Saturday, June 27, 2009

UUA GA Quickie #4: Backstory

Today in conversation with a group of adults from my original church, I was asked to specify why I joined my second church during college, and why I am still in the faith when so many people my age raised UU have left. There is no single factor; here's the list of things I proposed as playing some role:
  • The Mid-High Guidance Committee. When I was 13, I was upset with the curriculum that year (bible-based), and with the decision to break middle schoolers into a group of 6th-7th graders, and a group of 8th-9th graders. I was in 7th grade; my closest friends were in 8th grade. I wrote a letter to my teachers and the Director of Religious Education expressing my discontent. Within months, the "Mid-High Guidance Comittee" had been created, for the purpose of sustaining community among middle schoolers.
  • Church Camp, which was the first real place that I was introduced to a broader community of UU peers, and which as always to me been an affirmation of community as a religious discipline. It helps, too, that the camp has involved into a highly generationally integrated setting, with children as young as five, elementary schoolers, middle schoolers, teenagers that run programing, college kids that do behind-the-scenes camp maintence, young adults that steward high school programming, and adult adults that run elementary and middle school curriculum.
  • Youth Leadership through Church Camp and YRUU. As mentioned in the previous point, high schoolers do a lot of the actual work of church camp. For me, that opportunity to be in a leadership position with other youth helping Unitarian kids from that age of 14 was a tremendous affirmation of the value of community, and the right of everyone involved to shape the circumstances around them. My experience with YRUU was similar. As a new youth, I did not really enjoy Conferences, but I found he business of Cons fascinating and loved the good work of improving our community. In my sophomore year, I was able to serve my home state as the New Mexico Social Action Coordinator. That too was a powerful experience for me, as it connected leadership/community involvement and works towards social justice.
  • Religious Education Committee. In high school, I was asked to fill a vacancy left by my father leaving the RE committee, and also to accompany a fellow youth. Being able to advocate for those younger than myself, and to strike compromises between the desires of adult teachers and the needs of UU children was valuable. It also let me see the inner workings behind a significant part of my childhood, and realize what adults could be like in decision making, which helped me see myself as just as worthy of having a say.
  • Worship Committee. In late high school, after leaving the RE committee, I was asked to be on the Worship committee, tasked with lay-leading and planning our services. This was the first leadership opportunity I had that did not involve youth or children as the primary focus, and it was a joy and an affirmation to be part of working for the larger church community. It also put me on stage as a lay leader about once a month, and that meant as a given I was at church at least once a month.
  • Denominational Affairs Committee. I was asked again to first serve alongside and then replace the friend who had founded the committee.
  • Youth Worship. Youth Sunday at First Unitarian Church of Albuquerque stands as my favorite worship ever, and for five years I was able to speak at it. First year was with the coming of age sermon, and the next four years were all as part of the youth group. Speaking one's spiritual story is important for many UU's (all, really), and to be able to year after year speak my story as a raised UU with other raised UUs was truly an affirmation of our place within the denomination
  • Opportunities to speak to the congregation outside of youth worship. I was at 17 asked to give a pulpit editorial for something like stewardship sunday. This was my first time speaking not with oter youth, and I was able to share my experience of church camp and its sacred community. More recently, as a college student I was invited back to contribute a pulpit editorial for Christine's presidential campaign sermon. While having the editorial ready on the day of the sermon fell through, I was able instead to speak to a post-election mindset. As someone away at college studying politics, the ability to share that part of my life with my home congregation was again affirming.
  • Other programming I've forgotten. OWL, coming of age, my church extended family, the meaning found in my grandfathers memorial service at All Soul's in DC, the ability to use anti-racism training at my high school, the mid-high steered chirstmas pageants, and myriad other examples that have at the moment slipped my mind exist. While all important in their own way, they signify also that I am someone who would have the church be a part of my life as almost a given. Whether or not I am that way now because of any part of programming in my life is debatable, but I think the role played by all the programmign and engagement I have had with this faith makes it undeniable.
When asked by Albuquerque what they did right in raising my UU, I can't answer with anything other than this: they gave me religion that was not just spiritually satisfying, that was not just built around community, that was not just built around work towards social justice, and that was not just handed down to me. It was, instead, the sacred community whose work was justice, and whose rules and governance was malleable by one who felt the need to be involved and to effect change. It was holistic religion.

And it is what enabled me, in the first weeks of my freshmen year of college, to attend First Unitarian Universalist Church of New Orleans. It is the backdrop I had in my mind when I wrote these first impressions of what it was New Orleans UUs did right.

Friday, June 26, 2009

UUA GA Quickie #3: Election

There is a lot, a lot, a lot to be said about the UUA presidential election. I had at one point considered doing an objective, issue-by-issue analysis of the candidates similar to what I'd done for last years USA presidential election, but by the time I got around to writing it, my decision had been made, by ballot sent in, and my bias/partisanship would have been removed all hope at an objective reality. So for now, I will direct you to Christine's post, where she sums up most of the reasons why I support Peter Morales, and does so with less word-mincing or restraint than I would have used.

My few salient points not covered:
  • Both candidates are amazingly well qualified, and we as a faith are blessed to have such a choice
  • This is not the Boomer Woman/Outsider Male POC dichotomy that it superficially appears to be, and we can be greatful for this as well
  • If I had to stereotype, Hallman's approach is ministerial and Morales approach is technocratic
  • Given that choice, I feel a technocrat better serves the organization of the UUA, while a focus exclusively on ministry is useful on the congregational level
  • That said, I think ministry gets the votes, and I'm anticipating a 52/48 Hallman/Morales split based purely on GA presence and the specificity of the audience (existing UU's with the affluence to come to GA)
  • And, qualified though I think both are (see first bullet point), I really, really, really think that Peter Morales has the ability to lead the UUA as an organization instead of a very large church. Not that being part of the larger fellowship is unimportant, but the UUA must be treated as an organization and not a congregation
  • Lastly, there is the matter of rhetoric. Hallman writes in the eloquent vague that could almost be called house style for Unitarians, and that's powerful with the Unitarians already present. Morales presents explicit plans, data, and is keenly aware of the nitty-gritty of the tasks he is going to undertake. Specificity allows plans to be attacked with greater ease, but at least he has set out plans
And all that said, the campaign has been only slightly uncomfortable. Cheering at candidate forums + visible candidate identification signs + leading questions all allow for tension, but I think I'm only sensitive to these tensions because of how otherwise aligned I feel with all attendees.

UUA GA Quickie #2: More about Evil

There is a lot to be said for Bill Sinkford's emphasis on the language of reverence in Unitarian Universalism today. After all, we cannot be a faith that intends to shape the world if we trap ourselves with academic formalities and euphemisms. The life we lead is profoundly affected by religion, by the divine, and if we cannot address the holy as holy, then we have failed in understanding life. And so far at GA I have seen a positive move towards the language of reverence, towards and acknowledgement of that which is divine as divine, and towards the truly meaningful parts of human life as religiously powerful. This is a positive step.

What concerns me, however, is the ease with which we adopt the language of denunciation and evil. To me, the strongest part of our UU heritage, and the most gut-reactionary part of my being, is the abscence of sin as a meaningful concept in human life. This has a lot to do with my personal character - as someone rather political, it does me only harm to assume evil on behalf of my opposition. But I have said my piece here about evil and politics, and this is more than that.

The concept of evil, of sin, of profound wrongness equal to the peaks of reverence all strike me as oppositional to the Unitarian understanding of inherent worth and dignity. More importantly than that, they to me stand in stark contrast to our Universalist heritage. The core tenent of universalism is that God loves all of us too much to ever see us without redemption. And I think the usage of evil in UU discourse removes the possibility of change and redemption for any who finds themselves as oppositional beings.

Not that I am willing to elmininate the usage of evil from our discourse entirely: the Holocaust, the genocide in Rwanda, the US slave trade, the conquest of the Americas, and myriad other actions stand out in my mind as evil. But those are actions not individuals, and while we can deplore them now, denouncing the dead is in no way helpful. For evil to be a useful concept, we have to be able to examine the why of evil; the who is almost meaningless. With a who, we can assign blame. With a why, we can understand how evil happens and has happened in the past, and we can act on that information.

~

It is also important to notice how powerfully alienating "good and evil" are for our humanist and athiest co-religionists. We should be exceptionally careful with the use of "evil" for that reason alone.

Thursday, June 25, 2009

UUA GA Quickie #1

Last night, the opening sermon was given by a young and talented raised UU minister. Her speech was intricate, optimistic, and contained a call for action. It even saw the logic behind "We affirm and promote the inherent worth and dignity of every person" and transformed that into "we are already holy". Magnificent, moving stuff.

I profoundly disagree with her, however, on the necessity of evil in the systems that oppose us. It goes too strongly against my faith in humanity, and in my understanding of politics. Closest to this sentiment, I think, is James Madison, writing in the Federalist No. 51
But what is government itself, but the greatest of all reflections on human nature. If men were angels, no government would be necessary. If angels were to government, neither external nor internal controls on government would be necessary. In forming a government which is to be administered by men over men, the great difficulty lies in this: you must first enable government to control the governed; and in the next place oblige it to control itself.
We are not more holy than any other in creating our governance, and while I do feel that crafting society is sacred work, I do not see the evil inherent in its creation, nor in its creators. If there is evil in the result, it is because humans cannot foresee every problem, and because systems are slow to adapt to change.

But that does not make the opposition evil. It may make it obstructionist, misguided, or harmful. But that doesn't make it evil. That makes it human.

Wednesday, June 24, 2009

Why I'm still for Team Obama

As someone who plays with nuance all the time, the actual effect of rhetoric on politics means a lot to me. Specifically, though, it isn't just the content of a speech but the tone that is important; very rarely in US politics will I support a statement that draws its inspiration from anger or an US vs. Them mentality. That was awful during the Bush years and the Clinton years, and does not seem terribly worthwhile now.

Of course, I'm still playing for a team here. Broadly, it's the left, and more specifically it is the policy of a sane left. Not a compromising, mid-90s centrist left, but a left that is both self-assured in the correctness of its view while not being overbearing about it. It is nice to see these sentiments echoed in an analysis of Obama:
Democratic partisans think the enemy is vicious and must be met with uncompromising force. That's exactly how conservative foreign policy hawks feel about the world. Unsurprisingly, the right-wing foreign policy critique of Obama today sounds eerily like the partisan Democratic critique of Obama during the primary...

This is a perfect summation of Obama's strategy. It does not presuppose that his adversaries are people of goodwill who can be reasoned with. Rather, it assumes that, by demonstrating his own goodwill and interest in accord, Obama can win over a portion of his adversaries' constituents as well as third parties. Obama thinks he can move moderate Muslim opinion, pressure bad actors like Iran to negotiate, and, if Iran fails to comply, encourage other countries to isolate it. The strategy works whether or not Iran makes a reasonable agreement.
The full article is here, and is about 10 paragraphs. Well worth reading, and a welcome break from the angry echo chamber that is most politics on the internet.

Saturday, June 13, 2009

What to do with all that Anger

I went to the ABQ pride parade today in my "Dare to Hope. Prepare to be disappointed." shirt. It's more or less my mantra when be excited about politicians, and after Barack's upsetting support for the Defense of Marriage Act (DOMA) on Friday, it seemed the thing to do. A mild protest, sure, but really an acknowledgement that people, especially people in power, will do things we don't like, and we should be ready for this.

That doesn't excuse it. Readiness for suck doesn't negate the suck. But it should get us past the "oh no! why is this suck happening now!" part of the process, and onto something meaningful. Stay angry about it, sure, but then do something with that anger.

You can give to organizations. PFLAG is always worthy of support, as is the ACLU and Lambda Legal. You can sign petitions. Here's a petition calling for the repeal of DOMA, and here is another. And lastly, if you're in NM, Equality New Mexico is pretty fantastic, and has volunteer opportunities.

There's certainly way more that can be done. There are countless other places to start from. The point, though, is to take that anger, and do something with it. Not "fringe violence" something, mind you. But something. Constructive uses for that anger abound.

The work of being an active and concerned citizen never went away - the political climate right now is not great, but it is not explicitly hostile. Obama feels that the legislature is who needs to change DOMA; pressure legislators. (Contact information for Tom Udall, Jeff Bingaman, Martin Heinrich, Harry Teague, and Ben Ray Lujan.) And this is something that can function on the state level, and takes momentum. So. It is work, but it is doable work. Unfavorable presidents haven't stopped it before; why are we afraid that will hold us back now?

Friday, June 12, 2009

Iranian Presidential Election Quickie

Iran's political system fascinates me; besides actually having a constitutionally enshrined "Supreme Leader", it combines democratic organs with tight controls in the hands of many unelected bodies. It appears to be an almost perfect dystopian entity, with competing policies, shadowy bodies, a "council of Guardians", and a separate military that is the personal arm of the Supreme Leader in the form of the Revolutionary Guards. A great setting for fiction, if ever there was one.

But Iran is also far more realistic and livable than that description gives it credit for. And despite the willingness of people to dismiss Iran as just another dictatorship, it is really too elaborate for that. Iran, though not a democracy, has profound democratic organs, and though those organs are constrained, they perform a valid function in society, and are not controlled so tightly as to make the future the direction of the country inevitable.

This is an elaborate introduction to a post on fivethirtyeight about the Iranian Presidential Election. The whole post is rather short and a good read. The best line is here:
In summary, the Iranian system is slowly maturing, with more a more competitive and multi-candidate system. The candidates are still restricted to the mainstream approved by the Guardian Council, but this is certainly no one-party system.

The Problem of Modern Healthcare, pt 3: Doctors as For-Profit

As outlined in post 1 of this series, McAllen (in Hidalgo County) manages to have the highest healthcare costs in the country at the same time that it has among the worst care provided. This is in stark contrast with places like the Mayo Clinic, where low cost and high quality healthcare combine. The most obvious and glaring difference between the two systems is the goals of the doctors. In McAllen, they are for-profit and paid for procedure, and they let this focus determine the kind of care they provide. At the Mayo Clinic, doctors are salaried, and so while they are well off, they have no need to order procedures for procedures sake. Instead, Mayo Clinic doctors put the emphasis on effective care, rather than expensive care. And it works.

If this sounds a little socialist, it's because it is, in a way. It is very much a not-for-profit ethos, and it knows that the profit motive here doesn't lead to best care. The US already has a class of people engaged in nonprofit work, as government employees, with 6 figure salaries, who could stand to make a lot more in the private sector but instead function as civil servants. The federal court system is a great example of this - it combines job security, meaningful work, a generous pension, and a 6-figure income to take brilliant and qualified people and employ them appropriately.

The example isn't perfect; the fact that the private practice of law generates millions for the kind of people sought out as public servants limits the candidate pool. And in medicine, it makes the Mayo Clinic model riskier, as doctors are drawn towards the greater wealth accumulation (and accompanying security) of for-profit medicine. But that doesn't' mean a civil-service model for healthcare doesn't exist.

In part 2, I mentioned that the single-payer debate is mostly meaningless as far as the pricing of medicine is concerned. Government can, however, be much more involved in price structuring of medicine, and as the payers of doctors under a single-payer program, they can change medicine from the source of wealth it is to McAllen doctors into a stable, well-paying civil service job. As a corollary, government can also offset the high costs of medical school with loans and debt forgiveness, a power almost unique to government and one that would make the profit-seeking of doctors less vital. This, more than anything else, is the promise I see inherent in any talks of universal healthcare reform. But it doesn't actually require a single payer model to come into being.

The Mayo model came about in a very profit-centric world. It thrived and expanded. Government doesn't need to be in control to allow that kind of success to continue. They just need to stop disincentivizing against it. Providing debt forgiveness for doctors who work in Mayo-model or similar clinics, changing away from a pay-for-procedure model, and providing additional benefits to salaried doctors are all within reach of government legislation.

It just takes effort, observation, and political will.

The Problem of Modern Healthcare, pt. 2: Who Pays is Moot

From the New Yorker Article mentioned in part 1 of this series, the most crucial three paragraphs:

As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.

Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of co√∂rdination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check.

This last point is vital. Activists and policymakers spend an inordinate amount of time arguing about whether the solution to high medical costs is to have government or private insurance companies write the checks. Here’s how this whole debate goes. Advocates of a public option say government financing would save the most money by having leaner administrative costs and forcing doctors and hospitals to take lower payments than they get from private insurance. Opponents say doctors would skimp, quit, or game the system, and make us wait in line for our care; they maintain that private insurers are better at policing doctors. No, the skeptics say: all insurance companies do is reject applicants who need health care and stall on paying their bills. Then we have the economists who say that the people who should pay the doctors are the ones who use them. Have consumers pay with their own dollars, make sure that they have some “skin in the game,” and then they’ll get the care they deserve. These arguments miss the main issue. When it comes to making care better and cheaper, changing who pays the doctor will make no more difference than changing who pays the electrician. The lesson of the high-quality, low-cost communities is that someone has to be accountable for the totality of care.
Emphasis mine. Not that the single-payer/insurance debate isn't a valid one. But it's not a valid one when it comes to absolute cost. That will come from changing the autonomy of doctors, which I discuss in part 3 of this series.

The Problem of Modern Healthcare, pt. 1

The New Yorker recently had an article examining how healthcare in the US goes wrong. The article is a great read, in-depth and devoid of the classic free-market/single-payer argument that pervades the discussion of healthcare reform in the US today. Notably, the article focused on two separate methods of healthcare practice in the US. Healthcare in McAllen (in Hidalgo County), where average medicaid costs are $15,000/person, and the practices of the Mayo Clinic, which costs medicaid an average of $6,688 per person. McAllen also has some of the poorest health of anywhere in the nation, while the Mayo clinic is a national leader in quality. The fascinating part of the article is that these differences happen within the current free(ish) market for healthcare in the US, and they go against standard logic that more $ = better. Here's my breakdown of the salient points in the article:

The McAllen Model:
  • high doctor autonomy
  • doctors paid per service rendered, not salaried
  • extra tests/medicines incentivized
  • do the expensive thing by default
  • reliance upon patients with medicare = almost unlimited pool of money available to patients
  • patients always choose more services, assuming more = better
  • the culture of the doctors is very much medicine ==> wealth
  • as a corollary, doctors make millions and are the major landowners in the county
  • this is rather justified by the high initial costs of getting into and practising medicine
  • the other justification for such wealth accumulation, fear of/protection from malpractice lawsuits, isn't really a threat in Texas, where McAllen is located
The Mayo Model
  • doctors salaried, at a decent pay level
  • doctors paid in 6 figures
  • doctors work in concert as medical team, rather than as individuals
  • preventative medicine is offered more consistently, as doctors have no reason to want to do more expensive things later
  • wait to see if low-cost methods work before recomending expensive methods
  • patient-first healthcare considerations are emphasized
While this may seem obvious (profit-incentive for doctors doesn't equal good care for patients), it's a point that renders almost moot the debate over single-payer healthcare. (See part 2 of this post for a full excerpt explaining why).

It does, however, is present a strong case for doctors being civil servants (or quasi-civil servants, which I'll get into in part 3 of this post.

Sunday, June 7, 2009

George Will: Wrong on Language

George Will, it seems, is taken to inaccurate hyperbole about personal pronoun usage by our sitting President. This is really no surprise, since he has frequently overstated cases against our president before, but it is nice that a linguist complaint now joins those raised earlier. The best line?
Now, maybe there's some selection of Obama's interactions where his use of the first person singular pronoun is higher than expected for someone in his circumstances. Alternatively, maybe George F. Will is a bullshitter, who doesn't bother even to ask one of his interns to check whether the alleged "facts" in his columns are true or false. We report, you decide.