Archive for June, 2012

Medicaid expansion

June 29, 2012

My impression of yesterday’s Supreme Court reasoning about the Medicaid expansion was not that they said Congress couldn’t coerce states, period, but that they said Congress couldn’t change a program midstream through that mechanism — in effect, that Congress should have labeled the expansion a new program and made engaging in it as optional as the initial Medicaid program I am supposing originally was.  I assume the Court assumed that approach never would have generated the same response as the scheme that was enacted, including the ability to say that now everybody could get affordable health insurance.



June 29, 2012

The Supreme Court ruling on the Affordable Care Act seems to leave a (potential) big hole in health care coverage in this country: people eligible for coverage under the expansion of Medicaid authorized in the law who may not have access to it if the state in which they live chooses not to expand its version of Medicaid.

This is troubling to me.  I think it has to do with my lack of trust in people to act for somebody else’s good in this kind of context.  I know that in economic terms, it’s actually a very good deal for the states to engage in the expansion — the federal government provides most of the money and the state saves money elsewhere in its own budget.

But in this current political and social climate — especially, it seems, among conservatives — helping those “other” people is either a low priority or rejected with convenient rationalizations that amount to, “If people can really be in difficult situations through no fault of their own, my own sense of safety is compromised.”  I worry that states, especially if they think it will make the current presidential administration look bad, won’t opt into the expansion.

I also worry they won’t because in my personal experience, people often decline to help in such situations.  I have learned they can do that, even if social, moral, legal, and other codes require that they do help, and even if they themselves have actually agreed to:  when push comes to shove, they don’t have to.  And often they don’t.

The world goes on nonetheless.  There’s always help at a spiritual level.

For me, then, this situation is a challenge about trust, acceptance (of other people’s free will and that things don’t always work out pleasantly for all), and faith — and hope.  Hope is actually the part I have the most trouble with.  Hope that isn’t wishful thinking or holding my breath.  I have felt hope on some occasions very deeply, I know it exists in the universe, just as the great love I have experienced exists.  It’s like trying to find that musical note in my voice again, this time on purpose rather than through stumbling into it.

This is not about affecting what (Republican-controlled?) states do about Medicaid, although that situation has prompted me to think about it.  It is about my own need to find a way to live in this world that is most consonant with the currents of the universe that move in a helpful direction.

Activity, inactivity, tax, not a tax

June 29, 2012

One person’s sophistry is another person’s reasoning, it seems.  That, to me, is one of the lessons of yesterday’s Supreme Court ruling on health care, more specifically, on the Affordable Care Act.

Not buying health insurance: can Congress regulate that?  According to enough justices, no, it is not activity within the scope of the Commerce Clause.  Can the Court review the legislation or is it a tax and must we then wait for it to be implemented before it can be reviewed judicially?  No, but it is characterizable a tax for other purposes, namely finding a basis in the Constitution for its lawful creation.

Is this why we go to law school?  To learn how to think like this?  Maybe.  But to me it speaks more to the limits of how we think generally in our culture, in black and white, in terms of X and not-X, opposites, and opposition.

There are other ways of thinking, but they are not developed through our intellects (although we do express them through our intellects and language once we have developed them elsewhere in our psyches).

One of the hazards of having done so is losing the patience or interest in communicating and working with people who haven’t; but that’s no less important a challenge to be mastered than moving beyond dualistic thinking.


June 27, 2012

I started realizing how different my own experience of someone with a sterling reputation can be from the apparent norm, when my older son’s elementary school teacher, who had such a reputation (including for warmth and kindness, intelligence and creativity, dedication to teaching and interest in her students beyond the usual), insisted that he too begin his autobiography at birth and include information about all his “firsts” (words, steps, smile, teeth, etc.) and name and describe those around him during his infancy.  My son, whom we adopted as a toddler, had no idea what to write, since we don’t have that information (we don’t even know when he was born) and much of that time he spent ill and without parents in a hospital and then in an orphanage.

I went to speak to the teacher after school.  We were on friendly terms, she liked Jonas, I expected we would work something out together.  I explained the matter.  She said he should make up the information.  I was puzzled.  Couldn’t he just start the autobiography at whatever point he first had information?  Just include what he and we knew?  Maybe even just start the account at a slightly later point in his life than his birth?

No, he had to include all the information listed in the worksheet and make up what he didn’t know.

I was truly amazed at what she was asking Jonas to do — both asking him to relive something he might not be ready to think about and think about without some sort of support, and also at what I considered dubious ethics of making up something that purports to be fact in an autobiographical account.

Since that episode I have heard worse stories about other teachers and family situations, but for me this one sticks out now not as much for its content as for its lesson about what may lie behind a reputation.

The goat in the house

June 27, 2012

It’s a parable, I’ve seen it written up as a children’s book, Willy used to tell the story, too.  It’s about a family in a one room and very small home, the kind with a dirt floor, and lot’s of extended family living together in it cheek by jowl.  The husband of the primary couple in the family goes to his local religious leader and complains about his living conditions (in great detail, if you want to prolong the story).  The religious leader instructs him to bring a goat into the home as well, the husband protests in surprise, the leader says do it and come back in a week.  The fellow does, the home is even more difficult to live in, the fellow returns to the religious leader a week later, the leader instructs him to remove the goat from the home and see him again the following week, which he does.  This time he is not complaining, he is “grateful” for the relative peace of the household in within the home.

This notion of “gratitude” has confused me.  It’s not that I don’t understand or haven’t experienced that feeling of relief and adjusted perspective, but I think we probably need to reserve the word gratitude for a purely positive feeling towards something; our total attitude about it may well be mixed, but the grateful part would be the strand of positive feeling — enjoyment, appreciation, positive regard of some sort.

I say this because when I think about things in my life in terms of “it could be worse,” it is a fragile bit of acceptance, kind of shallow and not robust when it does get worse.  Acceptance can be neutral but gratitude I think is more positive.  Both of them I think don’t waver when things do get worse.

For example, if I’m driving and grateful for an open road, it can’t be that I’m glad there’s no traffic, it should be my actual enjoyment of relaxation or ease, the view or the wind in my hair.  If around the bend I encounter a jam, my enjoyment may cease but I think I will feel less disappointed and frustrated if my gratitude was for something positive, not the absence of something negative.  Similarly, if I thought I wouldn’t have to fill out a particular bit of long and involved paperwork this year, I could just enjoy the time spent doing something else — if I try to be glad of not doing the report, when I find out I have to do it nonetheless, I will feel more frustrated.

I do think that the goat-in-the-house routine can help us locate what might be enjoyable in a situation that is difficult on its own, but I think I, at least, need to focus not on the absence of something worse but on the pleasure where I can find it in the situation, however fleeting it may turn out to be.

“Tell me what to say and do”

June 27, 2012

I get this from my family of origin a lot, and sometimes from other people, too:  “Tell me what to buy you for your birthday,” “Tell me what to say [after I’ve treated you badly],” “Tell me what to do differently.”

Already I feel disappointment, because it would be so much nicer for me if they figured out on their own what would meet my needs — there is a feeling of loss for me involved with their not doing so.

But if they can’t, how can I blame them?  I would prefer that they look into their own hearts to figure it out, but standing on ceremony feels sort of like an empty posture to me, on the other hand.

Do people learn compassion and understanding from being patterned to think or act in certain ways?  If I keep telling them what I think they should do or say, will it improve their capacity to do so on their own?  I usually suppose learning compassion and understanding comes from having access to a person’s own deeper mechanism for perceiving and responding to the world, and when they can’t locate it or access it, I suspect my providing a substitute is probably an enabling device — that they need to do something themselves, like deal with their own issues or allow their hearts to be broken open.  But I know I shy away from this attitude, because I am concerned that for people who are closed off (or maybe, close themselves off), through their free will and intellectual ideas, from what we might call faith, it could be devastating and lead to more regression.

Luckily it doesn’t matter that I don’t have this all worked out, all I need to do is keep my own heart open, listen, and be willing.


Wasp gall

June 27, 2012

I don’t think I had ever heard of this until I found one this afternoon at the reservoir and ran into a botanist there who explained to me what I had found.  (Here’s what it looks like.)

Having accused (in a reply this morning to a comment to one of his columns) David Brooks of living in a cocoon, I thought this was a nice bit of synchronicity.  (Bruce Springsteen figured prominently in the column, so I guess I could take as another, though more complex, example of synchronicity the comment I got from a fellow taking tree wood out of the brook that flows away from the reservoir, as I ended my walk, namely, that I look like Janis Joplin.)

But what fascinates me is the bit I read about this evening about how parasitical wasps sometimes intrude their own larvae into these galls — what a concept!  A coerced form of surrogacy, in a way.  (The parasite aspect seems echoed by the fact that with the botanist I also found the woman who cuts down bittersweet vines along the path around the reservoir, whom I’ve met before.)

It reminds me of an old tale about a woman who is visited by a incubus who commandeers her husband’s body, and through it, makes love to her.  She becomes terrified she will become pregnant with a monster through this and hopes to somehow “replace” this unborn monster with her husband’s child by making love with her husband while he is not possessed, the next night.  I’m not sure she ever learns the outcome of her situation, however, because I think she either loses her mind before the birth and doesn’t even realize she has been pregnant, or she dies immediately after the delivery.  The baby in fact is taken away by one of the women attending the birth, and placed with an unsuspecting family.  The husband and the incubus are both angry (at being deprived of “their” son).  The baby grows up to “have issues.”

I am pretty sure my wasp gall in empty; the botanist thought so from the small hole in it and its brown color, and I noticed when I first picked it up how empty it feels.  Wouldn’t want to bring any creepy crawlies or stinging things into my house.

Supreme Court baseball

June 25, 2012

I was following the scotusblog live blogging this morning because I was invited last week to submit a question to a NYTimes Room for Debate feature about the Supreme Court’s decision on the Affordable Care Act when it comes down.  Apparently the live blog attracted close to 100,000 viewers, according to the bloggers there.

What I noticed were the forces that were encouraging me to get very caught up in the excited energy around this event and how that seemed to contribute to removing the decision itself from the realm of the everyday and the everybody.  My personal need to execute a task well made it easy for me to justify being a part of something I might otherwise have clicked away from with a sense that I did not want to contribute to the escalation of policy disagreements into political fighting spectacles.  The contents of the blog read to me like “inside [Supreme Court] baseball,” and while it was very well done and I could follow most of it, it really lifted the whole thing out of the realm of Main Street and into the realm of Law Reviews.

On the other hand, I wondered whether there is an upside to political controversies becoming arcane and legalistic: maybe it really does help filter out raw emotion and self-interest and lead to decisions more in the public interest, in contrast to something like a referendum on a ballot or a debate in a legislative forum.

In any event, it felt to me that the realm of the blog and the decision-making was far removed from my other tasks this morning of calling various health insurance bureaucracies about paperwork and eligibility requirements.

Health control

June 25, 2012

I was reading yet another person’s comment on line that took the attitude that people have control over whether they are, and stay, healthy.  I think these people are conflating two separate issues:  whether we can worsen our health and whether we can ensure that we have good health.  We can worsen our health, but we can’t be assured of having continued good health, even if we do everything right.  I don’t think that’s a reason not to try to encourage good heath in ourselves, but we should have reasonable expectations of ourselves and others about maintaining good health.

Pattern recognition

June 24, 2012

I seem to keep repeating the same pattern with someone in my life.  Every time this person denies there’s something more they could be doing within the relationship and tells me to pick up the slack, I respond with something to the effect that having a relationship with them is a mistake.

Whatever one thinks of the merits of the substance of the positions, the pattern is unmistakable at this point — we’ve been doing this for over a year.  I am wondering whether they will ever propose a different idea or whether we will just keep repeating this exchange of telling the other person what they don’t want to hear.

I actually suspect both positions may be tenable if both are adopted simultaneously — no relationship and I pick up the slack.  What I don’t think can be the case is having one of the positions adopted and not the other.

The piece that is missing that I suspect allows this pattern to continue is a lack of appreciation that however much they are trying to avoid harm to themselves, they are asking the other person to accept that much harm themselves.

What would resolve this situation into a win-win would be a proposal for which the mirror image would be equally acceptable to the initial proposer.