I have been reading the Winter Edition of Lapham's Quarterly entitled "Night", and came upon an excerpt from Karl Marx's Capital. Marx was not a fan of capitalism as an economic system as he felt that one of its biggest flaws was the abuse of the labor force that made it run.
In the excerpt mentioned above, he details how extending the working day from its historic definition, during the daylight hours, to include working at night, the ability of capitalist production to increase almost two-fold is a boon to those who benefit most from this production, the owners of the businesses, but does harm to the laborers who are forced to work at this time.
Of course, at the time of Marx's writings, mid to late 19th century, the industrial revolution which featured a host of inventions that made mass production possible while requiring a vast amount of labor, was into its second century. While Marx may have focused too heavily on the evils of capitalism, he was not the only voice condemning the abuse of the labor force. This was a time when child labor was not uncommon, women were first employed in mass numbers, working conditions for all were hazardous, and 12 hour shifts, 6, even 7 days a week were the norm.
It should come as no surprise that the labor movements began to gain traction in the late 19th - early 20th century. The everyday worker who could be fired for no reason, who had little recourse if injured on the job for sick pay or the job itself when they recovered, who did not have vacation time, whose pay was controlled entirely by the bosses, regardless of the profitability of the business, and who, when the time came for retirement, had no source of income once they could not work due to health or age, finally found relief by organizing.
It seems unthinkable, today, that the working class might be bullied, beaten, or even killed for requesting a safe working environment, benefits which include holiday pay, vacation and sick time, a retirement plan, perhaps even maternity/paternity leave, and the option of working from home, yet in those days, all the cards were held by the employer. And more than a few workers died in the efforts to balance the relationship.
Yet the labor movement, unions, collective bargaining agreements, etc, are now more associated with socialism, decried and ridiculed by the powers of capitalism. Union membership is half what is was in 1985. Whether there is a link between that fact and the stagnant condition of the buying power of the middle class is certainly debatable, but it is not debatable that the forces of big business have worked tirelessly to paint labor unions as enemies of capitalism and individualism, hence America.
This is all too clear in the voices of those against an increase in the minimum wage when they claim that by paying workers a livable wage, consumer prices will increase and the economy will suffer. Funny how the dramatic increase in the higher end of wages since the mid-1980's which one might say has, in fact, contributed to the higher costs of housing, vehicles, entertainment, technology, etc, was never questioned or addressed. I would imagine that if Marx were alive today, he would be happy that so many of the needs of the working class were addressed via benefits, working conditions, and length of the work day, but might be just as adamant in his condemnation of a system which distributes a disproportionate percentage of the fruits of the labor of the working class to those who control the reigns of capitalism.
There are many who cite income inequality as a contributing factor for the Great Depression. Of course, we have made a number of improvements on the safety nets since that horrible time, yet we are in the midst of another big shift of income away from the working class towards the top 5%, the recent tax reforms being one of the biggest examples. When we hear certain politicians blaming "entitlements" as the real reason for our rising national debt, it strikes me as an attack on the gains made by the labor movement to even the balance between employer and employee, especially when those attacks are framed as capitalism vs socialism. Perhaps the next time you here someone say that socialism has never helped anyone, you might ask them about their 40 hour work week, benefit package, and employer retirement contribution, all which emerged from the labor movement which was associated, for better or worse with the rise of socialism.
I have had some experience with unions, so I know the good and the bad of it. There is something to be said for everyone getting the same raise, regardless of ability or contribution, in that this might encourage mediocrity while suppressing excellence. But there is also something to be said for earning a livable wage when most of those employed without the benefit of a collective bargaining agreement, doing the same kind of job, find themselves seeking public and private aid for lack of good pay and benefits.
I think that what is comes down to is that capitalism is a system that is prized by the strong, the smart, the rich and powerful, the individuals who would be successful if all they had was a piece of string and a paper clip, whereas socialism provides the safety nets for those with less ability and less good fortune. We need aspects of both to survive and succeed, both as individuals and as a nation. The question is how to balance the tenets of each. Whether it is 80-20 or 60-40, without some social programs (that the detractors call socialism) embedded within our capitalistic economic system, we will not provide the foundation for the most people to reach their highest potential.
Finally, don't be fooled by those who claim that it was capitalism alone that provided their success, or the great achievements of America. A large percentage of rich people were very well off from birth. And there is much evidence that the source of much of the "old money" in America, came from a time when monopolies, skewed laws which favored the rich, little worker protections, and a good old boy network that eliminated competition from those of color or of the female gender was the unwritten rule of the day. Also, the simple fact that the last recession featured a tax payer bailout of the banking and investment industries, to name two, reveal that the rich and powerful love capitalism when times are good, but are not shy to take the benefits of the social safety nets, when times are tough.
Let's not forget that more than one historian notes that the GI Bill (actually called the Servicemen's Readjustment Act of 1944), was a large contributor to the economic success of the United States in the post World War 2 world. Perhaps one of the most successful social program of its age. A social program which entitled veterans to special benefits. Seems strange how the word entitlement is now a code word for socialism, yet I bet many of those spitting out the word entitlement as if it were poison, actually benefited from the GI Bill, directly or indirectly.
At this point, it seems clear to me that the S word is used to belittle any program that helps even the playing field between the rich and the rest of us. What surprises me is how many everyday working people have been fooled to believe that the social programs which they are told equate to socialism, were designed specifically for them so that they do not suffer the pitfalls that past generations of working class people did when they lost a job, fell ill, were injured in an accident, or got old, that last one being the one common denominator that we all, hopefully, share.
Wednesday, February 20, 2019
Wednesday, February 13, 2019
What is so bad about Socialism
As the approval ratings of our President slide while the number of Democrats willing to challenge him in 2020 multiply, it appears that the defense of the current administration comes down to the economy, the rise in the stock market (since late 2016), and the historic drop in unemployment. While one could argue that all three of these trends started in the second half of President Obama's first term, it is still true that all three trends have continued under the Trump Administration, and for that, credit is due. I am certainly not a fan of most of President Trump's policies, but it does not negate the truth that America's economy is going well, and if we are to give credit for Obama for pulling us out of the morass that was left to him by Bush 2, we should give credit to Trump for continuing the positive momentum.
A quick digression. If anyone is serious about unity, then we need some people to begin expressing unity through praise of those on the other side. If President Trump wants those who voted for Hillary, to believe in his call for unity, he should remind all Americans that in 2008 we experienced an economic meltdown that could have become a depression, but through the work of the Obama Administration, the Fed, Congress, and the private business sector, we recovered from that scary time, and so began the unprecedented surge in our economy that we are currently experiencing. Additionally, if one of the current or soon-to-be Democratic presidential candidates wants to be taken seriously in his/her call for unity, they should remind those who voted for Hillary that we are doing better as a nation, economically, and that we can't pretend that some of decisions made by the GOP controlled Congress and Trump Administration are not partly responsible for that success.
There, I said it.
Before beginning this post, I read two of my previous posts concerning socialism. Here are links to those two. The free lunch post details my agreement that there are far too many free lunches being distributed in America, but who is on the receiving end of those free lunches may surprise you. The capitalism and patriotism post was the third in a series of posts I did on capitalism and among other things, discusses how the perception of the source of criticism about capitalism can make all the difference in the world, just as constructive criticism from someone in one's family (spouse, parent, sibling) is received differently than the exact same fault finding should it come from outside the family.
https://wurdsfromtheburbs.blogspot.com/2014/03/free-lunches.html
https://wurdsfromtheburbs.blogspot.com/2011/07/capitalism-and-patriotism.html
As I said in the beginning, the bulk of the defense for President Trump's Administration is based on the good economics of the day. As a result, the S word (Socialism) is used by many of his defenders as a way to frame any disagreement of his policies, and/or as a way to describe the democratic party. We see pictures of Venezuela on our screen, we know it is a socialist country, and so we assume it is a direction we should not pursue. Or we listen to a panel of erudite individuals who extol the virtues of capitalism (of which there are many) in comparison to the shortcomings of socialism (of which there are also many).
So, let's be clear. As an economic system, capitalism has proven itself to be the better choice. It provides the most opportunity for the most people, generally rewards hard work with material success, promotes self-sufficiency over dependence, and allows for more upward mobility in a quicker time. I can't imagine that there is much debate, even among most liberals, certainly among the democratic presidential candidates, that capitalism helped make America great.
Remember, as defined, socialism is an economic and political system in which the production and distribution of goods is controlled by the government rather than private enterprise. Have you heard any serious Democratic candidate say we should nationalize any industry? I know, health care you say. But that is not true. Universal Healthcare is about placing everyone in the country in one big pool in order to spread costs among the entire population, while providing one network through which to pay for all health services.
We already have such a system, called Medicare, and while one could certainly argue that it pays providers amounts that are often less than costs (a good deal for the consumer, the US taxpayer), it is also true that it provides health care services to people who would not otherwise have access to health care services. And that those people are those who are the most vulnerable, the elderly and chronically sick to name some, who could either not afford health insurance or would not "qualify" for it in the private market where profit is part of the equation.
Still, the production and distribution of health care services is not controlled by the government (the definition of socialism) as providers are still local doctors and hospitals. It is a social safety net not socialism, and it evolved as a result of people living longer past working age, without the usual method of paying for services, yet needing more health care services due to their longevity. In essence, as individuals, you have two choices. Die young and rail against old people using a disproportionate amount of our health care dollar, or live longer and be grateful that a system exists so that you don't have to choose between medicine and food.
And that, my friends, is one of the problems with capitalism. When everything is weighed by monetary gain or loss, then people become a liability, especially sick and or old people in the case of the health care industry. Survival of the fittest sounds good when applied to better business ideas, or better business efficiencies, or even just better products and services, but not so good when applied to your sick mother, or disabled child, or mentally challenged relative.
Clearly, America's political system of choice is democracy, or to be more precise, representative democracy. And again, no serious democratic presidential candidate is advocating socialism as a political system to replace democracy.
However, there are a number of social programs that liberals and democrats do advocate. Universal Healthcare, as I mention above, being one of them. But also, methods to address income inequality, which, on its surface seems to violate one of the ideals of capitalism; equal opportunity. If too much money, or too many resources are in the hands of too few people or too few corporations, then opportunity for economic advancement is reduced. Capitalism is hindered. If, by applying higher tax rates on the very rich, we can allocate that money for education, infrastructure improvements, small business entrepreneur-ships, public-private cooperatives, etc, then perhaps capitalism will be better served. Clearly, we don't want all the money in one man's hands, yet when we hear progressives talk about placing ceilings on salaries or enacting rules so that billionaires pay the same rates as their chauffeurs, the S word is tossed on our TV screens and we cry foul.
Free education is another example. We already provide free public school education up to 12th grade, an idea, by the way, that was not fully embraced by all in the day. There is certainly plenty of evidence to indicate that a high school education is not enough in today's world. The boon in college enrollments (and tuition) in the past 30 years demonstrates that a high school education is not enough to provide economic security. Nor is it enough to provide our workforce with the skills to make our industries (and country) competitive. It is past time to create a framework that enables all young adults the education to pursue a career, or job, which both advances their opportunity for personal success, and in aggregate, does the same for America.
Whether that extra two to four years be in a community college, technical school, or any of the myriad other ways that a young person can continue to develop her skills, an educated citizenry should be one of our top priorities. Of course, we will need some out-of-the-box ideas to make it work, not just two or four more years of the same thing. But when a percentage of the voters cast aside their heads when they hear about creating a framework for reducing the costs of advanced education simply because someone associates the idea with socialism, that is a shame.
Some seem to equate the battle against climate change as some kind of tenet of socialism, perhaps because it is framed by its detractors as damaging to our economy. It is hard to imagine what life might be like in our neighborhoods, if the voters who supported environmental regulations 30, 40, 50 years ago, had been convinced that clean air and water were some type of socialist propaganda. Yet here we have reams of scientific evidence that we are doing harm to our planet, our gift from our creator unique in our galaxy, perhaps even our universe. Yes, a Green Deal with our environment in which we acknowledge that we can't continue to act like there is a backup planet for us, that we act in unison with all other countries, and for today, as well as tomorrow's Earthlings, may sound like socialistic hogwash, if your only concern is profit, but sounds like responsible stewardship of our planet and our children's' future to me.
And, of course, we already enjoy a number of social programs that each and every day help the majority of American families. Our parents are able to live modestly with the help of Social Security and Medicare. Our chronically sick relatives can live in an assisted living environment with the help of Medicaid. Many of our suburban dwelling neighbors commute on public trains, which while not making a profit, reduce the number of cars on the road along with the pollution they create. During the 2008-2010, financial crisis, far too many us remained in our homes and provided food for our children (me, among them) through the assistance of unemployment checks, food stamps, perhaps even a welfare payment. The crushing wheel of layoffs, less people earning money, more layoffs, was slowed due to the safety nets that were created after the Great Depression.
One of the most effective arguments against social programs and socially (meaning group) driven solutions is that it contradicts the narrative that we have purchased part and parcel in America; the glorification of individualism. Don't get me wrong, the emphasis on the power of each person to make their own way, find their unique place among men, be more than just one of the crowd is an important as anything in the big picture. It is often the lone voice that sparks change.
But progress, real progress, cannot occur if only one person believes in it. Yes, one can start the wave, but it takes the community to keep it going, to spread the advantages, to inspire through words and deeds, its merits. When someone in power or with great influence dismisses social programs he is generally dismissive of the forces that helped him acquire his influence or power. Perhaps he forgets his birth in a household of wealth, or his early education in private schools, or the many contacts he inherited simply due to his last name, or the advantages that money can buy as he climbed the ladder of success, or perhaps simply the mentor he listened to in the beginning, when success was not certain.
Social programs are designed to provide the temporarily needy with a respite from a downward spiral to economic death. Yes, it should not be considered a lifelong answer. But if we are to condemn the social networks because there is some fraud, we must also curtail all the business tax breaks because there are those who cheat in their use as well. No program is without its abusers, yet there are too many pundits who use an example of welfare fraud to justify ending all social programs, then to add the cherry on top, associate those social programs with socialism. End of story.
So, what is so bad about Socialism. Well, as an economic system, and as executed with political systems that were not democratic in nature, a multitude of things. But that is not what the progressive liberal agenda (I love that phrase) is about. It is about social programs that are designed to provide a net when events are less than positive. A framework to allow those with less to function within our capitalistic society. A network for those who did not win the birth lottery. Resources and paths for all to access so as to enjoy the fruits of their efforts. And mostly, a hedge against our democracy becoming a plutocracy which is my biggest fear.
Like so many things in life, balance is necessary. Perhaps someday a more advanced form of government will evolve, an enlightened economic system will be developed. But for now, capitalism, mixed with social programs to even the playing field a bit, and democracy, with its emphasis on one person, one vote, seem to be our best bet. While each has its flaws, blended together they make an effective recipe for our time. It's in the mixture that we argue, fight and fuss. But that is the beauty, the essence of this experiment we call the United States of America.
A quick digression. If anyone is serious about unity, then we need some people to begin expressing unity through praise of those on the other side. If President Trump wants those who voted for Hillary, to believe in his call for unity, he should remind all Americans that in 2008 we experienced an economic meltdown that could have become a depression, but through the work of the Obama Administration, the Fed, Congress, and the private business sector, we recovered from that scary time, and so began the unprecedented surge in our economy that we are currently experiencing. Additionally, if one of the current or soon-to-be Democratic presidential candidates wants to be taken seriously in his/her call for unity, they should remind those who voted for Hillary that we are doing better as a nation, economically, and that we can't pretend that some of decisions made by the GOP controlled Congress and Trump Administration are not partly responsible for that success.
There, I said it.
Before beginning this post, I read two of my previous posts concerning socialism. Here are links to those two. The free lunch post details my agreement that there are far too many free lunches being distributed in America, but who is on the receiving end of those free lunches may surprise you. The capitalism and patriotism post was the third in a series of posts I did on capitalism and among other things, discusses how the perception of the source of criticism about capitalism can make all the difference in the world, just as constructive criticism from someone in one's family (spouse, parent, sibling) is received differently than the exact same fault finding should it come from outside the family.
https://wurdsfromtheburbs.blogspot.com/2014/03/free-lunches.html
https://wurdsfromtheburbs.blogspot.com/2011/07/capitalism-and-patriotism.html
As I said in the beginning, the bulk of the defense for President Trump's Administration is based on the good economics of the day. As a result, the S word (Socialism) is used by many of his defenders as a way to frame any disagreement of his policies, and/or as a way to describe the democratic party. We see pictures of Venezuela on our screen, we know it is a socialist country, and so we assume it is a direction we should not pursue. Or we listen to a panel of erudite individuals who extol the virtues of capitalism (of which there are many) in comparison to the shortcomings of socialism (of which there are also many).
So, let's be clear. As an economic system, capitalism has proven itself to be the better choice. It provides the most opportunity for the most people, generally rewards hard work with material success, promotes self-sufficiency over dependence, and allows for more upward mobility in a quicker time. I can't imagine that there is much debate, even among most liberals, certainly among the democratic presidential candidates, that capitalism helped make America great.
Remember, as defined, socialism is an economic and political system in which the production and distribution of goods is controlled by the government rather than private enterprise. Have you heard any serious Democratic candidate say we should nationalize any industry? I know, health care you say. But that is not true. Universal Healthcare is about placing everyone in the country in one big pool in order to spread costs among the entire population, while providing one network through which to pay for all health services.
We already have such a system, called Medicare, and while one could certainly argue that it pays providers amounts that are often less than costs (a good deal for the consumer, the US taxpayer), it is also true that it provides health care services to people who would not otherwise have access to health care services. And that those people are those who are the most vulnerable, the elderly and chronically sick to name some, who could either not afford health insurance or would not "qualify" for it in the private market where profit is part of the equation.
Still, the production and distribution of health care services is not controlled by the government (the definition of socialism) as providers are still local doctors and hospitals. It is a social safety net not socialism, and it evolved as a result of people living longer past working age, without the usual method of paying for services, yet needing more health care services due to their longevity. In essence, as individuals, you have two choices. Die young and rail against old people using a disproportionate amount of our health care dollar, or live longer and be grateful that a system exists so that you don't have to choose between medicine and food.
And that, my friends, is one of the problems with capitalism. When everything is weighed by monetary gain or loss, then people become a liability, especially sick and or old people in the case of the health care industry. Survival of the fittest sounds good when applied to better business ideas, or better business efficiencies, or even just better products and services, but not so good when applied to your sick mother, or disabled child, or mentally challenged relative.
Clearly, America's political system of choice is democracy, or to be more precise, representative democracy. And again, no serious democratic presidential candidate is advocating socialism as a political system to replace democracy.
However, there are a number of social programs that liberals and democrats do advocate. Universal Healthcare, as I mention above, being one of them. But also, methods to address income inequality, which, on its surface seems to violate one of the ideals of capitalism; equal opportunity. If too much money, or too many resources are in the hands of too few people or too few corporations, then opportunity for economic advancement is reduced. Capitalism is hindered. If, by applying higher tax rates on the very rich, we can allocate that money for education, infrastructure improvements, small business entrepreneur-ships, public-private cooperatives, etc, then perhaps capitalism will be better served. Clearly, we don't want all the money in one man's hands, yet when we hear progressives talk about placing ceilings on salaries or enacting rules so that billionaires pay the same rates as their chauffeurs, the S word is tossed on our TV screens and we cry foul.
Free education is another example. We already provide free public school education up to 12th grade, an idea, by the way, that was not fully embraced by all in the day. There is certainly plenty of evidence to indicate that a high school education is not enough in today's world. The boon in college enrollments (and tuition) in the past 30 years demonstrates that a high school education is not enough to provide economic security. Nor is it enough to provide our workforce with the skills to make our industries (and country) competitive. It is past time to create a framework that enables all young adults the education to pursue a career, or job, which both advances their opportunity for personal success, and in aggregate, does the same for America.
Whether that extra two to four years be in a community college, technical school, or any of the myriad other ways that a young person can continue to develop her skills, an educated citizenry should be one of our top priorities. Of course, we will need some out-of-the-box ideas to make it work, not just two or four more years of the same thing. But when a percentage of the voters cast aside their heads when they hear about creating a framework for reducing the costs of advanced education simply because someone associates the idea with socialism, that is a shame.
Some seem to equate the battle against climate change as some kind of tenet of socialism, perhaps because it is framed by its detractors as damaging to our economy. It is hard to imagine what life might be like in our neighborhoods, if the voters who supported environmental regulations 30, 40, 50 years ago, had been convinced that clean air and water were some type of socialist propaganda. Yet here we have reams of scientific evidence that we are doing harm to our planet, our gift from our creator unique in our galaxy, perhaps even our universe. Yes, a Green Deal with our environment in which we acknowledge that we can't continue to act like there is a backup planet for us, that we act in unison with all other countries, and for today, as well as tomorrow's Earthlings, may sound like socialistic hogwash, if your only concern is profit, but sounds like responsible stewardship of our planet and our children's' future to me.
And, of course, we already enjoy a number of social programs that each and every day help the majority of American families. Our parents are able to live modestly with the help of Social Security and Medicare. Our chronically sick relatives can live in an assisted living environment with the help of Medicaid. Many of our suburban dwelling neighbors commute on public trains, which while not making a profit, reduce the number of cars on the road along with the pollution they create. During the 2008-2010, financial crisis, far too many us remained in our homes and provided food for our children (me, among them) through the assistance of unemployment checks, food stamps, perhaps even a welfare payment. The crushing wheel of layoffs, less people earning money, more layoffs, was slowed due to the safety nets that were created after the Great Depression.
One of the most effective arguments against social programs and socially (meaning group) driven solutions is that it contradicts the narrative that we have purchased part and parcel in America; the glorification of individualism. Don't get me wrong, the emphasis on the power of each person to make their own way, find their unique place among men, be more than just one of the crowd is an important as anything in the big picture. It is often the lone voice that sparks change.
But progress, real progress, cannot occur if only one person believes in it. Yes, one can start the wave, but it takes the community to keep it going, to spread the advantages, to inspire through words and deeds, its merits. When someone in power or with great influence dismisses social programs he is generally dismissive of the forces that helped him acquire his influence or power. Perhaps he forgets his birth in a household of wealth, or his early education in private schools, or the many contacts he inherited simply due to his last name, or the advantages that money can buy as he climbed the ladder of success, or perhaps simply the mentor he listened to in the beginning, when success was not certain.
Social programs are designed to provide the temporarily needy with a respite from a downward spiral to economic death. Yes, it should not be considered a lifelong answer. But if we are to condemn the social networks because there is some fraud, we must also curtail all the business tax breaks because there are those who cheat in their use as well. No program is without its abusers, yet there are too many pundits who use an example of welfare fraud to justify ending all social programs, then to add the cherry on top, associate those social programs with socialism. End of story.
So, what is so bad about Socialism. Well, as an economic system, and as executed with political systems that were not democratic in nature, a multitude of things. But that is not what the progressive liberal agenda (I love that phrase) is about. It is about social programs that are designed to provide a net when events are less than positive. A framework to allow those with less to function within our capitalistic society. A network for those who did not win the birth lottery. Resources and paths for all to access so as to enjoy the fruits of their efforts. And mostly, a hedge against our democracy becoming a plutocracy which is my biggest fear.
Like so many things in life, balance is necessary. Perhaps someday a more advanced form of government will evolve, an enlightened economic system will be developed. But for now, capitalism, mixed with social programs to even the playing field a bit, and democracy, with its emphasis on one person, one vote, seem to be our best bet. While each has its flaws, blended together they make an effective recipe for our time. It's in the mixture that we argue, fight and fuss. But that is the beauty, the essence of this experiment we call the United States of America.
Friday, February 8, 2019
About Time
I watched the end of the movie About Time earlier today. It was not the first time I saw it, so I knew the basic story, but it effected me differently than before.
For those of you who haven't seen it, the premise of the movie involves a secret ability among the male members of an English family. Not withstanding the fact that this secret leaves the women of the family without a clue about their husbands, the movie is much less about our male dominated society as it is about the father-son relationship, and living life to its fullest.
Today, I reflected much more on the relationship I had with my dad, than when I had seen the movie in the past. I was fortunate enough to have spent time with my father at his work, helping him perform his job. While those times occurred when I was quite young, age 10 or so into my early 20's, I still regard them as special experiences in light of how and where most boys interact with their fathers.
Still, spending time with your dad, and knowing about your dad are two very different things. I know now that I did not know much about the man, his experiences as a child, his youthful dreams, his fears and joys through adulthood. We seldom see our parents as people, the title mom and dad overpowering all other potential perceptions, and I know this is certainly true for me. Do I know his favorite color?His favorite food? His favorite movie or music? Perhaps we might be able to answer some of those questions, but even then they represent such a surface knowledge of the men we called dad.
In the movie, due to the fact that the male members can travel through time, (that is their secret ability) the son, who is also the narrator of the story, comes to know his father in a much more intimate way than most sons. Perhaps it is partly because they share the secret, and that his dad is the only one he can go to for advice about this skill. Perhaps it is merely because the son wants to know his dad more than most of us.
As the movie progresses, the rules of time travel are also revealed. One such rule is that the son cannot travel back in time before his children are born. This becomes important at the end when his wife wishes to have a third child, which means that the birth of this child, after his father's death, means he will no longer be able to "visit" his dad again. That one last visit, just before his third child's birth, coupled with the visit he makes on the day of his dad's funeral, are both very poignant, and instructive.
They conjure up thoughts about what I might have said to my father had I known which conversation we had would have been our last. And what times when it was just me and him that I would have wanted to relive, knowing we could converse in ways that transcended father-son.
It is during that last visit, that the father passes along a knowledge about time travel that he hopes will provide his son with the key to life. He tells him to live everyday, first, as we all live it, one moment to the next, experiencing life but also filled with the anxieties of what today's acts might mean for the future, or the regrets of what was not done or said in all the yesterdays which have passed. But then he advises his son to live the day again, less worried about what might happen, and more conscious of the moments. So, we see the son go through his day, then we see him experience it again, but this time with more awareness of those he encounters, the places he works and lives in, his children, his wife.
And, as the movie ends, the son takes that advice a step further. He consciously lives his life without the necessity of a replay. His life is more rewarding because he appreciates the everyday joys and beauty. While it is true that time travel enabled the son to understand his father as more than a dad, it may also be true that living one's life more fully also contributed to this deeper relationship.
It is that hope, that we can all live our lives more fully, more joyfully, without the benefit of time travel, that we should wish for our loved ones, ourselves, all those who touch our lives both briefly and more profoundly, and the remainder of people whom we never meet yet whose transformed lives will all contribute to the improvement of our understanding of each other.
For those of you who haven't seen it, the premise of the movie involves a secret ability among the male members of an English family. Not withstanding the fact that this secret leaves the women of the family without a clue about their husbands, the movie is much less about our male dominated society as it is about the father-son relationship, and living life to its fullest.
Today, I reflected much more on the relationship I had with my dad, than when I had seen the movie in the past. I was fortunate enough to have spent time with my father at his work, helping him perform his job. While those times occurred when I was quite young, age 10 or so into my early 20's, I still regard them as special experiences in light of how and where most boys interact with their fathers.
Still, spending time with your dad, and knowing about your dad are two very different things. I know now that I did not know much about the man, his experiences as a child, his youthful dreams, his fears and joys through adulthood. We seldom see our parents as people, the title mom and dad overpowering all other potential perceptions, and I know this is certainly true for me. Do I know his favorite color?His favorite food? His favorite movie or music? Perhaps we might be able to answer some of those questions, but even then they represent such a surface knowledge of the men we called dad.
In the movie, due to the fact that the male members can travel through time, (that is their secret ability) the son, who is also the narrator of the story, comes to know his father in a much more intimate way than most sons. Perhaps it is partly because they share the secret, and that his dad is the only one he can go to for advice about this skill. Perhaps it is merely because the son wants to know his dad more than most of us.
As the movie progresses, the rules of time travel are also revealed. One such rule is that the son cannot travel back in time before his children are born. This becomes important at the end when his wife wishes to have a third child, which means that the birth of this child, after his father's death, means he will no longer be able to "visit" his dad again. That one last visit, just before his third child's birth, coupled with the visit he makes on the day of his dad's funeral, are both very poignant, and instructive.
They conjure up thoughts about what I might have said to my father had I known which conversation we had would have been our last. And what times when it was just me and him that I would have wanted to relive, knowing we could converse in ways that transcended father-son.
It is during that last visit, that the father passes along a knowledge about time travel that he hopes will provide his son with the key to life. He tells him to live everyday, first, as we all live it, one moment to the next, experiencing life but also filled with the anxieties of what today's acts might mean for the future, or the regrets of what was not done or said in all the yesterdays which have passed. But then he advises his son to live the day again, less worried about what might happen, and more conscious of the moments. So, we see the son go through his day, then we see him experience it again, but this time with more awareness of those he encounters, the places he works and lives in, his children, his wife.
And, as the movie ends, the son takes that advice a step further. He consciously lives his life without the necessity of a replay. His life is more rewarding because he appreciates the everyday joys and beauty. While it is true that time travel enabled the son to understand his father as more than a dad, it may also be true that living one's life more fully also contributed to this deeper relationship.
It is that hope, that we can all live our lives more fully, more joyfully, without the benefit of time travel, that we should wish for our loved ones, ourselves, all those who touch our lives both briefly and more profoundly, and the remainder of people whom we never meet yet whose transformed lives will all contribute to the improvement of our understanding of each other.
Monday, February 4, 2019
Health Care: Cost VS Outcome
Catching up on my reading after the chaos of overseeing the move of the retail store for which I manage, and the normal holiday hustle and bustle.
The January edition of National Geographic features many interesting articles concerning the future of health care. Advances in technology and an acceptance by Western Medicine to treat patients as individuals, should result in future health care services which are long on technology and long on specific diagnosis tailored for each patient. Imagine the days when the doctor made house calls, knew you as a person not just a chart, but now would be able to bring with her a tool kit filled with the most up to date technology. Individualized treatments, rather than the "take this pill, it works most of the time on most people" approach.
What struck me about this particular edition, however, was the chart in the beginning which detailed the relationship between life expectancy rates and health care spending, from 1980 to 2015, along with the article towards the end of the magazine about maternal mortality rates.
First, the cost vs outcome chart. It depicts the life expectancy rates for 36 of the world's most affluent countries along with their 1980 per person health expenditure. At the time, the United States was a bit above the average for these nations in life expectancy while spending more per person than all but one.
Thirty-five years later, the US is last among these nations, over 2 years per person, on average, below the bottom of the chart, while spending over $2500 per person more then the second highest spending country, over $4000 more person than most of them. In other words, we are spending far more for poorer results.
Of course, the facts are one thing. Why is a whole different subject.
Some analysts point to unequal access and poor preventive care as part of the explanation. When sick people are reluctant to see a medical professional, either because of cost, or proximity of a health care facility, then when they finally are treated, it is because the problem has become serious and will result in a higher cost, either at the emergency room or after being admitted to a hospital by the doctor. Regardless, the malady has worsened, more extensive treatments are required.
In addition to this interpretation, I also think that even for those with health insurance, it can sometimes be difficult to navigate the rules, so seeing the appropriate health professional doesn't occur. Questions about referrals, co-pays, in network or out-of-network doctors, even which hospital to go to in an emergency can delay or prevent proper care from being sought. Not to mention, the almost yearly exercise by your employer to provide health care insurance without spending a fortune or passing along higher premiums, create another obstacle to knowing where to go for health care.
I had an experience this year where I received a bill from a testing facility after my yearly physical. The bill was for the blood test which checks for possible prostate cancer. Apparently, this test was not covered by my insurance as of 2018 (it was the previous years) unless the doctor indicates that it was necessary due to a prior condition. Since I had a prostate biopsy just a few years ago, my doctor resubmitted the test with a different "code" and it was covered by my insurance. Had I not called, and just paid the bill, I wouldn't have known to make sure future prostate blood tests are coded correctly, or worse, perhaps requested that the test not be performed in the future.
I am sure most people have had such an experience as well.
There is no doubt that the United States health care system is among the best in the world. People from outside America routinely come here for the most advanced care and treatments. I have no doubt that as the technological advances occur, we will all benefit.
Unfortunately, I also have no doubt that those with the most money will benefit the most. The fact is, health care is treated just like any other commodity in America. Have a six figure income, and work for the biggest corporations, and you will have access to the best care anywhere. Be a small business owner, or work for a small business, and your access will be very good. Work for a company that does not provide health care insurance, or provides very poor coverage, and your access will be very limited, if you can afford it at all. So, while the rich from other countries flock to the United States to pay for the best health care in the world, millions of working class Americans will struggle to balance paying for health care or foregoing a doctor visit until the situation is serious.
When at my most sarcastic, I see the access issue as one of a refusal for those with the most to wait their turn in line. You know who I am talking about. People for whom the rules don't apply. People who believe that their money and influence guarantees them to be first, never having to wait for anything.
I think that is behind some of the claims that people in other countries have to wait for doctor appointments or surgeries, etc. The fact is, when most people call a doctor, it is difficult to get an appointment same day unless it is an emergency, and even then, sometimes one must go to a hospital.
We all wait for things, at the supermarket check-out lines, at entertainment venue entrances, for food delivery. But some people thing they are above waiting; they are the ones with special parking, reservations when no one can get one, personal assistants who wait for them.
It is not a coincidence that almost all of the affluent countries in the world have some form of universal health coverage provided by public or private insurers, and that their cost vs outcomes are better than ours. It is obvious that some form of universal health care will not only extend our lives, but cost us less, both as individuals and as a nation. If we were a sports team, and our team came in last five straight years, but did not change their system because they were afraid of being like everyone else, or afraid of a loss of individuality, or worse, were owned by someone who just didn't care what we thought as long as he made large sums of money, we would demand change, loud and vociferously.
The crazy thing is, most Americans are demanding change, but many are scared of the obvious answer because of a few powerful groups and individuals who prefer the status-quo where they get rich and we get sick and die so they use the "S" word with pictures of Venezuela in the background.
Speaking of dying, the article on maternal mortality rates was startling. Are you aware the United States is one of only two developed nations (along with Serbia) to see a rise in maternity mortality rates since 1990? More women are dying as a result of childbirth in our country than 25 years ago!
Our mortality rate was below such countries as Slovenia, Croatia, and Montenegro among other more recognizable names, in 1990, and is now below Malta, Cyprus, Macedonia, and Belarus, among others which you might struggle to identify on a world map. A rise in pregnancy related medical conditions, the age of women giving birth, along with a lack of standardized protocols across hospitals are all mentioned as causes.
How about our medieval perception of birth control and contraception? We allow a minority of righteous individuals to stand in the way of common sense sex education and universal access (without stigma and high cost) to preventive birth control measures, and then are surprised when our female children are becoming mothers too soon, and do so without strong support systems.
Sadly, we are our own worst enemy when it comes to health care outcomes vs cost. We fail to see that we all do better as a group when it comes to these big social issues. That spreading the costs out, even among those who are sick less than average, enables those that are sick more than average to be treated.
That you could spend 60 years in that first group and the last 5 in the second. That social nets keep our grandparents and parents from living in our homes, or dying in the streets. That the vast majority of us will need the help of our government for health care and income when we can no longer work, yet we decry the "nanny" state forgetting that only the rich had nannies; we all had our parents wiping our butts, paying for our food and shelter, and, in some cases, staking us to $300 million.
Precision medicine which will monitor our health, alert us to issues both present and future and provide individualized treatments designed just for us is the future. I only hope that once it arrives, we will have determined that inequality is our enemy, unequal access to health care is bad for Americans, and that together we can solve our problems much more efficiently than any one one of us, regardless of his perceived regal residence.
The January edition of National Geographic features many interesting articles concerning the future of health care. Advances in technology and an acceptance by Western Medicine to treat patients as individuals, should result in future health care services which are long on technology and long on specific diagnosis tailored for each patient. Imagine the days when the doctor made house calls, knew you as a person not just a chart, but now would be able to bring with her a tool kit filled with the most up to date technology. Individualized treatments, rather than the "take this pill, it works most of the time on most people" approach.
What struck me about this particular edition, however, was the chart in the beginning which detailed the relationship between life expectancy rates and health care spending, from 1980 to 2015, along with the article towards the end of the magazine about maternal mortality rates.
First, the cost vs outcome chart. It depicts the life expectancy rates for 36 of the world's most affluent countries along with their 1980 per person health expenditure. At the time, the United States was a bit above the average for these nations in life expectancy while spending more per person than all but one.
Thirty-five years later, the US is last among these nations, over 2 years per person, on average, below the bottom of the chart, while spending over $2500 per person more then the second highest spending country, over $4000 more person than most of them. In other words, we are spending far more for poorer results.
Of course, the facts are one thing. Why is a whole different subject.
Some analysts point to unequal access and poor preventive care as part of the explanation. When sick people are reluctant to see a medical professional, either because of cost, or proximity of a health care facility, then when they finally are treated, it is because the problem has become serious and will result in a higher cost, either at the emergency room or after being admitted to a hospital by the doctor. Regardless, the malady has worsened, more extensive treatments are required.
In addition to this interpretation, I also think that even for those with health insurance, it can sometimes be difficult to navigate the rules, so seeing the appropriate health professional doesn't occur. Questions about referrals, co-pays, in network or out-of-network doctors, even which hospital to go to in an emergency can delay or prevent proper care from being sought. Not to mention, the almost yearly exercise by your employer to provide health care insurance without spending a fortune or passing along higher premiums, create another obstacle to knowing where to go for health care.
I had an experience this year where I received a bill from a testing facility after my yearly physical. The bill was for the blood test which checks for possible prostate cancer. Apparently, this test was not covered by my insurance as of 2018 (it was the previous years) unless the doctor indicates that it was necessary due to a prior condition. Since I had a prostate biopsy just a few years ago, my doctor resubmitted the test with a different "code" and it was covered by my insurance. Had I not called, and just paid the bill, I wouldn't have known to make sure future prostate blood tests are coded correctly, or worse, perhaps requested that the test not be performed in the future.
I am sure most people have had such an experience as well.
There is no doubt that the United States health care system is among the best in the world. People from outside America routinely come here for the most advanced care and treatments. I have no doubt that as the technological advances occur, we will all benefit.
Unfortunately, I also have no doubt that those with the most money will benefit the most. The fact is, health care is treated just like any other commodity in America. Have a six figure income, and work for the biggest corporations, and you will have access to the best care anywhere. Be a small business owner, or work for a small business, and your access will be very good. Work for a company that does not provide health care insurance, or provides very poor coverage, and your access will be very limited, if you can afford it at all. So, while the rich from other countries flock to the United States to pay for the best health care in the world, millions of working class Americans will struggle to balance paying for health care or foregoing a doctor visit until the situation is serious.
When at my most sarcastic, I see the access issue as one of a refusal for those with the most to wait their turn in line. You know who I am talking about. People for whom the rules don't apply. People who believe that their money and influence guarantees them to be first, never having to wait for anything.
I think that is behind some of the claims that people in other countries have to wait for doctor appointments or surgeries, etc. The fact is, when most people call a doctor, it is difficult to get an appointment same day unless it is an emergency, and even then, sometimes one must go to a hospital.
We all wait for things, at the supermarket check-out lines, at entertainment venue entrances, for food delivery. But some people thing they are above waiting; they are the ones with special parking, reservations when no one can get one, personal assistants who wait for them.
It is not a coincidence that almost all of the affluent countries in the world have some form of universal health coverage provided by public or private insurers, and that their cost vs outcomes are better than ours. It is obvious that some form of universal health care will not only extend our lives, but cost us less, both as individuals and as a nation. If we were a sports team, and our team came in last five straight years, but did not change their system because they were afraid of being like everyone else, or afraid of a loss of individuality, or worse, were owned by someone who just didn't care what we thought as long as he made large sums of money, we would demand change, loud and vociferously.
The crazy thing is, most Americans are demanding change, but many are scared of the obvious answer because of a few powerful groups and individuals who prefer the status-quo where they get rich and we get sick and die so they use the "S" word with pictures of Venezuela in the background.
Speaking of dying, the article on maternal mortality rates was startling. Are you aware the United States is one of only two developed nations (along with Serbia) to see a rise in maternity mortality rates since 1990? More women are dying as a result of childbirth in our country than 25 years ago!
Our mortality rate was below such countries as Slovenia, Croatia, and Montenegro among other more recognizable names, in 1990, and is now below Malta, Cyprus, Macedonia, and Belarus, among others which you might struggle to identify on a world map. A rise in pregnancy related medical conditions, the age of women giving birth, along with a lack of standardized protocols across hospitals are all mentioned as causes.
How about our medieval perception of birth control and contraception? We allow a minority of righteous individuals to stand in the way of common sense sex education and universal access (without stigma and high cost) to preventive birth control measures, and then are surprised when our female children are becoming mothers too soon, and do so without strong support systems.
Sadly, we are our own worst enemy when it comes to health care outcomes vs cost. We fail to see that we all do better as a group when it comes to these big social issues. That spreading the costs out, even among those who are sick less than average, enables those that are sick more than average to be treated.
That you could spend 60 years in that first group and the last 5 in the second. That social nets keep our grandparents and parents from living in our homes, or dying in the streets. That the vast majority of us will need the help of our government for health care and income when we can no longer work, yet we decry the "nanny" state forgetting that only the rich had nannies; we all had our parents wiping our butts, paying for our food and shelter, and, in some cases, staking us to $300 million.
Precision medicine which will monitor our health, alert us to issues both present and future and provide individualized treatments designed just for us is the future. I only hope that once it arrives, we will have determined that inequality is our enemy, unequal access to health care is bad for Americans, and that together we can solve our problems much more efficiently than any one one of us, regardless of his perceived regal residence.
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