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14 August 2009


There’s a lot of screaming just now.  A lot of fear mongering about what might happen if private health insurance must compete with public health benefits.  I’ll tell you why I don’t want access to health insurance.  I want access to health care. 

This is the way health insurance works:  The insurance company bets that you will stay healthy; you bet you’ll get sick.  Sometimes you’re right and sometimes the insurance company is right, but like gambling in Reno or Los Vegas, the house wins over time.  The odds are rigged to ensure that while sometimes the gambler goes home with money, the overall profit is retained by the casino.  Insurance has it even better.  If they charge too little for insurance in a given period so that profits drop, they simply raise the rates for everyone to ensure they keep their profit margin where they want it—high.  This margin is based on a percentage of the amount you spend for coverage.  Let’s say they want 10% (or 15%?).  Last year, my employer paid over $12,000 a year for my medical insurance.  Ten percent of that would be $1,200.  But the cost of medical care continues to rise and my insurance costs must rise with them.  The insurance company is tracking these costs and soon my medical insurance might cost $14,000.  Hey, their profit rises to $1,400.  And it didn’t cost them anything to rake in that extra $200.  Multiply my premium by the millions of premiums paid each year and you can see why the major lobbying against nationalized health care is coming from health insurance companies.  It’s in the interests of insurance companies that the cost of health care continue to rise.  The more expensive the care, the higher their profit and they don’t have to do a thing but track their money and raise rates to ensure they stay in business. 

I don’t have major issues with paying for auto insurance which protects me from bankruptcy at the hands of litigious drivers, but I do have trouble with the idea of middlemen profiting from my health care.  Doctors and nurses, hospitals, medical research, even pharmaceutical companies contribute to the health of Americans.  The insurance industry profits from my medical care while contributing nothing.  The thousands spent on my medical insurance have nothing to do with my health or lack of health.  My insurance isn’t based on my healthy diet, a lifetime of nonsmoking, moderate alcohol intake, no illegal drug use, and regular exercise.  I pay the same rate as my coworker who is overweight, has high cholesterol and blood pressure, and type two diabetes—though the rate we all pay is based on an average of her health needs and mine and of everyone else in the program.  If I get sick and my insurance pays for my care, everyone will pay.  And unless someone else gets really healthy, all our rates rise. 

The insurance companies claim that nationalizing health care will result in a whole raft of problems—losing access to a chosen physician, long waits for care, etc. etc.  But if you’ve ever fought with insurance over coverage, you already know the truth.  The insurance company exists to make a profit, not to make you well.  The more claims they deny, the better their bottom line.  And the higher health costs go, the higher will be the costs of health insurance and higher profits for insurance companies.  It’s a win-win for them. 

In the mean time, many Americans can’t afford health care at all, much less insurance.  And many small businesses suffer from the unfair burden of providing healthcare to their employees, or, when they can’t, must compete with larger companies who can.  Medicare overhead costs amount to about 3%; the cost of private insurance plus profit runs up over 20%.  Imagine if those private costs went away.  My medical insurance would have cost less than $10,000 last year.  And then we start negotiating about prescription drug costs with the pharmaceutical companies (an industry with one of the highest profit margins in the nation).  Though we rank low in overall health compared to other nations, we pay more for it than anyone. 

If America has the strength to take over health care, we’ll also have the strength to demand that it cost us less.  Canada, for example, pays 40% less that we do for health care and Canadians live longer, healthier lives.  Am I supposed to believe that Canadians are naturally 40% healthier and less susceptible to illness.  No, their drug costs are lower.  Is it magic that they pay less and stay healthier?  No, it’s simpler.  My one personal experience with Canadian health care was an emergency that was handled swiftly, gently, and without cost.  My Canadian friends have personal physicians and all the benefits I have with private health care, only it doesn’t cost them anything.  Maybe there are problems with the national health care systems in all of Europe and most of the rest of the industrialized world.  Maybe it’s risky to change—the devil you know, rather than the one you don’t know—but poor people, children, and the elderly have health care under those systems.  In America, 44,000,000 people have no access to health care they can afford, and every year the most common cause of bankruptcy is catastrophic health emergencies.  A child becomes sick and her parents lose their home paying for care that exceeds what their private insurance allows.  The local school throws a spaghetti dinner to help out.  Free market?  Nothing’s free.  But too much is at stake to allow private interests to trump the public good.    

A young man opposed to health care reform wants to serve his country when he graduates from high school. He’s the same one who donated to Haiti on his cell phone. He’s not hardhearted, he’s a pragmatist and a capitalist.

So let’s have look at the health care reform bottom line. America has a health care system inferior to many in the world, measuring by the ratio of doctors to patients, life expectancy, infant mortality, health, and cost. We pay more than any country in the world for an inferior return. This isn't capitalism stimulating competition, this is a sign of a corrupt marketplace. As consumers, citizens, and small business owners we want our money’s worth. We deserve to live. As health care costs soar, individuals and companies deserve an honest profit, but they should not be allowed to continue in a system that deprives us of life.

So where am I?  My employer can pay $12,000 a year for my medical care (a hardship for any small business) or he could pay me a higher salary and I could be taxed more in order to provide medical care for everyone.  The Declaration of Independence recognizes the rights to Life, Liberty, and the Pursuit of Happiness.  Start with life and ensure that every American has access to what every Brit, Canadian, and Japanese assumes as a right—health care.  It’s about life.  Just tax me already.  

07 August 2009


I went looking for Isabel Allende's "Two Words" to add to my reading packet for my lit class this fall and discovered it on line so I didn't have to transcribe it. Thank goodness! Though you learn something when you do that. I typed several stories beginning to end and found no flaws the way I do sometimes when I'm reading. I typed Perlman, Dybek, Schultz, Munro, Carver, and others.

I began noticing a certain type of story in the 1980s maybe, and then more noticeably in the 1990s when I was seriously studying stories instead of just reading them. These stories were about hard-luck people, poverty and drunkenness, anger and trivial useless violence. Abuse. Despair. Painful stories that failed to touch me. They didn't read true; they seemed affected. I felt the authors were trying to use the sorry lives of people they didn't actually know, much less care about. When I was in the novel workshop with Bret Lott in 2002 there was a lawyer who had a novel like that. It made me almost angry. He wasn't a criminal lawyer, he was taxes or probate... no, corporate, oil rigs I think.  I didn't believe his story.  

Now I understand the writers of these grim tales were trying to write like Raymond Carver, but they don't have his life to draw from.  All they can do is imitate suffering they don't actually understand. It's a risky thing—writing what you don't know. But we all must cross borders writing fiction—explore the lives of people who are nothing like us—who have dreams and fears and goals nothing like our own, who live in places and times we've never known first hand. The ability to create a complete life out of our imagination is one critical skill of the novelist. If we are too afraid of getting things wrong to cross boundaries of time, place, age, religion, ethnicity, philosophy, passion, we can only write about ourselves—novels about middle class white women living on the Oregon coast. Novels about affluent lawyers who write contracts for oil companies. Thus we must stretch. But if we reach for what seems exotic, tantalizing, dramatic, without entering into that life, that setting, we are merely tourists shooting our vacation photos. The reader demands more. The reader is entitled to a story from the inside. I imagine that's what we mean when we talk about telling the truth.  

I taught I Know Why the Caged Bird Sings before I read The Bluest Eye and, though I love both books, I would argue that Morrison tells more about destroying childhood than Angelou. Morrison isn't limited by facts, but has everything available to her as she tells the truth.  Every time I've read "memoir" and "fictional" versions of the same event; the lies have provided a stronger story, a more truthful version than the facts allowed.  

03 August 2009


In case you are curious—this is what a one-day-old Saluki puppy looks like.  Salukis can be all sorts of colors, white to red to black. This little girl is pale gold.  Like all pups in her first weeks of life, her eyes and ears are sealed shut and her pigment is still incomplete.  


Gary skipped running yesterday and so today was a resting day for me and a running day for Gary.  He and Yeti went out early because of the minus tide and on his way home, Gary took them out on the sandbar.  He decided to head inshore and figured he could cross the crab pools without getting too wet.  The pool was over his head and soon both he and Yeti were hanging onto one another and thrashing their way to shore.    

I read a story about a shipwreck (during war time?) at sea.  Many people were in the water (solders?) and a large dog.  Everyone was panicking, but the water was not so cold it was killing them in minutes.  Exhaustion and the dog would kill them.  The dog swam to a person and tried to climb out of the water, pushing the person into the water and eventually drowning them.  Then the dog paddled to another person.   

When he walked, dripping, into the house Gary announced, “Salukis make excellent flotation devices.”  Other than that he is unclear how they got out of the water.  He didn’t drown under Yeti, but I was the one who showed him that he has claw marks all over him that indicate she was looking to him to be the flotation device.    

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