Everything You Want to Know About Andrew Yang & the Forward Party
*But the Pundits, Politicians and Parties Hope You Won’t Ask
A Virtual Discussion Hosted by Politics for the People and Open Primaries
Wednesday, January 12th at 3pm EDT
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By Frank Fear
January 10, 2022

“I feel more…independent,” Andrew Yang wrote in his blog recently, announcing that he was leaving the Democratic Party. In a crisply written piece entitled “Breaking Up with the Democratic Party,” Yang declared, “I believe I can reach people who are outside the system more effectively. Making partisan arguments—particularly expressing what I often see as performative sentiment—is sometimes uncomfortable for me. I often think, ‘Okay, what can we actually do to solve the problem?’ I’m pretty sure there are others who feel the same way I do.”

To understand more about Yang’s substantive trajectory, I picked up a copy of his new book, Forward: Notes on the Future of our Democracy (New York: Crown, 2021). I found it to be an excellent read, especially for Progressives. Here is why.

“Yang calls out the political system for what it does—a great job serving ‘The Establishment,’ including myriad professionals who work in supporting fields, professions, and sectors.“

First, Yang calls out the political system for what it does—a great job serving ‘The Establishment,’ including myriad professionals who work in supporting fields, professions, and sectors. Second, Yang addresses a trifecta of political issues–electoral, institutional, and public policy reform—and does so carefully by describing why things got off the rails and how we can make things right. Third, Andrew Yang tells the truth about the corporatized, 24-hour (not) ‘news’ networks. Yang makes fact-based assertions and personalizes his critique by drawing on his experience as a presidential candidate. Finally, Yang writes about party politics with clarity and honesty. His is not just another homily on “What’s wrong with those Republicans?” Democrats are not off the hook. That is because parties—irrespective of stripes—suffer from self-aggrandizing, inside-the-tent, salvo-throwing behaviors. They are parties after all.

I found Forward to be a powerful book written by somebody who does not fit the conventional political profile. Of that, I am thankful. However, I do not get why Yang’s practical response (the subject of the book’s last chapter) involves establishing a new political party—The Freedom Party. I can live with that outcome if it happens; I support about any initiative designed to shake up the system. But it was not the chapter on the Freedom Party that captured my attention; it is what came before. Here are four examples of what I mean.

First, I applaud Yang’s emphasis on open primaries and ranked-choice voting—two methods to reduce, if not eliminate, the party-centered approach that has American politics in a stranglehold.

Second, I like Yang’s focus on setting goals and tracking progress on matters that affect people (e.g., reducing the percent living in poverty, the infant mortality rate). Organizations everywhere set goals and measure progress, but it is not the way we do business in American government. Because we do not, the U.S. does not have targets to achieve—as it did in the 1960s with the quest to go to the Moon. And not having national goals is a significant reason the U.S. looks terrible in international rankings. With nothing to shoot for, we wander. The U.S. ranks #28 in the most recent edition of the Social Progress Initiative, an embarrassing and unnecessary outcome.

Third, I support Yang’s emphasis on human-centered capitalism. His proposal for Universal Basic Income could be implemented quickly and efficiently—just as were the Subsidy Checks—without people having to meet a list of qualification standards. Just allocate funds to improve lives and advance the economy. Doing so would also contemporize the concept of Social Security. I also like his take on how we measure the economy currently—that it needs to change, from tracking Gross National Product and the stock market, to focusing on measuring impacts on human well-being.

Fourth, I applaud Yang’s emphasis on public policy reforms, three reforms in particular. It is time to replace the concept of employer-offered health benefits (an approach that became widespread following WW II) with single-payer health care. Access to health care is a public right. We also need to re-establish The Fairness Doctrine, which the Reagan Administration repealed in 1987. Otherwise, the public will continue to be fed ‘spin,’ and fair and balanced news coverage will continue to be at risk. It is also time to reform the tax code and end the ‘elite charade’ Anand Giridharadas writes about in Winners Take All. Monied elites need to contribute their fair share to the commonwealth rather than picking charities they deem worthy and then getting tax credits in exchange. Finally, it is time to modernize the Communications Decency Act of 1996, Section 230 in particular. Corporatized social media platforms, like Facebook, should be held legally responsible for content published on their platforms. Today—with an Act passed nearly 30 years ago—they are not.

Having highlighted things I value in Yang’s book, what do I think about the concept of the Freedom Party? There is a better alternative. I’d like to see a politically unaffiliated Andrew Yang join forces with organizations that function in the Independent political sphere, Open Primaries and IndependentVoting.org, among other groups. Establishing a national coalition with Yang as the public face of an Independent political movement appeals to me. Here is why.

If we are truly serious about transforming America’s political system, let us do it by taking an unwavering voter-centered, candidate-driven, and party-less approach. Besides, it avoids a common trap associated with making any type of transformational/extraordinary change possible, that is, relying on a conventional means (a new political party in this instance) to produce out-of-the-box outcomes. It is the new wine in old bottles syndrome. In politics, it will not be a matter of whether—just when—problematic features of party organization take hold.

That said, it is an easy trap in which to fall. Transformational thinking focuses all too often on what we seek to accomplish and not equivalently (as it should) on how we propose to make transformation a reality. Really smart people think that they can overcome past issues—even issues they readily acknowledge—because (this time) they will build a better mousetrap. It is still a mousetrap, though, with the same problematic features, including (in this case) the structures, processes, and culture of party organization. Yang acknowledges as much when he writes: “Putting people—however well-intentioned—into a corruptive system of personal and political incentives produces nothing but dysfunction and disillusionment.” (p. xxvi)

He is right. Parties are a problem. Any party. Any time. The party option is unnecessary, too. I believe America is ready for a party-less approach to electoral reform, human-centered capitalism, and effective/modern government. I also believe that a good share of America’s Independents (consistently self-identified in Gallup tracking polls as between 40-50% of voters)—as well as a fair number of party affiliates—will be drawn to those outcomes, especially if they are articulated by a charismatic, intelligent, and authentic spokesperson like Andrew Yang.

“The time to build anew is now,” Yang writes (p. 296). “Change won’t come easily. We are going to need to fight for it.” He is right. And I am in.

Frank A. Fear is professor emeritus, Michigan State University, where he served as a faculty member for thirty years and worked in various administrative positions for nearly twenty years. Frank also writes about issues that intersect sport and society.

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Reader’s Forum — Al Bell

July 28, 2021

cathylstewart

3 Comments

2034: A Novel of the Next World War

A Review by Al Bell

“It is possible to read this book in increments as time permits. However, by the time you get to page 234 or so, good luck on that pace. I put the world on hold at that point and finished the book in one sitting.

Then I sat and thought for a very long time. That is the clue that I had just read something of considerable importance. It forced me to clarify what I had thought I understood.

As a novel, this is an attention grabbing tale of war. As a wake-up call, it is a world-class messenger.”

Let’s begin at the beginning. All the books we read and discuss together in our book club have to do with sustaining and improving the Great American Experiment. Like all experiments, it is vulnerable to influences we can control and those we can’t. It has been, and will always be, subject to threats small and large, internal and external. 2034: A Novel of the Next World War clearly fits into the “large” category. What we do because of it will have to match the gravity of the theme—or so the authors would hope.

If my genes permit, I will wake up on my 100th birthday to the terrifying world created by Admiral Stavridis and Mr. Ackerman. I’d rather not. Neither would they. So they use their imaginations to get our attention. Why? To engage enough minds about the possibility they describe that we might devote our energies to shaping a better path while that’s still an option.

At least, that is what I glean from the (hopefully fictional) narrative in 2034. I owe whoever reads this review a few disclosures, as well as admitting the perspectives that drive my observations. You can read them at the end of my review if you wish.

A major impact on my reaction to 2034 is provided by one of my heroes, the author and brilliant (my view) analyst, Andrew Bacevich. I was reading his latest book, After the Apocalypse: America’s Role in a World Transformed, when I began 2034—which surely counts as a world transformed, alright. I alternated between them until finishing 2034 first. I urge readers of 2034 to also read the Bacevich book. In fact, for any reader who wants to think further about avoiding the 2034 option, Bacevich offers some challenging ideas to shape an agenda for a new calibre of leaders that we need to elect. Sounds like a job for Independents, doesn’t it?

Both books deserve to be read by anyone honestly interested in the fate of the world generally and the United States specifically. They offer thoughtful insights insulated from the noise defining what passes for information on our breathless news sources: the internet in its various guises, television, and even a large proportion of printed news media. Thoughtful matters.

It is possible to read this book in increments as time permits. However, by the time you get to page 234 or so, good luck on that pace. I put the world on hold at that point and finished the book in one sitting.

Then I sat and thought for a very long time. That is the clue that I had just read something of considerable importance. It forced me to clarify what I had thought I understood.

As a novel, this is an attention grabbing tale of war. As a wake-up call, it is a world-class messenger.

A definition of terms is probably in order. Merriam Webster defines war as:
1) a state of usually open and declared armed hostile conflict between states or nations;
2) a period of such armed conflict.
Von Clausewitz, the renowned military theorist, described war as “politics by other means.”

I see it differently. Webster is too general to be useful. Von Clausewitz is talking about how war is used, not what it is. I offer this definition instead:

War is institutionally sponsored and conducted mass murder.

Why, when and how it is used varies considerably in scope, timing, duration, and intensity. “Institutions” can include nations, tribes, political states, religious communities, insurgent movements, confederations, or even privately structured forces (e.g., mafia). Defining it otherwise is like defining guns as devices for target practice.

The war described in 2034 requires no declaration. It requires only action and deceit, including self-deceit. This should come as no surprise. The combination occurs globally and has been for some time. The book reminds us of the price we could readily pay for such behavior.

We currently experience considerable—and appropriate—angst about the state of affairs globally and, certainly, within the United States. The authors of 2034 deliberately use a hypothetical extension of contemporary incompetence and myopia to devise a plausible (if not likely) catastrophe only thirteen years into the future.The priceless public service they offer is not to predict the future (they explicitly do not), but to stretch our imaginations so enough people to make a difference will be motivated to lean on the curve of history toward a different trajectory. There is no way that will be easy. And it will take way more than thirteen years.

The re-orientation of our Nation’s global role entails, among other things, seriously overhauling the nature of our military/congressional/industrial complex, partially described by President Eisenhower in his 1961 Farewell Address, and its heavy hand on our highly stressed public treasury. Push-back will be immense because vested interests are ubiquitous and deeply entrenched. So, we are way behind the curve. Still, getting seriously started is better than sleepwalking and is demanded by any true sense of patriotism. This is a multi-generational endeavor, as is the case for every serious issue we have ever confronted. Only this one is compounded by several parallel complications, not the least of which is the deterioration of America’s capability for self-governance, courtesy of toxic political party dysphoria and general civic ignorance on a massive scale.

A major requirement for any progress toward a better direction is to elect a different breed of decision makers to federal and state leadership positions. Absent that, reflection on how to deflect our path toward destruction with enough depth to implement an alternative is highly unlikely and may be impossible. Our organization’s focus on voting rights clearly applies.

One way to imagine the magnitude of public awareness shift that faces us is to contemplate our current coronavirus disconnect, in which the killing of over 600,000 Americans can’t even get us to the halfway mark of personal commitment to take preventative action—yet. That’s half the number of all Americans who have died in all of our wars. This is civic irresponsibility taken to the extreme. Had such a mentality prevailed in the generation before mine, we would be speaking German east of the Mississippi and Japanese west of it. Dialing back the level of excess spending on our war machine is a heavy lift almost as unimaginable as the nuclear game of chicken outlined in the novel.

We have been told that our failure to anticipate 9/11 was, at base, a failure of imagination. 2034 no longer lets us off the hook for a similar failure on a vastly magnified scale, with horrific outcomes to match. It might just behoove us to overcome our pervasive inattention. Or, more precisely, our inclination to devote attention to what doesn’t matter much and that, more often than not, is not our business anyway. Priorities do matter.

Self-interest and true belief in the Idea of America demand a reading of 2034. Such a commitment would properly be considered an act of patriotism. Becoming motivated to do something because of the images it portrays would be an act of survival.

DISCLOSURES

“In an earlier life, I was a Navy pilot. Our squadron’s primary function was anti-submarine warfare. I was also qualified to deliver nuclear weapons. Had I been ordered to do so, I would have. Several incidents involving Hiroshima, Japan during our deployment in 1959, changed my life. They inspired a fifty year exploration of the Nuclear Age and its impacts on civilization.”

This had nothing to do with any other part of my life. Twelve years ago, I donated over 9,000 items—books, periodicals, special reports—on the subject to the State of New Mexico Historical Library in Santa Fe, New Mexico. They call it the Al Bell Nuclear Age Collection. I mention this, not to assert that I am an expert on the subject (I am not), but, rather, to simply declare that the potential for nuclear war is an idea I have lived with for most of my life.

Just a mental aside: having experienced all of this, would I still follow that order? That’s a discussion for another day. The answer is anything but simple. Easy judgements do not apply.

This sequence of events convinced me that our relationships with the rest of the world and our own self-image had evolved in some unfortunate and increasingly damaging ways. This pattern has cost us and many others dearly. Here’s my conclusion.

The only way the United States can sustain a positive influence on global affairs as well as increase its potential as a democratic republic that does justice to “the Great American Experiment,” is to demonstrate that we are continually getting better at that experiment. Not enough Americans actively believe that. It is instructive that, according to many important metrics, the United States now punches far below its weight in comparison to other nations.

We will not get there primarily with military might. We will not do it by pretending that we rule the world and—even worse—are the sole nation deserving that role. We cannot continue to get away with fooling ourselves nor the world at large. We have been coasting on our undeniably deserving World War II reputation far too long and the world has noticed. Leading by example is the ultimate form of persuasion. Leading by arrogance and intimidation is self-destructive.

These are not really my ideas; they are gleaned from decades of messages delivered by numerous men and women far superior to me in their knowledge, wisdom, and dedication to the service of our Nation. People with a profound grasp of “the Idea of America” and a clear understanding of the demands that places on us, individually and collectively.

Lest there be any misunderstanding, my view does not embrace the notion that we can do without a strong military capability, any more than our society can get along without police departments. In both cases, however, clarity of purpose, informed scope, responsible behavior, and focused funding are essential. This reflects a life-long aversion to either/or thinking and embrace of a both/and perspective. Yes, there are either/or choices (e.g., whether or not to jump out of the way of an oncoming truck), but they rarely apply to complex situations.

We have been here before and recovered, for the most part. However, the powerful leverage of modern technologies on excess weaponry, mis-communication, information distortion, economic manipulation, gross financial usury, governmental ineptitude, and plain despotism on the part of small leaders in large positions, create an unprecedented vulnerability to Malcolm Gladwell’s “Tipping Point.” We may not recognize when we have already passed it or, realizing it after the fact, be incapable of reversing direction.

I suspect that most of us are victims of some form of confirmation bias: seeking information that reinforces what we already think we know. The only antidote I know is to force open our minds by learning and listening. One of the most powerful is reading; listening to authors who have invested the time and made the effort to think deeply, share perspectives that challenge our biases, open our eyes to new perspectives, and force us to be more honest with ourselves. And then do something. Informed action is what brings improvement. Learning without doing, especially on pivotal matters, is just another form of serial self-indulgence.

It turns out that continuous learning and relentless engagement are essential, though far from painless.

That concludes my disclosures. For now.

Al Bell lives in Peoria, AZ and is an activist with Independent Voters for Arizona. Al served on Independent Voting’s Eyes on 2020 National Cabinet, working to get the 2020 presidential primaries open to independents across the country.

***

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Reader’s Forum — Dr. Jessie Fields

July 26, 2019

cathylstewart

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Politics for the People

Conference Call

Let All Voters Vote: Independents and the Expansion of Voting Rights in the United States

With Authors Jeremy Gruber, Michael A. Hardy, & Harry Kresky

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Reader’s Forum — Jennifer Bullock

July 16, 2019

cathylstewart

Reader’s Forum — Maureen Albanese and Helen Abel

November 30, 2018

cathylstewart

1 Comment

Maureen Albanese

Elizabeth Rosenthal lays out in clear language why our healthcare system got in this sorry state and what we can do to help ourselves get better and cheaper care — but that is not enough. We must also start electing politicians who will get us to a better healthcare system. Healthcare should be a right — not a privilege as it is now. We need to organize our fellow Americans around this issue as we are all but one illness away from homelessness. This book will be a great conversation starter, but more people need to read it and work together to get the system we deserve.

We can look to France, which has the best healthcare in the world, to help us formulate a better healthcare system. This healthcare system is not sustainable and until a major overhaul is done America itself will be bankrupt.

Maureen Albanese is an administrative assistant and activist. She lives in Manhattan.

Helen Abel

I found An American Sickness a provocative look at the health care industry and how big profits have been substituted for humane patient care. Elisabeth goes into great detail about how this has happened and definitely makes a case for the Canadian or Great Britain models of health care. She also gives tips on how to find out how your hospital rates nationally, where to get drugs more cheaply, and a host of other information. A good go-to also if you are dealing with a difficult medical situation.

Helen Abel is a Life performance coach and political activist.

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Politics for the People

Conference Call

An American Sickness

With Author Elisabeth Rosenthal

Sunday, Dec. 2nd at 7 pm EST.

Call in number: 641-715-3605

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Reader’s Forum — PJ Steiner, Steve Guarin, and Jessica Marta

November 28, 2018

cathylstewart

PJ Steiner

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back was recommended to Politics for the People by PJ Steiner. Read on to see PJ’s response to Elisabeth Rosenthal’s book.

I initially heard about An American Sickness by Elisabeth Rosenthal while listening to an NPR interview with Terry Gross. Dr. Rosenthal was incredibly well versed on what the challenges in our healthcare “system” really are and how those challenges came to be. She absolutely wowed me with her excellent communication skills and journalistic chops.

But unfortunately, I became immediately worried about my own, and my children’s, healthcare future. As a Dad of two awesome autistic children, I worry about how they will be cared for throughout their life. I worry even more because our healthcare system (like public education) doesn’t really want to help them as much as it wants to profit from them.

Now that I’ve had a chance to read Dr. Rosenthal’s book, I feel the true immensity of the amoral “healthcare industrial complex” we have in this country. But I also feel some hope. There are a lot of tools and advice to be had to help the regular American fight their way to better care at a more reasonable cost.

Pick this book up. You’ll be glad you did.

PJ Steiner is the Vice President of The Utah League of Independent Voters.

Steve Guarin

20161005_awards_014 — Steve Guarin (r) being presented with a 2016 Anti-Corruption Award by Juliana Francisco

If you want to learn why your wallet is getting lighter and your purse is becoming empty, read An American Sickness by Elisabeth Rosenthal. She lists and explains all the many ways medical care robs your billfold. They will even charge you for things you didn’t use. People have called the billing predatory, which is an outrageous situation to be put in by the people and organizations that are supposed to be helping you.

The subtitle of the story is, “How Health Care Became Big Business and How You Can Take It Back.” In a small part of the book I felt as if she was talking directly at me, the Compliant Patient. Up until I read this book I strived to be a compliant patient. I thought these were the people trying to make me better, but I have learned that is not true. Your family doctor is under a lot of pressure to make use of the expensive facilities of the hospital or medical group that employs him. One type of lab-test which we all get is the simple blood test. It behooves you to ask your doctor to use one of the commercial laboratories, i.e. Quest or LabCorp. It will be exactly the same test but the results from a hospital can be priced one hundred times higher.

Read this book and you will learn how medical care became a rapacious big business. More importantly, the author will teach you to be a Non-Compliant patient, and save some money.

Steve Guarin lives in the Bronx. He is retired and an activist with the New York City Independence Clubs.

Jessica Marta

Marta

As a health-care provider, I’m familiar with many of the issues that Ms. Rosenthal is talking about in An American Sickness. All the unscrupulous things Ms. Rosenthal mentions, particularly price-fixing by pharmaceutical companies, are happening every day.

Is single payer health-care the solution? I don’t know. The single-payer idea has been around since the ’50s. Back then the American Medical Association shot it down by hiring Ronald Reagan to do TV ads telling the American public that single-payer health-care would take away our Freedom of Choice.

If not single-payer, then why couldn’t the government set limits or standards on the price of drugs or medical procedures? Because our government still caters to powerful special interests.

As long as we live under the current paradigm, that making money is the supreme good, poor people won’t have access to good care and middle-class people who can’t afford to pay for their own health insurance will go bankrupt after paying for long-term treatment. But we just see these as consequences for “others” and hope we are never in those situations.

I feel that patients are not the only casualties of our dysfunctional system. There are many providers who go out of their way for patients, jump through bureaucratic hoops to get care, but these folks can get very weary. I don’t know what the answer is, except a shift in political power on behalf of the interests of ordinary people.

Jessica Marta is an independent activist with Independent Voting and the New York City Independence Clubs. She lives in Manhattan and is an Adult Psychiatric Nurse Practitioner.

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THIS SUNDAY

Politics for the People

Conference Call

An American Sickness

With Author Elisabeth Rosenthal

Sunday, Dec. 2nd at 7 pm EST.

Call in number: 641-715-3605

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Reader’s Forum — Al Bell

November 27, 2018

cathylstewart

1 Comment

**A Commentary on An American Sickness: How Healthcare Became Big Business and How You Can Take it Back by Elisabeth Rosenthal**

My first question to any elected official I contact about health care legislation (and I will) will be: “Have you read Elisabeth Rosenthal’s book, An American Sickness?”

If the answer is yes, my second question will be: “How have her ideas been incorporated in health care legislation you will sponsor or support?” You can probably imagine the course of the ensuing conversation.

If the answer is no, my second question will be: “Why not?” If the answer is, “I haven’t heard of that book,” or any pathetic derivatives of that answer, I will proceed as follows.

“Here is why you should buy it and read it. Elisabeth presents a comprehensive picture of why and how the medical industrial complex in America mistreats patients, the people we used to believe were the beneficiaries of what we used to think of as our health care system. Patients: that is us. She reveals why and how the complex focuses on profit and not health; why it is a cartel and not a system. She goes on to offer advice on how to work around the obstacles to effective health care despite the non-system by providing information on important sources of aid. She closes by explaining what needs to happen to reclaim a responsive health care system from the piranhas that now call the shots. She reminds us that we have a cadre of superb medical professionals, some of whom have become complicit in this disaster, but most of whom ache to carry out their role as healers and menders to those in need.”

“If you are not willing to read it yourself, then assign it to one of your brightest staff members and insist that she/he communicate with Elisabeth before getting back to you with recommendations on how to proceed. Then contact me and let me know what you intend to do, when you intend to do it, and who else you have joined forces with to make it happen. I especially want to know the names of any in the latter category who are not members of your political party.”

While it may be generally agreed that health care has become a major, if not the major, current concern of Americans, it is also self-evident that the medical industrial complex has shanghaied our political world and inoculated it against any conceivable common sense fix. The same force that is necessary to rescue our dysfunctional federal governance miasma from itself is the one that will turn health care around as well: we the people.

We the people need a tool for opening doors, slamming inattention to the floor, and prying open windows to an approach that will actually work. Elisabeth Rosenthal has given us the pry-bar; it is now up to us to wield it.

Elisabeth is not asking the doctors, specialists, technicians, hospitals, pharmacists, pharmaceutical companies, and others to sacrifice reasonable income and profit. She is making the case that extortion in those areas is not legitimate, especially when we pay with not only our money, but our health outcomes as well.

A message to my 60-some active contacts and my elected (some newly) officials in Arizona urging them to read and act on An American Sickness will go out this week.

Oh, one more thing. Thank you, Elisabeth, for the immense public service you have performed in crafting this report to the American people. Bravo, indeed!

Al Bell lives in Peoria, AZ and is an activist with Independent Voters for Arizona.

*******

Politics for the People

Conference Call

An American Sickness

With Author Elisabeth Rosenthal

Sunday, Dec. 2nd at 7 pm EST.

Call in number: 641-715-3605

Passcode 767775#

*******

Reader’s Forum — Susan Massad

November 26, 2018November 27, 2018

cathylstewart

2 Comments

A Review of An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

I am a consumer of health care, a practitioner and educator in general internal medicine for over fifty years, and a lifelong advocate for health care reform–single payer, a national health care service, and health care for all. In college, my sophomore term paper was a history of the AMA’s role in defeating Truman’s proposal for a national health service for America.

Critiques of the American medical system have been with us for decades but more recently, as our system becomes more and more dysfunctional, the level and volume of critique has accelerated. The system is too big, too bureaucratic, user-unfriendly, exploitative, bad for our health, inaccessible, and too costly. These are some of the recurring themes that one encounters in the explosion of commentary in books, articles, political polls and in my favorites, television shows, such as New Amsterdam, and the Resident, that are chronicling the faults in our system that make it so impenetrable to both consumers and practitioners.

I was an avid reader of this literature until there were just too many articles and books to keep up with. I am grateful that I was introduced to Elisabeth Rosenthal’s An American Sickness through Politics for the People as I might have dismissed it as just another critique that I already knew what it was going to say. Even for the jaded and cynical, Rosenthal grabs your attention. I was totally engaged with the first part of the book, How Health Care Became Big Business. She brings her talents and experience as a doctor, social critic, and journalist to her writing, producing a devastating analysis of how the patient, aka the consumer, is caught in a web of confounding business operations designed to maximally exploit them and their illnesses. The book is filled with clinical vignettes that are case studies in patient exploitation, such as the shell game of adding expensive testing, medical equipment and ancillary services to the hospital bill, the charging for the extra anesthesiologist, the moving of procedures to ancillary sites where extra facility fees can be collected as providers form LLCs to increase profit. It is the patient who is left alone with the financial impact of an unregulated drug market, lack of transparency in anticipating hospital and procedure costs, and an insurance market that simply passes on the costs of this exploitative care to the consumer in the form of higher and higher premiums.

Coming away from the book one is left with a strong sense of outrage, and a much better grasp of the complexities and deceptions of the system. I have been in treatment for breast cancer for over six years and continue to be confounded by my monthly bills that quote the charge for the service as one amount, the amount the plan pays as another and the copay as another inexplicable amount and none of it adds up. Rosenthal gives us some way of understanding how these unfathomable charges have landed on our health care bills.

I was somewhat disappointed in the second half of the book “How you can take it back.” Rosenthal provides some invaluable tools in the form of apps and sources of information and organizations that support us to become more astute consumers of health care as we shop around for the best hospitals, compare drug prices, and question the charges on our hospital bills. She exhorts us to speak up and push back; something that is not so easy to do as individual operators in a system so big and opaque as ours.

What I found most lacking was some recognition of how politicized our health care system is. The three-trillion-dollar American medical machine did not just happen to become the profit center for insurers, hospitals, doctors, manufacturers, politicians, regulators, charities, banks, real estate, and tech—or any of the many other entities that have no connection to health or health care. Much of this giveaway was accomplished through the compliance of our representatives, who vote on the legislation that has facilitated the turnover of medical care to private industry. Medicare and Medicaid were established in 1965 under Lyndon Johnson, a master of the deal. Steven Brills’s book, America’s Bitter Pill, is the sad story of the making of the Affordable Care Act, a political-mash up of deal-making and trade-offs that is the best that our partisan and divided Congress could offer the American people. I am not critical of Rosenthal for not including an analysis of the politics of health care in America in the book, and I would have liked to have some recognition of what we are being asked to push back against in challenging big business health care. I have learned in my many years as a health care activist that I could not impact the flawed nature of our health care system without engaging in changing the way politics is conducted in our country. Health care reform, like educational reform and other major reforms, is not a single-issue item. It is embedded in everything we do.

Where does one look for hope, a way out of this mass of corruption and deception that health care in the US has become? For me, one has to get out of the system and look elsewhere to a number of grassroots, community-based, and patient-initiated efforts to take control of their own health care. A few examples of this are: Patient run self help organizations such as SHARE that provide support, education and empowerment to women affected by breast or ovarian cancer; Gilda’s Club, a community organization for people with cancer, their families and friends; Project Open Notes, an international movement advocating change in the way visit notes are managed by providing access to patient and families of their medical records; The Maven Project that is leveraging medical school alumni to connect experienced volunteer physicians with safety net clinics across the US to augment and meet unmet health care needs in underserved and uninsured patient populations; The Beryl Institute, a global community of practice dedicated to improving the patient experience through collaboration and shared knowledge, as well as my own efforts to help patients to self-organize health teams that perform as collective, social units for health and healing that is amplifying the patient’s voice in taking control of their own health care.

In An American Sickness Rosenthal eloquently chronicles how dreadfully sick our health care system is. It made me think about the advice that All Stars Project and East Side Institute founder Fred Newman gave at the Performing the World conference in 2007. In speaking about the despair and chaos of our world, Newman says, “We have to perform the world again—and we are all involved in this—because this one stinks.”

I take this to mean that if we are going to create our way out of the three-trillion-dollar morass that health care in the US has become, it is we the people who will have to do it.

Susan Massad is a retired primary care physician educator who is on the faculty of the East Side Institute where she leads workshops/conversations exploring what it means for people to grow and develop in the face of serious illness, aging or memory loss. Susan is a long time independent activist with Independent Voting.

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Reader’s Forum — Steve Richardson

November 20, 2018November 20, 2018

cathylstewart

2 Comments

We Need a Game-Changer

boston 0614 If there is any issue that should unite our divided nation, it’s health care. Mortality limits every one of us; even those blessed with good genes and good habits are one accident away from dependency. And we all have relationships that change quickly – or cease to exist – if either party is seriously ill. Most of us spend an enormous amount of money on health insurance – or earn what our employer pays for it. Instead of appealing to our interest, the industry and our own Congress have taken advantage of us.

Dr. Rosenthal pulls no punches in applying her medical knowledge and journalism experience to exposing the collusion among health care providers, insurers, and politicians that has us in such an unenviable financial and moral predicament. As an economist, I was impressed with her “Economic Rules of the Dysfunctional Medical Market,” which are carefully linked to examples that I could easily relate to as a consumer. And I especially appreciated her documentation in Part I of how we got here (“The Age of” Insurance, Hospitals, Physicians, Pharmaceuticals, etc.). What comes across quite clearly is that it is indeed a systemic problem. As she notes in the Introduction, the rules that govern delivery of health care in the US are no accident, and it’s up to us to change those rules.

Of course, we’re a few Davids taking on many Goliaths. So in Part II, Dr. Rosenthal provides thoughtful measures for personal and political action to incrementally address the dysfunctional relationships we have with insurance companies and providers. Each is worth considering and sure to benefit some of us, and taken together, they are a good start toward reform. However, I don’t think we’ll see real change unless we amputate the “invisible hand” on the till that she refers to in the Introduction. The Affordable Care Act was stillborn because the health care industry made sure it posed no real threat to their market power. In my view, we will never win control of our own health care by working within a system designed and controlled by special interests. We need something radical like single-payer, but I would prefer something that restores a free market – like eliminating tax deduction of health insurance premiums by employers and making all health care expenses (premiums and out-of-pocket) deductible for individuals. That’s not a new idea and it’s not the only solution, but it would be a game-changer.

Steve Richardson is a founding member of the Virginia Independent Voters Association and serves on IndependentVoting.org’s national Election Reform Committee.

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Reader’s Forum — Jennifer Bullock

November 19, 2018November 27, 2018

cathylstewart

1 Comment

Healthcare as a Social Activity

Thank you, Elizabeth Rosenthal for An American Sickness: How Healthcare Became Big Business and How You Can Take it Back.

It is a sobering and useful breakdown of what has happened with our healthcare industry in the last several decades. I so appreciate your helpful and insightful outline for how we can ‘take back’ this for-profit machine and put human healthcare and cost-savings into action.

As a progressive psychotherapist practicing a group therapy approach called Social Therapy, we work outside of the medical/insurance/ healthcare industry as independent collaborators with clients and communities. I work to help clients exercise our collective power to live a more humane, less alienated life together. From that perspective, I wonder what you think about an added recommendation to how to take back our healthcare: Do our healthcare socially, collectively, in teams, in partnership with our support networks. I often invite clients to take a friend to a medical appointment, have a friend on hand when doing the fun activity of calling an insurance company to clarify a bill or ask for coverage, and have a support ‘health team’ when admitted to a hospital to help navigate medical care, billing, treatment direction. It seems to me our collective power needs to be exercised against the monstrosity of big business industries, and especially so when it comes to a vulnerable area of life called our health care.

Jennifer Bullock is the Director of Independent Pennsylvanians and a social therapist in Philadelphia.

april2018 antigunrally philly 3 — *Jennifer Bullock gathering signatures in Philadelphia.*

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An American Sickness: How Healthcare Became Big Business and How You Can Take It Back was recommended to Politics for the People by PJ Steiner. Read on to see PJ’s response to Elisabeth Rosenthal’s book.

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**A Commentary on An American Sickness: How Healthcare Became Big Business and How You Can Take it Back by Elisabeth Rosenthal**

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