Single-payer!

The typical American knee-jerk condemnation of single-payer systems for the delivery of healthcare care, i.e. the socialization of healthcare is a crystal clear example of knee-jerk, i.e. non-thinking. The knee-jerk response is likely in many cases to reflect the type of "thinking" that loves to proclaim that the American healthcare system is "the best in the world." And repeating "America is s the best country in the world" ad nauseam is a mantra the origins of which I am quite curious. I don't believe that the slogan was commonplace in the 1950s although I am not sure. I suspect the origins of the braggartism may have been a collateral outgrowth of the Vietnam War and other follies in which some Americans have felt forced to justify the needless sacrifice of human life—while other Western democracies stand aside relatively unscathed. Thus, of course, the cost of American blood was worth it because, after all, "America is the greatest country in the world!"

Don't get me wrong, I love America too. But arguing that all things American are better than that had by any other country is patent nonsense and unflattering jingoism. Acknowledging that China may have a competitive advantage in their space program because they don't have to deal with democratic resistance to policy does not constitute an endorsement of the Communistic dictatorship even if we acknowledge their edge. Regardless, hardly any American would trade his liberty in return for getting back to the moon first! Dear  Americans, self-proclaiming ourselves as the best in everything is arrogant and, thereby, self-diminishing. And America is far from being best when it comes to the delivery of affordable and effective healthcare. A key ingredient to greatness is an ability to deal with hard facts, and then use them to achieve a positive outcome.

Some parameters of the healthcare problem are nicely spelled out by Todd Hixon in "Why Are U.S. Health Care Costs So High?" in a 3/01/2012 Forbes.com article. Hixon reports that various, highly credible analyses conclude that the cost of American healthcare is about twice that of "peer countries" such as Japan and the U.K. One of the largest disparities is the dramatically higher earnings of medical specialists in the U.S (three to six times higher). And the use of specialists in the U.S. vis–à–vis primary care doctors is also much higher than in other countries.Yet, the outcome in quality when measured in terms of longevity is about the same. I decided to do some quick web surfing to see if this claim is supported and it quickly became apparent that, indeed, it is. A University of California, Santa Cruz website shows that, based on figures for the year 2000, despite its enormous lead in per capita healthcare spending the United States ranked 27th in the world in longevity. Cuba, which ranked 28th, spent $186 per capita while the U.S. spent $4,500 (no, this is not a misprint). [http://ucatlas.ucsc.edu/spend.php]  Consistent with this perspective, the online Wall Street Journal's Market Watch site reports that, "However counterintuitive, spending more on health care does not result in better health outcomes. Of [the] top 10 nations with the highest health expenditure per capita, only three are in the top 10 for life expectancy." [http://www.marketwatch.com/story/10-countries-that-spend-the-most-on-health-care-2013-07-30].

These trends indicate that the primary drive for higher prices is not the quality of healthcare but the desire for profit. Some self-examination by the American psyche reveals, fairly easily, that while many sectors of the economy operate on purely capitalistic principles of charging what the market can bear, the practice does not always hold up and is not justifiable in all areas of economic activity. This mentality is wrecking the American healthcare system and it is also wrecking its system of higher education. I would put the "justice" system in the same boat because the purchase of justice just ain't justice. There is no persuasive reason for why a single-payer system—the government, cannot efficiently administer the healthcare system. A culture that cultivates an ombudsman mentality and internal competition can succeed in areas of economic activity that have little use for profit. It is anathema to suggest that a surgeon might recommend surgery because of undue influence by the opportunity for profit. Take your head out of the sand! And Big Pharma brings to mind a caduceus with the dollar sign superimposed on it. But this is a subject for a future posting. 

ArthurDSchwartz.com                                                                                            IntegralHypnosis.com

Standing Up to Monsanto

The strength of a democracy may best be tested by successful challenges to vested power interests who affront basic rights with the arrogance of might makes right. The Farmer Assurance Provision (a.k.a.  "The Monsanto Protection Act") of 2013 and its recent revocation by means of allowed expiration is a case in point. The behavior of Monsanto, the multibillion dollar agribusiness has been, according to numerous reports, beyond the pale. The legislation allowed the USDA to over-rule court orders to stop the growing and sale of genetically modified crops (GMOs) until the process of legal challenges would finally run its course. Essentially it allowed the Monsanto Company, the primary developer of GMOs, to turn the world's populations into its guinea pigs even if courts were to find that enough evidence existed to halt production.

It is amazing that the legislation was allowed to be inserted into the bill last March, but it is also a source of democratic pride to see that, in the aftermath of a massive reaction by the public and the anti-GMO movement, the law was allowed to expire on September 30th. But the Monsanto Protection Act is only a recent example of incredible corporate bullying that should provoke corrective public action. I refer to the company's lawsuits against farmers for selling crops that have been contaminated with their Roundup resistant GMO crops. The compelling story of Percy Schmeiser is told in the "Monsanto vs Farmer," a blog post from "The Grand Disillusion." The blog quotes a letter sent by Monsanto to farmers who they believe are growing Monsanto's genetically modified grape seed: "We have reason to believe that you might be growing Monsanto’s GM rapeseed without a licence. We estimate that you have so many acres. In lieu of us not sending you to court send us $100 000 dollars or $200 000 dollars in two weeks time and we may or may not send you to court.” And the letter closes with a threat that if it were to be made public the farmer would be "fined." Behavior such as this, if correct, is warrant in and of itself and sufficient reason to dissolve and reorganize the company. I don't know what specific criminal laws are violated by this type terrorizing tactic, however, I am fairly confident that they are on the books. If not, then laws criminalizing such behavior should be enacted.

The other question that needs to be addressed is how it is possible that corporate monsters like Monsanto amass their political power. Clearly, a huge element of the problem is the overwhelming corruption of American politics that is due to the astronomic levels to which campaign financing has evolved, only increasing the unholy alliance between money and politics. If the legalized bribery, otherwise known as campaign contributions made by lobbyists, is eliminated we will go a long way to ending the privileged treatment that companies like Monsanto are accorded. And then, doing something about the revolving doors between industry and regulatory agencies—a problem in most countries—will contribute much towards restoring or, perhaps, creating a new level of social integrity. Political movements to require GMO labeling, despite or because of its defeat last year in the California referendum, are now spreading to many states. It's time to tame the monster.

ArthurDSchwartz.com                                                                                            IntegralHypnosis.com

Hyper-prescribing and Natural Alternatives

The ignoring or dismissal of natural alternatives to the use of prescription drugs or pharmaceuticals has little justification. And it is more than a little crazy. Let me use myself as a case in point. I remember, almost ten years ago, that my blood pressure had rather suddenly spiked to about 150/100. That's high but not extremely high, but I hadn't experienced a blood pressure issue until this time and I was naturally concerned. I went for an examination, in this case I was examined by a nurse practitioner, and it was recommended that I immediately go on high blood pressure medication. I decided to pass; I chose instead to monitor my sodium intake and also take various supplements such as olive leaf extract. It took some time, but gradually my blood pressure returned to normal levels. Now, about ten years later, my blood pressure is within normal range and I avoided, quite possibly, the taking of blood pressure medication for the rest of my life.
 
The rush to prescribe powerful prescribed pharmaceuticals has become commonplace. However, natural supplementation with extracts from herbal and nutritional sources have never been more effective. I think the pharmaceutical industry likely deserves some of the credit here because today the active compounds in natural extracts are far more accurately identified and measured than in the past. Taking herbs and other natural substances today has science behind it, and clinical studies too even if the DSHEA statute in the United States prohibits any claims on product labels concerning efficacy regarding their use in treating disease.

And then, of course, there is the ever-present issue of profit. Pharmaceutical companies cannot patent natural substances derived from foods or traditionally used herbs and as a result they have little or no motivation to perform the highly expensive clinical trials required by the FDA to certify their effectiveness as medicinals. And so, as a result, individual consumers can only experiment on their own; physicians are generally untrained in their usage and the prescription of ridiculously expensive pharmaceuticals, with their serious potential side-effects, are the norm. Some patients go to see alternative holistic practitioners but the mainstream, in general, won't go to them and most, anyway, are not covered by insurance.

Dietary and herbal extracts are not endorsed by the FDA and, therefore, they are not "proven" to be effective. Therefore, they are unproven and, thus, officially "unscientific" and not used in traditional protocols.

What is the net result of this charade? The obscenely high cost of prescribed pharmaceuticals are a significant factor in the soaring cost of healthcare and the current healthcare crisis, which is endemic of the cultural epidemic of hyper-profiteering in economic sectors that do not distinguish profits in, say, the computer or shoe industries from profits made, for example, from the delivery of healthcare and education. Clearly, pharmaceuticals have their role, but the point that I am making here is that nutritional or dietary supplements also have their place in treatment regimes, often as an initial therapy, but they are too often ignored because of inexperience and lack of knowledge pertaining to their usefulness, or disparaged with a knee-jerk and smug dismissal.

ArthurDSchwartz.com                                                                                            IntegralHypnosis.com


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On "Being Entitled' and "The Attitude of Entitlement"

Fellow motorists, don't you just love it when a pedestrian is crossing a street at a busy intersection, oh so slowly moseying along showing all-too-clearly that s/he has the right of way and—Heaven forbid! don't let the rush cause any uptick in the pace. I especially love it when the pedestrian is walking across the street with nose buried in his or her cell phone! And, hey, if there is an accident, of course, the driver is to blame! This little vignette is a picture of the attitude of entitlement!

Oh my, I can hear now the sanctimonious defenses! Of course, I'm not talking about an elderly or infirm pedestrian but c'mon! Unfortunately the slow pokes may also be automobile drivers and they may well feel as I do when they they're the ones in the car.  The truth is, it is a thoughtful gesture to pick up the pace in order to ease the traffic flow that is certainly possible when multiplied hundreds of times.

I am using this rather insignificant but very common annoyance because it clearly depicts the "I don't give a damn" state of mind that most of us are capable of assuming from time to time; it is the attitude of entitlement. And the attitude of entitlement, unfortunately, provides ample ammo for the enemies of entitlement, such as the Randians and the libertarians and all who claim that social entitlements are giveaways and the disempowering tools of the Nanny State. The abusers of social entitlements allow the other side of selfishness to proclaim that entitlement programs only nurture the selfish, gluttonous greed of those who choose to live off the system.

But the irony is all too clear. Those who assume the attitude of entitlement and demand more than what is fair or justly deserved are the true cousins of the uber selfish who would deny virtually all social services and benefits even when basic needs and corresponding entitlements have been fairly established. The uber selfish may indeed show the most audacity in their display of the attitude of entitlement. They are ungrateful for their wealth and their good fortune—even if justly earned, and do not appreciate the profound debt owed to all those whose sweat and struggle have made their financial good fortune possible. The uber selfish owe their attitude of entitlement to arrogance, which is blind to the reality of how much each and every human being owes to its fellowship with others.

ArthurDSchwartz.com                                                                                            IntegralHypnosis.com

The Crux of Social Empowerment

A philosophy that deeply understands the moral imperatives of fairness, beneficence and compassion must on some level accept the necessity of social entitlement. The question becomes, then, What constitutes an entitlement?

Basic needs would seem to encompass the notion of a social entitlement, but if we end the inquiry with that we will surely have begged the question by merely passing the onus from the term 'entitlement' to 'basic needs'. Indeed, the reason for this demonstrates, I think, that a social entitlement is in almost all usage synonymous with 'basic social needs'. What constitutes a basic social need, i.e. a service or a material need of which is the right of every member of society to be afforded.

Even libertarians recognize certain basic needs. Roads and public works including infrastructure for plumbing, if I am not mistaken, are accepted by most libertarian as necessary provisions that society must to some extent provide or at least facilitate. Also, I believe, they would allow for police and some military capability to be put in place to protect the public against domestic violence or foreign attack. However, where is the line drawn. In the previous blog post I argued that individuals who are members of a democratic political system are entitled to a system that maximizes opportunities for the electorate to choose between a diversity of candidates while also being a afforded an environment most conducive a discussion of the issues that could admirably inform electoral decision. In my view, a democracy free of the disruption and division that is the political party is an entitlement. I realize that this statement goes much further than many may want to go, but it serves as an example of trying to distinguish what is and what is not an entitlement.

I suggest that a social entitlement is a combination of a need or the provision of a service that should be afforded, based upon—as outlined in Ethical Empowerment: Virtue Beyond the Paradigms, principles of fairness, beneficence and compassion. However, this entails the empowerment of both individuals and society. The establishment of a functional and efficient system of roadways will benefit the welfare of both society as a whole as well as the welfare of individuals. This is obvious to most, however, I argue that the same argument supports an end to the needless division of political parties. And it applies to universal healthcare. And the injustice of a "justice" system that allows wealthy defendants the opportunity to purchase justice by buying the best legal defense but which is not available to all. It applies to equal opportunities to receive a quality education, and without the necessity of going broke in the process.

"The whole is greater than the sum of its parts," a maxim coined by G.E. Moore, may be clearly seen to support a notion of entitlement that goes beyond the myopic sort of view that only allows for the provision of basic needs in the most dire of situations (e.g. starvation), and entails a deep appreciation of the mutuality of self-regarding and other-regarding interests. And this is the crux of social empowerment.

ArthurDSchwartz.com                                                                                            IntegralHypnosis.com

Crash the Party!

Imagine a democracy without political parties!  Imagine the empowerment to both individual and society that would ensue if needless political division is eliminated, and real differences of opinion concerning institutional and public policy become the norm of a society, a nation and even of a world's free political expression.  Is an independent, non-party system desirable and/or feasible?

The inherent dangers of the political party were forewarned by George Washington (in his Farewell Address) and by James Madison (in Federalist No. 10).  In our era the prescience of these men is being borne out. Moisei Ostrogorski proposed the de-institutionalization of the political party in 1902, and in the current day "nonpartisan blanket primaries" that put Democratic, Republican and all other candidates on a single primary ballot without stated party affiliation (often entailing a runoff election between the top two finishers) are gaining ground in California and other states.

Consider the recent shutdown of the federal government that was spurred by Republican opposition to the Patient Protection and Affordable Care Act ("Obamacare"). Would a hypothetical non-party democracy have reacted differently?  I believe it would have!  Consider the nature of political coalescence or the coming together of diverse interests. It has been argued that political parties act as a safeguard against despotism and dictatorship, however, it is worthwhile noting that Stalin and Hitler rode to power on the backs of their respective parties.  On the contrary, is it not reasonable to imagine that without the pressures to align with political parties politicians and individuals alike would more easily and freely resist the efforts by political leaders to impose unwanted policies?  With the free flowing of opinion unimpeded by divisive political parties, policies could be thoughtfully considered by individual reflection while at the same time the natural coalescence of opinion could interfere with ill-advised implementations before they take root by means of the artificial mobilization of opinion marshaled by party apparatus and knee-jerk political allegiances.

The independent, non-party system that I recommend in my book would require and depend upon the formation of a broad spectrum public financing of elections. One of the keys to the existence of institutionalized political parties is the dependency of candidates on parties for fundraising. Public financing is in some respects a separate issue, however, as with political parties, unequal private financing disharmonically skews and imbalances the free flowing of political opinion.  Legitimate entitlements are routinely rejected by Libertarians, followers of Ayn Rand (and others) at the expense of true flourishing and individual freedom.  And there is little doubt that the entitlement to democratic elections unimpeded by divisive party influences would also be rejected by them, especially if public financing in involved. But entitlements will be the topic of the next edition of this series.

This blog post is also the script for this video/podcast:



ArthurDSchwartz.com                                                                                            IntegralHypnosis.com