Thursday, August 30, 2018

humans as trash.

I heard a story of an immigrant that, in his own words, "was born trash, lived as trash, and will be thrown in the trash at his death"  He spent his life picking through the trash for food and clothes and to find things he could sell.  The journalist he was talking to was asking him if he could talk to him and maybe take photos, and he seemed shocked that someone would talk to him about his life.
He agreed to cooperate, because those anonymous words by that journalist would be the only proof the world would have that he had lived.
Listening to them tell the story (NPR, I don't remember more, because it had me choking on tears in the driveway.)

I'm not an easy crier.

That story made me aware of the number of people that see themselves as nothing.  They are hopeless.  They have no one that cares if they live or die.  No one thanking god for them.

And, they are invisible most of the time.

The thing most of them have in common is they are poor and powerless.

Most countries turn a blind eye to the poor.  They are like cracks in the sidewalk---expected but not important.

Syria currently has an over 80% poverty rate.  Their most recent GDP places them at 66th place.
The USA has a rate of 15%, falling between Tunisia and Sweden and tying with Belgium.
The USA has the highest GDP in the world.
Tunisia's GDP is 84th.
Sweden's GDP is 23rd and Belgium is 26th.

That was by Gross Domestic Product.
If you use the Gross Domestic Product per capita, things change a bit.
At that point, the USA is the 11th ($59,532 per capita), Belgium was 19th ($47,561 per capita), Sweden was 18th ($50,070 per capita)and Tunisia was 96th ($11,911 per capita).

That means that Qatar http://www.borgenmagazine.com/the-qatar-poverty-rate/, Luxembourg https://borgenproject.org/luxembourg-poverty-rate/, Singapore https://borgenproject.org/poverty-singapore/, Macau https://borgenproject.org/poverty-in-macau/, Hong Kong https://borgenproject.org/poverty-rate-in-hong-kong/, Brunei https://borgenproject.org/poverty-in-brunei/, Ireland https://borgenproject.org/poverty-in-ireland/, United Arab Emirate https://borgenproject.org/poverty-in-the-united-arab-emirates/, Kuwait https://borgenproject.org/poverty-in-kuwait/, Switzerland https://borgenproject.org/7-facts-poverty-switzerland/, San Merino https://borgenproject.org/poverty-san-marino/ and Norwayhttps://borgenproject.org/look-poverty-norway/ all had a higher GDP per capita than the United States.

So highest GDP, not highest GDP per capital in the USA.  And higher GDP per capita is related more to the number of very rich people than the amount the average person is making or the number of poor people in the country.
The USA has 15% poverty rate.
That means that fifteen of every hundred of our people is invisible and powerless.
One thing that is always true in every country and in every time; children and the elderly are always the most vulnerable poor.
About 49% of babies born into poverty will remain poor throughout their lives. So 7 of every 100 people born in the United States are born invisible and powerless, born throw-a-ways, born trash.

When I was a little girl, my grandmother, who considered cats to be nasty but necessary around a farm told about when she was small, "younger than I was" is what she said, her parent told her to put the latest batch of kittens in a burlap bag and take them out to the pond and throw it in.
She didn't want to, but a "switch" convinced her.  She handled her farm cat population herself until she was in her 80's, when she developed a most surprising attachment to her barn cats, letting them not only take over her buildings, but feeding them scraps daily.  She was dismayed when they all disappeared on week. The cougar paw prints and screams explained that, but what was shocking was---"she was dismayed" at the loss of the kittens.  Suddenly they weren't nasty creatures with no reason to live, they had value to her.

Maybe they just stopped being invisible to her.

How do we start seeing that 15% of our population as people like us, deserving of our empathy and compassion.

How do we stop treating 15% of our population like rubbish?

How do we make them visible, empowered, worthy of a decent life?

I am personally fond of the idea of getting rid of actual poverty--change our taxation system to a leveling system, so that no one pays taxes on the amount of money that is considered poverty level.  And we need to make sure that the poverty level is based on real numbers per geographic regions.  Our Federal poverty number is $12,140 and $4,180 for each additional family member.  Obviously that amount is more likely to work in some areas than others.  I realize that places like Beverly HIlls and Fifth Avenue cost a lot, as much to keep out the poor as to make a living.  Rich people like to only see rich people.  

Maybe that is how the poor became invisible in the first place.

But we need to make getting rid of poverty a goal for our country instead of just trying to hide our poor.

No more homelessness.
No more Hunger.
No more lack of healthcare--including mental health and addiction treatment.
No more lack of educational opportunity from lack of funds.
And we need jobs that allow all to contribute to society with their time and efforts, not like a punishment, but like a recognition that most people want to participate, to contribute, to be partners in our country.

No one's future should be determined by their accident of birth circumstances.
No old people should find themselves choosing between rent, food, and medicine.

Life is never trash.







Friday, August 24, 2018

medicare for all

Not just current medicare, but a no deductible, minimal copay, everyone gets meds and everyone can schedule an appointment at a Drs. office. No more EMTALA as the only human safety net.  No more of Dr.s and pharmacy's, etc., trying to find ways to get more from the people with good coverage while trying to avoid taking patients with poor payor sources like Medicaid and the local jails.

Medicare-for-all has become a battle cry for many of us.

I don't care what we call it, as long as it takes all the profit out of healthcare and makes sure every single person has the ability to receive the same healthcare as a person with excellent insurance.

The arguments against it include:

"My taxes should not pay for other peoples health issues" (who, exactly, do you think is paying for the care provided in emergency rooms, hospitals, ambulances, nursing homes, etc, for those patient's without insurance/jobs/money?)

"My taxes should not pay for the poor life choices of crackheads and junkies and lazy bums"
 1. I'm pretty sure my taxes have paid for some poor life choices of rich people, bank bailouts, failing automobile manufacturers, infrastructure prettiness in the expensive zipcodes of my city, and
2. my taxes are paying for their incarceration, and for the increased policing where they are hanging out, why not invest that in drug treatment, mental health care, affordable housing, life choices and coping education when young, especially in areas hit by poverty and job retraining programs that are easy to access as opposed to the current federal goldmining system in which career colleges get loans for people in fields in which there are no opportunities , that will never pay well, and then we ruin their credit for life since there is no loan forgiveness for education loans--not even bankruptcy.

"If your job doesn't provide good insurance, get a better job"  (ok, so either require every employer of even one person,no matter how part time, to provide insurance, with those making too little to live (less than 15$ an hour) having no part of the payment, or what?  Do we quit having cosmetologists, and wait staff, and dishwashers, taxi drivers and carnies?  They have jobs.  They just don't get insurance with them. )
This side of the argument is all from the idea that anyone with worse insurance or no insurance can only blame themselves and therefore need to die. (apparently in an ER)

The truth is, they do die, but not quickly or cheaply.

They may not be able to get any mental health treatment or chemical dependency treatment or chronic illness treatment or other basic preventative medicine screenings, but the law is, when it is bad enough, they can go to the Emergency room and get full service---if what they have wrong can cause death, dismemberment, if it isn't treated.
Many (not all, there are good, conservative ER Docs that do the mandatory medical exam and tell them they need to see a doctor but that they are not in danger of death or permanent disability from their complaint.--they can't see any other doctor which is why they went to the ER in the first place) but many of the ER doctors take their Hippocratic oath seriously enough and get that the people really can't go anywhere else, thus send them out with a prescription and suggestions for future good health.  Most of them can't fill the prescription, though.  Pharmacies have no requirement to give drugs to people without money.

The flip side (sides) of the "no universal healthcare" argument is:
"Without competition, no one will do new research" (that is the reason that there are so few drugs and treatments for orphan diseases, no big money so, no! money isn't the motivator.  But what if we had researchers that were trying to find cures, trying to make scientific breakthroughs, trying to save the world and NOT DEPENDENT on the money the drug companies give them.  There is a reason we have many treatments for erectile dysfunction, baldness, short eyelashes, and wrinkles but few treatments for neurofibromatosis, progressive supranuclear palsy, leukodystropies.  We also need to do more research into causes and preventions for chronic illnesses instead of just making more "bread and butter" treatments that patients take their whole lives till they die.  Soooo, as long as competition in this country is measured by dollars, only money items get researched.  More people want it, more research.  More rich people want it, Big Research.
"rich people from other countries come here for healthcare so they won't have to wait or risk being turned down for their treatment"  (I guess that is also why rich people here go to other countries for treatment they can't get here, rich people all over do whatever they want, and after we all have healthcare available without having to fear dying of a simple infection or a treatable chronic illness, the rich people will still be able to find doctors--US doctors, doctors in other nations, that will do whatever they want.  John Doe the homeless guy can get his insulin and his foot care and it won't hurt the Forbes 400's healthcare one bit.  They can go where ever they want, or hire their own, private, fulltime physician that only cares for them.  (reminds me of the old royal poop examiner)
"But we won't have the best healthcare system after we have universal healthcare, medicare-for-all, call it what you will"
https://www.numbeo.com/health-care/rankings_by_country.jsp
There are bunches of sources regarding quality of healthcare by country.  The USA is at about the 30th position every time, EXCEPT by COST of healthcare.  WE pay more than any other country.
Apparently paying multiple insurance CEO's millions and insurance marketers commissions and multiple Pharmacy CEO's millions and drug rep's commissions and Dr.'s educational cruises and ski trips and expensive dinners to use those drugs on their patients, really increases money in healthcare.
We have Medicaid being applied like an HMO, with physicians getting paid monthly for providing care for a certain number of patients (capitation) and then, since it pays less than other insurance, they arrange for a set number of available appointments for those Medicaid patient's and when that number has been reached, they tell the patient to go to the Emergency room.  Poor people going to a Doctors office by appointment instead of waiting till it's nearly too late and going to the ER and on to the ICU then dying is much more economical.  IF you consider that healthcare providers are physicians, nurses, therapists, pharmacists and technicians, then the huge numbers of people making a living off those people's work is basically padding the bill.

So, in truth, those that sing the chorus against universal healthcare, are just being gullible.

If the used car salesman told them that blacksmoke coming out the tailpipe was because it was so new the paint was still burning off, you wouldn't believe them (I hope).
If your child's teacher told you that it has been proven that children shouldn't be taught to read before age 16, when you asked why your 7 year old couldn't read, you WOULD seek other information.
So why, when those people making craploads of money off our nations healthcare problems tell you universal healthcare is bad, do you not even question their motivation.

The insurance companies do not want universal healthcare, it will likely put most of them out of business.
The pharmaceutical companies do not want universal healthcare, it will make them have to charge prices competitive with what other nations, those with universal healthcare, already pay for drugs.

The Physicians are split on it, some are fine with it, it fits their view of caring for people, others don't want it, it will decrease some of those insurance and pharmaceutical perks used in marketing.  It will make them follow the evidence based practice guidelines so they can't do more invasive tests than are frankly good for a patient or required for diagnosis and treatment.

But employers should want it, it is good for employees to have access to healthcare that is not tied to their own ability to make some high-volume purchase.  (that is why small businesses have problems, they don't get the high volume lowered price)

It will be great for emergency rooms and ambulances, they will be back to treating emergencies.
It will be great for poor people and addicted people and chronically ill people and people under 65 that want to retire but couldn't get affordable care till 65.
And, it will eliminate the need for states to provide Medicaid for their poor and disabled.

There is a reason that access to healthcare is a human right.  It is as necessary to life, liberty and the pursuit of happiness as all of our rights are per the Bill of Rights.  It's our ability to choose life over death, life over disease, life over dysfunction.

Why are we even having this discussion.

To your health!



Monday, August 6, 2018

Remember that moment...

When you first realized that all that elementary school history and civics lessons were basically propaganda?

When I was a child, I had the history of thanksgiving and George Washington and Abraham Lincoln and the flag.

Those were tied to holidays in 1st,2nd,3rd, and 4th grade--every single year.  We made a turkey and colored it, cut out pilgrams, talked about the first thanksgiving and how the pilgrams came for religious freedom.  We cut out hearts and glued the faces of Washington and Lincoln in them, talked about how brave they were. Talked about Washington's false teeth and cutting down a cherry tree and never telling a lie and Lincoln being born in a log cabin--which is why our Lincoln Logs are called Lincoln Logs. Talked about Betsy Ross and the flag and the stars are for the current states and the stripes are for the original 13 colonies.

Four years of that, no further details.  Each event pretty isolated and unattached to everything else.

In fifth grade, (And 6th, 7th, 8th, 10th, 11th) we had history ( in 9th grade we had a semester of Oklahoma history, starting with the dinosaurs and ending with statehood, and Civics, "how a bill becomes a law" but before the songwriter made it a catchy tune):  U.S. history, starting with the European explorers discovering America while seeking a faster route to India and China so they could NOT go over the mountains that separated Europe from Asia, and so they could NOT go all the way down and around the Cape of Good Hope at the southern tip of Africa.

Someone decided that the Earth was a sphere, and we could go straight west to reach the Far East.  This, according to our history books was Columbus, although the theory was accepted in Ancient Greece by the 6th century BC.

Sometimes, the Church is not the best thing for  the progression of basic science and math.

We learned about all the explorers reaping the Gold of the Aztecs and Incas and Mayans. (And what savages they were, how backward, easier to take from bad people) We learned that Columbus called the people "Indians" because he thought he had reached India. We eventually learned that Ponce de Leon went through the swamps that would become Florida in search of the "Fountain of youth" and conquistadors went through Oklahoma in search of Cibola--the 7 cities of gold.  We learned that fur traders went across the top of North America and that explorers sought a "northwest passage" so the fur traders could get the furs out faster.  We learned about Pocahontas, though the story was not so embellished as Disney's, it was also not very clear about why this young woman married some man she barely knew. 

Then we had the revolution and the War of 1812 and the civil war, then the school year ended.

Every year, we finished just at the end of the Civil war.

We memorized names and dates and places.

The only thing we learned with great assurance was that the United States was the greatest Nation that had ever existed.

Everyone hated history.

Except for the art and construction paper.

I had to take a US history class in college, so I took post-civil war, since I had never gone that far before.  It was a bit meatier, but still heavy on the names and dates and places.  It was all about wars and politics and economics and not at all about the people that actually lived or died in those wars or politics or economics.

While this class did discuss some corruption, it was not focused on except as aberrations but rather on specific "bosses" that sounded like crime syndicates had gotten themselves elected to positions of power.

Then, I took a few electives in history.  Wonderful stuff.  Where every single individual that lived in a period is part of that history.  History is alive, its our story, our ancestor's stories and is happening as I type.

I read some books, and discovered that history is all about perspective.  I talked to some people that lived through some well known events, the co-worker that was hiding behind a large rock with bullets and bottles flying while attending Kent State.  She was not protesting.  She was going to a class. The co-worker that drove to Wounded Knee to deliver a collection of weapons and food stuffs, my father, who was in WWII, and saw no battle, only German and Italian prisoners-of-war in a camp in Louisiana.  (what? we didn't have prisoners-of war, I never heard a word about that!)

I was on a roll.

Talk to people, talk to grandma about the depression.  Talk to Daddy about the KKK.  Talk to mom about being a war bride, the PSO's, the hose and leg shaving and tanning.

Talk to strangers.  Talk to strangers about whatever.  Listen.

And start to hear what the history books didn't include.
Stories about the Indian Schools, the blankets we gave away--infected with smallpox--on purpose or by accident, the stories about land-grabs when oil became a valuable commodity.  Homesteaders with little, losing everything to rich ranchers that paid the sheriff to move them on.
The twists of history brought on by women, long relegated to powerlessness, so long that all they could focus on was getting the vote and making their man quit drinking.  Such low goals set.  The second backfired so badly.
Prohibition, which just created a new opening for a giant criminal enterprise.  Yet, slow as we are, we repeat ourselves with criminalized drugs that are highly sought either for their effect or for their addictiveness. ( a great little pharmacy museum in New Orleans went over so much info about drug usage before government regulation--drug addicts are nothing new) If they try it with tobacco, the country will burn unless we learn to cure the addiction before making it illegal.

So, do you remember the moment that you started questioning whether this was really the greatest country that has ever existed.  Or perhaps the America we were all taught NEVER existed: only as An Ideal, A Myth.
It's a patriotic stance.
It's a loyal position.
But is it about reality?
Does it have anything to do with anything any of us have actually seen?

"History is written by victors"  doesn't have to be true.  When it was oral history, only those that survived could tell the tale.  Today, we have not just books but also audio tapes and video tapes and film and pictures.

We can see all the sides, from all the sides.
Instead of patriotic loyalty that does nothing but teach us lies, we can learn from our mistakes and become a better nation.

There is no single best country.  Every country that has a single person experience something horrifying could be improved.  Every horrible country that exists has nurtured someone that was needed in the future.

Instead of always comparing our country to other countries, using less then honest parameters to make ourselves look better, how about we only compare ourselves to ourselves--are we getting better for everyone, or are we losing ground.

We could always be our own best country.  Neither patriotism or loyalty will improve us.  We need great compassion and high goals for every single person.

We are all a part of history and every time we let a child fall through the cracks educationally, every time  we convict an innocent person, every time a poor person dies of a easily treatable disease, we are creating a history that some future historian will judge us all for.

Remember that.



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