Like many of you, I’ve been watching with dismay as the remaining Democratic candidates, those with enough cash to be contenders in an ultimate World Series, attack each other’s health plans. It’s not the attacks that bother me, though. (It’s amazing how little tolerance Americans have for substantive disagreement.) It’s that the plans in question are so anemic.

It should obvious by now – especially to those who’ve experienced the tender mercies of our current profit-oriented system – that only something like “Medicare for All” can succeed. Yet politicians posing as reformers continue working mightily to preserve the status quo.

That’s why it’s so important to support groups like Physicians for a National Health Program (http://pnhp.org), which haven’t let up on fighting for a single-payer system. Check out the open letter below and, as PNHP suggests, send it to the candidates, your reps and friends.

 
PHYSICIANS FOR A NATIONAL HEALTH PROGRAM

An Open Letter to the Candidates on Single Payer Health Reform

America's health care system is failing. It denies care to many in need and is expensive, error-prone, and increasingly bureaucratic. The misfortune of illness is often amplified by financial ruin. Despite abundant medical resources, care is often inadequate because of the irrationality of our insurance system. Yet our political leaders seem intent on reprising failed schemes from the past, rejecting the single payer national health insurance model that is the sole hope for affordable, comprehensive coverage.

Leading Republicans propose tax incentives to encourage the uninsured to buy coverage, but these subsidies fall far short of the cost of adequate insurance. For cost control, they suggest high co-payments and deductibles. Yet these selectively burden the sick and poor, discourage preventive and primary care, and have little effect on costs, since seriously ill patients - who account for most health spending - quickly exceed their deductibles and are in no position to forgo expensive care.

The incremental changes suggested by most Democrats cannot solve our problems; further pursuit of market-based strategies, as advocated by Republicans, will exacerbate them. What needs to be changed is the system itself.

Most leading Democrats offer a mandate model for reform. Under this model, the government would require people (or their employers) to buy private coverage, while offering an expanded Medicaid-like program for the poor and near-poor.

Variants of the mandate model, first proposed by Richard Nixon, were passed with great fanfare in Massachusetts (1988), Oregon (1989) and Washington State (1993). All died quiet deaths. As costs soared, legislators backed off from enforcing the mandates or funding new coverage for the poor. Massachusetts' recent reform, which largely excuses employers from the mandate but imposes steep fines on the uninsured, appears poised to follow a similar path. Of the middle-income uninsured who are required to pay the full premium for coverage, few have signed up. Meanwhile, the state has already announced a $147 million shortfall in funding for subsidies for the poor.

Mandates and tax incentives can add coverage only by increasing costs. They augment the role (and profits) of private insurers, whose overhead is four times Medicare's, and whose efforts to avoid payment impose a costly paperwork burden on doctors and hospitals. The cost cutting measures often appended to such reforms - computerization,
care management and medical prevention - have repeatedly failed to yield savings.

In contrast, single payer reform could realize administrative savings of more than $300 billion annually - enough to cover the uninsured, and to eliminate co-payments and deductibles for all Americans. It would also slow cost increases by fostering coordination and planning.

Political calculus favors mandates or tax incentives, which accommodate insurers, drug firms and other medical entrepreneurs. But such reforms are economically wasteful and medically dangerous. The incremental changes suggested by most Democrats cannot solve our problems; further pursuit of market-based strategies, as advocated by Republicans, will exacerbate them. What needs to be changed is the system itself.

We urge our political leaders to stand up for the health of the American people and implement a non-profit, single payer national health insurance system.

Posted by jackbradiganspula at 15:48 EST

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Under former county executive Jack Doyle - to whom Al Franken’s epithet for Rush Limbaugh, “big fat idiot,” so precisely applies – Rochesterians got almost weekly reminders of how vicious and ignorant the local Republican ruling clique can be.

Then came Maggie Brooks, whose stage presence, honed by years as a TV “personality,” put a human face on the GOP machine. But every once in a while, the velvet glove slips off the raised iron fist.

And so it was late this week, when Brooks said the county would appeal a recent decision by a state Appellate Court (one step below the highest state court, the Court of Appeals) in favor of marriage rights for two local women, one of whom is a Monroe Community College employee. The Appellate Court decided that this couple’s marriage, performed a few years ago in the province of Ontario, Canada, where same-sex marriages are legal, must be recognized in New York State.

The legal principle is straightforward: New York has long recognized legal marriages from other states and countries that use different criteria from those obtaining here.

Brooks has couched her appeal, or at least her advance PR, in “moderate” language. In effect, she pleads she’s only doing the right thing – preserving the commonly understood definition of marriage and the sanctity of the law - not harming anyone or sowing hatred and division. But oh yeah, there are financial considerations: she hints that Monroe County can’t afford to give marriage-related benefits to the hordes of sodomites on the county payroll who will now demand them.

The county exec always adopts a pleading tone when she does this kind of damage. Take her insistent claims that her “FAIR” tax-shifting scheme was so, so equitable – and wouldn’t take candy from babies. In that case, of course, she just ignored the numbers, as she has right from the beginning of her years at 39 West Main Street. (Remember how she ran for county exec the first time on a plan that would cut taxes yet not gut any popular programs? That was a most painful exercise in the new conservative math.)

Nobody will ever call Brooks a big, fat anything. No, she’s more subtly dangerous than the Limbaughs of the world, mostly because she gets things done for the Limbaughs behind the scenes – like Steve Minarik, who by the way is married to Judge (!) Renee Forgensi Minarik, who ran for Congress against Louise Slaughter on the (hold your breath, or nose) Contract With America.

You might therefore say Brooks is just working on contract now: imposing the moral vision of the neo-Reaganites on us at the local rather than the federal level.

And it’s all perfectly legal! So far.

Let's hope the Court of Appeals sees the light and does the right thing.

Posted by jackbradiganspula at 11:51 EST

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I loved reading Adam Durand’s recent post (rocbike.com) about, shall we say, spontaneous ice-biking. It can happen to anyone: the evening begins with a warm breeze, but then comes the rain, which soon turns to sleet; and as the temperature keeps dipping, the whole visible world becomes as slick as a “greenwashed” ad from Big Oil. And there you are, the intrepid bicyclist, faced with riding when even walking is a challenge.

The scenario is one of many arguments in favor of studded tires for winter riding. I’ve been using a pair of Nokians this year, after an apprenticeship in past winters with some cheaper but less durable Innovas. The Nokians are peerless (well, maybe equaled by Schwalbe, about whose studded tires I know very little) and well worth the price (the model I have runs about $60 apiece).

When the latest ice storm struck the other day, I had to do my usual commute to the RIT campus, about seven miles one-way from my place, through varied conditions: level streets, a couple gentle hills, some parking-lot-shortcuts, and a good length of untended multi-use trail. After the ice had landed, these surfaces were slippery as all get-out, and worse, textured by a wind-driven splattering effect (the elements as a sort of environmental Jackson Pollock) that added a little bounce to the ride. Still, the tires worked nicely. There were a few times when I felt a bit insecure, as when I went up and then down a steep pedestrian bridge over the Erie Canal. But for the most part, the tires kept me upright and going forward on ice that would have stopped a pedestrian cold.

I’ve got a lot of winter riding under my belt, and the experiences have included more than a few wipe-outs on unexpected or unseen ice. I remember one afternoon a few years back on the Genesee River Trail near the UR campus: it was about 10 degrees F, sunny and clear, and the ground and trail were almost bare. But as I swooped down and around a curve under a railroad bridge, I “encountered” a patch of black ice maybe 20 feet long that covered the full width of the trail. By the time I understood what was ahead, it was too late to take evasive action – or even let out a good ole Tarzan yodel. Down I went, sliding along on my left side as various add-ons from my bike tinkled and scattered on the cold, cold ground. (I instantly recalled an earlier fall on ice, this one at night, when it took me a while to find and reassemble all the little pieces of my headlamp, some of which had skittered under a parked car.) But my bike and I escaped without real injury. And I was glad nobody had been around to witness a most uncool maneuver.

Now cycling life is boring: my studded tires keep me from having more experiences like the above. So what stories am I going to tell my great-grandkids? Surely if you embellish it enough, you can make an absolutely uneventful ride into a heroic journey. I’ll give it a try.

Posted by jackbradiganspula at 23:04 EST

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I'm now teaching Tom Paine in my writing courses. But I chose the title of this piece to reflect the views of another real mensch, who, as seen below, speaks truth to power while demonstrating what musicians can achieve in their "leisure time." (Credit: I actually found the piece on the website of scholar-activist Norman G. Finkelstein, www.normanfinkelstein.com.)

Passports to progress

Israelis and Palestinians alike should join me in taking dual citizenship - for we share one destiny

Posted by jackbradiganspula at 14:13 EST

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Call them the establishment, the defenders of the status quo, the business community, whatever: in celebrating the withdrawal of Dennis Kucinich from the presidential race and denigrating his campaign of conscience, our betters are telling us to forget about fair trade and labor policies, true universal health care, peace and nonintervention, and much more.

The Big Boys are telling us to accept whatever they’re willing to concede. And so we’re supposed to swallow years more of troop deployments in Iraq and Afghanistan, half-trillion-dollar annual Pentagon budgets, pennies for housing, unaffordable health care and inadequate insurance, and relentless attacks on unions and working people’s lives.

I hope Kucinich will win re-election to Congress. His Cleveland-area district is fortunate to have him; voters there should watch out for the business-friendly Dems who’d like to snatch the reins from him and put them back in “respectable” hands. Kucinich’s presence in Congress is important for all Americans, too, since his steadfast progressive voting record shows the way for others (like our own Louise Slaughter) to oppose war and corporate power.

The other day on the Diane Rehm show (NPR), commentator Juan Williams, who plays a liberal on the radio though he profits from an association with Fox, chuckled loudly when Rehm asked him about the effect of the Kucinich campaign. The laughter was typical of the lumpen pundit class: these people don’t recognize anything beyond economic brute force, in the form of political contributions, which they regard as the sine qua non of the “credible” candidate, and promises of revolving-door payoffs. Populist insurgencies? Don’t make these guys laugh.

But as bad as Williams was on NPR, a Rochester liberal beat him in this media race to the bottom. Mary Anna Towler, in a City Newspaper editorial endorsing Barack Obama, dismissed Kucinich as one who ran more on rhetoric than substance. Even more oddly, she charged his “anger is troubling.” (Vital context: She said much the same about John Edwards. In this case, too, it’s probably a pro-union stance that put her off. I know from hard experience that she and her associates and attorneys are fans of what in the trade is called “union prevention.” City Newspaper occasionally papers this over with sympathetic coverage of local workers’ issues. Don’t be fooled.)

Towler’s characterization comes out of nowhere. I’ve followed the Kucinich campaign pretty closely; I’ve seen him in debates, on news programs, and in video clips – and never once have I seen anything like anger. He’s consistently analytical and measured, with just the right level of intensity to show he really cares. But I know Towler has had a mindless grudge against Kucinich for years. She brushed his 2004 candidacy aside in a rush to endorse John Kerry for the New York primary. The pattern is clear: City Newspaper hunkers down in the undemocratic wing of the Democratic Party.

Posted by jackbradiganspula at 10:36 EST

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