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Around here, we’re proud of our nation’s Pilgrim heritage. We live right on the
boundary, after all, between the
Plymouth
and the
Massachusetts
Bay
colonies. (As most of you probably already know, the line between
Stoughton
and
Easton
forms the “borderland” between those two entities.)
Sometimes, when we look back at our Pilgrim forebears, they might seem awfully
quaint and old-fashioned. In all honesty, we know that they weren’t perfect. Their
relations with the Native peoples weren’t always the best. Some of their religious
concepts might seem awfully archaic to us. They were far from a “perfect” society.
But they are, for better or worse, the rock from which we are hewn. They form an
important part of our heritage and our collective identity. They are essential to
the founding myth by which we define ourselves, still, as a people.
And in some ways, they weren’t so old-fashioned.
They seemed to know some things about life (and human society) that we seem to have
forgotten in the hustle and bustle and sound and fury of modern life.
As the Mayflower anchored off the coast
of Cape Cod, its long voyage across the sea almost complete, the 41 passengers on
board (just the men, of course; this was 1620, after all; I said they weren’t perfect)
signed what came to be called “the Mayflower Compact”. There was covenant between
God and humankind, the Pilgrims believed, established in the Old Testament, radically
expanded in the New, which needed to be reflected in the way people related to one
another, in human society, here on Earth. There needed to be a covenant among people,
which reflected the divine-human covenant upon which all life was based.
So, the Mayflower Covenant began, “[We] solemnly and mutually in the presence of
God and one of another, Covenant and Combine ourselves together in a Civil Body
Politic, for our better ordering and preservation and furtherance… and by virtue
hereof to enact, constitute, and frame such just and equal laws… and shall be thought
most meet [that means “suitable’ or “proper’ in old-fashioned English] and convenient
for the general good of the Colony, until which we promise all due submission and
obedience.”
Our nation, then, began on the very basis of the idea of
covenant—the idea that as citizens we are all bound, most of all, to the civil
body politic, to the general welfare of all—indeed, to the “commonwealth” of all.
Our Pilgrim forbears understood that if a colony was to survive that its people
had to be bound by some greater idea than “what’s in it for me”. So they covenanted
with each other to work for the common good. Later political philosophers of the
Enlightenment, like Hobbes and Locke, developed the idea of covenant further, into
what came to be called the Social Contract. These thinkers believed that, left to
their own druthers, people would lead lives that were selfish and brutish; so, by
joining in civil covenant with one another, man’s natural selfishness is kept under
control, for the good of all society. The idea of the Social Contract is deeply
engraved in the founding documents of our
American Republic
.
So I think that many of those with the loudest voices in the current health care
debate sure as heck need a great big civics lesson. What has become of the idea
of the Social Contract in our nation’s politics today? “Become part of the mob!”
Sean Hannity counsels those who listen to his ragings on television. A Baptist minister
in
Colorado
leads his congregation in prayers for the death of the President and preaches a
sermon called, “Why I Hate Barrack Obama.” Have we totally given up on the idea
that public policy should be decided by more than who can scream the loudest—by
those who can make the most absurd claims against their opponents—and that civility
and respect should be replaced by the sad spectacle of a U.S. Congressman shouting
“You lie!” at the President as he addresses a joint session of Congress. (As many
of you already know, the antipathy felt by me and some of my friends on the political
Left toward a certain former President Who Must Not Be Named bordered on the obsessive,
perhaps even the excessive, at times. That’s just the way things go in the heat
of partisanship; you can’t be neutral on a moving trains, as Howard Zinn says. But
through eight very long years of He Who
Must Not Be Named, Congressman Dennis Kucinich never yelled “You lie!” at the President
as he addressed Congress. Congressman (now Senator) Bernie Sanders of Vermont (who,
unlike almost everyone else in this debate, really
is a socialist) never interrupted a presidential speech to hurl an epithet.
Congressman Barney Frank, a man who has never met a microphone he didn’t like, held
his tongue again and again and again out of respect for the office and person of
the President (even if that was held by… whomever…). We have reached a new low point
in American civil discourse, it seems to me.
Could it be that we are witnessing, once and for all, the crumbling of the very
idea that we are bound, as Americans, as citizens, in any kind of Social Contract
with one another? Many people carry on about the need to defend “In God We Trust”
as the American motto; they grow apoplectic about the need to keep “under God” in
the “Pledge of Allegiance” (a phrase only added, as we know, in 1954; the author
of the original pledge, Francis Bellamy, also was a “real” socialist, by the way;
a “Christian socialist” back when using those words together would not have been
considered an oxymoron). But if you judge many of these same people by their
deeds, and not by their words (especially in the context of the present health
care debate), I think “Survival of the fittest” is what should more aptly be engraved
on our currency.
Sadly, in our present society, “survival of the fittest” has become “survival of
the one with the best health insurance”—which can be rendered in shorthand as “survival
of the richest”.
According to most objective estimates, about fifty American men, women, and children
die every day because they have no health insurance. “Only fifty people a day!”
you might say. But do the math and that’s over 18,000 people a year. So it’s “only”
about 200,000 people each decade—about the population of
Providence
. What’s losing one
Providence
every ten years if it means that the profits at the ten leading publicly traded
health insurance companies can increase by 428% over seven years, as they did between
2000 and 2007? What’s a couple of hundred thousand people if it means that the sales
for drug companies like Merck can quadruple in just
two years (from $ 1.1 in 2005 to $ 4.3 in 2007)?
So what if fifty people die every day because they lack health insurance? As one
earlier political wag might have put it: “Better that they should die, and decrease
the surplus population.” That might well be Ebenezer Scrooge’s take on the current
health care debate, if he were around today.
But wait: Scrooge was English. And in
Great
Britain
, they have a government-run program that guarantees free, universal, high quality
health care for all. A Bolshevik, anti-democratic program defended by such well-known
“socialists” as Winston Churchill and Margaret Thatcher.
But in spite of its iniquities, our system is “better” than theirs is—isn’t it?
Government health care isn’t just “wrong”, some people say, it’s also inefficient,
corrupt, inept, backwards, and ineffective—right? We have the “best healthcare system
in the world”, or leaders are fond of telling us, over and over again We’re number
one! We’re Americans! We top the list when it comes to healthcare—of course!
Well, when it comes to what we pay for healthcare, no other nation is even close.
Not even
Switzerland
, where you need to take out a loan to buy a cappuccino.
Switzerland
is the only country that’s even in the vicinity of the same ball park—and it’s not
even that close, either: The average American (one who has insurance, anyway) spends
53% more than the average person in
Switzerland
for healthcare. He or she spends 140% more than the average person in one of the
other major industrialized nations of the world. The average American spends 38%
of his or her income on taxes or healthcare. The average citizen of
Germany
or
France
(whose health care costs are borne directly out of his or her taxes) pays about
34%.
But good things are worth paying for! So if we do indeed have “the best medical
system in the world”, then we should be willing to pay more for it, then. That would
make sense.
But, frankly, we don’t have the best
system. Not for all Americans. Not for many Americans. Maybe not for most Americans.
I’m sure that many of us (those of us who have health insurance or have Medicare
or Medicaid) have gotten excellent medical care at various times in our lives. I
know I have. Many of us have had our share of MRIs and
CAT
scans and upper-GIs and lower-GIs and all manner of high tech pokings and proddings.
(I even got to swallow a camera once—how “Fantastic Voyage” is that!).
What is the bottom line for all this spending ($ 1.4 trillion in 2004; $ 2.4 trillion
in 2008)? As far as life expectancy
is concerned we rate…. first (right?) … second? (nope)… fifth? tenth? eleventh?
fifteenth?... No, the
United
States
ranks 50th among all nations
of the world for life expectancy (we beat
Albania
—that’s # 51—by all of seven weeks). We rank 46th as far as the infant
mortality rate is concerned (Cuba
has a better infant mortality rate than we do.)
The most recent World Health Organization comprehensive ratings of the healthcare
systems of 191 nations the world over reads as follows:
1
France
2
Italy
3
San
Marino
4
Andorra
5
Malta
6
Singapore
7
Spain
8
Oman
9
Austria
10
Japan
11
Norway
12
Portugal
13
Monaco
14
Greece
15
Iceland
16
Luxembourg
17
Netherlands
18
United
Kingdom
19
Ireland
20
Switzerland
21
Belgium
22
Colombia
23
Sweden
24
Cyprus
25
Germany
26
Saudi
Arabia
27
United Arab
Emirates
28
Israel
29
Morocco
30
Canada
31
Finland
32
Australia
33
Chile
34
Denmark
35
Dominica
36
Costa
Rica
37
United States of America
38
Slovenia
39
Cuba
We beat
Cuba
that time. But
Cuba
spends $ 229 per person each year on healthcare. We in the
United
States
, spend $ 4271 per capita. That’s twenty times more per person; more than $ 4000
extra for each man, woman, and child to move up those two measly spaces—and to still
get beaten by
Morocco
and
Dominica
.
So, we are spending more (much, much more) than other nations. And we are getting
less. What kind of a free enterprise economic model is that? Even according to the
economic values of capitalism (which are, let’s face it, the only
values that really seem to matter for much in our society these days) the
American healthcare system would seem in need of a complete overhaul.
From an ethical perspective (from the perspective of the
commonwealth we are pledged to uphold) our healthcare system would seem even
more sorely lacking. (I don’t know: Some people in
Rhode
Island
want to remove the words “Providence Plantations” from the official name of their
state because it reminds some people of slavery. Maybe we should remove “Commonwealth”
from the name of
Massachusetts
because any talk of common-wealth might remind some people of socialism. I don’t
think it’s been suggested yet, but wait-- more absurd things have been said in recent
days.)
As far as healthcare is concerned, here is where out bottom line ought to lie, as
religious men and women:
Uninsured Americans are 3.6 times more likely to die in the hospital than those
with insurance.
Uninsured children and adults are 30% less likely to receive preventive care, increasing
the likelihood that they will be eventually diagnosed with more advanced conditions
and earlier deaths.
Uninsured women with breast cancer are 50% more likely to die of that disease than
women with insurance.
As Rev. Dr. Martin Luther King said (years and years ago) “Of all the forms of inequalities,
injustice in healthcare is the most shocking and the most inhumane.” Healthcare
reform really is a matter of life and death. It can’t wait any longer. We’re not
just talking statistics here. We’re talking about people’s lives.
And do not ask for whom the bell tolls: If any of us should lose our jobs, or lose
our health insurance, or be denied insurance when we apply in the future, then we
might well be one of these statistics next time around. Catastrophic healthcare
costs are the leading cause of personal bankruptcies in
America
. As Michael Moore once put it, “Unless we’re Bill Gates, most of us are no more
than one catastrophic illness away from financial ruin.”
All this nonsensical talk of “rationing” and “death panels”… As a wise friend of
mine put it recently, we already have healthcare rationing and death panels. We
just call them “co-pays” and “pre-existing condition”!
Rev. Anna Clock Saxon tells a story of her days as an oncology counselor at a hospital
in
Texas
:
“I remember distinctly a hot, humid
Texas
afternoon when the primary doctor, who had been seeing a woman patient for the first
time, came out and told me he wanted me to come in to the room. That didn't happen
very often, and so I was quite curious about his reasoning.
As we walked into the room there sat a middle aged woman who looked older than her
age, very timid, her head down. She answered the doctor’s questions in almost a
whisper; her grammar was quite poor, bespeaking of a life of little education.
The doctor said, "please show me your breast again so that I can have Anna look
at it." As she slowly moved aside her gown, both the sight and the smell were ghastly.
Her breast had an open, ulcerated tumor growing out of it. The doctor asked the
patient why she hadn't sought treatment earlier. Her reply, “I don’t have any insurance.
I thought it might just be an infection so I treated it with Witch Hazel and Peroxide”.
The doctor explained, once we were outside of the room, that the pain must
be excruciating and that he had never seen breast cancer that advanced outside of
the body. Unfortunately, he added, it was highly likely, given the advanced stage,
that the cancer had spread to other parts of her body and she would not survive.
[Sadly,] He was correct on both accounts.”
When filmmaker Michel Moore decided to make a film about the American healthcare
crisis, he sent out a call for stories from people who had faced what they felt
were problems with our system. Within a week, he had thousands of emails, thousands
of stories. Like from the man who lost three fingers in an accident, but had to
choose which one to re-attach because he couldn’t afford all three. Like the husband
and wife who had worked hard all their lives, but had to move into their son’s basemen
because they both had the bad luck of getting sick at the same time. Like Dawnelle
Keys, who told about her 18 moth-old daughter, Mychelle:
One evening, little Mychelle suddenly became sick with vomiting, diarrhea, and a
high fever. Whose child hasn’t? So Dawnelle took her back to the nearest hospital
emergency room, at the
Martin
Luther
King
Medical
Center
in
Los Angeles
. The attending physician suspected that Mychelle had a life-threatening bacterial
infection and called the insurance company to get approval to treat her. The hospital
was not in the company’s health care network, so they refused to authorize payment
for treatment. Her mother protested that her child’s condition was life-threatening
and pleaded with them to treat her. The hospital denied Mychelle care because they
were out of her network. So Dawnelle took her baby to another emergency room that
was in the network, and Mychelle died thirty minutes later, her little body wracked
with seizures.
What kind of a country have we become if stories like this don’t seem to matter
to us any more? Have we become so sated on our material comforts, so holed up in
the fortresses of our personal lives, that we no longer care about the plight of
those with whom we share this sacred land?
Why is it that every other advanced, industrialized democracy in the world has accepted
the concept of universal healthcare as a basic right a generation or more ago—yet
America
still lags behind?
Maybe it’s political expediency. Maybe it’s hard-headed, rugged individualism. Or
perhaps it points to a deep flaw in our national character.
The film critic Roger Ebert is a cancer survivor.
Recently, he wrote a beautiful and thoughtful essay on healthcare reform and why
a moral society would ban together and push for a plan that would provide basic
medical service to every American. Ebert ends his appeal with this quote from scripture:
“...for I was hungry and you gave me no food, I was thirsty and you gave me no
drink, I was a stranger and you did not welcome me, naked and you did not
clothe me, sick and in prison and you did not visit me."
Then they also will answer, "Lord, when did we see thee hungry or thirsty or a
stranger or naked or sick or in prison, and did not minister to thee?"
Then he will answer them, "Truly, I say to you, as you did it not to one of the
least of these, you did it not to me."
This is the real challenge we face now as a nation. We will face the whirlwind if
we do not start taking care of one another, and meet the needs of all our people.
It might be an economic whirlwind, or a political whirlwind, or a deeply moral one.
But the crisis in our healthcare system—this profound economic crisis, and this
deeply moral one—is not going to go away of its own accord.
May the light of wisdom, justice, and compassion enlighten our leaders, and our
fellow countrymen, in the critically important days ahead.
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