The Home of Steven Barnes
Author, Teacher, Screenwriter


Wednesday, August 19, 2009

I fight with the weapons I have

Wanted to congratulate Erich--I thought that he expressed his views with great clarity and precision. Thank you.

I am looking for statistics on a few different things:

1) comparable survival rates on the top ten killer diseases in Industrialized countries.

2) Statistics on murder, suicide, and accidents in Industrialized countries before and after adopting UHC.

3) Stats on the amount of research funded by governments as opposed to private industry in Industrialized countries, including the U.S. Cross-referenced with the number of, say, medical oriented Nobel prizes for different countries, adjusted for GNP.

##

I find it interesting that so many think that the murder, obesity, hypertension and other stats that are said to make up the difference in life stats between countries have nothing to do with the health care systems and social safety net. It is understandable that I would find this noxious considering that these factors so powerfully impact the black community. When people suggest that these factors are because people don't care, or don't want to be healthy, or are intrinsically inclined toward negative behaviors, it is impossible for me not to think that they are privately thinking that about the racial groups most affected by them. And while (most) people won't say that publicly, it sure seems to be driving their positions. I have, over the years, heard entirely too many Conservatives actually say "who cares, that's their choice" or imply that there is simply something...sub-standard. Countless times. And while I know that doesn't reflect the attitudes of all Conservatives (by any means) it is precisely these comments that drove me out of the fold.

##

It is impossible for me (or anyone else) to completely separate my feelings from my thoughts, so I want to label today's rants clearly: I know I'm emotionalized, and while I won't apologize for it, I do want you to know I'm aware, and that I'm repeating some things I've already said. I just don't feel like editing myself this morning.

##

A couple of days ago in Arizona, a dozen people brought weapons, including automatic weapons, outside a convention center where the President was making a pro-health care speech. Conservatives have been careful to point out that the guy carrying an automatic rifle was black. When asked why they showed up with weapons, one guy answered "because we can."

This is so transparent. Note: while one need not be racist to oppose ObamaCare (I actually don't completely mind that term), we can be pretty certain that the 10% of white racists would tend to come down against it. Or anything he has to say or do, based on a vague if not powerful sense that "this isn't my country any more." And of course if you start with that feeling, you are going to find plenty of evidence.

Barnes' Law: any group of people large enough that the people cannot recognize each other by sight will begin to act like a living thing, with its own drives and needs. These drives and needs will not necessarily be in alignment with the values of any particular person in that group...or their conscious thoughts.

In this case, the legitimate political opponents are, in typical political "Big Tent" fashion, aligning themselves with anyone who will vote their way...including racists and Wingnuts. And it has seemed to me for a while that what is happening with the Birthers and so forth is that the unconscious drive on the Whacko element of the Right is to troll for an assassin. Or for a fall guy, someone who could plausibly be believed to be a "Lone Gunman." And of course, the perfect "Lone Gunman" in this instance would be black.

As you can see by the interview quoted at:

http://www.huffingtonpost.com/2009/08/18/right-wing-radio-host-sta_n_262559.html

The black guy, "Chris", was invited to the rally. And that was what I said to Tananarive yesterday: that I would bet that he was specifically asked to show up with his automatic rifle, with my interpretation being that they wanted his skin tone to provide cover for the ugly element within the opposition (note that I'm being careful not to suggest that the entire opposition is racist. I don't believe that. But the idea of a black man in the White House is driving racists crazy, and which side of the spectrum you YOU think they're settling on?)

We're watching the collective unconscious of the ugliest elements in our culture crawling out from under their flat rock. It's going to get worse. When you say you bring weapons "because you can" you aren't answering the question. The question is: why now, and not at a Bush rally? Or a McCain rally? You had the right then, too. My conclusion: pure intimidation. Oh...and setting up a plausible pattern for a "Lone Assassin" scenario: overwhelming the Secret Service, providing distraction ("multipliers") to stress out the protective services and increase chances of a mistake.

##

I'm aware that a consistent talking point now is that murder, obesity, smoking, suicide and other "lifestyle factors" are being pointed to as making up the difference in statistics between America and countries with UHC.

And this, precisely, exactly, is an example of my position that a core difference between Left and Right is "where do you come down on the Nature/Nurture debate?" Because they very well may be right: but teasing out causality from correlation may turn out to be more difficult than one might think. This is why I want to see bunches of people examining the trend lines for these (and other lifestyle) factors in the pertinent countries BEFORE and AFTER UHC.

My position, clearly stated: I believe that within a generation after such UHC programs were put into place, these factors decreased. I mean, once upon a time, we were near the top in terms of health care. And now we seem (if we include these factors) to be near the bottom. What happened? My sense is that those on the side of the just believe that something intrinsic within many Americans just suddenly began to command them to die young. Or that they wanted to die young. Or are just innately murderous and self-destructive. That these things have nothing to do with social context.

All right--because these positions are ultimately based on arguments about the soul going back thousands of years, it is very unlikely to be resolved in this generation. Here's where it sticks in my craw: if you take that position, you would seem to be standing on the same side of the room as those who think that an entire group (say...black people) WANT to have more crime, be poor, and presumably be sick and die early. Black men die an average of five years earlier than whites. Many of these reasons are lifestyle factors. One can either (basically) conclude that this is due to a grotesquely unequal social environment stretching back 400 years (and FINALLY beginning to change perhaps 30-50 years ago) or one can conclude that there is something innately different about the group. Guess which side I come down on.

So here's my belief: that America used to be among the best. Then these other countries put in place a stronger social safety net, lifting their citizens up while ours remained in a "dog eat dog" situation, with some of the dogs muzzled by law and centuries of programming. They got better, while we remained the same or got worse, creating a relative negative result: America WAY down there in terms of life expectancy, infant mortality and so forth.

And those who think it is primarily "Nature" conclude that these statistics "prove" that America has the best health care--because if you just remove those pesky blacks and other groups who are disadvantaged, or remove the problems that are symptomatic of being crushed in the gears of a soulless machine (stress-triggered disease and obesity, isolation-induced suicide, sleep-deprivation accidents, rage-induced murder, etc.), why, middle-class whites are doing just fine! Why the hell should anything change? Why should the least capable in our society "drag down" the most capable? It's a scandal, I say!

THAT is what I hear.

Politics makes strange bedfellows indeed.

##

A reader recently said that, basically, women were intimidated by him. That's the first time I've heard a guy say that, but I've heard it from women for years: can't find a guy because all the men are intimidated. I especially used to hear this from women who, in the real world, would be thought average, but were Goddesses in science fiction fandom. And my reply is the same: you must be fishing in a very small pond indeed. The "Big Fish In A Small Pond" syndrome is common among the insecure. It just means that they wouldn't really be attracted to themselves. They don't really like or love themselves. Do you really think that the women married to Nobel Laureates, pro athletes, professional entertainers, multi-billionaires and so forth would be intimidated by you? What a joke. Grow up. Heal yourself and start producing the type of life results that will allow you to attract the truly brilliant and spectacular women available--to men of high accomplishment and proven worth. When I can Google you and be impressed, we'll have something to talk about.

##

Of all the arguments against UHC I've heard, perhaps the most interesting is the assertion that if we had it, medical research would suffer because of loss of profit motive, and ultimately death rates would rise.

That's really interesting, and I have to admit that I just don't have the data to refute it...and that under the right set of circumstances I could see how it could be true. While I search for information, though, it seems to me that for it to be true a number of different things would have to first be established:

1) That profit motive is stronger than fear of death, altruism, or intellectual curiosity in terms of producing valuable results (or at least that, in a situation with a reduced profit motive, these other factors would not compensate sufficiently)

2) That America produces more medical advances than countries with UHC, adjusted for GNP, population, etc.

3) That those advances are largely due to private sector profit-based investments as opposed to government or non-profit investments.

4) That for-profit companies are not primarily investing in medications that have a high profit margin or potential, thus affecting mortality statistics primarily among the rich, but not overall population mortality.

5) That the majority of changes leading to more favorable mortality statistics are not simple low-cost changes: prostate exams cost a hell of a lot less (how much is a rubber glove?) than late-stage emergency cancer treatments.

6) That Universal Health Care doesn't impact lifestyle problems (obesity, smoking, suicide, stress illness, fatigue-related accidents etc.) or social problems caused by alienation (murder, etc.). My guess is that some of these factors are NOT directly impacted by UHC, but ARE impacted by the kind of humane society that says that every member has intrinsic worth. Correlation, but not causality.

7) That billion-dollar compensation for Insurance executives somehow benefits the insured. That, in other words, such men and women provide services THOUSANDS of times superior to bureaucrats earning, say 250,000 dollars a year. Because otherwise, that's just flushed down the drain.

##

I have a vested interest here. My belief is that 400 years of abuse has done fantastic damage to the black community, from which it is just now beginning to emerge. That in our population are a minimum of 10% of white people who believe that the inequality is due to innate differences, and for that reason (as well as basic tribalism) fight against anything that would even the social playing field. That few of them will be honest about this, and hide in the ranks of those who talk about "reverse racism", embracing anecdotal stories of oppressed whites above statistical evidence of gigantic, lethal effects on blacks. Because of them, it is almost impossible to pass any legislation that might directly benefit blacks. I've said for years that I'll know when things have changed when a few things like infant mortality rate, life expectancy, incarceration rates and inherited wealth are equal.

If nothing can be done that is specifically targeted at blacks, then the only option is to raise the social safety net for all. To allow those who have benefitted most from the system (yes, I'm aware that Libertarians would probably say that the wealthiest have GIVEN most to the system) to pay more taxes, which I believe to be a stabilizing influence (to a point: as I've said, I suspect that there is an ideal range of wealth disparity. I don't know what it is, but I'm sure that a statistical analysis would show what multiples of income between poorest and wealthiest are safe for a society. In my opinion Communism doesn't work -- we're just not wired that way. But limited Socialization of "the commons" does. The only valid argument is: what should be included in the Commons? We have many examples of Industrialized Countries who are healthier than we are and provide health services to their people without bankrupting themselves. Hell--we're the greatest debtor Nation in history right now. And the countries above us seem to all have UHC. To me, unless beneath it all you believe the Soul enters the world already formed, the conclusion is obvious.

##

Rant ended. I've made it clear that I have a raw nerve here: the countless times I've heard Conservatives either directly or indirectly accuse the poor and sick of being that because on some level they want it, or have no capacity to do better.

Whether dealing with people on an individual or group level, I reject this clearly, stating my position in Mile-High letters. Most people who are getting brutal results in the arena of finance, relationships, or their bodies are running seriously screwed-up programs. Few of those programs were self-inflicted. People who are NOT balanced in all three arenas often lie to themselves about why they are not, and project those lies out into the culture they see.

Most (but certainly not all) of the people who ARE balanced in all three areas have, to my experience, huge empathy for the work it takes to get there. They tend to be compassionate toward the human condition because they have done the work, faced their demons, fought past their fears, or been the recipient of high-level teaching without which they might have foundered. They look at those who are less successful with a deep sense of connection.

If the poor, and the sick, and the lonely are these things primarily due to confusion (and yes, even in the best world, we would stil have unequal results. But there is little innate reason for as much sickness, despair, loneliness, and grinding poverty as we have). So I fight for YOUR health in the belief that in facing the reality of how your body was shaped by fears, beliefs and emotional anchors you never put in place, you will start grasping what shaped others as well. I fight for YOUR success because embracing it means leaving behind the preconceived notions of hierarchy that kept racist beliefs in place for so long. I fight for YOUR right to love and intimacy because love and fear compete for the same place in your heart, and when you reduce fear, you begin to feel the connection to all other living things, and all other human beings, and the mythologies that have kept us isolated in separate tribes begins to fall away.

I fight for YOU because it is the only way to create a better world for my own children. I fight with the weapons I have.

50 comments:

Steve Perry said...

This is much too simple and not really accurate, in that labels tend to be less than totality, but I've always thought that it approached what I believe is a core difference in sociopolitical thought:

Liberals tend to be *for* things.

Conservatives seem to be *against* things.

That is: Yes, we can. as opposed to No, we shouldn't ...

From my onboard dictionary:

liberal |ˈlib(ə)rəl|
adjective
1 open to new behavior or opinions and willing to discard traditional values : they have more liberal views toward marriage and divorce than some people.
• favorable to or respectful of individual rights and freedoms : liberal citizenship laws.
• (in a political context) favoring maximum individual liberty in political and social reform : a liberal democratic state.
• ( Liberal) of or characteristic of Liberals or a Liberal Party.
• ( Liberal) (in the UK) of or relating to the Liberal Democrat Party : the Liberal leader.
• Theology regarding many traditional beliefs as dispensable, invalidated by modern thought, or liable to change.
2 [ attrib. ] (of education) concerned mainly with broadening a person's general knowledge and experience, rather than with technical or professional training.
3 (esp. of an interpretation of a law) broadly construed or understood; not strictly literal or exact : they could have given the 1968 Act a more liberal interpretation.
4 given, used, or occurring in generous amounts : liberal amounts of wine had been consumed.
• (of a person) giving generously : Sam was too liberal with the wine.

Versus:

conservative |kənˈsərvətiv; -vəˌtiv|
adjective
holding to traditional attitudes and values and cautious about change or innovation, typically in relation to politics or religion.
• (of dress or taste) sober and conventional : a conservative suit.
• (of an estimate) purposely low for the sake of caution : the film was not cheap—$30,000 is a conservative estimate.
• (of surgery or medical treatment) intended to control rather than eliminate a condition, with existing tissue preserved as far as possible.
• ( Conservative) of or relating to the Conservative Party of Great Britain or a similar party in another country.
noun
a person who is averse to change and holds to traditional values and attitudes, typically in relation to politics.
• ( Conservative) a supporter or member of the Conservative Party of Great Britain or a similar party in another country.

Mike Ralls said...

>When people suggest that these factors are because people don't care, or don't want to be healthy, or are intrinsically inclined toward negative behaviors, it is impossible for me not to think that they are privately thinking that about the racial groups most affected by them.<

Sounds like projection there. Minority groups usually think about the majority far far more than the majority thinks about the minority for the simple reason that the minority group is usually weaker and hence in more danger from the majority group than vice versus. It is then common for the minority group to then project and think that the majority group thinks about the minority as much as the minority think about the majority, but this is usually not the case. The most common attitude of majority groups towards the minority groups is usually one of indifference.

Keep in mind that there are seven states in the Union where blacks make up less than 1 out of every 100 people. You could fit the entire black population of ten states into one football stadium and still have empty seats (Beaver Stadium sits 107K, and the total black population of the least black states is 105K http://www.statemaster.com/graph/peo_tot_bla_pop-people-total-black-population). In those ten states most people probably just don't think of Blacks very often. Rather than being at the forefront of their mind, as you seem to be suggesting, many many Americans just don't think about blacks that often (mind you, indifference can also have quite strong negative consequences). I don't say this to make you think better of those who are opposed to your goals, but because the danger in projecting is that it is a dishonest form of thinking. It gives you a false reality map.

Dan Moran said...

Mike,

Yeah, there are states with not many black people. But the white people who live within those 10 states are less than 3% of the American population, and their circumstances don't change the broad experience of black and white and brown in this country.

Mike Ralls said...

I'm not talking about the broad experiences of Americans, I'm pointing out what I regard to be as a suboptimal way of thinking on Steve's part. Short version; Steve thinks about blacks a lot, therefore I think he is assuming that his opponents/other people/etc think about blacks more often than is the case.

A minority being less than 1% of a population is a rather extreme case where the majority can really just not think about the minority pretty much _at all_, but even being less than 10% of the population puts the minority in a position that is easy to be ignored, especially if the minority is geographically or socially isolated from the majority. And Blacks make up less than 10% of the population in 31 states.

I tried to find some polls on how often whites think about blacks and vice versa, but no luck. The closest I could find to my position (In general, blacks think about whites more than whites think about blacks) is this;

http://www.gallup.com/poll/17503/Sparks-Fly-When-Blacks-Whites-Neighbors.aspx

Integrated Blacks and Whites Perceive the Most Racial Enmity

The same survey probed Americans' perceptions of racial hostility with this pair of questions:

* Do you think only a few white people dislike blacks, many white people dislike blacks, or almost all white people dislike blacks?

* Do you think only a few black people dislike whites, many black people dislike whites, or almost all black people dislike whites?

Whites who live in areas where there are many blacks are more likely to say that "many white people dislike blacks" (44%) than those who live in areas where there are just some (30%) or a only few (31%) blacks. At the same time, the prevalence of blacks in their communities does not affect whites' perceptions of how many blacks dislike whites.

The question for future study is whether whites living in highly integrated areas are simply more aware of white hostility toward blacks (perhaps integrated whites are more vocal about it), or whether there is, in fact, more white hostility toward blacks in these environments.
--
If we take the position that whites who live in more integrated communities are simply more aware of hostility towards blacks and are aware of this because they live around blacks and therefore think about blacks, this would support the position that whites who don't live around blacks are more likely to not think about blacks as much.

Dan Moran said...

I should clarify, I actually think your basic position -- out of sight, out of mind -- is correct. I see no reason it wouldn't be. I just think that the percentage of Americans who live in genuinely lily-white environments is pretty small these days. (Though state and even city level data is deceptive, there; Los Angeles is a majority Latino city, but there are sure neighborhoods where almost everyone is white.)

The question for future study is whether whites living in highly integrated areas are simply more aware of white hostility toward blacks (perhaps integrated whites are more vocal about it), or whether there is, in fact, more white hostility toward blacks in these environments.

I suspect so, from personal experience, but there's a caveat ...

Rubbing shoulders against people is likely to piss you off. I've been kicked unconscious once, knocked unconscious another time, and shot at three times in my life -- kicked by Latinos, shot at twice by Hispanics, sucker punched by a black guy, and shot at once by a black man. I've won and lost fights to white guys but never hit the level of violence in those encounters I reached with men of other races. (The only guy I ever kicked after he went down was a Mexican guy, for what that's worth.)

On the caveat hand, about half of all the relationships I've had in my life have been with non-white women. So ... yeah, there's an experience of actually living with people that's different from having paranoid ideas about them based on what other people tell you about them. And it's both good and bad.

Mike Ralls said...

>I just think that the percentage of Americans who live in genuinely lily-white environments is pretty small these days.<

Doing some quick googling I see that that Fifty percent (50%) of whites say that the employees in their workplaces are all or mostly white;

http://www.gallup.com/poll/12883/Few-Americans-Feel-DaytoDay-Racial-Tension.aspx

And in a separate poll, 62% of respondents said that all of their neighbors were white.

http://books.google.com/books?id=L-fWJf4vhWUC&pg=PA242&lpg=PA242&dq=what+%25+of+neighborhoods+are+mostly+white&source=bl&ots=FgJWihYfl2&sig=gNDWnqUVvYM456Uxi0VKoWRfLUo&hl=en&ei=XGOMSuCjOpPYsgOQ89DCCQ&sa=X&oi=book_result&ct=result&resnum=1#v=onepage&q=&f=false

Given that your home and your work are where you spend the most time, that's a good enough rough-and-ready definition of environment that I feel comfortable in stating that rather than being tiny a substantial percentage of white Americans live in just such an environment.

Dan Moran said...

I stand corrected. Wow. Those are striking numbers.

Marty S said...

Steve: I tried to find some of the numbers you asked about, and have found hem difficult to obtain. I did find some numbers on U.S. and Canadian life expectancy. Canada passes its UHC law in 1966 since then life expectancy in Canada has has increased a over 9 years for males and in the U.S. it has increased over 8 years. The actual difference was .9 years in Canada's favor. For females it was over 8 years in Canada and over 6 in the U.S. the difference was 1.84 years. This would help make the case for UHC except of course that murder rates and obesity have increased in the U.S. in that time and so we end up back with the question of does UHC affect one or both of those statistics.

Travis said...
This comment has been removed by the author.
Travis said...

This doesn't relate directly to the discussion about health care but does to the ideas about groups 'wanting' things such as sickness, poverty, higher crime rates.

One, I don't think people actively 'want'these things. However in many cases they want short term benefits that RESULT in these long term problems. I'm thinking mostly of the health care issues here. People know at least the basics of how to live healthy. Yet choose not to. Why? short term versus long term and a poor understanding of risk vs. gain as applied OVER TIME.

Re: crime rates. I had a legal history class once and clearly remember the day we talked about the long term crime trends in the US. You know what the best correlation to crime rates (per capita) was? Not race, not poverty, not socio-economic anything. It was number (or rather percentage as we are discussing per capita) of young males. Don't remember the exact age range that was used, something like 16-24. Times and places with lots of young males equalled more crime.
Now true this is a correlationthat was shown, not causation. But I'd bet dollars to doughnuts that there is a causal relationship.

Travis said...

Mike,

There are problems with your data and conclusions.

Do you realize that the book you quote was published in 1975?

The first survey is from 2004, so only a little dated. It also has a sample error of +/- 5% (which will become important later).

Even if you took the data as valid (which I can't given the dates) there is not neccessarily a large correlation between the respondents in the two seperate polls. 50% of one poll and 62% of another means that the overlap would be somewhere between 12% and 50% and we have no way to know what the percentage actually is without more data. This is where the +/- 5% is relevant, once we are down to, potentially, only 12% then a 5% error is huge.

Marty S said...

Some more numbers: The two biggest medical killers by far are cancer and heart disease. Those two together are more than nine times the third place cause of death. So looking at these pretty much gives you the picture. On a per person basis the death rate in Canada from cancer is about 12% higher than the U.S. Again on a per person basis the death rate in Canada from heart disease is 27% lower than the U.S. Where does that leave us. Well to my knowledge there is little to no relationship between obesity and cancer, but a high relationship between obesity and heart disease. So this supports the argument that the difference in obesity is a major cause of the difference in life expectancy, and leaves with the question of whether or not UHC results in lower obesity.

Quis custodiet ipsos custodes said...

"And of course, the perfect "Lone Gunman" in this instance would be black".

Or a "fanatic" with a foreign background that has certain beliefs that could be philosophically aligned with known terrorist organizations far far away without having actual membership which would soften any adverse public reaction to prolonging hostilities far far away and accomplishing two things that were accomplished before in the early 1960s when something quite similiar and successful occurredn and that former President Eisenhower and General Smedley Butler, USMC, made specific mention of and warned us about. Naturally, any person of any background and belief system would most SURELY not survive to stand trial.

Marty S said...

In looking for health statistics between Canada and the U.S. I have found an interesting one. A greater percent of Canadians are smokers than Americans. If UHC helps people be more health conscious one would expect Canada to have fewer smokers as well as fewer obese. The larger number of smokers would seem to argue against UHC affecting peoples personal health habits.

Mike Ralls said...

>Do you realize that the book you quote was published in 1975? <

Nope. Missed that. Thanks for pointing that out. My quick and dirty google search was, well, quick and dirty. Anyone have any more recent data? The 2004 poll showing that 50% of whites say that the employees in their workplaces are all or mostly white would make me think that the % who would say that they live in an all or mostly white neighborhood would be be similar, but it's data that matters not supposition. A few more minutes of googling haven't turned up anything. Someone else want to see if they can find the stats?

Travis said...

I was pretty sure that's what happened. My original point was just that we don't know how much overlap there actually is in the groups. We might guess that it's likely to be somewhere in the mid -range of the percentage but we don't KNOW. I almost didn't even look at your sources but just wanted to be complete and was surprised by what I saw.

Dan Moran said...

But I'd bet dollars to doughnuts that there is a causal relationship.

There's a broken phrase. The Old Fashioned Donut at Starbucks costs a buck seventy five ...

Lynn Gazis-Sax said...

That's the first time I've heard a guy say that, but I've heard it from women for years: can't find a guy because all the men are intimidated.

Generally the way it works is that men complain that they can't find a woman because they're too darn nice, while women complain that they can't find a man because they're too darned smart and competent. Both complaints have long struck me as ways to avoid facing whatever the reason may be that people really aren't finding relationships; I don't think nice or smart or accomplished people of either gender really go loveless because they're nice, smart, and accomplished (though it's possible to be nice, smart, and accomplished and go loveless for other reasons).

Saskplanner said...

Marty. You're a knob. Who says UHC is necessarily a preventative system? Ideally yes, but... Specious reasoning on your part. And don't start talking about obesity.

I am a Canadian and have lived in the US and you know what? The average American is 40 pounds heavier and 40 IQ points lighter than the average Canadian. Sorry - first hand experience...

I'm watching this all from Canada and you guys are doomed. I don't know how the thinking segment of your society can pull away from the raving and ranting of all the hillbillies and white trash and religious reich twats who seem to derail pretty much anything progressive that seems to be promoted.

And the hilarious thing is the prospective people who would GAIN from such things as UHC (poor people, hillbillies and white trash who likely would GAIN in such a system) are the ones who are the most vociferous in their opposition. I don't get it.

Marty S said...

Okay here's some more information. The life expectancy numbers I quoted before are life expectancy at birth. If one exams the life expectancy at age 65 the U.S. actually has higher life expectancy numbers than UHC countries like Canada and the UK. Now Steve asked about the top ten killer diseases. I had trouble finding data googling that so I googled top ten causes of death instead. These list included causes like accidents, suicides, murders. Accidents casing death were 60% higher in the U.S. than in Canada. I can't think of a link between UHC and accidents. So clearly using life expectancy as a criteria if you are a senior you prefer American health care system to others and the argument that UHC helps other based upon life expectancy is questionable.

Marty S said...

Obama has been catching a lot of flack from the left for backing off from the "public option". My question is if two health care reform packages both result in 100% coverage one public and one not then why should it matter to the left which way its done.

Shady_Grady said...

"My question is if two health care reform packages both result in 100% coverage one public and one not then why should it matter to the left which way its done."

Well if the non-public option costs more or limits the ability of the government to negotiate price reductions on drugs, then it would matter a great deal. If we have 100% coverage but we're paying even more than before and getting worse results that's no good.

But it's not just about a "public option" whatever that might have meant. It's about the growing worry among self-identified progressives/liberals etc that Obama either may be too weak to stand up to sustained Republican opposition, or (in some ways worse) not at all interested in the sorts of transformation the "Left" was interested in.

William Greider gives a pretty good summation of that POV.

http://www.alternet.org/politics/142063/is_obama_squandering_our_best_chance_for_better_health_care/

Travis said...

"There's a broken phrase. The Old Fashioned Donut at Starbucks costs a buck seventy five ..." LOL!

This may be why 'kids these days' (you know, 25 year olds)haven't seem to have heard the expression, which is precisly why I use it.

But then, while I don't have the data in front of me (and this thread seems to be all about data)Starbucks strikes me as about the LEAST economical way to purchase doughnuts. Kinda like saying 'I don't have a car because BMWs cost too much'.

Travis said...

Yeah Marty, your a knob for looking into actual data and trying to have a discussion about about facts.

"The average American is 40 pounds heavier and 40 IQ points lighter than the average Canadian. Sorry - first hand experience..." How do you get that data first hand? Walk around weighing people and giving IQ tests?

Mike Ralls said...

>My original point was just that we don't know how much overlap there actually is in the groups.<

Given the limited data I posted, no, we can be 100% sure, but we can be fairly confident given the very low black-white intermarriage rate that there are fairly large numbers of whites who just don't interact with many blacks above the "Here is your change" or "Do you have the TPS report?" level, and sometimes not even that. You just don't get two groups that are genuinely integrated and heavily interact with each other on the personal level and that still retain largely separate marriage markets.

If we include church as part of one's environment, the the figures I found here (2004) also suggest a large number of whites who don't interact with blacks;

http://www.gallup.com/poll/12664/race-religion-divisions-steeped-history.aspx

. . . 64% of non-Hispanic whites worship in congregations that are all or mostly white and 56% of blacks worship in congregations that are all or mostly black . . .

Lynn Gazis-Sax said...

I grew up in a town that was maybe 90% white, going to a church that was probably more than 90% white.

Now I live in a town that's 76% white, go to a workplace where maybe a third of my coworkers are Asian (and have in the past, at a different workplace, been in the minority in my work group for being white), go to a mostly Latino neighborhood to attend a church where the majority is white, but with a significant minority not (and with more partly white and partly Asian children than fully white kids), and am part of a family where half my siblings married someone who's either of another race or mixed race (so that a clear majority of my nephews and nieces are mixed race), and probably all of us have slept with someone of another race. And none of that involved trying hard.

I realize that living in California might throw me a little more into contact with people of other races than people in some other states (and it's still the case that a majority of the people in my cell phone contact list are white), but I find it hard to believe I'm that much of an outlier; I think that there really has been a shift in the direction of more mingling of the races, since I was a child in the 60s. Rather a large one, even if we still have a large way to go.

Mike Ralls said...

I think it's important to keep in mind that there is a difference between increasing integration between all the races in America, and increasing integration between Blacks and the rest of America. The two are related, but there are also some wide differences in them.

In terms of intermarriage, which I think is the best statistic to see how the races get along with each other because it shows the members of one race are wanting (at least in theory) to spend the rest of their life committed to a member of another race, the Hispanic, Asian, and Native America rates of intermarriage have definitly skyrocketed over the last 50 years with some of them approaching rates of 50%. The Black intermarriage rate has also grown but not nearly to the same degree (under 5% IIRC). If the Black intermarriage rate were to double, double again, and then double a third time, it would still be less than the Asian rate of today. To me, this shows that Hispanics, Asians, and Native Americans are mostly integrated with White America, but that Blacks are not.

Steve Perry said...

If you're white, you're all right; if you're brown, stick around; if you're black, step back ...

Broad, sweeping comments about race are tricky things, Mike.

Steven Barnes said...

Mike:
I'm sure that blacks think about whites more often than the reverse. However, with a black President in the white house, ah do think it's reasonable for the concept of race, so much in the news, to be prominent. I never said, or thought, that whites think about it as often, and don't believe this to be true. Still, my comment holds: when I hear someone say that they think the poor want to be poor, I suspect that they generalize that to groups as well. But I enjoyed your reasoning.

Steven Barnes said...

Marty: re smokers. No, I'd expect that post UHC, smoking rates would decline more than the same percentage reduction in Non-UHC countries with similar demographics. Whether it would be lower overall can relate to other social factors. But isn't this conversation fun?

Steven Barnes said...

Saskplanner--

I appreciate your input, but ask you to stop the name-calling. This blog is SPECIFICALLY intended to allow people of different beliefs and positions to express themselves without being attacked. I'm sure your intentions were positive, and would thank you kindly if your language is the same.

Steven Barnes said...

Relation between UHC and accidents: stress and lack of sleep are, to my knowledge, major factors in accidents. Stress relieve and deeper rest (as well as a clearer understanding of the risks of sleep deprevation) are both things that can be, and are taught to those with access to the information.

Steven Barnes said...

Marty--

The reason to get the government involved is that I've seen it to work in many other countries, and I've lost my trust of Insurance companies, unless they have serious competition. THAT, I believe, will keep them honest. I've simply watched too many claim denials, rate hikes, and rejection of policies to believe they will reform without a gun to their heads. Also...why should I pay an executive a billion dollars a year?

Marty S said...

Shady Grady: I'm not sure what you mean by the results are no good. If you get the same health care plan and the same doctors with two plans I don't see why the medical results should be any worse one way or the other. On the other hand if you go public, end up with zero completion, which allows you to dictate drug prices, then comes the question do you have less incentive to develop new drugs and end up with worse health care. Life Expectancy has jumped in the last fifty years world wide. Will it continue to rise if the U.S. drug market goes down the tube. One question Steve asked was how many advances came from the U.S. but another aspect is how much has the ability to sell at a good price in the U.S driven foreign as well as U.S. research. One thing I've noticed in this debate is the ability of both sides to 1) cherry pick data to support their side and 2) to interpret the same data to support their side.

Mike Ralls said...

Sweeping generalizations about race are tricky, but I beleive my statements were all backed up by data, logic, and reasoning. If anyone sees a flaw in them I'm more than willing to listen. In fact, that's the whole point. One puts one thoughts out in the open so that others can point out flaws, and one can adjust one's thinking if necessary. That's how one learns and grows.

Marty S said...

In my search for information on medical comparisons between the U.S. and Canada I came across this interesting document.

http://www.strokesurvivors.ca/professionals/documents/FINAL_News_Release_English_091208.pdf

Note this is a Canadian organization, no axe to grind in our health care debate and published in September before the debate started.

Lynn Gazis-Sax said...

If anyone sees a flaw in them I'm more than willing to listen.

Well, the main thing I'd note is that there's a broad range in between "don't think about blacks much at all" and "would be willing to marry someone who's black." Strom Thurmond, for instance, wasn't willing to marry the mother of his first child, but he wasn't exactly indifferent to blacks.

I'd agree that white people on average think about black people a whole lot less than black people think about white people, and that a lot of what looks from the black side like active prejudice against black people may from the white side look more like obliviousness, ignorance, and indifference. But at the same time, I think there are enough white people paying attention to race for negative prejudices to have significant influence on attitudes toward social programs.

The other thing that strikes me, though, about Steve's list ("murder, obesity, hypertension"), is that I can see where if you just look at the racial differences one at a time, it's easier not to see the social safety net as being a significant factor (well, at least if you leave out the murder rate - I have trouble imagining a benign way of not seeing that as tied to social conditions). For instance, hypertension's a condition with both a biological and a lifestyle component; if you just take it by itself, it's not that obvious that a racial difference might not be (like the fact that blue-eyed people are more prone to macular degeneration when they get old) genetic. It's only when you look at the whole picture that it starts to look increasingly unlikely that differences in black and white lifespans in this country aren't strongly related to safety net issues. So to some extent indifference could lead in the same direction as active prejudice, here.

Shady_Grady said...

Hi Marty.
I didn't think you would necessarily agree but I was just trying to explain why just getting to 100% health coverage was not the Holy Grail to many people.

If you think that health care should not be a for profit business then reforms that don't challenge that basic assumption will leave some people on the Left (not all by any means) less than happy.

Most people don't care about that. But what they do care about is whether or not they have coverage or can get coverage and what it costs. If a reform passes and the 47 million people without health coverage are able to get it but have to pay a pretty penny, or have to pay more than they would with a "public option", and still can't afford it, then 100% coverage doesn't really solve their problem. There are and will be tremendous arguments over what the baseline insurance package would include. Again, if the public option is neutered or the government is unable to get a handle on pharmaceutical costs, "reform" will have been much ado about nothing according to this POV.

I know you don't agree with much of that but that is what some people are worried about.

Steven Barnes said...

By the way--I wouldn't want the ONLY insurance to be the government, either. I just believe that the Insurance companies' primary responsibility is to make a profit, and I've seen them perfectly willing to hurt people to do it. I'm sick of it. And I don't care if they can't pay executives a billion dollars a year any more, I really don't.

Steven Barnes said...

What is wrong with any American citizen being able to buy into Medicare for cost plus 10%?

Marty S said...

Steve: There needs to be a solution that makes some form of health care available to those who don't have any. But it must be done in such away that we don't end up with one national insurer. We all know pure capitalism doesn't work. That's why we have anti-monopoly laws. My position is that a government monopoly of something like health care is no better than private monopoly. The profit motive is often cited as important to the development of new drugs and other medical advances but competition is also important. If a single government health entity is responsible for driving the development of new drugs the most likely approach will be a contract to one drug company which will try one approach. In a competitive market different researchers trying different approaches are more likely to come up with a better drug.

Marty S said...

Steve Perry: Your interpret that liberals are *for* and conservatives are *against* is self contradictory since it demonstrates that liberal are against conservatism. But on honestly discussing the the issue liberals tend to be for more radical change and conservatives for slower more gradual change. Being at either end of the scale is bad. Since we are so wrapped up in the subject of health these days lets look at an example in that area. Examine the question of when a new drug is developed how soon does it get released to the public. If the government made no regulations it would get released immediately. Sometimes this would result in good things for people who are helped by drug receiving it earlier, and sometimes it would result in a lot of harm from undiscovered side effects. On the other hand too onerous requirements for releasing a drug, will delay it getting to people who need it and in some cases discourage their development. So moderation in both liberalism and conservatism is needed.

Travis said...

It seems like liberals ought to be AGAINST bigger governmental programs if they are "• favorable to or respectful of individual rights and freedoms : liberal citizenship laws.
• (in a political context) favoring maximum individual liberty in political and social reform"

Clearly that's not the case.

I fundamental tenet of my beliefs about government is that I don't want it to try and be 'dad'. I don't really want a government that tries to be my moral guide. I don't want a government that cooks me dinner. I want a government that provides a basically fair legal system and , figuratively speaking, keeps the barbarians outside the gates.

And I think that's pretty much what the 'founding fathers' wanted to when they wrote the Constitution.

But hey, I know that's not what we have or what we're going to get.

Dan Moran said...

Marty,

If one exams the life expectancy at age 65 the U.S. actually has higher
life expectancy numbers than UHC countries like Canada and the UK.


Not surprising to me. That's the age at which the American population receives UHC ... Medicare.

Obama has been catching a lot of flack from the left for backing off from the "public option". My question is if two health care reform packages both result in 100% coverage one public and one not then why should it matter to the left which way its done.

I'm not clear Obama has backed off; if he has, he's not going to get a bill passed.

I'm genuinely baffled why he's bothering to deal with Republicans, unless it's purely for appearances so that he can blame them later (might be) ... everyone knows that there's no conceivable bill that any but a few Republicans are going to vote for. He might as well do a good bill as a bad one, in that scenario.

It doesn't matter much to me how UHC is reached, as long as it's, 1, Universal, and 2, does something to restrain costs. I see how the public option does both; I don't see how anything else being discussed does either. (Short of single payer, which is where Obama should have started this negotiation.)

Marty S said...

Dan,
Its that last bit about cutting costs that bothers me. While there may not be "death panels" by name in the health care bills there is a panel to decide efficacy of potential medical and drug research programs, in the name of cost cutting. If a that panel decides that researching a drug that will help seniors live longer is less efficacious than researching a drug that will help younger people then that panel is making life and death decisions. I would prefer a for profit system where both drugs are pursued and that's why I want a solution that keeps the federal government out of making those kind of decisions. By the way medicare allows for the sale of private supplemental insurance which plays a substantial role in the health statistics for seniors and the fact that the government doesn't control the whole health industry means that private companies are still making the decisions on what medical advances to pursue. Finally, medicare as currently run is too expensive, who is to say how happy people will be with it or how their life expectancy will be affected by cost cutting efforts in medicare.

Lynn Gazis-Sax said...

By the way medicare allows for the sale of private supplemental insurance which plays a substantial role in the health statistics for seniors

Well, personally, as a liberal, I'd be strongly opposed to any government health insurance that didn't either, a) compete in a free market with private alternatives (as would be the case for the "public option" that currently looks likely to pass the House of Representatives, be dropped by the Senate, and then get debated in whatever committee reconciles the two bills) or b) allow people to buy private supplemental insurance (as is the case with Medicare). But I don't see that kind of complete shutting out of the private market as likely to happen in this country. Even a single payer system, which I can't imagine happening any time soon, would likely allow for supplemental insurance in the same way that Medicare does.

Shady_Grady said...

Marty, would you agree that private insurance bureaucrats are already making life and death decisions on who gets care and how much if any the private company will pay for care?

Dan Moran said...

Man, the death panels thing has legs.

Marty, we have death panels now; they're private insurance companies, and they operate without oversight or conscience.

If a that panel decides that researching a drug that will help seniors live longer is less efficacious than researching a drug that will help younger people then that panel is making life and death decisions.

Far as I know, no one's even discussing such a step.

Marty S said...

On the subject of racial intermingling, I wonder if there is difference in generations. As a statistician I know that drawing conclusions from a single non-random sample is dangerous. But yesterday was my younger son's wedding and leaving aside family the wedding was attended by eight friends of my wife and I, all white and thirteen friends of my son and the bride nine white and four black.

Nicholas said...

We need the Public Option. We need UHC. This is particularly true if you are a minority. We NEED to close the gap on a lot of these health disparities, disparities that to my knowledge are not as pronounced in countries with UHC.

We also have to realize that everyday 1,000 people wake up in Middle America and realize, really REALIZE that the PRESIDENT is BLACK. No more shock, no more denial. And that apprehensive/negative energy has to be directed somewhere...and its been showing up at Town Halls.