Is it Socialism?

I was sitting in my living room watching President Obama's speech on healthcare this past Wednesday. I had Facebook up and the chat window opened.

Why are people so opposed to a public option? a friend asked.

It's socialism, I replied.

There was a pause. Then the reply...

So is a municipal police department.


Is it?

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There's not some official definition of Socialism I can refer to in order to answer that question. Wikipedia says this:

Socialism refers to various theories of economic organization advocating worker or public ownership and administration of the means of production and allocation of resources, and a society characterized by equal access to resources for all individuals with an egalitarian method of compensation.

I know, kind of vague and wordy. Wikipedia goes on to say that it is primarily an economic system, and that it stands in contrast or capitalism. And perhaps in a purely theoretical world that might be true. But in the real world societies tend to blend elements of both systems.

Americans today have very little experience with hard socialism. We don't have a history of state owned industries. We don't have a sovereign wealth fund with hundreds of billions of dollars in assets to invest (like the United Arab Emirates, China, Norway, Singapore, and a few other countries).

We do have a few industries where a major portion of that industry is actually managed by the government, in the sense that projects are government funded and workers are either government employees or are contracted by the government. Transportation stands out: government (federal, state, or local) builds and maintains our roads and manages our airports. Public safety is in that same boat (and that answers the question about the municipal police department). Education is another biggie. Most American's don't think of the word "Socialism" when you talk about public schools or state universities. But in the strictest sense of the definition, schools like Georgia Tech, Oklahoma State, and UCLA are socialist institutions. So are most elementary schools.

We don't think of roads and schools as socialism. Maybe they are, maybe they're not. But we don't think of them as such.

A softer, fuzzier form of socialism worries most Americans much more. It's the idea that the government might provide services of some kind - a social safety net for the poor (or for the middle class, on the chance that they might become poor), health coverage, financial services (like mortgages or student loans), etc.

The problem is, we have those things to some extent already. Not only do we have them already, but most Americans like them.

We could do away with those things. We could put an end to social security. We could tell our senior citizens that we're sorry if they didn't plan well when they were thirty, but now that they're 69 and unemployed, they're own their own when it comes to medical bills. Their families should take care of them. We could close the VA medical facilities because they're Socialism. There are people who advocate that idea, based on the principle that Socialism is bad - somehow immoral, definitely anti-Christian, economically unmotivating, yada yada yada.

Why hasn't that happened? The politician who voted to end Social Security or Medicare would never be re-elected. The majority of people in his district would vote for his opponent in the next election. Most American's want those programs to continue to exist. Our voters aren't alone in that. I can't think of a developed democracy without these sorts of economic safety nets.

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Politics and religion is a combustible mix. In injects emotion into most discussions and tends to remove reason from the discussion.

One of the loudest arguments being voiced against the growth of the soft and fuzzy sort of socialism represented by government supported health coverage (the so-called "government option") is that it's somehow "un-Christian." In support they often site II Thessalonians 3:10 - If a man will not work, he shall not eat. (NIV)

The verse is a good argument for the concept of work ethic. But it's hardly theological backing for an entire economic system. Capitalism has more to do with marketing goods than producing them - with supply and demand, profit and loss, and pricing. And people in the Religious Right who want to argue that Socialism is evil neglect the fact that early Christians practiced it in the Book of Acts (chapters 2 & 4).

The theological argument breaks down when real theology is applied. The truth is simpler than politicians want to acknowledge. Mature, devote Christians work because it's, well, righteous - not because it's personally profitable. Non-Christians may find their own reasons to work, but the flawed character they have (described in the early chapters of Romans) means they find a way to avoid work in any system.

The religious argument breaks down. And Christians outside America aren't as preoccupied with it. Americans have their perception of the issue skewed by the ties fiscal Conservative (Republicans) have created here with Evangelical churches.

America is a long, long way from being a Socialist country. Americans don't like the word "Socialism" because they associate it with Communism and with dictators. That association is fed by Fiscal Conservatives who, among other things, play the religious card. American's like the Socialism they have and fear the Socialism they don't have. With political purpose in mind, Conservative politicians feed that fear. But so far, a little Socialism (once it's part of the system) has proven to be easily tolerated and well like by the majority of Americans. And no one I know wants wholesale, hard Socialism.

Almost time to go back...

Summer break is drawing to an end. I have eight busy days left before the first teacher work day. Tomorrow I have to attend a training on some tools we plan to beginning using in the classroom. One is an online grade book. I supposed to take tomorrow's presentation and give it myself somewhere on August 24 to a group of teachers...

While summer break may be ending, I'm not sure summer itself ever made an appearance. We had an extended Spring that included lows in the 40's in July, a continuing cycle of on-and-off rain showers, and the occasional "hot spell" that saw temperatures climb into the upper 80's for a day or two. If the pattern of precipitation continues into November and December it will be a very snowy Winter.

I am trying to get ahead of the curve at the moment on writing. But I haven't been very successful at it.

Next week I'm working a booth for the local Democratic Party at the county fair for a couple of days. I'm also driving to Abingdon, VA on August 20th to participate in a town hall meeting on health care that my Congressman (Rick Boucher) is holding.

Well, let's see how much writing I can get done today...

McCain Has Succeeded in Making Health Care an Issue for Almost Everyone

It hasn't gotten much press yet, but I predict that it will. Candidate McCain has probably succeeded in making health care an issue for all Americans, even if they already have pretty good health insurance. Especially if they already have pretty good health insurance...

John McCain wants to turn your medical bills into taxable income if you get your health insurance through work.

I first heard about this aspect of the McCain health care proposal from Robert L. Borosage, courtesy of the Huffington Post. According to Borosage, the McCain solution on health care is to move America away from employer-provided health insurance and have each of us, individually, go to a private insurance company and negotiation our own health insurance package. To McCain, the results would be obvious:

• The heavy burden of financing employee health care would be lifted from business - which would be good for "the economy" (by which McCain means big business).
• Deductibles would be higher in the new privately insured America, and as a result people would be more cautious and selective in their health care demadns. No longer would we run to the doctor for every little cough or sniffle...

Sticks and Carrots

McCain's plan would offer you a tax credit if you had private health insurance - $2,500 per person or $5,000 per family. That's a credit, not a deduction. Reducing your federal taxes by $5,000 a year could be a powerful incentive - if you make enough to pay that in income tax. That's the carrot.

The stick is bigger. McCain want to take the dollar value of what your employer-based health insurance pays out for you in a year and count that as income. If you're one of those stubborn souls who kept your health insurance at work, consider this. If you make $35,000 as a teacher and on the way to work you're in a car wreck that results in a couple of weeks in the hospital, a surgery or two, and your employer-based health insurance footing a $40,000 bill for your medical expenses, your income just more than doubled because that $40,000 payout on your behalf would be taxable income under the McCain plan.

Oh, and since it shows up on your 1040 form, you'll likely end up paying state income tax on it, too.

Skeptical? I'm not horribly familiar with Robert L. Borosage myself, either. But then I figures out that the UMWA was telling its members much the same thing.

Health care used to be an issue for those didn't have it, or if you had loved ones who couldn't afford it. McCain has succeeded in making it an issue for everyone. If you didn't care before, you probably do now. And for what it's worth, as the son of a Navy admiral, a member of the armed forces himself, and the a member of Congress, McCain has had government sponsored health insurance almost every minute of his life...

What PEIA Won't Pay For...

I don’t really like being on the phone – which is not to say that I dislike it, I just prefer to be face-to-face with people. But, I spent about two hours on the phone Tuesday anyway and another 90 minutes today trying to get my health insurance providers to pay for a drug.

My family is covered through PEIA, the West Virginia Public Employees Insurance Agency. It went like this…

We called our pharmacy and asked them to refill a new anti-smoking drug, Chantix. When I went to pick it up on July 3rd I learned that:

• July 1st marked the start of a new plan year so I had to pay my deductible on prescriptions again.
• The co-pay has gone up on brand name drugs from $30 to $50 per month's worth.
• The insurance company had not reauthorized Chantix.

Sometimes that’s a matter of paperwork. PEIA farms out management of prescription services to a company called Express Scripts. I called them. My wife had already called them once and been told to call a tobacco-free hotline; it was a dead end and, later we learned, it was a contractor who had stopped dealing with West Virginia employees some seven or eight months earlier. Express Scripts was giving out the wrong contact number for “step two” in this process.

During the course of the day Tuesday I spoke to Bob, Linda, and Sherri at Express-Scripts. I learned to get their phone extension out of them before I hung up so that the possibility existed that I might speak with the same person a second time if I had to call them back.

Eventually we figured out that we needed to be talking to the people at the Free & Clear Quit for Life Program. The people at Express-Scripts told me that Free & Clear had the power to reauthorize the medication. The people at Free & Clear didn’t know that Express-Scripts existed. And the people at Free & Clear thought that their job was to pass information along to Rational Drug Therapy at the West Virginia University School of Pharmacy so that they could decide whether to reauthorize the drug. (Rational Drug Therapy, incidentally, doesn’t speak directly with patients.)

Linda, a "patient care advocate" at Express-Scripts, was eventually convinced to read me my benefits. She’d been trying to convince me that we could have a 90 supply of Chantix, but that we had to wait a year before they’d pay for it again (even though the drug’s manufacturer says at their website that if you’ve quit at the end of the 90 day course you should ask your doctor if it would benefit you to take the drug for another 90 days). When she read me the description of benefits it stated that Express-Scripts would pay for a 90 course of the drug three times in the life of a patient and only once per plan year. Her conclusion was that I’d have to wait a year. I pointed out that the plan year had just changed, that it was now a new plan year and that I wanted the 90 days for this plan year to now be authorized. She was confused; she agreed that it was a new plan year, but was skeptical that the drug would be reauthorized.

The last person I spoke to Tuesday was Mary at Free & Clear. God bless Mary. She read me what the contract between PEIA (she’d never heard of Express-Scripts) and Free & Clear. That contract said that Free & Clear wasn’t supposed to authorize the drug if a patient had received the drug within the last 12 month. I told her what Linda had said. Mary “escalated” my case to her supervisor to try and resolve exactly what our benefits were, evidently spent an hour or more in research and in discussions up the chain of her command, and called me back at 8pm at night. Rational Drug Therapy doesn’t take her phone calls after 2:30 in the afternoon, so it was already too late to get the drug reauthorized Tuesday, but Mary said someone from her office would call Rational Drug Therapy today for me, and suggested I call PEIA’s customer service number (which she gave me).

Customer service was closed…

Today I talked to Judy at Free & Clear. For 75 minutes the Free & Clear people worked with us to determine if there was a way to get the prescription reauthorized (covered by our insurance). Eventually Judy decided that the best approach was to call the pharmacy side of Express Scripts and have a conference call with them so that I could be on the line. Kendra there at Express Scripts told us the computer had rejected the authorization. Kendra read the rules about authorizing the drug – a different set of rules (different verbiage) than what Free & Clear had. With Judy from Free & Clear on the phone, Kendra gave us the toll free phone number for the West Virginia Tobacco Quit Line. (The Quit Line told me Tuesday that they couldn’t understand why Express Scripts still gave out their number since PEIA decided seven or eight months ago to do business with Free & Clear instead of them.)

So I have three different versions of what benefits we are supposed to have regarding Chantix:

• Linda’s (at Express Scripts) version that she read from her computer screen, which says that we can get it three times in our life, but no more than once per plan year. Plan years align with fiscal years.
• Free & Clear’s version, which says that they’re supposed to ask if you’ve taken the drug in the last year and they’re suppose to say “no” to reauthorizing it if you say “yes” to that question.
• And Kendra’s (also at Express Script, but on the pharmacist’s side of it) who says that the medicine can be prescribe for 90 days in a 365-day period.

Kendra’s version is open enough to interpretation to be compatible with either the Free & Clear version or Linda’s version.

Bottom line, I don’t really know what our benefits are and if I have our benefits spelled out in writing somewhere, I don’t know about it. I called the PEIA customer service line to ask about it and a recording told me to leave my name and number.

It was an incredible exercise in getting the run around. And PEIA never returned my phone calls, so I guess I'll try them again tomorrow...