I suppose on some level I must be an optimist because I can’t seem to dispel the notion that something good might come out of the health care debate, even when confronted with such a hopeless legislative clusterfuck as the Baucus bill. Maybe it’s our recent experience with the topic of global warming that nudges me in that direction. Think of it – a few short years ago our leaders were disputing the science of climate change with some confidence. Now that skepticism is the province of the tin hat patrol and the policy debate is over how much (or how little) to do about the problem. Too little, too late? We did lose precious years during the Clinton and Bush administrations (particularly the latter) when fundamental changes might have been set in motion, but were stonewalled. Those changes will come harder now, and perhaps to insufficient effect. Nonetheless, there was a kind of sea change in 2007 and I suppose something like that could happen with health care in America. If we could all recognize the existence of the problem and its fundamental nature, that would be a big step forward.

The reason I think of this as a possibility, albeit a remote one, is the fact that right now the only real alternatives are some kind of have-measure hybrid (like what Baucus coughed up) and single payer. What else is there, aside from meaningless modifications of what we have right now that won’t stop the eventual breakdown of this for-profit system? I think there’s fairly broad recognition right now that the current situation is unsustainable and will not remain as it is, even if now legislative measures are taken. Everywhere you look, companies are changing up their health insurance or dropping it altogether. So we’re left with some ineffectual public-private partnership or expanded Medicaid for all. Looks as though we’ll get the former in some respect; when (and I do mean when) that fails abysmally and millions more find themselves unable to hold on to adequate coverage, there will be only one alternative: the same one used by every other industrialized nation in some form. Single freaking payer.

This is similar to the experience of the early nineties in that we are starting out with a watered-down solution and compromising right-ward from there, as if the “magic of the marketplace” still holds a great deal of promise in the wake of last year’s economic meltdown. The rhetoric, by and large, has been anything but inspirational. A lot of talk about “bending the cost curve” – whoa, there’s something that will get the rank and file heated up. And yet, single payer is avoided by the liberals and used as an epithet by the right… even when it’s clear that it would be the most cost-effective means of providing health coverage. I’m convinced that the reason why there is so much talk about “choice” in this debate is to undermine the case for single payer… as if “choice” of health plans is the highest value one can imagine. I’m in the goddamned private market, and what choice do I have? One freaking plan that pays for anything. That’s it. And I’m among the luckiest. Seems to me we should concentrate more on giving people security. Seems like we should think of it more like we do about our fire departments or other life-saving services. It’s really about having that reliable resource, not choosing between competing vendors as a value in itself.

They say the arc of history bends towards justice. I would like to believe that’s true. Maybe if we press it a bit, it will bend a little faster.

luv u,

jp 

Has it really been eight years since we started this phase of the Afghanistan catastrophe? I can hardly believe it. Even so, those dark days of late 2001 are beginning to seem like a long time ago now. It was a difficult time, to be sure, on so many different levels – a nation still reeling from the 9/11 attacks, lashing out at one utterly destroyed by decades of warfare, much of it stoked by our government (with the cooperation of Pakistan and Saudi Arabia). We are now told that the place is being overrun by religious fanatics – the Taliban – who want to bring the place back to the 13th century. From where it stands now, that wouldn’t be a very long trip.

The Soviets pounded the living piss out of the place, to be sure, but we made a very conscious decision to fund and support hyper religious elements within Afghan society as the core of that nation’s resistance efforts – some say before direct intervention by the Soviet military, and certainly thereafter. Our relationship with Pakistan’s ruling general Muhammad Zia-ul-Haq during the Reagan administration helped transform Pakistani society into one that is now, if not ruled by fundamentalist Islamists, at least defined by the degree to which that extreme brand of religiosity has constricted civil society.

So, if we go back eight years, we should certainly go back another 20 years before that… and more, when the Carter Administration started funneling support to the Mujahideen – a policy later carried forward with great enthusiasm by the even more craven Reagan, who built the effort up into the largest C.I.A operation up to that point. That was when legions of fighters from Muslim countries (including that guy named Osama) flocked to the Afghan frontier to fight the Russians and, into the bargain, any thought of secularism in that country. When the Russians left, we lost interest and the place went even more profoundly to hell, descending into fratricidal war and chaos that made even the Taliban’s tenuous rule seem stable by comparison. But the one-eyed mullah and his pals, along with Sheikh Osama and his, were creatures of our own manipulative foreign policy.

And all these years later, here we are again, poised on the brink of yet another policy decision. Will Obama, Nobel Peace Prize in hand, commit another 40,000 troops to an effort he just shored up with another 17,000 a few months back?  I’m almost certain that the answer will be… more dynamite from the Nobel laureate, for the people of Afghanistan. Change comes hard. Mighty hard.

luv u,

jp