  Those beliefs make statistics on America’s health system meaningless except for the few cases, like number of treatments for prostate cancer, where America claims superiority.
Unfortunately, America’s middle class are those most entrenched in American exceptional-ism.  Taught so throughout our school system, we in the middle class hold tightly to that belief because the belief adds status to our lives.  Whatever our life history, occupation, or economic status, we belong to the best system the world has ever seen.  What change could be necessary in a system that produces the best?
The challenge for those seeking change to the health care system is then to devise change in a way that continues that sense of exceptionalism.
Carol Ashley, July 30, 2009:  I’ve been on Medicare for a very long time due to disability. I’m very grateful for it.
But what I really want to shout into some reporter’s mike is that we have a lot of socialism going on.  Do people want unsocialized police departments, fire departments, court systems, roads, education?  If we didn’t have socialism in these areas, rural areas like mine wouldn’t have or would have inadequate police departments, fire departments, etc.  And can you imagine paying tolls on all roads?  I wonder how many people would like that?
And there is non-governmental socialism in existence like car insurance (though mandated and regulated by government) and our local electric cooperative.  Yes, in the latter, we each pay our own electric bills according to usage, but that covers getting electricity restred to places when it doesn’t affect me.
Right now, we have a form of socialism called private health insurance which pays for emergency room visits from the non-insured through increased costs.  The public pays in very indirect ways through multitudes of bankruptcies that occur due to lack of or inadequate health insurance.
It’s time for people to stop panicking on the socialism thing and to decide when, where and how they want it.

#62 – Dick Bernard: Long Term Care: moving from Charity to Profit Center

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This is post #6 of 13.  The others: July 24, 26, 27, 29, 30, August 1, 2,5,6,7,10,15.
What follows is my response to a long editorial in the July 22, 2009, Minneapolis Star Tribune “Don’t ignore costs of long-term care“.  My response was sent U.S. mail to the writer of the editorial and the legislators mentioned.  I did not write it for publication – it is too long.  I may shorten it for submission as a regular newspaper column in August.
It is important to read the editorial first, as it provides the context for the response.  The editorial on which the letter is based should remain archived at www.startribune.com, (click on Opinion, click on Editorials and look through the archived list.)  I have typed the text of the editorial at the end of this post. 

July 28, 2009

Dear Editorial Writer (“Don’t ignore costs of long-term care”, July 22, 2009)

I have been letting your editorial of July 22 settle for a bit before responding.  I am armed only with personal experiences, your editorial and the enclosed [June 2, 1995 ] editorial by former Mn Governor Elmer L. Andersen.  I didn’t know about the Center of the American Experiment symposium, and in any event wouldn’t have been in their loop anyway. 

 

 To be succinct, the saying “fox guarding the chicken coop” came to mind as I was reading the proposal for (possibly) more taxes made by the Minnesota Free Market Institute representative.  Of course, in this case, the “fox” wouldn’t eat a few chickens and dash away; he’d “monetize” them by careful stewardship of the “eggs” – tough luck for Farmer Jones (the taxpayer) who accepted the “deal”…so it goes.  Money in the bank.

 

It happens that the Sunday before your editorial I was standing in the churchyard of the magnificent Cathedral of St. Boniface in Winnipeg.  We were there to close out a fascinating delving into the last days of my great-grandfather Octave, who died destitute in 1925 at what was described by my father as the “poor farm” in Winnipeg.  I envisioned what this must be.  I’d written about these recollections in a June 21st piece in my blog, and one thing led to another.  “Poor farm” came to be called “rest home” and by July 19, it turned out Great-Grandpa died in the Old Men’s section of Hospice Tache, the hospital of the Grey Nuns in Winnipeg, next door to the Cathedral.  In other words, as was true in those years, he was dealt with as a charity case, and the good nuns, who took seriously their vow of poverty, cared for him in his final days (he is buried in northeast North Dakota, appropriately at rest.)

 

In 1963, Great-Grandpa’s daughter, my grandmother, died.  This was before Medicare.  I was 23 at the time.  To my recollection, she spent most of the last six years of her life in a private room in a small town Catholic hospital.  Her husband had died.  She’d had a stroke, but she could hobble around with a walker.  Dad used to say that her hope was that she would not run out of money before her death.  She had little money to begin with.  I think she probably achieved her goal, probably with the the hospital administrators “wink” at bills. Her care was very inexpensive, and caring. 

 

About 1970, I was at a meeting with a Minnesota state legislator about some local issues.  Nice guy.  It was some years later that I learned that he and I were shirt-tail relations on Great-Grandpas side.  Some time after that I learned the legislator had made a lot of money through Nursing Homes he owned.  He’s long passed on, maybe visiting with Grandma….   Times had changed.  Cheap care had gone missing.  It was now in the Marketplace.

 

In the early 1990s it became my great good fortune to begin a dozen year friendship with Elmer L. Andersen, former MN Governor. 

 

He and I became acquainted through a column he’d written in the Anoka Union.  He was a good writer, and I looked forward to his columns, many of which I kept, including the one that is [below, following this response].  It too, speaks for itself.

 

At some point, in some other context, I learned of the problem that (so far as I know) may still be a problem in American society: people with money (or their heirs) developed strategies to protect their assets so that when it came time to go to the nursing home, their inheritance was protected and the state (“we, the people”) would pay the bill.  Of course, this was a perfectly “honest” strategy.  I seem to recall legislated efforts to close that loophole – probably they still happen – but my guess is that someone with a good lawyer and tax man can figure out ways to shelter their funds while the state pays the lion’s share of their costs.

 

The business of making money is rarely a kind and gentle one.  The astute capitalists figure out ways to figuratively pick people’s pockets.  One of those groups ripe for the picking is, likely, the older age health care sector, which is why the Free Market guy is so compassionate towards the future needs of baby-boomers: there’s lots of money to be made from them….

 

As for myself, for a long time I’ve had what I understand to be the “top of the line” Long Term Care insurance (another lucrative business).  Whether it is more than I need, or if there is a loophole that will deny me essential coverage because of something I didn’t notice, or if it becomes prohibitively expensive to maintain – all of these and other questions are unknown to me, now.  I can’t afford the necessary lawyers and accountants.  And I’m perhaps more astute about this than the average consumer.

 

Bottom line for me is that the profiteers are the ones who have driven the health care industry into the state of crisis in which it now finds itself.  I’m skeptical about the gushing “honestly and courageously” statement near the end of the editorial.  Altruism is of little matter, so long as plenty of money is made, and there is nothing to be lost if they’re hypocritical by criticizing the government at the same time as they’re making sure the government keeps their own trough plenty full.

 

No doubt your editorial is getting wide circulation in the “right-of-center” world….

 

Sincerely, Dick Bernard

 

Enclosure: Editorial of former MN Governor Elmer L. Andersen, then newspaper publisher, in the June 2, 1995, Anoka County Union:

“For the fiscal year ending June 30, 1995, the state Department of Human Services had a budget of $9.2 billion.  That is an enormous amount of money and an incredible responsibility to administer.  Commissioner Maria Gomez, a highly qualified and dedicated professional, has issued a “Report to the Public” that, in plain straightforward language, states the mission and priorities of the department under federal and state law.  Copies of the report are available by calling 612-297-5627.

 

Money flows through County Human Services units, supervised by the County Board of Commissioners and directed by a professional social worker.  Services are also purchased from non-profit church related and other community welfare agencies.   There are misconceptions which the report seeks to correct with clear factual statements.

 

Foremost in the minds of most people is the question.  “Where does all that money go?”  Health Care related expenditures account for 72.7% of the entire total.  By far the single largest item is nursing home care for the elderly.  It has become a part of our culture to place older people in nursing homes at public expense.  The nursing home industry has responded with facilities and programs that provide a variety of services to meet needs in generally pleasant situations.  Increasing population as well as an increasing percentage of older people and an increasing percentage of them in nursing homes, plus rising costs of everything results in soaring expense.  The department is encouraging a program to aid older people to live independently and thus postponing the need for residential care.

 

Aid to Families with Dependent Children is 8.7% of the budget.  All other programs account for 13.2%.  Child care is only 1.2%, Food Stamps .7 of 1%, work readiness .4%. Minnesota Supplemental Aid .9% and “other services” still smaller.  It should be observed that to “get people off welfare” affects relatively small budget items, is welcomed by recieipents and administrators alike but may not accomplish as much as hoped because of the nature of disabilities and will require up front investment.

 

We can be proud to be part of a society that is concerned for the well-being of every individual but we must realize it is a huge, complicated and costly operation.  People who read the report will understand better all that is involved.”

 

Minneapolis Star-Tribune Editorial July 22, 2009

Don’t ignore costs of long-term care

 

The symposium sponsored by a right-of-center Minneapolis think tank was an unlikely place to propose a new federal tax and an even unlikelier place to find agreement that it’s time to consider one.

 

Yet that was the situation of a thoughtful gathering on entitlement programs – Medicare, Medicaid and Social Security – conducted recently by the Center of the American Experiment.  The conservative Minnesota participants – Chuck Chalberg, Laurence Cooper, Tom Kelly, Peter Nelson and moderator Mitch Pearlstein – called passionately for cost containment as baby boomers age.  Toward the end of the program, when the subject of long-term care came up, things took a surprising turn.  Kelly, a Dorsey and Whitney attorney who’s chairman of the Minnesota Free Market Institute, shared perspectives from his parents’ and grandmother’s long-term care experiences.  “We should…simply say that if you have the good fortune to live into the twilight years when you require this care, it will be provided for you.”  Pressed by Pearlstein on how to pay for this, Kelly replied: “We would have to have a tax…the same as we do for Social Security.”

 

It was a striking exchange, one calling attention not only to long-term care costs, but also the opportunity afforded by our shared experiences to explore meaningful solutions to the challenges of caring for the nation’s elderly and disabled in years to come.  Most families have seen up close how costly and frustrating the process can be.  More than just about any issue, there’s common ground on which to build real reform: policies that reduce reliance on expensive institutional care and encourage more personal savings.

 

Whether that involves a new taxpayer-supported social insurance program remains to be seen, and it’s too early to support any type of tax.  But make no mistake, it’s time to act.  The nation’s long-term care system is in crisis.  The reason is that far too few Americans save for long-term care expenses, yet the majority of them will need it – nearly 70 percent of people over age 65 will require this kind of care at some point.  Private long-term care policies pick up just 7 percent of the nation’s long-term care costs.  Those without insurance go through their savings and then turn for help to Medicaid, the $360 billion-a-year medical care program for the poor that is administered jointly by the state and federal government.

 

Medicaid’s costs are unsustainable.  In 1971, Medicaid consumed 0.7 percent of the U.S. Gross Domestic Product.  That total had climed to 2.1 percent by the early part of this decade.  Long-term care services comprise about one-third of the program’s total spending and are expected to consume dramatically more dollars as baby boomers age.  Despite the money spent, and despite recent policy fixes, families remain frustrated by the program’s institutional bias.  It’s designed to put people in nursing homes, not keep them in their own homes.

 

Minnesota is fortunate that its politicians understand the issue’s urgency.  In the state Legislature, Rep Laura Brod, R-New Prague, and Paul Thissen, DFL-Minneapolis, teamed up admirable this spring on a bill that would have allowed Minnesotans to open up tax-advantaged savings accoutns for long-term care expenses.  The bill wasn’t passed during the 2009 session, but it deserves a second change in 2010.  While a small step, it’s a start in getting more people to save for their own care.

 

Newly installed U.S. Sen. Al Franken, who sits on the Senate’s Special Committee on Aging, also understands the issue’s urgency.  Just days after taking office, Franken told the Star Tribune that long-term care must be part of the health care reform debate going forward, and his ideas bear watching as he offers specifics.

 

The new Senator’s focus is welcome.  Even during this summer’s historic health care reform discussions, long-term care has unfortunately remained an after-thought.  The U.S. House bill, introduced last week, essentially ignores it.  On the Senate side, Sen. Edward Kennedy has introduced a program that calls for Americans to voluntarily pay long-term care premiums into a new government-run long-term care insurance program.  That program, called the CLASS Act, deserves a higher-profile debate than it has gotten.

 

Kelly and his colleagues at the Center of the American Experiment symposium spoke honestly and courageously about long-term care.  Their conclusions are correct.  Drastic action is needed and all options must be on the table.  More blunt talk is needed if the nation is to continue providing the quality affordable care its most vulnerable citizens deserve. 

 

#60 – Dick Bernard: Health Care Reform and the Middle Class: The Middle Class fighting against its own best interests?

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This is post #4 of 13. The others: July 24, 26, 27, 30, 31, August 1, 2,5,6,7,10,15.
Please note comments filed at July 24 and 26 posts.  I also added a brief update at the end of the July 26 post.  The final planned post on this series will be tomorrow.  I hope they elicit at minimum some thought.  If there is to be change, it is up to us, not to somebody else, to bring it about.
This post is particularly difficult to write, even though, except for a couple of too-close calls to long-term “poor”, I’ve always been middle class.  Even with some serious ‘speed bumps’, I’ve been pretty fortunate so far.
It is the middle class (most broadly defined) in this country which bears (and will bear) the consequences of chaotic health care “choice”, misleading sales pitches, and profiteering by assorted entrepreneurs committed to maximizing the “monetizing” of Health Services through many assorted means.  The pinnacle of today’s medical industry, most broadly defined, is about making money, lots and lots of money.  World Class Care is a distant second, and care for all is bad economics if the monetary bottom line  is the objective.
It is ironic, then, to see that the middle class is actively recruited for – and willing to – lobby against any substantive attempts to reform the system that in far too many instances hurts them. 
If anyone will, it will be the American middle class that will truly kill health care reform. 
It is not hard to figure out how “recruitment”  happens.  Fear.  For just one example, somehow or other I got on a nationwide e-list that is, charitably, anti-government and thus anti-tax.  (I’m actually glad I’m on this list (passively) since it opens a window into the exploitation of the Fear people have of change.) 
Here’s the subject lines to date (I may update as new ones come in, as they will): July 3 – generally anti-Taxes; July 18 – Congress plans to Outlaw Private Insurance; July 26 – the insurance reform will cover 12,000,000 illegals; July 28 (three e-mails) – Congress won’t enroll in its own Government Health Care; Obama-care Night-mare; call for One million Tea Bag faxes targeting two Democratic Senators.  The bottom line for this initiative: keep the middle class fearful and confused and divided.  Works well.  Who funds this initiative?  Whatever the case, it exists.
The tone of these e-mails are on the verge of hysterical (and written to sound believable), and my guess is that plenty of middle class folks bite.
But of what benefit to the middle class is the continuation of the current system, essentially unchanged?  If you are very lucky, you are enrolled in a large group plan, you aren’t facing layoff, and the plan has a retirement supplement option which won’t disappear and which you can afford.  That is the kind of plan I’m in, I think.  But I’m in a pretty sheltered environment.  And the part of my plan that covers what Medicare doesn’t – the supplement – is never certain.
(A year ago all retirees of the company were called together for a special session where the benefits people introduced ten or more competing alternative plans that we, the consumers, were invited to look at.  There were hundreds of people there.  Why is Plan E cheaper than Plan A?  What does Plan E take away that you would get with Plan A?  The devil is always in the details, or in the fine print.  Most of us don’t have the skills or the time to navigate this morass.  But this is the choice we consumers are constantly asked to make – and then it’s our own fault if we make a dumb choice.  So, I pick a choice that barely covers chemotherapy because I don’t need that coverage, and I end up with cancer?  My problem.)
The Health Care crisis didn’t happen last week…it has been evolving for years (read tomorrow’s post).  But like the person with a suspicious symptom who refuses to go see the doctor for fear of what the doctor might find, society (based on the rhetoric of its political representatives) seems to believe that refusing to acknowledge the problem will make it go away.  Not.
I know the general parameters of the field of health care pretty well.  In addition to personal experience over the years, and close relatives in the field, for nearly 30 years I was intimately involved with negotiating and administrating several hundred collective bargaining contracts for tiny to large union locals, all of which had some form or another of group health insurance. 
These plans were good, bad or sometimes awful.  Sometimes the participants paid nothing for the coverage; in other places they paid a lot.  In every case, to belong to the plan they had to be a contracted employee, and if they were laid off or left for some other reason, their health benefit ended at some early point. 
Long before I retired in 2000, efforts were already being made to pool the small plans into a much larger state-wide plan, which would spread the risk, and thus create greater efficiencies (lower cost).  To date, so far as I know, such efforts have failed, in large part because the have’s are not (if we’re to be really honest) interested in compromising parts of their quality plans to help the have nots.  In the end, both the haves and the have nots suffer from this short-sighted approach.  But logic doesn’t often fit into this debate, which is emotional.
I’d like to see light at the end of the tunnel, but absent citizen outrage the problem will get worse.  People are and will continue to be forced to make decisions based on bad or manipulated information which, of course, will have bad consequences.
In the end the American Middle Class will decide whether to do the common sense thing and go to some kind of single payer option, or choose instead the status quo which will (my opinion) only continue to get more and more chaotic. 
The decision will be up to us….  What are YOU doing to impact?

#59 – Dick Bernard: Should there be Health Care for all? A simple exercise.

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This is post #3 of 13: the others are July 24, 26, 29, 30, 31, August 1, 2,5,6,7,10,15.
Posts #58 and #56 (July 26 and 24, 2009) are also on the Health Care Reform issue; Post #60 (not yet begun) will be on Health Care and the Middle Class conundrum; and #61 on Nursing Home and Long Term Care.  I’m not an “expert” in this area (I doubt even the “experts” are, but I know quite a bit from work and life experience.) 
What started out as a simple idea has become more complicated than I thought, but the simple exercise, below, might help individuals begin to get an idea of the complexity of health care systems in this country, how a simple system can become bewildering – a system promoting individual disasters. 
Take a single sheet of paper, crease it down the middle, making two columns.
In the first column make a list of everyone you know in your own family, among friends, colleagues, their families, etc., who in one way or another cannot economically navigate by themselves.  This could include people with serious mental, physical or emotional handicaps; people in jobs without adequate insurance, or those who might be laid off from such jobs and be without insurance for short or long terms, ETC.  (There are many et ceteras.)
In the second column, make a similar list of everyone you know personally who is “wealthy”.  For purpose of discussion, this could be anyone who could financially survive a catastrophic medical event even if uninsured. 
There could be a third column – the big majority of us, with all the unusual arrangements which make up our own health care – but the first two are good to illustrate how our system works (or doesn’t).   #60 will speak directly to the Middle Class insurance problem. 
My first column is quite lengthy, even though I come from a family that values hard work and self-reliance and would be considered middle class, and is white.   I can ask myself, and I ask you as well: “which of the folks on the first list should be set adrift, to ‘sink or swim’ on their own?  If they die, tough.  Don’t send me the bill.”  Most of the people on my personal list already receive one public benefit or another, as they do in all families, including a very large number on Medicare. The often-reviled Medicare law of 1965 assured that: when you turn 65, as I have, you’re on Medicare – no choices.  But also on my list, and probably on everyone elses, are some people now in the “middle class”, who very well may find themselves, their kids or grandkids in crisis down the road, marooned outside the health care system.  If health care for all is a gravy train, as some may suggest, who do we throw off of it?  Do we solve the problem by getting rid of Medicare and Medicaid?  These are not simple questions.  (More on Medicare history at http://encarta.msn.com/encyclopedia_761568111/Medicare_and_Medicaid.html)
My second column includes a single name.  He was a very wealthy businessman, and almost 50 years ago was a governor of my state, and before that a respected state legislator.  He developed his small company into a Fortune 500 International Corporation.   He and I came to be very good friends.  He died in 2004.  It was a great personal gift to get to know him.  Most of us don’t even know a single truly wealthy person.  Not all of them fit the caricature. 
I could go on at great length about the people in my first list.  My “Exhibit A” is the relative who was caught on a home movie at a large family reunion 16 years ago.  I looked at this home movie just a week ago.  This person, who appears on screen by herself for only a few seconds, was an adult, and she was clearly cowering in the corner of a building, most likely terrified by the throng at the festive gathering.  I didn’t know of her then, but later learned that she was chronically and quite severely mentally ill and simply could not function in “normal” society.   So far as I know, she is no different today.  She lives at home; most certainly she receives public assistance, as she should.
Each of the others on the my list – and yours – have their own stories, some possibly self-inflicted (as chemical abuse); most through bad luck or no fault of their own. 
My points about these lists – and yours – are these: 
1)  Every one of us, if honest, can make similar lists of people in our own circles.  Every one in our society could.  These folks are part of humanity, deserving of treatment for their ailment, and care beyond minimal needs.  They exist everywhere in our country, no less than around the world.  They just happen to have dis-abilities.
2)  That single wealthy guy on my list?  He was no pariah, worthy of scorn.  He has important public buildings named after him.   Were he around to engage in this health care debate, it would probably be a no-brainer for him: if it is for the good of society then everyone should be covered, he would probably say, today.  He spent a good part of his young life as an orphan, and he understood what it was like to be under-privileged.  In his public policy days, group insurance was basically unknown, but medical care was also very inexpensive.   He’d probably say, “let’s figure out how to get this problem solved”.
3)  Probably the real dilemma comes for the folks in the middle – the vast majority of us.  Some of us have insurance, some don’t, some pay more, some less, for better or worse coverage.  We deal with great uncertainty, and it is in our interest to get some consistency for all. #60, on July 28, will deal with this issue.       
4)  To those who say “this is all well and good, but don’t expect me to pay for illegal aliens” or, “we can’t afford this”, or “fill in the blank” pet exclusions to universal care, a simple thought: we are in a global world, and among the problems we face is that communicable disease does not stop at state lines, or town boundaries, nor country borders.  Wouldn’t it at least make sense to take care of the basic care for all, since it would lower the odds of that killer disease reaching our doorstep?  And shouldn’t health care, like education, be a basic human right for all of us?  It is, after all, in our own selfish interest.