A Forgotten (?) Aspect of the Affordable Care Act

There are many aspects of the Affordable Care Act that have been getting some mention lately, such as:
--state marketplaces
--young people up to age 26 being added to their parent’s health care policies
--no more pre-existing conditions being used as excuses for denying coverage
--no more lifetime caps to allow insurance companies to avoid further coverage
--no more cut-off of insurance coverage because of onset of an acute illness
--women pay equally for same coverage as men, not more
--all plans must provide services in 10 essential health benefits categories.

These are all examples of how the Affordable Care Act is meant to aid the consumers of health care plans.  But strangely enough, those sections that are meant to advocate for consumers receive nary a mention.  Why is that?  Could it be that it’s not “sexy” enough?  Or that it’s not important? Or that Tea Party-types don’t want it known that consumers can get lots of attention and support in this law?  I tend to believe that the latter thought begins to get at the truth.  Right wing radicals just do not want to tout something—even negatively-- that might give consumers a reason to actually like this law! 

First, let’s take a quick look at some consumer-oriented items that perhaps have received a mention:
1)    Subsidies-- for small businesses and for individuals who qualify. One of the main features of ObamaCare is the creation of a new federally-financed health care provision that will subsidize the insurance premiums for low and moderate income Americans, beginning in 2014. The amount of the subsidy is inversely related to family income and will be administered by the new state-based ”exchanges.”
    There are also subsidies available to Seniors for the cost of medicines under Medicare Part D, along with a gradual lessening to zero of the “donut-hole” provision involved in providing huge profits for drug companies when Part D was promulgated. 
    Medicaid will be extended to those who earn up to 133% of the Federal poverty level. That's $15,281 for an individual, or $31,321.50 for a family of four in 2013. The poverty level usually increases each year to keep up with inflation.  About.com reminds us that “not all states have elected to expand Medicaid, even though the Federal government will subsidize it.  If you live in a state where you are eligible for Medicaid, but the state won't give you coverage, you won't have to pay the tax if you can't get insurance.”

Small Business Owners, with 25 employees or less, can get a tax credit of 35% of the costs of health insurance. This goes up to 50% in 2014.  Employers with fewer than 50 employees, don't have to pay a fine if their workers get tax credits through an exchange. Those with 50 or more employees must provide health insurance or pay a tax of $2,000 per employee (for all but the first 30 employees) starting in January 2015.  Those businesses with fewer than 100 employees   can shop for insurance in exchanges in 2014 that should provide cheaper alternatives than are available now. In addition, companies that offer health insurance as a benefit to early retirees 55-64, can get Federal financial assistance.

2)    Rebates—from insurance companies when they fail to meet the 80-20 split on health care provision/administration; some people have already started receiving these rebates which began on August 1, 2012.  ABC News tells us: “A new provision of the Affordable Care Act — called the Medical Loss Ratio, or the “80/20″ provision — could mean some Americans will see a rebate from their health insurance companies. The provision is aimed at holding health insurance companies accountable for how they spend the money collected through premiums. It compares the dollars they spend on health care costs vs. other overhead costs — like marketing, salaries and administrative expenses.”
Under the law, small-group and individual-plan insurance companies that annually spend less than 80 percent of premium dollars on medical care owe their customers a rebate. For insurers to large businesses, the percentage split is 85-15.  Last year was the first year the provision was in effect, and insurance companies that owed rebates had to pay them out starting Aug. 1, 2012.  Here’s a look at the health care rebates, by the numbers:

Health insurance companies in 2012 had to pay out a total of $1.1 billion in rebates.  About 12.8 million Americans received a rebate, according to the Department of Health and Human Services.  The average privately insured family saw a $151 rebate from this provision, but payouts varied by state.
About 31 percent of Americans who have individual insurance are eligible for a rebate. They’ll get their checks directly in the mail, averaging about $127, according to a study by the Kaiser Family Foundation.
For people who buy insurance through their employers, those rebates won’t come directly in the mail. They’ll first go to the employer, who decides how to distribute it. Employers who offer insurance can either send out individual checks to their employees, or put those rebates toward lowering future premium costs.
The employer could also use the rebates as a lump-sum reimbursement to the accounts that pay premiums, or spend it in other ways that “benefits its employees,” according to the Department of Health and Human Services.  This can include lowering co-pays or adjusting cost-sharing to cut group insurance costs.  Employees should contact their employer for details about how their rebates will be distributed.
Whether they owe a rebate or not, insurance companies in every state have to notify their customers if they’ve met or failed this part of the law.

    So, how many have gotten rebates this year?  Well, the numbers range from about 5 million to 8.5 at about $100 on average, in the range of maybe $500 million to $850 million.
    Fox News disagrees with the President’s numbers, as one might expect: “In his speech defending his health care law Thursday, Obama said rebates averaging $100 are coming from insurance companies to 8.5 million Americans. In fact, most of the money is going straight to employers who provide health insurance, not to their workers, who benefit indirectly.”  Of course, what Fox doesn’t bother to say is that the Law is quite specific on the fact that companies supplying health care as a benefit to their workers are made recipients of these checks, which are used to benefit consumers of health care, albeit indirectly, by perhaps being applied to the cost of the company plan.  One thing seems clear – last year checks went out that totaled $1.1 billion; this year they only totaled around $850 million.  The government points to this as an indication that administrative costs in private insurance companies may be coming down because of the ACA ratio requirement.

3)   Tax credits – Those who earn too much for Medicaid will receive tax credits if their income is below 400% of the federal poverty level. In 2013, that's $45,960 for an individual, or $94,200 for a family of four. The credit is applied monthly, rather than as an annual tax rebate. There are also reduced co-payments and deductibles.
4)    Choice of plans in the marketplaces – already, vendors are coming out of the woodwork in some states to take part in the marketplaces; in this area of New York, there are 18 different vendors offering plans – a totally unexpected number!  There are reports that the same is true elsewhere.  Exchanges will allow you to compare health plans before you buy one. The exchanges will also help you find out if you qualify for tax credits or other government health benefits. States are being given substantial Federal grants to fund the exchanges.

Second, we also need to look more closely at other-than-monetary supports for consumers:
1)    Navigators & Counselors -- The Affordable Care Act recognizes the vital role of community outreach in successfully connecting people with coverage. “Navigator” programs will be set up in each state to help consumers enroll in and retain coverage by providing fair and impartial information about qualified health plans and available subsidies.  Community outreach will also play a vital role in the success of reaching newly-eligible Medicaid beneficiaries.
    As we are reminded by Georgetown University Center for Families and Children: “Navigator-type programs are a tried-and-true concept. In Medicare, the State Health Insurance Assistance Program (SHIP) has been in place assisting seniors for more than two decades. And community partners who assist with outreach and the application process have been a key aspect of our nation’s success in covering children.”  So Navigator programs are tried and tested, and: “The fact is consumers need navigators. Applying for means-tested public benefits isn’t as simple as filling out a form. And while there are many positive changes coming with new high performing eligibility and enrollment systems, and modernized requirements to use electronic data to cut red tape in verifying eligibility, it will be a while before things are running smoothly. And consumers deserve formal programs – like those managing navigators and certified application counselors.”

2)    Public Health Council - The Act established the “National Prevention, Health Promotion, and Public Health Council.”  It's overall goal is to support preventive health care. It is chaired by the Surgeon General, and composed of the heads of 17 Federal agencies. It will coordinate Federal health efforts around seven priority areas: 1.Tobacco-free living. 2.Preventing drug abuse and excessive alcohol use 3.Healthy eating. 4. Active living. 5.Injury and violence-free living. 6.Reproductive and sexual health. 7.Mental and emotional health.

3)    Medicare improvement - The Affordable Care Act (ACA) requires that the Centers for Medicare and Medicaid Services (CMS) issue employer group health plan quality improvement reporting that covers specified quality improvement activities regarding plan or coverage benefit and provider reimbursement structures. Those requirements include efforts to improve health outcomes, ensure patient safety and reduce medical errors, prevent hospital readmissions, and implement wellness and health promotional activities.
The Innovation Center leads CMS efforts to test new models of care so that care is more coordinated, resources are used more efficiently, and the health care system works better for patients, families, and providers.
Under the Affordable Care Act, the Independent Payment Advisory Board (IPAB) is a feedback mechanism to Congress ensuring Medicare remains solvent without shifting costs to beneficiaries or reducing the level of care that they receive. When Medicare growth per beneficiary exceeds a certain target, IPAB − an independent group of doctors, nurses, patients, and health care experts − will recommend to Congress policies to reduce the rate of growth to meet specified savings, without harming beneficiaries’ access to needed services, beginning January 15, 2014. The Board is prohibited by the Law from recommending any measures that would ration care, increase revenue or change benefits.
The ACA also allows the establishment of Accountable Care Organizations (ACOs) that voluntarily meet quality thresholds to share in the costs savings they achieve for the Medicare program.  These organizations began in 2012.

4)    Appeal process -- For health plans created on or after September 23, 2010, the ACA ensures the right to an appeal or reconsideration when services or payment for services are denied by a health insurer or plan. Regulations were issued by the Departments of Health and Human Services, Labor, and Treasury on July 23, 2010, that set out standards for internal and external processes that consumers can use to appeal “adverse” coverage and benefit decisions (e.g., pre-existing condition exclusions, provider network exclusions). A subsequent regulation issued in July 2011, gave states options for implementing consumer protections.

5)    Other -- The ACA funds scholarships and loans to double the number of health care providers in five years. It cuts down on fraudulent doctor/supplier relationships. It also requires background checks of all nursing home staff, to prevent abuse of seniors.  Insurance companies must submit justification to the states for all rate hikes. ObamaCare provides funding to the states to administer this.  Title VI also cracks down on fraud by identifying high-risk providers, and preventing them from setting up in another state. It gives states the ability to test legal reforms to reduce waste, enhance patient safety, encourage efficient resolution of disputes, and improve access to liability insurance.
In addition, the Attorney General, the Secretary of the Department of Health and Human Services (HHS), and the Chairwoman of the Federal Trade Commission (FTC) announced an interagency initiative to prevent consumer fraud and privacy violations in connection with the Affordable Care Act’s Health Insurance Marketplace.  Officials noted that the initiative builds on a successful consumer fraud infrastructure that already exists and highlighted that the new initiative will:
--Dedicate a Marketplace Call Center as a resource and referral to FTC for consumer fraud concerns, with trained staff to refer consumer threats and complaints;
--Connect consumers to FTC’s Complaint Assistant through HealthCare.gov;
--Develop a system of routing complaints through the FTC’s Consumer Sentinel Network for analysis and referral as appropriate;
--Establish a rapid response mechanism for addressing privacy or cyber security threats; and
--Ramp up public education to empower consumers to know the facts and avoid scams.

Finally, it is clear that the promises inherent in this law tend to enhance the standing of millions of consumers:
1)    Quality plans
2)    Lower premiums
3)    Enhanced benefits
4)    Improved access
5)    The end of paying an average of $1000 extra premiums per family to cover the uninsured who use emergency rooms as their primary care

The point is: this law is a broad-based approach to insurance reform, delivery of services, medicine costs and the need for quality health care that provides all necessary basic services at lower costs.  It is not what its right-wing opponents have painted it.  It never was.  This is destined to be a strong Law favoring consumers once its promises begin to be fulfilled by its many reforms and provisions. Even Senator Ted Cruz of Texas, who is leading the fight against funding this Law with an all-night filibuster, has admitted to a reporter in an interview that once ObamaCare provisions take hold, it will be impossible to do anything to stop it! 

This re-formation of health care is long overdue and no amount of negative press will delay its advantages.  However, an editorial on the Kaiser Family Foundation website demands serious consideration:

“Typically the process of learning from experience culminates in Congress with new legislation. Welfare reform legislation, for example, began in the Reagan years but was revisited comprehensively in the Clinton years. And both Medicare and Medicaid have been substantially modified through successive waves of legislation over the years. Laws are changed as we learn what works, as needs and circumstances change, and as political support for needed changes coalesces. Can today’s hyper-partisan, largely paralyzed Congress agree on legislation to improve ACA as we learn from implementation? Would Republicans agree to anything Democrats want? Would Democrats open up the ACA for legislative tinkering? It is not easy to envision agreement on ACA-related legislation any time soon.
One thing that could change the picture somewhat is the current negotiations occurring between several states and the administration over the Medicaid expansion. If HHS and these states can successfully negotiate arrangements that give the states the flexibility they want and at the same time provide adequate protections for beneficiaries, it will bring more red states and their governors into the fold and create a much more bipartisan base for the ACA in the states than it has had in Washington, as well as a broader constituency for changes to improve the law over time. This will not happen overnight.
Another factor that will affect the ability to learn and adapt as implementation proceeds is media coverage. If journalists focus on both what is working well as well as what is not, they can make a real contribution not only to public judgment about the ACA but future efforts to improve it. If they focus only on gotcha outlier horror stories that do not reflect general experience with the ACA, their reporting will do more to fuel political partisan debate than inform future policy.”
 
That there will need to be amendments and changes is inevitable. Already the tax on large medical devices is being re-considered, for instance.  But that is the way with any decent comprehensive plan.  First, it must be constructed, then tested, then evaluated fairly, and then adjusted.  The fact that it will need adjustments and amendments is not a sign of failure.  It is, rather, a sign of strength and endurance.  Just as with any great change – like Medicare and Social Security – the proof is in the implementation.  This is such a grand plan on behalf of healthcare consumers that, in this writer’s opinion, it is going to be unstoppable and eminently successful once all its provisions, with necessary adjustments, are in place. Then, as we did with Medicare, we are going to wonder:  “why all the fuss?  This is great!”  And, we may even hear people proclaim: “I actually got a real live person to help find the best plan for me, and she guided me through the whole process!  WOW!  I love it!” 

Distort and Capture: a New Technique for Our Times!

“Don’t believe everything you hear!”  Have you heard that before, perhaps in childhood, or in the workplace, or at a friendly gathering?  So, how come so many people in this country are more than eager to believe every negative thing they hear about the Patient Protection and Affordable Care Act (“Obamacare”), and more especially about our President?  I suspect it is the way that right-wing radicals distort the truth that draws people in, and makes them forget everything they should have known about political rhetoric.  So, beware, and do not fall into their web of distortion and capture!  Watch for the following warning signs:

1)  You can’t often trust what comes from a politician’s mouth, or from the broadcast booth of a right-wing commentator like Rush Limbaugh, or Glenn Beck, or Ann Coulter.   Why?  Simply because they have ulterior motives in saying what they say.  The politician wants above all to be re-elected so it is in his/her best interest to garner all the money and votes possible to win.  The radio commentators want fame, sponsors, and a substantial return for their “entertainment value.”  So, they distort the truth to make it palatable for you to swallow.  And, they continue to be quite successful in capturing the loyalty of their audiences.

2)  You can’t trust their rhetoric because they are intent on “blaming” someone else for their lack of ability to control all the power necessary to turn the world toward full acceptance of right-wing conservative ideology.  And, that someone else is clearly Barack Obama.  For some unexplained reason, the two-term, duly-elected President, is to blame for pushing a left-wing, socialistic, Islamist- and communist-inspired agenda that has detracted from their own agenda, and which continues to hamper their road to POWER. 

The “unexplained reason,” of course, has been, and will continue to be, that Barack Obama is a man of color, and therefore unworthy of the Presidency, in their view.  Their efforts to fault him for everything, their rhetoric about his birth, about his religion, about his “differentness,” about his socialistic agenda, about his association with “revolutionaries” in Chicago, about his “laziness,”  his lack of leadership, his aloofness (“Uppity?”), and so on and so forth -- it’s all a cover for what they cannot say directly, but want to say in the worst way.  He is not white -- he is not really a Christian -- he is not “one of us” -- he is black, and for them that constitutes an illegitimate Presidency!  Whenever they speak, this is the “shadow” that stands behind their words: he is not worthy of the Presidency because he is an Afro-American!

And so, they rant and they rave and they conspire, and they act upon de-funding his crowning achievement - the Patient Protection and Affordable Care Act.  They try to pin some made-up “scandals” on him, threaten to impeach him, say he is weak in foreign policy, say he plays golf too often, say he “leads from behind,” and we will thereby destroy any legacy he might have been able to claim.  But most important, they say he was elected illegitimately because he is not native-born! 

3)  You can’t trust their rhetoric because they can’t escape their own duplicity and hypocrisy.  This is a group of prevaricators who have taken lying and distorting to a whole new level.  In fact, because they have now made distortions and lies an integral and accepted part of campaigning, of legislating, and of garnering votes, they have achieved a level of indecency and lack of respect for voters that has perhaps never been accomplished to this extent in the past. 

But, more to this particular point, they have turned their own failings into achievements, their own former views into not their views, their own past laws and policies into things that never existed.  Take RomneyCare:  in Massachusetts, the plan is good and touted as working to a great extent; when it became associated with Obamacare, it was just the opposite.  Or take use of drones: have you forgotten the U-2 spy plane, or the strafing of innocents in Vietnam, or even agent-orange?  But let’s be more current.  What about the latest turn-around: we shouldn’t be going into Syria with a military strike they say!  What about the Eisenhower doctrine and the battalion of Marines sent  into Lebanon?  What about Desert Storm and H.W. Bush?  What about dispatching of troops to Lebanon by President Reagan? 

4)  You can’t trust their rhetoric because they have an agenda that wants to weaken and perhaps destroy the power of the central government.  They are using all kinds of tactics to achieve their goal, and one of them is to get the public to believe that a strong central government is detrimental to the people’s freedoms and liberties. 

On the contrary, the central government has been, and continues to be, the protector and defender of civil, consumer, and patient rights, and of the rights of the vulnerable in our society.  The states have not measured up in this regard.  They never will; they are incapable of it.  But, the Radical Right would have you fear the national government that mandates anything, even if it is in the best interests of a majority or of a significant minority of the people.  That latter is a good reason to have a strong central government: the protection of minority interests.  Let us count the ways:  the ADA (persons with disabilities), repeal of “don’t ask, don’t tell,” and the promulgation of gay rights, the Civil Rights and Voting Acts, the many programs and benefits for veterans, children, and the poor, the emergency relief efforts of FEMA and other national agencies. And something we keep forgetting -- the role of first responders (police, firemen, EMTs) in protecting and rescuing a small portion of population when they are in harm’s way; let’s not forget to mention the often unsung National Guard, as well.

You would think that this would be enough to overcome the objections to having a strong central government, but apparently not for many in this country who actually benefit from the many laws and programs that are legislated and operated by the central government -- Social Security, Medicare and Medicaid come to mind-- while still buying into the idea that we need to give more autonomy to the states. Devolve any of this to the states, and you will soon find yourself back in the boots of General George Washington who could never forget (especially after the hard winter at Valley Forge) how inadequately the states responded to his need for troops, supplies, and support.  That’s partially why he knew that to be successful, America must have a strong central government, focused mainly in the legislative branch. 

5)  You can’t trust the political rhetoric of the Radical Right because they want the power of the central government and state governments to be used only in ways that will favor them and their cohorts, not the vast majority of the people.  You won’t hear many complaints from the Far Right when the following happen:

--when they can cut all tax rates, especially for those at the top of the ladder - the 1% who they figure should get all the breaks because they supposedly make the economy stronger
--when they can force all public institutions and entities to incorporate prayer and the Ten Commandments into their domain, and we become a “Christian” nation, whatever that is
--when they can totally ban all abortions and severely restrict any use of contraceptives
--when they can drastically reduce the involvement and the freedoms of the lower classes, minorities, and immigrants to a level of minimal impact on our government and society; voter suppression, drastic cuts to “welfare” programs and devolvement of many programs to cash-strapped states should about do it
--when they can eliminate all unions and have Right to Work laws govern all the states in relation to labor
--when they can put women back into the role of subservient housewives by reducing their rights and their access to government and the marketplace
--when they can control who goes to what universities and colleges, and when they can control the curriculum that exists in K-12 grades, so that their ideology is the only one reflected in our history and in our schools

--when they can place most of the national government functions and operations into the hands of private contractors
--when they can control all regulations so that big (and maybe small) businesses can act in whatever ways will grow them and allow them to profit in whatever ways are of their choosing: no more FDA, no more EPA, no more consumer protection agencies
--when they can make an exit from restrictive international agreements, the United Nations, and involvement in any international courts
--when they can strip the federal government of social welfare programs and allow everyone to beg for assistance from wherever they can get it
--when they can further the War on Drugs (read “arrest more minorities and immigrants“), expand the prisons, further militarize the police forces, and use the military to achieve hegemony once again for their belligerent, bellicose nation
--when they can procure for themselves more privileged positions in business and finance that come with service in the national Congress

This has been  a snapshot of what we are going to look like if the rhetoric of the Radical Right continues to capture the minds of our electorate.  They are already working toward these goals.  They will not stop; their actions will not abate.  Their interests are not the interests of most of the middle class, yet there are still those who will vote for them even though it is against their best interests. Indeed, their interests are not even in accord with their constituents in some cases, such as regards gun background checks.

The challenge is: how do progressives counter the rhetoric of the Right Wing zealots?  By winning elections.  By acquiring newspapers, radio stations and TV stations, and by flooding the social media.  By paying more attention to local politics and the need there for Progressive voices and candidates.  By winning statehouses and state legislatures.  By training a new generation of leaders and volunteers.  By growing the Progressive Movement.  Progressives like to talk and debate, but action is the key.  Is it too late?  2014 may give us a partial answer.

“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!

SYRIA: One More Quagmire

A disturbing video of victims of the gassing in Syria has been released to the public by the Obama administration.  The video evokes an emotional response, but is that what we need? Let’s take a step backward and take stock of how we may have come prematurely or impulsively to this “red line” war action that is now being vigorously promoted.

1)    Assad has been a tyrant toward his people for a fairly long time
·    Initially seen by the domestic and international community as a potential reformer, this expectation ceased when he ordered a mass crackdown and military sieges on pro-rebel protesters amid recent civil war, described by some commentators as related to the wider "Arab Spring" movement (Wikipedia)
·    Immediately after he took office a reform movement made cautious advances during the Damascus Spring, which led al-Assad to shut down Mezzeh prison and release hundreds of political prisoners (Wikipedia)
·    A 2007 law required internet cafes to record all the comments users posted on chat forums. Websites such as Wikipedia Arabic, YouTube and Facebook were blocked intermittently between 2008 and February 2011.
·    Human Rights groups, such as Human Rights Watch and Amnesty International, have detailed how Bashar's government and secret police routinely tortured, imprisoned, and killed political opponents, and those who speak out against the government. Since 2006 it expanded the use of travel bans against dissidents. In that regard, Syria is the worst offender among Arab states. (Wikipedia)
·    The New York Times reported the arrest of 30 political prisoners in Syria in December 2007.
·    In 1970, Hafez al-Assad, Bashar’s father, seized power after rising through the ranks of the Syrian armed forces, during which time he established a network of loyal Alawites by installing them in key posts. In fact, the military, ruling elite, and ruthless secret police are so intertwined that it is now impossible to separate the Assad government from the security establishment.... So... the government and its loyal forces have been able to deter all but the most resolute and fearless oppositional activists. In this respect, the situation in Syria is to a certain degree comparable to Saddam Hussein’s strong Sunni minority rule in Iraq.  (Wikipedia)
·    Torture has always been a part of the Assad regime, even before the current uprising, says Donatella Rovera, a senior crisis response adviser at Amnesty International. But now, as the battle waged by Syrian rebels reaches a bloody stalemate, it’s a full-fledged crisis. “Torture in police detention [has] increased dramatically with the uprising,” she says. “Of course, there were some cases in which people were not tortured when detained, but those are the exception.” (Dailybeast)
·    A report, “I Wanted to Die: Syria’s Torture Survivors Speak Out” documents a wide range of practices the regime has used against its citizens since rebellion broke out.  The report identified 31 methods of torture and other ill-treatment. Many of them, it said, were methods that had not been used in years as the incidence and severity of torture declined when Bashar Al-Assad took over Syria after his father’s death in 2000.   The report comes as Damascus launches an assault on rebel redoubts in the north that have left scores dead and accusations of widespread abuse and torture. The Local Coordination Committees of Syria, a network of opposition activists, released footage showing men, women and children lying dead in a blood-drenched room, many with their throats slit.  In its report Amnesty said people are almost invariably beaten and tortured and ill-treated during arrest, often beaten again during transportation to detention centers, and routinely once they arrive. Among the victims are children under 18, it said.
·    Among the methods of torture revived over the last several months, Amnesty said, is shabeh, whereby the victim is hung on a raised hook, handle or door frame, or by manacled wrists, so that his feet hang just above the ground while he is beaten. Researchers found evidence for the frequent use of electric shocks as well as rape and other tortures and ill-treatment of a sexual nature, all of which had largely gone into abeyance. 
·    A report from Amnesty International says that at least 256 children have been deliberately killed at the hands of Syrian security forces including a two year old girl shot in the head at point blank range by an officer because he “didn’t want another protester to grow”. Many more have been tortured and apparently the guards at Syrian prisons don’t differentiate between children and adults keeping both adults and children in the same detention centers (some of which are schools) where they torture children in front of adults. In addition to this the report also documents the case of a 15 year old boy shot in the leg who was denied access to medical treatment by soldiers. The report concluded by pointing out a rather comprehensive list of breaches of international law by the Assad regime.  As well as systematically torturing, raping and killing kids, the Assad regime has also been dabbling in executions, according to a report by the human rights watch.
 
If this is primarily a moral question, what have we been waiting for?  Does not all this beg the question, why did we wait so long to declare that Assad was abusing his own people?  Perhaps we just didn’t have the equivalent of “weapons of mass destruction” so we could mimic our lead-up to war with Iraq, until we discovered the use of chemical weapons.  However, if it’s so darn important to act against the use of chemical weapons, why is it OK to be silent about torture and killing of innocent children which is also a breach of international law and conventions?  The answer is: because it’s nothing more than an excuse we use to justify our intervention in the internal affairs of another nation.

So now, “chemical weapons” are the reason we would attack: first, because their use against the people of Syria violates a UN convention signed by 188 nations; second, because we can’t let these weapons get into the hands of terrorists like Al Qaeda; third, because if we don’t act, it will send a message of weakness, or a message of a lack of resolution, to other countries, especially rogue nations like Iran.  Substitute Iraq wherever Syria is used, and we are back to the G.W. Bush reasons (excuses) for going to war against Iraq!  Same excuses, same reasons, same stupidity.  Now unspecific terror alerts are being issued because retaliation for a US attack on Syria may bring terrorist attacks on airlines, hotels and cyberspace.  It’s ‘Ground Hog Day’ and we’re being made to re-live the same mistakes, fears and excuses for war that we have already endured.  Mr. President: please don’t go down this road!

2)    Factions have been at each other’s throats in Syria for centuries
Dailykos.com brings some important information to our attention.  “You could look anywhere in the world and not find a more mixed cauldron of ethnicities, racial characteristics, languages, and countries of origin.”  Look for a moment at just the foreign contingents; there are Turks, Portuguese, Kurds, Arabs, Persians, Greeks, Spaniards, Russians, gypsies, French, Bulgarians, German, and Armenian nationalities; 28 languages, and who knows how many dialects. 
Assad’s people are Alawites, a splinter sect of Shia Islam, which by the way is thought of as heretical in Pakistan.  The Alawites are outnumbered by the Syrian Arabs, mostly Sunnis, about 10 to 1. And it’s not smart to intervene in a tribal war/ religious war, which is what the conflict in Syria is.  It’s Sunnis that are being killed by Assad’s modern army; so, why don’t THE SAUDI’s act? They certainly have the money to buy whatever is needed.  Strictly from a desire to spare the bloodshed -- as was done in Libya, where Gaddafi threatened to wipe out the city of Benghazi -- the Saudi’s need to act.

If we target-bomb the chemical weapons plants, who have we protected and who have we punished?  Who wins anything by this action?  Is it simply a moral question: that we must act to uphold a matter of international law?  Just what would be the purpose behind a “limited action” against Assad? 
Another writer asks: “So what happens if we intervene? Are we morally bound to save people’s lives?  Do we blame ourselves for not interfering in Sudan? In Rwanda? Are we the policeman of the world? We “brought democracy” to Iraq and they are killing each other as much as Saddam ever did. Libya is (also) in turmoil.”

The real point for me is that a “limited action” is still a war-like action.  It cannot help but kill Syrian people who are nearby – the “collateral damage.”  It will not stop the proliferation of chemical weapons; it will only diminish their production capacity.  It will not protect the United States – or Israel or Syrians– from future attacks.  It most certainly will not force Assad to leave office.  It will punish those who work in the plants, or who live nearby, but no one else, certainly not Assad himself, and not Al Qaeda.  It will never sort out the factions that exist in the Syrian civil war.  So what outcomes will we achieve?  That question still remains, and it has not been answered.

3)    We have reduced options to one bad option: a military strike.  Have other options existed?
The answer of course is that other options have existed, and we have acted on some of them -- economic sanctions for instance -- but we either didn’t take notice or didn’t act on most of them:
·    Establish diplomatic talks with the new government in Iran
·    Build a coalition with the other 188 members of the UN convention against use of chemical weapons;
·    Work to reform the UN by changing the ability of five major powers to veto resolutions and motions in the Security Council
·    allow U.N. experts to investigate the alleged chemical attacks and wait for their report before taking any action
·    Go to an International Court or economic group
·    Get the Saudi’s to act as they did with Libya (there are rumblings that they are active behind the scenes)
·    Don’t draw “red lines” in the Middle East, or elsewhere
·    Never act alone on issues that can bring war
·    Provide humanitarian aid only, and let that be known up-front
·    Keep working on the Israeli-Palestinian peace accords – do not stop
·    Identify Syrian rebel leaders who are truly secular and who oppose radical Islam; who will disavow al-Qaeda, Hezbollah, and other terrorist groups; and who will reject Russian and Iranian hegemony over their country.
·    Support those rebel forces in the Syrian conflict who will sign a contract or memorandum of understanding with the United States as to governance outcomes they will achieve; include agreements about conditions that will lead to abrogation of U.S. support
·    Reduce the amount of money being made on all these “wars.”  Don’t think that the manufacturers of all the weapons that are being used aren’t taking their cut of the squandered scads of money!
·    Talk with China as a shadowy figure in this mess, but who might influence Russia’s support of Assad
·    From Slate comes an interesting option: Obama’s good option would be to reread his administration’s official National Security Strategy, which sagely argues that “[a]s we did after World War II, we must pursue a rules-based international system that can advance our own interests by serving mutual interests.”
·    Other military options—short of direct boots on the ground or bombing raids—could include no-fly zones, blockades, and arms embargoes. But any of these can be a double-edged sword.

And now, out of the blue, Russia has proposed that Assad internationalize control of his chemical weapons and a Syrian official has publicly accepted that option as a possibility.  Although trust between our two countries is at  a new low, doesn’t this open up the option of talking with Russia about the details of such a proposal?

One Syrian writer pushes back:
“For some skeptics on Capitol Hill, the question is why we don't wait for others to act — the U.N., perhaps, or some of the 188 other nations that have ratified the Chemical Weapons Convention outlawing atrocities such as those committed in Syria. I guess hope springs eternal, but that's how long the wait will be. Russia has vetoed every attempt by the U.N. Security Council to act. Britain's House of Commons has said no. France is willing but won't go it alone.
Maybe all this reluctance is a warning that we, too, should demur. But let's at least be honest with ourselves: If we don't act, nobody will. The clear message to Assad — and to other tyrants — will be that poison gas is frowned upon but not actually prohibited.
There is no way that Assad can be shamed into contrition and atonement; at this point, he's fighting not just for power but for his life. He has to believe that if he loses the war and is captured by rebels, be they the “good” ones or the “bad,” he will be tried and executed like Saddam Hussein — or perhaps killed on the spot like Moammar Gadhafi.”

Sunday, on Meet the Press, former Congresswoman, Jane Harmon, spoke for many when she said:  “This is a choice between bad options; this is the least bad.”  That is what this situation has produced because other options were not pursued early on.

Perhaps we must also consider what other Syrians in exile have to say.  One with surname of Hamza expressed his thoughts on the least bad of bad choices:
“There was martial law for many, many, many years. That needed to be lifted. [The Assad regime] made a lot mistakes, and they admit that.”
However, Hamza does not believe that there is a popular uprising in Syria. He says it’s a plan by Islamic extremists to take over the country.  “They’re waiting for any weak moments to come out,” Hamza said. “They’ve been waiting for a long time.”
He fears that if the rebels win, they will impose Islamic law on the country.
“We’ve learned some harsh lessons through our history,” Hamza said. “[Religion and government] should be separate.”  Hamza says European and American intervention on behalf of the rebels is based on a naïve hope for creating democracy in Syria.
“Democracy cannot be exported. It’s a different culture, a different history, a different setup and mixture,” he said.  Hamza believes Assad is the better of two bad choices for the country, because Assad would at least be able to stabilize the country.  (From Hereandnow.com).
 
Secretary of State Kerry said, “This is not about getting into Syria's civil war. This is about enforcing the principle that people shouldn't be allowed to gas their citizens with impunity.”

Columnist Eugene Robinson says “Congress is asking the wrong questions about Syria. The issue can't be who wins the civil war. It has to be whether the regime of Bashar Assad should be punished for using chemical weapons — and if the answer is yes, whether there is any effective means of punishment other than a U.S. military strike.  If Assad and his government are ever going to be held accountable for the use of forbidden weapons to murder hundreds of civilians, the only realistic way for that to happen is a punitive U.S.-led military strike. This is the question that Obama put on the table — and that too many members of Congress seem determined to avoid.”

Well then, what is the question we should be asking?  Unfortunately, there is not a single question that would yield a single definitive answer to the dilemma of Syria.  We have mistakenly allowed one option or answer to predominate: that Assad must be shown by U.S. military force that he cannot, with impunity, gas his own people.  And the corollary to that is that it is probably going to happen only if the U.S. makes it happen.  How do we get ourselves into these quagmires?  By not taking short-term and long-term steps toward peaceful and humanitarian solutions to problems that arise in other countries.  Oh yes, there are probably times when we need to take bold action as well, but military action should be a final resort after all other options have been exhausted.  That is not the case here; it was not the case in Iraq, and it probably won’t be the case in any Middle Eastern country.

The administration and Congress seem to be extremely worried about the messages we are, or are not sending to other nations and peoples.  Well here’s one message we ought to abhor: whenever we use force to solve an internal problem presented by other nations, we risk sending the message that we are a bellicose nation, not a humanitarian nation.  Our actions should not be based on so-called “messages” but on policies, programs, monetary aid, agreements, and mainly on our humanitarian actions that will help other nations find their potential, their best practices, and their ability to treat their people, and people of other nations, with dignity, respect and concern.  We must stop this nonsense of thinking of the U.S.A. as the policeman, or even the moral or governmental guide, for the world.  A little humility wouldn’t hurt. 

Whatever happened to the spirit of the “Peace Corps”?  Whatever happened to long-term government initiatives like education for girls, or fighting hunger or eradicating certain diseases?  Are we now simply the purveyor of arms and the first to take military action against perceived “threats” to our national security?  National security is not our most important priority, and national pride is not our greatest asset.  Our importance and our national identity must be measured by humanitarian efforts to heal, to educate, to lift up the poor, to seek peaceful solutions to global problems.  We are a nation of rights, of liberties and of innovations.  Let us not fall prey to the lesser options of our darker nature, but let us pursue the path to better options.  Let us help the refugees fleeing Syria; let us find ways to aid the victims of chemical weapons and their families by offering the Syrian rebels a chance to show their true colors in a cooperative effort at bringing such relief; let us offer to give up our veto in the UN Security Council if others will do the same; let us at least offer to talk to Iran with no pre-conditions. 

We cannot punish Assad without consequences for our own nation.  So let us turn over that responsibility to the proper authorities: the UN; the International Court; the Saudis, and let us provide all the support we can to them.  The Syrian Civil War is not our responsibility, except insofar as people need our help and aid.  We must eschew the role of policeman of the world and return to our role of humanitarian nation.  The sooner the better.

We Learn Best When…

We just don’t seem to be able to see the real problem with public education.  We’re not failing in our schools simply because of all the things that usually receive blame --  such as buildings, teachers (and their unions), textbooks, resources, and tests -- although their lack is not helpful.  These items are more representative of symptoms rather than the causes of our problems in education.  No -- We are failing in our ability to stop thinking and acting in 18th and 19th century terms.  In other words, the one thing that we fail to ask seriously is: how do people usually learn and in what circumstances do they learn effectively, and how does that apply to the 21st century?

Instead, we keep trying to “tinker” with the same old tired constructs and concepts in order to make a difference in test scores, achievement gaps, and school standings.  First, there was the “No Child Left Behind” debacle under which test scores became the end-all and be-all of education.  Then there came the “Race To The Top” which was more sophisticated, but ended up being a bit of largesse given to states to help them improve their existing schools.  In either case, the essence of learning and education took a backseat to test scores and questionable innovations layered over an outmoded system.

The educational philosopher and psychologist, John Dewey, had to deal with a similar environment and questions at the beginning of the 20th century.  He well knew that the industrial revolution of the 19th century had set in motion certain forces with which schools had to contend. He believed students would become more well-rounded, productive members of society through their natural inquisitiveness, and experimentation through interaction with the world around them.  His efforts were directed at conceiving “what roughly may be termed the ‘New Education’ in the light of larger changes in society.”  He said essentially, if we can connect this ‘New Education’ with the march of events,  public education “will lose its isolated character, and will cease to be an affair which proceeds only from the minds of pedagogues dealing with particular pupils.  It will appear as part and parcel of the whole social evolution…”  We exist in a similar time, when the forces of society have evolved to a point where they have made schools disturbingly irrelevant and lagging behind the curve.  It is time again to cease using outmoded constructs, concepts and methods, and to re-make the public school system into a “part and parcel of the whole social evolution.”

Putting aside the fact that we do learn something in our outmoded classrooms, how do we usually learn outside school buildings; in a more natural state of being?  Let me advance just ten ideas, with the caveat that these ten items do not cover the waterfront, and that some concepts - such as vocational training - have not been touched upon.

1.    We learn best in small, often intimate, groups – in families, with companions, in work settings, in team sports, sometimes in quiet contemplation, or by individual experimentation or research, as well as in one-to-one relationships.  Experts say that to be effective, these small groups should not be larger than about 10-12 participants.  We do not learn as well in large groups like classes or lecture halls.  Why can’t we see it?

    School buildings are not built to accommodate this natural phenomenon.  If a project team needs to meet together they have to go to a corner of a classroom and contend with actions, motions and noise from the rest of the class.  If small groups are naturally productive in terms of learning, why is space not allocated for their functioning?  Secondly, a teacher cannot be everywhere, so this natural construct also speaks to the dilemma of having just one “teacher” in a classroom.  We need multiple facilitators for multiple groups, working on multiple projects, which speaks to our next point.

2.    We learn best when we have support from another person or persons – we have only to look at babies and toddlers to know that this is true.  They thrive when a parent or sibling lends a hand and shows interest and love.  That is no less true as children grow and develop. Why then do we insist on separating schools from communities? Why do we insist on classes where only students & teachers may enter?  Why do we discourage one-to-one relationships in school rooms?  We do it because we still believe that the teacher is all one needs for education to take place.  This is a fatal flaw in our system: that we continue to define “teacher“ in an extremely narrow way.  We shall continue to explore this as we move on.

3.   We learn best when we set our own educational goals and programs- look at  examples of babies and toddlers again – they learn to walk, talk, eat, etc. at their own pace even though Mom & Dad (and others) may contribute to the process.  We set our own goals from our early years and continue to do so throughout our lives. With help and encouragement from parents and significant others, we grow and thrive.  Yet, in school, it is an acceptable standard for others to do that for us:  the courses we must take, the path we should follow, the books we must buy and use, the rules and procedures we must follow.  Schools can thus be a detriment to an individual’s growth and development, and a hindrance to the process of learning.

I advocate a well-defined individual education plan for every student, to which all “teacher-types” might contribute as long as the student agrees.  There could still be certain prerequisites that individuals might choose, as from a menu.  The student must, however, remain the manager of his/her own goals and program.  Here’s another key ingredient:  all of the “teachers” in the student’s sphere must contract with the student and the school to support the student in that educational plan which then becomes something of a “contract” for all to sign. 

4.    We learn best when our senses are stimulated – music, comfortable furniture and clothes, perhaps posters, colors, other decorations help soothe our weary souls.  But not in schools -- take a look at those walls, those awful desks and even blackboards, found nowhere else but in school buildings.  It should tell us something, but fails to penetrate the curtain that separates us from the 21st century!  Of course conformity and order hold sway in our schools so it is doubtful that our public schools can ever tolerate comfort and color.  Another good reason for us to use other kinds of buildings, constructed or re-constructed, to accommodate new concepts.

5.    We learn best when we participate fully in the process of learning and of teaching- it is amazing that we ever let children get near their siblings, or that we let our kids play with others.  After all, such interactions involve learning; learning from each other.  How many times have astonished parents asked their children, “Where did you learn that?”  Why, then, don’t we have peer tutor programs in every school?  Once we are in a school setting, we essentially deny that pupils can learn from other pupils. 

Moreover, learning is a discipline, and it requires the attitudes of striving, and struggling, and seeking, and achieving.  Learners must be as engaged as their teachers, else the process of education is short-circuited.  One of the things we fail to teach adequately is the role of the learner in the educational process. We talk about teachers all the time, but learners are given short shrift.  They are mere puppets in the hands of a puppet-master or mistress, and they act or react only as the teacher directs.  This is a failing of public education that still believes that the Socratic method is the basis of learning, and that we all start out with a blank slate needing to be filled by others. Learning is one with teaching, and to stress it less is to encourage apathy and a “failure to thrive.”
 
6.   We learn best when we learn from experience and in natural circumstances - I recently spent 12 years of my retirement researching my paternal Family Tree, and examining many original sources and documents.  In tracing the personal history of my ancestors, I found myself also learning a great deal more than I did in schools about history and locations and famous and interesting individuals.  Why, then, do we continue to learn dates and events by rote in schools, instead of looking at the lives and times and products of real people.  Why don’t we have students look at original documents and sources and build from there?  Why don’t we have more projects involving the tracing of individual lives in relation to history of their times?  Why don’t we place all students at a certain age into real community situations as “interns” or “seekers” and have them learn from a broad experience of people and experiences? 

7.    We learn best from people we respect, and who respect us – of course that could be a “teacher”, but it could also be a tutor or mentor, or Foster Grandparent or volunteer or intern or guest speaker.  Of course, it’s of prime importance to have excellent teachers, but why can’t we broaden that category; that title?  Because we think in out-moded terms, we think teachers are the source of knowledge, the fountain of wisdom, the purveyor of facts, the disciplinarian, the questioner.  Rarely do we think of teachers as enablers, resources, guides, challengers, catalysts, facilitators of learning.  To broaden our concept of teachers, the teacher’s schools and their curricula must also change.  But just as important, we must find a way to build community support for those who seek out this profession and thereby also broaden our respect for “teacher-facilitators” from the beginning of their course of training. 

We too often forget that “teachers” are everywhere: at home, in school, at work, at play, in therapy, in prisons; in stores, bars, factories, and even in poor neighborhoods.  Some of the best teachers we will ever know are not in schools, and yet we fail to bring them in, or better, to go out to them and learn from them.  This is not meant to denigrate classroom teachers; it is meant to raise respect for all our teachers to a new level.  One of the goals of a school administration ought to be to find these community-based “teachers” and to utilize them in creative ways to expand the minds of learners.  

8.    We learn best from people who point us toward sources, books, documents and materials that might speak to our particular personhood – a facilitator - Teaching is an art form.  All good teachers have to know their audience; know their pupils.  They must know their strengths and weaknesses, their talents and their failings; they must know what motivates them and what does not.  They must know how to present material to be learned in a way that captures imaginations and interest.  They must be able to “paint a picture” of a concept so that pupils can see that concept in vivid terms. They must know when to stop speaking, and when to listen to what others have to say.  They must know when to point to other persona and voices, so that a student can hear many viewpoints, and take away what they will.  A facilitator knows how to point people in helpful directions.  Teachers must approach every student with respect, just as an artist respects nature and symbols and revelations and space.  They must help individuals who need something extra.  They must be prepared and they must be engaged.  “Teaching” is an art, but it is not confined to one person, and public schools must broaden its definition.
 
9.   We learn best when we help and serve others - only lately have some schools begun to learn this truth, and made service-learning a part of their curricula.  It should be a part of every public school’s curriculum because schools are an integral piece of community functioning, and every piece must contribute to the whole.  Learning how to serve one’s community - to give back to a living entity made up of many people - is to learn one of the most valuable lessons of life: that human beings are mutually responsible for a community’s well being, and responsible for one another, in a way that cannot be ignored, or the community will inevitably decline.  We are interdependent, after all, and what one human being does, or does not do, can be harmful to the whole community.  We learn about human nature and human frailty as we become active contributing members in our communities.  To let this aspect slide is to deny very important questions of life - why am I here, and what should I do about it? 

However, one failing of public education is it’s inability to reflect upon experiential learning.  That is, a set curriculum too often overrides what could be learned from  experience.  What is needed is the ability to lead individuals and groups through a process of reflection on an experience by which one draws out certain “learnings” from what just occurred.  Otherwise, an experience in community service remains just that, and “learnings” go un-articulated. 

10.   We learn best when we aren’t being forced to learn – when there is some freedom to find answers for ourselves and when we are challenged to find answers - of course, some children prefer safety and protection to challenges and freedom.  They must be treated with care and respect.  Volunteer mentors or companions might be helpful for them.  They might be led toward responding to challenges, or they may just need reassurance that they are doing their best.  But there are many children in our public schools who need the sense of challenge and freedom. 
   
This brings up the whole question of levels of instruction.  We have chosen in public education, a model that is questionable as to its efficacy, and that is the age-related classroom.  Children are essentially grouped by age, within one-two years of each other.  In some cases, this works well, especially if all in the class are within the same range as to ability and experience.  But, is this the only model that should be used?  What about grouping pupils by interest, or by project, or by teams?  I can see a team of children of different ages taking on a particular task or investigation or research by which they together produce a product (not necessarily a physical product).  Within that team might be some younger children; within that team might exist some partnerships based on interest or skill rather than age; within that team might exist unexpected leadership skills that were previously undeveloped, but which a peer mentor encouraged.

All kinds of possibilities exist that might not be appropriate to the usual class construct.  Teams and team work are prevalent in the industrial and techno world of the 21st century, yet public schools seem to want to ignore this construct as a way of learning and achieving.  Projects done by teams is a construct that every child will meet along the way in the adult world.  Let us resolve to introduce them to each other at a much earlier age.  The “catch” is to use these team groupings for appropriate goals and purposes, and not as gimmicks.
 
Our obsession with classes based on age, levels of attainment based on standardized tests, directions based on god-knows-what is an obsession related to the same phenomenon that affects - and infects - all public education: the reluctance to give up past constructs and procedures even though they no longer quite fit the demands of a technology-based world.  We continue to build school buildings that say “isolation” “segregation” “conformity” instead of saying “community” “integration and interdependence” “freedom to explore.”  Should we be building new schools on the old models at all?  It’s doubtful.  We need to build new schools only when other adequate and appropriate buildings are not already available in the community.  We need to build new schools only when the purpose, goals and objectives of the school have been constructed by all members, including the public, and then architects can be hired who can fit the old or new buildings to those concepts and to the realities of the 21st century. (And, no more blackboards, please!).
   
The school year, the school day, vacation periods, absences, homework - must all be re-examined in the light of a school’s mission and purposes.  These are all constructs built around a 19th century (or earlier) agrarian society, and yet we have maintained them into the 21st century dominated by a technology that did not exist in those by-gone eras.  Why?  Why do we insist on buildings with classrooms and blackboards and teacher at a front desk with pupils seated at desks in neat rows.  Why do children get a whole summer vacation?  There are no crops that must be harvested by them!  Why are classes 40-45 minutes long when some children sit at computers or TV screens for hours at a time?
 
When we conform to constructs and concepts that are outmoded, we are simply hanging on to the past, instead of venturing into the challenges of the future.  We are allowing the cart to pull the horse, the dog to lead his master; the form to dictate substance.  This is equivalent to death by strangulation, cutting off vital life-giving oxygen by means of a physical form or instrument.

Shall we talk about standardized tests in this context?  They are anachronisms; leftovers; mostly useless.  Do such tests really reveal anything about the learners and the teachers?  Good question.   The Education Opportunity Network reports:

“School grading systems have been sold to voters as accurate measures of school quality. Armed with such measures in a “choice” system, parents, we’re told, can go shopping for higher-rated schools, and bureaucrats can target lower-performing schools for shutdown or takeover by an agent, usually a charter school, who can “fix” the school.
But based on an analysis conducted by…the Albert Shanker Institute, the grading system devised… had more to do with the characteristics of the students served by schools than it had to do with giving parents and policymakers real insight into the effectiveness of the schools.”  The analysis showed, “Almost 85 percent of the schools with the lowest poverty rates receive an A or B, and virtually none gets a D or F.” Conversely, over half of the schools with the highest percentages of the poorest students received “an F or D, compared with about 22 percent across all schools.”
The conclusion?  “as is the case with most states’ systems, policy decisions will proceed as much by student performance/characteristics as by actual school effectiveness.” (emphasis original).  Such a grading system “is a de facto system that metes bad grades onto schools serving children who are already bound to struggle in the system and gives a near free pass to schools that service students who are the least apt to struggle.”

Self-evaluation, self-examination, and self-improvement are rarely addressed by standardized tests.  Evaluation by others is also important, especially within a team construct; not to determine a grade, nor one‘s “score“ in relation to others, but to determine one’s own standing in relation to the goals one has set and the accomplishments and progress that are evident in the individual, and certainly in relation to a team or project.  If we have individual education goals and plans for each student, then evaluation according to those plans becomes paramount.  You can’t test for “class” standing because that concept is then invalid.  What do you then test for?  Skill acquisition, research acumen, personal interactive skills, knowledge of the sources one chose to examine, experimentation, meeting challenges, overcoming obstacles -- it goes on and on in that vein, but not in terms of class standing or competition.  Learning is not a competition; it is a discipline, and everyone learns at their own pace.  However, that does not mean the end to all forms of competition: debates, contests, trivia games, and team competitions are all legitimate, but grading must be more individualized.  What we must evaluate and measure is how each pupil is doing according to their individual interests, goals, skill-sets, challenges, and how they are relating their education and learning to others, not how they are achieving beyond others. 

Does anyone understand this approach?  Apparently not, or we would be seeing mega-changes in our educational concepts and constructs that are now pretty much unchallenged.  It is not important that ideas like mine hold sway.  What is important is to examine our public education system with the harsh thoroughness it deserves.  We must be willing to replace old concepts and constructs with new ones that can meet 21st century demands.  Rigidity in educational theory and practice is not a pathway to an effective public educational system, yet it persists in spite of the “tinkering“ that politicians and others perpetrate on the public.  We continue to fall farther and farther behind the developed countries of our world because we continue to utilize concepts and constructs that are moribund.  Public education can not simply be revamped or reformed; it must be re-conceptualized and re-constructed.  We are not even near that point.

 

(The author is not a certified “teacher” in the conventional sense, although Publius has taught classes in grade schools, junior high and senior high, and at the college level.  He is likewise, not a school administrator, although he has had responsibility for managing and overseeing teachers and curriculum in other than public school settings.  Nor is he a philosopher of education, although he has had occasion to experiment with some concepts herein described in an other than public school setting.  He is not an expert on public education, although he has testified before Congress in regard to a federal Program that employed some of the concepts herein described.  His experience in the educational field outside public schools was rejected by the State of New York when he once tried to challenge the system of teacher certification built solely on college courses, internships, and practice teaching, which is perhaps indicative of the many reasons why public education has not changed much over the last century.)