I.  As I have pointed out endlessly in essays like Health Care, Race and Treachery, the United States has undoubtedly the most unsatisfactory record among any technological country in providing health care for its citizens. At times, opposition to reform in the United States takes the shape of the worst of American society: racism and brutality. However, in spite of this, here is what I found:

Over 40 million Americans have no health care insurance at all.

Those who have health care may lose it suddenly if they become unemployed through no fault of their own. One may be denied health care coverage if a “pre-existing” condition exists.

Coverage may be suspended even while one is receiving treatment for a serious – life threatening – illness for something as simple as an administrative oversight.

There is no control of prices or premiums. The Corporate Healthcare Monopoly can raise the cost of premiums at any time of its choosing without providing or needing a reason.

The lack of health insurance is the third leading cause of death in the United States; heart disease and cancer are the top two.

Recent “health care reform” in the United States has done little to change any of this.

There are several factors that contribute to this shameful situation, the most important are the health insurance monopoly; health care providers, pharmaceutical companies and irresponsibility in state and federal government also play a role. Most importantly, it should be no surprise that the opponents of health care reform are members of a particular political party. They could be called the Health Insurance Corporate Monopoly Party.

The Republican campaign against health care reform has rested in part on the traditional arguments, arguments that go back to the days when Ronald Reagan was trying to scare Americans into opposing Medicare — denunciations of “socialized medicine,” claims that universal health coverage is the road to tyranny, etc. But in the closing rounds of the health care fight, the G.O.P. has focused more and more on an effort to demonize cost-control efforts. The Senate bill would impose“draconian cuts” on Medicare, says Senator John McCain, who proposed much deeper cuts just last year as part of his presidential campaign. “If you’re a senior and you’re on Medicare, you better be afraid of this bill,”says Senator Tom Coburn. If these tactics work, and health reform fails, think of the message this would convey: It would signal that any effort to deal with the biggest budget problem we face will be successfully played by political opponents as an attack on older Americans. It would be a long time before anyone was willing to take on the challenge again; remember that after the failure of the Clinton effort, it was 16 years before the next try at health reform.

Again, no surprise at all, these people have been on the wrong side of history their entire lives. The same ideological positions they are now taking on Health Care reform in 2009 are identical to the ideological stance they presented against Medicare in the 1960s and Social Security in the 1930s. Some things never change. See, for example, Washington Sketch: On Health Care, Republicans Aren't Listening

The Senate Finance Committee was barely an hour into its consideration of health-care reform on Tuesday morning, but Sen. Jim Bunning (R-Ky.) already knew where he stood. "I do not support a government takeover of the health-care system," he railed. The proposal "confiscates more money from the taxpayers," he went on. "It tramples on American freedom and liberties." After this vigorous display of open-mindedness, Bunning was spent. About an hour later, spectators noticed that the senator, who had been resting his chin in his hand, had fallen fast asleep. As giggles rippled through the chamber, an aide shook Bunning, who woke with a start.

II.   Now I want to discuss Phenomenology as a scientific discipline and methodology. 

Phenomenology is the study of structures of consciousness as experienced from the first-person point of view. The central structure of an experience is its intentionality, its being directed toward something, as it is an experience of or about some object. An experience is directed toward an object by virtue of its content or meaning (which represents the object) together with appropriate enabling conditions.  

Or to say it slightly differently:

Phenomenology is a theoretical orientation, but it does not generate deductions from propositions that can be empirically tested. It operates more on a metasociological level, demonstrating its premises through descriptive analyses of the procedures of self-, situational, and social constitution. Through its demonstrations, audiences apprehend the means by which phenomena, originating in human consciousness, come to be experienced as features of the world.

Phenomenology then is a mechanism for a comprehending and developing a Weltanschauung which may also be referred to as a world view. Succinctly then, Phenomenology is concerned with the individual processing and acting upon experience and not necessarily understanding it.

Phenomenology is concerned with the study of experience from the perspective of the individual, ‘bracketing’ taken-for-granted assumptions and usual ways of perceiving. Epistemologically, phenomenological approaches are based in a paradigm of personal knowledge and subjectivity, and emphasise the importance of personal perspective and interpretation. As such they are powerful for understanding subjective experience, gaining insights into people’s motivations and actions, and cutting through the clutter of taken-for-granted assumptions and conventional wisdom.

Alfred Schutz is frequently given credit for bridging European Phenomenology and American Sociology. To Schutz reality is always in a process of construction. Reality is constructed by an individual in an on-going process. And so:

Gestalt is therefore the habitual possession of meaning-contexts which supply the indivisible unit of the phenonomenal configurations in which we apprehend the objects of the outer world.

Human beings then are always in a process of developing meaning from what they perceive.

III.  I was employed in the IT Industry in large corporations for 27 years and during this time my wife and I had excellent health insurance provided by my employer. It covered not only medical expenses, we had dental and vision coverage as well. When I retired, we returned to our home in Oregon. When our coverage under COBRA ran out, I was eligible for Medicare however my wife had no option other than to apply for health insurance with Blue Cross of Oregon. They didn’t check with her doctor or ask for any medical records but rejected her application summarily because of two medications she was taking: Atenolol and Boniva for osteoporosis.

Taking Boniva or something similar is recommended for a large percentage of middle-aged women. The point is that her doctors never felt that she had "preexisting conditions" but Blue Cross Blue Shield of Oregon jumped to this conclusion based on the medication she said she was taking on the application.

They said she had a “heart condition” and a “bone condition”and made their decision on nothing more that the prescription medication she was taking. Again they never contacted her doctors or requested any medical records which would be required before making an accurate determination on the status of one's health.

She was denied medical coverage because Blue Cross of Oregon said that she did have “preexisting” conditions – to reiterate they never contacted her doctors or requested copies of medical tests – and she was put into the Oregon Insurance Pool, which is also administered by Blue Cross of Oregon. The Oregon Insurance Pool is something for those who can afford insurance but have a "preexisting" condition.

My monthly income is from my social security and from rent we are paid from the rental of business I inherited from my parents. Our income totals $2197.00. I pay for a Medicare supplement which is $148.75 a month. I also have prescription drugs that I must take every month which total $94.28.

So we are spending at least $704.03 every month on medical expenses. Another premium increase is something our current income cannot sustain.

As dire as our situation is, we are fortunate. If we had social security alone, we would have to choose between medical needs and food. However at the rate Blue Cross is raising its premiums, I don’t know how much longer that will be true and a difficult choice will have to be made. It appears that this is just another example of life in Oregon and the United States.

Anyway my wife couldn’t be denied coverage in the Oregon Insurance Pool - it is the place for those with pre-existing conditions. Here is the record of her experience there:

When she started in the Oregon Insurance Pool on October 1 2008, her premium was $320.00.

On January 1, 2008 it was increased to $383.00.

On October 1, 2009 it was increased to $397.00.

On January 1, 2010 it was increased to $461.00.

Her doctor says the expenses for medical care have not increased 30.5% since January 2, 2008 as her insurance premiums have. From the examples of health care practice I originally stated, these seem to be most appropriate for my wife's experience:

One may be denied health care coverage if a “pre-existing” condition exists.

There is no control of prices or premiums. The Corporate Healthcare Monopoly can raise the cost of premiums at any time of its choosing without providing or needing a reason.

One wonders, what exactly is the business case for increasing premiums $64.00 between October 1 2009 and January 2 2010? You can find it in the fine print but what it really comes down to is greed. To see how health care is provided in the other advanced technological countries, this Frontline Program provides documentation: Sick Around the World. To compare how this works in the United States Sick Around America does that. The conclusions are irrefutable. And until Congress acts, they aren't likely to change.  

IV. I now want to summarize what I have covered so far. In the first section drawing on information from other essays that are available on this blog,  In so doing  I covered many of the salient properties of the health care system one finds in the United States today.

Next  I discussed the general characteristics of phenomenology as a discipline and methodology.  In terms of impact, the information I present forecasts a system that is in a slow or relatively slow decline. Like other systems, there may be a point where key resources become scarce and marginally available; this could eventually lead to conflict between groups formed around aspects of age, race, ethnicity, gender, wealth, power, ideological and other indices. As the general situation deteriorates, conflict could escalate. In an entropic system or group of systems, the probability of conditions improving is low. That is to say change can occur in only one direction, that of decline.

In the third section, I focus on a specific example of how the health care system in the United States affects an individual. Knowledge of this example is based on my personal experience.

The kind of personality one is dealing with here is described by C Wright Mills noted in The Power Elite:

They come readily to define themselves as inherently worthy of what they possess; they come to believe themselves 'naturally' elite; and, in fact, to imagine their possessions and their privileges as natural extensions of their own elite selves. In this sense, the idea of the elite ascomposed of men and women having a finer moral character is an ideology of the elite as a privileged ruling stratum, and this is true whether the ideology is elite-made or made up for it by others.

As in the example of my wife's experience with the health insurance monopoly, the decisions they make affect the lives of others often adversely.

In an entropic paradigm there is no reason why I shouldn’t end this here.  The reason is simple: the economic model the United States has in place is in decline and will eventually fail.  I would give it 50 years at most.   Canada and Western Europe should do much better.

Events that are beyond human decisions do happen; social arrangements do change without benefit of explicit decision. But in so far as such decisions are made--and in so far as they could be but are not made--the problem of who is involved in making them--or in not making them--is the basic problem of power. It is also the problem of history making, and so of the causes of war.

- C. Wright Mills, The Causes of World War III, 1958.

For the past several months I've been occupied with other interests and have not written anything on my blog for some time. However if you aren't aware, there was a multiple-murder event in Tucson AZ on Saturday January 2011. The injuries to at least six people were fatal, among them was U.S. District Judge John Roll, a nine year old child born September 11, 2001, an assistant to Rep. Gabrielle Giffords, D-AZ. Others were seriously injured, one of whom was Congresswoman Giffords, who appears to have been the primary target.

The alleged perpetrator captured while attempting to leave the scene, Jared Loughner, is now held under Federal custody and has been described by MSNBC as (a) paranoid, aggressive, conspiracy theorist. Theorist? This guy has gotten way out of the realm of theory.

The story is quite convoluted. Today the media is full of stories on this topic and the MSNBC story seems to cover the most pertinent details. Laughner faces multiple Federal charges including an attempt to assassinate Representative Gabrielle. Her condition remains critical at the time of this article.   If I were only interested in covering the incident, what I've written so far is a reasonable summary of what is known at this point in time regarding the events that took place on Saturday.  Events of this nature have been replayed in the United States so many times now beginning in the 1960s. However there is perhaps more to this story than what you've read so far. As Paul Krugman notes in Sunday's New York Times:

When you heard the terrible news from Arizona, were you completely surprised? Or were you, at some level, expecting something like this atrocity to happen? Put me in the latter category. I’ve had a sick feeling in the pit of my stomach ever since the final stages of the 2008campaign. I remembered the upsurge in political hatred after Bill Clinton’s election in 1992 — an upsurge that culminated in the Oklahoma City bombing. And you could see, just by watching the crowds at McCain-Palin rallies, that it was ready to happen again. The Department of Homeland Security reached the same conclusion: in April 2009 an internal reportwarned that right-wing extremism was on the rise, with a growing potential for violence. Conservatives denounced that report. But there has, in fact, been a rising tide of threats and vandalism aimed at elected officials, including both Judge John Roll, who was killed Saturday, and Representative Gabrielle Giffords. One of these days, someone was bound to take it to the next level. And now someone has. Let’s not make a false pretense of balance: it’s coming, overwhelmingly, from the right. It’s hard to imagine a Democratic member of Congress urging constituents to be “armed and dangerous” without being ostracized; but Representative Michele Bachmann, who did just that, is a rising star in the G.O.P.

Some of my friends in Western Europe have asked me in the past why the political discourse in the United States is so xenophobic and filled with obvious precursors of violence. I've never had an answer but you can feel it everywhere, e.g. Health Care reform becomes "socialized medicine" and those who support it are compared to Hitler.

There are far too many examples of this brand of thinking and I don't feel like going through them, all of them. However you may look backward in the blog and see many stories I've written on this subject even before the election of November 2008. What you will find is the right-wing nutcases always were there.

Here is suggested reading:

Neo-Right - Neo-Nazi

Blowout Prevention

The Politics of Reality Denial

Living on the Edge of Madness

Say Americans - Why So Scared?

Delusional Beliefs and Political Extremism

The Already Wealthy  

However there is a major perversion here, actually there is no "Sanity Defense." It is really a call to action for those who are not insane. The claim for sanity alone is totally insufficient for credibility. Something greater must be done to halt this madness.  For a beginning, the ideologues and the nut-cases who take what they (the ideologues) iterate literally and constantly must be separated. The terror of violent rhetoric and what it induces must be stopped. 

So I think there is cause for concern about the United States. Just what is going on here, why all the screaming, name calling and thinly veiled threats in what passes as public discourse? It is legitimate to ask is this an example of a second amendment remedy. President Lincoln, a victim of violence himself, described that process as "going from the ballot to the bullet."

Most modern nations have federal, state and local police forces to defend citizens from violent attacks. In such locations citizens aren't required to be overly concerned about protecting themselves, i.e., personal possession of weapons for safety is not required. Also in other modern states, a high level of trust is given to government and its ability to shield its citizens from events now seemingly uniquely common to the United States.

And most importantly, in other countries individuals that are mentally ill would not be able to easily obtain weapons of lethality. Indeed it is far more likely that the mentally ill would receive medical care as opposed to weapons procurement and training. Comprehensive health care for all would be a much higher priority than for example accumulating nuclear weapons and delivery systems.

It is long overdue for the United States to decide what kind of country it really is and wants to become. Otherwise now as in the past, it remains a problematic and in certain locations a dangerous place to inhabit. 

It seems that Democrats in Congress are feeling a bit insecure because the voting polls are predicting Republican gains in both the Senate and House of Representatives in the November 2010 election. If the people who voted in 2008 for the Democrats would all vote in 2010, I don’t think they would lose any seats, in fact they might gain some.

There are two reasons why they are vulnerable. One is because the Republican leadership (sic!) is claiming the Democrats have created the federal budget deficit (which is not true, the last Republican president created it) and also because there are so many very strange people (who even scare most Republicans) whose names may appear on the ballot as Republican candidates in November.

There is no point in addressing the second issue anymore, I’m really tired of writing about it. See for example Iraqi Finis elsewhere on this blog. Why there is such a huge deficit is in some ways more complex but if one narrows the timeline to the events of the 21^st Century, it is really simple to understand. If you missed it, this is what happened.

After the 2000 Presidential election the federal government was operating with a surplus. One can thank Democrat Bill Clinton for leaving a prosperous economy and balanced budget for Republican George W. Bush when he took office in January 2001. Did he mess it up? Yeah, you could say that. One wonders how anyone could have possibly thought this guy was ready for the job.

The fundamental points though are these:

The U.S. economy was prosperous, unemployment was low and some people made a lot of money in the 1990s.

The Federal Budget was balanced; in fact it was running in the black.

Then by the end of the year things considered impossible happened and the United States found its national security under threat. Wars and draconian domestic policies followed. Once more, no need for details, everyone knows what I’m writing about. You can send me an email if you don’t.

Wars cost lots of money even if they are contracted out and if taxes are drastically cut at the same time, the federal budget goes into the red.

Essentially that’s what happened. I would add that 2003 through the early fall of 2008 were some of the most terrible years for the United States and its population that I can remember. I was born after World War II ended, so I can’t personally say anything regarding how things were before that.

The short version for the 21^st Century problems are that the wars were terrible and without any redeeming qualities. Then in 2008, the economy collapsed.

These are a very few references on the economy situation:

The Already Wealthy

Living on the Edge of Madness

Forgetting the Past and Its Consequences

What I mean by the title of the last reference is forgetting that the past has consequences. Ok so far?

For the wars I would recommend the documentary available on DVD No End in Sight.

The points of importance though are that even if there were no blatant Republican opportunism which may cost the Democrats votes in Congress and the economy was in better condition, some things would still be bad and others not so bad.

The Democratic Administration and Democratic Congress have really accomplished a lot, saved the economy from a much more disastrous fate and enacted historically important legislation. See for example:

Xenophobia: Fear-Mongering for American Votes

President Obama's winning streak

It’s Witch-Hunt Season

As I see it however even if the Republicans do well in the 2010 Congressional election, I would not be overly concerned. First, as mentioned, the accomplishments made by Democrats in less than two years are historically important. And regarding Republicans, they are so incompetent and advocate such extreme ideology, they are going to become easy targets in 2012.

The issue that is hurting Democrats is the high levels of unemployment. Essentially what they thought would create jobs wasn’t of sufficient scale. More needs to be done and the condition the U.S. economy is in really needs to be understood. Let me summarize my thinking on the U.S. economy.

The problem is that the U.S. is an example of a post-Keynesian economy where there is a complex relationship between public and private sector indices with no known direct cause and effect relationships. So every attempt to achieve something relatively straight forward in a less complex model, like creating job growth, is kind of an experiment to determine what works. Probably a large and sustained stimulus would yield job growth but it would have to be first directed in creating a new economic infrastructure. A“clean energy” economic sector for example. In general, the U.S. economy is heavily leveraged in defense industry and aerospace corporations where there is no real demand and no real customers. Does anyone want to buy an F35? If so, the deal is you’d have to pay for it. This relationship is a result of the United States fighting the Cold War with the USSR alone and now it is not going to be easy to revert to a more direct economic model where cause and effect are clearly defined.

I made these comments in the Washington Post Democrats add fiscal austerity as a campaign issue and someone remarked:

BarryOR:
I don't dispute what you wrote but challenge the whole underpinning logic/ontology of your analysis.
It's thinking like yours that got us into this mess in the beginning. In the end it's a rationalization to ignore reality and spend the nation’s wealth on "eye candy" rather than doing what is needed.

BarryOR is me, needless to say.

Well if the person making the comment agrees with the analysis, which amounts to 90% of my statement, the only non-analytical thing I said was prefaced with “Probably”. The important point was that the economy is so complex and intertwined with variables that a specific policy to create job growth will not be something one can grab off the shelf. Actually if one looks at it closely, there simply aren’t that many options available and I don’t think the present economic infrastructure will survive much longer. I don’t know if this person is a reality denier or not but by any measure fossil fuel energy sources are not a good long term investment. And I didn’t say anything about climate change.

I know from my experience as a software designer and systems analyst that when cause and effect are not easily discernable, the best thing to do is to SIMPLIFY THE MODEL.

Suggested ideas to explore:

What happens on Wall Street and in banking is far too complicated to maintain legality over; determining how to tax and regulate their activities is more complex. The relationships need to be simplified and adequately regulated to prevent continued scams and disasters carried out, intentionally or otherwise, by such loosely controlled entities.

In general, federal, state and local tax structure should be dramatically simplified.

The defense sector is still a far greater component of the economy than is reasonably justified by potential threats.

Taxes from working class and middle class income pay for a far greater percentage of what government spends than it should. It logically follows that taxes do need to be lowered and government spending does need to be reduced provisionally. For example, tax cuts should focus on families with incomes less than $200,000 a year. Elsewhere taxes should be targeted at obtaining a sustainable balanced federal budget within a decade.

Federal government spending in the private sector should focus on inducing job growth and infrastructure creation that generates sustainable global markets in which the U.S. economy is a leading force.

Most importantly, government programs should protect working and middle class individuals and families from catastrophic events they can neither predict nor influence.

Toleration of government and corporate malfeasance must immediately end.

Many still object to the Wall Street and Bank bailouts that Henry Paulson sold to Congress. Paulson scared so many people. I would recommend another documentary also available on DVD called Plunder: the Crime of Our Time.

It should be clear that I’m somewhat busy right now and others are going to have to start thinking differently about problem solving as well. Basically it is your country and you've broken it though greed and negligence. You treat it the same way you treat everything else. Why don't you do something differently for once and get it fixed.