Why I move right – but could never vote Republican

In accordance with the old truism, I’ve moved right – I’ve become more conservative – as I’ve gotten older. This is partly the natural cleaving to the old ways, it’s partly getting an MA in Economics from the University of Tennessee, and it’s a lot about moving to the UK and seeing the consequences of a true welfare state. You talk about dependency culture – whooo-weee, daaaang – there are generations of people here who don’t have the foggiest about work.

So in Mitt Romney’s withdrawal speech (full transcript from the NYT) there were some things I agreed with:

Dependency is death to initiative, risk-taking and opportunity. Dependency is culture killing. It’s a drug. We’ve got to fight it like the poison it is.

Yep. I agree. It is a poison. A poison that rots the soul.

But he goes on in that mean spirited Republican way which just sickens me. Sickens me with its mantle of “personal responsibility” – which is just a slick cover for tight-fistedness, for I-got-mine-so-screw-you, and most shamefully for sticking their noses in the trough of public goods that they like (highways, infrastructure, business tax credits and subsidies, policing and defense) and turning off the tap for other social goods that they have access to privately ( i.e. health care) despite the fact that this approach is actually economically inefficient and delivers poorer outcomes overall.

Now, some people think we won that battle when we reformed welfare. But the liberals haven’t given up.

At every turn, they tried to substitute government largess for individual responsibility. They fight to strip work requirements from welfare, to put more people on Medicaid, and remove more and more people from having to pay any income tax whatsoever.

And the crowd cheered and the band played on.

Is this the latest sick, selfish Republican mantra? Make sure that poor folk don’t have access to health care? Make sure the low paid pay through the nose but get rid of taxes on unearned income (e.g. capital gains, estate taxes)?

One thing I’ve learned about a dependency culture in the UK is that you want to make the transition into working as easy and rewarding as possible. One truth about universal health care that the Selfish-right don’t want you to know is that it actually encourages economic activity and entrepreneurs. In the US, some people get caught in the trap of losing health benefits when they start to earn too much money. In the US, people are stuck with dead end jobs or denied the opportunity to go out on their own because they must cling to their employer provided health care.

In the UK, the non-working have every incentive not to work (at least in the short run) as they lose benefits pound for pound as they start earning (which doesn’t take into account that leisure does have value) and they come into a rather punitive and regressive tax system. My tax burden is far lower now than it was when I was barely scraping by (though of course I am paying far more overall – it annoys, but it doesn’t hurt now.)

The point is, of course, that everyone has to start somewhere. And unless you’re the privileged child of wealth, the place you start is at a very low wage job. You work your way up. And you should be rewarded for trading a life of penurious leisure for penurious labor by keeping as much of your wage as possible when you’re at that rough, rotten bottom rung of the economic ladder.

It’s not as if the low-paid don’t pay taxes. They pay a lot of tax (proportionately). They pay taxes on goods and services. They are almost certainly paying other payroll taxes (FICA in the US, National Insurance in the UK). And they can’t escape the taxman with sheltered income and offshore accounts.

I believe in the hand up, not the handout. But forcing the poor to hand-over disproportionately, making their precarious situation all the more tottering is just wrong.

Anticipation

Genderist is still waiting to find out about her thyroid cancer treatment:

I’m still waiting until May to know how well my November’s treatment worked. To say I’m pre-occupied with thinking about May is almost accurate. I think about it when I wake up in the night, when I hit the alarm clock, when I drop the soap in the shower, when I’m packing my lunch, when I’m stopped at a red light, during meetings, when I read email, when my patients at work come and tell me either really good news or really bad news, when I’m waiting for the microwave to cook my lunch, when I check my pedometer, when it’s time for my three o’clock snack, when The Hater sends me sweet text messages to tell me he loves me, when I’m trying to look busy, when I actually am busy, when the cat runs to meet me at the door, anytime in church that anybody refers to faith or hope, when I water the plants (including John Wayne, which still isn’t dead after 2 years under our care), when I’m grocery shopping, when I tie my shoes, when anybody asks me how I’m feeling… and any other time when I breathe.

Jab the kids

Y’all remember how Bob Barker used to admonish the viewers to spay and neuter their pets at the close of every Price is Right? Man, I wish somebody would update that message for the noughties.

And remember, please vaccinate your children.

For pete’s sake people, pleeeease, vaccinate your children.

I participate in these online forums for babies born in May 07. Yes, my baby wasn’t born in May, but he was supposed to have been. Anyway, on both the US and British equivalents, there are a number of parents who have chosen not to vaccinate their children. Generally, the discussion forum etiquette is to not criticize. I skirt the line already and I knew that I couldn’t reply and be civil. These are threads I’ve seen today:

American scenario in which I paraphrase:

I want to give up pumping breast milk. It’s a pain. It takes a good part of my day and I only get 8 oz a day for my 7 month old son. But the thing is, I haven’t vaccinated my child so my husband is on my case saying that what’s a little bit of time when it’s our son’s health on the line? What should I do (support only please)?

OK, sweetie. I’m a big breastfeeding advocate, and I would gently (hopefully) encourage anyone with a baby under one to stick it out a little longer. But I gotta admit the pumping thing is a pain in the ass and frankly I probably would have given that up ages ago. But kudos to all the pumping moms who are able to do it. And for sure, your hubby probably doesn’t understand what it’s like to have a machine slurping at your bosom, so I’d discount his opinion slightly.

Yes, I also believe that breastfeeding helps with immunities and it’s part of the reason I continue to breastfeed Buddy.

But breastfeeding is not a magic bullet. It does NOT GUARANTEE against your child catching infectious diseases. If it did, do you think infant mortality pre-vaccines and pre-formula when babies breastfed would have been quite so high? If it did, do you think we’d have epidemics and stuff? We’d all be drinking little bottles of breastmilk daily.

If you don’t want to pump anymore, fine. But please, vaccinate your child.

British scenario:

I think my 4 year old son has measles, he’s been (a run down of measle like symptoms). I asked the doctor what I should do? He said not to worry, but to keep my son away from old people and those who haven’t been inoculated. Now my baby has a fever, too.

I feel bad for this woman. I do. I hope it’s not measles. I hope it’s just a little snuffles that goes away tomorrow. But she’d be a lot more sure it wasn’t something serious if she had vaccinated her child.

And you know, I’d be a lot more sure that Buddy wouldn’t be exposed to measles before he was old enough to get the shots if she and a lot of other people had vaccinated their children.

Sicko crosses the pond

Michael Moore’s film Sicko is finally being shown in British cinemas*. I’m sure many Brits will take this as an opportunity to gloat and to bask in the reflected glory of the sacred status of the National Health Service. Apparently, Mr Moore paints an overly rosy portrait of the NHS.

Don’t get me wrong. I’m like many who can say “At least it’s there.” I’ve used the service for the normal, the chest infections and the sprains. I’ve used it for the stupidly self-inflicted wounds (I got glass in my eye from an art project gone wrong). I’ve used it during my pregnancy and emergency c-section. And through all that, I’ve never paid a penny for services and I’ve paid very little for prescriptions. Although, of course, I have paid. I pay through my taxes.

I’ve probably experienced some of the worst of the NHS. London gets a raw deal from most national services. We really don’t get what we pay for. I could complain a lot about my maternal care. I didn’t have a continuous relationship with any single person on the obstetrical staff. The conditions in the post-partum ward were extremely unpleasant (lack of privacy, noisy, hot and piss-poor decor**) and I rarely saw the same professional twice. But on the upside, they supported my home birth until I passed out of their clinical guidelines (baby was 16 days late). I could have chosen another, prettier hospital. But the hospital I chose was across the street from our house and is a center of excellence for obstetrical emergencies. And, at least, it was there.

And I never had to worry about how I was going to pay or what it was going to cost.

I never had to skip appointments because I couldn’t pay. I never had to negotiate a payment plan with a hospital and hope it didn’t go to c-section because then I’d have a bill I couldn’t afford. This happened to women on the American baby discussion forum I participate in. Some folks on this forum even now have worries about their babies’ health but are putting off visits to a pediatrician because they’re waiting for new insurance to kick in.

We all know that there are problems with American health care, but there are problems with the NHS, too. Just different problems. Problems which Michael Moore didn’t raise: From Peter Bradshaw’s review of Sicko in The Guardian.

By way of contrast, Moore visits those countries with free healthcare: Canada, France and Britain. And this last visit is the one to make us sit up. With much elaborate comedy and saucer-eyed cod-acting, Moore visits the NHS hospital of Hammersmith in London, and deploying many a gasp and double-take, refuses to believe that the sick folks aren’t charged hundreds and thousands of dollars. He doesn’t mention the waiting lists, the filth, the degrading mixed wards and the MRSA that are a staple of all media coverage of the National Health Service. So perhaps he’s got a starry-eyed view of our healthcare.

And he goes on to suggest that maybe Mr Moore has the right idea:

But isn’t it obtuse to focus so excitably on what goes wrong with our health service, when so much more routinely goes right and when, incidentally, there are those with a vested interest in promoting these scare stories as an excuse for privatising it? Isn’t it, for all its faults, exactly the miracle that Michael Moore portrays it?

Actually, no. The NHS is not the miracle that Mr Moore portrays. It’s a system, designed by humans. Humans with good intentions, but humans who get things wrong. Like all systems it has its flaws. And when we ignore the flaws and make the system sacrosanct then we have no chance to learn from other systems and to correct those flaws, to innovate and improve.

The same with the American healthcare system. It’s not the envy of the world any more. It’s inadequate and does not provide the American people what they pay for. It’s the most expensive health care system in the world and it’s no longer delivering the best outcomes.

But yet, there are some really good things about American health care. There are some wonderful things that need to be kept and nurtured. Americans, like the British, need to look with a clear eye to their health care, keep what’s right and fix what’s wrong.

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*I won’t be seeing it – at least not in the cinema. I don’t like the cinema and what with the baby and all, it’s not really easy. But I anxiously await the DVD release.

** You can say that this matters little, but I think that people do fare better in nicer surroundings. Partly things were bad because I gave birth in June – and a new maternity ward was due to open in September.