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America’s healthcare act schizophrenia

Sticking stubbornly to our broken model is wrong

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Earlier this month, the Republican-controlled House of Representatives voted once again to repeal the Affordable Care Act. House Speaker John Boehner (R-Ohio) said the Act is “making our economy worse, driving up the cost of healthcare and making it harder for small business to hire workers.” He has plenty of Americans behind him in that belief. A majority of Americans want the Act repealed, though 82 percent support the Act’s new rule that bans insurance companies from denying coverage to people with pre-existing conditions. Our nation has developed Care Act schizophrenia.

When the Supreme Court ruled on the Affordable Care Act a couple of weeks ago, I found myself in the perfect laboratory of national opinions, surrounded by families, businesspeople, and gay flight attendants all passing through Atlanta’s Hartsfield-Jackson airport. As CNN announced the breaking news that the Supreme Court had left the Affordable Care Act standing, passengers waiting for flights started speaking out:

“There goes the middle class,” groused a guy behind me.

“Now we know what we need to do—get that guy out of office,” snorted a woman sitting with her elderly mother.

“This is why our forefathers left England. It’s Socialism!” insisted a history-challenged senior.

Right now, more Americans have come around to accept gay marriage than are in favor of the Affordable Care Act. What’s behind this virulent hatred of a national healthcare program? Ignorance.

Now, I’m not saying that there aren’t legitimate concerns about the ACA in its current form. We can have a good debate about the details of its roll out. But first let’s put some common arguments to rest.

  • “The U.S. has the best healthcare in the world.”  Not if you agree that healthcare should prevent untimely deaths. The U.S. is in eighth to last place in the industrialized world when it comes to life expectancy. The only relatively developed nations we outlive are the Czech Republic, Estonia, Hungary, Mexico, Poland, Slovakia and Turkey. We rank dead last among highly industrialized nations. Not exactly what you would expect for the third wealthiest country in the world with the “best” healthcare.
  • “We just can’t afford universal healthcare.” We’re already paying the price tag for universal healthcare, just not getting its benefits. The U.S. pays two-and-one-half times per person as much for healthcare as the average for all other industrialized nations. Pre-existing condition exclusions blocked many Americans from getting health insurance, and high premiums still block others. So many of the 50 million uninsured Americans use the emergency room as their primary healthcare provider.

The average emergency room visit costs $1,318, or $1,565 for patients over age 45. Worse, by the time uninsured people get to the ER, their conditions are much more costly to treat. For example, we spend more than any country in the world on hospital admissions for preventable diabetes. When patients can’t pay, you and I are already picking up the tab through increased insurance premiums, and increased taxes as hospitals write off their losses.

  • “Well, we don’t want to be like Canada, with its rationed healthcare, or socialist like France!” Agreed, we’re an innovative capitalist country. But since we’re paying more and getting less for our healthcare dollar, just saying “no” to “socialist ObamaCare” isn’t good enough. Let’s borrow a better business model from one of the industrialized nations that has a successful healthcare system without resorting to universal healthcare. Have you got a country in mind?  If you do, you must have gone back in time, because ever since Israel changed its system in 1995, we’re the only nation in the industrialized world that does not have universal healthcare.

That’s right, it’s not just Canada and France that have universal healthcare, but also Australia, Austria, Bahrain, Belgium, Brunei, Cyprus, Denmark, Finland, Germany, Greece, Hong Kong, Iceland, Ireland, Italy, Japan, Kuwait, Luxemburg, New Zealand, the Netherlands, Norway, Portugal, Singapore, South Korea, Spain, Sweden, Switzerland, the United Arab Emirates, and the United Kingdom. And they all pay less per person, and all live longer, on average, than we do.

Not a single American I’ve spoken to who is opposed to the Affordable Care Act knew this most basic fact.

The truth is, we can’t afford not to have universal healthcare. Among those employed, medical expenses are the No. 1 cause of household bankruptcies in the U.S. You can sock away savings all of your life, but when genetics, age, bad habits or bad luck bring a major medical issue to your home, too often all financial reserves are lost.

So go ahead and call universal healthcare “socialism.” I believe government has two core functions: to defend the nation’s people against enemy attack and defend citizens from unnecessary death. No town buys its own tank and jet fighter for a possible war, and very few households could save up enough for a medical catastrophe. This is why societies have governments in the first place, not just socialist governments.

Take it from Mitt Romney, who supported an individual mandate to establish universal healthcare in 2006, “Folks, if you can afford health care, then, gosh, you’d better go get it. Otherwise you’re just passing on your expenses to someone else. That’s not Republican, that’s not Democratic, that’s not Libertarian. That’s just wrong.” Sticking stubbornly to our broken, privatized model is just plain wrong.

Stephen Fallon is president of Skills4, a healthcare consulting firm that provides services to CDC and HRSA funded providers, primarily gay- or minority-based agencies and clinics. Reach him via skills4.org.

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3 Comments

3 Comments

  1. John-Manuel Andriote

    July 21, 2012 at 12:17 am

    To add another point to your excellent summary of why universal health care coverage for every American is the only effective solution for our health care schizophrenia…We need to decouple health insurance from employment. It makes no sense for people to have access to semi-affordable health insurance only through employers’ group plans (or individual plans that are usually quite expensive). As soon as someone gets too sick to work, there goes his or her insurance–and the downward economic and medical spiral toward disaster begins. Medicare for all paid for through taxes–think of all the money you save from deductibles and co-pays!–and if you want supplemental coverage, you can pay out of pocket for it. But no American should ever face financial ruin, or untimely death, because of a medical crisis. It really is a crazy system we have.

  2. Jeff Wennberg

    July 23, 2012 at 2:52 pm

    Once again the myth of poor US life expectancy gets repeated in support of socialized medicine. The statistic is grossly misleading and produced by a study that punishes any country without soup to nuts socialized medicine. First, the statistics include deaths resulting from automobile accidents and violent crime, both of which the US has in excess but neither of which are a reflection on the quality of health care. If we remove these two causes of death from the statistics the US moves from #19 to #1 in life expectancy in the industrialized world. This makes sense when you also consider nearly 50,000 Canadians sought treatment outside their socialized system – the vast majority coming to the US. If the US has such horrible services and embarrassing results, why do so many foreigners flock here for treatment?

    The infant mortality statistics (thankfully not repeated here) are equally misleading.

    As for universal health care, I agree that the US can and should achieve it. But please look to models like Switzerland and not the single payers of which there are 3 – Canada, Cuba and North Korea. Surely we can do better than that. And please let’s use real facts upon which to base our policy debate.

  3. Bear

    July 27, 2012 at 1:07 pm

    Not to be picky, but is schizophrenic really the correct term to use to describe this? :/

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Commentary

It doesn’t take a miracle

Hanukkah a time for LGBTQ Jews to celebrate full identity

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(Public domain photo)

For Jews around the world, Sunday night marked the beginning of Hanukkah. The story of Hanukkah celebrates the liberation of Jerusalem by the Maccabees, a small and poorly armed group of Jews who took on, and defeated, one of the world’s most powerful armies. 

Upon entering Jerusalem, the Maccabees saw that there was only enough oil to light the Temple’s eternal flame for one night. But the oil lasted eight nights — enough time for new oil to be prepared. The eternal flame remained lit, and light triumphed over darkness.

The story of Hanukkah was a miracle. While we celebrate and commemorate that miracle, we should also remember that it doesn’t take a miracle for one person to make a difference. 

The entire world is shaking beneath our feet. The climate is in crisis and our planet is in danger. A viral contagion has claimed the lives of millions, and there’s no clear end in sight. Creeping authoritarianism threatens the entire world, including here at home.

Sometimes it seems like it will take a miracle to solve even one of these problems. The reason these problems seem so overwhelming is because they are — no one person can fix it themselves.

Here in the LGBTQ community, we have made enormous strides, and we ought to be proud of them. But there is so much more work to be done.

Not everyone in our community is treated equally, and not everyone has the same access to opportunity. Black, brown and trans LGBTQ people face systemic and structural disadvantages and discrimination and are at increased risk of violence and suicide. It must stop.

These are big problems too, and the LGBTQ people as a collective can help make the changes we need so that light triumphs over darkness. But it doesn’t take a miracle for individuals to light the spark.

Our movement is being held back by the creeping and dangerous narrative that insists that we choose between our identities instead of embracing all of them. 

The presentation of this false choice has fallen especially hard on LGBTQ Jews, many of whom feel a genuine connection to and support for Israel. They feel marginalized when asked to sideline their identity by being told that the world’s only Jewish state shouldn’t even have a place on the map. And they feel attacked when asked about the Israeli government’s policies during a conflict, as if they have some obligation to condemn them and take a stand simply because of their faith.

One of the ways we can shine our light is to fight for an LGBTQ community that is truly inclusive.

This holiday season, pledge to celebrate all aspects of your identity and the rights of LGBTQ people to define their own identities and choose their own paths. If you feel the pressure to keep any part of your identity in the closet, stand up to it and refuse to choose. 

In the face of enormous challenges that require collective action, we must not give up on our power as individuals to do what’s right. It doesn’t take a miracle to do that.

The tradition of lighting the menorah each night represents ensuring the continuity of that eternal flame. One of the reasons the Hanukkah menorah is displayed prominently in the windows of homes and in public squares is because the light isn’t meant to be confined to the Jewish home. The light is for everyone — and a reminder that we can share it with the world every day to try to make it better.

As long as we keep fighting for justice, we don’t need to perform miracles. But we do need to do our part so that light triumphs over darkness.

It is up to each of us to map out what we can contribute to create a truly inclusive LGBTQ community. This holiday season, be the light. If you can, donate to a group that helps lift LGBTQ youth in crisis. Volunteer your time to fight for the rights and the lives of trans people. And be kind to one another.

Whether you are Jewish, Christian, Muslim, or of no faith at all, take this opportunity to share your light with the world. It doesn’t take a miracle to do that.

Ethan Felson is the executive director of A Wider Bridge.

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Opinions

Trend of banning books threatens our freedom

‘History has taught you nothing if you think you can kill ideas’

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National Book Festival, gay news, Washington Blade

I knew Helen Keller was a DeafBlind activist. But, until recently, I didn’t know that some of her books were torched.

Nearly 90 years ago, in 1933 Germany, the Nazis added “How I Became a Socialist,” by Keller to a list of “degenerate” books. Keller’s book, along with works by authors from H.G. Wells to Einstein were burned. 

The Nazi book burnings were horrific, you might think, but what does this have to do with the queer community now?

I speak of this because a nano-sec of the news tells us that book censorship, if not from literal fires, but from the removal from school libraries, is alive and well. Nationwide, in small towns and suburbs, school boards, reacting to pressure from parents and politicians, are removing books from school libraries. Many of these books are by queer authors and feature LGBTQ+ characters.

Until recently, I didn’t worry that much about books being banned. My ears have pricked up, every year, in September when Banned Books Week is observed. Growing up, my parents instilled in me their belief that reading was one of life’s great pleasures as well as a chance to learn about new ideas – especially, those we disagreed with. The freedom to read what we choose is vital to democracy, my folks taught me. 

“I don’t care if it’s ‘Mein Kampf,’” my Dad who was Jewish told me, “I’ll defend to my death against its being banned.”

“Teachers should be allowed to teach it,” he added, “so kids can learn what a monster Hitler was.”

In this country, there have always been people who wanted to ban books from “Uncle Tom’s Cabin” by writer and abolitionist Harriet Beecher Stowe to gay poet Allen Ginsberg’s “Howl.”

In the 1920s, in the Scopes trial, a Tennessee science teacher was fined $100 for teaching evolution. (The law against teaching evolution in Tennessee was later repealed.)

But, these folks, generally, seemed to be on “the fringe” of society. We didn’t expect that book banning would be endorsed by mainstream politicians.

Until lately.

Take just one example of the uptake in book-banning: In September, the Blade reported, Fairfax County, Virginia public school officials said at a school board meeting that two books had been removed from school libraries to “reassess their suitability for high school students.”

Both books – “Lawn Boy” a novel by Jonathan Evison and “Gender Queer: A Memoir” by non-binary author Maia Koabe feature queer characters and themes, along with graphic descriptions of sex.

Opponents of the books say the books contain descriptions of pedophilia. But, many book reviewers and LGBTQ students as well as the American Library Association dispute this false claim.

The American Library Association honored both books with its Alex Award, the Associated Press reported. The award recognizes the year’s “10 books written for adults that have special appeal to young adults ages 12 through 18.”

Given how things have changed for us queers in recent years – from marriage equality to Pete Buttigieg running for president – it’s not surprising that there’s been a backlash. As part of the blowback, books by queer authors with LGBTQ+ characters have become a flashpoint in the culture wars.

As a writer, it’s easy for me to joke that book banning is fabulous for writers. Nothing improves sales more than censorship.

Yet, there’s nothing funny about this for queer youth. My friend Penny has a queer son. “LGBTQ kids need to read about people like themselves,” she told me. “It’s horrible if queer kids can’t find these books. They could become depressed or even suicidal.”

If we allow books to be banned, our freedom to think and learn will be erased.

“History has taught you nothing if you think you can kill ideas,” Keller wrote in a letter to students in Nazi Germany.

Anti-queer officials may remove LGBTQ books from school libraries. But, our thoughts will not be unshelved.

Kathi Wolfe, a writer and a poet, is a regular contributor to the Blade.

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Opinions

Thanksgiving is a time to share

Take a moment to think about what you can do to help others

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This Thanksgiving, many of us will once again celebrate with family and friends around the dinner table. Sadly at too many tables friends and family members will be missing. They will be one of the over 766,000 Americans who lost their lives to coronavirus. May the shared grief over lost loved ones cause us to try to bridge our differences and lift each other. As those of us with plenty sit down for dinner let us not forget the many in the world not so fortunate and think of what we can do to make their lives better.

In the midst of the pandemic we defeated a president who through his words and actions tore our country apart — a president who managed to poison relationships among family and friends. We elected a president who we felt would try to unite the nation. But we know that has yet to happen and the recent reaction to the not-guilty verdict in the Kyle Rittenhouse trial shows us that. The use of race-baiting in the recent Virginia governor’s election shows us that. We still suffer from the implicit permission the former president gave to some Americans to once again give public voice to their sexism, homophobia, racism, and anti-Semitism. That didn’t suddenly end with his loss. While we cannot pretend those feelings weren’t always there it seemed we had reached a point in American society where people understood you couldn’t voice them in public without rebuke. While it will take many years to put that genie back in the bottle we need to try if we are to move forward again. Around our Thanksgiving table is a place to begin. I am an optimist and believe we can do that even while recognizing it won’t be easy.

Thanksgiving should be a time to look within ourselves and determine who we are as individuals and what we can do to make life better for ourselves, our families, and others here in the United States and around the world.

Around our Thanksgiving table we should take a moment to think about what we can do to help feed the hungry, house the homeless, and give equal opportunity to everyone who wants to work hard. Maybe even give some thought as to how we change policies causing institutional racism to ones giving everyone a chance to succeed. It is a moment to think about how we can open up the eyes of the world to understand how racism, homophobia, and sexism hurt everyone, not just those who are discriminated against.

We must renew our efforts to heal the rifts in our own families and make an effort to try to see each other in a more positive light. If we start to do that with those closest to us we might have a fighting chance to do it with others.

I recognize my life is privileged having just returned from a 14-day transatlantic cruise. My Thanksgiving weekend will be spent with friends in Rehoboth Beach, Del., and we will remember our experiences over the past year. For many it also begins the Christmas season and the Friday of Thanksgiving weekend each year Rehoboth Beach lights its community Christmas tree. So surely we will talk about what that season means to each of us.

For me each year it means thinking about which charities I can support as the requests for end-of-year gifts arrive. It is a time to think about volunteering some precious time for a cause you care about.
Wherever you live, there are many chances to volunteer and do your part to make a difference for others. The rewards of doing so will come back to you in abundance. As anyone who has helped someone else will tell you the feeling you get for having done so is wonderful.

So wishing all my friends and those of you who I may be lucky enough to call friends in the future, a very happy Thanksgiving. May this holiday find you happy, healthy and sharing peaceful times with those you love.

Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist. He writes regularly for the Blade.

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