RAD shared the podium Thursday morning with a Pacific colleague before an Occupational Therapy class on the Hillsboro campus discussing whether or not health care in the USA ought to be considered a "human right."
My colleague pointed out the conceptualization of what is a "right" is fraught with many terminological and real world problems. If such a "right" exists what is its origin? And if such a "right" can be clearly explained does this mean we should act on such a claim?
The First Amendment of The Bill of Rights guarantee us freedom of speech, press, religion and peaceful assembly. The Second Amendment gives us the more problematic right to bear arms. Are "rights" totally elastic? Can we afford to act upon all such "rights" claims?
The answer seems yes, rights are elastic. As the nation has matured we have expanded rights not granted early in our history: the right of women to vote; the right of African-American's to be liberated from slavery; the right of 18 year old to vote and the right of Native Americans to tribal status.
In the aftermath of the Great Depression and before Pearl Harbor FDR expanded the concept of rights to include the Four Freedoms including freedom of speech and expression, freedom to worship, freedom from want and freedom from fear.
President Truman was the first president to commit specifically to viewing health care as a right. But he got nowhere on this agenda. But two decades later LBJ Great Society program launched Medicaid and Medicare.
As time has moved on we have also incorporated the concept of affirmative action to make rights claims actionable for racial minorities, women, those with disabilities and more recently gay and lesbian Americans.
But there has also been political backlash against the concept of entitlements for such targeted groups. President Nixon adopted benign neglect on the racial front, while President Reagan worked unsuccessfully to end the entitlement state.
If we consider K-12 education as part of the social contract underwritten by taxpayer dollars, whether or not one is a parent or your kids attend a public school, it appears to be a defacto "right" even though the Supreme Court in San Antonio v. Rodriguez found in a 5-4 vote that education is not a "fundamental right" nor does it require equal funding.
If education is a "right" within the framework of the American social contract should health care be considered such a right too? The right to health care like education offers the promise that everyone should begin life on an even playing field as they pursue happiness.
Today D.C. insiders are gridlocked over the expansion of SCHIPS and Oregon voters just turned down expanding health care to 60,000 of our children. The division between Red and Blue states and voters seems to be located in the political equivalent of the Deep Muddy.
Nevertheless, a consensus from the current debate on health care is emerging that Americans should have the right to some type of universal health care insuring basic coverage. However, the line that divides basic from supplemental coverage is open to interpretation.
We've come to a point where Americans claim many "rights" but few responsibilities. Along with the claim of the "right" to health care what responsibilities do we incur with such a claim? As consumers of health care and engaged citizens what can we do to bring health care costs down?
In the health care arena three responsibilities stand out: 1) we need to focus on removing health care disparities along class, racial and urban/rural lines; 2) we need to focus on primary care to get at health problems before they get truly serious; and 3) we need to focus on chronic care, preventive care and wellness strategies.
So what is the status of the right to health care in the US? We know that Bill and Hillary Clinton tried to advance the cause in 1993 only to be shot down by the Harry & Louse commercials fronted by the Health Care Industrial Complex of big drug, insurance and hospital corporations aided by the AMA, forever hostile to anything smacking of "socialized medicine.
But we have programs which give "protected" populations a right to government sponsored health insurance or access to health care accommodations - those over 65 (Medicare); those living in poverty (Medicaid and SCHIPS); those who have served in the military (VA); members of Congress; and those with disabilities (ADA).
Despite these efforts we still have 47 million Americans without any health insurance, 1 in 3 Americans who at any time are in between coverage due to a job loss or change and 1 in 4 Americans who are underinsured.
The cost of this benign neglect is that life expectancy in the USA is lower than in Britain, France and Canada. While we e spend more for health care we get less bang for our buck. And the productivity of the American worker is compromised by our gap ladden multi-layered, public-private system.
Why do we accept a heath care insurance system that results in such disparities? And would the option of universal health insurance, not "socialized" medicine, be advanced by a "rights" claim for it?
The short answer is the lack of political will has prevented us from doing what every other democracy in the world has done on the health care front. But along with a failure of nerve, Americans seem tone deaf to the concept that health care is a fundamental "right."
Why is this so? Some trot out the well tested "socialized" medicine argument. Others fear inventing another big government, big spending program. Other detractors argue that we will lose our right to chose our doctors and/or hospital.
The choice argument is very curious since under the current HMO dominated system this "right" to choice is problematic. If your doc or favorite hospital is not in "network" good luck! Canadians have choice - so what's the real issue?
Now to be fair, moving to a national health care insurance system like the Canadians have will not be cheap. There will be upfront costs and deferred care costs that can't be anticipated just like there were when the Oregon Health Plan came online in the '92.
We pay 16% of our GNP for health care while our Canadian friends pay around 11%. Why is health care more costly in the USA? Answer, the fancy ads you see on TV for meds and insurance plans are NOT free. Besides the Health Care Industrial Complex are for profit businesses where stock holders are more important than patients.
Guess who pays for those fancy ads or the salaries and stock options paid to health care CEOs? Those of us with insurance! We also pay for those who go to an ER when they are really sick but have no insurance! Cost shifting in the USA is a major cause of rising health care costs.
Should access to health care in the USA be considered a "right" or a privilege of those who can afford it? Historically it's been a negotiated "right" between employers and employees with the gaps covered by the government. But facing global competition employers want out. Yes health care should be a "right" whether that "right" is founded on the concept of "natural rights" (i.e. the inalienable right to life, liberty or the pursuit of happiness) or embedded in the penumbra of our "social contract" (our Constitution).
Such a "right" emanates from the notion that our Constitution as a living breathing document can be adjusted to the challenges of the 21st century rather than be forever stuck in the 18th century.
US history is a saga of expanding "rights" claims that the Founders turned a blind eye towards - the rights of the propertyless, indentured servants, women, slaves and Native Americans. The genius of the Founders' construction is that our Constitution is not stuck in time.
It's past time we joined the most progressive nations of the world by including health care as a fundamental human right. To get there takes political will and money. And the devil is always in the details. But a nation which rebuilt Europe and Japan after WW II and which spends $12 billion per month in Iraq has no excuses.
As the current presidential campaign moves along we need to do what Nixon admonished voters to do - "watch what we do, not what we say." This was good advice in the '60s and good advise now.
While the "dark" Lutherans of Garrison Keillor's Lake Woebegone felt suffering was inevitable and noble, why should a child be denied medical care simply because of their street address, race or class? Why should they be a victim of the circumstance of their birth?
As Jesus said - "do unto them, as you would have them do unto you." Who would of you deny a homeless child in Washington County medical care simply because of his or her lack of a home address?
To paraphrase Martin Luther King, Jr. - we should judge a person by the "content of their character" not the color of their skin or the size of their parent's wallet. In God's eyes we are ALL human. We can do better!
The city on a hill that Governor 0John Winthrop promised his flock of Puritans upon coming to America is still a work in progress. It's time the politicians quit haggling about the shape of the health care table and the price tag. It's time to pay on the next promissory note of the American Dream.
So is health care a "right?" It is if we make it so. There will be thorny issues to debate along the way. How long do we prolong life? What extraordinary care should be included? How should the health professions be organized to best serve heath care consumer-citizens?
But these are the pesky details. Right now we need to develop the "will" to do the right thing before we design the new health care system. Fortunately, Oregon's legislature in '07 signed on to the concept of universal health care. Now an interim task force is working on the design features of an Oregon model.
If former Governor John Kitzhaber has his way we'll take the Oregon Plan on the road to the nation!
RAD shared the podium Thursday morning with a Pacific colleague before an Occupational Therapy class on the Hillsboro campus discussing whether or not health care in the USA ought to be considered a "human right."
While the death toll in Iraq is down for the month, 2007 was still the most deadly year of the Iraq war. The impression that the "surge" is working may belie the hidden realities on the ground. The lowered death toll may be more of an indicator of how successful "ethnic cleansing" has been over the last year than a mark of success of the surge or the capacity of an improving Iraqi military or a still thoroughly corrupt local police to carry the load. It also may be an indicator that the insurgents have moved out of Baghdad and are hunkered down for now waiting for the US withdrawal.
In an article by Phillip Carter, an Iraq veteran and attorney, written for Slate.com the facts of a slowdown in killings this month may be something other than what it appears on the surface:
Carter comments that "… the most persuasive explanation for the good news is that the Shiites have won the battle for Baghdad. Shiite militias and partisans have killed or expelled tens of thousands of Sunnis, changing the ethnographic map of the ancient city. The few Sunnis who remain in Baghdad do so under the protection of U.S. military forces, secured by a labyrinth of concrete blast walls, checkpoints, and security bases. Violence is down because the Shiites have fewer Sunnis to kill, and the Sunni insurgents now find it harder to move around in order to strike with suicide bombers, rockets, and roadside bombs."
When one considers the migration of 2,000,000 middle class Iraqis to Syria and other Middle Eastern nations administration declaration's of victory are wildly premature as they have been all along! To barrow a quote from Charles Dickens in his novel a Tale of Two Cities: "It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity." Incredulity may be the operative word for American policy in Iraq. After all remember when Vice President Cheney assured us the Iraqis would welcome the American troops as liberators?
Press accounts of American soldiers experiences on the ground, not the brass safely inside the Green Zone, suggest another reality that is not so benign but more ominous. As we found out in Vietnam, the strategic hamlets were secure in the day, not so in the night. The US won Tet but lost the war. Why should the battle for Baghdad be any different in this war of occuption?
Governor Kulongoski's op ed piece for The Oregonian on November 9th "Tax Reform and The Economy: Finding new paths to a better Oregon" offers some insights into Gov T's thinking. It also leaves a lot of questions to be answered.
Governor Ted distances himself from major tax reform ideas like a sales tax or a business receipts tax. Instead he suggests "…before we take up these options, we should ask whether we can stabilize our existing system by increasing our rainy day reserves…"
OK Ted, but show me the money?
He also points out correctly that the lid put on local property taxes "…fail[s] to reflect the value of new construction…" thus limiting the ability of local government to build the necessary infrastructure to sustain current business and/or to attract new business.
This is a bit disingenuous in that city and county government in the metro area have had no problem in attracting high tech and other industry. But to do so they have given tax breaks on local property taxes that in effect raise the property tax bills of homeowners and small business already in these areas.
Ted also points out that with the phase out of Federal forest payments to county governments over the next five years, if not sooner, once timber rich counties are going to face serious cutbacks in government services unless local taxpayers step up, not a likely prospect in "the other Oregon" which is a hotbed of anti-tax voters.
The governor believes the path to overcoming this challenge is to "…create a stable tax system that can promote growth, be accepted as fair by voters and provide the resources we need for the future…" But does that tax reform nirvana exist? And will the anti-tax crowd led by the likes of Don McIntrye or Bill Sizemore accept it?
If the governor is not willing to go the road of a sales or business tax "fix" then the options narrow considerably: 1) continuing to use the corporate kicker for the rainy day fund and/or 2) eliminating the personal kicker. If these approaches were taken that would put over $1.5 billion per year into state coffers. But that "fix" requires a vote of the people since both kickers are embedded in Oregon's constitution.
Another scenario is to bring back the universal tax on corporations in Oregon - taxing their worldwide wealth, not just value added income generated here in Oregon.
Other options include a trade off - eliminate local property taxes while increasing the income tax on individuals and corporations and/or adding a sales or consumption tax.
There are obviously many permutations to each of these ideas. But until Governor Ted moves from the "task force" approach that has proved to be a way of dodging the tough questions - RAD considers the Governor's position just smoke and mirrors.
The only "task force" that means anything is the Gov meeting behind closed doors in Mahonia Hall with the key leaders of the legislature and cracking some eggs to craft a reality based fiscal plan. Until then, it's all talk and no walk.
PS: For those who want to know what the Gov knew about Neil G way back when or what the Gov is going to do about that little boy who DHR wants to ship back to Mexico, RAD will leave those weighty questions to the likes of Lars et al. On the first issue, Gov T please oh please just clear the air so we can move on. On the second, the last time I checked the Gov is the fellow who hires the head of DHR. RAD recommends a good "heart to heart" chat with the pointy heads in DHR in the Gov's office. Bring some breakable plates Ted...
Floyd J. McKay / Guest columnist, "Blackwater: bulging bicepts fueled by ideological purity," from Seattle Times
BLACKWATER, the secretive private army now emerging into public view, is a perfect hinge linking two key elements of the Republican political base: America's war machine and a muscular form of fundamentalist Christianity.
Military contractors such as Halliburton and Blackwater are the brainchild of Vice President Dick Cheney and former Defense Secretary Donald Rumsfeld. A major goal of Cheney when he was secretary of defense in the first Bush administration was to privatize as much military work as possible, ostensibly to make it more efficient. He commissioned a study by Halliburton, which predictably liked the idea and wound up as America's largest military contractor. Cheney was hired as Halliburton's chief officer, awaiting the return of a Republican administration.
When that occurred, Cheney and Rumsfeld enthusiastically promoted privatization, and went so far as to include private contractors in the "Total Force" of the American military, standing never before given to contractors. When Rumsfeld left the Pentagon in 2006, there were nearly as many private contractors in Iraq (100,000) as American troops (130,000). Contractors provided food, fuel, housing and, in the case of Blackwater, heavily armed soldiers with a license to kill and an aggressive attitude.
Blackwater operated basically without oversight since proconsul Paul Bremer gave it a no-bid $27.7 million security contract in 2003, with immunity from Iraqi law. In 2004, four of its soldiers were ambushed in Fallujah and their bodies desecrated, bringing retaliation that killed hundreds of Iraqis, leveled the city and fueled the insurgency. A month ago, Blackwater guards killed 17 Iraqi civilians, in an incident that has drawn the attention of Congress and the FBI.
Blackwater soldiers, often with Navy SEAL or Army Special Operations backgrounds, are paid from $500 to $1,500 a day, far more than regular-duty troops. Their image is straight from central casting: young men, tanned biceps bulging from black T-shirts, wearing wraparound sunglasses and brandishing automatic weapons. For young veterans who loved military action but couldn't afford to stay in, Blackwater offered big money and plenty of opportunities to order people around. Blackwater's aggressive guards became the image of American cultural insensitivity, sometimes erasing the best efforts of our uniformed soldiers.
Blackwater is the private empire of billionaire Erik Prince, a major Republican fundraiser and bankroller of several fundamentalist Christian organizations. His private army employs some 2,300 active gunners and boasts a register of 21,000 ready to serve on call. He has the largest privately held arsenal in the country and the expertise and firepower to bring down a small country.
In 2006, Prince expanded internationally, forming a new subsidiary in Barbados, outside American taxes and regulation, to train foreign forces, often funded by American military aid. Elite Blackwater soldiers have conducted secretive "black jobs" for the CIA or other spy agencies.
Despite its financial success, Blackwater is under fire from two sides: Democratic critics who want accountability and families of the four men killed in Fallujah in 2004. The families have sued, alleging negligence.
Blackwater's lawyers assert it cannot be sued because it is part of the "Total Force." But, while Congress demands that it be subject to American military codes and international treaties, Blackwater takes the opposite view — it is not military, it's a civilian contractor. Big money has gone into D.C. lawyers, lobbyists and public-relations spinners to sell this apparent contradiction.
There have always been mercenaries, and a case can be made for limited use of contractors, but the Bush administration has erased the line between a national military and a private war machine. Iraq is our first outsourced war, siphoning billions of taxpayer dollars into the private war machine.
Military contractors have become an integral part of the American military, allowing the White House to understate troop numbers and avoid a military draft. Unpopular wars for oil or ideology can be waged without calling on middle-class families to send their children; mercenaries will fill the jobs if volunteers don't come forth.
In Prince, the Republicans' radical Christian base is wed to the war-machine base, the one providing votes and manpower, the other providing campaign funds.
The resulting combination is one of rigid ideology and eagerness to solve any problem with overwhelming force. The Bush administration convinced itself its views on Iraq were right, pushing aside contrary evidence, then failed to think beyond "shock and awe," with resultant horrors.
In a world of nuance and gray areas, ideological purity and bulging biceps will cause as many problems as they solve. Blackwater seems to epitomize a dark side of our psyche that should be troubling to all Americans.
Floyd J. McKay, a journalism professor emeritus at Western Washington University, is a regular contributor to Times editorial pages.
Editor's Note: During the Iran/Contra investigations in the Reagan administration, Oliver North boasted that he and then CIA Director (and close friend of Reagan) William Casey envisioned creating "a stand alone, off the shelf entity" which they called "the enterprise" which could be used in so-called "special ops" projects around the world. They key is that such an entity would be below the radar screen of congressional oversight and accountability.
This creation of a privatized army is exactly what Blackwater and the other 180 outsourced secondary contractors in Iraq represent. So the dark vision of Reagan era crypto-fascists like North et al has become actionable in the Bush II era. If Congress doesn't put the fork in this type of mercenary military then the Congress will forever lose control of its ability to hold the commander-in-chief responsible in national security policy.
We on the home front may not be safe from these "bulging biceps fueled by ideological purity" and big paychecks. What's to stop Blackwater neo-fascist goons from becoming a new generation of Pinkerton police used to supplement local cops on the beat in the midst of civil unrest like we saw in Seattle during the WTO summit several years ago? Or imagine another 9/11ish attack - will they be a part of the first responders?
Mussolini had his Brown Shirts, Bush has his Black shirts!
George W likes to claim that global terrorists are out to attack America because “They hate our freedoms.” But we’re learning that it’s really the Bushites themselves who hate America’s freedoms.
Retired Army Col. Ann Wright and one of America’s leading peace activists, Medea Benjamin, have recently felt the bullying hate of the Bush regime. Both women have been very vigorous practitioners of our freedom to speak out and assemble in opposition to government policies, using these freedoms to protest the war in Iraq. They’ve put themselves on the line and been willing to undergo several arrests for their nonviolent civil disobedience.
This is as American as the 4th of July. Yet Wright, Benjamin, and civil libertarians everywhere were stunned to learn last August that Bush’s FBI has suddenly turned this misdemeanor into a weapon of political intimidation, using it to bar the two women from traveling to Canada… and perhaps to other nations.
When they tried to visit Canada, Wright and Benjamin were detained by Canadian customs officials and told that their names were on an FBI no-entry list. Even though this list is meant to stop fugitives, potential terrorists, and violent felons – not peaceful protesters – they were told that they would have to apply for “criminal rehabilitation” and pay a fine if they ever wanted to enter Canada.
Unintimidated, the women have since tried to re-enter, this time at the invitation of five members of parliament to come speak to that assembly. Yet, Canada’s officials have bowed to the Bushites, honoring the FBI’s no-entry list, rather than respecting their own parliament. The FBI refuses to say why non-violent protesters are on a terrorist list.
Chillingly, the U.S. media have ignored this story, but you can learn more about this blatant assault on our freedoms by going to www.codepinkalert.org.
For other links about this story go to:
“US Peace Activist, Retired Col. Ann Wright, Detained at Ottawa Airport,” www.commondreams.org, October 25, 2007
“US peace activist detained at Ottawa airport en route to meet MPs,” cnews.canoe.ca, October 25, 2007
“U.S. peace activist refused entry for second time,” www.thestar.com, October 25, 2007
“US peace activist barred again from entering Canada,” www.iht.com, October 25, 2007
“Protesting the Bush Agenda in Canada,” www.codepinkalert.org, October 4, 2007
“Barred from Canada,” Press Release, October 22, 2007
“Address to a Joint Session of Congress and the American People,” www.whitehouse.gov, September 20, 200