Thoughts on Race and Racism

W.J. Astore

I’d like to say I don’t see race or color or ethnicity and so on, but of course I do. We all do, once we’re alerted to it. Racism exists in our society, and in fact I’ve been an instrument of racism myself.

At my first job, when I was about seventeen, a Black man came into the shop where I worked. He was looking for an apartment to rent (there were rental apartments above the shop). He asked me to check on a listing he’d seen. I left the counter and asked the boss in back. The boss peeked out and saw who it was — that is, the color he was — and told me to tell him the apartment had been rented. I did so, and the Black guy looked at me and said, “I just called a few minutes ago and was told you had an apartment.”

I felt ashamed and used; the boss later told me he’d rented apartments to “them” before and had had trouble. The Black guy I’d talked to was the epitome of class; he just shook his head at me and walked out. I think he understood, from my apology (“Sorry — my boss told me it’s been rented”), that I was merely a messenger boy, an instrument of another person’s racism.

Three other small episodes from my high school years. I recall a race riot in my high school (there were about 6000 students at my school), and I remember one of my white friends told me he’d talked to one of his Black friends who’d said, “I’m not your friend today,” during the riot. Second, I recall a friend (white) who got into a fight with a Black kid in school, after which he told me one of the white teachers had complimented him. (Imagine a teacher complimenting a student for fighting simply because the student had punched a Black kid.) Finally, I remember taking a school bus that I didn’t normally take. I tried to sit next to a Black kid and he told me I couldn’t sit there. This was repeated again until a Black girl told me to come sit next to her.

The shock of being told I couldn’t sit next to another student because of the color of my skin stayed with me. I have no resentment against the kids who said it; indeed, it made me realize, in a small way, the prejudice these kids faced every day from white America. I gained a little empathy that day.

All this is on my mind due to this remarkable interview between Daryl Davis and Jimmy Dore, which is frank and moving in its discussion of racism and some of the ways we can fight against it and overcome it in America. I welcome your thoughts and comments on this.

Medicare for All: Force the Vote

It’s time! Commonwealth for the common health. Medicare for All!

W.J. Astore

The comedian and activist Jimmy Dore has inspired a movement for a vote in the House on Medicare for All early in January 2021. (Here’s Jimmy Dore talking to Cornel West on this issue.) Go to forcethevote.org and sign the petition to put pressure on Progressive Democrats to withhold their vote for Nancy Pelosi for Speaker unless she brings Medicare for All (M4A) to the floor of the House for a vote. If not now, during a global pandemic that has killed more than 300,000 Americans and caused nearly 15 million Americans to lose their employer-based health insurance, when are we going to consider M4A?

I rarely sign petitions. But my wife and I instantly signed this one. Americans supposedly live in the richest country in the world, yet we allegedly can’t afford to fund health care for everyone. It’s absurd. Not only that, it’s a crime against our common humanity. Which of you, if a friend or even a stranger came to you sick and asking for help, would seek to profit off this? Which of you, if a friend or even a stranger came to you seeking a diagnostic test to see if that lump was possibly cancerous, would seek to deny such a test as “not needed” or “not covered”?

It’s obscene that America’s health care system is based on the profit motive and the exploitation of the sick and dying. That it drives families into bankruptcy. That people sometimes die because they’re afraid to go to a doctor or the emergency room because it will cost too much.

Progressives say they want Medicare for All. A majority of registered Republicans and nearly 90% of registered Democrats say they want M4A. Why can’t Nancy Pelosi hold a vote on it? She claims to represent the people. That she even “feeds” them. Why isn’t she working to give the American people health care during a deadly pandemic that may cost as many as 600,000 Americans their lives? Is it because she doesn’t really represent us?

It’s not just about holding a “performative” vote on M4A. It’s about forcing the hand of Congress and seeing who the phonies are. Who wants to deny Americans M4A at this awful time? I’d like to know. I’m sure all Americans would like to know. And if Joe Biden is willing to veto M4A, as he’s said he will, I’d like to see that veto and his rationale for denying Americans the health care they so desperately need.

Again, if not now, when? If Progressives aren’t willing to force a vote on M4A during a deadly pandemic, when there’s deep suffering in America, when will they be willing to act?

We need to force them to act. Sign the petition, call your Member of Congress, and spread the word.

Update (12/26/20): In the comments section below, JPA made a strong argument for institutionalized corruption within America’s privatized medical system. With his permission, I’ve added his comment here so that more people will see it:

When people lump “doctors” into a homogeneous group that is a mistake because “doctors” are no more homogeneous than “cops” or “blacks” or “gays”. Most doctors want to deliver good patient care. Most of these hate the [American medical for-profit] system. However, a significant minority of doctors is quite happy with the current system and oppresses doctors who speak out against it. I work with a lot of healthcare professionals who are driven to depression or suicidal despair because they are trapped in a system which abuses them and their patients.

It is very likely that the tests ordered by the doctors who treated Maine’s brother were mandated to do so by the hospital’s electronic health record (EHR). EHR’s are mandated by law in large healthcare organizations ostensibly to improve patient care. In reality these make patient care more difficult and their real purpose is to run algorithms to determine the way to maximize the billed charges.

Doctors who work in hospitals are employees who are pressured to admit patients, do procedures, and run tests. If they don’t they can be fired, and their contracts usually contain non-compete clauses that prohibit them from working in the area. When someone has a family, and large student loan payments, then one is at the mercy of the employer. Very few people have the courage to stand up to that kind of pressure. Those who do often risk bankruptcy or divorce when the spouse realizes that they are not going to have the lifestyle they planned upon.

Or the hospital labels the physician as “disruptive” and other physicians who act as stooges for the hospital fabricate complaints that get the “disruptive” physician in trouble with their state medical board.

Here are the main things I hear from healthcare providers:

  • It is not possible to practice good medicine in the current environment
  • The pressure to meet corporate demands for revenue generation is contrary to good medical practice
  • Clinical guidelines are set by people/organizations with conflicts of interest
  • Upcoding, excessive testing, unnecessary procedures/screening/testing are expected and demanded
  • For-profit medicine does not work

Individual corruption occurs when a person behaves unethically. That is not the problem in American medicine. The problem in American medicine is institutional corruption.

1) Institutional corruption occurs when the laws, policies, and guidelines of a system are structured to enforce a set of values that is antithetical to the values the system is ethically obligated to express and uphold.

2) Health care professionals are obligated to place a higher value on patient care than on making profit.

3) The laws, policies, and guidelines of the American healthcare system are set up to prioritize making profit over providing patient care.

4) From 1, 2, and 3 above, the American medical system is institutionally corrupt.

This system is supported and maintained by a corrupt system of government. For further reading on this I recommend On Corruption in America by Sarah Cheyes.

Healthcare in America: No Pony for Us

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Wise up, America!  Only the richest little girls get ponies (Scene from “Gone with the Wind”)

W.J. Astore

The comedian and political commentator Jimmy Dore has a great sketch about Americans not getting a pony.  The “pony” in question is taxpayer-funded, single-payer health care.  Only the most naive or gullible or spoiled Americans could possibly believe they deserve such a pony — this is an argument advanced by Democratic sages like Hillary Clinton, among many others, like Nancy Pelosi.  She’s supported today by “sensible centrists” like Joe Biden and “Mayor Pete” Buttigieg, who argue that Medicare for All is wildly impractical and crazily expensive.

As my wife quipped, for “sensible centrists” and their ilk, we don’t get a pony — but we do get to pony up.

Yes, Americans get to pony up — and up — and up, in the form of high insurance costs, deductibles, co-pays, and the like.  And let’s not forget the high cost of life-giving prescriptions, such as insulin, which under our wonderful private systems have soared in price.

Those who attempt to sell Medicare for All in America, like Elizabeth Warren this weekend, are dismissed as delusional.  Take this headline at Reuters: Republicans, Democrats, ‘SNL’ attack Warren’s U.S. ‘Medicare for All’ plan.

Wow!  Everyone is against her — even liberal comedians at Saturday Night Live (SNL).  No pony for us!

Yet, as Jimmy Dore pointed out in his skit, other countries and peoples get ponies.  The Canadians do.  The British do.  The Germans.  The French.  The Italians.  The Japanese.  And so on.

Want a pony, America?  Better move to Finland.  Or Hong Kong.  Or Greece.  Or New Zealand.  Or Tara.  Because you’re not getting a “pony” here.