The Kindness of Strangers

I recently had a conversation with a person who earnestly believes that all entitlement programs are unconstitutional and should be eliminated.
The constitutional arguement is based on the notion that since nothing in the constitution specifically provides for federal social welfare entitlements it is forbidden to provide them. The counter arguement is that not being specifically permitted does not mean that these entitlement programs are forbidden.
An arguement over the finer points of the constitution offers little comfort to the parent of a young child newly diagnosed with a lifelong disability or to the aging parent still struggling to care for an adult disabled child. It offers little comfort to the husband or wife unable to provide a spouse with the best possible care for cancer or heart disease.
That same person who would have all entitlement programs stopped believes with apparently equal sincerity that charitable giving could and should take the place of these programs.
But how realistic is that? And even if it could be done, how palatable would it be for the recipients to live their lives, as Tennessee Williams famously said, depending on the kindness of strangers.
Could it possibly work? I put the question to several people involved in one way or another with either the health care reform debate or with providing assistance to individuals with disabilities. As it turns out, it seems that depending on such kindness is, at best, a stop-gap measure.
Individuals and organizations alike immediately point out that even now, with entitlements or with good insurance, not all needs can be met nor can all those needing help get it. As for resorting to charities, again none of them have proven to be complete solutions either. They are both needed to provide stability for the individuals in need and for the organizations caring for them.
For a healthy person with a healthy family, I'm sure it makes perfect sense to think that privately funded philanthropic organizations and facilities would and could fill the gap. And we all know that in some instances this is indeed the case.
But when we are talking about catastrophic illnesses and injuries, chronic conditions, and permanent disabilities, it is not realistic or kind to expect our brothers and sisters and their families to live out their lives hoping every day that a charity which has no obligation to care for them will do so.
Charity is a wonderful thing and it has a place in a society that considers itself moral. No system of entitlements will ever be perfect. There will always be those who slip through the cracks and there will always be unexpected new challenges to be met. There will always be a need and a place for charity and for the fortunate to experience the joy of sharing their abundance with those less fortunate. But what is moral about having a significant percentage of the population live in daily want and constant fear that because of some illness, accident, or disability they will never be able to move past the need to depend on the kindness of strangers?
That is not what I consider to be a moral society. The 19th century German philospher Arthur Schopenhauer took the position that compassion is the basis of all morality. For those of us who agree with Schopenhauer, it is an immoral society that fails to be compassionate.
A compassionate society incorporates and encourages charity but it does not demand that any of its members sacrifice their security and dignity by depending solely on charity. A compassionate society gladly and unbegrudgingly guarantees and affirms that access to health care and related support is a basic right. Access to health care and related support are not privileges to be dispensed by the wealthy to the poor. They are essential components of a compassionate society. Both the right to have them and the obligation to provide them are shared by all.
Health care and disability entitlements fulfill that obligation.
It is the responsibility of those of us who believe that we have that obligation as a society to a act accordingly.
We can act to improve the delivery of charitable giving or we can act to ensure the continuation and improvement of entitlement programes.
Doing nothing is not an option.

Jane Q Public

My name is Jane Q Public.
I have a huge family known collectively as The Public.
We are a pretty diverse bunch. Old, young, rich and poor and in-between, many shades of brown, more female than male, more older than younger, some healthy, many not, some insured, some uninsured, most underinsured.
And we are a dysfunctional family. Some of us care about our brothers and sisters, some of us don't. Some of us like to share, some of us don't. Some of us work and play well with others, some of us don't.
We see and hear a lot about ourselves in the news these days.
It seems we are sort of confused.
We are totally for . . . no mostly against . . . wait a minute . . . we are undecided about health care. We definitely do . . . we absolutely don't . . . oh, no, hold on . . . we can wait for a public option.
Undecided? I don't think so.
Speaking for myself and most of the other people who share my surname, I'm pretty damn sure I know what I think and what I want. I think it is a travesty that people are suffering and dying every day as a result of lack of access to affordable health care. I think it is outrageous that politicians on both sides of the aisle are engaging in re-election calculus instead of acting on my family's behalf.
Confused? I don't think so.
I know what I want. I want change. I want what we were promised when we voted last year. I want health care reform and I want my family and I to be able to live in a civil and compassionate community.
Uncertain about a public option? Nope.
A public option. Think about it. The public part, that's you and me and everyone you know. The option part, that's well . .. not optional. It's essential. Let the insurance companies compete against a non-profit public option and may the best plan win.
My name is Jane Q Public and I approved this message because lives depend on it.

If the bra fits . . .

The word 'breast' is powerful in our culture. It conjures up images of all sorts -- from the maternal to the sensuous, the artistry of the great masters to the distorted visions of pornographers, and fashion trends ranging from the demure necklines to the most revealing styles.

Used in a tweet on twitter regarding the impact of the health care reform debate on women like me who have breast cancer, it becomes strangely impotent.

Such tweets do not get 'retweeted'. They do not elicit direct replies. Fellow progressives and right wing nut jobs alike are loathe to discuss it. Decorum reigns supreme.

When I try to engage conservatives in a discussion about the direct consequences for me if health care reform is not passed, they rant and rave about socialism and government control and then they disappear. My fellow liberals either delicately avoid the subject entirely or offer private, and I'm sure sincere, best wishes and then go back to bashing Glenn Beck and others of his ilk.

The best wishes are appreciated but they are not the responses I am looking for. I want to hear conservatives tell me directly how they can oppose reforms which will save my life and the lives of countless other women. And I want progressives to get more specific also. I want them to address breast cancer and the many other diseases and conditions that kill and debillitate millions under the current health care system and to shed virtual tears. I want them to scream their outrage in capital letters and to tell me they are fighting both with me and for me.

Other stand alone tweets using the phrase 'breast cancer' can be found. Those posted by conservatives make unsubstantiated claims that more women with breast cancer will die if a health care bill with a public option is passed. Those posted by liberals make equally unsubstantiated claims to the contrary. The truth is that unless and until all women have equal access to early detection and prompt treatment, women will continue to die of this disease. And the bigger truth, the elephant in the room, is that without a public option, the women who die will continue to be disproportionately poor and non-caucasian. Another truth rarely discussed on twitter is the fact that even women like me, who have insurance and who have had the benefit of early detection and prompt treatment may die if pre-existing condition clauses and caps on coverage are allowed to continue.

But after making the painful decision to 'go public' and tweet about my breast cancer as an object lesson in why we need health care reform I have been surprised and disappointed by the muted response.

The only noticeable impact my tweets have had have been on my list of followers. A couple of legitimate cancer support group type sites, a plethora of cancer cure peddlers, and my personal favorite, an online purveyor of bras guaranteed to fit.

Guaranteed to fit? Really? Even after my upcoming bilateral mastectomy and during the year long reconstruction process? Really? Maybe I should put their promise to the test and then when they fail to deliver I can rant and rave about that. Maybe that will get more of a response.

In the meanwhile, as a consequence of the weight loss that accompanies battling cancer, I have very little need of a new bra.

And soon, I won't need one at all.

For awhile.

But when I do, I guess I know where to go find one that fits.