I was born in 1948, at the foot of an enchanted mountain whose spirit enjoins me to rise higher

Ordinary citizen, empathetic contemplator (maybe a little too empathetic to be fully comfortable in the world, as it is). Don't look for academic credentials; this guy has none, save those gained over the course of many interesting (and, at times, difficult) life chapters, spent surviving on a shoestring budget.

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Thursday, December 10, 2015

The Affordable Care Act - affordable for whom?


Never

We've got to find a quick way out of here, or we can stay here and rot.
We, living shadows in the smoke and beer, resenting all we never got.
We've got to claim the age and make it ours; put down our fears and just begin.
We'll make no deals, we'll take no captives, we'll play the game to win!  Yeah!

Somewhere back there someone is fooling you - you're skunked enough to think you're free.
Too duped to know this one is ruling you - you slave for what you cannot see.
The only one who knows what's good for you is you, within, it's yours to own.
Don't beg for handouts, don't play the victim, your soul is not on loan -
Your soul is not on loan.

Chorus
The architect of your intellect calls you but the urge to disconnect stalls you,
Do you cringe and genuflect to some insect who expects you to defer? 
Never!

You're caught up in the old, enticing view:  the law will honor what you own.
A potentate who'll just be nice to you - forbid the thought, you stand alone.
Remember what you call the Infinite - if infinite, then who are you?
Don't let the dreaming forget the dreamer or what you came to do -
Or what you came to do.

Chorus




The lyrics above are those for a song that I wrote back in 2006. It can be heard at http://hashtonealley.mymusicstream.com/track/never. What moved me to write the song was my concern over how unquestioningly America's newest generation of adults seemed to accept the status quo with respect to what government was or wasn't doing. Since it's modern inception back in 1776, democracy has always been as much an opportunity for the wicked as a refuge for the good and only the unflagging vigilance of those who are it's masters - that is, the People (the Greek words, 'demos' and 'kratos', meaning 'people' and 'rule', respectively) - has allowed it to gain credibility with the passage of time. Otherwise, it is remarkably susceptible to being manipulated for the selfish purposes of the powerful at the expense of the weak. Conveniently for them, the powerful can afford to have representatives probing 24/7 for opportunities to tweak the making of law in a way that favors them disproportionately and, even singly, in some cases. The poor, on the other hand, must go through an arduous process of forming organizations fueled by the collection of chump change to be able to match the forces arrayed against them.

Of the poor, the young poor are the least organized and the most vulnerable. They're at a stage of life when solipsistic immersion in one's own trivial affairs and all the challenges of developing a true and dependable self identity lay an all-consuming claim on one's time and energies. Additionally, the best and brightest of them are overwhelmed by the challenges tuition and hard-scrabble employment put on them. There just simply isn't much left over in terms of resources or attention for the average young adult to participate, in concert with others, in the protection of their collective interests. I've been heard to say on more than a few occasions that America eats it's young for breakfast. As if this bias were not enough, in the last twenty years, the young have had the developing front of information technology descend on them like a tsunami. While there are definitely opportunities for preservation and defense of social equity available through the internet, the overwhelming bulk of activity is clearly distractive and, unless one is intellectually and spiritually committed to not being negatively entrained in internet content, one can waste a lot of one's life in front of a computer screen, to no good long-term end.

All of the above was true back in 2006 and, ten years later, it is only more pertinent. The writing of the song, 'Never', was an attempt to use popular media to jolt consciousness among music lovers toward being more circumspect with respect to what government was up to.  

Right here, I must go on record as saying that I believe that the only system of health care that truly serves people on a socially equitable basis is a responsibly and honestly managed universal, single-payer health care system, in which physicians are guaranteed a good income, protection from unfair lawsuits and freedom from onerous paperwork obligations. Further, I do not believe that Americans should be subsidizing the rest of the world for drug development through the insurance rates they're paying. It's a burden that should be shared internationally under the aegis of a rigorous process of general accountability where governments are the first purchasers of large lots of drugs in a competitive in a free, international market. The last thing that individual needing health care should have to do is to have to prove eligibility before treatment. That's insane. And yet, that's the system we have today under the ACA. It is simply ridiculous to assume that America's most intellectually challenged - literally, tens of millions of people - should be able to arrange for themselves insurance contracts that suit the needs of a personal future they have no means of divining. It is that psychological factor that insurance milks. The most fear-prone give up everything they can spare to try and have that base covered. How often have you heard people say, if you think you can't afford insurance, you should ask yourself, how can you afford NOT to have insurance? What a trite piece of propaganda that is. It's a convenient play on words that selectively omits consideration of all the other financial priorities forced on one if one is to live a halfway fulfilling life in today's economy. From an objective point of view, that same argument turns a blind eye toward the huge diversion of cash it proposes, that would exit the consumer demand sector for the coffers of insurance corporations, their management and shareholders, none of which would be good for the American economy, as a whole. No one has yet been able to show how complete compliance, with all the demands of the ACA, could possibly occur without leading to an implosion of consumer demand and another deep recession, if not depression. Couldn't those architects of the ACA, with all the informational resources available to them, not see how burdened the consumer side already was with excessive rents, high housing costs and astronomical tuition fees? Where was the extra money supposed to come from, if not out of the consumer economy? Yes, we heard all kinds of justification how new market conditions imposed upon the health care industry would lead to lower costs, most of them remarkably tendentious, while those of us who said this couldn't be affordable were labeled as simpletons and kneejerk naysayers, as if these reservations were politically motivated. The fact is that some of the best and most analytical minds had already done the basic math - not much more than addition and subtraction - and found that the imposition of this Act would have negative economic consequences. But, the passage of the ACA was not driven by math. What it was driven by was a mishmash of conflicting, political stances that turned the original idea of the public option into a Frankenstinian compromise.  

As the 2016 deadline approaches, we can feel the panic that's out there at every level. Noncompliers are in a state of frantic denial, while legislators whose reputations are under the spotlight for the votes they cast, are in a state of disbelief that the Act has failed to force Americans to comply. In addition, insurance rates have not dropped for the American public, as a whole, but only risen as insurance companies seek to defend themselves, financially, against being obliged under law to accept all who apply, medical preconditions notwithstanding. Any fair-minded person in their right mind wishing to preserve the solvency of their business would do the same, and when the market is literally captive, the reasons against not raising prices simply evaporate. Basically, the ACA has put freedom-loving Americans in the position of coraled sheep waiting to be financially fleeced. From a constitutional point of view, it boils down to this: technocrats versus traditional American values of freedom of choice. One can be forced under the Constitution to pay a tax, where the process under which that tax is paid is equally burdensome to one and all. But the government is constitutionally barred from forcing individuals to buy services from private parties in a system of exchanges that has highly variable impacts on individuals based on their means, their intellect, their literacy level, their health condition, their geographic location or other factors. To imagine that somehow that would constitutionally equable is - forgive me from using the same word again - insane. We should either go back to the system we had before, in which individuals could at least hang on to some remnant of what they earned and apply that to what they felt best served their interests, given the very personal circumstances they each faced, or push through to the public health care system I've described above.  

What to take away from the song above, is that a universal health care system will only ever arise in this country when the 'demos' in the word, democracy, find their 'kratos' in the word democracy. Until then, all we will ever have is Frankenstinian accommodations that rumble Rube Goldberg-like, erratically into the future, leaving a trail of broken lives and unfulfilled promise behind them.