Tuesday, December 20, 2016

Flirting With Anarchy: My Path to Understanding The Need For Good Governance: Part One.

NOTE: This was written a few years ago. I am publishing it now, after Trump's victory, because I believe that once we truly experience how a businessman runs the US economy, people are going to come to understand the need for government involvement in our lives.

During the 60s many people in the US were exploring many different ideologies and anarchism definitely struck a chord with many hippies. My father was a hippie and being raised by him gave me a unique introduction to Anarchism and an interest into Libertarianism. US history has seen many different movements that were influenced by libertarianism and/or anarchism. I have always been quite confused by the two ideologies.  During my years of trying to understand them, I have found that there are only slight differences between the extreme right and the extreme left. Anarchism is generally considered part of the left and libertarianism is generally with the right. The major difference between the two is that anarchism doesn’t not believe in a nation state at all where as the extreme right believes in one to protect the individual’s freedom. I know it is kind of weird to see the extreme right and extreme left being so close ideologically. It gets even weirder especially when you find out that liberalism is a term for fiscal conservatives but progressive liberals believe in increasing government intervention in business and fiscal conservatives and Christians that want to increase government’s role in limiting freedom when it comes to a women’s decision about abortion and whether people can be married and they want to continually make a drug like marijuana illegal when it is much safer than Alcohol. But let’s stick to the point. I am happy to know that many true libertarians, including Ron Paul want to legalize all drugs because the government doesn’t need to be regulating people’s behavior.

When Punk rock was just beginning to become popular I dropped out of college after deciding to be an artist and follow an anarchist way of life. I didn’t want anyone telling me what to do, especially not some faceless bureaucrat. I was young, strong, and smart, I could do anything.  With that attitude, the only job I could get was for a moving company, ironically named, Starving Students. When customers asked if we were actual students, we all answered, “students of life.” We were students of the school of hard knocks. Back then many people would have called me a radical but they probably couldn’t quite nail me down. I had this all too common American mix of libertarianism and anarchism and a definite distaste for socialism. My chosen path led me to a hard job. I worked there for two and half years and saw many people come and go, some people never showed up again after one day of work. So it was no surprise that I got injured while lifting a large upright piano up a few, very curvy, flights of stairs with only one other person helping.

My introduction to the US health care system began in 1994, with my boss at the moving company yelling at me for putting in a workman’s compensation claim. Then sitting in the doctor’s office waiting for what I thought would be a “visit,” but turned out to be me watching him write a prescription for painkillers. I was out of his office so quickly I am still not sure if we actually exchanged words. While I sat there wondering what the hell had just happened, he was back to his colleague discussing his golf form. I know that image is a trope but it really happened. However, those experiences were nothing in comparison to dealing with the insurance claims. I found that when you change jobs, you lose insurance coverage. When you get a new job you get new coverage after a six-month waiting period and when you submit a claim on the new account it gets denied. So you call a customer service rep and they say they “accidently” overlooked the new account and put it under the old one. This happened to me so many times I believe it was not simple mistakes by these clerks, but an orchestrated way of delaying payment.

It wasn’t long before I turned to alternative medicine, as so many in the US do. I had some amazing experiences but was still a little skeptical because the logic wasn’t adding up. None-the-less, I continued passionately seeking alternative care. In fact, my recovery went so well I was soon in the best shape of my life, and found myself wanting to become an alternative medicine practitioner. As I began researching careers and teaching Tai Chi, I wondered why these alternative practitioners were not fully integrated into the health system.

After experimenting with almost every type of alternative care in the US, my wife and I decided to embark on a life-changing trip to Asia. We went to India and Thailand for about 3 months. We sold our car put everything in storage and wandered around Asia. We received Ayurvedic treatments and Thai massage from different practitioners. It was amazing to experience traditional medicine practitioners in an ancient culture. I was in awe of these traditional practitioners with their natural cures. One highlight was when an Ayurvedic doctor brought me to Deepak Chopra’s family house in New Delhi, which was turned into an Ayurvedic medicine facility.  

However in India, my anarchist leanings started to waiver. Many in the US flirt with the idea but in India, at that time, there was little government control with scarce infrastructure. Electrical wires hanging on everything, everyone trying to get enough electricity for himself, by any means necessary resulted in daily power outages. Moreover, there wasn’t any kind of garbage collection service so people would dump their garbage in the streets for the wandering array of animals to glean nutrients from. Cars driving on the wrong side of road are a frequent occurrence and traffic accidents are one of the leading causes of death there. I could go on and on, but basically, I had seen enough of anarchy in action and began to see that there was a place for government involvement. Today, India is a great example because their laiseez-faire ways have raised their country’s prominence on to the world economic scene, however their Achilles heel is still infrastructure. The government is now investing heavily in this but whether it is enough to sustain growth remains to be seen. Many people in the US Romanticize less government because it seems more direct and they are tired with the red tape but they haven’t seen its application.  

If India opened my eyes to the pitfalls of minimal government involvement, Mississippi perfectly illustrated three major flaws in our health care system. Fresh from India and Thailand, I was ready to teach Tai Chi and Qigong and I soon found a job as an activity director in an elderly facility teaching Qigong to the residents. My wife and I moved there to find jobs with meaning, instead of becoming corporate drones. I began to see with my own eyes how elderly people’s dependency was a by-product of the health system. Since it is the case that the US health care system does not focus on prevention of chronic disease, it actually delivers what is called secondary and teriary prevention. Secondary prevention is making sure the patient doesn’t get worse or die from a disease they ready have, and tertiary prevention is when you have a long term illness and your treatment is focused on increasing quality of life. The focus is not curing or preventing disease in the first place. Many nights I laid awake wondering why are we not preventing the disease from entering the body in the first place. This type of prevention is known as primary prevention. It is the kind of prevention everyone wants but few achieve.

The second problem was that most of the resident assistants or RAs are paid around $7-10 per hour to clean bowel movements, assist the nurses and do whatever else was needed. Many were single moms and couldn’t afford health insurance. The irony here is the rich, mostly conservative, all white residents were always complaining about the quality of care but couldn’t see the connection to lack of funding of education in the US and certainly didn’t care that they were uninsured. Many of the RAs were afflicted by back problems because of lifting residents out of bed or on and off the toilet. Forget, for a second about any moral issues, just from a pure quality of care issue. It is most likely you will grow old and odds are really good you will probably end up in one of these places. Because you will not want to burden your children with your care, especially while they are trying to get the grandkids into good schools. So it seems obvious that it is in our own best interests to have healthy educated people helping? Do you think if you supported affordable health care and education that it would directly affect the quality of your end of life care?   

Thirdly, I saw by what means private care stays solvent. If your residents can’t pay they get kicked out. It was always a sad day when we had to drive one of our residents who ran out of money to the public nursing home. So it is easy to blame public care for poor quality or inefficiency when they do not turn anyone away.

The one question no one every asks Libertarians, fiscal conservatives on these television interviews is “What kind of society would we live in if we threw people on the streets?” “Do you really believe that is the kind of society that is healthy and good?”

After realizing the sum total of these experiences I began to have serious concerns about health care in the US, and I hadn’t even read any journal articles or even gotten involved in any political party. In addition, I certainly didn’t draw any connections to the huge conflict between libertarian ideals vs. socialist ones. I simply thought even if you were the most selfish person on the planet you would want a system that educates and provides health protection to even its lowest status citizens. I saw that it was inevitable that one day you will have to rely on them in and/or work with them.  Ironically, this is the exactly kind of probing that John Rawls did when he wrote about social justice.

And of course, we haven’t even discussed morality, I can’t believe that anyone thinks that the US has a great medical system when it has the highest infant and maternal deaths than any developed nation and that some middle income nations are doing better than us. I wonder what kind of measure those proponents of our system are using?  

Finally fed up with privately run eldercare, I headed back to college. I had done some community work and I thought I could figure out a way to prove that Tai Chi has what it takes to prevent chronic disease. I became a psychology major and absorbed as much knowledge of research as possible.  With years of research and statistics courses, my critical thinking was raised to high level. After a more than a few social pyschology courses I started to understand the placebo effect and the power of authority. From there I went to Canada to study public health. I figured it would be there that I would finally be able to create my ideal public health program that changes the medical paradigm. I written about Canada’s excellent health system (here) and when the debate about US health care reform began to focus on our neighbor I was shocked at the outright lies being propagated by the conservative media.

In three years I lived in Canada, I never had heard of anyone having any of the experiences purported by these commentators and personally, I had to wait for one of many appointments, while every other interaction from the birth of our second child to many checkups was of a higher quality with less out-of-pocket cost than any experience I had within the US health system.

My experiences also made me look into the benefits of a single-payer, government run health care system and if you look at them from cost of healthcare and overall health indicators e.g. infant mortality, and life expectancy you can see that a single payer system is clearly the most efficient and viable option for providing health care for all. But the main substantial point of libertarians is that once the government tells you to buy something, or forces you to wear a seatbelt it can tell you to do anything. For them this is their driving motivation or the road to serfdom. They feel that the “gimme people,” the “slackers” and the poor will drive the economy in to ground and that they, the hard working, risk takers will be forced to give their hard earned money to people who made poor choices in life. But once again, there is a serious lack of evidence. If we look at most Northern European countries where there is strong government involvement in healthcare we don’t see a slippery slope. They are not slaves. To the contrary, the middle class is thriving in those countries with higher wages, longer lives, longer vacations and less out-of-pocket healthcare expenses, and most importantly, less people bankrupt by healthcare debt.  

I still enjoy an occasional punk rock song but the movement itself has led to a dead end. Some Libertarian ideas are good for a nation but there is a point where it doesn’t provide the solutions a nation needs to prosper. Once people come to understand the literal Libertarian end game and not the fantasy of some country where rational self-interest and freewill create the best steel and the best of everything. The single-payer system is inevitable just like gravity because just like every physical object has to obey its force. I predict Libertarianism will end up with the other litter of impractical ideas to heavy to lumber on in the long journey of history.  

In Part Two, I will go into how this decision to take this path affected my life on a personal level.

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