“Yes, A Birthright To Health Care”: America Joins The Developed World, Thanks To Obamacare
I’m sitting here very early Christmas Eve morning staring at a chart from the Organization for Economic Cooperation and Development. You know the OECD—they’re the people who keep all those annoying stats about how the United States is 17th in this and 32nd in that, the kind that alas aren’t very surprising anymore except that they do make us shake our heads and wonder how we managed to come in behind even Belarus.
This chart is on an Excel spreadsheet, so I can’t provide a link, but it shows access to “health insurance coverage for a core set of services, 2009.” It then lists the 34 OECD member states, showing percentages of citizens with “total public coverage” and with “primary private health coverage.”
In 19 countries, 100 percent of the population is covered via public insurance. In 11 more, more than 95 percent are covered the same way. So all but four countries basically provide universal or near-universal public coverage. In Turkey, Mexico, and Chile, between 70 and 80 percent are covered—also publicly. In the United States, that number is 26.4 percent. That’s the seniors, the veterans, and the very poor who get direct public health care. We then add 54.9 percent who get private coverage. No other country even bothers with private coverage at all, except Germany a little bit (10.8 percent). Our two numbers add up to 81.3 percent, ranking us 31st out of the 34. The rest of the advanced world, in other words, with not all that much fuss and contention, has come around to the idea that health coverage is a right.
As I think back over 2013, in my sunnier moments, I try to think of it as the year that future historians will point to as the time when the United States finally and grudgingly started joining this world consensus. Sometime in the 2030s, after Medicare for all has passed and we’re finally and sensibly paying taxes for preventive cradle-to-grave care, people will note—with pride!—that the long process started with Obamacare (yes, conservatives: I’m admitting gleefully that the elephant’s nose is under the door, so spare yourselves the trouble of thinking you’re clever by tweeting it!).
There were of course other important stories in the year now ending. For my number two, I’d choose Iran and Syria; that’s certainly one to watch heading into next year. Barack Obama mishandled Syria with all that talk of red lines that ended up being unenforced, badly letting down the small-d democrats in the region who count on the United States to countervail Iran. On the other hand, those chemical weapons actually are being destroyed, evidently. On the other other hand, the slaughter continues, and we will do nothing. Even a deal with Iran on nuclear technology, certainly a thing to be celebrated in one respect, will also allow Iran to show the region (that is, Saudi Arabia, its main competitor for regional domination) that it’s in the big leagues now too. As is typical in that part of the world, no diplomatic development is all good or all bad.
But this has been the year of Obamacare first and foremost. And next year pretty much will be, too. I’m glad the website was fixed, and glad for the apparent surge in the enrollment numbers. But it’s still the case for the change to take root and really succeed, Democrats from Obama on down have to defend this policy on principled terms, not just practical ones.
That is—right now, Democrats and progressive groups are mostly trying to get people to sign up for coverage by scaring them into thinking they might break their leg. But there are two problems with this approach. One, most people don’t break their leg. I’ve been on this planet 53 years and I’ve never broken a bone.
Two, it’s not completely honest as a selling point. Yes, liberals are concerned that people who face injury have coverage. But that’s not the main reason liberals support health care reform. We support it because we think health care coverage should be a right, and this is a big step down that road, or the best step we could make under current reality. Like any right, it comes with responsibility, so that’s why you have to buy it. But it’s a right. It’s not an extravagance or something you earn by having a better-than-Walmart-level job. You “earn” it by doing something a lot simpler than that—you earn it by being born.
This is one of those occasions where I wish desperately that Democratic politicians would just say what they believe without worrying how it’s going to be played in Politico or what those fat-mouth propagandists on the right are going to say about it. Obamacare isn’t just about getting people to fear illness or injury. It’s about changing people’s minds about what health coverage fundamentally is. And they’re not going to change any minds unless they’re willing to say that.
Hey, I’ve kept flipping through those OECD spread sheets and I’ve found some things we’re number one in. Male obesity—70.3 percent in 2011! Female obesity, too—56.1 percent! Infant mortality rate of 6.1 per 1,000 live births! Okay, we trail Mexico and Turkey there, but still. Income inequality—well, thank God for Turkey, Mexico, and Chile. Whoever let them in was really thinking ahead, so at least we’d look OK compared to someplace.
Something like reducing obesity can be best done through preventive care that kicks in well before a person has a BMI in the 40s. Obamacare already has started the process of changing this. More than 5 million Medicare recipients are getting free preventive treatments across a range of categories (PDF). That’s health care as a right. Democrats need to be unapologetic in talking like that.
By: Michael Tomasky, The Daily Beast, December 26, 2013
“The Weighty Issue Of The Day”: Irresolution Of The Schizophrenia Of Fat People
So it turns out Chris Christie is fat.
If, somehow, that fact had escaped you before, surely it came slamming home last week after he appeared on The Late Show with David Letterman. There was the 50-year-old governor of New Jersey jokingly snacking on a doughnut as the talk-show host — who has taken a jab or two at Christie’s weight — gently asked him about his girth. The bit was in keeping with how Christie usually deals with weight-related humor. He seems to feel the best defense is a good fat joke.
The laughter curdled the following day, however, as Dr. Connie Mariano, a former White House physician, told CNN that Christie is a “time bomb” who, if elected, might die in office. Christie exploded, calling her “completely irresponsible,” and a “hack,” and told her to “shut up” about his health. After that, Christie reportedly spoke to her by phone and, presumably, told her what he really thinks about her. All of which has ignited a national debate that has raged from the couch on The View to the op-ed page of The New York Times.
And here, several things need to be said.
The first: Christie says what really bothered him is that one of his young children heard the doctor say his dad might die and came to ask if that was true. Even granting that Christie’s response was over the top, is there anyone who cannot empathize with the fatherly anguish that caused it?
The second: Does anyone really believe Christie does not already know he is overweight? Or that he is not already aware that this carries serious health risks?
The third: When has the hectoring of friends ever convinced an obese person to make a serious and lasting commitment to weight loss? Does it not more often trigger resentment than resolve? So how much less effective is national hectoring likely to be?
The fourth: There is something disingenuous in framing this as a question of Christie’s medical fitness for the presidency. The present holder of that office is a recovering nicotine addict and surely the lethality of tobacco is at least as great as that of fat, if not more so. Yet, in 2008, when the nation was debating his fitness for office, the fact that Barack Obama was a smoker rated barely a mention.
What is on display here, then, is neither noble concern for Christie’s health, nor high-minded rumination over what constitutes physical fitness for the presidency, but, rather, irresolution, the schizophrenia of a fat people, hooked in equal measures on fried chicken and Nikes, supersize drinks and fad diets. It is a blithe duality that makes it possible for a morning show to do a cooking segment filled with butter and cheese one moment and then in the next, with barely a twinge of irony, pivot to a segment on how to choose the best exercise equipment.
The problem with Christie is that he makes the irresolution manifest. His corpulence registers differently than does that of a Kirstie Alley or an Al Roker. On a celebrity, it is seen as human drama in which we have a rooting interest. Christie doesn’t get that pass, because he isn’t a celebrity — he is a politician, a leader, and maybe, a future president.
And the tone of this conversation, the high profile of this conversation — indeed, the very fact of this conversation — seems to suggest that in such a person, fat is almost a betrayal. If elected president, after all, Christie would be the living representative of all of us. One suspects that fact gives many people pause.
Because if Christie does, in fact, represent us, irresolution becomes more difficult, duality more threadbare, and the guy who says his pants shrunk in the wash must find a new excuse.
So don’t hate him because he’s bountiful. The governor is a mirror, reflecting truths we decline to accept. Some people seem to think that, once declined, a truth thereby goes away.
Fat chance.
By: Leonard Pitts Jr., The National Memo, February 13, 2013
“For The Right Reasons”: Yes, Let’s Weigh In On Chris Christie
Every week, it seems, New Jersey governor Chris Christie’s name inches higher on the list of potential 2016 Republican presidential candidates.
As a result, unlike any public figure in recent memory, he is increasingly compelled to assure reporters and the general public that his weight does not impair his ability to lead.
Christie, by any measure, is obese. This has provided endless fodder for late-night talk show hosts — David Letterman has ridiculed him for years — and politicos who hope to use his weight against him.
Stereotypes masquerade as facts: Fat is undisciplined. Fat is lazy. Fat is bound for an early grave.
Fat makes for great TV, too, the theory goes, from sitcoms to cable news shows. So after Christie jokingly pulled out a doughnut on Letterman’s show earlier this week, former White House physician Connie Mariano diagnosed the governor from afar on CNN:
“I worry that he may have a heart attack,” she said. “He may have a stroke. It’s almost like a time bomb waiting to happen unless he addresses those issues before he runs for office.”
Mariano worked for three presidents and wrote memoirs about her time at the White House. Visit her website, however, and you’ll find a photo of her only with former President Bill Clinton and a quote from him extolling her book. Combine her on-air interview with her website and she comes off as unprofessional and partisan.
Christie’s response to Mariano was typically brusque: Unless she does what a doctor is supposed to do — examine the patient and record his family history — “she should shut up.”
Agreed.
The Centers for Disease Control and Prevention reports that more than one-third of Americans are obese. Still, fat jokes are a popular form of entertainment in this country. If you’re on Facebook, for example, you probably have seen the photos of morbidly obese customers at Walmart. The comment threads about the ample backsides of unsuspecting shoppers will make you lose faith in humanity, I swear.
Such cruelty can play out differently in politics, which brings us back to Christie. His approval ratings soared in the wake of Hurricane Sandy. Even those who hated him had to concede that he was there for the people of his state — so much so that he hugged the president and then fired back at those who dared to criticize him for his gratitude.
The flood lines receded, and the fat jokes returned, but Christie’s political opponents — Republicans and Democrats alike — are ill-advised to make his size a campaign issue. When it comes to the governor’s struggles with weight, millions of Americans are on his side. Don’t think for a minute that Christie doesn’t know that, too.
“If you talked to anybody who has struggled with their weight, what they would tell you is, ‘Every week, every month, every year, there’s a plan,’” Christie said Tuesday at a news conference in New Jersey. “The idea that somehow I don’t care about this — of course I care about it, and I’m making the best effort I can.”
Sounding like millions of other Americans, 50-year-old Christie acknowledged that dieting has been a regular part of his life for decades.
“Sometimes I’m successful, and other times I’m not,” he said. “And sometimes periods of great success are followed by periods of great failure.”
But I’m not a Christie fan, because of his version of America. He has consistently attempted to demonize public-school teachers and called their union leaders “political thugs.” When a woman asked him, during an interview on a local television show, whether it was fair for him to cut funding to public schools when his children attend private school, he smacked her down.
“None of your business,” he said. “I don’t ask you where you send your kids to school. Don’t bother me where I send mine.”
Christie opposes marriage equality for gay Americans and vetoed a bill last year that would have allowed it.
He is also anti-choice. He’s just fine with turning over control of a woman’s body to the government. He’s got an attitude problem with women, too. Responding to a female heckler at a Mitt Romney rally last year, he said, “You know, something may go down tonight, but it ain’t gonna be jobs, sweetheart.”
Those are just some of the reasons Christie should never be president. There are plenty more.
Enough with the speculation about Christie’s health.
It’s the weight of his politics that could threaten the well-being of Americans.
By: Connie Schultz, The National Memo, February 7, 2013
GOP Sen Chuck Grassley: We Need “Child Labor” To Fight Obesity Epidemic
At a recent town hall in Osage, Iowa, Sen. Chuck Grassley (R) responded to a question about the Labor Department’s stricter limits on child labor by claiming that they could exacerbate the child obesity epidemicby making kids less “active”:
Concern was raised about the proposed Department of Labor’s intent to greatly limit child labor on family farms.
“This farm bill will greatly affect our FFA and 4-H programs,” said Grassley. “Kids won’t be able to help on farms not owned by their parents.
“It’s interesting that this child labor bill goes against Michelle Obama’s anti-obesity initiative,” said Grassley. “How can kids be active if they are limited by this law?“
Grassley represents a farm state that both relies on child labor and contributes to the national obesity epidemic through its production of corn products like high-fructose corn syrup. Iowa farmers benefit from billions of dollars in corn subsidies that allow them to put a glut of cheap, unhealthy foods on the market.
As for his Dickensian defense of child labor, that’s sadly par for the course for Republicans these days. Several GOP-led states have rolled back child labor laws. In December, seventy rural state lawmakers led by Rep. Danny Rehberg (R-MT) denounced the Labor Department’s new protections for the country’s most vulnerable workers. They argued that hard manual labor teaches children important “life lessons.”
Under current law, 400,000 children working on farms are not protected from exploitation and dangerous labor. The proposed rules would forbid children younger than 16 from working with pesticides, timber operations, handling “power-driven equipment, or contributing to the “cultivation, harvesting and curing of tobacco.”
Contrary to Grassley’s suggestion, the physical activity children endure during farm labor is no picnic. The fatality rate for child farm workers is four times higher than that of nonagricultural child workers.
Many Republicans have mocked First Lady Michelle Obama’s anti-childhood obesity initiative, but Grassley in particular has powerful financial motivations for supporting some of epidemic’s worst culprits. As a member of the Agriculture, Nutrition, and Forestry committee, he’s raked in hundreds of thousands of dollars in campaign contributions from the Food & Beverage, Food Processing & Sales, and Agricultural Services and Products industries.
By: Marie Diamond, Think Progress, January 17, 2012
Eating Fruits And Vegetables Is Not A Job Killer
Major food manufacturers are readying their next attack on nutrition by calling proposed food marketing guidelines “job killers” that will devastate the American economy.
Earlier this year, the Federal Trade Commission, along with three other Federal agencies, proposed voluntary guidelines for marketing food to children to reduce sugars, fats and salts and increase fruits, whole grains and vegetables in the diets of American kids. In 2008, led by Senators Sam Brownback (R-Kan.) and Tom Harkin (D-Iowa), Congress asked for the recommendations to address the nations’ growing obesity crisis.
Studies show that one third of all children aged 10 to 17 are overweight or obese. In the past three decades rates have more than doubled among kids aged 2 to 5 and more than tripled among those ages 6 through 11.
A coalition of major manufacturers of processed foods, fast-food chains, and the media industry that depends on their advertising dollars are spending millions to derail the proposed guidelines. The FTC has already started to trim the proposal in response to the lobbying blitzkrieg but industry wants to go ever further. They want to use an industry-designed scheme that would declare Chocolate Lucky Charms, Marshmallow Pebbles and Cookie Crisp cereals as healthy.
Despite industry claims, these guidelines aren’t mandatory; they are voluntary guidelines developed by an independent committee of nutrition experts about how we can improve children’s health. They are sensible, science-based recommendations.
That hasn’t stopped industry predictions of economic disaster. According to comments filed by General Mills’ to the Interagency Working Group “the economic consequences [of the guidelines] for American consumers and American agriculture would be devastating.” They also predict “severe” economic consequences for the media industry and their employees.
They argue the voluntary guidelines would cause consumers to eat more fruits and vegetables produced in other countries and therefore fewer grains grown in America. According to research funded by the Grocery Manufacturers of America “demand for fruits and vegetables would increase by 1009% and 226% respectively” resulting in almost $500 billion more spent on imported food and $30 billion less on domestically grown grain.
Even if the voluntary guidelines were that effective and their study accurate, it’s audacious marketing spin to turn an overwhelmingly positive victory for public health into a big government, job killing attack on freedom.
Another industry-funded study claimed that the voluntary guidelines would result in the loss of 74,000 jobs. An analysis by the Economic Policy Institute, found the study riddled with “implausible” assumptions, historical inconsistencies and incomplete analyses of potential impacts to both the industry and economy as a whole. For example, the industry study assumes, without justification, a 20% decline in advertising and completely ignores the likely scenario in which companies shift advertising to other products or audiences. It also ignores the fact that there has been no negative economic impact since industry adopted its own guidelines in 2006. In fact, EPI concludes that the guidelines could have no impact on jobs or could even lead to job growth in other parts of the economy.
Finally, General Mills adds that the $1.6 billion in food advertising expenditures “would go up in smoke.” “$1.6 billion in economic activity cannot disappear without an impact on people’s jobs and livelihoods” they wrote.
While it’s likely food conglomerates would redirect their advertising dollars, media companies would also look for and find plenty of buyers. In fact, they’ve done it before. When Congress banned tobacco ads on TV and Radio in 1970 media companies stood to lose $220 million in annual cigarette advertising. Like their counterparts today, the networks, and broadcasters associations lobbied hard alongside big tobacco against the ban.
The media industry did fine. Total TV and Radio advertising sales has increased every year before the ban and after. According to media analysts, in 1969 ad expenditures on TV and radio were $4.85 billion. In 1972, they were $5.7 billion.
For decades, industries have opposed laws, rules and even basic consumer information that have made us all healthier. They always predict disaster but, in fact, they respond with new ideas and innovations and we all benefit. These voluntary guidelines merely suggest a path that industry should embrace.
By: David Cohen, Director, Cry Wolf Project, published in The Hill Congress Blog, November 23, 2011
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