aca – Unspoken Politics

The Democrats and the death of SB 562

Over here in California, a considerable wave of excitement was building around SB 562, a bill that would can the current healthcare system in the state and replace it with a single-payer structure. For supporters, there was budding optimism. The current national framework created by the Affordable Care Act seems doomed, either through legislation or executive neglect. Polls indicated strong support, and though support dropped when the prospect of new taxes was raised, studies showed that implementation was probably not nearly as expensive as projected. The Democratic Party holds the governor’s office and has big majorities in both houses of the legislature. And single-payer had been passed twice during the Arnold Schwarzenegger administration.

But it died this week when Assembly Speaker Anthony Rendon shelved the bill. Activists I know are, as expected, absolutely livid. Part of the anger comes from how illogical SB 562’s death was. There was the means, motive, and opportunity to change things, but that didn’t happen. Political paralysis in a one-party state.

There are two ways to look at this. The first, pretty common among lifer Democrats, is that this was a bug in the system- SB 562 should have eventually become law, and there needs to be a couple small changes to make sure the next time (whenever that is) it succeeds.

The second is that this failure is a feature of the political system. A key piece of evidence is that single-payer has gotten through the obstacles that doomed it this time around, but in a different context:

Similar bills passed the legislature fairly easily in 2006 and 2008, only to be vetoed by then-Governor Arnold Schwarzenegger. At a time when premiums were rising and there were few other proposals out there, it was an easy vote for Democrats certain of the governor’s veto.

When legislators craft bills that are guaranteed to receive a veto, what they produce is more marketing than ideology. Republicans and their endless ACA repeals passed between 2010 and the end of the Obama administration were this- political theater. In the theater, the chains of pharmaceutical and insurance influence are invisible. It tells activists that the Democratic Party can be the vehicle of progressive action, even if that never happens when cards are on the table. The California Democrats haven’t lifted a finger on higher education affordability, the housing shortage, and healthcare. The main shift since Brown took office is from purely symbolic action to milquetoast half-measures, which are passed but don’t change the trajectory of any social problems.

The failure of SB 562 will make Rendon a convenient boogeyman. There will undoubtedly be a campaign to remove him from office, or his position of power in the Assembly. It will disguise the truth: that both major parties take cash from the only groups that lose out in single-payer.

The Democratic Party feeds on the dreams of its most active members- it is the fuel that makes everything else happen. SB 562 didn’t die immediately, preserving the idea that the future is within the Party, and that the important thing is the next election. More time, more money, and what was promised will be fulfilled.

General Assembly: Why wasn’t there a second banner?

This will be the first of several posts written in the aftermath of Unitarian Universalist General Assembly 2015, held in Portland, OR from June 24-28.

A workshop I wandered into on Friday was “Class Diversity: Exploring Our Past, Building Our Theologies”, which was an interesting take on why class-diverse Unitarian congregations are rare exceptions- the socioeconomic strata of membership being very similar to what it was in the 19th century.

This was on the day that the Supreme Court announced same-sex marriage was a right under the 14th Amendment. Right outside the room this workshop was being held in, a massive rainbow banner had been constructed and signed by hundreds upon hundreds of people.

A woman came up during question-answer and gave an emotional statement that I think really dug at the heart of how Unitarian Universalism can have clear biases with regards to class. I don’t know how many people ever thought of the day as an exercise in classism, but her remark made it clear to me that there was a double-standard in play at Assembly.

Her question is this post’s title. While the court ruling about marriage equality is landmark and an important victory in the 21st century civil rights movement, it was not the only important ruling that week. The day before, the court upheld a key portion of the Affordable Care Act, which threw a lifeline to millions of poor Americans:

The latest filings show that about 10.2 million people had signed up and paid their insurance premiums through the exchanges as of March, and 6.4 million were receiving subsidies to help afford coverage in the 34 states that had not set up their own marketplaces.

Those consumers stood to lose their subsidies, worth about $1.7 billion a month, if the justices had agreed with the challenge.

These two rulings affected several million people directly. Being unable to marry who you love and being unable to pay for live-saving medical care are both serious social problems which were addressed to some degree this week. But there wasn’t a banner out in the convention center hall celebrating that 6.4 million people could keep their health insurance.

Detroit's racial segregation. Blue is black, pink is white. [http://www.radicalcartography.net/] — Detroit’s racial segregation. Blue is black, pink is white.
[http://www.radicalcartography.net/]

And I think if a banner was appropriate to celebrate a civil rights victory, a third banner should have sat there as well. The same day as the ACA ruling (Thursday afternoon), and the day before the marriage equality ruling, the Supreme Court enacted a significant change in how the law deals with discrimination cases. It allowed for a new type of argument in cases of housing discrimination. Previously you had to prove intent in a very strong standard- basically a smoking gun saying “I’m denying housing to this community based on race”. Obviously it was hard for those affected to successfully sue; now something called disparate-impact theory can be used- if evidence shows that a law statistically promotes housing segregation, that can be enough. If this is to spread to other places- disparate-impact is used for hiring in some circumstances, but not many other places with potential for discrimination, it will be just as important as the marriage equality and ACA cases.

So why only one banner? The housing case is also a discrimination issue, and both are part of the modern civil rights movement. The ACA ruling in terms of dollars is a big win for the working class. I don’t know why there was only one banner, though I’ll offer this potential theory:

What makes marriage equality different from healthcare subsidies and housing discrimination is that marriage equality is a civil rights issue that affects everyone regardless of race or class. In a faith that skews white and upper-middle class, the presence of one banner (and one banner for that particular case) is evidence of implicit bias. I agree with the woman who spoke up, she added a concrete sense of what classism is that the workshop really needed to be worthwhile.

The next post will tackle how the Black Lives Matter movement caused tension and strife, both across racial lines but also generational ones. Certainly if Black Lives Matter, a step towards ending racial discrimination in housing (with its ties to the ghetto and redlining) should be celebrated. How does Unitarian Universalism grapple with its own diversity questions, the balance between support and paternalism, and being a leading force for change versus being earnest and strong followers?

Understanding what mental illness is and is not

I’ve been featured twice recently in articles about the Affordable Care Act and its impact on mental healthcare- first by the Peninsula Press, and subsequently by Generation Progress, which is an offshoot of the Center for American Progress think tank. This wasn’t by accident- I approached the author of the first article, Maya Horowitz, during a county meeting on mental health. What prompted me is the serious lack of literacy in regards to what people with mental disorders are like and the challenges they face. The ACA is a good legislative step by eliminating these disorders from disqualifying individuals from quality insurance, nevertheless there still is societal stigma.

A place I return to time and time again is the largest bipolar community on reddit.com. To some extent, in a non-medical sense I’m already somewhat of an expert. Living with bipolar disorder for almost nine years now, I see my own early struggles in new people that show up. In the pre-ACA era there was what I described to the Peninsula Press as “a climate of fear.” Consequently most people stayed in the closet, and avoided disclosing their status to co-workers. It was dangerous to let insurance companies know too much about your chronic condition, and embarrassing to disclose in a social setting.

Polls show that a third of Americans think prayer alone can overcome serious mental illness. People who openly talk about their struggles will inevitably get condescending suggestions to ditch their medication in favor of alternative remedies, yoga, or positive thinking. Many can improve their mood with exercise, sunlight, and improved diet; but scientifically it is clear that medication is the primary answer for people with severe major depression:

The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms, and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial. (2010 study, source)

The public by and large does not understand major depression, or bipolar disorder, or schizophrenia are, how they present, are diagnosed, and are treated. This lack of tangible knowledge leads to one of the most offensive aspects of mental health in America.

That the media and special interest groups are lumping all violent behavior with mental illness, and erasing any distinction between violent individuals, those with mental disorders, and violent individuals with mental disorders.

A large portion of mass shootings lead to a blame game, and mental illness is always brought up as a hand-wave answer for why such things happen. This is reinforced by scary news features, along with TV and film portrayals of sadistic, insane villains. However, the link to violence is an illusion. Terrible crimes are committed routinely by people with no trace of mental illness; the more blame lumped onto mental health, the less vigilant people are about other at-risk groups.

Indeed several mass shooters had serious mental issues, but they also had warning signs that should have been picked up on. More stigmatization keeps people from seeking treatment, and leading to risky and destructive behavior.

The reason I volunteered to go on the record is because there need to be more voices with experience, even though it’s always awkward to talk about mental illness in public. Anti-stigma campaigns are being formulated and launched- my county now has a unified campaign with quality materials. One way I look at the 21st century is how there are a shrinking number of acceptance prejudices. In many ways those with mental health are not treated with the same empathy and respect as others. They should.