So When IS the Right Time?

You may have noticed a certain audacious argument coming from elite circles about why we shouldn't be letting the Bush era tax cuts expire. The argument is that in the middle of a recession, it's the wrong time to ask people (even very rich people) to pay more in taxes. They need to have more cash in hand so as to spend more, which means industry will produce more, which means they'll hire more people...a virtuous circle leading to economic recovery.

It's funny how corporations, bankers and politicians who used to think they could control the economy simply by raising or lowering interest rates have rediscovered John Maynard Keynes just when they might have to fork over more in taxes. But the audacity of the argument is that it can be used at any time. If we are in recession, we don't want to raise taxes lest it make things worse. If the economy is improving, that's the wrong time, too: do you want to choke off the recovery before it really takes effect? And if the economy is going great guns, why raise taxes and ruin the great thing you've got going? It's as if the whole purpose of government were to avoid taxing people--not to spend taxes wisely for the public good.

Now we are hearing a similar argument about putting people out of work. It seems it's always a good time to "downsize" and never a good time to make sure more people have jobs. "That's the story at State Street Corp., which recently announced the elimination of 1,400 jobs, including 400 in Massachusetts. Those jobs are gone, even though State Street last reported profits of $427 million, up about 20 percent from a year ago," reports Joan Vennochi in the Boston Globe.

There's a word for this in Yiddish: chutzpah. The old joke said that chutzpah means murdering your parents and asking the court for mercy because you're an orphan. The new joke is the chutzpah of corporate fat cats who justify their huge profits because they "give us jobs"--and then increase their profits by taking those jobs away.

The Limits of Power

Americans confuse freedom with a never-ending abundance of goods. As the economic power of the U.S. has declined, we have naively relied on military power to keep the goods flowing. But this has cost us our real freedom: freedom from an imperial presidency that keeps spilling the blood of our own citizens (and the citizens of many other nations) in a fruitless attempt to create a permanent American empire. We need to get over our illusions and embrace what's really possible and necessary. Ending the threat of nuclear war, for instance, is achievable in a way that ending terrorism is not.

These are the lessons that Andrew J. Bacevich wants us to learn. His short book The Limits of Power lays them out in clear language, with compelling examples, in a factual manner but with the courage to point out when American policy is stupid, or absurd, or self-destructive. Bacevich has the experience to write this book. He retired from the Army at the rank of lieutenant colonel and now teaches history at Boston University. He also possesses the moral authority. His son, Andrew Jr., followed his father's path into the military and died in Iraq in 2007.

I tremendously respect Bacevich's honesty, intelligence, and well-placed outrage. He is politically conservative and intellectually rooted in Reinhold Niebuhr and the "enlightened realism" school of foreign policy, whereas I am a man of the Left and rooted in Marx and the analysis of imperialism that grew up in the U.S. around the Vietnam War, but we both see the folly of this country's course in foreign affairs.

Where I think Bacevich falls short is that he roots this problem in a moral failing. Using 19th-century language, he accuses Americans of "profligacy," meaning a wasteful addiction to consumption without any regard for the consequences for ourselves or others in the long term. I can't argue with that as a description, but it falls short as an analysis. Why has our culture grown in this direction? Isn't it because corporate capitalism requires an endlessly expanding market of people to buy things they had no idea they needed before they were produced? When people stop spending more than they can afford, this economy falters, meaning people get thrown out of work. Pretty soon, they can afford even less...and so it goes.

It's not a moral failing that makes the pursuit of abundance the goal of U.S. foreign policy. It's a contradiction within our economic system. Bacevich speaks eloquently about the limits of power, but he does not observe the limits of capitalism that have pushed us toward using power willy-nilly as a last resort to avoid economic decline. It will take more than sermons about profligacy to change something that's so fundamental to the way work, investment, consumption, leisure, and political power are all organized in this country.

It may take a catastrophe. I hope not, and if we avoid a catastrophe, it's because people like Bacevich sounded the trumpet for a new way of thinking. Even if he hasn't totally achieved that himself, he deserves thanks--and your reading time. (You can also see an interview with him on Democracy Now!)

The Audacity of Disappointment

Why are we so disappointed with Barack Obama? A recent piece in the Boston Globe blamed it on our brains. "Research suggests that even when people know that someone has nothing but bad options to choose from, they still blame the decider for a bad outcome." Even worse: as time goes on, we think in more and more glowing terms about "what might have been if different decisions had been made, different policies pursued, or different politicians elected," and therefore feel even more disappointed with what actually happened.

The psychological explanation of "the big letdown" is a conservative explanation. It implies that things never could have been as much better as we think. Hope and change are delusions. As Hegel said, what is, is right--because TINA (There Is No Alternative).

How about a political explanation instead? We are disappointed with Obama because as a candidate, he seemed to get it that radical change in this country is urgently needed, and then as President, he forgot all about that. We are disappointed because he and his advisors said, in so many words, that a crisis is a terrible thing to waste--and then proceed to waste it, by failing to explain to the country what got us into this mess and what it would take to get us out, permanently. We are disappointed because it doesn't matter what options it seemed he had: the reason we elected him was to create new options. We are disappointed even if we knew all along ( as many of us did, and wrote) that Obama was a cautious technocrat by training and inclination. We are disappointed because we need and deserve better--and because not to be disappointed would be to accept the unacceptable state of affairs in which we continue to live.

Extreme Words about Smug Moderates

I hate smug moderates.

Scott Lehigh of the Boston Globe recently ended a column on taming the deficit by saying, "But even if you’re a left-winger insistent that it all be solved with taxes or a right-winger adamant that spending cuts are the only acceptable remedy, the Pew report is still well worth your while."

Has Lehigh ever met a real left-winger? If he had, he might know that we do want spending cuts: on wars of choice, and military hardware we don't need that mainly fattens the wallets of military contractors. We also want to end tax giveaways, like the ones that let many millionaires and multi-nationals avoid paying a nickel for the common good. If you want those things, maybe you're a left-winger too. Welcome to the club!

We also want taxes, on the right things, for the right purposes. A war surtax on the people with the highest incomes would be reasonable and fair--and it might also prevent future wars. A small wealth tax could go a long way toward closing the deficit that has middle-of-the-roaders so worried.

But the fact of the matter is that when millions of people are out of work, or working part-time, or doing two or three jobs that don't pay enough individually to support a family, this is not the time to be worrying about deficits. Franklin Roosevelt listened to people like that, and it extended the Depression for years after it could have been over. People like that: good, sensible, cautious people who thought they knew what left-wingers stood for and opposed it.

Moderates. Pfui. As a real left-winger, Jim Hightower, says, "There's Nothing in the Middle of the Road but Yellow Stripes and Dead Armadillos."

Time for Less Positive Thinking!

I understand that people who are out of work have to stay positive, as an article in the Boston Globe reported today. It's a psychological necessity--even if it gets extreme at times.

Steve Kitay, laid off from Fidelity Investments, made a vow to stay upbeat during his job search, even as his wife, Cilla, was diagnosed with breast cancer. “Nobody wants to talk to you if you’re negative,’’ said Kitay.

And he's right, unfortunately. But the rest of us, those who have jobs, should not stay positive. It's our duty to be critical--and even negative.

We should think critically about the claims that people are personally responsible for their unemployment. It took years and years of rapacious profits and mendacious politics to get us to this point. Close to one out of every six people in Massachusetts are not living in poverty because of character flaws. This is a social problem.

We should also think critically about the claims that government has done all it can do and that it's time to worry about deficits. There is no history to back that up, and the economic theory that supports laissez-faire and trickle-down is the same theory that got us into the recession in the first place. Even Alan Greenspan confesses that.

We should be negative. We should say no to tax breaks for the rich, bonuses for the speculators, and war profits for Halliburton and Xe (which is really Blackwater but dares not speak its name). We should say no to wars that waste the lives of people back home as well as those who are killed and maimed in battle. Unemployed people cannot afford to be negative? Then they must depend on us to do it. We cannot afford to be brightsided any longer.

Justice and Lovingkindness

One of the most haunting melodies of the High Holy Day season is the one that wafts the prayer Avinu Malkeinu up to the rafters at my synagogue, Temple B'nai Brith, every year. The words are equally poignant. Taken literally, they ask God to answer our prayers and show us a grace we don't deserve, because our good deeds are nothing close to what they should be.

This year, I read the prayer against the grain. I know that aseh imanu tzdakah va-chesed means that we ask God to show justice and lovingkindness in God's dealings with us. I choose to read "with us" as meaning "through us." As John Kennedy once said, "Here on earth God's work must truly be our own." When we chanted Avinu Malkeinu, I prayed that we in this community become the agents of justice, and of kind and loving deeds, that we would normally think are too much for us to achieve. This poor world needs so much from us. It is so daunting sometimes. Let us find the strength to go on working for a better world.

You Don't Have to be Jewish..or Even Believe in God

Last Saturday, the weekly Torah portion pictured God saying about the people who are about to enter the Promised Land, "They will forsake me and break my covenant" (Deuteronomy 31:16). Reading that verse reminded me of a very similar verse in Jeremiah, which states: "[They] have forsaken me and have not kept my Torah." To which the Pesikta D'Rav Kahana, a 5th- to 7th-century midrash, glosses: "If only they had forsaken me--and kept my Torah!"

Torah literally means teaching, instruction. It is not only the contents of the five books of Moses, or even of the whole Hebrew Bible: it's the tradition that's developed--and still developing, this instant--about how we should live our lives. As the rabbis read it, the God who is a character in the Torah (narrow meaning) says that we don't have to believe in God as a reality in the universe at large. What we have to believe in is Torah (larger meaning): that there is a way to lead a moral life as a person and as a society, and that studying to understand it and to walk in that way is the most important thing we can do.

A God who can say that I don't have to believe in God: that is a God I can believe in! Even if that God doesn't happen to exist (as Stephen Hawking is now arguing, and which would be a most inconvenient truth), that God is still the moral example I can follow and in whom I can put my trust. And my belief that I am in partnership with the moral force of the universe allows me to be partners with you, whether or not you believe in God.

So let's make this world better. We'll find out about the next one if and when we get there.

We Are NOT Out of Iraq

President Obama's declaration last week that combat operations in Iraq have ended is just as big a lie as President Bush's banner, "Mission Accomplished." Your tax dollars and mine are still paying to defend a government in Baghdad made up of warlords who have the same approach to women that the Taliban does. The money is not going to GI's anymore. It is going to mercenaries.

As Derrick Jackson pointed out in the Boston Globe, as the regular military stood down, the shadow military stood up.

A July report from the Congressional Research Service indicates that the number of private security personnel has risen by 26 percent during the drawdown. The report also says there are 11,600 private security forces in Iraq operating under the Department of Defense, a number corroborated by the federal bipartisan Commission on Wartime Contracting. So the total US security force level in Iraq — both military and private — is around 64,000.

Regular U.S. troops and spies have treated Iraqis in ways that poisoned the name of the U.S.: remember Abu Ghraib? What do we think will happen when soldiers-for-hire, including the infamous Blackwater under its new name of Xe, are in charge of U.S. interests in the country?

We in the U.S. may want to "turn the page" on Iraq, but our debt to the Iraqi people is still on the books.

Who's Responsible?

Rosh Hashanah, the head of the Jewish year, begins at sunset this Wednesday night. It's a joyous time, with many beautiful melodies and the sound of the shofar wafting through the synagogue sanctuary, which is filled with friends and neighbors I might not see more than a few times a year. There are folk customs like eating apples dipped in honey and casting the failures of the past year into the river in a ceremony called tashlich. Even Jews who are not religiously inclined tend to get together with family and friends to celebrate the season.

Yet for many thoughtful Jews, the festivity of the new year is overshadowed by Yom Kippur, the day of atonement, that falls ten days later. Many of us don't know what to do with this holiday. It is not that we think we are so perfect. We are acutely aware of our failures to live up to our highest ideals. Judaism also stresses tikkun olam, the repair and perfection of the world, so it is not only our personal shortfalls that weigh on our conscience at this time: we feel responsible for the planet!

With such a highly tuned sense of moral responsibility, some Jews find a whole day when we focus on repenting for our sins of omission and commission unbearable. I have felt this way, some years in my life. If you are struggling to be joyous this new year, knowing that Yom Kippur looms ahead, I have one thing to say to you:

"Then the Lord said to Moses, 'I have pardoned them, just like you asked."

Where do we see this line in the liturgy? During the Kol Nidre service, the very first set of prayers at sunset on the eve of Yom Kippur! We spend the next twenty-seven hours searching our souls and praying (mostly as a community) for forgiveness and the power to do better, knowing that we are already forgiven!

This might seem illogical to those who think of God as a divine scorekeeper, counting points in favor and points against each person. To me, it makes the deepest sense. It reflects my understanding that God never forsakes us and always wants to see us do better. On Yom Kippur, one day a year, we stress the aspect of God as judge--but that is within a year-round understanding that God and we are loving partners, engaged in a great work together. God needs us as we need God. We are all going on together after Yom Kippur.

If that is too serious for you, then please take the words of Heinrich Heine to heart instead: "God will pardon me. It's his business."

A good, sweet year to all.

Happy New Year

Hello again. I haven't been posting very much this past year, and not at all in the last few months. That's partly because it's been the busiest year of my life at work. Because of thre recession and because of economic stimulus funding, we've been able to add new programs and help many more people who were about to lose their homes, or who needed food stamps and fuel assistance to make sure they could both heat and eat...or who took the longer view and enrolled in our job readiness course, believing that sooner or later, jobs would be available again. That's all to the good, of course--but it has meant I have personally been responsible for submitting four times as many reports to Washington as in 2008. I came home each day and felt more like going to bed than like writing a blog.

I have to admit, though, that what really held me back was the sinking feeling that nobody was listening. I am not so vain, or so enamored of the sound of my own voice, as to send my words out to the blogosphere just for my own satisfaction. Making a difference has always been my passion. Feeling as if I made no difference whatever has kept me from trying, and therefore, I failed to make the small impact it is in my power to make. I am sorry for that. I will try to do better.

I feel a little bit like Peter Pan asking this, but if you want to see more writing from me, please clap your hands--I mean, show your support. Comment on what I've written. Repost pieces you think your friends will want to read. Keep the conversation going. As we begin a new school year and a new year on the Jewish calendar, I hope we can write a new chapter in this book of life.

Use Your Powers for Good

Rand Paul, who is running for the U.S. Senate from Kentucky, thinks for the President to criticize (much less regulate) BP, which is spewing oil all over the Gulf Coast is putting the government's "boot heel on the throat of BP."

http://news.yahoo.com/s/ap/20100521/ap_on_bi_ge/us_rand_paul

He also thinks the federal government used too much power when it passed the Civil Rights Act in 1964. Restaurants, hotels, and such are private businesses, according to the son of former Republican presidential candidate Ron Paul, and the government shouldn't demand that they serve black people--just politely suggest that it's the civilized thing to do! Same thing with the Americans with Disabilities Act: just another instance of "big government."

http://www.boston.com/news/nation/articles/2010/05/21/tea_party_candidate_faces_heat_for_stance/

When you hear people complain about "big government," remember what they really mean is government that stands up to the powerful people in America. Whether those powers are the white supremacist establishment in 1964 or the corporate elite today, government is the only institution with enough countervailing power to call them to account. But we, the people, have to force the government to use its power in our interests--and we won't do that if we get distracted by people like Rand Paul.

Health Insurance Bill is a Ticking Bomb

I have been showing how the new federal bill that requires people to buy health insurance resembles the system we have here in Massachusetts, which is wrong and unfair. It forces people to buy coverage without actually getting care. It plays Robin Hood in reverse by sending working- and middle-class people's money to rich insurance companies and hospitals. It stigmatizes women who exercise their right to obtain an abortion. People who don't have health insurance yet think the Massachusetts plan doesn't give them what they need, and they resent having to pay for something that doesn't save them any money.

(It may be true, as my friend Larry Lennhoff says, that people will realize the value of health insurance the moment they have a catastrophic illness. For most of us, fortunately, that means never realizing it. It may also not be true. If the public was going to be on the hook for your care before, and now you are paying for insurance yourself, how does that make you happy?)

What I fear most about the new health insurance bill is that it may make people oppose ALL forms of publicly funded health care. Some people think this has happened already. They read the recent election of State Rep. Scott Brown to the U.S. Senate seat as a referendum on health care. I believe this is a whopping big mistake: the Democratic candidate, State Attorney General Martha Coakley, failed to mount any real campaign after she won the Democratic nomination. In effect, she gave the election away. Furthermore, I believe people took their frustrations with the corrupt Democratic monopoly of the Massachusetts legislature out in the Senate race. It doesn't matter that the two have nothing to do with each other.

Still, I do hear people complaining about the Massachusetts bill in casual conversation--in the public library, for instance, checking out books. People are forming the impression that if the government runs it, it's bound to favor the rich and hurt them. They have a lot of reason to think that, and the mandatory health insurance bill just adds one more. To me, that's the biggest reason to oppose it and want to replace it. When you're alienating voters who should be your strongest supporters, you need to think again--before it blows up in your face.

Stigma against Abortion: What's to Oppose in the New Health Care Bill. part IV

Abortion is a legal right. What's more, it gives women the opportunity to refuse to give their bodies to pregnancies they don't want, or spend years raising children they may not have the money or the will to raise. No man has to make that choice: the least we can do is support women in the choices they make. Yet the new mandatory health insurance bill passed by Democrats in Congress and signed into law by President Obama paints a scarlet letter on women who choose abortion.

Sharon Lerner wrote in The Nation:

When the debate moved to the Senate... another Democrat, Ben Nelson, led the charge to restrict abortion coverage, proposing an amendment requiring any woman who wants insurance to cover the procedure to write a separate check for that premium. The Nelson Amendment also requires health plans to keep funds for abortion separate.

Apparently, there is no problem with funding agencies that bomb civilians and torture prisoners, but health plans that pay for women to exercise their legal rights are so shameful the government of the people, by the people, and for the people cannot be seen to support them. This is a tremendous step backward for women's rights and health, as well as for equality in America.

Uninsured Don't Think the Answer is Forcing Them to Buy

I've been recapping the Massachusetts experience with mandatory health insurance, asking what it can tell us about the federal plan just passed. Back in 2008, I wrote:

If you believe the papers, the politicians, or the pundits, the Massachusetts plan to make sure everyone has health insurance--by forcing them to buy it for themselves--is a great success. The uninsured don't believe it, however. Neither do low-income people in Somerville, where I live. Neither do I.

According to the Boston Globe, "The number of uninsured adults in Massachusetts fell by almost half last year." Proponents of mandatory health insurance said "that not only are more people getting coverage, but that only a fraction of taxpayers contested the health insurance mandate."

Sounds like great news, right? It does--until you look at who supports mandatory health insurance and who doesn't. People who already have insurance favor the plan by 71%. Not surprising: it doesn't cost them anything out of pocket, and the taxes needed to fund the plan haven't kicked in yet. But a majority of people who don't have health insurance yet--the people the plan is theoretically supposed to benefit--don't support it, according to a study by the Massachusetts Dept. of Revenue.

In Somerville, where I live, we recently [in 2008] surveyed 537 mostly low-income residents or employees. We asked them what should be the top priority of CAAS, the anti-poverty agency where I work. Keeping housing safe and affordable was the $1 priority (not a surprise, given the high cost of housing in our area). English literacy and finding a job, or a better job, were essentially tied at #2. "Access to health insurance" ranked #3. The people who need health insurance the most are telling us that the Massachusetts plan is still a problem and not yet a solution.

You MUST Buy Health Insurance--Corporations Need Your Money!

I've been sharing the Massachusetts experience with mandatory health insurance with my readers, so you can know what to expect from the federal plan that's modeled on Massachusetts. Expect Robin Hood in reverse: a big subsidy by the working poor and middle to the richest of the health care providers. I originally published this piece last summer.

Massachusetts requires all residents to buy health insurance, even if it means coverage without care. Buying a health plan with a high deductible means paying for nothing, which is what thousands of Massachusetts residents are doing. But it's worse than that.

It turns out that our state government forced struggling young people and families into the insurance business partly so that hospitals didn't have to give them free care any more. "Today, hospitals typically spend about 1 percent of expenses on free medical care, as measured by the attorney general, half of what they spent before reform made insurance available to many more low-income people," according to the Boston Globe.

Meanwhile, nonprofit hospitals are making a profit out of their tax-exempt status--an exemption granted to them largely so that they could offer free care!

The 10 leading hospital companies benefited from an estimated $638 million in federal, state, and local tax breaks as well as state discounts on borrowing in 2007, the latest year for which complete data are available. More than half of that goes to two large and growing companies, Partners and Children's Hospital. Overall, the 10 hospital companies' tax breaks and other benefits were worth $264 million more than the value of the "community benefits" - care for the poor and other charity work - they reported to the state attorney general that year.

It's important to mention the hospitals that ARE offering a lot of free care: "Three companies - Tufts Medical Center, UMass Memorial Health Care (owner of UMass Memorial Medical Center in Worcester) and Boston Medical Center - reported spending more on community benefits than the value of their tax breaks as estimated by the Globe." But they are the shining exceptions--and Boston Medical Center is having severe financial troubles because of its commitment to serving the poor.

In short, so-called nonprofits like MGH and Children's Hospital are stiffing the poor, and we are giving them a tax break at the same time. This should be the shame of Massachusetts.

Coverage Without Care: What's to Oppose in the New Health Care Bill. part I

OK, so last week, in all fairness, I pointed out that the health insurance bill does contain some provisions that will help people--especially really poor people or really young adults (26 and under). In general, however, the national health insurance plan follows the path already trod in Massachusetts. Having lived under it, the Massachusetts plan is not one I would recommend.

What's wrong with it? Plenty. Let's start with one issue I have been observing for almost a year now: coverage without care.

I wrote on May 4, 2009, "Across Massachusetts, people are facing a stark choice: pain or poverty. The mandatory health insurance law forces people to buy some kind of coverage, but often, what people can afford won't pay for the care they need. In today's Boston Globe, Judi Campbell of Northampton says she's putting off hip surgery because she already owes the hospital $1,000 for arthritis-related surgeries her insurance wouldn't cover."

"And yet the Globe and many policy makers proclaim the "success" of the Massachusetts health insurance plan. For shame!"

On June 21, I wrote:

"The Globe reports:

People with robust [sic] health insurance are putting off doctors’ appointments and skimping on prescriptions because they can’t afford the increasing costs of copayments and deductibles, according to managers of patient-assistance hot lines in Massachusetts.

"All right, let's give the reporters credit. Never mind the logical impossibility of health insurance plan being "robust" if you can't actually use it. (The operation was successful, but the patient went broke?) Also, forget about the fact that this only becomes news when it affects middle-class people, the kind who thought they were already well insured. "

"Let's be happy that finally, it's front-page news that the Massachusetts individual mandate to buy health insurance is failing to deliver actual health care to a large and growing number of people. The key word here is "failing." This is not a model for national health insurance. It's an object lesson in what happens when the hospitals, insurance companies, and doctors all design a health plan without the slightest thought for its effects on actual patients."

Next installment: how the Massachusetts health insurance plan is Robin Hood in reverse--and the federal government follows suit.

To be continued over matzah

All right, the preparations for Passover have put my blogging behind schedule. I will get back to analyzing the health care bill next week, after the seders. In the mean time, here's a very narrow but deep problem with the health care system that the bill won't fix: http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2010/03/28/the_high_price_of_pain/.

Also to Like, but Not about Health

I forgot to mention that the health insurance bill does some good things on an entirely unrelated subject: student loans. It increases the maximum Pell Grant and forgives the debts of more students quicker. It provides money to community colleges for career training. Most interesting: it makes families who want federally backed student loans get them from the federal government, not from banks. It cuts out the middleman and saves a ton of money.

Question: if the federal government can lend money directly, why can't it buy health care directly? If cutting out the middleman is good in education, why not in health care?

What's to Like about the New Health Insurance Bill

How should we regard the new health insurance bill that President Obama just signed into law? On Monday, I gave an overview. For the next few days, let's go into the details.

Compared with the system we have now, there's plenty to like about the new plan. Based on a summary in the Boston Globe, here are some of the good points:

More money for states to pay for poor people's health insurance. "Massachusetts would receive a $2 billion boost in Medicaid assistance over 10 years to help pay for insurance coverage for low-income residents." Medicaid plans let poor people get decent health care they couldn't afford otherwise.

More money to help moderate-income people pay for their own health insurance. "Tax credits are provided to help pay for insurance, and that aid is available for people with incomes up to four times the federal poverty level, which is $88,2oo for a family of four and $43,32o for an individual."

Fewer denials of coverage. "The measure would prohibit insurance companies from denying coverage because of a preexisting condition," within six months for children and by 2014 for adults. It also lets young adults stay on their parents' plans until they turn 26 (meaning fewer will go without health insurance), and it makes sure Medicare pays for elders' prescription drugs (eliminating the "doughnut hole" in which, if you paid more than $2,700 a year for prescriptions, you were on your own until your expenses mounted to $6,200). People with pre-existing health problems, young people, and seniors make up a large part of the population! They will all be better off because of these provisions.

Coverage for legal immigrants. Currently, the federal government provides no help at all to legal immigrants seeking health insurance. In 2014, under the new bill, the feds would send money to state governments like Massachusetts which choose to subsidize health insurance for low- and moderate- income legal immigrants the same way as they subsidize low- and moderate-income American citizens.

If your question is, "Will anybody be better off under the new bill than they were before?", then the answer is, "Yes, lots of people will." And I agree with columnist Scot Lehigh that Obama and the Democrats need to go on tour to promote it. They should use every mass marketing and social networking trick in the book to spread the word and build support for the bill.

That doesn't mean I think it's a good bill. Why? Come back tomorrow to find out.

The Blessing and the Curse of the Health Insurance Bill

Democrats will say that the health insurance bill which passed the House of Representatives last night is a historic expansion of the right to health care. Republicans will say that it's full of loopholes and sweetheart deals and that it costs too much.

They're both right.

We in Massachusetts have lived under something a lot like the new federal health insurance system. We are in a privileged position to tell the rest of the nation what to expect. Over the coming days and weeks, I will try to do just that.

Here's a hint at what you're likely to hear from me. I work in an anti-poverty agency, and the way that both the Massachusetts and the federal bill expand high-quality care to the poorest of the poor is something I can applaud. Plus, everyone can be happy that insurance companies will have to cover people regardless of pre-existing conditions--and that they have to cease and desist dropping people's coverage once they get sick. These are real gains.

For people who are not among the poorest, this bill is bait and switch. It promises health care, but only delivers on health insurance, mostly at our own expense. The kinds of health insurance that many working poor and even middle-income people will be forced to buy won't help them with the things they need most: doctor visits, preventive care, prescription drugs. Instead, they'll be required to send their hard-earned money to fatten insurance company profits for policies that only kick in when they have medical emergencies. By delivering new customers to already-wealthy insurance companies while not paying attention to the daily needs of the working and middle classes, Obama and the Democrats are creating a constituency that will blame them, think of them as out of touch, and be open to manipulators like Scott Brown.

The country would be better off if our rulers had passed the Medicare-for-all type system that most people want. It would include everybody, meet all their basic needs, and cost much less. But it was never seriously discussed. That's why we're left picking out crumbs of good news on a day when we should have been able to feast on victory.

The Real Economy is People

Note: This entry first appeared as a column in the Somerville Journal.

They say the economy is improving. But you can’t tell it by Anne.

Anne is a graphic designer in her mid-50s. She has made her own living all her life, either in her chosen field or in general office work. She hasn’t been able to find a steady job for the past year. Anne came to the Community Action Agency of Somerville (CAAS), the anti-poverty agency where I work, to apply for the Supplemental Nutrition Assistance Program, or what most of us still call “food stamps.” She was denied. Having a little bit of savings for her retirement meant Anne was poor, but not poor enough for benefits.

They say the economy is improving. But you can’t tell it by Matt.

Matt is one year out of college with a degree in mathematics. He is working in a corporate mailroom, as a temp. Matt has the skills to do a lot more. His first temp job had him troubleshooting a web site designed to let middle school students study math at their own pace. He had hoped a few months’ temp work would put him in line to use his skills in a permanent entry-level job. No one was hiring. For now, he is sorting the mail.

They say the economy is improving. But you can’t tell it by the Blanco family.
Antonio and Maria Blanco have lived in Somerville since 1988. They have gone to church here and raised their three children here. They both commute into Boston where he works as a janitor and she as a nurse’s aide. Two full-time jobs are not enough to support a family in Somerville. So, four nights a week, Antonio comes home for dinner and a quick hello to his children. Then he heads out again to his second job as a night watchman in an office building. With two-and-a-half full-time jobs, the Blancos are still living at the poverty level.

For whom is the economy improving? Not for tenants living in buildings where the owner can’t pay his mortgage and the bank is taking over and evicting the tenants. Not for disabled people, who have a harder time finding work than average even when the economy is sound. Not for most of the people we call our neighbors. A few are fortunate to work in high-income jobs. Most are struggling to get by.

At CAAS, we are on the side of the struggling. We can help people narrow the gap between what they have and what they need, with services like job readiness training, housing and benefits advocacy, and early childhood education and daycare through our Head Start program. But human service agencies cannot do it alone. If life is really going to improve, all of us, in Somerville and across the country, have to change the way we think about “the economy.”

The real economy is not corporations, nor the stock market, nor the price of real estate. The real economy is people. How many people have jobs that pay a living wage? How many families can pay for the necessities of food, clothing, shelter, healthcare, transportation and childcare without working all day and all night? Who has a sense that they really belong, as a respected member of this community? Who can look forward to a better future?

These are the questions we must ask ourselves. These are the goals we should set for our city and our country. We will know we live in a better economy when the answer to each question is, “We are all doing better, together.”