Tag Archives: Health Care

2016 Year in Review

My experience of this year mostly lends itself to sorting into two, very different, categories: political, and other.

Except that politics isn’t really something separable from other areas of life, however much one may wish or believe that to be so.

Once again, I confront election results that are not only distasteful, but could very realistically make me a healthcare refugee in the foreseeable future. I’m self-employed, I have an expensive preexisting condition, I’m ineligible for Medicaid and a long way from Medicare (both of which will also come under fire anyway). If a Republican federal government junks the Affordable Care Act (and rules out substitutes which feature either redistribution or heavy-handed regulation, which are the only real ways to make private health insurers cover someone like me), I’ll have to look for other governments that might be more helpful. Which, right now, probably won’t include Ohio.

Meanwhile, even in my own life this year, “political” bled substantially into “other,” although this was admittedly voluntary to a great degree.

I really feel that, looking back, I actively “volunteered” for very few of the political activities in which I found myself immersed in 2016. But if I was recruited over and over, I rarely said “no,” and perhaps after a time that amounts to volunteering.

Oh, Lakewood politics, you’re crazy but maybe that makes us a match.

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America goes bonkers, contd.

Recently I wrote up a post about Bernie Sanders, Hillary Clinton and the Overton window, but I have since decided to throw it all out. In a way, further reflection has convinced me that the whole Overton window concept may not even be useful any longer, as my earlier post was in fact implying, even if I hadn’t realized it. At this point I think a single “window” of what’s possible in American politics, at the national level, is not even accurate as a simplified model. It feels like a relevant update would now involve something out of a nightmarish video game, with multiple holes opening, closing, changing size, etc., simultaneously without any reference to one another.

Obviously Republican America has ceased giving any heed to any universal idea of what’s practical, or of anything else. I mean, what is there to say? The latest word from those pundits still attempting to make meaningful observations is that the GOP establishment is, now, preparing to embrace Donald Trump for president because they find him less offensively deranged than his leading rival. I’m not even sure what part of that sentence it would make sense to emphasize; it’s all surreal.

In the meantime, some kind of much more modest but still dumbfounding suspension of reason seems to be creeping through Democratic America. I’m certainly not unbiased, but here’s what I’m seeing. A growing number of putative liberal voices are

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2015 Year in Review

One year ago, I expected that “keep doing my thing and try to make ends meet” would predominate in 2015, and that forecast wasn’t wrong. In day-to-day existence, that definitely characterized most of this year. But there were exceptions, and in looking back on the whole year… those exceptions loom remarkably large.

Unlike 2014, it feels like the “events” of 2015 are such as to support a “top stories” list. Probably something like this:

Save Lakewood Hospital. After 36 years without any real involvement in local politics, anywhere I’ve lived, I dove straight into the deep end and have spent almost 12 months, now, involved in an impossible soap opera controversy that is still a long way from ending. For much of the year, a logo that I designed over a weekend was on signs on just about every street in Lakewood. Last month I got up and spoke to city council; strangers have stopped me in public to thank me and ask my opinion. Just about every day of “Christmas vacation” I replied to at least some correspondence about this campaign. Etc., etc., etc. The experience as a whole has been fascinating, energizing, demoralizing, rewarding, and maddening.

Japan! I spent a week in Tokyo. It was actually a bit like my experience with Save Lakewood Hospital—fascinating, energizing, demoralizing, rewarding, and maddening—but more compressed, more expensive, less worrying and way more fun. (Aside from flying across the Pacific. Blecch.)

Authorship continued, and actually turned a profit! In 2015, I attended another author fair, spoke at Lakewood Library, mostly finished my research on a third book and got an early draft nearly complete, and craziest of all I showed a modest profit for the year. I’m still a long way from an all-time profit, thanks to spending a bunch on publishing Brilliant Deduction, but if that’s viewed as a sunk cost I made a real profit for the first time, this year.

I went to Baltimore, for three hours. Related to the aforementioned research, I made a round-trip visit to Johns Hopkins University in right around 16.5 hours. (From Lakewood, Ohio.) This wasn’t actually… awesome, aside from verging on awesomely stupid, but 1) it makes for a story, 2) I did find material to justify the trip, thankfully, and 3) it’s nice to know that I can still pull off a stunt like that.

Politically, despair was mixed with multiple instances of hope, and even near euphoria. There was bad in 2015, oh my yes. From the dismal election outcome here in Lakewood all the way up to not-so-grand geopolitics. Yet… who can forget those incredible days in June, when the Supreme Court gave marriage equality the green light and basically pulled the plug on “undo Obamacare” hopes. Who can forget “PURE APPLESAUCE!,” ever? Then there have been the ongoing follies of the Republican party, from March’s fiasco in Indiana to what one pundit seriously predicted would be “the best field in a generation” of presidential candidates… bwa ha hah. Just weeks ago, even as Lakewood city council was disgracing itself, real leaders met in Paris to negotiate the future of the entire biosphere and actually didn’t produce a complete disgrace, for once.

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What next for the Democratic Party?

Let’s indulge hope, just for a moment, and play pretend. Let’s imagine possibilities, precisely because we’re pessimists and expect that even an illusion of encouraging circumstances is usually short lived, and so one might as well daydream when one gets the chance.

Along these lines, then, let’s ask what liberals/Democrats should do next?

The prompting for this bit of whimsy is, obviously, the Affordable Care Act’s most recent Houdini Act. Plus a couple of recent articles that more directly considered the idea that the Democratic Party might be about due for a new project.

This is, on a basic level, not actually all that fanciful. It does seem possible that the years-long effort to implement and defend the Affordable Care Act is, at least, ready to shift from war-of-survival to maintenance-program. I think it isn’t completely delusional to suggest, as Vox has, that Republicans are just running out of ideas to disembowel the ACA with one stroke. More importantly, perhaps, I suspect that they may also just be running out of steam a little bit. At some level. Certainly the fact that, by the time the Supreme Court finally ruled on King v Burwell, many many elected Republicans were actually quietly relieved that they didn’t have to deal with the consequences of a “victory” suggests that they may be ready to redirect resources to some other issue.

So perhaps the Democratic Party ought to be thinking the same thing. Significantly, and strange as it is to suggest, “Obamacare” arguably completes the several-decades-long project of safety net programs. Compared with e.g. a European welfare state, America’s redistributive social programs are still a net, indeed, i.e. full of holes. But as a skeleton, an outline, they do seem basically complete: old-age pensions, unemployment insurance, disability payments, and, finally, a program that at least aspires toward universal health care access (however short it falls at present). There is no longer any obvious, complete void to demand patching over as priority one.

At the same time, I might add, it looks (from my point of admitted privilege) like social equality is making reasonable progress. Racism, sexism, homophobia etc. still certainly exist, but the space in which it’s okay to be noticed practicing these -isms seems to get narrower every year. Maybe, as I will speculate with some other issues as well, progress from the bottom up is now self-sustaining here without top-down pressure. Perhaps.

All of this suggests both an opportunity and a challenge. A once-in-a-generation chance to think big and dream of something more than just building a floor is kind of exciting, in theory. At the same time, however, a description I read a few years back of legislative reform in America having “limited bandwidth” has only seemed more and more apt with time. It seems likely that Democrats will mark eight years in the White House with precisely one major legislative achievement to show for them (health care reform). It seems just about as likely that accomplishing even that much in the next decade will be a tall order. Yet that’s all the more reason to prioritize. Chance is always a factor, but for the most part this generation shouldn’t expect much further in the way of big, national progressive reform without a sustained, focused campaign for it. Plus, a party ought to have some national agenda to run on in a national election, however dim that agenda’s prospects, right?

So: what to place first in that low-bandwidth download queue? (Note: as this is primarily a look at what should be done, even if there is limited support, it won’t be constrained by present congressional malapportionment, etc., because what do several more years of locked-in gerrymandering matter when it may take 10, 15 or more years to build your case for action anyway? That said, I am going to “score” each issue and will examine political prospects therein, briefly.) Read More →

Save Lakewood Hospital

I feel like I ought to make a few notes here about Lakewood Hospital, and the grassroot campaign to save it, since I have been assisting said campaign for several weeks now.

Logo for Save Lakewood Hospital; links to campaign site

My work. Probably not destined for any design annuals, but my clients are pleased and I can argue for everything going on here.

At the risk of me-centrism, I think there are some notable aspects to the fact that I am interested in and supporting this effort.

I certainly do not seem to be from central casting, based on the other people I have met. Most of the people exercised about keeping Lakewood Hospital in business are middle-aged or older, and long-term residents. Many were born in the hospital, most have at least some personal interest in it. More than a few have longstanding axes to grind with city hall, as well.

This is not me. While it feels like I have been in Lakewood for a remarkably long time, at this point, my seven years still make me new guy compared with residents of 40, 50 or more years. Despite the fact that I have had more than enough run-ins with local healthcare, I have never been inside Lakewood Hospital for any reason; others’ fretting about having to travel a few extra miles for non-emergency care seems rather abstract to me, at best.

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The health care reform dissatisfaction taboo

Thank you, Helaine Olen.

For some time now, especially throughout the past couple of months, I have been stewing in dissatisfaction with the progress/prospects of health care reform from my individual perspective. I have nonetheless been reluctant to complain because the issue has become so absolutely binary. Either “Obamacare” represents the ruination of all that is good, is the source of every problem with anything, anywhere, and must be erased from the Earth… or, the good news just keeps on coming, millions more Americans insured, it’s the dawn of a “get more pay less” era in health care, etc., etc.

The former is just hysterical revanchist psychosis. The latter is very possibly all true, as far as it goes, and I want very much to believe that it’s going to go further, that I just need to be patient and give it another year or two or five. I can’t say for certain that this won’t happen, but so far I sure don’t have enough evidence to be confident.*

So I appreciate Helaine Olen stepping forward to say, at Slate, that “Those Protesting Harvard Professors Have a Point: We’re all still paying too much for our health care.” Basically, she has nailed almost every one of my concerns, concerns that I have been reluctant to voice, worrying that “I support the goal of reform and don’t want to lend any support to its absolutist opponents,” and “maybe it’s just me, maybe I’m being too selfish dwelling on my personal and perhaps atypical circumstances when so many people are getting help with greater needs.”

Maybe I am, but for what it’s worth, without hearing it from me someone else has now pointed out just every dissatisfaction I have identified…

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2014 midterm election implications

I have read very little news or punditry the past week. Most immediate post-election “analysis” is dregs-of-adrenaline meaningless noise, even by journalism’s ordinary standards, and in this case the specific election results make me physically ill.

Most of the few peeks I have taken have been over at Vox. The conclusions of their staff are thoughtful, appropriately cautious… and horrible. Matthew Yglesias has noted that “American politics is descending into a meaningless, demographically driven seesaw.” If you want more than that, well, that’s a problem, as Ezra Klein has elaborated:

The last five elections, taken together, wreck almost every clean story you might try to wrap around them. They show an electorate that veers hard and quickly between left and right and back again — shredding any efforts one might make to draw deep ideological conclusions from a single campaign. They show that Democrats can, in the right circumstances, win midterm elections. They show that incumbents can win presidential campaigns. They show an electorate that seems to be searching for something it cannot find.

Indeed. Perhaps because that electorate is doing something wrong… one could, of course, easily point to the system in a number of ways, but the strongest hope of changing that system rests in the hands of the electorate… On the whole, it’s easier than ever to see why people are disgusted by politics and declining to participate; unfortunately the spotty, knee-jerk participation that this leaves behind exacerbates the randomness and dysfunction that turn people away.

As someone wrote at The Economist a few years ago, “we have a system-wide problem with system-wide problems.”

Perhaps it might help if the idea that elections have real consequences, for real people, became once more central to political conversation, instead of just a source of anecdotal weapons. Very possibly not, but as self-indulgence is one of life’s few dependable consolations at present…

What state I live in a couple of years from now could well depend on what happens—or does not happen—next in our nation’s capital.

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