Tuesday, January 27, 2009

The Health Care You Have, Not The Health Care You Want

I believe in health care reform, but since I can't read or listen to more than 20 or so words at a time without thinking about food or wanting to take a nap*, it's hard for me to sink my teeth into, you know, learning anything about it. Fortunately for me, there exist magazines to cater to me and my tiny attention span.

The New Yorker came out this week with Atul Gawande's kind of sweet overview of how universal health care evolved in slavering backwards socialist nations like France, Switzerland and the UK. The thesis is pinned to path-dependence: there was never a traumatic overhaul with bureaucrats scrambling to radically change everything, rather, things just kind of happened. For example in the UK, WWII required massive government assistance to put health services out in the sticks, where everyone's kids were fleeing, and then when all that stuff got bombed they had to redo it. So by 1948 the NHS sort of already existed.

Many Americans envision universal health care as a change on the level of a Bolshevik revolution, and the author's idea is that it doesn't really have to be that way. No one is going to shut hospitals down for 5 days and raise your taxes to 50%. You build gradually on what you have, and the result is an imperfect but workable patchwork-quilt-style safety net.

I like the idea of making universal healthcare a palatable idea, which Gawande does in a very straightforward, non-wonky way. The problem he overlooks, I think, is that for these European countries, there was a serious impetus for these incremental changes like war (UK), famine (France), everyone else is doing it (Switzerland). Here, it seems that impetus does not exist, but for the Cries Of The People (and who ever listens to those anyway).

Well, actually, there is the obvious: that nearly 50 million of us have zero insurance, but that doesn't seem to have resonated with many of us. (I don't like thinking that we're so callous as to say that a Teddy Grahams heiress should be able to have lots of extra money lying around for Botox but not have to contribute jack to a laid-off factory worker's cancer treatment. But maybe small, incremental edits to our collective consciousness have created that culture.) It does seem that at a minimum, almost everyone agrees that more people need to have their basic needs cared for. So, a journey of a thousand miles, etc. But will there have to be a catalyst to, you know, take that first step? A catalyst besides the problem itself? I hope an administration that is supposedly built on pragmatic competence will find a way to get us somewhere without requiring it.

*Which makes being a) married to an academic and b) the sister of a health policy nerd AWESOMELY FUNNY. Them: "So basically this method of measuring the effect gives us new ways to control for these variables, and predict the..." Me: "Look, a butterfly."

Saturday, January 17, 2009

Labor Glory

This emptywheel piece gives the rundown of how unions and their oh-so-cumbersome insistence on safety training saved the bacon of the passengers of the airbus that glided onto the Hudson on Thursday.

Fascinatingly, the lauded pilot was a "former safety chairman, accident investigator and national committee member for" ALPA. Representatives of various airport unions have criticized pilots' for a perceived bugger-anything-the-flight-attendants-and-mechanics-or-anyone-else-at-the-airport-needs arrogance and lack of solidarity. (Imagine how much power pilots, flight attendants, skycaps, mechanics, baggage handlers, and everyone else would have at the airport if they worked together effectively.)

But while our unions don't play together as nicely we would like them to, this case is certainly something the labor movement should feel great - and brag - about. Let's hail the awesomeness of these experienced and union-represented pilots, flight attendants, air traffic controllers, ferry crews, cops and firemen who have stuck around long enough to be effective, their choice to stick around partially due to guaranteed wage increases, nice benefits, and pride in their jobs. And the piece concludes, sweetly:

"But I haven't heard much about Bob Corker and Richard Shelby saving 155 people's lives."


Monday, January 12, 2009

A Girl and Her Racist Dog

Mike3550 is out of commission this week defending his prospectus. So I thought I would attempt to insert some blog posts between last week and next, bringing the level of discourse down from politics and neighborhood effects - all the way down, in fact, to topics like our stupid dog.

We've suspected it for a long time, but the events of this evening have pushed me to state publicly: my dog is racist. Tonight Dog and I are going for a nice brisk walk in our neighborhood, and it becomes apparent that someone is walking behind us. I turn around, and it is a tall Latino. Dog looks behind her, starts barking her head off for about five barks. I apologize, man laughs. Okay, I think, he's behind us, he surprised her, fine. But then I thought, wait, we live in New York City, not the postapocalypse. These sidewalks are busy. People walk behind us all the time. Just - mostly white people. This is, by the way, at least the fifth time she has singled out a Latino for her rage.

The rest of our walk goes nicely, without any hate/harassment. We get back to our building and get into an elevator. Who comes through the door - surprise! - but our nice new white neighborman and our nice new Indian neighborwoman. NEW neighbors. Would you expect some skepticism from Dog? She has never met them before. But lo and behold, she puts on the greatest kiss-ass puppy-eyes display known to man. She is a hit, and gets her chin rubbed and ears scritched. Score.

They get out on 3. We get out on 5. A Latino who doesn't live on our floor stands before us on 5. Dog freaks out. Barks as though the man is ripping apart my body and feasting on my entrails. In fact - and I've never seen her do this before - she lunges at him.

No one was hurt, thank goodness - she didn't really get on him, just near enough to provoke deep visible fear in the man's eyes - but the man got a profuse gushing apology from me and was very gracious considering an animal apparently wanted to end his life because he was standing there. Dog got some serious yelling and alpha-domination by yours truly.

I don't get it! I never thought of myself as a racist owner, but maybe I evoke barely perceptible tension when I'm around people who are different from me and she picks up on it. Maybe she turns on Lou Dobbs when we're asleep. Maybe the other dogs in our building are a bad influence. Maybe my racism is like a dogwhistle, and only she can hear it.

Friday, January 9, 2009

Inauspicious Start

Although I tend not to make New Year's Resolutions, I have decided to try to make two this year:

  1. Try to be more consistent blogging

  2. Eat healthier and exercise more (I know, how cliché, right? But, since I figure that I study health, perhaps it would be wise for me to actually pay attention to some of the research and keep myself healthy)

I have made less than an auspicious start on the first. However, I am going to give myself a pass for last week and the next couple of weeks because I have spent the last five days finalizing my dissertation proposal. It's all done - submitted, in the hands of my committee to do with it what the will. I will find out what they intend to do with it this coming week when I head back to the Midwest for my defense. Then, after that, I am off to Philadelphia immediately from Michigan, then off to D.C. next week, then back to the Midwest the week after that. Needless to say, if I can find some time (and an internet connection) to catch my breath and write in the next month, I will be amazed. But, seeing as how I have made this public revelation, let's see if that will encourage me to write more!

Wordle: UntitledIn the meantime, here is a Wordle of my proposal. I bet you would never be able to guess what I study!