The spiritual side of health care

On June 14, 2009 on Face the Nation the Senate Minority Leader, Mitch McConnell (Republican, Kentucky) said to the host, Bob Schieffer, that most Republicans would oppose any plan that included government-backed health insurance. (More details about his interview can be found on a Face the Nation blog posting.)

This seems to be another case where the Republican Party stands in opposition to the spiritual foundations that guide most people in the United States. According to Rabbi Akiba, the most important teaching in the Torah is the injunction in Leviticus 19:18 to love one's neighbor as oneself. Jesus took this teaching to heart, and it became a summary of the most important teaching in Christianity. Similar teachings can be found in Buddhism, Hinduism, Islam and Confucianism. It is also found in the traditions of many North American native peoples. It would be hard to deny that in the United States, a country in which religious faith and practice is central to the lives of the majority of citizens, that tending to the needs of the sick, the poor, the weak and the downtrodden is at the very core of what most Americans profess. Why is it not at the core of the values professed by Republicans?

I can only offer an amateurish response to my own question. For as long as I can remember (which is a span of time going back to the late 1940s), Republicans have been identified as the party most concerned with fighting what they perceive as enemies of American values. In the 1950s, the principal focus of Republican concern was communism. Communism was routinely depicted as anti-Christian and atheistic. It was an easy, albeit fallacious, step from that premise to the conclusion that anything communists favor must be in some way contrary to the basis teachings of Christianity. On the principle that any friend of my enemy is my enemy, and any enemy of my enemy is my friend, anti-Communists (both Democrats and Republicans) came to see labor unions as a threat not only to the American way of life but to the core values of Christianity. Not only organizations that sought to improve the working conditions of paid workers, but organizations that sought any kind of economic justice, or any other kind of justice, came to be regarded with suspicion. People working for the abolition of racial segregation, or for international peace, or for nuclear disarmament all came to be seen as enemies of the state. People seeking racial equality or gender equality could be (and were) dismissed as Communist sympathizers seeking to undermine the core foundations of the American way of life. Those who sought to maintain the systematic injustices against which labor unions and other social activists fought, on the other hand, were depicted as the pillars of American democracy. Those who opposed racial equality and gender equality and most other forms of social justice were those who had something to lose if justice were to prevail. Those who had something to lose were the wealthy and the powerful, not only individuals who were wealthy and powerful but corporations. What they had to lose was their material wealth. And so it came to be that many Americans, in the name of standing against godless Communism, came to stand for the very forces that were least interested in fighting for the sick, the poor, the weak and the downtrodden. In the name of defending Christianity, many (perhaps even the majority) of Americans ended up supporting the principal forces working against the realization of Christian social values.

The same skewed logic that drove the anti-Communist fervor of the McCarthy era and the Cold War era continues to drive the policies favored by Senator McConnell. Rather than working tirelessly for programs that would bring affordable and efficient health-care to the millions of people who now cannot afford the artificially high prices of medical care in the United States, McConnell and his fellow Republicans work tirelessly not for the sick and the weak individuals who require compassionate care but for the powerful insurance companies and pharmaceutical companies that have made a lucrative commercial enterprise of health care and that have, in so doing, driven medical and pharmaceutical costs higher in the United States than in any industrialized nation. Americans pay far more for significantly inferior health care than do Canadians, Europeans, Japanese and Israelis. Many Americans get no health care at all, not even of the inferior kind available in the USA, because they simply cannot afford it. Many Americans who do get the health care they need face financial ruin as a result of getting the care they need. This is hardly what one would expect of a nation run according to Christian (or Buddhist or Confucian or Hindu or Islamic or Jewish) religious principles. It is what one would expect of a nation run according to callous materialistic values pursued in utter contempt of spiritual values of any kind. It would be difficult to find a more godless nation on this planet than the United States of America as it has evolved under the influence of powerful politicians claiming to operating on Christian family values.

Turning anti-spiritual nations around has traditionally been the work of prophets. Prophets are rarely loved by the generations that they seek to heal. As recently as 2004, the American Friends Service Committee, which has worked for prison reform and more justice in immigration policy and more humane policies in governmental relations with native Americans, was declared a “criminally extremist organization” by the Denver police department. Other organizations founded by Quakers and other religious communities—organizations such as the American Civil Liberties Union, Amnesty International, Greenpeace and Friends Committee on National Legislation—are under constant surveillance by the FBI and Homeland Security. Acting in accordance with the Christian principle of loving one's neighbor as oneself, and actually trying to do something to lessen one's neighbor's suffering, is regarded as criminal conduct by many of the politicians who claim most loudly to be defending the Christian heritage of this country.

It is time to call their bluff. It is time to make them ashamed of their hypocrisy. We live in a time that has been brought to ruin by those in pursuit of profits. We live in a time that can be brought back to harmony by listening to prophets.

Lest we forget

On the last Monday of May, people in the United States celebrate a holiday called Memorial Day. Originally, Memorial Day was a day set aside for remembering those who had died fighting in the Civil War. Days of remembering those who had died in that war were celebrated in various locations, and eventually there was a consolidation into a single day of remembrance. It was not until 1967 that the day was officially called Memorial Day. Until 1971 Memorial Day was celebrated on May 30. In 1971 it, along with numerous other holidays, was turned into an occasion for a long weekend, and so moved to the last Monday of May and the first long weekend of the summer.

Memorial Day appears to have been hijacked by patriots and made into a holiday for honoring people who have died in the course of military service. That is an unfortunately limited selection of the dead to honor. The day should be a time of remembering all those who have died whom one wants to make sure not to forget.

An expression that one hears often during Memorial Day with reference to those who have died in wars is the phrase “those who gave their lives for their country.” One might as well refer to people whose houses have been robbed as those who gave their property to theft. People do not give their lives. People join the military for any number of reasons—at many times in the history of the United States they were required by law to do military service—and politicians send armies into armed conflicts in which people's lives are taken, not given. Referring to a killed soldier as someone who gave his or her life to his country is a way of trying to distract everyone's attention from the ugly and tragic and unnecessary waste of life that invariably takes place in war.

Memorial Day is a time to be ashamed. It is a time to hang our heads in shame for being part of a society that sends people to their death as part of serving the selfish interests of the powerful and the unimaginative. As long as we are recognizing our shame, let us remember that war has many more victims than those who die in uniform. Everyone on the planet is in some way or another a victim of every war that takes place. Wars devour resources, destroy habitat, create shortages of food, and disrupt the natural economy in countless other ways. Not only human beings but creatures of all species suffer from the environmental degradation that takes place in wars. As Edwin Starr sang about war, “it ain't nothin' but a heart breaker, good only for the undertaker.”

It is worth remembering that war is not the only form of human incompetence that leads to suffering and death. We should also hang our heads in shame for allowing people to live in poverty, and for using products (such as computers and mobile telephones) that place strains on the environment by using energy that must be generated and by concentrating toxins that eventually return to the earth and endanger life in ways we can barely comprehend. Memorial Day is a time for not being forgetful of all the ways we contribute to death and devastation through our incessant craving for short-term comfort and convenience. It would be good if we had an entire holiday set aside for nothing but remembering that, but until such a holiday is declared for that purpose, we can use Memorial Day.

Shame is only part of life. Memorial Day is also a time to celebrate, a time to be grateful. It is a time to recall all the positive contributions made to the world through noble thoughts and noble actions. It is a time to contributions made in the past by all the peacemakers, philosophers, holy people, artists, authors, actors, painters, sculptors, music makers, scientists, engineers, philanthropists, mothers, fathers, grandparents, aunts and uncle and neighbors who have enriched our lives in obvious and in subtle ways. To forget all them while remembering only fallen military people would be tragically narrow and short-sighted.

Life is possible only through death. The dead literally provide the living with their food. On most days of the year we forget the everything that sustains our life is something that was itself at one time alive. We forget that we ourselves are food, that our bodies will eventually sustain the lives of creatures who come find ways to eat us. Memorial Day is a time to remember that, in the wonderful words of the Taittirīya Upanishad “Oh, how wonderful it is! I am food. I am food. I am food.”

I wish everyone a Memorial Day spent in fruitful reflection, a bit of shame, a lot of celebration and a recollection of our place in the food chain.

Laws in a land of outlaws

The city of Albuquerque passed a law some time ago against using a hand-held mobile telephone while driving a motorized vehicle. The intention of the law is clear enough, and the motivations behind it are a mystery to no one. Holding a steering wheel with one hand and holding a telephone up to the ear with the other hand gives a driver less control in case of an emergency, and being distracted by a telephone conversation is more likely to get one into an emergency situation than if one were devoting full attention to driving. (The Insurance Information Institute has a web site with information about cell phones and driving.)

I have not conducted a systematic or scientific investigation of the matter, but as a pedestrian walking several miles daily along busy streets, I have amused myself by making observations of how many drivers I see talking on cell phones as they turn corners, change lanes, approach intersections and perform other maneuvers that require a combination of paying attention and keeping a vehicle under control. I have seen drivers hurtle through red lights, apparently unaware that they did not have the right of way. I have seen truckers negotiating a tractor-trailer through a left turn using one hand on the wheel and one hand to the ear. I have seen motorcyclists holding a cell phone to an ear as they drive; since wearing a helmet would interfere with talking on the telephone, they wear nothing to protect their heads in the event of a crash or a spill. I have seen drivers holding to the wheel with the little fingers of both hands while the rest of their two hands were holding a telephone as their thumbs poked keys to dial a number or send a text message.

While looking at people driving while using cell phones, I have also seen drivers doing other potentially dangerous things while driving, such as eating or drinking or lighting cigarettes. I saw a car weaving back and forth across a divider line on a busy city street as the driver used both arms to pull a sweater over her head. Watching what people do while driving is a good method of witnessing a number of astonishing practices.

In observing mobile telephone booths, I have counted the number of cars traveling along a stretch of road for a period of time and also counted the number of drivers ignoring the law against driving while using a hand-held cell phone. Sometimes only 3% of the drivers are observed breaking the law. Sometimes it's 12%. Whatever the percentage may be, it is clear that the law is being ignored. The law seems to be as difficult to enforce as it is necessary. And this raises an interesting observation one could make about laws in general: by the common sense has degenerated to such an extent that one needs laws to protect people from their own foolishness, the laws are unlikely to be capable of doing what they were designed to do. Virtues cannot be legislated into existence, and folly cannot be legislated out of existence. As soon as government is necessary, it is too late for government to do any good. Laws do not make idiots wise; they only make idiots outlaws.

When George Fox was challenged on his interpretation of the Bible and asked whether he could read Hebrew or Greek, he responded that a knowledge of the languages of scripture are not nearly as important as having the spirit that made inspired the scriptures in the first place. If a person is already filled with love and generosity, then he can easily understand a text urging people to be loving and generous. If a person is not filled with love and generosity, then a text urging people to be loving and generous is unlikely to be understood or followed. Scriptures are effective and inspirational only for those who do not need them. Those who have the spirit have no need of being inspired. Those who are uninspired can only make a travesty of texts and institutions meant to inspire them.

My idea of a utopia would be a society in which people are so spontaneously aware that they would avoid dangerous activities without being prompted. People would simply not do such stupid things as driving while talking on a telephone. They would not become intoxicated. They would not enrich themselves by cheating or stealing from others. They would be truthful. In such a society there would be no laws, because there would be no need for them. (Recall Bob Dylan's observation (in the song Absolutely Sweet Marie): "To live outside the law you must be honest." Living outside the law, however, is not the same as being an outlaw. Living outside the law is having such a elevated degree of integrity that one has no need for laws. Being an outlaw is having such a diminished degree of integrity that laws are incapable of altering one's behavior. I would love to live in a utopia filled with people who live outside the law. Alas, I live in a dystopia filled with a bad combination of laws and outlaws who cannot benefit from them.

What a waist!

In an ediorial entitled Universal Healthcare and the Wistline Police in the Christian Science Monitor dated January 7, 2009, Paul Hsieh describes a policy in Japan whereby citizens over the age of 40 have their waists measured by the government. If the citizen's waistline is large enough to indicate obesity and its attendent health risks, the citizen is required to undergo dietary counseling. Paul Hsieh finds this policy “nightmarish” and sees it as just the sort of evil that is bound to occur in a government-run health care system. As an advocate of a single-payer government-run health care system (because I have had the benefits of living under several such systems in several Canadian provinces over the course of more than thirty years), I cannot seem to find the Japanese system in any way nightmarish. Indeed, I would heartily welcome such a program in the United States.

The issue that seems to terrify Americans is the prospect of paying money into a system that takes care of people who have not taken care of themselves. People who stay slender resent paying into a system that takes care of obese people. People who exercise regularly resent paying for the health costs of couch potatoes. People who don't drink or smoke resent paying into a system that cares for the health costs of drinkers and smokers. People who oppose abortion are unhappy about paying for legal abortions. Vegetarians do not like having to pay for the medical costs of those who get cancer as a result of eating animal flesh. In a society that loves its fantasies of self-reliance and personal responsibility and especially freedom, the very idea of paying for those who are not blessed with good physical and mental health seems all but intolerable. Why, Americans ask, should I help anyone who does not think and act in exactly the ways I personally approve?

I understand the resistance. As someone in favor of banning all ownership of firearms, I am not happy having to help pay for people who get shot by pistols and rifles. As a pacifist, I do not like having 43% of my tax dollar paying for America's unnecessarily bloated military. During the twenty-five years of my adult life when I did not own or drive a car, I thought it would be nice if my hard-earned money was not paying for those who were injured in traffic accidents and for those who were made sick by air pollution coming from burning fossil fuels. But I also realized that such resistance was petty and selfish. On the balance, I wanted my fellow citizens to be healthy, and I was very happy to pay into a system that helped people retain their health. The more money I earned, the more taxes I paid, and the more I helped support the tax-based health care system, and the more I felt good about doing my share to keep the nation healthy.

Part of keeping health care costs under control is practicing preventive medicine. Taking measures to keep employees healthy makes good sense. At the place where I work there are numerous programs for helping people stop smoking, stop using alcochol, stop taking drugs, get enough exercise, stay slender and keep their blood chemistry within healthy tolerances. I am deeply grateful for those programs. I get my waist measured, and I gladly participate in exercise and diet programs. I would appreciate the programs no less if they were run by the government. (In fact, they are government programs, because my place of work is paid for by the state.)

Those who claim to love freedom but who are unwilling to pay for those who experience the consequences of exercising their freedom show that they do not love the freedom of others. They love only their own freedom. But not to love the freedom of others is not to love freedom at all. The cry of freedom is hollow and meaningless unless it is expressed in the form of helping one's neighbors when they have made their choices.

The Paul Hsieh's of the world have little reason on their side. They appeal to emotional argumentation and other fallacious methods of persuasion. Most of all they appeal to an irrational fear of government. Read his editorial for yourself. If you find anything of value in it, report back to me. A discussion on health care is something the United States of America needs to have. I'm happy to participate in that discussion with anyone who is interested.

Is Buddhism obsolete?

In a recent conversation with a group of Quakers, a Friend made the observation that the Quakers may have become obsolete, because most of the radical changes in religion they stood for in the seventeenth century have become realities in the twenty-first century. Quaker values that have not become realities, such as disarmament and prison reform, are also the values of so many other religious and secular organizations that the Quakers are no longer distinct. Whatever the answer to the question about the current relevance of Quakers may be, I have often mulled over to what extent Buddhism still has a role to play in the modern world.

In the fourth century, Vasubandhu argued that Buddhism was unique among the religious philosophies of India in that it denied that there is a permanent and unchanging self. This denial of a permanent self, said Vasubandhu, made Buddhism the only reliable path to liberation from suffering. Modern Buddhists—at least the ones I am familiar with—are rarely inclined to think that Buddhism is a uniquely effective path to liberation. Some Buddhists, influenced by modern psychology, question whether it is possible to eradicate the root causes of suffering at all and so would question whether Buddhism can actually deliver what it promises. Others, who have confidence that Buddhism is indeed a way to eliminate the causes of distress, see Buddhism as only one of many possible paths to the goal. I am not sure which of these two stances I take; I tend to waver between them, although I probably spend more time in the camp of those who think no one ever has and no one ever will attain nirvana or become fully enlightened in the way traditional Buddhism promises.

Setting aside the question of whether anyone has ever actually been a buddha or an arhant, there are modern Buddhists who question how unique Buddhism is in today's world in taking the position that there is no permanent self. I frankly have never, to the best of my knowledge, met anyone in the modern world who believes in permanent selves. Buddhism seems to me like a remedy for a disease no one has any more. Buddhism has a penetrating analysis of delusions that may have been common two millennia ago, but they are not common any more. We suffer from other diseases these days. We need other kinds of penetrating analysis.

Taking all this into account, I suppose I have to say that I do not see anything of importance in Buddhist theory and practice that makes Buddhism unique or even particularly distinctive in today's world. That could account for why my missionary impulses have always been rather feeble. On the other hand, it has never been at all important to me to be part of a unique system of religious philosophy and practice. Much more important to me has been to do the best I can in following the precepts that Buddhism has in common with most other philosophies. I am familiar with Buddhist thought and practice, and I try to be competent at it. Insofar as I succeed in being competent, it turns out that I end up also being equally competent at being a Stoic and a Quaker.

The truth of the matter is that I'm not very good at being a Buddhist, a Stoic or a Quaker. I am a man of many shortcomings and failings. I fall far short of the ideals of all the world's religions and philosophies. As long as that is the case—and I expect it will be the case for as long as I live—I will need the guidance of everything and everyone that can provide it. It would be foolish to limit myself to just one guide. In short, as long as I am in the condition I am in, neither Buddhism nor Quakerism nor Stoicism is obsolete. In me they will always have a loyal customer.