Sheila – Page 1088 – Sheila Kennedy

Healthy Societies

One reason the legal recognition of gay marriage or civil unions is so important is very prosaic: health insurance. Currently, if you are gay and don’t work for an enlightened employer, you cannot put your partner (or your partner’s children unless you have somehow established a legal relationship with them—itself not easy) on your health insurance.

Of course, that assumes your employer even offers health insurance. And the number of employers who do is declining.

The bottom line is that America’s refusal to deal with our dysfunctional health system in a rational way affects gays and lesbians and poor people disproportionately. It is one more example why bad public policy—and not just bad policy on obviously gay-related issues—is especially important to the gay community. (The same thing is true of the battle over “net neutrality”—if the giant telecoms get their way, the web sites that will be hurt will disproportionately be those with fewer resources, those espousing less “mainstream” opinions. There are many issues with grave consequences to the community that are not “gay” issues.)

So what would a rational, economically and fiscally sound, humanitarian and fair health system look like? What if the country were to go to a “single payer” health insurance system funded through tax revenues and administered through selected insurance companies, as is done in western Europe?

Increased economic development/job creation and competitiveness with foreign companies. Businesses currently expend an amount in excess of total net profits on health insurance for employees. The cost of health insurance is the single largest “drag” on new job creation. For companies that can afford to offer health insurance, negotiating and administering those benefits, and complying with government regulations attendant to them, consumes untold hours of HR time as well. (It should be noted that doctors’ overhead would similarly decline: currently, medical offices spend considerable sums on personnel whose sole job is confirming insurance coverage, complying with insurer regulations, submitting claims and collecting amounts due.) Smaller companies—the engines of economic growth—are often unable to offer benefits, putting them at a competitive disadvantage for good employees. If health coverage was de-coupled from employment, these enterprises would be able to add workers. Employers could also increase wages by some percentage of the amount currently being paid for insurance.
The additional tax revenues needed to accomplish this would be minimal, for the following reasons: governments at all levels already expend huge amounts for health, through Medicaid and other federally required programs (Mothers and Children, AIDS, etc.), through benefits for public employees (Universities, police, public school teachers, etc.), and through support for public hospitals. A national system could effect considerable savings, by standardizing paperwork and administrative procedures (it is estimated that 30% of U.S. healthcare costs are administrative); negotiating with insurers to administer the program on condition that the premium structure eliminate marketing costs that are now included; providing more effective public health and prevention services; and by negotiating with drug manufacturers and other medical vendors for lower prices. Cost controls would also be enhanced by eliminating the practice of cost-shifting by hospitals (where those with insurance pay prices that have been inflated in order to cover the costs that cannot be recovered from those without), and by efficiencies of scale. Costs also decline when people are able to access routine medical care soon after the onset of symptoms, rather than visiting far more expensive emergency rooms when they can no longer ignore the problem.
Individuals would save money. Auto and homeowners insurance premiums would decline, because the underwriting would no longer need to take the costs of medical care into account. The considerable percentage of citizens who are currently uninsured would not incur significant out-of-pocket costs attributable to illness or accident.
If all citizens had basic health coverage, we would also experience a decline in the social costs associated with the current dysfunctional system. Over 50% of personal bankruptcies are attributable to medical bills; those bankruptcies cost businesses millions of dollars, and are a drag on the economy. Employees with pre-existing conditions would no longer be chained to jobs they dislike. Absenteeism could be expected to decline. Immunizations would increase, and infant mortality decline. Studies also suggest that violent crime rates decline as social safety nets increase. While not quantifiable, these consequences are significant.

And gay families would no longer face barriers to adequate medical care that straight citizens don’t face.

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Desecrating the Flag

Nothing demonstrates the differences in Americans’ worldviews more vividly than disagreements over periodic efforts to ban flag “desecration.”

Many officeholders who are currently promoting this effort are, of course, doing so cynically, in a frantic effort to change the national dialogue and divert attention from a government that looks more dysfunctional every day. But many people support a constitutional amendment out of a sincere belief that such a move would demonstrate respect for the country and recognize the sacrifices so many of our soldiers have made over the years.

Many, if not most, of the amendment’s supporters readily acknowledge that flag-burnings are rare (according to the numbers I’ve seen, there have been fewer than 45 documented cases in the last half-century). Some of them will even concede that the passage of such an amendment is likely to spur more such acts of defiance rather than reducing that already low number. But putting a halt to some epidemic of civil disrespect is not the point; supporters don’t want to control social behavior, they want to send a “patriotic message.”

Those of us who look at this proposal with dismay are not—as the Ann Coulters of the world insist—traitors, terrorists or anti-American provocateurs. Actually, we believe we are the real patriots. We just define patriotism differently.

The United States Constitution and Bill of Rights gave America the best, most workable, most enlightened governing structure yet devised. Certainly, it is the system most respectful of individual dignity and autonomy. The flag—the cloth emblem that legend tells us was devised by Betsy Ross—is a physical symbol of that system. People honor the flag by respecting the Constitution, and they desecrate it when they elevate the piece of cloth over the principles and values that make it worthy of respect.

When we approve government actions inconsistent with our most basic governing premises, we are desecrating the flag.

When those we elect to high office routinely ignore the foundations of republican government—separation of powers, accountability, the insistence that—as John Adams put it—we are “a government of laws, not men,” they are desecrating the flag.

When our lawmakers intrude in areas that are simply no business of the government, whether it’s Congress insisting that fourteen state court decisions have been wrong, and Terry Schaivo’s feeding tube cannot be disconnected, or South Dakota lawmakers deciding that it is their place to criminalize a woman’s decision to terminate a pregnancy, or a Pennsylvania school board deciding that their religion should be taught in lieu of science in public school classrooms, those lawmakers are desecrating the flag.

A President who unilaterally designates people as “enemy combatants” and imprisons them indefinitely without permitting review of that designation by the courts, or who issues “signing statements” declaring that he has no obligation to comply with acts of Congress he doesn’t like, is desecrating the flag.

I have a radical suggestion: let’s honor the flag by insisting that our elected officials respect the Constitution it symbolizes.

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Making War on Making Love

A blog that I read fairly regularly calls it the “War on Fucking.”

I think the blogger is on to something. As she points out, it is a mistake to look at the right-wing attacks on gays, abortion, “pornography,” “non-traditional” families and the like as separate issues; at base, what these people are against is sex, sexuality, and anything that smacks of acceptance of the role sex plays in human existence.

Her explanation for this war is that those waging it are people who have terrible difficulty controlling their own urges, and who assume that everyone else is having an equally difficult time controlling theirs. If there are not strict—indeed, inviolable—social controls to keep these passions in check, they are sure the result would be social chaos. (This theory may or may not be true, but it sure would help to explain all those child molesting cases involving pastors and choir directors…….). As a result, they live in a state of fear, and they cling tightly to the “eternal verities” provided by highly restrictive religious doctrines and punitive laws, which they see as the only alternative to social disintegration.

A glance at history will demonstrate the effect this fear has had on women and our place in society. Women were seen as uniquely and mysteriously powerful—as magical beings whose appeal could make strong men weak. Thus, the notion that “good” women might actually enjoy sex has been an especially terrifying idea. This is the real root of support for “abstinence education” rather than accurate and effective sex education, of the campaign against Plan B, the “morning after” contraceptive, and more recently (and incredibly) the opposition to inoculation against cervical cancer. In case you haven’t read about this latter controversy, medical scientists have developed a highly effective immunization against cervical cancer. But it must be given to girls before puberty. As the Washington Post recently reported:

“A new vaccine that protects against cervical cancer has set up a clash between health advocates who want to use the shots aggressively to prevent thousands of malignancies and social conservatives who say immunizing teenagers could encourage sexual activity.

Although the vaccine will not become available until next year at the earliest, activists on both sides have begun maneuvering to influence how widely the immunizations will be employed…

Groups working to reduce the toll of the cancer are eagerly awaiting the vaccine and want it to become part of the standard roster of shots that children, especially girls, receive just before puberty. But because the vaccine protects against a sexually transmitted virus, many conservatives oppose making it mandatory, citing fears that it could send a subtle message condoning sexual activity before marriage. Several leading groups that promote abstinence are meeting this week to formulate official policies on the vaccine.”

This war on sexuality and sexual desire is the larger context within which we must understand the ferocious resistance to "legitimizing" gay relationships by allowing same-sex adoptions, marriage or civil unions, even laws protecting gays against discrimination. Because of their single-minded preoccupation with sex, social conservatives do not see the other elements of human relationships; thus they equate any legal recognition of gays with an endorsement of sex—and, in their worldview, “deviant” sex to boot.

It must be hard to live in a world where some sex fiend is hiding behind every bush, waiting to pounce—waiting to defile “pure” women and molest small children. And when you are terrified all the time, it is really hard to be logical, let alone fair or loving.

I’d pity them, if the rest of us weren’t civilians in the line of fire in their War on Fucking.

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Protect Me from the Protectors

Senate confirmation hearings on General Michael Hayden raised a number of questions about the NSA surveillance program. While the devil is always in the details, let me risk oversimplifying the arguments pro and con: one side says such programs make us safer without unacceptably invading our liberties; the other side says—to plagiarize New Hampshire’s motto—live free or die.

That’s the wrong debate.

Leave aside the troubling issue of government honesty and accountability. For the sake of argument, let’s assume the Administration played by the rules. Let’s further assume that intrusions on our liberties are, as proponents assert, minimal. What are the risks and rewards of this data mining operation? Is it making us safer—or is it actually compromising our safety?

Whatever its effectiveness in protecting us from terrorists—a hotly debated proposition within the FBI and CIA—this program and the “War on Terror” create significant non-terrorism-related security risks. As one scholar warns, the executive’s power to do whatever he deems necessary to “conduct war” will “displace the area previously assumed to fall within the criminal justice system.” In other words, the President will increasingly have a choice whether to categorize threats as matters of national security or matters of crime and criminal justice. We are already creating a “parallel law enforcement structure” not subject to constitutional restrictions. It will be increasingly tempting to argue that the criminal justice system is too inflexible and outmoded to use during the war on terror.

If that is too abstract a concern, consider the very immediate, practical dangers posed by the existence of such a database. To begin with, it vastly increases opportunities for identity theft. Even if (as the Administration insists) conversations aren’t being monitored, numbers are. How many times have you used your telephone’s keypad to punch in bank codes or credit card numbers? All it would take to give thieves access to that information is one breach in computer security, or one NSA employee with financial problems or dubious ethics.

How about blackmail? What if government had evidence that an annoying activist or legislator was calling a phone sex line? Do you think that information might be used to get votes changed, investigations dropped, or public criticisms muted? It happened to Martin Luther King—and that was before we got so technologically sophisticated. The government has already used NSA information to identify who is leaking information to the press. If whistleblowers know their calls can be tracked, how long before we stop getting any inside information about government wrongdoing?

American privacy is vanishing. Our telephone companies willingly sold the records on each of us to the government. For money. Other businesses—Amazon, Google, your doctor, your insurance company—amass huge amounts of data on us all. We trade this information for convenience, and like many people, I have considered that trade mutually beneficial. If I knew the information might be turned over to government, I would have second thoughts, and I imagine many other people would as well.

For most Americans, Big Brother poses a much greater threat than Osama Bin Ladin.

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Confronting Ambiguity

This is the time of year when I envy colleagues who teach math and science—courses where final examinations are filled with questions to which there are clear right and wrong answers. Students are comfortable with the certainties of such subjects; they have far more difficulty dealing with questions that are often answered—at least in part—with “it depends.”

When undergraduates are told that the “right” answer consists of identifying and analyzing the issue—and not just choosing the correct outcome—they can find it positively disorienting. They tend to want clarity and bright lines–rules that can be memorized and regurgitated. That works when the question is two plus two; it’s dicier for most areas of real life.

Despite all the rhetoric that gets thrown around these days about the differences between conservatives and liberals (whatever meaning those abused terms currently retain), I think it is this discomfort with the ambiguities of reality that best defines the contemporary political divide. Conservatives and liberals may be guided by different philosophies of government and different views of virtue, but most recognize the inherent messiness of life and acknowledge the dangers of too-rigid, too-doctrinaire approaches to our common civic life.

There are people of all political persuasions, however, who find the absence of moral certainty unbearable. We all know folks who began their civic life as passionate believers in one “ism” or another, and who reacted to disillusionment by embracing an opposing, equally extreme philosophy. Talk radio and shout television programs are filled with ex-communists who have fervently embraced right-wing dogma. Bookstore shelves display manifestos by former right-wing activists now devoted to unmasking the agendas of their erstwhile culture-war colleagues.

These are people who find the inevitable ambiguities of real life not just distasteful, but terrifying. Much like those ex-cons who can’t cope with life outside the predictability of prison structure and who purposely re-offend in order to be sent back, they need the psychic comfort that comes with imposed discipline—no matter how confining.

For better or worse, however, political and civic life requires compromise. Thoughtful conservatives, libertarians and liberals can generally find some common ground that makes governing possible. They understand that no one gets his own way all the time, and that an acceptable middle-ground is no small achievement in a society as diverse as ours. Zealots, however, find compromise not just distasteful, but evil. They don’t acknowledge the ambiguities; they not only don’t see shades of gray or moral complexity, they believe that people who do are the “real” enemy.

This dynamic plays out on both sides of the political spectrum, but in Indiana it has been most notable in the Republican primaries of recent years, where moderately conservative lawmakers have been defeated by people campaigning on the proposition that moderation itself is evil. Larry Borst and Bob Garton were not defeated by opponents debating the nuances of policy. They were victims of holy wars.

And even undergraduates understand that holy wars will ultimately victimize us all.

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