Wednesday, December 14, 2011

Everything is Political. Especially politics.

Thomas Mann, the German social critic and Nobel laureate once memorably said, "There is nothing that is not political. Everything is politics." Like much of what he wrote, he was dead on. Particularly in the politically charged atmosphere of a highly divided nation on the brink of an election that will decide whether or not it continues as a center-right social democratic republic or a hard right confederation of business-dominated special interests.

And nothing illustrates that like the debate over the Patient Protection and Affordable Care Act, known to Fox News viewers as Obamacare, but to the rest of us simply as health care reform. I'm not a huge fan of the PPA-ACA, but not because I believe it to be some sort of dark socialist plot to undermine the American health care system, but because I believe it to be a large-scale giveaway to insurance companies in the largest corporate raid on American pocketbooks ever. And because it does not solve the basic problem of health care for millions of people. Even the most rosy estimates of the PPA-ACA put the number of uninsured at 14,000,000 after the full implementation of the law in 2018. Single-payer, universal health care access would be cheaper, simpler and fairer. But the law is at least a start towards insuring that every American can get access to health care without using hospital emergency rooms as primary care centers.

One of the law's provisions is that each state must implement a state-run "health insurance exchange," a sort of Travelocity of health insurance, public and private. If a state elects not to do that, then the federal government will operate the exchange in that state. Back in March, South Carolina Governor Nikki Haley issued an Executive Order creating a nonpartisan South Carolina Health Planning Committee to decide whether or not the state should establish a health insurance exchange.

Today's Charleston Post and Courier published an article headlined "SC Gov. Haley dictated health panel finding" with the subtitle "Outcome ordered before committee met." The article cited recently released emails among the Governor, her staff and the Director of the the Department of Health and Human Services, Tony Keck. The work of the Committee, it charged, was a sham, and all along the Committee's report was fixed.

Don't believe everything you read in the newspaper. I know, because I was a member of that Committee.

 When Governor Haley asked me to serve as a consumer advocate and representative of the nonprofit sector, I agreed without hesitation. I spend way too much time advocating for quality health care access as a basic human right to say no to an opportunity like that. Besides, I wanted to advocate for a federally-run exchange, because I simply don't trust South Carolina state government to serve the interests of people who are not a)wealthy and b) well-connected. Whatever problems the federal government has in its programs to serve the poor, the sick, or the disabled, (and they are many) it still does it better than we do things when left to our own devices in the Palmetto State.

We worked long and hard through months of meetings, reams of reports, mind-numbing Power Points and expert testimony. Some members of the Committee originally felt that South Carolina should run its own exchange and tell the Feds to take a hike. But after all the work, and more than a few good-natured political jabs around the table, we came together in a final report that said there were so many unknown factors around the implementation of the law that we could not, in good conscience recommend a state-exchange. As one of the Senators on the Committee noted, "we can't even get the computer systems we have up to federal standards, there's just no way we are competent to do something this complicated."

We encouraged some interim steps: staying in serious conversation and negotiations with the federal agencies charged with implementation, encouraging private exchanges, and promoting smaller-scale, community-based health access networks, like the Duke Endowment funded AccessHealth SC and Tri-County Project Care, run by Charleston's incredible visionary surgeon, Dr. Casey Fitts.

And you know what? Not once did I hear from Governor Haley telling me to support a pre-determined outcome. Because if she had, I would have raised hell. And though I may have been the token liberal on the Committee, I believe many of the other Committee members would have as well.

Everything is politics. The Committee's final report contained a lot of politically charged language that made me roll my eyes. But I voted for it because, in 2014, South Carolina will not have a state exchange and barring a Supreme Court overturn or a Congressional roll-back, the federal government will be running the South Carolina Health Insurance Exchange and hundreds of thousands of people who don't have health insurance now will have it.

It's precisely the opposite of what the tea-guzzling-tell-the-feds-to-get-their-goddam-government-hands-off-our-health-care crowd wants. And that's a good thing.

Thursday, November 17, 2011

SNAP Challenge Day 5: The Banality of Poverty


There is a sameness to it, an endless, soul-sucking semi-existence that offers neither a way out nor a way through but only a way to exist. It is the banality of poverty.

We feel sorry for the poor. Sorry that they don't live the way we do, sorry that their values are not ours, sorry that they smell bad or don't pick up the trash in their yards or have all those loud and undisciplined children with the runny noses and the wild, animal eyes. Sorry that they stay poor. We pity them, for we are not in their dark cavern with them.

Mother Teresa of Calcutta wrote that "the poor do not need our sympathy and our pity. The poor need our love and compassion." Of course, she was a saint, so she often said outrageous things. Love and compassion are too much to ask for in a society where if you don’t have a job, you should blame yourself, as former and probably future GOP front-runner Herman Cain said the other day. We can feel sorry for the poor (probably Herman Cain does), but we will be damned if we are going to love them and feel compassionate towards them.

Love, particularly in the Judeo-Christian tradition, has the sense of self-giving. It is not about throwing money at a problem, it is about throwing one’s very life at it. And compassion? It means “to suffer along with.” Teresa threw her life at the problem of the poorest of the poor. And the problem didn’t go away, in spite of all her prayers. And so she moved on to compassion for the poor—suffering along with them. She immersed herself in the poor, lived, worked and died among them. Still, poverty didn’t budge. It just went on and on.

The nature of poverty is to design itself for perpetuity. When Bill Clinton, that famous Reagan Democrat, conspired with current and probably soon to be former GOP front-runner Newt Gingrich to “end welfare as we know it” he succeeded. Welfare, as it existed from the time of the New Deal until the late 1990’s, ceased to exist. People were expected to get an education and then get a job. They would get temporary assistance from a society that felt sympathy and pity but not love and compassion. Thus ended welfare. Still, poverty didn’t budge. It just went on and on.

 Today, the welfare system has been transformed into Temporary Assistance for Needy Families and the Supplemental Nutritional Assistance Program.  The first assumes that after 48 months of a poor person’s life, he or she would have the capacity to stand up and take responsibility and join the great American middle-class, replete with SUV, two-car garage, flat-screen television and soccer games on Sunday morning. The second assumes that the food budgets of the lower class would be “supplemented” until they accumulated enough wealth to be respectable and responsible consumers of gadgets, clothes, houses, and marble slab ice cream. But the assumptions were wrong. Poverty didn’t budge. It just went on and on.

The banality of poverty is clearest in its food: cheap, low in nutrition, but high in fat and processed sugars. It’s sameness is numbing. After awhile, you don’t even think about it, you just eat it. After awhile, it even starts to taste good.

Like my grits ($.15) from this morning. Or my peanut butter and preserves sandwiches on white bread ($.35 ea.) at lunch. Or my spaghetti with canned green pepper flavored sauce ($.88). It’s not bad. Not good, either, but not bad. It leaves you numb. Full, but not satisfied. And it goes on and on, just like the problem it was supposed to fix.

Wednesday, November 16, 2011

SNAP Challenge Day 4: On the Limits of Existential Activism


When the Hollywood types, who are unrepentant members of the 1%, were dropping by New York's Zucotti Park to show their "support" for the Occupy Wall Street protests led primarily by drumming, chanting unemployed young people in Guy Fawkes® masks, I knew the movement was doomed. Just like the Tea Party (which is so 2009), was co-opted by the mainstream GOP, the Occupy movement was being co-opted by the forces against which it protested. Of course, the Hollywood types wanted to be identified with the purity of youthful protest. They wanted to experience, to live into, to participate somehow in this great generational Munchean scream against the power elites, because they knew in their heart of hearts that it had the moral high ground. It is an existentialist dream: to learn by pretending to be something one is not.

John Paul Sartre once described existentialists as people who "believe that existence comes before essence." The elites who show up and pretend to protest against themselves, gain not the moral high ground, but merely an absurdist henna tattoo of truthiness (to borrow a Colbertian term) designed to display what it means to be 25, jobless, highly educated and without hope for the future. The tattoo will eventually wash off and the elite can go back to their everyday world of money, power and privilege. But for now, they bear the marks in their bodies of suffering and protest.

I write this, not as an anti-government “conservative” (a lovely, but meaningless term), but as an enthusiastic advocate of activist, efficient and effective government. In today’s strange political environment, that makes me a “liberal” (another lovely, but equally meaningless term). It was my liberalism that caused me to sign on to the SNAP Challenge, where participants agree to live for a week on a $4 per day budget for food in order to “experience” what the people who really live on a $4 per day budget for food really experience.

I’ve been saving my money all week, so I could go out with friends tonight to Motor Supply Bistro and have a salad. I blew the $7.50 I had saved so far this week on a sliced Fuji apple salad with blueberries and pecans over curly leaf lettuce with feta and an orange-key lime vinaigrette dressing. It was utterly Divine. I would have worshipped it, but I was too busy eating and reveling in the incarnate glory of fruits and veggies. Strangely, I felt that I deserved it: I had grits for breakfast ($.15) and two peanut butter and strawberry preserves sandwiches ($.35 ea) for lunch.

Years ago, when I was much closer in socio-economic level to people who live on food stamps, I was visiting a friend in Atlanta who really did receive food stamps. He described the giddiness of going to the grocery store at the beginning of the month and carefully choosing a month’s supply of food. Carefully, because he was going to include a large, juicy porterhouse or rib eye as part of his monthly allotment. I was shocked—after all I paid full price for all my food, and as a tax payer, I was paying for his porterhouse. Shouldn’t he be buying more peanut butter?

“You just don’t get it, do you? We are barely scraping by most days. Can’t I have a day once in a while where I get to eat something I want, instead of just eating to fill me up?”

Here’s the real lesson I’ve learned this week. SNAP recipients are people for whom food becomes an obsession, not because they are gathering with other rich people to nibble on the latest Pate de Foie Gras washed down with Beaujolais Nouveau, but because they have to obsess with food to simply stretch their inadequate resources over a month. The poor are just like us, with less money. I have not been poor this week. I live in a nice house, I have a great job, I drive a fabulous car, I’m writing this on a computer that costs as much as some poor people’s cars. I could quit this experience anytime I choose. This is all experience, not essence. I am only existentially poor.

But I am more aware that my food choices are just that: choices, not necessities. And though I may not be in the 1% of American wealthy, I am in the 1% of the planet’s wealthy. And I can make better choices, every day, in my ethical and personal life. I can stand up for people who don’t have choices. That’s what this week has been about. And I am profoundly grateful for having been reminded of that. 

Woody Allen once said: “I took a test in Existentialism. I left all the answers blank and got 100.”  There are no easy answers to the problem of food insecurity in the richest country in the world. But experiencing it, even for just a few days, even in such a limited and yes, hypocritical manner, has made me more determined than ever to keep working on the problem.