with John DiLeo
No recording this week
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John DiLeo © 2 January 2022
Since I mentioned it at the beginning of our time together, let me start my musings with a bit more background on my hospital stay. As I mentioned when I last led our service, in October, I’ve found myself during this lockdown eating less well, gaining back weight I’d thought I was long rid of, and becoming more and more sedentary. My workdays have gotten really long, resulting in my spending as much as 15 hours a day sitting in this very chair.
Not surprisingly, this had an adverse effect on my health. As it turns out, I started developing blood clots, most likely in my legs, though I wasn’t experiencing any of the classic symptoms associated with deep-vein thrombosis. Also not surprisingly, these clots eventually made their way to my lungs in the form of pulmonary emboli.
How did this present to me? Well, on Tuesday afternoon (23rd November), I walked the 400 metres from our apartment to Lari’s primary school, then the 400 metres back with Lari. It occurred to me during that short walk that I wasn’t merely winded, I was panting and feeling light-headed from hypoxia.
I made an appointment with my GP for Thursday afternoon. They did a basic assessment, ran an ECG to confirm I hadn’t actually had a heart attack, then said those words I was really hoping they wouldn’t (but kind of knew they would): “you should go to the hospital now; we’ll let them know you’re coming.” So, Tess drove me to Auckland City Hospital, where I spent the next two nights.
If you’re familiar with this condition, then you already know there isn’t any direct intervention that can be taken to eliminate the emboli – rather, you rest and get started on anti-coagulants, while the hospital staff keeps an eye out against things taking a turn for the worse – thankfully, they didn’t, so I was discharged on Saturday, and we had a slightly delayed Thanksgiving dinner on Sunday. My stay ended up being only two nights, because my case was assessed as low-risk; I had sought medical attention before things got really bad, and I never needed supplemental oxygen.
But, my remarks today aren’t about what happened during my hospital stay – they’re about what didn’t happen. I was never asked about how I was going to pay for my care, or if I had insurance. I was never presented with a tax invoice for my stay in the hospital at all. The total out-of-pocket costs, to date, have been $175, for my GP visit and prescriptions (I do have private insurance, which reimbursed me for $80 of that amount).
As anyone who’s lived in the US knows, that’s not how things go when you’re hospitalised there. In many cases, patients – even those presenting with acute, but not immediately life-threatening, conditions – are turned away for lack of, or lack of sufficient, private health insurance.
If the hospital does let you in the door, somebody (often a distraught family member) has to sign a raft of forms promising you’ll pay whatever the hospital decides they’re owed, regardless of your means. In many cases, a hospital stay – even a relatively short one – can break the patient’s family financially, with or without insurance. For my condition, average treatment costs in the US are relatively low – only US $11,500 in 2016 – and insurance will cover 50% – 80% of the costs (assuming you have any).
During the three most recent national elections in the US – 2016, 2018, and 2020 – the topic of single-payer healthcare came up a lot, thanks to Democrat candidates like Bernie Sanders and Alexandria Ocasio-Cortez. They variously labelled themselves ‘socialists,’ ‘socialist democrats,’ or ‘democratic socialists.’
The right-wing opposition was – and still is – in an absolute froth over the spectre of (gasp!) socialism in the “land of the free and the home of the brave.” Invariably, this outrage leads to bad-faith comparisons between proposed policies and totalitarian Red Communist states, such as the old USSR, China, and North Korea, with accusations that “these socialists” want to take away Joe Six-Pack’s home, cars, and guns, and tell them how to live their lives.[Brief aside: These just happen to be the same people who have no problem at all telling everyone else exactly how to live their lives.]
Similar rhetoric abounds here in New Zealand, with right-wing politicians and groups – most notably, the MP for my constituency, David Seymour, and that bastion of compassion, the New Zealand Taxpayers Union – breaking out the “communism” accusations, complete with hammer-and-sickle imagery.
Growing up in the US, I remember the “Red Scare” mentality was still going strong into the 1970s and ‘80s. During the 1974-75 school year, a sixth-grade (Year 7) teacher in my school taught a unit on Russian culture and history. It seems he failed to present “those damned commies” in a sufficiently negative light, though – several parents complained, and he was summarily fired.
Popular rhetoric during those times left me indoctrinated to the idea that ‘socialism’ is the same as (or inescapably leads to) Red Communism and is, therefore, unconditionally ‘bad.’ It took a long time before I could make the conscious distinction between ‘socialist’ programmes and policies and totalitarian ‘communist’ regimes – and I still, at times, have an instinctive negative response to accusations of “that’s socialism!” or “she’s a socialist!”
On examination, I came to see there was little to no discernible difference between the traditional “tax-and-spend liberalism” of the US Democrat party in the 1970s and ‘80s and the “democratic socialism” espoused by Sanders and AOC in the 2010s and ‘20s. This, naturally, led to another Google search…
In a Spring 2013 article in Dissent magazine, Avishair Margalit wrote about this very thing:
Is there a difference between a liberal and a social democrat that amounts to a distinction? If there is, is it a distinction with merit?
Sidney Morgenbesser, a master of fine and funny distinctions, tried to answer our question with a quip: A liberal believes money should be taken from the very rich and handed over to the poor. But he stands exactly at the point at which no money should be taken and no money should be given. In contrast, the social democrat believes she, too, has to give money.
Social democrats are more concerned about the distribution of income than are liberals. For the social democrat, it is not just taking from the rich and giving to the poor. Rather it is about caring about equality all the way down the slope of the income curve.
There is another quip, the source of which I don’t know: a social democrat is a socialist who compromised with reality, whereas a liberal is an anarchist who compromised with reality.
Reflecting on all of this, I’ve concluded that Democratic Socialism is precisely what’s needed to counteract the societal ills that necessarily follow from unrestrained capitalism and “free markets.”
Employers cannot be permitted to pay their staff as little as they can get away with, a behaviour that’s compulsory in a “free” market. Unionisation and collective bargaining must be protected and promoted. In professional fields, salary transparency must be encouraged – including prohibitions on salary “gag rules” – to promote fair and equitable compensation.
Manufacturing and industries cannot be allowed to get away with externalising costs resulting from their activities – environmental impacts, hazardous wastes, consumption of natural resources, and real labour costs must all be addressed explicitly. While it’s reasonable for governments to grant subsidies to products (for example, electric cars) or industries (say, green energy production) considered to provide a “public good,” those subsidies have to be explicit and purposeful.
Existing enterprises cannot be allowed to leverage the power of government to stifle competition, or prevent consumers from seeking alternatives, allowing them to profit unreasonably from a closed market.
Nobody should ever find it impossible to obtain and pay for appropriate housing, keep their family fed, or receive quality preventive and restorative health, dental, or vision care.
I was surprised to learn that dental care is an area where New Zealand is still failing hard – to my knowledge, there’s only very limited public support for dental care above the age of 18, and no public funding for orthodontics at all.
Home ownership must not be an unattainable dream for anyone not born into wealth and privilege. Post-secondary education must be attainable by all, without anyone’s having to take on a crushing and life-long burden of debt.
I’m strongly in favour of government’s taking a hand in making all these things happen, as a mechanism for the greater good, and funding them through aggressively progressive taxation. I definitely don’t stand with Morgenbesser’s ‘liberals,’ as I’m happy to pay a fair share to help those in need. I’m not sure exactly what a ‘fair’ share is, but I sure do know an ‘unfair’ share when I see one. In a fair system, I’m positive effective tax rates would never go down as incomes, profits, and wealth go up.
In other words, I’m in favour of pretty much everything Bernie, AOC, and scores of other “democratic socialists” have been proposing for years! Huh…I guess I know the right term for my politics, after all.
Meditation / Conversation starter:
Chalice Lighting is:- “That Which Abides” By Martha Kirby Capo
Reading: “What Is Socialism? And How Is It Different Than Democratic Socialism?” By Samantha Vincenty, posted 6 August 2019.