The Great Social Experiment Part 5

The path toward socialized medicine by New Zealand is quite different from the one the United States is taking. This is due in a great part to the very different traditions in the founding of the two nations. New Zealand is a part of the British Commonwealth and the long tradition of power, rights and benefits flowing from the government to the people is fundamental to that system. So, it was entirely natural for New Zealand to establish socialized systems for institutions such as health care, transportation and utilities.

The concept of rights and privileges flowing down from the government to the people is natural to someone who comes from a monarchy. Kiwis expect government to provide for them. Americans come from a very different idealogical foundation. It was the Americans who gathered the states together to create their own central government. It was the Americans who stated so eloquently in their founding documents that rights were inherent in humanity and government got power and authority from the people, not the other way around.

Nonetheless, the United States is embarking on the same path New Zealand has taken. It behooves us to examine the record of countries that have a long experience in government-backed health care. There are numerous arguments for lower costs and better health by centralizing health delivery systems. The question is, "Does it really work that way?" Given the Kiwis 37 year history, we can see how their system works after almost two generations.

From the standpoint of the locals I interviewed, the standard of care available to citizens is world class. The largest teaching hospital in the Southern Hemisphere is in Dunedin, NZ. As promised, people pay little for care. From a statistical standpoint the care New Zealanders get is nearly identical to what US citizens get. The number of doctors, nurses, hospital beds and so on per capita is very similar.

The real difference is in procedures performed. Knee replacements and heart surgeries are performed at a small fraction of the rate in the US. Indeed, from a world standpoint, the US is far ahead of the rest of the planet in the delivery of these services while spending in the US per capita is much the same. Generally, these procedures are more likely to be performed on aging people. From my interviews I learned that joint replacements are very difficult to get for aging Kiwis and just impossible for the elderly. In New Zealand, the wealthy can purchase private coverage and get the procedures they need. 22% of the population has private coverage. For the rest, these procedures just are not going to happen. We met a 55 year old bus driver whose mother has been waiting for knee replacement since she was 70; she is now 85 and no longer expects she will have the surgery.

The people of New Zealand approached their health care design with a lot of thought and planning. They distributed the administration to 21 district agencies since they do not have anything like our states or county governments. Local policy is made at the local level. Doctors and other providers are self-employed and compete for business within the districts. Nonetheless, costs have risen beyond the level of reason and services are rationed. The promise of universal health care has not been fulfilled. The people are now discouraged and believe their problems cannot be solved.

In our next post we will speculate on why this happened.

The Great Social Experiment - Part 4

The social and economic contract between New Zealanders and their government has given the populace just about everything they could want from a generous and large government. They have a first-rate universal health care at virtually no direct cost to the consumer. But the elderly cannot get expensive treatment in a timely matter. The highway system is paved and carefully maintained but clogged so badly at rush hour they cannot meet their traffic needs. Ports are clean and well-staffed, but larger ships cannot dock in severe weather because of inadequate planning. Airports are able to handle huge volumes of tourists with little fuss and confusion unless they use the larger planes essential to cross the Pacific Ocean. Larger cities have suburban rail, but light rail service has been discontinued. All but the smallest towns have bus service and all are subsidized. Ridership on public transportation is very low at 2.5% despite high taxation on motor fuels and vehicles.

The government provides free broadcast television. There are four channels, two of which have part time high definition broadcasts at 720p only. Radio stations are commercially run. High speed internet is not common and most ISPs hold customers to a very small monthly 10GB limit.

So, is this beautiful country the paradise it appears to be? With high taxes, high prices and low private sector wages, they are exporting their highly motivated and highly educated workforce overseas. In our next segment we will study just where their economy got derailed.

The Great Social Experiment - Part 3

New Zealanders are eager to proclaim that they were the first in the world to create a social welfare state. They are proud of their healthcare, their environment and their record in creating social justice. Their two principle islands are clean, free from pollution and have virtually no crime. There is virtually no political dissent and town counsel meetings are likely more about what color to paint the bicycle lanes than dealing with roving gangs. Sailboats are moored everywhere, patiently waiting for their owners to take them out once again for a quick offshore barbecue after work.

It would be so easy to fly back to the US and proclaim that all we have to do here is to extend healthcare to everyone, repay native peoples for the land we stole from them, close polluting businesses and paint our bike lanes green and we too could have a perfect life like our Kiwi friends. But, if you stay a bit longer, ask a few questions and visit a supermarket or two the view changes. Yes, it is still a paradise, but there is trouble.

New Zealand has been exporting its workforce at an alarming rate, approaching 50,000 per year. If the US had that rate, we would be losing over 4 Million workers a year. Further, many more Kiwis commute to Australia for much higher wages and lower taxes. Even though the minimum wage gives the lowest paid workers a minimum of $8.75 (US equivalent), the skilled trades earn just under $20 US. Factor in $8.00 gasoline, $7 toothpaste and Diet Cola for $4 and you have an economic boat that just won't float for many workers.

So, what happened? All their social programs have driven up taxes and created new bureaucracies chock full of high-paying jobs. The average government worker earns 50% more than a private sector employee. Income tax rates are similar to the US, but they have the dreaded European style GST. This adds taxes to products each time a product works its way through the economy; we call it a Value Added Tax. Manufactured products like cars, cosmetics and processed foods are taxed beyond all reason. Meat and produce remain somewhat affordable, but everything else is just scary high.

In our next post we will look at what the economy provides for citizens.

The Great Social Experiment Part 2

Today will be remembered for a long time as a turning point for our country. It will be up to the historians to determine whether it will be compared to September 11, or Apollo 11. Today our US Congress voted to fundamentally change the relationship between government and people, doctors and patients, employers and employees. Some did this because they believe that access to healthcare is a right. Some say the economy requires us to do this to save us from collapsing under our own waste and debt. Some, I fear, voted for this plan to further their Progressive / Utopian dream for America. That it passed at all means that the legislation had enough "stuff" in it to appeal to a lot of diverse people for a lot of diverse reasons.

This may sound like the legislation had broad support; it did not. It passed by the slimmest margin and without any Republican support. It required some parliamentary chicanery to get the bill past the narrow majority. By all accounts it required some severe "arm-twisting," back room deals and sleazy promises. Nebraska and other states got Federal dollars, California got water; Colorado and Kansas had some of their money shut off. Democrats were promised by a majority of voters that they will be voted out of office in November if they supported the bill. Despite this, 219 Democrats did vote for the plan. Given the certainty of their political "suicide" and the already fallen election losers piling up, why would anyone vote for this? The C.B.O. estimates already have it as a trillion dollar looser. Moody's threatened to downgrade the US Treasury's bond rating if it passed. China dumped $38 Billion in US T-bills in advance of the vote. So, then, what is the political and social capital that is so valued that so many would risk everything for this vote?

Clearly, the motives of the supporters are many, Obama and Pelosi may have entirely different underlying goals in their respective quests for universal healthcare. President Obama has very clearly stated what he wants for the nation's healthcare system. He insists on the government as a single payer as in the Canadian and Massachusetts systems. He also says he knows it will not happen overnight, that the process will take at least four years to fundamentally transform the system. So, then, what is this system going to look like when our promised transformation is done. This is what we will explore in the next post.

The great social experiment - Part 1

I have the extreme pleasure to visit one of my favorite places, Australia and New Zealand. Alas, this is not a travelogue but social commentary. New Zealand took the steps in 1973 we are contemplating now when they implemented universal health care. So far, I've interviewed nearly a dozen Kiwis and Aussies about how this is working for them. Proponents of a single payer system have told us that there would be no increase in costs, that rationing will not occur and the quality of care would increase.
I this series, we will look at how the last 37 years have worked for the two countries. We will see what promises have been kept and which have been broken; we will not venture into whether the system is good or bad. We will offer some ideas about the value to the societies as a whole.

A "Contrarian" View

I have just read an editorial by John Rennie in Scientific American be-bunking seven myths about global warming. These seven concepts are offered by those who do not believe the current political solutions offered by government are appropriate answers to the problem. Few would disagree that Earth's climate is changing; we can see glaciers retreating in some areas and sea levels are rising causing problems in low-lying areas throughout the world. The arguments then are what impact human activity has upon climate change and whether the offered "political" solutions will have any useful impact on climate.
The now famous "climate-gate" e-mails from the summer of 2009 point out how politics have entered into what we hoped would be a scientific discovery process. Unfortunately, science has to be funded and the funding process requires scientists to compete for government and private money. If a field of study has interest for the political community, the temptation for researchers is going to be to "bend" the science to fit the politics involved. We have about 10,000 e-mails clearly showing how that temptation plays out. Grant money clearly follows favorable science. This is not going to work.
We are now left with some real doubts about what the truth is really going on. Surely, glaciers in North America are retreating while those in Russia and Asia are not. Some ice packs in Antarctica are growing in depth while others have broken off. Snow levels in Africa are nearly gone. As an individual, I now do not know how to form an opinion with so much conflicting evidence.
Traditionally, I would then turn to the government for the truth. I cannot believe some in government right now. We have now managed to collect a "Perfect Storm" of

1. Progressives who want to adjust the Constitution to fit their agendas
2. Former and current lobbyists who want some "green" obamamoney
3. Liberals who want to redistribute wealth
4. Low lifes who want that money (Venezuela's Chavez)

So, my vote on giving more money and more power to anyone to "solve" climate change has to be no. When I see science that makes sense or politicians that make sense I just might change my vote.

The Obama Doctrine

Alas, I wasn’t able to make it to Oslo for the ceremonies surrounding Barak Obama’s award of the Nobel Peace Prize on Thursday. So I printed out a copy of the speech and took it with me when I went to give blood. I had a chance to read it through several times while I was hooked up to the pheresis machine and then later I watched parts of the resulting commentary by the talking heads online.

As a result I was pretty well versed in what he had to say when I chose to share segments of it with Joan Thursday evening. I was surprised, nevertheless, when I became overwhelmed with emotion reading it to her. All of which is to say that I find it to be a powerful and important statement, not just of American foreign policy under this President, but of how we as humans might learn to address and resolve conflicts.

I have been working on an essay about principles of nonviolence that King used in his efforts on behalf of civil rights in America so I was already primed for those themes. To have a President, especially one who is increasing the number of troops in Afghanistan, cite King (and Gandhi) as models to follow and to do so in a way that is coherent and carefully considered illuminates the reasons Obama got the award. That he received it saying so many things that so many of his liberal supporters find disagreeable makes it only more remarkable.

I myself didn’t agree with everything he had to say. But my disagreement has mostly to do with his use of the term nonviolence in ways that, while consistent with popular usage, limits the meaning to a set of tactics appropriate to actions taken by oppressed persons addressing grievances against an authority which is morally sensitive. If we limit the term in that way then he is right, it wouldn’t have worked against the Nazis and it won’t work with al Qaeda.

But if we are looking not so much at the tactics as at the philosophy that undergirds it, and think more creatively about how conflicts can be resolved, then we discover some important principles that unite Nonviolence and the Obama Doctrine. Among them:

· We are all connected in a great web of care and concern. What affects one of us affects all of us.

· Passivity or patience in the face of oppression is not only an abandonment of our moral responsibility but is also an invitation to greater violence.

· The road to peace is through a process of relationship building with those with whom we disagree.

· Justice is not simply about the rule of law but is also about the equitable distribution of rights and resources, but such equity is not possible without the rule of law.

· We cannot allow the fact that others abandon righteous behavior to allow us to depart from the values we hold.

These are all examples of the kinds of principles which I hope to celebrate and promote through the promulgation of Creative Conflict Resolution and through Just Conflict.