Saturday, May 09, 2015

It's Getting There

It was one small step for political hacks, one giant leap backwards towards the new Dark Age.

The Republican Congress has passed a budget which slashes funding for NASA's earth sciences research.  There are many other preposterous cuts in their budget so when it comes time to compromise with the White House on a final budget, this funding may be sacrificed.

The cuts are obviously aimed at NASA's climate research, which includes weather forecasting.  Republicans and their fossil fuel masters are at war with reality, but everyone else is going to pay the price.

Jane Jacobs wrote a book, her last, called Dark Age Ahead, published in 2004.  Jacobs, along with Margaret Mead, Ruth Benedict, Frances Perkins, Halle Flanagan, Eleanor Roosevelt and others, was one of the great women of the 20th century.  She was famous for The Death and Life of American Cities and other books on cities, and she changed what cities look like and what they are today.  But this last book was ignored.  It's time for it to be revived.

She writes that a Dark Age is not just some primitive state.  It is a time when what was once known is culturally forgotten.  It is when knowledge is at first denied and ignored, and then it disappears.  Once started, it can become very extreme.  In the last Dark Age, people lost the skills required to measure time, and so in a sense in daily life, time itself was forgotten.

"Cultural xenophobia", a "fortress or fundamentalist mentality" are the signs that the fall into an age of darkness has begun.

In the New Yorker article I linked above, Elizabeth Kolbert uses a term I've used here before: willed ignorance.  That's what is happening among our "leaders."  That's why, if it's not dark yet, it's getting there pretty fast, and this latest effort--especially if it succeeds--is a notable step towards that darkness.  With chaos ahead.

The cost of willed ignorance is increasingly steep, as is the lack of societal will to do the difficult things necessary to stop our self-destruction.

So the news is always the same, and yet significantly worse.  Species disappearing from the planet,including large herbivores like elephants and rhinos and species of primates, with consequences of the crash of natural systems we can't predict.  And of course, the continuing acceleration of pouring carbon pollution into the atmosphere, condemning our progeny to a hotter, more violent and in many ways, a poorer world.  This week it reached a long-feared record.

Meanwhile the rabid right grows ever more extreme and perverse, with the latest feverish delusion of an ordinary military training exercise really being an Obama-led military takeover, because (as columnist Gene Lyons wrote) "where else would you start a military takeover but the strategic hamlet of Bastrop, Texas, commanding the crucial highway junction between Elgin and LaGrange?"

 And when it doesn't happen, rabid rightists and their pandering politicians will brag that their vigilance stopped it.  It would be nothing but funny if it weren't another de-legitimizing tactic that has consequences for the planet and the future well beyond the petty careers in the tiny lifetimes of power-hungry hollow men.

Friday, May 08, 2015

The Doctor Won't See You Now

"People don't eat in the long run, they eat every day."  That Hopkins quote is, in a nutshell, why I supported Obamacare.  It did  not solve the increasingly stark problems of medical care in the US, but it made improvements in the insurance system that are already proving for some many Americans to be the difference between getting medical care and not getting it, and therefore, between health and pain, between life and death.

But the successes of driving a stake in the heart of the worst private insurance excesses (like "pre-existing conditions") and making insurance available and more affordable to more people haven't driven the utter insanity out of the system.  Some of the less publicized reforms--in efficiencies and so on--may eventually make some difference.  But the basic system is still out of kilter, and very onerous.

One simple but massive disproportion: There are now diagnostic and treatment methods using expensive technology that didn't exist a generation ago.  According to the true cost of using this technology and the time of skilled personnel, one would expect them to be more expensive, and even "expensive" relative to other costs and income.

But one would expect that procedures that are simpler, that don't require these technologies, would be cheaper--that is, affordable, as they were before.  But mostly they are not.  In America, absolutely anything that requires hospitalization, and almost anything that requires a physician, is impossibly expensive.  What was once a relatively minor illness or injury can easily become financially ruinous.  In this respect and others, affordable medical care for many in America has deteriorated from what it was 40 or 60 years ago.

The cost of medical care to patients has gone up faster than most peoples' incomes, and this has been going on for so long that the disproportion is extreme.  And that's for people with insurance.

Opponents of Obamacare from the left called for a public system dubbed "Medicare for all."  In the debate before the Obama bill was written, I favored this alternative.  But I knew then and I certainly know now that even this is not the solution.  Relative to what recipients receive in Social Security, Medicare is expensive insurance.  It is not free--the part that covers doctors costs in the neighborhood of 15 to 20% of an average Social Security monthly payment.  And there are deductibles and copays, just as in private insurance.  And there are enough holes in coverage that supplemental insurance is a big business (with the usual fraud we've come to expect from insurance companies.)

Moreover, between the machinations of private health care companies contracting with Medicare, and the bureaucracy of Medicare itself,  getting care is at least a part-time job.  And not a nice one.  It's a lot to ask of people who are old and sick as well.

Add to that the tests and procedures that aren't needed, but that involve time, expense and anxiety:

"In 2010, the Institute of Medicine issued a report stating that waste accounted for thirty per cent of health-care spending, or some seven hundred and fifty billion dollars a year, which was more than our nation’s entire budget for K-12 education. The report found that higher prices, administrative expenses, and fraud accounted for almost half of this waste. Bigger than any of those, however, was the amount spent on unnecessary health-care services. Now a far more detailed study confirmed that such waste was pervasive...

Virtually every family in the country, the research indicates, has been subject to overtesting and overtreatment in one form or another. The costs appear to take thousands of dollars out of the paychecks of every household each year. Researchers have come to refer to financial as well as physical “toxicities” of inappropriate care—including reduced spending on food, clothing, education, and shelter. Millions of people are receiving drugs that aren’t helping them, operations that aren’t going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm."

This hodgepodge of systems has roiled the world of physicians, clotted their hours with paperwork and thrown everything into chaos.  The money involved means that physicians are clustered in high income urban areas, and leaving places like Humboldt County in droves--there just aren't enough rich people here to make up the low income from Medicare and programs for the non-rich.  The number and proportion of doctors who will not see Medicare patients also seem to be increasing.

Getting sick or injured is always a crapshoot, and so is getting the right medical care for it, especially in proportion to your wealth.  The odds are increasingly against.

Think They'll Go Back to Alberta

Electoral politics is a mug's game.  Maybe it never made much sense but these days it seems all about money and whim.  I have no idea what just happened in the UK and apparently the experts there don't either.  There was a surprise earlier this week in the province of Alberta, Canada, when the iron grip of a conservative party very friendly to fossil fuel industries was defeated for the first time since Caesar.

David Suzuki has an analysis at the Guardian full of green hopefulness.  Another analysis suggests the electorate just didn't like the snobbish conservative candidate.  But one thing from Suzuki stands out: though the province has been and is being literally carved up (forests downed, as in the photo above) and polluted by immense tar sands oil projects, the provincial government didn't get much of a cut from the immense revenues.  So very friendly to the companies; I assume the suddenly unemployed leaders responsible will find cushy jobs there.  But the province is unable to handle a drop in oil prices, because it was operating too close to the margins to support its services in bad times.

So maybe a motivation among the electorate was regret.  I'm betting that in future years in the US, regret is going to be very big.  

Tuesday, May 05, 2015

Roosevelt & Hopkins: Every Day

I'm about to let go and take this book back to its home in the library.  It's a first edition of Robert Sherwood's Roosevelt and Hopkins: An Intimate History.  It's not everybody's idea of a great read, not at more than 950 pages with notes.  And it basically covers only the years of World War II, though there's biographical material and material about the Depression early on.  Although a playwright, Sherwood was also a writer and adviser for FDR, and he witnessed this history in the White House.  He had access to documents, to actual notes in the hand of FDR and Churchill, etc.  So there is a lot of detail.  The book was published in 1948, but both of his subjects-FDR and Hopkins--were several years dead.  It's clear from this book that they'd given their lives for their country.

I suspect not a lot of people have read this book, let alone re-read parts of it, but some have. One of the things I love about old library books is the Date Due sticker, and this one shows that at least one or a few people have taken it out every decade, beginning in April 1948 and ending so far with me in 2014.  I do worry that the library will get rid of it, as they have so many books (all the better to give more space for computers.)  But I think I've saved it for awhile--they tend to go after books that haven't been taken out for 10 years.  There is something special about this very book being a first edition, the feel of the paper and the typeface as well as the language and punctuation all shouting 1940s.  (This photo of the spine seems to be of the first edition; the HSU library edition is red and black, and this spine title is worn to almost illegible. The cover above appears to be a later edition.)

But I'm not bidding farewell to all that just yet.  I've typed out a number of especially interesting passages, especially those that still pertain.  I'm going to reproduce them here now and again.

In my first post I'll give my favorite Harry Hopkins quote, and one of my favorite quotes of all time.  It probably came directly from this book.  But before then...a little background.

Harry Hopkins, born in Iowa (small town, lower middle class), graduate of Grinnell College in Iowa (member of the Midwest Conference with my Illinois alma mater Knox College), he had a few jobs in New York City administering programs for the poor, worked for the Red Cross in New Orleans, returned to Manhattan and caught the eye of then Governor Franklin D. Roosevelt by his efficient administration of a state relief program in 1931.  FDR brought him to Washington to run New Deal programs including public works.

Though he also helped organize the American Association of Social Workers, he loved the Manhattan night life, and knew a lot of celebs.  He had a talent for friendships, which eventually included Eleanor Roosevelt, Winston Churchill and even, to a degree, Joseph Stalin.

 People liked him because he was trustworthy, direct and to the point. (One of the reasons he was also vilified by political opponents.) Sherwood writes that Churchill teased him with the prospect of a royal title to be conferred after the war.  He said it had already been picked out: Lord Root of the Matter. (p.5)

Harry, Sherwood wrote, "could slip now and then into skepticism but...always returned to a state of passionate hopefulness." [15]

Now a story with that quote from Hopkins very early in the New Deal. Hopkins boss was Harold Ickes, Secretary of Interior.  But his real boss was FDR.  When public works projects weren't getting started fast enough for FDR, he made a change by establishing the Civil Works Administration.  (Now I quote directly from Sherwood, p. 52.  The only changes I'm making are dividing the text into shorter paragraphs, placing FDR's words in italic and adding my own emphases in bold.)

 “...Civil Works Administration which put four million people to work in the first thirty days of its existence and, in less than four months, inaugurated 180,000 work projects and spent over $933 million. It was the parent of W.P.A. and marked the real establishment of the princple of the right to work from which there could be no retreat.

Of the formation of C.W.A. Roosevelt wrote:

‘The Public Works Administration (P.W.A.) had not been able by that time to commence a very extensive program of large public works because of the unavoidable time consuming process of planning, design and reviewing projects, clearing up legal matters, advertising for bids and letting contracts.’

This was Roosevelt’s tactful means of explaining why he took nearly a billion dollars away from Ickes and entrusted the spending of it to Hopkins at that time (he eventually did the same with many times the sum.)

Ickes was a very careful, deliberate administrator, who took pains to examine personally every detail of every project and the disposition of every nickel that it cost, whether it be a village post office or a Triborough Bridge. This is hardly to his discredit for it was the approach to each problem of a hardheaded businessman as well as a conscientious public servant.

 Ickes was concerned about the return on the taxpayers’ investment. Hopkins did not give a damn about the return; his approach was that of a social worker who was interested only in getting relief to the miserable and getting it there quickly. His ultimate argument was “Hunger is not debatable.”

 Ickes thought primarily of the finished job—Hopkins of the numbers of unemployed who could be put on the job. As an instance of Hopkins’ impatience: someone came to him with an idea for a project which would take a lot of time to prepare in detail but which, Hopkins was assured, “will work out in the long run,” and his exasperated comment on this was, “People don’t eat in the long run—they eat every day.” [end of excerpt]

Long range planning is important, as is envisioning the future.  But we must always remember that people eat every day--the present, especially for people at the edge of need, can be more important.  Reconciling the two is the art of policy.  But the point Hopkins made is about not forgetting the most important and urgent task (Lord Root of the Matter, remember?) in the fog of planning.

The debate over spending money to meet infrastructure needs as well as for social good continues in our time along some of the same lines.  However we've even further behind that debate in acknowledging the real problems.  Jonathan Chiat today writes about a "debate" over poverty ostensibly between NY Times columnists David Brooks and Paul Krugman.  Krugman alludes to "some people" who insist people in America are poor because of moral failings and wrong values.  Krugman, sounding a little like Hopkins, writes: "The poor don’t need lectures on morality, they need more resources — which we can afford to provide — and better economic opportunities, which we can also afford to provide through everything from training and subsidies to higher minimum wages.”

But even this debate pales against the stark realities that Hopkins recognized by addressing them directly.  And by building the public infrastructure that is still the foundation of economic as well as public and personal life in America.  Including infrastructure now crumbing dangerously, more than 80 years later.  Which our elected representatives ignore.

Monday, May 04, 2015

Emerson for the Day

“Silence is the communing of a conscious soul with itself.—If the soul attend for a moment to its own infinity, then and there is silence. She is audible to all men—at all times—in all places—and if we will we may always harken to her admonitions.”