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FeedMedical Morality
It’s been interesting to watch Hawaii raise cigarette taxes, this time to cover the budget gap. Usually, such sin tax increases are tied to arguments that the money raised will go to cover health care services, something the state has done before. This is all part of a national pattern, Hawaii is no different from any other American state on these issues. My lunchtime Web browsing took me a corner of the CNN.com site where Jack Cafferty discusses the latest move to raise cigarette and junk food taxes to raise money for national health care reform. Cafferty pointed out that such tax moves can be controversial, something we’ve seen locally with the recent hikes of cigarette taxes.
What caught my eye was this comment, posted there by “Mark,” which reminds me of everything I find most disturbing about the health care debates:
What is the controversy? Those who persist in creating a health care crisis by ingesting crap into their bodies should pay for their vices. Why should I, as a non-smoker, non-drinker, gym-goer pay higher health care costs for the indulgences of the mindless?
Well, sure, Mark. Hope your active lifestyle doesn’t include an injury from all that gym-going, or an accidental fall while hiking, or a tumble off a ladder you forgot to brace properly. Because the funny thing is, once we start looking for reasons why people don’t deserve the health care they need, there will be no end to the inquisitions.
I wonder if people like Mark realize how much they sound like Republicans from the 1980s and 1990s, grumbling about “welfare queens?” The complaint then went like this, “Why should I have to pay for this person’s bad choices? I didn’t tell them to drop out of high school, have three kids out of wedlock and take up a crack habit!” This made so much moral sense that, under President Clinton, welfare was dramatically reformed so that it would not be an unending river of money for people making bad choices.
A lot of people are invested in the idea that moral living yields health and that health is a civic duty we owe each other. Why do they think it’s a civic duty? Because the cost of health care is paid collectively—now through insurance premiums and socialized programs such as Medicaid, perhaps in the near future through a universal single-payer scheme. As long we are paying for each other’s health care, of course we think we have a right to tell each other how to live.
Whether your contempt runs toward lazy welfare recipients or obese smokers, the only way out of the “Why should I pay for your bad choices?” conundrum is to have everyone pay for themselves. This draws the most direct line between a person’s choices and the true cost—moral or financial—of those choices. Then the Marks of the world should have no objection. Except, what I’ve just described is also known as free-market, cash-and-carry medicine, and we can’t have that. The prevailing sentiment is that it would be unfair and immoral, because some people can’t afford health care, which is something everyone has a right to. Unless they’ve been mindlessly indulgent, as Mark puts it.
So—we seem to be stuck with these people who would ration health care on the basis of moral worth. How certain can they be in their judgments? Some people do work quite hard to have the health problems that plague them, but treating this as an absolute law of nature is irrational and unscientific. Despite our arsenal of laboratories, MRI machines and electron microscopes, science does not always know why some of us get sick and some of us don’t. Even smoking refuses to prove the morality-equals-health equation. Lethal as it is, it kills some of it habitués, but not all, not even most of them. On what basis does lung cancer decide who gets a tumor and who does not?
Still, the Marks of the world would build universal health care on the foundational belief that the health care crisis is created by people who deserve to be sick. How could this build anything other than an institution more effective at punishment than healing? That’s what makes me so anxious—when I see a comment like Mark’s, I’m more and more convinced that punishment is actually the goal.
Posted on Thursday, May 14, 2009 in Politics | Permalink
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Reader Comments:
I would like to shed further light on why our teachers and our schools are failing. I worked as a kupuna in the Hawaiian Studies program for 14 years, so I was in many classrooms at many different grade levels.
First: I witnessed first hand the problems imposed on the teachers, as well as bright students, by the policy of "mainstreaming". This system puts children with learning disabilities and lower I.Q.'s in the class room with normal and gifted children. The result is that the classroom achievement level is brought down to the lowest common denominator. The collateral result of that is the educationally challenged children are frustrated because they can't keep up, so they act out. And the bright ones are bored and so they act out. The teacher spends the major portion of her time in classroom control at the cost of academic achievement.
Second observation. Every year or so, some new system comes down the pike as the answer to low score results. The teachers discard all of their carefully crafted scope and sequence plans and start over, only to have this situation re-appear in a season or two. The teachers get burned out quickly with this added work.
Third observation. Ineffective teachers are simply shuffled off to another school. The good ones often get so fed up with the systems unwillingness to support the teachers when they use innovative and effective teaching techniques that they get out of the profession. Our talented and dedicated teachers are being lost. I have witnessed this first hand in two instances in my short career in the school system.
Fourth observation. Many times the school does not back up the teacher when it comes to discipline. I have witnessed how destructive this is to the teachers ability to enforce standards on the work performed.
I can state a case I witnessed in the school where I taught. The teacher of one of our sixth grade classes went on maternity leave. A series of substitutes were brought in. The classroom went successivily from mild disorder to mounting chaos. Finally, one of our teachers helpers was brought in. This teacher had taught for years in American Samoa, but had not completed the prerequisite certification for Hawai'i. Within two weeks, this classroom went from total disorder to focused calm learning.
I asked her how she managed this miracle. Her response is that she always followed through with whatever punishment she would hand out. If the student did not turn in the requisite work, she kept them in during recess. if it still wasn't done, the student stayed after school until it was done or until she was ready to leave for the day. The parents protested, but my principle supported her, and it was soon clear to parents and students what the requirments were.
My recollection is that she did not wish to become a teacher in our system. She preferred her role as teachers assistant because of the problems I have stated above.
Fourth observation. It makes no sense to have our school day end at 2:45 or 3:45! The teachers don't have enough time in the school day as it is, and they are constantly asked to include other things in their curriculum. In addition, most parents in Hawai'i are working parents so the choices arefor the child to come home to an empty house or pay for after school care. How much better it would be to hire special skills teachers to add to the child's educational experience. Teachers for art, music, dance, sports, drama, etc. This would give the teacher time to grade papers, plan etc. rather than increase their burden. Also, a study hall is a wonderful thing for students.
And yes, we need to pay our teachers more. We say education is important but the salaries of our teachers does not support that statement. America is dumbing down, there is no question about it. We must roll up our sleeves and face reality. Enough of the theories already. Separate the children according to their academic abilities and natural interests. And always be willing to reassess. Everyone will be better served.
Thank you for giving me a foram to express my thoughts. Pattye Wright