Health reform: a start

Victory finally came, but only for those who were hanging onto the shreds of earlier wishes, and it wasn’t ever pretty. Watching C-SPAN on Sunday, in fact, was a little like watching grass grow, with every other blade sniping at the blade just around the corner. But at least that much is over.

Congress gave final approval on Sunday to legislation that would provide medical coverage to tens of millions of uninsured Americans and remake the nation’s health care system along the lines proposed by President Obama.

By a vote of 219 to 212, the House passed the bill after a day of tumultuous debate that echoed the epic struggle of the last year. The action sent the bill to President Obama, whose crusade for such legislation has been a hallmark of his presidency.

“This isn’t radical reform, but it is major reform,” Mr. Obama said after the vote. “This legislation will not fix everything that ails our health care system, but it moves us decisively in the right direction. This is what change looks like.”

Minutes after thebill was approved, the House passed a package of changes to it and sent it to the Senate. The Senate majority leader, Harry Reid of Nevada, has promised House Democrats that the Senate would quickly take up the reconciliation bill with the changes in it, and that he had secured the votes to pass it.

But while the Senate is bracing for a fierce floor fight over the reconciliation measure, the landscape was permanently altered by passage of the original Senate bill. Should the reconciliation bill, which cannot be filibustered, collapse for any reason, the core components of the Democrats’ health care overhaul would move forward. Indeed, Senate Republicans were quickly faced with a need to recalibrate their message from one aimed at stopping the legislation to one focused on winning back a sufficient number of seats in Congress to repeal it.

It was mean and divisive and ugly, and will surely get more so, but at least it’s a start. We can finally begin to reform what is a cruel and unworkable system. And maybe, just maybe, there will some day be access to health care for all. Does anyone remember when there was no Social Security or Medicare?

House Approves Health Overhaul, Sending Landmark Bill to Obama – NYTimes.com.

Homeless & still grinning

President Obama’s proposed budget for FY2011 includes a broad range of programs addressing homelessness, from provision of new services to the “Zero Tolerance” initiative for homeless veterans; I wish them all well. Aside from national efforts, most of us struggle with our personal relationship to the growing numbers of homeless citizens: Look the other way? Drop coins in cups? Buy snacks? Volunteer with the Food Bank? Most of us try to give something.

Occasionally, we get something more. This is such a story.

My friend Kevin left our neighborhood park in December, bound for Bakersfield in California’s central valley. “The Saint Vincent de Paul bought me a ticket,” he said. I worried about who would look after him. In our neighborhood he could sit in the sun and watch the birds on the lake, the joggers and strollers, and children on the playground. On rainy days he could sit on a corner bench inside the library. He never asked for money, but many of us gave him a dollar or two whenever we met. “Oh, I think he’ll be okay,” said one of the dog-walkers who is also among the Mountain Lake Park regulars. “He’ll find a meeting, and they’ll help him. He’s been doing really well with his drinking.”

Turns out it was not really Kevin I was worried about, but myself. Things were not the same. I would finish the hop kick on my loop around the parcourse fitness trail, and Kevin was supposed to be there. Instead, I would encounter an empty bench, or a disinterested stranger preoccupied with someone at the other end of a cell phone line. I missed the “How you doin’?” or the “Where you been ?! I ain’t seen you in a long time!” The occasional pause to sit beside him in the sun and pay attention to the feasts of nature everywhere.  Most of all I missed the wide, semi-toothless grin and the parting “Have a guht one!” that sent me brightly on toward the push-up bars just around the next bend in the trail. I was bereft.

Then a couple of weeks ago, headed from the chin-up station (I wish), I spotted a vaguely familiar figure walking slowly toward me. Decked out in a puffy new jacket (Kevin’s fashion tastes lean toward multiple bulky layers) and a new, bright blue cap, his beard somewhat trimmed, I did not recognize him until the great, toothless grin broke across his face. I ran down the trail, catching myself at the very last minute to restrain the hug I felt – this, I think, would’ve been too much for Kevin to handle – but grabbing both of his mittened hands.

“Kevin!” I said. “I thought you’d left us, gone off to Bakersfield forever!”

“Naw,” he said. “It’s too wahm in Bakersfield.”

So there it was. We were redeemed by the perpetually mild weather of the San Francisco Bay, where it seldom gets too warm and on rainy days one can find refuge in the library.

Did he have a good time in Bakersfield? “Oh, yes.” Did he get to see family? “Mmm.”

I still don’t know all the answers, or whether one day I’ll get to the hop kick station and find him gone again, for good.

What I do know is that for now the universe is proceeding as it should. And that one man with seemingly nothing to celebrate has brought the spirit of celebration back to Mountain Lake Park. It’s a great gift.

Catholic nuns urge passage of health bill

There’s hope. The U.S. Conference of Catholic Bishops may be trying to sink health reform because they feel they know best about women, but a few thousand good sisters are raising their own voices. And not just your everyday sisters.

Catholic nuns are urging Congress to pass President Barack Obama’s health care plan, in an unusual public break with bishops who say it would subsidize abortion.

Some 60 leaders of religious orders representing 59,000 Catholic nuns Wednesday sent lawmakers a letter urging them to pass the Senate health care bill. It contains restrictions on abortion funding that the bishops say don’t go far enough.

The letter says that “despite false claims to the contrary, the Senate bill will not provide taxpayer funding for elective abortions.” The letter says the legislation also will help support pregnant women and “this is the real pro-life stance.”

This space, a space which claims several priests as good friends despite our frequent and vehement disagreements, hereby sides with the sisters. And offers a sincerely respectful three cheers.

Catholic nuns urge passage of Obama’s health bill – Politics – Wire – TheState.com.

Abortion foes stoop to new low

Not satisfied with the use of fear and intimidation to deprive women of their right to choose an abortion, or closing clinics by murdering dedicated doctors, anti-abortion forces have now taken on a new mission: to convince African American women that pro-choice is really a plot to exterminate their race. In other words, desperate, vulnerable young women will now get a new message: You must always bring an accidental, unwanted child into the world — forget the cost or damage to its mother (and often to the child) — because it is your ethnic duty.

When these people achieve their goal of eliminating abortion rights altogether, it will be these women who will die from butchered, back-alley abortions. Is anybody considering that? Or do they really believe the twisted rhetoric they are employing in the damn-the-torpedoes drive  to abolish a woman’s fundamental right to control her own body?

For years the largely white staff of Georgia Right to Life, the state’s largest anti-abortion group, tried to tackle the disproportionately high number of black women who undergo abortions. But, staff members said, they found it difficult to make inroads with black audiences.

So in 2009, the group took money that it normally used for advertising a pregnancy hot line and hired a black woman, Catherine Davis, to be its minority outreach coordinator. Ms. Davis traveled to black churches and colleges around the state, delivering the message that abortion is the primary tool in a decades-old conspiracy to kill off blacks.

The idea resonated, said Nancy Smith, the executive director. “We were shocked when we spent less money and had more phone calls” to the hot line, Ms. Smith said.

This month, the group expanded its reach, making national news with 80 billboards around Atlanta that proclaim, “Black children are an endangered species,” and a Web site, www.toomanyaborted.com.

Across the country, the anti-abortion movement, long viewed as almost exclusively white and Republican, is turning its attention to African-Americans and encouraging black abortion opponents across the country to become more active.

A new documentary, written and directed by Mark Crutcher, a white abortion opponent in Denton, Tex., meticulously traces what it says are connections among slavery, Nazi-style eugenics, birth control and abortion, and is being regularly screened by black organizations.

Black abortion opponents, who sometimes refer to abortions as “womb lynchings,” have mounted a sustained attack on the Planned Parenthood Federation of America, spurred by a sting operation by young white conservatives who taped Planned Parenthood employees welcoming donations specifically for aborting black children.

“What’s giving it momentum is blacks are finally figuring out what’s going down,” said Johnny M. Hunter, a black pastor and longtime abortion opponent in Fayetteville, N.C. “The game changes when blacks get involved. And in the pro-life movement, a lot of the groups that have been ignored for years, they’re now getting galvanized.”

What’s giving it momentum is a history of ugliness on both sides of the issue, especially ugliness and worse suffered by African Americans. Hunter, of course, cannot understand the desperation of a woman with an unwanted pregnancy. But adopting a tactic of this sort can do nothing for understanding — and a lot to increase the future suffering of women of all colors.

Many black anti-abortion leaders, including Ms. Davis and Alveda King, a niece of the Rev. Dr. Martin Luther King Jr. and the director of African-American outreach for Priests for Life, often recount their own abortion histories (each woman had two).

Shaila Dewan’s New York Times story detailing this new campaign does not point out the fact that Davis and King had access to safe, legal abortions, which theirs presumably were. Had that not been the case, either or both might well not be here today.

Those who support abortion rights dispute the conspiracy theory, saying it portrays black women as dupes and victims. The reason black women have so many abortions is simple, they say: too many unwanted pregnancies.

“It’s a perfect storm,” said Loretta Ross, the executive director of the SisterSong Women of Color Reproductive Health Collective in Atlanta, listing a lack of access to birth control, lack of education, and even a high rate of sexual violence. “There’s an assumption that every time a girl is pregnant it’s because of voluntary activity, and it’s so not the case,” Ms. Ross said.

But, she said, the idea that abortion is intended to wipe out blacks may be finding fertile ground in a population that has experienced so much sanctioned prejudice and violence.

Black opponents of abortion are fond of saying that black people were anti-abortion and anti-birth control early on, pointing to Marcus Garvey’s conviction that blacks could overcome white supremacy through reproduction, and black militants who protested family planning clinics.

But that is only half the picture, scholars say. Black women were eager for birth control even before it was popularized by Margaret Sanger, the founder of Planned Parenthood, and black doctors who provided illegal abortions were lauded as community heroes.

“Some male African-American leaders were so furious about what they perceived as genocidal intentions that in one case they burned down a clinic,” said Carole Joffe, the author of “Dispatches From the Abortion Wars.” “But women were very resolute, saying, ‘We want birth control.’ ”

Sanger was not perfect, and Planned Parenthood employees have made reprehensible statements at times. Crutcher’s documentary, “Maafa 21”, (the name is a Swahili word used to refer to the slavery era) weaves a few threads of truth into a vicious, two-hour screed tying the pro-choice movement to the Nazis and a “great conspiracy,” proclaiming pro-choice as “Black Genocide.” It was screened recently at Morris Brown College, a historically black institution in Atlanta.

“Before we saw the movie, I was pro-choice,” said Markita Eddy, a sophomore. But were she to get pregnant now, Ms. Eddy said, “it showed me that maybe I should want to keep my child no matter what my position was, just because of the conspiracy.”

Eddy at least knows that she still has a choice. The goal of the anti-abortion movement is to eliminate that choice. I would fight for her right to have and keep her baby. But the choice should not be made by some angry white man in Texas, or by someone else’s patriarchal religion or politics. It should be made by her, the owner of her body. To have that choice removed, now that is like slavery. Show me one member of the movement who has had a back-alley abortion and I will discuss that point with her. To promote these tactics, to foster this sort of hate-based rhetoric is almost as cruel as the fate to which the anti-abortion movement would consign American women. Of every color. It makes my heart ache for us all.

(A note: If you find this appalling, check out the subsequent post, and learn what’s going on in Poland. Women’s choices are under attack around the globe.)

To Court Blacks, Foes of Abortion Make Racial Case – NYTimes.com.

The Elderly: root of society's ills

This is a bad way to start a geezer’s day:

Deakin University researchers questioned 113 people about their views on the over-65s for a report commissioned by the Victorian aged care organisation Benetas. The university’s Associate Professor David Mellor says young people and baby boomers perceived older people as unproductive.

“While older people are seen as friendly and pleasant, ultimately, they’re seen to be unproductive,” he said. “Now, that ties in with baby boomers talking about older people as having no ambition, or as being fragile and being a burden on society.”

OK, “friendly and pleasant,” I’m good with that. But fragile. Come on, professor, I’m still doing my par course workouts.

Professor Mellor says the research revealed a number of reasons why older people are not treated with respect. “Things like the smaller family size, broken families, the pressure of time that affects people who are working, and the rise of technology,” he said. “All of those kind of factors were seen to be barriers to younger people giving respect or expressing respect to older people.”

However. That ‘ABC’ refers to the Australian Broadcasting Corporation, not the American. And can any study commissioned by a Victorian aged care organisation be fully trusted? Let’s have a little respect here, please.

Elderly seen as ‘burden on society’ – ABC News (Australian Broadcasting Corporation).

Jenna & Barbara Bush doing good? Building better global health? Believe it

Saying good things about anyone named Bush has not been a priority of this space. But an article by Sarah Adler that appeared in today’s San Francisco Chronicle, and a quick visit to the Global Health Corps Web site, suggest that the former first twins have found a way to turn their considerable name recognition and fund raising skills into an innovative program at work to improve health access and care in the U.S. and across the globe.

When first daughter Jenna Bush attended a Bay Area AIDS summit hosted by Google.org two years ago, some skeptics doubted it would amount to more than a photo op.

But they were wrong. In a conversation with a Google staffer and a Stanford AIDS activist at one session, she helped come up with a big idea: A plan to improve health care access in the poorest parts of the United States and the world. What may have seemed like a pie-in-the-sky plan has morphed into a nongovernmental organization with an impressive roster of donors and more than $1 million in funding. Few may have heard of the Global Health Corps, but as its influence grows, that is likely to change.

“So many ideas come up in group conversations that never get realized,” said corps founding director Dave Ryan, who at the time was the executive director for Face AIDS, a nonprofit group that helps Rwandans living with HIV. “But when we all got together, we saw there was something special that could happen.”

Having watched friends transition from college into careers through organizations like Teach for America, they wondered whether they could create a similar organization dedicated to health care.

“We felt like there should be a similar program for public health,” said Charlie Hale, who works in Google’s direct ad sales division and is one of the group’s co-founders.

They enlisted an eager group of socially conscious friends and secured $250,000 in seed money from Google.org. Jenna’s sister, Barbara Bush, became the president of the organization, after spending time working in Africa with UNICEF and the U.N. World Food Program.

Rather than plunging into provision of health care or supplies, GHC finds people with skills in supply chain, design and technology often learned outside of the health care field, and partners with public health organizations to fill such needs within the field. These tend not to be old fogeys over 30, either; it is twenty-somethings like themselves that GHC seeks to attract. They have thus far sent 22 fellows to 12 countries in East Africa and the U.S., and plan to send 36 new fellows out this year.

The organization has also formed partnerships with the Clinton HIV/AIDS Initiative, which is part of former President Bill Clinton’s global nongovernmental foundation, and Partners in Health, which was co-founded by Dr. Paul Farmer and has a large presence in Haiti.

The Global Health Corps has four staff members in New York and three volunteers in San Francisco and relies on group calls, e-mail and video conferencing at cafes, such as the recent session at Philz Coffee where Barbara Bush, Hale and Chief Financial Officer Jenny Miller exchanged updates.

The group has raised more than $1 million, and Hale said that while he’s aware that the group has more advantages than others, it also has a greater obligation to prove itself.

“Our contacts got us in the room, but at the end of the day, no one is going to significantly fund you unless you show that your good idea can work,” he said.

The Global Health Corps is accepting applications for fellowships in Burundi, Malawi, Tanzania and Rwanda, where Barbara Bush recently traveled to meet with the group’s fellows.

Boomers and beyonders need not apply. This is a new-grads generation thing. Working backwards from the Greatest Generation through the Depression-scarred and the super-achievers and the me-firsters and the whateverers, it is encouraging to see a new generation of energy and optimism deciding to take on global issues of real significance and need. Even if the decider is named Bush.

Opportunity, optimism in Global Health Corps.

Anthem Blue Cross 'doing the right thing'?

In testimony before the California Assembly Health Committee yesterday, Anthem Blue Cross President Leslie Margolin said of her company, “I think we do the right thing, and we try to do the right thing every day.”

What that means is, turn a profit for the company every day. If you are in business to make money, that is the right thing to do.

On the other hand, when Margolin says the company’s goal is to provide “care, comfort and coverage to those in need,” that is simply not true. Physicians and health care professionals provide care and comfort. Anthem provides coverage which sometimes pays for these things and often does not, if they can help it.

Is there no way to connect those dots? Care and comfort for those who need and deserve it — i.e., every human being — are not going to happen until we get the coverage people out of the equation.

OK, not going to happen any time soon. It could happen in California, except for Governor Schwarzenegger‘s probable veto. It should happen in Washington, except for the money and muscle of the coverage people. In lieu of those realities, a health bill that takes a tiny step in the right direction would be welcome.

Health care reform solution: eliminate insurance

“Insurance? My whole point is I want to kill it.”

Gil Ahrens knows health insurance. One terrible accident. Years of life turned upside down. Denials of payment. Claims argued. Liens placed on property. Throughout a long and arduous struggle to get life back on track, obstacles created by insurance issues stood in the way of what should have been everyone’s focus: care. It is a story familiar, in one variation or another, to millions of Americans.

Author of the recently released Shattered, Shaken and Stirred, Ahrens began his eye-opening journey through the catacombs of our health insurance system almost simultaneously with a devastating automobile accident. He escaped with a badly mangled foot and other injuries, his wife was left paralyzed. Their three-week-old daughter survived intact — but that was about the only good news the Ahrens family would have for a very long time. For the successful California businessman/entrepreneur and his family, life was forever changed; the book tells the years-long challenge of that change.

In recent appearances and radio talks, Ahrens has spoken out against what he describes as a health system “in shambles. In its current state, health care is a bigger threat than terrorism. And needless to say, we are paying through the nose.”

Shattered, Shaken and Stirred, written in the form of a letter to his now-school-age daughter, is part description of unbearable tragedy and misfortune, and part how-to guide for rebuilding one’s spirit. But underlying it all is an unvarnished message to America from one person who has been entrapped in the system: insurance is the #1 evil of American health care.

Elsewhere around the globe are examples of how to do health care right. The world’s top ten livable cities, Ahrens points out, share one characteristic: their citizens have health care. Not health insurance, health care.

“Americans do not want coverage,” Ahrens says; “they want care.

Does that not make sense?

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