Americana

Contrary to some people’s opinion, last time I checked I was still a card-carrying member of the Democratic Party.  (Well, OK, they don’t generally issue membership cards anymore.  But you get the sentiment.)  And, speaking as a Democrat, I want to say this:

We need health care reform immediately.  That is a given.  There is absolutely no reason why we should be in the position of having the most advanced health care network in the world yet have it be the least accessible.  The arguments of rationing health care, of a particular brand of natural selection, the fear that the government will tell Grandma she can’t have a life-saving surgery, they’re all blowing smoke up our collective bums.  The private sector already does that! Since deregulation in the 1970’s and 1980’s, we have been systematically and socially conditioned to fear the government and trust private interest.  Nowhere is this more despicable than in health care.  We are trusting our very lives to people whose sole interest is making such obscene amounts of money it is nothing less than criminal.

Last December, I went in for my annual physical.  I’m insured by Blue Cross Blue Shield of Illinois, part of the largest network of health insurance in the U.S.  While according to my policy preventative care is covered, BCBSIL informed me that particular visit was not.  They didn’t specify why, and when I even called they didn’t provide any rationale.  They simply told me the visit was not covered and now I needed to pay.

In January, I went in to the doctor again, this time because of a massive sinus infection coupled with strep throat.  (I don’t normally get sick, so when I am immobilized in pain, I know its time to go in.  Besides the fact that strep scares the living crap out of me.)  My insurance this time covered half the cost, though it was processed as being out-of-network.  Again, according to my policy, I was at an in-network facility, but BCBSIL justified it by saying that since I went to the urgent care operation — which, unbeknown to me, is outsourced to a different provider, even though it is in the same office — it was out-of-network and I was responsible for paying the higher coinsurance.

Question number one: What difference does it make who tells you no, rejects your claim, or creates the network?  Here are my examples, on the largest health care network in America, of experiencing just that.  Both of these instances were in large hospital systems.  Both of these instances were with the same insurance provider, the same individual.  So what difference does it make that BCBSIL told me no, but if a government administration tells me no, then somehow it is more obnoxious?

Here’s the second given: I don’t very much care how reform is accomplished.  There are some who are outraged over the past couple of days because the Obama Administration has been signaling it is ready to consider other alternatives to single-payer coverage (Medicaid).  Before I delve further into this, let me state for the record that yes, I do believe a universal health care system is the most long-term, sustainable, cost-effective, efficient solution.  I believe that it is an embarrassment that we don’t have this already.  It is yet another indication of how far behind the rest of the First World we are, even as we attempt to prop ourselves up as a global beacon.  But that all aside, the answer isn’t in who pays the bills, the answer is in how the system is governed and regulated.

And we return back to the late 1970’s, early 1980’s once again.  The mantra of the decade was Deregulate, Deregulate, Deregulate.  If we just deregulate everything, competition will flourish and the market will take care of everything.  Government oversight is unnecessary, an obstacle to trade, and generally harmful for business.  The individual is king, and will speak with her or his pocketbook.  If individuals want better health care, they can pay for it.  If individuals want better schools, they can pay for it.  If individuals want better products, they can pay for it.  Deregulation was good for jobs (more competition means more business means a greater workforce), deregulation was good for government (shifting the burden off government meant a trimmed budget and payroll, which meant fewer taxes and more liquidity in the economy), deregulation was good for individuals (more choice, more options).

Yeah, except that’s not exactly how it worked out.  You see, history has an awesome way of repeating itself.  Remember how the 1920’s lead to a Great Depression?  The stock market crashed because no one was paying attention.  No one thought they needed to pay attention — it wasn’t government’s role to oversee.  (And we had myriad more regulations then than 2007.)

Deregulation is not entirely bad.  I, for one, love Southwest Airlines and my cheap airfare.  Without deregulation, Southwest would still be prohibited to establish a hub in Illinois as they have done.  I do think we have too many airlines in general and the market is saturated, but that’s a discussion for a different time.  But when you fire the overseers, when you allow the market to dictate policy, you greatly expand the gap between the have-nothings and have-everythings.  And that is where we’re at with health care.

Private insurance carriers have no reason to cover everyone.  Why should they?  Its a drain on their resources.  Instead of making a $14 billion profit, they might be forced to make “only” a $10 billion profit — or worse yet, an $800 million profit.  That’s going to seriously cut into margins.  </sarcasm>  So, to protect their assets and financial position, private insurance says, “No, we won’t cover you because you have acne.”  Or if they are going to cover you, they’ll charge a severely increased premium so that it remains effectively out of reach.

If health care reform only accomplishes expanding the accessibility of health care, allowing more people to be covered with private insurance, bringing some controls and regulations back to the system that requires it to function in an ethical, responsible manner, I will die a happy person.  I will congratulate the Administration on a job well done.  More control and oversight is the Chevrolet solution instead of the Cadillac solution of single-payer.

I do not fear the government.  I may distrust it from time to time, I may disagree with Administrations that come and go, I may even exercise my Constitutional right to lodge my protest in a civil manner with my representatives whom I have elected, but I do not fear it.

I do fear people who make my life decisions without my interests in mind, but only the interest that my hard-earned money makes them.

We’re still receiving information about yesterday’s deadly crash on Washington, D.C.’s Metro system.  Having spent some time there (and almost relocating there a little less than a year ago), I’ve become familiar with the service, and a couple of things are coming up in my memory:

1. Every time I’ve ridden a Metro train, I’ve found it to be quiet and clean — a feature that is not shared by its Chicago brethren.
2. Almost every time I’ve ridden a Metro train, I couldn’t understand the train operator’s announcement of upcoming stations and I’ve had to be extra vigilant paying attention.

That’s what I remember the most; well, that and the cool blinking lights along the sides of the platforms that indicate a train is approaching.  (Last time I was there, though, it seemed like these have fallen into disrepair or are being phased out of use.  Its a pity.  I love unique things like that which add a certain intangible benefit to otherwise utilitarian aspects of civil engineering.)  My heart goes out to the families of those who died, and I hope for a speedy recovery for those injured — both of physical and mental injuries.  Its a shame that it always comes to something like this to hopefully get people to listen to this loud, echoing announcement:

AMERICA! YOUR COUNTRY IS CRUMBLING!

As I ride around on the Chicago L — a system which, for those who wonder about these things, doesn’t even have the “outdated” safety systems or “failing” relays that are being scrutinized on Metro but instead relies solely on operator driving skills with minimal automatic-kill devices to stop the train when approaching a dangerous system — I can’t help but notice it in my own city.  Train stations showing their age over the past century or more.  Steel elevated tracks that appear ready to collapse at any moment from decades upon decades of rust and deferred maintenance.  Rail cars being used far beyond their warranted and designed lifespan.  New technologies literally sailing over our aging, antiquated system.

Driving north on Lake Shore Drive this morning, I once again encountered a pothole of death, swerving to miss its deep trench of exposed rebar.  Driving over it at a controlled 5 mph would have been hazardous; had I been unable to swerve or apply the brakes at even the posted 45 mph (let alone my flow-of-traffic 55 mph) I would have had some serious damage.  My hometown ties still hold strong and I can’t get the images of the collapsed I-35W bridge in the Mississippi River out of my head.  Between that and living through the massive Marquette Interchange reconstruction in Milwaukee, I now instinctively look at the underside of bridges as I pass under them, and more often than not I cringe as I see the tired, worn out concrete dropping its calling cards for someone to repair it.

We removed upgraded destroyed our rail infrastructure.  We have miserably failed to maintain its replacement: the Interstate highway system.  Our attempts at efficient bus transportation has been equally poor.  As we moved further and further from city centers, we brought along our cars, trucks, and SUV’s.  We required our investment funds to be spent on new infrastructure — new roads, new water mains, new sewage lines, new energy construction — rather than attempting to maintain existing structures.  We created fictitious balanced budgets on the back of generations to come as we deferred maintenance, expecting less and less and instead requiring more and more of the future.

And this is why U.S. infrastructure terrifies me: because, try as much as our “leaders” might, they can’t indefinitely expand a definitive lifespan.  We will continue to have tragic accidents like Washington experienced yesterday until We The People stand up and say that we’ve had enough!  On Thursday, despite all of the previous doomsday scenarios from the CTA and RTA, here in Chicago I believe we will likely experience the end of those “comfortable” cutbacks of deferred maintenance.  Our insistence on economic unsustainability has reached its endpoint.  To prevent resources from being stretched too thin, to appease the suburban NIMBYs (and, yes, to support a bloated administrative structure hellbent on the politics of patronage) we will once again see a proposal that will cut transit service to those who need it the most.  To maintain service without a significant investment in capital improvements would be asking for an accident.  And without that significant investment, the RTA and its agencies cannot continue to operate the system at its current scale.

The answer is not privitization or continuing 1980’s style American capitalism.  Its not raising user fees, fares, tolls, etc.  We can’t even, for the short term, expect balanced budgets for our capital expenses.  We’re so far past each of those things its impossible to see them in the cracked, broken rearview mirror.  Its time to stop bailing out Corporate America and start focusing our energies on rebuilding the America that no one likes to see, no one likes to talk about: the part of America that moves us, that affects our everyday existence.

One of my mentors in college used to talk about “ugly projects,” the types of things that no one wants to donate money for or slap a dedication plaque on, but things that have to be done because if they fail everyone notices.  In college, these were things like boilers, water heaters, lavatory fixtures, sidewalks, steam distribution pipes, electrical wiring, network equipment.  Brand new, they are truly an investment.  Well-maintained, they are assuredly (though consistently) expensive.  To repair often costs more than their initial cost.

Its about 20 years past time for those ugly projects.  We don’t have another 20.

The Olympics in Beijing start in a couple of days.  Athletes from around the world will gather to compete, to demonstrate the individual physical heights we can accomplish as humanity.  I’m not a hugely athletic person — and the summer Olympics have absolutely no sports that I care to follow — but I’ll still catch the opening and closing ceremonies, and since there is a fellow Anoka High grad competing, I’ll follow the wrestling events this year.

But it sounds like no one in the Western world is going to — or supposed to — enjoy the events this time around.  From cries of cultural imperialism on behalf of the West thrust on the East, to being upset that the International Olympic Committee awarded the games to a communist government with a spotty-at-best human rights record, the general undertone of this year’s games is that of suspicion, of injustice.

At best, this level of indignation is bull.  And it only goes downhill from there.

I’m sorry, but I’m not going to feel guilty about cheering for the U.S. team.  I’m not going to feel as if I am somehow communicating that the U.S. is culturally superior to the rest of the world.  I’m not.  I’m simply cheering on my team, my nation, my fellow Americans.

I’m not going to boycott the opening ceremonies because of China’s human rights record.  And what’s more, if you’re really that upset at their government, then you should avoid buying Chinese-made goods, avoid benefiting from the burgeoning Chinese economy.  That means everything, from the product you use in your hair to the ballpoint pens on your desk.  Do you receive promotional materials or “freebies” from places?  Better check where those were made.  Do you enjoy authentic Chinese food?  Double-check the importation information.  What about the parts in your car?  In your computer?

I’m not going to protest the summer games because of China’s pollution problem.  We, as Americans, simply modeled this behavior and continue to do so as we now come to the stark realization that we ripped up our rail infrastructure, we destroyed our fresh water supplies, we continue to fear nuclear and renewable energy sources.  The people in Beijing live in dense structures, perform many of their daily routines on foot, and many do not even have access to a passenger automobile.  In comparison, here we work for the “American dream” of an acre or two of land, 2.5 vehicles per household, far away from centers of commerce and trade.

I’m not going to be suspicious of the media reporting from a country which censors its information.  How is overt censorship any worse than a government that purposely lies to its people and the wider world?  A population so disengaged and lazy to check facts for itself and taking E! television as high-class reporting?

I might give some credit if this indignation weren’t complete bull.  So go off, protest the games.  Stand on street corners and decry the awful affects of globalization and the industrial complex.  Do your “grassroots” blogging and reporting.  Just don’t you dare let me catch you doing it as you sip from a cup, wearing shoes, underwear and clothing, holding signs marked with ink, all made in China.

Of course, I don’t think this song ever went out of style.  It just keeps summarizing the global society…

Sorry, YouTube won’t let me embed it here.