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Radical Compassion – Healthcare

February 9, 2020 //
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I know that I’m extraordinarily blessed in that I live in a country with a safety net and that my health insurance costs are capped by law. There are a lot of complaints about Dutch medical care, and I’m sure that if I delved deeply enough, I’d find some horror stories. However, in the Netherlands, and in most of Europe, catastrophic illness doesn’t bankrupt the insured. Note that no one here is uninsured – the benefits system is such that a person in straits for whatever reason is still covered. If you’re not in straits, the system requires each person to pay for a basic level of coverage. At the moment, that basic level costs something like EUR 110 per month. (I don’t know the precise number because I take advantage of a higher level.

I don’t know how to address things like GoFundMe pages for people who suffer catastrophic illnesses or emergencies or simply get blindsided by insurance companies that cover ambulance company X, but not ambulance company Y. Too bad that company Y was sent when you called 911. No, it’s not that I don’t know how to address these things, it’s the fact that we’re still stuck in the situation that people aren’t covered for illness by default. When the Clintons tried to work out some kind of universal health coverage in the US in the 90s, they were beaten back by the insurance industry. When Obama tried the same thing, he was beaten almost from the get-go. The fact that he managed to eke some success out of all that political capital, and all that bloody opposition is a credit to the man.

I worked in healthcare for several years in the 90s. My mother was a medical secretary and my stepdad was an EKG tech before he moved into fundraising at the same hospital. So I’ve always had some input and insight as to how these systems work. For an idea, see the history section of the Wikipedia article on health insurance in the US.

Because Franklin Roosevelt sidestepped the issue at the time he was pushing for various reforms in social policy, the medical industries were able to consolidate their efforts against any kind of socialized medicine. By the time Truman took up the gauntlet in 1949, the AMA was prepared. And for 80 years they and the various for-profit healthcare organizations have fought tooth and nail to prevent any kind of socialized care in the US. And because everyone with full-time employment in the US has an insurance option through one of these plans, the money keeps flowing up to the healthcare industry. Woe be to you if you have to work multiple part time jobs to make ends meet, because it’s unlikely any of them will provide you with a company-subsidized option. So no matter what you do, you’re in deep to the industry should you need care. Of course, those who are uninsured or underinsured will hesitate to go to the doctor when there’s something seriously wrong. Heaven forbid the coronavirus gain a foothold in the US, but even without it, those at greatest risk for spreading communicable illnesses are those least able to take the time to get care for them. Even in my office (software company, generous work from home options), I have colleagues who feel compelled for whatever reason to come into the office when they’re seriously ill. (I shared a crowded train with one a couple of weeks ago – he’d been home for a few days, and was obviously still sick, coughing into his hands and rubbing his eyes. Alas, the drug store was all out of hand sanitizer because of the latest rush on the stuff.)

So not a week goes by that I don’t see a GoFundMe call on Facebook from someone whose friend is needing money for catastrophic healthcare costs. One level of compassion is to give something to each of those. This is reasonable, but also ridiculous, given how much money should be in the system but isn’t. Ridiculous because it’s somehow easier and better for those with little enough money already to help each other than for the obscenely wealthy to ease up on the greed in the system. It’s another version of the rich guy, working class guy, and immigrant/poor guy looking at a plate of cookies. As the rich guy takes all but one, he says, ‘Look out, the immigrant’s gonna take your cookie.’

I honestly don’t know what to say anymore about this situation. For several years now, I’ve seen the comment that this is the point at which the French started building guillotines. I think on a gut level we know that in France politics suddenly became bloodsport and didn’t stop until the engineers of the Reign of Terror were themselves sent to the scaffold. We also seem to have sufficient bloodsport/bread/circuses/entertainment to keep us looking the other way as the things we deserve as members of this society, as contributors to the social contract are taken away.

It’s not a just matter of someone less fortunate than we are taking our cookie, it’s that along with all of the other basics that are part of surviving and thriving together, compassion calls on us to fund as individuals what should be funded by society as a whole.

Edited to add this link, posted to cbsnews.com the same day I posted this entry:

“You wouldn’t think you’d go to jail over medical bills”: County in rural Kansas is jailing people over unpaid medical debt

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Categories compassion, Health, Politics, United States

Haven’t we done enough damage?

February 3, 2020 //
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Sometime during my freshman year at university (1985-86), I read an editorial in the San Francisco Chronicle suggesting that the current generation should be the last generation of humans on earth. This intrigued me because it seemed obvious to me we’d already done enough damage and perhaps the other species here could make a better go of it once we cleaned up our mess and got out of the way.

I made mention of this to a few people. My mother, if I recall rightly, found the idea distasteful to say the least. She hadn’t read much science fiction at the time, a lot of which probably influenced my agreement with the writer’s sentiments.

In the intervening years, I’ve occasionally tried to find the editorial in question, with no success. Recently, though, I read a letter to the New Yorker which made reference to the Voluntary Human Extinction Movement. Ah. That would be the group. It’s not hard to believe that the whole thing could be just one person who occasionally sends out a newsletter.

So I’m thinking about this in the context of compassion and doing right by the earth and those halcyon days when our population was only three or four billion. The image below is from the July 1975 issue of Mad magazine. Current population, 45 years later? 7.7 billion.

Mad Magazine, July 1975

Occasionally I hear people talk about healing the earth. Usually in the form of a platitude on a bumper sticker or t-shirt. This makes the person with the platitude feel better, If this is a form of virtue signaling (I’ve always been a little unclear on that concept), I’m still okay with the sentiment, regardless of whether it leads to concrete action. What gets me is the response one sometimes hears, that the Earth has been through worse and will heal itself.

This may be true, but we’re wiping out species at an astounding rate and can’t seem, as nations to stop being cruel (the US rolling back rules on national park exploitation, for example). And, it’s an attitude that absolves corporations and municipalities from their responsibilities as stewards of the earth and as stewards of various populations. Flint, Michigan and its drinking water issue – several years later, still not solved, for another example. The attitude that the earth will heal itself doesn’t absolve us of turning the oceans, once teeming with life, into garbage dumps, fished out. In his recollections of the Kon-Tiki expedition, Thor Heyerdahl shares over and over again how easy it was to survive in the middle of the Pacific Ocean on the fish that were in abundance. I think he’d be horrified today of the state of large swaths of that ocean.

What is it about these times that sets it all up as a zero sum game?

I keep saying it: No one gets out alive as an individual. This much we know, but do we have to take half or more of the earth’s species with us? We seem to have no restrictions on the amount of cruelty we’re willing to exert on other people, species – yes, a lot of us are good, but as a species, we prove ourselves incapable of making the place better for the next generation. Or even to maintain a baseline for this one. The number of people who are going to die as current trends continue – fires, lack of insects, dropping levels of protein in rice, dropping levels of ice – it’s something we seemed to be inured to. It’s okay to leave what’s left to the next species to come up. We’ve proved ourselves unworthy.

Is voluntary human extinction an instance of compassion for the rest of the planet? There’s a cynical part of me that says absolutely, because I’m not sure we’re likely to contribute anything meaningful in the greater universe, should we make it off this planet before wiping it out entirely. I’ve had friends argue that the art we create shouldn’t be lost. I hate to think that so much won’t be appreciated by later generations, but there’s so much that’s not appreciated by this generation. First world problem, that.

And anyone advocating this must be able to examine the question: How would I feel to be the last one remaining, the one left to turn out the lights on Homo Sapiens? I’d like to believe I could lie down having done the job well. But the thought also terrifies me.

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Categories history, Politics, religion

Radical Compassion 3 – The Social Contract

January 27, 2020 //
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My thoughts on compassion boil down to the question, ‘What do we owe each other?’ What do we with privilege owe to those without? What do the powerful owe to the powerless?

This isn’t original- it’s the entire premise of The Good Place. Have you watched The Good Place yet? Really, go and watch it. (And if you haven’t seen it, don’t read too far into that Wikipedia article – the twist at the end of season 1 depends on you having no idea. Most of the cast had no idea. But watch it.)

From a recent episode of the Allusionist podcast:

And the etymology of compassionate? It’s late Latin for com plus patti, so to suffer together. And yes, the root of passion is to suffer. But compassion is ‘to feel the pain of others,’ which is terribly moving.

Back when they still taught civics and government in American high schools (showing my age, I know), we learned that America’s founding fathers didn’t invent the documents on which the country is based from whole cloth. Teachers referenced and sometimes even assigned material from France’s Age of Reason. I’m sure one or two referenced Jean Jacques Rosseau’s Of the Social Contract. At 15, I’m sure I couldn’t actually have absorbed much about it. If one had boiled it down to this sentence (from the introductory essay of the Penguin edition (Quentin Hoare translation), I still would have zoned out:

‘Rousseau’s central aim in Of the Social Contract is to explain how the freedom of the individual can be reconciled with the authority of the state.’

What did stick with me was this: Rousseau argued that the members of a society owe certain things to the group, and can expect certain things, by virtue of all participating in the same society.

And so, reminded that we are all in this together, I started reading the source document. Rousseau is addressing not just any society but a certain kind of perfect direct democracy in which Citizens engage in public deliberation as the legislature of the State with the complete understanding that harm to other members harms the body of the State and that harm to the State directly affects the other members of it.

That’s a poor paraphrase of a very small part of Rousseau’s philosophy, but it’s something like this that the writers of the Constitution were after when they wrote ‘in order to form a more perfect union,’ into that document’s preamble, this idea that we form a government in order to do better by all of the members of the society.

Rousseau is philosophizing a utopia; the folks at Philadelphia were keen to put Rousseau’s principles into practice. It’s unlikely the founders had that much compassion on their minds, given that a few decades later we had to fight the Civil War over their abject failure to abolish slavery (for a start). They did, however, consider the need to have the branches of government independent of both one another and of the voter.

One of these things we learned in those Civics classes was that the amendments to the constitution were generally advancements towards that more perfect union. A sort of ex cathedra of the people. (Rousseau, I think, would have approved of the idea of the general populous acting as a single pope.) As such, the 17th amendment, which provided for direct election of senators, was an advance. I was listening to a political podcast a couple of days ago (It might have been WNYC’s Impeachment: A Daily Podcast – 22 January, but I wouldn’t swear to it) in which there as an assertion that the founding fathers couldn’t have foreseen a senate as craven as the current one because the original version of the Constitution called for state legislatures to elect the senators, avoiding certain issues regarding who senators might be beholden to.

There were a few good reasons to address the process for the election of senators, including periods during which at least one state failed to send any senators at all to Washington because of deadlocks in the state legislature. On the other hand, we can probably guess that a call for the direct election of senators led by William Randolph Hearst (yeah, the newspaper magnate who successfully agitated for war with Spain in the 1890s) might be suspect. (Note: I’m well aware that the issue is a lot more complicated than that and that for a few decades, the benefits of direct elections outweighed the disadvantages.)

This, of course, isn’t the first time I’ve questioned the truisms that a 1980s LAUSD education implanted in my brain, and that a couple of college poli-sci classes tried to remedy. For a long time I held to the idea that many of our steps were a step towards that more perfect union. To paraphrase Dr. King, the arc of our democratic experiment was bending towards some kind of perfection.

Of course it doesn’t, and the gravitational pull of so many things in our society has bent the arc towards indifference (at best). There doesn’t seem to be a Latin-rooted antonym for compassion that includes that root of suffering. Indifference is one of the clearer opposites – a complete lack of suffering with those nearest.

What am I getting to with this discussion: The question of what we owe one another relates directly to how we vote. I’ve talked about voting with compassion. I believe we owe one another a government that isn’t cruel, capricious, or beholden. At the moment we suffer all three, and the one thing that’s least helpful in these discussions is belief.

I don’t know if this statistic belongs in this blog entry or another, but I’ll leave it here for the moment:

Federal immigration officials told a judge last week they believe they’ve finally settled on the number of children separated from their parents by the Trump administration’s “zero tolerance” policy. The number is 4,368. (Los Angeles Times, 18 January, 2020.)

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Categories compassion, history, politicians, United States, Writing

Radical Compassion

January 15, 2020 //
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I’m working up a series of entries around the concept of living compassionately. This is not a new idea, and I’m willing to accept that I’m not the best qualified to preach it, but (in the words of someone better qualified): if not me, who?

Nicked wholesale from Wikipedia:

Radical compassion is a term coined by the philosopher Khen Lampert, in 2003. His theory of radical compassion appeared in Traditions of Compassion: from Religious Duty to Social-Activism (2006). Lampert identifies compassion as a special case of empathy, directed towards the “other’s” distress. Radical compassion is a specific type of general compassion, which includes the inner imperative to change reality in order to alleviate the pain of others. This state of mind, according to Lampert’s theory, is universal, and stands at the root of the historical cry for social change.

“I have noted that compassion, especially in its radical form, manifests itself as an impulse. This manifestation stands in stark opposition to the underlying premises of the Darwinist theories, which regard the survival instinct as determining human behavior, as well to the Freudian logic of the Pleasure Principle, which refutes any supposedly natural tendency on the part of human beings to act against their own interests and proposes viewing such an inclination as the product of cultural conditioning…”

While I’m not sure how much I agree with Lampert’s reduction of both Freud and Darwin, I agree with the basic premise: that there is an imperative to alleviate the pain of others. If I’m reading the summaries correctly, Traditions of Compassion looks at Christian, Buddhist, and modern secular traditions of so-called compassion and finds all of them wanting. The key to Lampert’s philosophy seems to be that the heart of the social contract is the need (and compulsion) to act in the interests of those in pain, distress, or otherwise at a disadvantage.

I started to formulate my own idea of radical compassion while watching the run-up to the recent parliamentary elections in the UK. Some of my friends who are able to vote there discussed ‘holding their noses’ and voting conservative for a variety of reasons, the main one being that they didn’t find that the Labour leader could realistically bring the UK out of its current crisis. I don’t fault this reasoning, but it seems to me myopic. The idea of ‘getting Brexit done’ doesn’t contain a plan, for example, for securing the food supply, keeping the peace in Ireland, or maintaining a functioning and affordable health service in light of how many medications and members of staff come from outside of the UK.

One aspect of this compassionate behavior is voting compassionately. My friend RC was accused of treason when campaigning for her preferred not-conservative candidate in this election. Treason for advocating for participating in the democratic process. (The shades of pre-fascist Europe in this exchange don’t escape me.) It won’t escape the reader’s notice that I’m socially liberal in my philosophy, and that when I talk about compassionate voting, my perspective is to vote for candidates who advocate for reducing suffering in whatever form.

My friends who advocated for the conservative candidates may very well project that there is greater long-term good to come out of what those candidates offer and promise and what their track records show they might get done.

I would argue that hunger and need shouldn’t have to wait for the undefined solution of this human-engineered crisis. Yes, I’m shouting at the barn door long after the horses have bolted.

To use another hackneyed metaphor, I know that expecting compassion from politicians is tilting at windmills, and that it’s probably no longer possible for voters to hold their representatives responsible for anything, but I’ll vote for the alleviation of pain rather than its aggravation every time.

There’s a further argument that voting this way can be seen as a kind of enlightened self interest. If we vote for greater access to medicine, we’re voting for a healthier population. (Also true for voting not to make life difficult for the large percentage of National Health Service medical staff who are from outside the UK.) Voting in favour of better primary schools sufficiently staffed with better-paid and -supported teachers so that your country’s children don’t grow up undereducated and resentful of the education system can also be seen as enlightened self interest. If that works for you, run with it, but I would suggest also doing so out of compassion for all the others concerned.

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Categories compassion, EU, Politics, UK, Writing

Rachel Churcher’s Victory Day

January 13, 2020 //
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Victory Day is an elegant and worthy conclusion to a fascinating series. It’s been a real ride following this story’s progress since I read an early version of Battle Ground two years ago.The storytelling gets tighter and tighter the farther along we get. There’s always been tension between the twin antagonists, even when one was in London and the other in Edinburgh, but Churcher ratchets it up in this concluding volume. Bex (‘The Face of the Resistance’) and her former trainer, Corporal Ketty, again tell their sides in short alternating chapters.

In some cases, those chapters are less than a page each, and the sequence in which Bex meets Ketty for the first time since False Flag (book 2) is one of the most heart-racing things I’ve read. I give nothing away by indicating that both have guns and shots are fired.

RMC-BG5-VDI especially liked how this book succeeds in making both Bex and Ketty more sympathetic characters than they were before. Bex had become less likable the more she resisted her role in the bigger conflict at play. Ketty, on the other hand, elicits more sympathy from us the more she learns about the nature of the forces for whom she’s working. This is an especially difficult trick for Churcher to have pulled off – the sheer sadism of some of Ketty’s behavior makes her about as likable as a Bond villain. (She pays a pretty stiff price for her redemption in a sequence that’s oddly, and appropriately, parenthetical in her journey.)

While there’s the tension of the two narrators facing each other as everything they’ve worked for comes to fruition or falls apart, depending on how you look at it, there’s a roll call of supporting characters who we experience through the eyes of both of the narrators. It’s really hard to write this without giving spoilers, because when I say Ketty has an interview with Person X, you readers of books 1-4 will say, ‘Well, it’s not necessarily surprising, but wait a sec, how did we get there?’ You just have to drop a few pounds to find out.

It was really interesting to reread this in its final form, having proofread early drafts of each book. This series takes up the mantle of many other dystopian series of being a warning, not a manual. As times have started to catch up with what was initially a (more) far flung future, some aspects of the books are difficult to read. I’ll be honest: It’s taken me longer to read each book (and not just because Victory Day is about 40% longer than Fighting Back) because I can’t read these things before sleep or in the middle of the night. There’s the page-turning aspect, for certain, but also heartbreaking nearness of what Churcher is confronting. With the UK becoming, it seems, less compassionate and more like the US in how it divides the rich and poor, the idea of a conscripted home force, for example, has almost entered the realm of possibility.

Go over to Taller Books to get the whole set.

Note: I received a free advance copy in exchange for an honest review.

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Categories Fiction, UK, Writing
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