Wednesday, May 10, 2017

Skills vs morality in the debate over health care

I found myself inspired to do a little bit of research on Mo Brooks after reading about his interview with CNN just the other day. In this particular instance, his grandiosity (or that of any Congressperson for that matter) was simply breathtaking. Numerous outlets have covered the apparent gaffe by Brooks and I found that Salon had a particularly insightful account:
As Brooks told [Jake] Tapper: “My understanding is that (the new proposal) will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool. That helps offset all these costs, thereby reducing the cost to those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy. And right now, those are the people — who’ve done things the right way — that are seeing their costs skyrocketing.”
Clearly, Brooks ignores the question of whether or not those people with higher health care costs have the capacity to offset those higher costs in the first place. When people are ill, their capacity to earn more money is diminished, and getting a job is more difficult when employers see your health insurance as a liability.

The implication of his statement is that people who have higher health care costs are "bad" and that "they deserve" their suffering for being bad people. To put it differently, Brooks seems to think that "people who lead good lives do things the right way" and that the bad people should be punished. The Salon article did mention that Brooks seemed somewhat aware of his gaffe:
Perhaps realizing that his previous comments sounded insensitive, Brooks did try to backpedal later in the interview. “In fairness, a lot of these people with pre-existing conditions, they have those conditions through no fault of their own,” the Alabama congressman told Tapper. “And I think our society, under those circumstances, needs to help. The challenge though is that it’s a tough balancing act between the higher cost of these mandates which denies people coverage because they can’t afford their health insurance policies . . . and having enough coverage to help those people truly in need.”
So, people who are addicts are not people who are truly in need? People who have compulsive diseases are not people who are truly in need? According to Brooks, people should get assistance only under certain circumstances. Which circumstances? If someone received a "preexisting condition" through no fault of their own, like an accident or genetics, they're covered. Oh, wait. Brooks wasn't talking about genetics now, was he? He must be thinking about people living in a polluted environment. Hmm. That's not it, either. Brooks believes that manure is not a pollutant and that business will regulate itself. I guess a disease from pollution is not a pre-existing condition then.

The underlying assumption here is that people who are bad should be punished. People who are bad have failed at making good decisions about their health. They should face the consequences of their decisions without government protection. Brooks claims that those bad people are the people who are increasing costs for the good people, yet he doesn't mind that members of Congress have no compunction about exempting themselves from their own laws.

I used to think this way, too. I used to be one of those "good people" who didn't want to pay for the poor health decisions made by others. But I've made plenty of mistakes of my own and I received plenty of help from other people along the way. In my life, I've learned to be more forgiving, and to let the one without sin cast the first stone.

Brooks seems to think of himself as a rational person. But he did pretty much what many other people do at the checkstand after shopping for groceries at the market. He seems to have made a rather impulsive decision about health care policy. From the Wikipedia page on Mo Brooks:
In March 2017, Brooks said that he would not vote in support of the American Health Care Act, the GOP's initial plan to replace the Affordable Care Act. Brooks said, "I will vote against the American Health Care Act because it has more bad policy than any bill I have ever faced."But on May 4, 2017, Brooks voted to repeal the Patient Protection and Affordable Care Act (Obamacare) and pass the American Health Care Act.
If the assumption is that good people make rational choices for their own health, and Brooks implies that he's one of those good people by his own statements, how did he flip on the vote? A few months ago he said that Trumpcare had more bad policy than any bill he had ever faced and still voted for that bill. I bet he succumbed to peer pressure.

The Nation set the record straight by noting that most members of the House had almost no clue about what they were voting for. It's like watching a flock of birds decide which way to go:
To do this [vote], Ryan’s Republicans voted for a devastating piece of legislation without knowing:
  • the cost of their plan
  • how many tens of millions of Americans will lose insurance
  • how their plan will be implemented at the federal or state level
  • what will remain of their plan after it is reviewed by the Senate
House Republicans simply did not care. The overwhelming majority of them cast their votes as Ryan said they should, and then they ran the gantlet—past crowds of citizens chanting “Shame! Shame! Shame!”—on their way to a White House Rose Garden “celebration” of their partisanship with Donald Trump.
So it was peer pressure! Is this is Mo Brooks' idea of rational? I find it supremely ironic how the conservatives in Congress seem so fixated on individuals making good decisions and yet they vote for bad legislation and know that they're voting for bad legislation. To vote for that bill, they must be thinking more about all the dark money that funds their campaigns than the people who live in their districts. Brooks is a member of the Freedom Caucus and was elected to Congress in 2010 with that infamous wave of Tea Party upstarts, but apparently, that isn't a sign of a rational thinker.

I believe that the debate about personal responsibility is a ruse, a deflection, a misdirection. Congress is asking the American people to take responsibility for themselves but at the same time, exempting themselves from the changes in law they propose to make. They are asking people to take responsibility for themselves while protecting doctors from international competition. They are asking people to get into shape while inflicting huge costs with drug patents. They are asking people to take responsibility for their own health care costs, but refuse to address 40 years of wage stagnation.

At the same time, they are not willing to acknowledge that living a "good life" requires skill. Remember 92% of Congress is Christian and the conservatives among them seem to think that if we could just "let Jesus into our heart" that all would be well and good. Perhaps those God fearing Christians in Congress believe that if we prayed about our health conditions, we could lower our health care costs, too. Ergo, we won't need universal health care because God offers the best plan of all: immortality through salvation.

Here's the thing. If you're a believer, and I say this with the utmost respect for your faith, and you are praying for something specific, then you're treating God as a personal assistant, not your master. You could just pray for knowledge of God's will for you and the power to carry that out, and be the servant you claim you want to be. Especially if you're a member of Congress (sample prayer in Congress here). As a believer, you can have only one master, and it's not you.

If you're a believer, and believe that all humans are God's Children, you would not make another person a slave or your personal assistant, either. Slavery, racism, and violent "redemption" (thinking of the movie, "7 Years A Slave" here) are all incompatible with Christianity. Yet history is replete with numerous examples of white Christians subjecting other human beings to awful indignities as punishment for their skin color or lack of religious fervor. Our Congress is mostly white, male and Christian, and seems to rely more on punishment for compliance with their ideology than compassionate teaching of skills, First Amendment be damned.

Evidently, religious fervor is not a very good substitute for skills. Consider sex education as a way to teach the skills young people need. Sex education can teach kids how to treat their sexuality with all the care and respect they need to avoid getting pregnant or getting someone else pregnant until they're in a committed relationship, prepared to accept the responsibilities and duties of parenthood.

Conservatives think that sex education is a private matter that should not be taught in school. But if kids live in God fearing homes where there is a lot of shame about sex, there will be no discussion of the subject, and like Sleeping Beauty, they're going to make the mistake that the parents always feared. At that point, can kids go to their church to learn what they need to know? You know, something beyond "just abstain"?

The point about teaching sex education in public schools is to put all the science on the subject together and explain it in a way that kids can comprehend and use. Yet conservatives the land over, seizing the power that they now have, are cutting funding for public education wherever they can. Education is what our society uses to transfer knowledge, including skills, from one generation to another. We teach reading, writing and arithmetic as basic skills. We teach communication as a fundamental skill because we transfer all skills through communication, not just genes.

Oh, yeah. Genes. We use genes to transfer knowledge in the form of instincts, but our brains are big enough to ignore or override our instincts, often at our own peril. Have you ever noticed that when you punish kids, they lack the ability to be rational? That's because punishment sends kids right into their instincts. They're all about fight or flight in the face of physical punishment. Is that love?

Communication leads immediately to collaboration. Humans collaborate to solve problems, even really big problems created by humans, and collaboration requires skill. And when governments cut funding for education to give a few very wealthy people large tax breaks, they reduce the capacity for our culture to teach the skills our next generation needs to not just to survive, but to live. I know, it seems evil, doesn't it?

Note to Mr. Brooks:

The word "evil" is a supernatural explanation for challenging behavior in children and adults, therefore, evil doesn't really exist. There is only confused (what we might call "evil") and less confused (what we might call "good"). Challenging behavior arises from a lack of skills needed to get one's needs met.

Teach the skills needed to get needs met and the challenging behavior goes away. This is how how brute nature yields to love. I say this because love is more than having a warm regard for another. Love includes teaching the skills required to get needs met, respectfully, honestly, openly and with regard to the needs of others.

As humans, we have cooperation baked into our genes. Love is the highest level of cooperation, includes sharing of knowledge and including skills, and is ultimately, human nature.

End of note to Mr. Brooks.

Human nature is to teach skills for survival, not punishment, and punishment doesn't teach any skills. If Mo Brooks wants high maintenance humans to pay for their health costs, he might take an interest in teaching those humans the skills required to make the money they need to pay for it. Or he can settle for creating a system where everyone pays for it with a universal health care system (think HR 676).

If Brooks is truly interested in making the world a better place, he may also want to take notice that in his faith, there is only one master, and it's not him.
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