Archive for July, 2007

As a PO I work with the underclass and I keep wondering what I can do to help, given the fact that the clients have so few resources. As a parent and grandparent I worry that my own kids will become victims of the system.

Michael Moore’s latest contribution to the national dialog had been playing for more than a week, and I already knew what to expect based on Moore’s previous works. I was prepared for the usual contrived stunts, confrontations with “bad guys,” love fests with “good guys,” black/white interpretations of complex issues. Add to that my disillusionment with Moore himself, who, like so many of us, in or out of the public spotlight, is less of a hero than he seems. He can be mean to others, disingenuous, coldly self-serving … yeah, just like the rest of us. It’s just that we expect more of our social philosophers.  

 The legislative point-counterpoint of the healthcare system debate had already begun at the state level, and media pundits were yammering about those events. I figured Moore’s point had passed its tipping moment ahead of Sicko’s release, rendering it redundant. So I admit, I almost didn’t go see Sicko.  

The earliest showing of Sicko played to a nearly-empty room at the local multiplex. Everyone was gearing up for the 4^th of July activities that would likely put them in need of medical services – greasy food, mayo left out in the heat too long, excessive alcohol coupled with driving, and beer-besotted hands lighting explosive devices with uncertain fuse-times. Seeing Sicko the day before all that fun would be major buzz-kill. 

And so it began. The egregious behavior of Humana and Kaiser Permanente … yada yada. The Congresscritter cost-per-head paid by Big Pharma (or was it Big Insurance?) in campaign donations (or were those figures lobbying fees?). Yada, and again, yada. The instant irritation of hearing the voices of Nixon and Haldemann approving Kaiser Permanente’s purpose of “deny medical care.” Fingernails-on-the-blackboard yada, but still yada. HMO employees, from first-line call center staff weeping as they described the heart-hardening process, to director-level MDs blowing whistles and quitting. Canadians who won’t come to the US without additional health insurance to cover them in the states. US citizens who fake Canadian residence to get necessary life-saving cancer treatments that their for-profit HMOs deem experimental or somehow not warranted. Yada yada yada.  The irritating stats piled up along with the human interest stories. We’re ranked 37^th in healthcare effectiveness in the world, as insurance companies doubled and tripled their profits and paid four times as many healthcare lobbyists as there are members of Congress. The Canadians, British, and French have better health and longevity than we do. And their doctors are paid quite well. One doctor said, “The better we do for our patients, the more we get paid,” for things like getting patients to stop smoking, lower their blood pressure and have regular health screenings.   Many other nations demonstrate the principle that our HMOs preach but don’t believe – it really is more efficient to maintain a populace’s health than treat disease later in the game. The “dangers” of socialized medicine that our health “care” system profiteers blind us with the very circumstances into which those profiteers trap us in their own system.

The arguments for the democratic nature of universal healthcare voiced by the British MP whom Moore interviewed are the single most rationally persuasive element of the documentary – contrary to what current conservative cognoscenti would have you believe.  Speaking of our general hoodwinking by the media propaganda machine, consider this reality-check. The French work a 35-hour week, get a minimum five weeks of vacation, and have a higher productivity rate the USA’s. While being healthier. While the USA is laying people off and productivity is flattening. 

Oh, I embraced all the supporting metrics. I intellectualized my outrage at the personal stories of American citizens whose financial security had been destroyed by medical costs for which their insurance companies refused to pay, in full cynical knowledge that their customers would be dead of their illnesses before they could complete the appeals process. My mental spreadsheet and logic calculator applauded the observations that we adopt other countries’ best ideas all the time, so why not the universal healthcare principle and the practices demonstrated to be effective. I expanded that calculation, along with Moore’s logic, to all the other debt shackles marketed aggressively to consumers, steeping us in debt that keeps us afraid to “step out of line,” keeps us hog-tied in the contortions required to be a “good employee” as our employers enrich the CEOs while shortchanging their stockholders as well as us.  My brain was clicking along, adding up the statistics, working the logic, on the one hand, and tallying Moore’s contrived scenarios with American expats in Paris and medically-disenfranchised American “boat people” in a flotilla to Cuba. I was pretty miffed that Moore provided no statement in a voice-over or bottom-of-the-screen text-crawl about the preliminary accords he had to engineer with the government of Cuba to get onto the streets of Havana, talk to the people on the street, and “wander” into the hospital with a camera crew and a bunch of sick foreigners. I viewed that “typical Cuban hospital” vignette with a heavy dose of skepticism. 

Then I felt water falling down my face and knew it wasn’t the fire sprinkler system leaking. Documentaries don’t usually make me cry. The tough old veterans behind me choked back a few sniffles themselves. What the hell were these tears about?  Not the stats. Not the (admittedly wrenching) personal stories of the Americans denied needed treatments. Not the growing envy of the French lifestyle, nor the exploding anger at the (not new by any means) ways in which our government and its corporate puppet masters use the media to turn us into consumer target-markets instead of informed citizens. It was the female Ground Zero first-responder from New York who spoke fluent Spanish (now that her Cuban doctor had given her the nickel-apiece inhalers that let her breathe again) telling the burly guys of the NYPD and NYFD quietly, “It’s okay to hug your brothers” – the Havana Fire Department members who stood saluting them, telling them—in English—that all rescue-workers are one family all over the world.  And they are. And so are we all, whatever we work at and give our best to.  

 Our governments must, as others successfully do, invest the capital of our tax dollars in the human capital that is us. We get the government we deserve, and we deserve better. For decades, we’ve allowed our governments to underfund public education, which creates the bedrock of democracy – an informed and critically-thinking citizenry. We’ve become a “healthcare market” instead of, well, just citizens whose health is important enough to the nation to figure out a fair and respectful way to maintain it. I’m not talking about overall socialism. I’m talking about sufficiently enlightened national self-interest (a solidly capitalist principle) to recognize that a healthy populace is necessary for a healthy national economy in all aspects.  I’m not some wide-eyed idealist here. I know that universal healthcare as practiced elsewhere is, as in the U.S., a system of allocating limited resources. Somebody has to wait for something some of the time. I’d just prefer that it be the guy with the cough but no fever waiting 45 minutes (the longest wait reported in one of those scary “socialist” countries), and the kid who’s unconscious, turning blue, and spiking a fever of 104 getting antibiotics right away, at the closest hospital, not being shooed away across town by car-not-ambulance to a hospital that does take his mom’s insurance … and arriving there DOA. (As in one of the first stories in Sicko.) See, it’s a different kind of triage. Treat the sickest first and everybody else promptly. Not, “wrong insurance, get outta here.”   

This is 2007, not 1948 when Great Britain first decided that universal healthcare was the way to go in the best interest of national security and overall health. Best practices have been established and proven for universal healthcare in several western nations. There are workable models out there to follow. It’s management science (even “Dubya” got a masters degree in it), not rocket science.   Worry less about changing management from our current broken system to one that works. Worry less about what “transitional” sops Congress tells we might have to throw to the industries that haven’t thrown any to us (“us” being you and me, not the Congresscoffers to which huge contributions have been made). Those industries have thrown our lives into chaos already and have done so for far too long – laid off the “us” who are their employees, transferred offshore the claims calls of the “us” who are their customers, disappointed us, disheartened us, disenfranchised us, cheated us (including the “us” who are their stockholders). Killed too many of us.  You know what? I’m not afraid of putting a few overstuffed CEOs out of work. They can sell their spare yacht—the one they keep in the Mediterranean—to pay for their own health insurance until the universal system is in place.

No, wait. What am I thinking? They’ll sell the yacht and the mansion(s) here, move onto the Mediterranean yacht, become French citizens, and get universal health insurance there right away. Keep their money in Swiss or Cayman Islands accounts, same as they do now, so no tax worries. Maybe buy a nice water-view place on the palisades of Portofino, and keep the little condo in Manhattan for theatre season and the occasional Yankees game. These are smart guys. They’ll be okay. It’s time we citizens took care of “us.” Let this revolution begin. The first shots have been fired in the battles of San Francisco and Massachusetts. Much suing and countersuing will surely ensue. But we’ve got to start somewhere.  Go. See. Think (critically). Engage. 

I hate to sound snobby, I really do. I hate to sound “entitled.” I hate to sound classist and “intellectual elite.” I hate to sound like I prefer more sophisticated spices to “salt of the earth.” I come from generations of blue-collar workers and entrepreneurs whose fondest dream was to college educate my generation. They got their dream.

Sadly, my generation is losing the same dream. The only things I hate worse than sounding snobby is to see people whose intellectual capabilities make them the bedrock of American excellence in every field, people who have sacrificed many hours of their youth and early adulthood to study, people who have used their educations to figure out complexities that make technological conveniences easy for the masses to enjoy – those people – reduced to beggary.

The continuing outsourcing of knowledge-work occupations to countries with far lower costs of living and therefore lower salaries for professional workers is lowering both the job security and perceived value of college-educated professionals. Welcome to the economy of 2007.

Today’s “Working” section headline in my local newspaper read “Top dollars for blue collars.” The article was crisply written and highly informative and sported a picture of a hard-hatted guy working high up in a steel structure. After appreciating those qualities, and wondering why the picture took up more space than the text, I turned it over to the cat to shred before his periodic claw-trimming. “Knock yourself out!” I encouraged him. And he did. I smiled. Then I vacuumed.

I got over the smiling, however, and turn now to serious consideration. The article cites the Bureau of Labor Statistics and CareerBuilder.com as the source for a list of the 10 most quickly growing blue-collar jobs, their median wages and expected growth through 2014. These jobs, states the article, are projected to grow at a rate of 9 percent to 26 percent. Most of the occupations are in construction-related industries or home- and industrial-equipment maintenance. Their highest annual income is $58,718, but most were in the low- to mid-$40,000’s. Okay. These are just the fastest-growing blue-collar jobs, and the article makes no mention of how they stack up against the 10 fastest-growing white-collar jobs. Facts are facts, but predictions are iffy (lies, damn lies, and statistics). My blood pressure returns to its usual range.

But the reporter’s analysis was chilling: Since “there are plenty of blue-collar jobs that technology and overseas labor just can’t mess with” if you’re a blue-collar worker you’ll be happy to “see another trend here, as well: You don’t have to earn a college degree to make a good living.” I figured the reporter earns what local newspaper reporters earn—those lucky ones who haven’t been laid off in Los Angeles and Philadelphia and elsewhere—so maybe to her mid-$40,000’s is a “good living.” Reporters have deadlines and space limitations that sometimes preclude giving the full context for the irresistibly pithy conclusion. But I found my irritation growing at the roughly 5-by-10 inch real estate occupied by the picture. Did this imply that the editor simply had too much space to fill – or that he thought blue-collar types liked pictures better than text they had to actually read? My snobby, classist self had to investigate that minimalist text further.

Even if the reporter’s conclusion is right—and I agree that blue-collar workers are absolutely deserving of a good living—the implication is that those are the only occupations not likely to be outsourced, and white-collar types had better go take a few courses in masonry and electronics repair. Let the fact-checking begin!

• -The Bureau of Labor Statistics “2000-2014 Employment Projections,” it turns out, was last modified in December, 2005, and provides more balance than the reporter’s simplistic conclusion. The information behind the not-exactly-breaking news-bite is this:

• -An associate or bachelor’s degree is the most significant source of postsecondary education or training for 6 of the 10 fastest growing occupations.
• -In the blue-collar realm of occupational employment, construction employment is projected to grow, but at a slower pace than during the previous decade (1994-2004). Manufacturing employment, is expected to decline by 5 percent, lower than the 16 percent decline of the previous decade. Employment in goods-producing industries is expected to decrease from 15 percent to 13 percent of total employment.
• -Professional and related occupations and service occupations—two groups on opposite ends of the educational and earnings ranges—are projected to add the most jobs, accounting for 6 out of 10 new jobs created over the 2004-14 period.
• -The 10 detailed industries with the largest wage and salary employment growth, led by employment services, local government education, and offices of physicians, are in the service-providing sector.

So let’s revise that news headline to reflect the broader facts and projections: “Near-future job security best in hands-on, people-to-people service industries.” Go study something medical, my white-collar friends. The Baby Boomers are aging, and we’ll need our meds to stay healthy enough keep working because we can’t afford to retire.

Informed by the full perspective, I apologize for the hype of my own headline. America is not really dumbing down to become a blue-collar nation – or not by any greater preponderance than we always have been. The broad swath of the bell curve of our labor force has always been in blue-collar industries, and they’ve had the sense to organize into bargaining units. And that isn’t dumb at all.