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Sunday, September 15, 2013

“Nattering Nabobs of Negativity”

I’m having a difficult time with something.  It seems to me that as a nation (at least in a large segment of it) we have gone from being known for our positive, open, creative answers or solutions for problems and difficulties, to a propensity for simplistic, negative, and diluted approaches and actions when confronted with hard problems to solve.  I don’t mean that we don’t still react generously when there is an emergency or tragedy that affects a large area or even a neighborhood.  We do respond positively and unselfishly to help where we can.  That part of our national character, along with other charitable causes, seems to remain intact. 

In fact, “No developed country approaches American giving. For example, in 1995 (the most recent year for which data are available), Americans gave, per capita, three and a half times as much to causes and charities as the French, seven times as much as the Germans, and 14 times as much as the Italians. Similarly, in 1998, Americans were 15 percent more likely to volunteer their time than the Dutch, 21 percent more likely than the Swiss, and 32 percent more likely than the Germans.” (American.com)
However, on aneki.com, the United States is listed as only 18th in “donor aid” per capita, but no year or basis for conclusion is given.

However, Wikipedia lists the USA as the world's most charitable country, meaning as a nation, the USA gives the most money to help the needy and others through public (government) donations.  But perhaps not for much longer, for it is the aim of the radical Right to reduce government social programs to a mere shadow of what they have been.  So far, the use of sequestration, combined with attacks on Head Start, food stamps, and the WIC program, has advanced their mission.

As a political writer, I am looking more assiduously at our political and governing process.  I’m concerned about how negatively or positively our legislative, executive, and judicial branches approach the citizenry and the difficulties that face us as a people.  Let me get right to a few examples.

1)     Immigration.  Reading the comprehensive immigration bill passed by the Senate, or looking at the piecemeal legislation in the House, one would get the idea that we must take many negative actions in order to resolve immigration problems.
 
First, it appears that our southern borders need to be “walled off” and heavily guarded to prevent illegal crossings from Mexico; thus, our legislators have put an extra $48 billion into border security and set a goal of 90% compliance before undocumented immigrants can obtain citizenship
Now that 11 million undocumented immigrants live among us mainly in the shadows, fearing that their undocumented status will be discovered, legislators declare that they must be punished by fines, restrictions, and back taxes for breaking our immigration laws.
 
Finally, because these undocumented aliens cannot be allowed to acquire amnesty, their illegal entry must be dealt with in a way that further penalizes them.  Thus their path to citizenship of at least 13 years must be circumscribed with restrictions and prerequisites that will most likely increase the number of years on that path.  Those strictures include: 
a.    Must have 100% surveillance of the border in place
b.    Ensure that 90% of would-be border crossers are being turned back or caught
c.    Those waiting to immigrate through the legal system get to go first

There must be more positive ways to deal with immigration policy.  First of all, why do people want to come here, particularly from Mexico?  Why are they willing to risk their lives to bring their families here illegally?  What do we want immigration to do for us as a nation?  How can we meet the needs of immigrants and still maintain a fair and just immigration system for all while not over-reaching on our resources and services? 

From a study and report authored by Colorado University, “Unclear or conflicting goals are the nemesis of good public policy. Nowhere is this better illustrated than in our own nation’s immigration policy, which is a tangled web of statutory and administrative approaches that have been patched together over many years. In truth, it is difficult to speak of an immigration policy as if it were a coherent set of actions leading to defined goals. Rather, today’s immigration policy is the result of a series of decisions based upon goals and priorities that seem to shift over time.”
In most policy areas there exists a consensus on broad aims to be achieved, even though there may be disagreement on the best means of realizing those goals.  Not so with immigration, where no shared consensus on fundamental goals yet exists. Without agreement on basic goals, there is the risk that the gridlocked status quo will define our future rather than defining for ourselves the role immigration should play. There is an urgent need to be clear about the ends we seek. With that in mind, the panel recommends that the basic purpose of U.S. immigration policy be the creation of economic, social and other benefits to the nation as a whole.”

It is always important to go back to fundamentals when current circumstances overwhelm our ability to be objective or to be fair.  That is our current situation with immigration policy.  So what fundamental positive ideas might be advanced to counteract our basically negative approaches to immigration?  I need to admit that I am not an expert on this subject, and realize these may sound sophomoric, but they are, after all, very basic.
1)    Negotiate and cooperate with Mexico toward common systems and goals to do with immigration.  We cannot resolve this problem of illegal immigration alone.  Walls and more patrols will not solve it.  Mexico must be brought to agreements on what is important for its people.
2)    What brings so many undocumented immigrants across our southern borders?  Jobs, money, a relatively good life.  Can we not offer a variety of short-term work visas that will draw people to certain job opportunities, and then set positive goals and criteria for how such short-term work visas can be turned into longer-term green cards or blue cards or whatever.  In other words, let’s offer a menu of positive choices so that people can come here with hope. 
3)    Let us emphasize good citizenship rather than punishment for coming here illegally. Maybe we even need to change our thinking about border security.  Can we turn from security to processing people at our borders for visits, work of certain kinds, skills, whatever positive categories can be developed so that people can be processed and vetted right there?  How about Ellis Island-like facilities where people can be processed according to our laws and our needs and our menu of choices for temporary stays and more permanent status?  Yes, we probably have to have quotas set up, but they don’t have to be based on prejudices; hopefully more on our needs and the needs of the people immigrating. 
4)    Family unification has to be a top priority.  The benefits here accrue directly to immigrants and their families; however, the nation as a whole benefits from the employment productivity and social strength derived from stable family life. 
5)    Refugee concerns are an important humanitarian matter offering momentous benefit to the individual refugee.  Relative to other nations the U.S. has had a generous refugee policy.  Humanitarian interests have often been emphasized in US immigration policy.  Now is the time to resurrect that important aspect of our policy.

In a world of limited resources, where not every objective can be equally served, positive priorities must be established if a coherent and effective policy is to be created. As noted earlier, the criteria used by the panel for establishing priorities among goals is the degree to which a goal provides benefits to the United States, but a positive approach also demands an equal priority for benefits to the immigrant as well.

2)     Gun Violence.  The NRA deals in what it regards as positive steps toward preserving the right to own and carry guns.  They think that the narrowly-based policies they promote are positive in nature in that they preserve the constitution.  But look for a moment at the bare ideas that get promoted:
a.    We need as many people as possible owning guns
b.    We need a police presence and teachers with guns in every school
c.    The more people who own guns, the safer we will all be
d.    Gun ownership must be protected at all costs so that the government cannot take (or register) all guns that could be used against a renegade government
e.    Guns must be able to be carried anywhere
f.    Self-defense must be applied to standing your ground against conceived threats

My own assessment is that it is difficult to call those statements “positive” when their results bring so much harm and anguish to ordinary citizens.  We are not safer as a country because guns are everywhere -- in fact, we are one of the most unsafe countries on this planet precisely because guns are so prevalent, and so often involved in injury and death for innocent people, including children and young people for whom gun violence is their second leading cause of death.  And, by the way, states with the highest gun ownership rates suffer twice as many suicides as states with the lowest gun ownership.  It can be fairly stated that a gun in the home increases the likelihood of homicide, suicide and accidental death (Children’s Defense Fund).

Easy access to guns is not good public policy, notwithstanding the supposed “right to ownership” some have found in the 2nd Amendment.  According to a Report from the Violence Policy Center, states with higher gun ownership and weak gun laws lead the nation in gun death rates.  States with strong gun laws and low rates of gun ownership have far lower rates of firearm-related death.  In Alaska - one of five states with the highest per capita gun death rates -  60.6% of households have firearms, yet the state has the highest rate of gun deaths in the nation: 20.28 per 100,000 people.  In contrast, New York is one of five states with the lowest gun death rates.  Just 18.8% of New Yorkers own firearms, and New York has the 46th lowest gun death rate in the country. 

Moreover, according to a study cited in the Detroit Free Press, in 2010, gunshot wounds and deaths cost Americans at least $12 billion a year in court proceedings, insurance costs and hospitalizations paid for by government health programs.  A more recent study by the Center for American Progress of direct and indirect costs of violent crime in 8 geographically diverse U.S. cities estimated the average annual costs of violent crime to be more than $1,300 for every child and adult.  

As I have maintained elsewhere in this Blog, these statements and policies of the NRA are not enhancing our society nor do they set a positive tone for practical measures that would reduce gun violence and its cost.  I have spoken elsewhere, too, of the practical and positive steps we could take to reduce gun violence, and because I have done so, I will just list a few of them in brief:
    -- expand background checks for all gun sales, not just those made through federally certified gun dealers, but including gun shows and internet sales
    -- put limits on assault weapons and high-capacity ammunition clips
    -- set consumer safety standards, childproof safety features, and authorized user-identification technology for all guns (micro-stamping, for example)
    -- better preventative and therapeutic services for families facing violence in their communities as well as for children with unmet mental health needs
    -- adequate funding for gun violence prevention research and programs
    -- resources and authority for the federal Bureau of the ATF and other law enforcement  agencies to properly enforce gun laws (for example, remove the ban on the Consumer Product Safety Commission regulating the sale and manufacture of guns).

Given the very real problems and fatalities associated with gun violence, these constitute more positive ways to balance out the right to individual gun ownership, and the unalienable rights of all citizens to life, liberty and the pursuit of happiness.  To continue to place the 2nd amendment above all others rights and responsibilities in the Constitution is a flagrant violation of that founding document.

3)   Health Care.  We come finally to that area of policy that should have all sorts of positive attributes.  Sadly, the radical Right has found a way to demean and destroy a bold attempt to reform our health care system.  They even oppose the efforts of the Affordable Care ACT to bring some semblance of accountability to an industry that has been guilty of practices that border on consumer fraud and intimidation.  In spite of the fact that this ACT is now the recognized Law of the Land, the Right-wing nuts continue on a mission to disable it.  Their negative mantras include:

a.    We must repeal the entire ACT
b.    Fines, taxes and fees will hurt small businesses and individuals
c.    The ACA is socialistic - it puts government in charge of your health care
d.    Rates will rise
e.    Don’t build-in any consumer advocacy or cost control boards
f.    Involves all kinds of new regulations harmful to businesses
g.    Medicare and Medicaid are in need of drastic reform (voucher system and devolvement to states)
h.    let people take responsibility for themselves without government intervention

I find it a bit overwhelming that health care reform is seen as a negative from start to finish by the Right-wing.  Like Texas, they would rather have a childhood disease re-invent itself, than have people covered by basic health insurance.  Yet, put in proper perspective, health care is a right not a privilege reserved to those who can afford it.  It is one of those unalienable rights that have to do with life and liberty and pursuit of happiness.  If you are sick without access to health care, you are being denied one of the very basic rights to live your life without burdens imposed by lack of government action and you are being denied a freedom to be as healthy as you can be, and you are certainly having your pursuit of happiness obstructed in a fundamental way.  The radical Right  does not want to grant you this fundamental right; it wants instead to use legislative power of government to prevent you from obtaining that right! 

In contrast, the Affordable Care Act is surprisingly positive and sensible about what it proposes. 
A) that health insurance companies must not take unfair advantage of consumers and thereby deny them accessibility to basic health coverage, in the following ways:

  • No denial on the basis of pre-existing conditions or mistakes on applications
  • No cut-off of benefits because one contracts an acute disease or illness that is costly
  • No cut-off of insurance after a certain lifetime limit is reached
  • Makes insurance more affordable through state health exchanges
  • Insurers can no longer charge women more than men for the same coverage
  • State Consumer Assistance Programs will help consumers file complaints and appeals based on their rights
  • Insurance companies have to spend at least 80-85% of premiums on medical care or give     a rebate to customers on premiums they paid      

B)  that government health plans - Medicare and Medicaid - should be expanded to cover more people and to offer better benefits

  • Expand Medicaid to all non-Medicare-eligible individuals under age 65 with incomes up to 133% FPL
  • Increase Medicaid payments in fee-for-service and managed care for primary care services provided by primary care doctors
  • Extend funding for CHIP through 2015
  • Increase the Medicaid drug rebate percentage for brand name drugs, etc., and expand this to Medicaid Managed Care Plans
  • Create an innovation Center within the Centers for Medicare and Medicaid Services to test, evaluate and expand different payment structures and methodologies to reduce program expenditures while improving quality of care
  • Establish a national Medicare pilot program to evaluate paying a bundled payment for certain services
  • Create the Independence at Home demonstration Program to provide high-need beneficiaries with primary care services at home
  • Develop plans to implement value-based purchasing programs for certain facilities

C)  that greater access and choice should enhance coverage and benefits

  • Makes health care more affordable through state health exchanges, tax credits and subsidies
  • Expands coverage for 32+ million people
  • Expands Medicaid eligibility
  • Young people allowed on parents’ policy up to age 26
  • Money follows the Person Medicaid grants extended
  • Free Preventive Services to anyone with private health insurance
  • Drug discounts for people who fall into Section D donut hole
  • State consumer assistance Programs help consumers file complaints and appeals, enroll in health coverage and learn about their rights as consumers

To date, it is clear that the Right wing nuts have not come up with any alternatives to the positive provisions and benefits contained in the ACA.  What is even worse is that they don’t seem to care and haven’t tried!  We have reached the epitome of a do-nothing Congress when a majority of its members would rather use their elected offices to destroy health care reform than to build it to a new level of care and quality.  We are now faced with the naysayers getting rid of benefits that have already been implemented and utilized.  Thousands of young adults, for instance, stand to be booted off their parent’s health care policies.  Many more persons with disabilities will be shocked to find that benefits they had begun to count on (such as expanded HCBS and Money follows the Person) will be pulled from them, thus threatening their ability to remain in their community homes and making very real the possibility that they must enter a nursing facility. 

The result of negative actions and policies that exude from these far-right Conservatives is that real people are hurt; real people lose benefits; real people have their lives torn apart. It is time for the Right-wing to examine its philosophy.  Are nihilistic actions such as repeal of a major health reform Act actually beneficial to anyone?  To whom exactly?  Perhaps for the huge health insurance Market that was working so well for the insurance industry, but not so well for patients and clients.   

Two things constantly amaze me about these legislators: one, they don’t see what negative actions do to real people, and two, they don’t allow for the fact that a lack of reform, a lack of investment, a lack of innovation leads us down a path to  having to spend more money on the flaws that remain in our system, whether it be in terms of gun violence, immigration policy poorly conceived, or health care un-reformed.  The numbers of  un-insured and the under-insured will continue to grow and the cost of that will be borne by government and by individual taxpayers. The use of emergency rooms as primary care and intensive care will overwhelm the system once again, and we will all pay higher premiums to get by with what we have.  Small businesses will be back to having no subsidies to help provide insurance for their employees, thus costing both the employer and the employees for lost work time. 

The nattering nabobs of negativity (where are you when we need you, Spiro Agnew?) have dismissed the thought that the lack of an electronic record system, plus all the other flaws in private insurance administration, are causing us to spend money on paperwork that has grown so disproportionately that all medical staff are wasting time and money on overseeing the horrendously regressive system of record-keeping.  Every where one looks at the health care system, we are wasting time, effort and money because reform has been put off for so long.  The time has come to let the ACA work and to see whether the promises of affordability, progress, quality care and system reform will be realized.  We cannot know beforehand if this will work, but the positive attitude is to give it a try and to see where we are in terms of outcomes annually, and then 5 years down the road.  It is the way of the world -- business plans, investment plans, career plans, even house-buying plans -- they all share one thing in common: we don’t know exactly how they will work out until we test them.  Time to leave behind the negativity, the nihilism, the distortions and the negative prognostications.  It’s time for testing and evaluating.  Let’s get busy!