Private Health Insurance: Pros and Cons

If ever you have any doubts about the relative virtues of the American commercial health care system, aka private health insurance and National Health systems, rather than focusing on the horror stories about socialized medicine in Europe and Canada, where, our American Republican politicians tell us (as if they know) there are death panels deciding who can get chemotherapy or waiting times of years before you can get your hip replaced, consider this: Has the American system become so corrupted that however bad the European national health systems may be, how much worse can they be than what we've got?

Oh, we all know some healthcare insurance plans are "Cadillac" plans, negotiated, for example, by unions over years and providing wonderful coverage for doctors' visits, hospitalization and even drugs. 

Sheelah Kolhatkar

But, after you ask yourself, "Do I have such a wonderful plan?" ask yourself what this passage, from the Sheelah Kolhatkar's New Yorker  article "The Whistle Blowers" might mean. Here she is describing the home Kiran Patel is building himself with the money he made from the health insurance conglomerate he fashioned, combining WellCare with Freedom and Optimum Healthcare. 

"The residence will be a cross between the Taj Mahal and Versailles--a sixty-eight-thousand square foot palace with a fountain, a twelve-car garage, a Hindu temple, domed pavilions, and latticework made of red sandstone imported from Rajasthan. There will be separate building for Patel's three grown children and their families, spread across seventeen acres that abut White Trout Lake, which is celebrated for its sunset views. The estate's centerpiece is a grand ballroom."

Kiran Patel

This from money made from health insurance here in the USA, mostly from billing Medicare.

You will say, well, I need to know more about Mr. Patel and how he was able to become so rich, as an entrepreneur. Perhaps he is simply more brilliant and more hard working and more of a risk taker than his fellow cardiologists. Maybe he made this money, fair and square. Maybe he deserves this. After all, we are a capitalist society. You cannot be envious of the winners.

Really? Do you really believe that?

Or do you believe, with Balzac, "Behind every great fortune lies a crime" ?

Carolyn Kormann and Boyan Slat: The Widening Gyre

Turning and turning in the widening gyre
The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.

--W.B. Yeats, "The Second Coming" 

My oldest son, from age ten wanted to be a photographer for the National Geographic, a fantasy for which I was partly responsible because I subscribed and he read everything which came into the house. 
Years later he read The New Yorker, cover to cover, when I was reading only the cartoons, but he got me into the habit, and that has richly rewarded me.

This week (Feb 4) it was a dazzling piece by Carolyn Kormann, a staff writer, about the problem of those Texas size plastic garbage heaps floating around the Pacific and one man who decided to do something about it, a Dutch guy named Boyan Slat.

Carolyn Kormann

Actually, it's not just one heap but at least four, and they are more like gyres (swirling things) and those are only the ones you can see. Much of the garbage may be sinking to the ocean floor, washing up on beaches.

I'd often wondered why someone didn't just get a big tanker, or a fleet of tankers out there and vacuum the stuff up.

There is the image of those starving polar bears on ice floes, victims of the global warming which Trump dismisses as a Chinese plot,  and now there are the images of those terminally cute sea turtles swallowing plastic straws and wrapping.

I've tried to get the staff in my office to switch to metal spoons rather than throw away plastic, but they have refused, the ladies claiming it would fall to them to clean the silverware and they may be right. Having read Kormann's piece, I now understand whatever de minimus efforts I might make, carrying groceries home in reusable cloth bags, eschewing plastic spoons and straws, it would be only a drop in the bucket, literally. 

Boyan Slat

Kormann manages to profile Slat, who is trying to do something, and is something of a hustler, necessarily, giving Ted talks, gathering up large quantities of money from foundations and on line donors--but he's hustling for a great cause, cleaning up the oceans, while she also renders an unsparing portrait of the man and all through she weaves in the science and technology and personalities which are being mobilized. She tells you what other workers in this field say about him, the criticisms of the concept--some think once the plastic is ocean borne, it's too late--other think the engineering is simply too complex. Then again, the guy is Dutch and the Dutch have a history of engineering the ocean. 

Decades ago--seems like a lifetime--Jacques Cousteau complained the oceans had become befouled by trash and garbage and although I noticed that, it seemed nobody else did--they were too busy delighting in the underwater things he recorded swimming by.

Slat's idea is to simply pull an enormous net behind a boat or boats and sweep up the garbage, but there are problems--the plastic just floats away from the net, elusively pushed away by the wave generated by the approaching finger. And the stuff may have sunk far deeper than the net and the stuff may be not just plastic crates and big things but tiny bubbles and shards. 

It's a project which Slat admits is daunting but he insists, as he must, it is not unsolvable. Like those oil rigs in the North Sea, where there's a will, there's a way.

Kormann ends her portrait with a gossamer portrait of surfing with Slat in the San Francisco Bay. The image is cinematic, two beautiful people, one Slat, who is a comically inept, who, one imagines, is only out there so he can be alone with the winsome Kormann, but both on surfboards and he tries and tries but he is, like Gatsby, trying to overcome the irresistible force of his own personality and of nature, "fighting the endless white water to get back out," a boat beating against the current, borne back ceaselessly.

Trumped Up

There is no possibility I am the first to note the irony of the meaning of "trumped up."

"fabricate, devise," 1690s, from trump "deceive, cheat" (1510s), from Middle English trumpen (late 14c.), from Old French tromper "deceive," of uncertain origin, perhaps from a verb meaning "to blow a trumpet." Related: Trumped; trumping.

But what is surprising is how seldom anyone comments on this, plays with it.

The idea that the man's very name means to "deceive" and "cheat" seems so obvious, the idea of "hiding in plain sight."

His acolytes simply will not believe this. In a sense this is exactly what Trump tells us when he says he could shoot a man on 5th Avenue in broad daylight and not lose a vote from his base.

The idea that his fans do not care, do not care if they are lied to, because they are not the ones who are being lied to--it's everyone else who is being lied to; we know better. We take him seriously, not literally. 

Listening to a podcast about Marie Antoinette done by Melvyn Bragg on "In Our Time," it is illuminating how little we know about public, not to mention, historical figures. Makes you think again about Bret Kavanaugh and Ron Northam. 

We can sell you anything: Smoking as an aphrodisiac 

Marie Antoinette, according to the panel was vilified with what would now be called an "ad campaign" which was almost wholely pure lies, although it was true she spent astonishingly, obscenely on clothes, but that is what royalty did in her time, (and still.)

So we may not know much about the real man, Donald Trump, but we can judge from his own appearances, statements, tweets and rallies, that he is a liar and a man who uses lies to spin a fantasy which is dear to his audience, very much as Hitler and Goebbels and Henry Ford and Senator Joseph McCarthy did.

There will always be prevaricators like Mr. Trump, but how many will be named, "Liar" or "Dissembler" or "Phony?"

Curious that. 

Trump, the Ravishing of White Women As a Trope

Whenever things slow down for Donald Trump, whenever he suffers a wound, he tweets MAGA or if he is particularly dyspeptic, he starts belching about the latest imagined or real rape or murder of a white woman by a dark skin, Spanish speaking nogoodnick, MS 13 illegal immigrant who has slipped across the border to seek out a white woman to rape.

Save Our Beautiful White Women

As others have observed, had the victim been a woman of color, there would be no story.

In this, Trump is one of a long line of racist demagogues stretching back to the American Revolution.

Reading, "The Men Who Lost America" a surprisingly engrossing account of the British generals and politicians (who were often one in the same), the king among them, I came across the story of Jane McCrea.

Jane McCrea was the bethrothed of a loyalist American soldier, on her way with General John Burgoyne, as he wended his way down from Canada with a British army, accompanied by allied American Indian warriors and somewhere between 500 and 2000 camp followers, women and children, among whom was Burgoyne's mistress. 

Burgoyne

(To digress: Burgoyne was much in love with his wife, 20 years his junior, but, apparently, while on assignment in the colonies, it was not remarkable for officers to take on a mistress, often the wife of another soldier, either loyal or Royal, who was occupied elsewhere. (Burr in "Hamilton" is carrying on with the wife of a British officer stationed in Georgia.) Apparently, what happened in camp, stayed in camp, in America.)

To return to the story of the unfortunate Ms. McCrea: during the trek south, two Indians argued over who was going to be the bodyguard of Ms. McCrea and apparently the disagreement got out of hand and one Brave ended the argument by bringing his tomahawk down through the skull and brains of Ms. McCrea.  If I can't get paid to guard her, then neither will you. So there.

The incident became a cause celebre. It was reported back in England, bloviated about in Parliament and it make every newspaper in America,

The event fed into the contention of the colonists that the king and his men were bringing savages to bear, savages and German mercenaries, which meant the king regarded the colonists as foreign, not British subjects and far from protecting the British colonists, was subjugating and murdering them. "I will kill your friends and family to remind you of my love." It even made it into the Declaration of Independence as one of the many depredations Jefferson attributes the king, 
"He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers the merciless Indian Savages whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions."

Gen, Horatio Gates

So there was the Trumpian racial thing, as General Horatio Gates of the Continental Army said, "That the famous lieutenant-general Burgoyne, in whom the fine gentleman is united with the scholar and soldier, should hire the savages of America to scalp Europeans and the descendants of Europeans."

Gates further embellished, just as Trump has, Trump who always speaks of "beautiful children" or "beautiful women" murdered or raped. He would not be as offended, presumably, if the woman raped were ugly or the child dark,

Painting by Vanderlyn

"A young lady lovely to sight, of virtuous character and amiable disposition...scalped, mangled in the most shocking manner...dressed to meet her promised husband."

A Trump before his time, Gates was.

It didn't matter this was a loyalist woman on her way to meet a loyalist man who was fighting against Gates and the Revolution. In fact, it may have played better that way: Look what happens when you make your loyalty to the British who consider us just chattel.

It's reassuring to see Trump is nothing so new. Just an new refrain of a very old song. 

Chris Hayes: A Colony within a Nation

One of those Christmas books you finally get around to reading turns out to be very worthwhile: Chris Hayes, "A Colony in a Nation." 

Before he gets to the riots and revolt in Ferguson, Missouri, Chris Hayes tells a few tales about the American revolution, beginning with the Boston Tea Party which, he says, occurred because the King and Parliament lowered the tax on Tea arriving at the port of Boston making legal tea as inexpensive as black market tea imported by bootleggers from the Netherlands.

Destroying the village to save it

(One has to imagine if we made heroin, cocaine et al available at cost at local dispensaries in downtown Baltimore whether the local drug lords would set fire to these dispensaries.)

So the Boston Tea Party was not about Americans indignant because they could not afford their beloved tea, but it was a black marketeers' action to protect their markets, more Tony Soprano than freedom riders.

The king's agents, who enforced taxes, were much reviled in the colonies and often attacked for doing their jobs. Some were pretty benign, but others, particularly soldiers who were forced into the homes of locals, were seen as agents of oppression.

Land of the Free

Fast forward to Ferguson in the 21st century and tales of how police executed the policies of local (white) government officials to collect taxes and you see the analogy. Rather than raise property taxes on the white property owners who had a voice in Parliament, the government officials decided to extort money from the poor Black community in a travesty of police work where sitting in a car while black, walking while black and certainly driving while black were all crimes, and black citizens issued summons, fines and fines upon fines. As Hayes notes, the federal Department of Justice was a little taken aback when they investigated, to see how very open the white town officials were about how they intended to ramp up revenues by assessing fines and penalties in a spiraling vortex of never ending penalties where black "offenders" were not even allowed to pay their fines and thus accrued more and more penalties. Arriving at the court room door, a long line awaited and the court closed before half of the citizens had a chance to pay their fines and more penalties were added.

Response to "tyranny" 

Blacks were routinely stopped, humiliated by gun toting police who would demand identification from a black man, and when he asked why, charged him with failing to carry a driver's license, making a false statement (calling himself "Mike" rather than "Michael" which was on his birth certificate) and so brazenly and cynically building a mountain on top of not just a mole hill but a cavity.

No real freedom without Economic Justice

Simply reading of the indignations visited upon the black population of Ferguson the wonder is why they hadn't burned down City Hall years before. 

I was once on a jury in very white Montgomery County Maryland, where a Latino man, Cesar, was on trial for selling a 1 oz pack of marijuana and he was arrested by nine Montgomery County police, who charged a cross a parking, lot, a field, a playground and arrested, mistakenly, the man's brother who was working under the hood of his car, only arresting Cesar, when he emerged from the apartment building carrying what might have been the change for his customer. I sat in the jury box thinking, "The real threat to the community that morning was all those police, waving Glocks as children in the playground and their mothers, scrambled to get out of their way."

The blacks of Ferguson daily had their 4th Amendment rights against unreasonable search and seizure violated not to mention their 1st, 13th amendment rights, and likely a long list of other Constitutional rights violated daily. 

Which is to say, they were treated as a hostile enemy and the police thought of themselves as an occupying army. It was the "Fort Apache, the Bronx" scenario, the police being the victims hold up in a fort, surrounded by hostile and barbaric natives.

Of course, some of this is imagery and hyperbole to make the point, but the basic point--that the police were seen as angry, dangerous oppressors working for a corrupt, criminal white government--is strongly supported. 

Maintaining Order

The details Hayes lays out make his case.
Criticisms about his use of the analogy of a "colony" miss the point. The basic truth is persuasive: the police are illegitimate in this setting, not representative of the people, not there to serve and protect the population against actual criminals who rob and murder. The police are part of the robbery scheme, and in some cases, the police murder. 

Whenever I see that confrontation between "black lives matter" and "blue lives matter" I'll see it differently now.

Indians, Native Americans, and Politically Incorrect Thoughts

Better take my temperature. 
Do a spinal tap.
Check my blood sugar.
My brain is clearly not functioning.
And I know, this is a rant which is an indication I simply need to do more reading, to educate myself, but I saw the photo of "Native Americans" which accompanied an article in the NYT Book Review of "The Heartbeat of Wounded Knee"  and I thought, "I'm getting so tired of Indians."

Frederick Banting, MD, artist 

Which is another way of saying, I'm getting tired of people who insist on living in the past. 
And I know, I know, you can say the same about the Holocaust remembrances going on: Get over it. It's past. Move on. And the reply is, we must remember the past or we'll repeat it. We can see the neo Nazis today and we ought to remember where their kind of thinking leads.

Discoverers of Insulin, Banting and Best

But really. 
"Native Americans" are no more native than European Americans: They just got here first. They migrated from Asia. Europeans migrated from Europe, but later.
And then the Europeans annihilated their predecessors, ruthlessly, relentlessly, as so many invading conquerors had throughout human history before them.
They introduced small pox to kill native Americans. They slaughtered women and children. They made a virtue of killing Indians: as Phil Sheridan said: "The only good Indian is a dead Indian."
Some Indians had lived in log cabin villages and they were slaughtered.
Some Indians were nomadic people who roamed the Great Plains and they were slaughtered. 

White slave

Indians who were forced into signing "treaties" and moved onto reservations did so with the gun to their heads.
Slavery was an odious system, and it caused a destructive Civil War. It was one of those instances where the history of barbarity was close enough and vile enough and the institution it created was such a festering wound, it could not be allowed to go un remedied. And Lincoln, reflecting on how history had caught up with America speculated that this might be a just God's punishment for 240 years of cruelty, such that every drop of blood drawn by the lash had to be repaid by a drop of blood drawn by the sword. 
Extermination and genocide of the American Indians was ineffably cruel, in a different way.
But, looking at it from the 21st century, we have to say, we can never atone, and we can never compensate blood for blood. Human history is so drenched in blood and cruelty we can only say: This the savagery we came from, but this is not who we want to be now.
I cannot help that my great greats beat and raped slaves. I cannot change that my great greats committed genocide against American Indians.  But I can be different myself, and that is all I can do.
At what point do you have to say: Okay, we have a blood drenched past, a past that like so much of human history is the story of struggle, remorseless killing and deception, lies, sanctimonious hypocrisy. 
But this is where we are now. 
A German, a 20 year old woman who was born in 1975, once asked me, "Why am I seen as a loathsome demon seed? What have I done wrong? I was born 30 years after Hitler died. He was hideous. But because I'm German, speak his language, I'm guilty? Of what?"
She might have added: "You lived in the United States when your countrymen were killing babies, napalming villages, spreading Agent Orange over Vietnam. And you look at me and call me guilty?"
We can look at Indians living on reservations and say, "Let us distribute some money in a way to give you a chance to live in our society, be educated to our ways, benefit from our system (health care, university education, learning a trade) and we can all be one big family. 

American children getting educated

Or you can continue to "honor the past" speak of great spirits and live in a fantasy world which rejects science and new knowledge, i.e. you can cleave to a primitive past. 
We, all of us, ultimately come from a primitive past, whether our ancestors were Scots, Vikings, Visigoths, Nazis, Romans, Israelites, Zulus, Masai or Incas. 
We can be enriched by the past, but we should not try to cleave too much to it, because, truth be told, the past was bitter, nasty and lives were short, brutal and ended quickly.

Trump's "infestation"

The important thing is to embrace each other. That the great great great great grandaughter of a Viking should, today, be happily give birth to the great great great grandson of a Masai warrior and that kid should grow up learning to code, be guided through his journey by a GPS from a satellite and possibly do heart surgery to save the great great great great granddaughter of an Apache chieftain, should be something to celebrate.
But spare me the feather in the cap, the rain dances and the beating drums. 

And definitely, spare me the MAGA hats. 
We are so much greater today than we ever were.

Shattered Dreams: Boston Globe Valedictorians Project, Journalism at its Best

If ever you are challenged by someone who says the media are lost and worthless now, you have only to refer to the Boston Globe's "Valedictorian Project." 

Yes, there was the Spotlight and its revelations about Catholic priests, but this piece is far more widely applicable.

The jist of the report is that top students graduating from disadvantaged city schools in Boston, the valedictorians, did not rise above their humble origins through the alchemy of public education and enter the upper classes. 

They, most often, failed. 

The implications for affirmative action are obvious.
The implications for America as the land of opportunity are dismal.
The idea of selling aspiring young people on a dream which turns out to be a fraud is repellent, but important. 

And it is all so obvious to anyone who has worked among the folks this story follows.

Of the more than 100 valedictorians who said they wanted to to medical school after high school, followed over the years by the Globe, only two are in medical school, both at offshore, non American medical schools.

The take home is that without a family to help navigate, support and guide a young person, the rise from one class to the next is doomed. No Great Expectations story of Pip here. These kids sink beneath the waves, overwhelmed by all that they cannot see or understand. 

It is a sobering tale.

It is also such a relief to see real reporting, amid all the stories about what Trump is thinking, what Mueller might be up to, what impact the latest Tweet will have on public opinion polls, whether tariffs are helping or hurting the economy.

This is a story rooted in actual experience, and it must have been the product of hours upon hours of hard work, pursuing people, getting their stories, shaping it.

The implications are important. There are uncomfortable truths.