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January 20, 2005

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So well written, so well said. I have to say that I agree with you on so many points. When will our country see that access to affordable, quality health care is a right for everyone? It never fails to disappoint me to see that our country fails to provide for its citizens what so many other industrialized nations routinely provide for their own.

Thank you for writing this, Jamie. It's good for me to hear a different perspective articulated with such charity and grace. Also, I'm glad for the reminder of something I often forget - that one's political philosophy is not necessarily tied to the orthodoxy of one's faith.

Can one be both pro-choice and pro-life at the same time? If I'm anything, that's what I am.

I hate those terms, anyway. So politically loaded and yet meaningless. I am pro-choice in that I do not believe that the government should restrict access to abortion. I am pro-life in that I don't want anyone to die before their time for any reason, and yes, I extend that to children in the womb. (How can a woman who still mourns a miscarriage not?) But I remain convinced that legislation isn't the way to save babies. Support for women and children is the way to save babies: support from the government in the form of medical aid, access to birth control, food aid, shelters, and decent public education; support from the Church(es), both moral and physical; and support from society. It's unfair for anyone to scorn both abortion and unwed motherhood at the same time. Unexpected pregnancies happen, nothing will change that. When my husband's cousin announced that she was pregnant and the father would have no involvement, I was shocked at the way the family reacted with such horror. "Wait a minute," I thought, "we're all Catholics. Shouldn't we be applauding her brave decision to raise her child on her own, rather than condemning her for a failure of birth control?" (Eventually the family came around, and now is very supportive of her and her son.)

There are just too many variable circumstances involved for me to ever support even a partial ban on abortion. What about mothers who need to terminate because their child can't possibly live outside the womb? What about desperate wives who need to abort to cut their ties to an abusive husband? What about teenagers who would rather commit suicide than face the wrath of their families? What about women with cancer, who have to choose between the life of their child and the treatment that is their only hope of survival? If you are to call yourself pro-life, then for God's sake take the life of the mother into account, too.

And if you are pro-life, how could you support a President who is so eager to send our sons and daughters to be slaughtered in war? Life begins at conception, yes, but I dearly wish that our politicians would remember that it doesn't end at birth.

Except the part about being a Catholic (Lutheran, here) I could have written your post myself. Thank you. loni

Wow! What in the modern Democratic party speaks to you so much that you are able to overlook 90% of George Bush's presidency because of the Iraq war?

If you don't agree with the war for the typical media reasons fine. If the UN Food-for-Oil Scandal didn't make you think twice about the motives of those who oppose the Iraq war then I would say the need for the history lesson might be late. If you don't mind the striking similarities between the German build up to WW2 when France and Britain lobbied to end sanctions against Hitler's country and in more recent history as France, Germany, and Russia (all opposed to the war) lobbying to end sanctions so they could get oil and trade in weapons, I can't help you. If all you see is war is bad, then please reference the Old Testament for the Books of Soloman I& II, and Kings I & II.

Domestically speaking though: a ban on federal funding of stem cell research, an end on pushing contraceptives and abortion in Africa to solve the AIDS crisis, unprecedented aid to both the US, North American, and the Africa's AIDS crisis, tax credits so that we could give or spend as we choose (not as a government agency chooses). You know, it amazes me that Democrats talk about doing this stuff (No Child Left Behind, the Ted Kennedy education bill, or the Medicaid Prescription addendum, also compliments of Senator Kennedy), but they never do it. And when they finally get a president to back it andsign it into law his accent makes your voice twitch. Worst president in history. Wow.

Is it really better to do for others yourself or just hope its getting done because you send your money somewhere on April 15 every year?

You ought to be appalled by what the Democratic party does in your name. Women's right, minorities rights? Where are the Democratics? George Bush has more minorities and women in his cabinent because he believes that they are qualified, not because the Rainbow Coilition threatened him. He says what he believes and demonstrates his belief in the Constitution by respecting it (go ahead, find me an example of the misuse of the Patriot Act).

Really, so you choose to vote for some 3rd party nobody instead of the man who believes your fetus is a child and would put up judges who not only respect the constution, but believe the same. . . real slick.

I'm with Summer on this one - I understand exactly where you're coming from Jamie. The whole abortion issue is such a tough one, but for me, when it comes down to the crunch, that embryo or foetus is the essence of what it will become. I know this is a sensitive issue, but the way I see it is that no-one would say it's o.k to "terminate" a new-born baby but not a nine-month old baby, or a six-month old baby. Because there is no difference except time...That's how I feel about a baby in the womb...it is that same little person in there, it just hasn't had as much time. I think it's much easier to see looking back. My daughter is now 4.5 months old and when I look at her scan pictures, taken at 14 weeks, I just think "wow-that's her". She may look like a jelly bean, but it's her! At the same time, while that is my view, I have no judgement whatsoever on any woman who chooses that decision. Even though I wouldn't say I was religious, one of my favourite sayings is "there but for the grace of God go I".
As for the health care situation in America, I think it's disgraceful. We are so lucky here in Australia. Everyone has access to free or affordable healthcare and it's good healthcare!. Sure, there are people who whinge about it, but my own experiences have been fantastic and since having my daughter I've suddenly become aware of how many free services there are for new mothers and children. Our government even pays us $3000 for each baby we have! So I will continue to thank my lucky stars.

I haven't been able to articulate much of a response to your post. I am wary of the future as well, but feel like that has less to do with the president, and more to do with the lack of moral certitude in our culture. I don't like the war at all, I don't like abortion, I don't like that there are poor people in this country, or any country. But there will always be war, poverty, immoral acts like murder. I don't think it is as simple as heaping it all on GWB.

A large reason health care is so expensive, don't forget, is because of liability insurance and lawsuits, especially in obstetrics. As a former member of a medical profession, I can tell you many excessive tests and treatments, as well as costs are due to fear of lawsuits. Again, not GWB's fault. I'm really not a big fan of GWB, but truly think the alternative would have been more dismal.

Thanks to everyone for commenting -- wanted to respond specifically to Lauren (and to Renee: you're right that the state of the nation is not all GWB's responsibility; didn't mean to suggest that it was). Lauren, I appreciate your leaving a detailed response and I just need to clarify a few things.

I didn't, and wouldn't, call GWB the worst president in history. I freely admit that my attitude toward him is unbecoming and something I need to work on. It's not his accent that bugs me at all. I'm kind of partial to Southern accents since I grew up in the South.

Absolutely, personal charitable giving is important -- I was just blogging about my efforts to be disciplined in that area a few weeks ago. Maybe we disagree over the role of government in assisting the poor, but I would cheerfully pay higher taxes if it meant a better standard of living (and esp. better health care) for people who are just scraping by right now.

Certainly there can be such a thing as a just war. In my view this isn't one, though I also am not ignoring the UN scandal. The war is only part of what I find objectionable about the past four years; supply-side economics, among other things, just will never make sense to me.

And while I acknowledge that Gore and Kerry would have run in a completely different direction on the issue of stem cell research, I was bitterly, bitterly disappointed in August of 2001 that Bush didn't keep his promise from the 2000 campaign to hold the line.

LMK if I'm misunderstanding anything you're saying. Please know that as far as I'm concerned you're welcome to your opinion (even if your opinion is that I'm misguided!) and also welcome to express it here.

Jamie, I have been thinking about this post all day and would love to blog a response, but I am feeling woefully inarticulate today. Sigh. ;)

You did make a comment above that intrigued me though: you said that you would "cheerfully pay higher taxes if it meant a better standard of living (and esp. better health care) for people who are just scraping by right now." If that is the case, why not simply give more to organizations in your own community that help the poor? Why entrust your money to a government that is all too eager to use it in ways that are morally offensive?

It's great in theory, the notion that we can allocate our own tax dollars. Wouldn't it be fabulous? But I doubt it will ever happen, at least not beyond the way we are currently represented. Do you really trust that a hulking, secular bureaucracy can spend your money with more wisdom, charity and compassion than you can?

I'm not trying to be harsh, I really hope I didn't come off as such. Still thinking...

Jamie, my husband and I both agreed several times during this election that if we could get a pro-life Democrat running for office, we would both dance around our kitchen table, donate money to his or her campaign, and gladly vote for that person.

As it was, we held our noses as we voted (as you said). I didn't like the recipient of our votes, but I didn't like the competition either. :-(

I was all set to come here and write something elegant about how I've come to the same conclusions Jamie has, but they lead me to be pro-choice, but then Summer wrote the exact post I was going to write.

I feel like I'd love to have the luxury of thinking we can outlaw abortion (although I never would, since I don't think I can determine what other people do, just help to try to give them a different context in which to make decisions), but the way things are in this country, well, I just can't stomach the thought of forcing anyone to go through a pregnancy she didn't really want.

I guess when I ask the question "Who's my neighbor?" it always ends up being the person who's already here and already suffering. So I just end up feeling we need to provide more support for families in this country, which leads me to the same actions many of the pro-life commenters have mentioned. Interesting that we start from the same place, diverge widely, and then come back together again.

Oh, and Lauren, the war disturbs me to my core, but it's the other 90% of what Bush has done that makes me lose sleep at night worrying about the future and my children. And it makes me sick that he plays the Christian card, yet ignores 98% of the Bible.

Hard decisions have to be made. Far better off are the women who have the luxury of choice than your neighbors in the Middle East. Women's rights? Rape rooms, people. Human rights: mass graves, people. Natural law: what about the liberation of those oppressed by tyrants, murderers, rapists, and criminals. Did God make some of us slaves and someof us free? Aren't we each created in His image?

Where in Scripture do you find play nice? Where does it say stand by and let evil happen? How isn't uncharitable to give people who truly want it stake in their own life? George Bush is far from the Frat boy image he projected 4 years ago. He truly is a man of deep and abiding faith: Faith in the Lord and in this country's people. The truth is that he has had to make the hardest decisions, with torrents of criticisms from do-nothings.
So I ask again: What is it that speaks to you in the modern Democratic party? All I see right now is: what can I get without having to work for it. And even then it is all talk. Do you realize that Michigan is only now requiring drug testing of welfare recipients? What does that tell you. Do you not see how government subsidies have oppressed the poor? GWB is right to say that to help someone is to give them a job. A job is dignity, hope, responsibility. Is it more charitable to give a handout and steal someone's dignity from them? I think not.

I think you really ought to turn off the tube and
really read what is that is asserted by both republicans ans democrats and try reconcile the facts with each.

Democrats have been all talk. George Bush is making true and good headway on the Dem's agenda. Hyperbole regarding Bush's faith is garbage.

Time to take off the feelers, girls, and put on the thinking caps.

Julie, you didn't sound harsh at all so don't worry. As much as I support local charity efforts, I see a need for a centralized safety net as well. Case in point: after my miscarriage in May I wanted to donate money in Dominic's memory to a local fund that provides prenatal care to women who can't afford it. I tried and tried and tried to track down the right office, but even people in related offices couldn't tell me where to go. Finally I gave up and sent the money to another agency that helps pregnant women with different needs. If I couldn't find the right office as a native English speaker trying to give away money, how much harder would it be for a woman in need? Where can she go under the current system?

I think the third-party payer system is irretrievably broken, and attempts to fix it are just delaying the inevitable. I think we need a single-payer system. It won't be cheap, and it won't be perfect. But if access to basic health care is a human right, and I think it is, then we as a society have an obligation to provide it.

There are related examples, like support for the aging, but health care is the clearest example for me.

I held my nose and voted for Bush, but I would have supported Kucinich if he hadn't flipped on life issues just before the primaries. I sent him an email and called in to a radio program to tell him so, as well. What follows here are my rambling thoughts about some of your well thought out post. Forgive if it seems disconnected at times.
Our health care system is severely disfunctional. However, I want to make a few observations from one who is within the system.
It is common to say that basic health care is a human right, but who decides what it basic? For example, the state of California decided decades ago that abortion is an important part of basic health care and so it is a covered benefit under Medi-Cal, the state's medicaid program. Local taxpayer money is being used for that. The state of Massachussets has decided that artificial reproductive technologies for infertility are basic health care - so there is a benefit under their Medicaid plan for IVF (did you ever wonder why Harvard is pushing so hard for embryonic stem cell research - they need to find some 'use' for all those leftover embryos). In Oregon, assisted suicide is part of 'basic health care'. So before we fight for some of this stuff, we need to define our terms. How much is basic, and what is a luxury? Should those decisions be based on economics or on outcomes? And how does one decide the relative value of various outcomes? Reduction ad absurdem - the most cost-effective way to deal with most chronic and many acute conditions is euthanasia - do we want to go there?
There are also conflicting needs that are invisible to the general public. For example, health care providers in training (from nursing aides to brain surgeons) need subjects upon which to learn. In order to provide these subjects, care has been centralized into hospitals - which may not always be the most effective or cost-efficient thing to do. But we can't provide that health care if we don't have a trained force of providers!
Some states have decided that the only prenatal and birth care that is a basic right under their programs is OB doc and hospital. Some states find that dental care is basic, others that it is an expensive luxury. I could go on and on, but first - what is basic? Who decides?
When I took an economics of health care class in grad school, we discussed the tensions among several laudable goals. Access, affordability, and quality are the three that I remember. If we have a universal single payer system, on what will it be modeled?
I currently pay close to 35% of my income in taxes of various kinds. I also attempt to tithe. I work in the trenches, providing what I hope is quality health care to those who fall between the cracks. We have a saying, though, that reminds us that we are only part of the issue. The saying "You can't work harder than the patient". We see some horrible abuses of the system, and we see some who have been horribly abused by the system. If we have limited resources to treat addiction - are we better off treating 10 patients a year for narcotic addiction with a high rate of success, or taking the same money and treating 100 a year for tobacco addiction with a fairly low rate of success. Should we give antidiabetic drugs to some one who refuses to change eating and exercise patterns? It isn't as simple as saying "basic health care is a basic human right"

This is such a fascinating discussion; I hope I'm not too late. Jamie, your post was, as usual, well thought-out and well-written. I may not agree, but I am interested in reading all sides. The one thing I was disappointed in, though, was your use of "tax-cuts for the wealthy"; you seem to be too much of an independent thinker to repeat these Democrat catch-phrases. It's my understanding that "the rich", when used in this context, is a married couple, each with a decent-paying (i.e. non-minimum-wage) job. Every tax bracket got a cut. The fact is, the rich pay most of the taxes. So of course (for instance, not sure of actual numbers here) 10% of what they pay is a lot more than 10% of what the lowest brackets pay.

I also am interested in what Alicia said -- what is basic health care? Is having more babies than you can readily afford basic health care? Is paying for something that is morally objectionable basic? And if you go down that road, objectionable to whom? (abortion, blood transfusions for Jehovah's witnesses, etc).

Also, Elizabeth -- historically, Catholics have been Democrats (JFK, for instance). In fact, many still are and seem to be considered by some as a "block vote".

Again, I am enjoying this debate. There is none of the "Republicans are STUPID" nonsense that went down immediately after the election. Thank you for your post and for provoking such good discussion.

Alicia, you are SO right that it is a diabolically complex issue. I don't have good answers for your questions, and I didn't mean to make it sound as if agreeing to move to a single-payer system would mean -- hey presto! -- an end to complicated decisions. I may see about writing another post on our time in Scotland, which was eye-opening for me as a patient, as a mother, and as an allied health professional. It would be a post more about questions than answers, but it was a really valuable experience for me on all fronts.

Mary, I didn't even know that "tax cuts for the wealthy" was a Democratic cliche, but now I'm laughing at myself for not seeing it before you pointed it out. It shows you that I've been reading The New Republic and not The National Review, doesn't it? The New Republic published what I found to be a devastating critique of Bush's tax plan. Of course, that's not a centrist source, and the numbers you end up with will be different depending on who's crunching them. One figure I've seen in several places, though, is that Bush gave $197 billion in tax cuts to just the wealthiest 1% of Americans. Let me do a little more digging and see if I can find some non-partisan numbers. (Does such a thing exist, do you suppose?)

And I am certain we would agree that no woman should ever abort a baby because she cannot afford basic health care. We might say together, "Hey, GWB, have you priced maternity care lately?

Gladly, being in my 20th week myself and watching the bills come in - I know the price of maternity care is ridiculous. In fact that is why for my last 3 births I opted for homebirths.

Nonetheless, it's not President Bush's fault nor the fault of the Republican party. When the managed care systems came into existence and government stuck its nose into the old pay for service system - prices went up. The prices are artificially manipulated because the system is artificially manipulated. That's why an aspirin pill in the hospital costs $10.00. The solution of course is reform - but that's not going to be easy or painless.

That's too funny that you didn't realize it's a cliche. :) I would love to see some non-partisan numbers, too. I am curious who the top 1% are (how much do they make?) and what is middle-class, and how much did their taxes get cut? And percentage would be good, compared to actual dollar amounts.
Still fascinated.

Elena, I agree that Bush and the GOP didn't cause prenatal care to be so expensive. I'm not faulting them for the problem, but I have a big disagreement with them about the solution. Cutting federal funding for Medicaid when that is the only source of prenatal care available to many women strikes me as an appallingly bad idea. Where will these women go? Increasing privatization doesn't address the core issue: I don't think we can cut the pie in that many slices any longer.

Mary, there's no shortage of opinions out there on the tax cuts, but I'm having trouble finding agenda-free opinions. Here is a page with answers to some of the questions you were asking about the top 1%. For balance, here is a page contending that average families will benefit from Bush's plan. (Any claims to agenda-free opinions there are undercut by the link that says, "Cut the spending, stupid.")

My computer is working v-e-r-y s-l-o-w-l-y so I'll be back tomorrow with a couple of ideas about the discrepancies.

Gladly, even the governors agreed that the status quo as far as Medicaid goes, isn't the answer. Eventually there will have to be changes.

The core issue, is that an entitlement system has helped to destroy marriages, it has kept people in poverty instead of having them rise above it. The old Johnson's War on Poverty didn't work.

I think there is a solution to this mess, but it's not going to be easy or painless.

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