The Alternative to Medicare: Ice Floes

            When anthropologists first began studying the Eskimos, so the story goes, they found out that when a member of the tribe became so old and infirm that he or she was a burden to the family, the elder was wrapped up, put on an ice floe, and pushed out to sea to die quietly and away from everyone’s sight.

            We don’t do that in America today — not yet, anyway — because we have Medicare and Medicaid to cover health care for our old people. But with the Republicans having voted unsuccessfully to end Medicare and replace it with private insurance vouchers, there’s a large and simple question that has to be asked here:

            What happens if Medicare no longer exists to guarantee basic medical care to Americans from the time of retirement to the time of death, regardless of what may happen to them in between?

            Whether Congress cuts back the scope of Medicare or passes the buck to private insurers, the reality is that some old and sick people — maybe your parents, your siblings or you — will reach a point where their medical coverage runs out. At that point, I see only three options:

            First, the coverage will be picked up by Medicaid or some other government program. This simply transfers the cost from one government agency to another, probably at greater expense owing to duplication of services.

            Second, the old person in question goes through every cent he or she has, then the children go through their resources until they file for bankruptcy, and if the old person is still alive at that point, the government takes over in some fashion.

            Or, third, we put them on ice floes and say sayonara.

            Call me sentimental, but I don’t see Americans embracing the third option. And call me a realist, but I don’t see the second option being viable for very long. Once voters realize their life’s work and savings have been placed in a lottery, where losing means utter ruin, they’ll start voting for people who promise to alleviate the risk. All of which leaves us back at option one or staying the course — in other words, about where we are now.

            For all the talk about curbing entitlements and living within our means, the reality will be that medical care for the elderly is what it is. There surely are ways of cutting costs and providing more effective health care, and those ought to be vigorously pursued, but it’s hard to imagine they’re going to cut the overall cost of senior health care by any dramatic amount. Ten percent, I suspect, would be a big win, given the age of the human machinery in question and how long it yet has to run.

            A century ago, when the life expectancy of an American male was 47, and when people got sick they generally got well or died in a couple of weeks, we didn’t need Medicare. Today the wealthiest one percent of the population and the healthiest two or three percent may never need government help with health care, but the rest of us will, and it’s only a question of when and how much.

 That’s a point most people instinctively grasp, either as a matter of self-interest or as a question of compassion and human dignity. And that’s why, in a wealthy and democratic society, the question will have to be, how do we make it happen?

             

           

           

             

           

Helping Hands Make a Difference

            In the summer of 2008 our son Nick, then 17, went to Africa to help build a school. It made enough of an impression that next year he asked to be sent back as his high school graduation present.

            Don Stoll and Marianne Kent-Stoll, two teachers from Nick’s high school, had been on vacation in Africa a couple of years earlier when they decided to visit the remote village of Bacho in Tanzania. There they learned that the town’s aging school was in danger of being closed owing to health hazards.

            They promised the villagers that they would return to help build a new school, then later held a meeting after school at Kirby Prep in Santa Cruz to see if there would be any interest in supporting the project. There was. More than two dozen students and parents, along with a few community members, signed up to work two weeks in Bacho, providing the sweat equity for the new Ufani School, as it was called.

            Don and Marianne created a foundation named Karimu (Swahili for “generous”) to raise funds for school supplies. They held fund-raisers, including a dinner featuring African cuisine, and rounded up support in the community outside the school where they taught.

            Getting to Bacho, even in the jet age, is an ordeal. The group flew from San Francisco to Heathrow in London; then after a long layover, from Heathrow to Jomo Kenyatta International Airport in Nairobi, Kenya; then from Nairobi to Kilimanjaro Airport in Tanzania. From there a long bus ride took them to Bacho, where the villagers greeted them with an elaborate, and quite long, ceremony.

            Building the school was hard work. With no machinery, everything had to be done by hand, often in a choking cloud of dust. One morning the crew came across, and removed, a venomous snake from the interior of the school building. The work crew subsisted largely on rice, beans, bananas and fried dough, with an occasional helping of local chicken.

            It took more than one summer, but the school was built and equipped, and is now in operation. Nick came back from that first trip more mature and aware, changed in several subtle and positive ways, and we figured that the cost of it was money well spent for that reason alone.

            But in a situation like that you always wonder, or at least I do, if it made any lasting difference to the people being helped. All too often, well-meaning volunteers put in a heroic effort on a project like that, then things go sideways after they leave.

            Last week we received word that this was happily not the case at Ufani School in Bacho, Tanzania. Before leaving on their fifth trip there, Don and Marianne sent out an e-mail reporting some good news.

            Primary school students at Ufani, and elsewhere in Tanzania, take high school entrance exams to see if they can proceed with their education. In a poor country with limited educational resources, this is a one-and-done process. If you don’t pass the first time, you don’t get another chance. This year the students at Ufani School had the fourth best success rate in the country on their exams, and many of them will be moving on with their education. It would appear that in this case the project transformed the beneficiaries as well as the participants.

            A Huffington Post article on the Ufani School project can be found at http://www.huffingtonpost.com/suzanne-skees/tourists-changing-the-wor_b_892635.html

  

           

The Last Good Republicans

            As a wool-gathering exercise the other day, I made up a list of politicians I didn’t always agree with but respected for their political attitude. Morals aside (a few of them got into trouble that way), they made the list because a) they showed a longstanding pragmatic concern for making government work or b) they at some point stood up against interest groups or party orthodoxy for something that was right:

            John Sherman Cooper, Nelson Rockefeller, Hugh Scott, Margaret Chase Smith, Frank Murphy, Donald Grunsky, Bruce McPherson, Thomas Kuchel, Earl Warren, Goodwin Knight, Charles Percy, Edward Brooke, Frank Murphy, Frank Lanterman, Arnold Schwarzenegger, William Scranton, Everett Dirksen, Gerald Ford, George H.W. Bush, Jacob Javits, Kenneth Keating, Charles Mc. Mathias, Robert Packwood, Mark Hatfield, Barry Goldwater.

            You may have noticed a trend here: They’re all Republicans, and none of them is holding office today.

            Seventeen of the names on that list are politicians who were prominent in the sixties and seventies and who were generally considered “moderate” Republicans. They were skeptical about the extent of what government could do, but ready to use the government when needed. Most of them supported bipartisan efforts on civil rights, the environment, and, to a lesser extent, social services.

            Two of them, Dirksen and Grunsky, were principals responsible for major and much-needed legislation. Dirksen pulled together enough Republican votes to override the Southern filibuster that had been blocking the Civil Rights Act of 1964. Grunsky, a generally conservative Republican from Watsonville, was a California State Senator who authored the legislation, subsequently approved by voters, to create the California Coastal Commission in 1972, establishing lasting protection for the state’s coastline.

            Only two of the above served since 2000. McPherson was a pro-environment, pro-education California Assembly member and State Senator fro Santa Cruz, who went on to become California’s Secretary of State. Schwarzenegger made the list for being pro-environment and pro-gay rights at a time when his party was in denial on the first issue and red-baiting on the second.

            Barry Goldwater is on the list for standing up for the right of gays to serve in the military (“You don’t have to be straight to shoot straight”) and for speaking out against the intolerance of some of the religious right. If he were still around, you’d have to wonder what he would be saying about the Tea Party movement today.

            For those who don’t remember or never heard of him, Frank Lanterman was a California Assembly member for more than a quarter of a century. He represented a conservative part of Southern California and typically ran up near-perfect voting scores as measured by conservative and business organizations and near-perfect negative scores from the groups I tend to agree with.

            But Lanterman was a strong supporter of the mentally ill and developmentally disabled. He was the lead author of the bipartisan 1967 Lanterman-Petris-Short Act, which established firmer guidelines for involuntary commitments under the 72-hour mental holds used by police. His name lives on in the Frank D. Lanterman Regional Center, serving people who suffer from developmental disabilities.

            Near the end of his career, when Gov. Jerry Brown was planning to close state mental hospitals and release many of their patients into the community, Lanterman was a voice in the wilderness against it. I’m a small-government conservative, he said, but there are some things only government can do, and taking care of the mentally ill is one of them. You might want to think of Lanterman the next time you see a disheveled and disoriented person in the street, swatting at imaginary flies while people walk by trying not to notice.

           

           

             

The Slow Fade of Institutional Memory

            When I joined the staff of the newspaper in 1972, at the age of 22, its City Hall reporter was a man named Howard Sheerin. Sixty three years of age, chain smoking, and hard of hearing, he had been with the paper nearly 40 years. By that time he was counting out the days to his retirement a year and a half later and most weeks generated a volume of work that would have horrified the productivity experts of today.

            Yet he was in many ways a highly valuable member of the news staff. When a local politician from the 1940s or 50s was unexpectedly dispatched to his eternal reward, Howard could turn out a masterful obituary within an hour, capturing both the essence of the man and his precise contribution to the local scene.

            There was no such thing, in those days, as computer searches for information, but with Howard close at hand, it wasn’t necessary. Everyone from the editor to a cub reporter like myself could go to him with a question of fact or context and get a solid answer.

            He was, in short, that most valuable of assets — the institutional memory of the organization. His pay didn’t reflect his value, but the same could be said of all of us.

            Fortunate is the business that has such a person, and there are fewer that do with each passing year. The modern business environment makes it all but impossible. For starters, staying with a company for four decades requires loyalty in two directions. Howard worked for a small family newspaper group that believed in that kind of loyalty to its employees and got it from them in return. Just inside the front door was a wall of photographs of the “Quarter Century Club,” people who had been with the company that long. Even the terms of employment were generously counted; if you left, for a period, to serve in the military, that time counted toward the 25 years.

            Few businesses foster that kind of climate any more, and few employees look for it or value it. At just about any newspaper today, Howard would have been let go in a round of layoffs and replaced with a younger man or woman, innocent of the community but able to provide more copy at a fraction of the cost.

            Newspapers themselves, which might be considered the institutional memory of the community, are similarly in danger. It is still hard to challenge the incumbent paper, even with a free, exclusively online publication. By virtue of having been around so long and having covered not only public affairs but the individual passages of life (births, deaths, marriages) for so long, the existing newspaper has a standing that is hard to topple.

            It may prove to be the case that the business model for the newspaper can’t be sufficiently adjusted to changing times and that newspapers will go away, leaving communities without their institutional memory. It may be that the entire concept of institutional memory will vanish as people come to believe that a few keystrokes on a computer can provide any answer they need. I hope not.

            The newspaper I used to work for now has no editors or reporters who were there before the year 2000. If someone dies who was active in civic affairs in the 1970s and 80s, I am likely to get a phone call or e-mail asking for a quote or information. In a sense, I have become the newspaper’s institutional memory, and the irony is not lost on me.           

Reflections of a Reluctant Juror

            Serving on a jury, as I recently did, is one of those things that prods you into thinking about larger issues of how our social, legal and governmental systems work. Having been made a part of that process, whether you wanted to be or not, you see it in a more real and tangible way.

            By dint of circumstance, one element of the jury experience hit me between the eyes. Here in California your exposure is limited to a week. You call in the night before to see if you have to go in the next day, and if you haven’t been called for five days, you’re off the hook.

            As chance would have it, I was called in on Monday morning, which exposed me to being seated on the jury for a six-day civil trial. Had I been called in any other day of the week, I would have been exposed to a three-month murder trial. Six days is a manageable inconvenience; three months is a business or job-destroyer. I cheerfully did the six days.

            When the concept of trial by jury was first introduced a few centuries ago, they didn’t have forensic specialists, psychiatric experts or most of the other things that add greatly to the time of a trial. Practically every case was heard in a few days, and just about anyone could afford to put the plow down that long.

            They also didn’t spend a lot of time picking the jury. The idea was that it was supposed to be 12 people who knew the defendant well enough to know whether he was probably lying or not. Now the idea is to come up with people who know nothing and have qualities that make them likely to be sympathetic to your side.

            During our little trial we would step out into the courthouse foyer during recesses and see dozens of prospective jurors for the three-month trial filling out a questionnaire that looked to be about 10 double-sided pages long. I hate that sort of thing. Most of the time the questions aren’t very good and force you to give an oversimplified and un-nuanced answer. For a nuance guy like me, that’s painful.

            The jury process itself is more than a bit humbling. A big part of that is that as a juror you have to make a decision that means a great deal to the people involved, but you have to do so based on incomplete knowledge derived from incomplete evidence presented to you. When our jury was in deliberation, I asked at one point, “Is it just me, or does anybody else feel like the evidence presented to us doesn’t adequately explain what the heck happened here?” There was a chorus of “yeas” and nodding heads.

            We moved forward and decided on the basis of the evidence we had that there wasn’t enough of it to prove the case and ruled in favor of the defendant. In casting my vote, I did so realizing that if I knew what God did, I might have voted the other way.

             Deliberations, in our case, brought out the best in most people. Another humbling thing about jury service is the realization that not everybody else looks at the evidence and sees it as you do. Tolerance and courtesy nonetheless prevailed for the most part, and we were eventually able to talk ourselves into agreement. For a fleeting moment I wondered how things would be if legislatures behaved like juries, but that’s not what they’re elected to do. Nice fantasy, anyway.

Mavericks and Fanatics I Have Known

            Early in my newspaper career I attended lots of public meetings. I covered school boards, water boards, fire boards, harbor boards, city councils and county planning commissions and boards of supervisors. It’s something every citizen should do, and I was lucky enough to get paid $3.26 an hour for doing it straight out of college.

            Every one of those boards, I recall, had a time in the meeting set aside for anyone in the audience to address the elected officials on any subject they wished. It was fairly common for such people to introduce themselves as “Joe Smith, Taxpayer.” When that happened, I, and the other reporters present if any, would set down our pens and take a break.

            We did that because, after getting excited about the utterances of such citizens a few times, we came to realize that, as H.L. Mencken once put it, “What ails them primarily is the ignorant and uncritical monomania that afflicts every sort of fanatic at all times and everywhere.” Invariably if you followed up on their claims, you’d find out that the thing they were complaining about was state or federal law or part of a contract, and that it was there for a reason that was at least arguable.

            That’s not to say the elected officials and their hired help were always right — far from it. Some of them may have been getting away with worse than what the “taxpayer” alleged, but when they were tripped up, it was usually because someone who knew about it took solid evidence to the Grand Jury or the District Attorney. Going to somebody who can actually do something about it makes a lot more sense than getting on a soap box and addressing the perps.

            Every once in a while, one of these complainers would run for office and actually get elected, which made him or her a maverick instead of a fanatic. Instead of derailing a public meeting for five minutes, they could derail the entire meeting. At such times it was good to be paid by the hour, but I earned it.

            During those years I also spent a lot of time on the phone. Anybody can call a small town newspaper office and get right through to a reporter or editor, and you wouldn’t believe some of the people who did.

There were chirpy eccentrics like Cosmic Ladye. As soon as you said hello, she would launch into a goofy, breathless free-association monologue that lasted for three minutes before she ended with a benediction and hung up.

Some callers were seriously disturbed, like the woman who accused a prominent politician of murdering her son and hiding the body. And there were the cheerful obsessives, like the guy who claimed to have scientifically calculated exactly where the state of California would split in half at the next big earthquake. It didn’t.

Then there were the repeat callers, like Mountain Lion Lady, as we knew her. Any time we ran a story about a mountain lion poaching someone’s goat, cat or dog, she would call to say the story couldn’t possibly be true because mountain lions were non-violent persecuted creatures who wouldn’t harm a flea.

A couple of years after I left the paper, a mountain lion killed a hiker in Northern California. I never asked if she had called the newspaper to complain, but I have no doubt what her spin on the story would have been: The mountain lion was framed.   

           

The Boys of Summer in 1959

            The Dodgers baseball team moved from Brooklyn to Los Angeles in 1958, and I became a fan in 1959. Talk about catching a wave.

            That first year in Southern California the Dodgers finished in seventh place, but had about the best attendance in the Major Leagues. Baseball experts didn’t expect much from them in 1959. Baseball experts were wrong.

            It was a curious team they fielded that year. Three of the Boys of Summer (Duke Snider, Gil Hodges and Carl Furillo) were in the twilight of their careers. There was some up-and-coming talent, including a couple of pitchers named Don Drysdale and Sandy Koufax. Three of those players (Snider, Drysdale and Koufax) are now in the Hall of Fame and a fourth (Hodges) should be. The manager, Walter Alston, is also in.

            You always remember your first one, and mine was June 21, Father’s Day. My dad and I went to see the Dodgers host the Cincinnati Redlegs, as they were then called, at the Coliseum. Cincinnati won 17-3, and I was so disappointed that it took years to realize how lucky I was to have seen future Hall of Famer Frank Robinson hit a booming home run for the visitors.

            By the time August rolled around, the Dodgers were in a three-way pennant race against the San Francisco Giants, who had Juan Marichal, Willie Mays and a sensational rookie named Willie McCovey; and the Milwaukee Braves, who had Warren Spahn, Lew Burdette and Henry Aaron.

            Koufax was still an erratic young pitcher that year, but at the end of August, in a clutch game against the Giants, he showed a glimpse of what was to come. He struck out 18, including the last six batters he faced, to set a new National League record. It happened way past my bedtime, but I was listening with a radio under the blanket.

            At the end of the season the Dodgers and Braves were in a tie for first place and had a best-of-three series to determine who went to the World Series. Los Angeles won the first game in Milwaukee. When the second game was played in Los Angeles (during the day, of course), I raced home from school, hoping to catch the end of the game.

            Down three runs in the bottom of the ninth, the Dodgers tied the score, then won in extra innings on a throwing error off a routine grounder to short. I still remember Vin Scully’s call: “Hodges around third … heading for the plate … We go to Chicago!”

            After losing game one of the World Series to the White Sox, 11-0, the Dodgers rallied to win it in six games. Furillo capped his career with a pinch-hit single to drive in the winning run in game three, and a pitcher named Larry Sherry, called up from the minor leagues in midseason, won two and saved two to become series MVP.

            Being nine years old, I assumed it would always be like that. The next three years taught me how to accept disappointment.

            It’s been two decades since I followed the Dodgers on any regular basis, and what got me to thinking about this was the news that the team filed for bankruptcy last month. The owners, the McCourts, are in a bitter divorce, and have reportedly been using their equity in the team to finance their high living while the team languishes below .500. When the owners make more news than the players, something is wrong.

            Oh, by the way, there’s a fifth Dodger from 1959 in the Hall of Fame: The owner, Walter O’Malley. Aside from moving to California, he rarely made news.