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Friday, September 16, 2016

"Silence = Violence" This phrase struck a cord with me!

Over the course of several weeks I have been writing down a few of my thoughts about current events, never quite sure where this task would lead me.

I happen to be watching ESPN one day when they aired a show from the South Side of Chicago's YMCA in conjunction with The Undefeated, where sports, race and culture intersect.  I had to look that up.  While watching as a 61 year old white male in American society, I began to wonder if I could relate to the subject matter, or what if anything I could do that might have an impact in the area of race relations. When one of the host used a phrase "Silence Equals Violence," that struck a cord with me.  That cord being you can relate, and anyone who has ever been ostracized by the majority can relate, to the fear, ignorance and misinformation.  In my case it was about HIV in the early 1980's that caused me to distrust most people outside of my inner circle of family and friends. Something which to this day has an affect on who I let into my immediate social circles.  For most readers, this might not seem like a viable connection between the two issues and they may well think this is a stretch for me to be able to relate the two, but here goes.

The links between my experience and the issues raised by the people of color living in depressed urban areas of this country is the fear, ignorance and the general indifference that is caused when the majority chooses to remain silent on any topic that does not affect them personally. Even when they think or feel what is going on is wrong.  Their silence leaves a vacuum which allows other voices to rush in to fill it with fear and ignorance.  In my case, it was the so called religious leaders that stated HIV was God's punishment, and the news media telling us night after night that first responders were afraid to touch someone with HIV or morticians were unwilling to handle the body of a deceased person with HIV. Finally, the person who should protect the rights of any minority, the President of the United States, Ronald Reagan, added to this fear by stating that medical experts had not definitively found that casual contact was safe as late as 1985.  So I can relate to how it feels to hear all of this negativity being pumped into the universe about you and seeing few coming to your defense.  Add to this that you might not be at a point in your life where you want to draw attention to yourself under these circumstances.  In reality, it is hard to put yourself out there with so much negativity directed at you and the uneasiness of not knowing if anyone will stand with you.  I have been there and it is a horrible place to be for those who have never been in such a place, I hope you never find out.  You might well imagine what it might be like to be in a place where you feel helpless and exposed, but never really comprehending what a prison this environment can be without having experienced it for yourself.  Only when I got to a point where I felt I had nothing else to lose was I able to truly break free of this bondage and find my voice.  Some might conclude that these were only words, why would you let them handcuff you so? Words have a way of turning into deeds. Within the hemophilia community, we saw children forced out of their schools based solely on fear, in at least one case, their homes were shot at, and the home of a family with three boys living with hemophilia and HIV was burned to the ground after disclosing their HIV status.  These actions and the silence by the majority sent a clear message you cannot trust anyone with this information in an environment of fear and ignorance.

Since the show aired, there has been a firestorm setoff by an NFL player not standing for the National Anthem before a preseason football game, When asked why, he stated that he supports Black Lives Matter and that he did not feel that the country is living up to the ideals that it espouses it stands for, freedom and justice for all, So he is silently protesting the symbol of his country. Everyone starts by stating that it is his right but few outside of black commentators want to address what he really sees as the real problems in this country.  Most want to state or imply that it is disrespectful of veterans who fought and died for this country, even though he clearly stated that was not the reason for his protest during the National Anthem.  Others want to say that this is not the right venue for his protest and that because he is rich, he is not a representative of his stated cause.  All of these things are pivot points, to divert or distract us from having an uncomfortable conversation about race in this country. Much in the same way that homosexuals, IV drug users and sex workers were used to divert attention away from the real problem of HIV.  That we had a new virus in our country and it was going to affect the blood supply which would have an impact on thousands of people who received blood or blood products.  Once again, fear and ignorance and our uncomfortableness with the topic of race is allowing us to be distracted from the tangible effects skin color has on a person in our society.

Before the ESPN program or the NFL player protest, there was the distraction over the name "Black Lives Matter".  There seems to be a endless source of conversation over the name of this organization or movement.  Some wanted to imply that the name meant that only black lives matter which is a stretch of any interpretation of the words.  All the name was trying to do was to point out, that in their view, society did not think that black lives mattered. This name also was to serve as a rallying cry for the issue. And then Dallas happened, where a black person co-oped their message by shooting and killing police officers from a Black Lives Matter protest and a new catchphrase was made popular "Blue Lives Matter".  Both are real issues and both need to be addressed.  However we all might have been better served if they had used the phase "All Lives Matter". But this too can be a distraction keeping us from having a real discussion about race in the United States of America, and what actions we should be doing to find that more perfect union with liberty and justice for all.

Instead we hear voices saying, the black community needs to work on solving black on black crime, as if the majority of crimes perpetrated on whites are not committed by other whites. Or they ask the black community to identify the solution to these problems. It seems very strange to demand that people who might be considered victims to first make us aware of the problems and then come up with the solutions to the problems before any of the rest of us will pay any attention at all.  It is this kind of malignant neglect by the majority that keeps us in an environment where we talk past each other or worst, over the top of each other, which prevents us as a community from solving really difficult problems together.  Dr Martin Luther King Jr stated this far better that I ever could, so here is an excerpt from his "Letter from Birmingham Jail" that illuminates this point.

I MUST make two honest confessions to you, my Christian and Jewish brothers. First, I must confess that over the last few years, I have been gravely disappointed with the white moderate. I have almost reached the regrettable conclusion that the Negro's great stumbling block in the stride toward freedom is not the White Citizens Councillor or the Ku Klux Klanner, but the white moderate who is more devoted to order than to justice; who prefers a negative peace which is the absence of tension to a positive peace which is the presence of justice; who constantly says, "I agree with you in the goal you seek, but I can't agree with your methods of direct action"; who paternalistically feels that he can set the timetable for another man's freedom; who lives by the myth of time; and who constantly advises the Negro to wait until a "more convenient season." Shallow understanding from people of good will is more frustrating than absolute misunderstanding from people of ill will. Lukewarm acceptance is much more bewildering than outright rejection.
 In your statement you asserted that our actions, even though peaceful, must be condemned because they precipitate violence. But can this assertion be logically made? Isn't this like condemning the robbed man because his possession of money precipitated the evil act of robbery? Isn't this like condemning Socrates because his unswerving commitment to truth and his philosophical delvings precipitated the misguided popular mind to make him drink the hemlock? Isn't this like condemning Jesus because His unique God-consciousness and never-ceasing devotion to His will precipitated the evil act of crucifixion? We must come to see, as federal courts have consistently affirmed, that it is immoral to urge an individual to withdraw his efforts to gain his basic constitutional rights because the quest precipitates violence. Society must protect the robbed and punish the robber.
 I had also hoped that the white moderate would reject the myth of time. I received a letter this morning from a white brother in Texas which said, "All Christians know that the colored people will receive equal rights eventually, but is it possible that you are in too great of a religious hurry? It has taken Christianity almost 2000 years to accomplish what it has. The teachings of Christ take time to come to earth." All that is said here grows out of a tragic misconception of time. It is the strangely irrational notion that there is something in the very flow of time that will inevitably cure all ills. Actually, time is neutral. It can be used either destructively or constructively. I am coming to feel that the people of ill will have used time much more effectively than the people of good will. We will have to repent in this generation not merely for the vitriolic words and actions of the bad people but for the appalling silence of the good people. We must come to see that human progress never rolls in on wheels of inevitability. It comes through the tireless efforts and persistent work of men willing to be coworkers with God, and without this hard work time itself becomes an ally of the forces of social stagnation.
 YOU spoke of our activity in Birmingham as extreme. At first I was rather disappointed that fellow clergymen would see my nonviolent efforts as those of an extremist. I started thinking about the fact that I stand in the middle of two opposing forces in the Negro community. One is a force of complacency made up of Negroes who, as a result of long years of oppression, have been so completely drained of self-respect and a sense of "somebodyness" that they have adjusted to segregation, and, on the other hand, of a few Negroes in the middle class who, because of a degree of academic and economic security and because at points they profit by segregation, have unconsciously become insensitive to the problems of the masses. The other force is one of bitterness and hatred and comes perilously close to advocating violence. It is expressed in the various black nationalist groups that are springing up over the nation, the largest and best known being Elijah Muhammad's Muslim movement. This movement is nourished by the contemporary frustration over the continued existence of racial discrimination. It is made up of people who have lost faith in America, who have absolutely repudiated Christianity, and who have concluded that the white man is an incurable devil. I have tried to stand between these two forces, saying that we need not follow the do-nothingism of the complacent or the hatred and despair of the black nationalist. There is a more excellent way, of love and nonviolent protest. I'm grateful to God that, through the Negro church, the dimension of nonviolence entered our struggle. If this philosophy had not emerged, I am convinced that by now many streets of the South would be flowing with floods of blood. And I am further convinced that if our white brothers dismiss as "rabble-rousers" and "outside agitators" those of us who are working through the channels of nonviolent direct action and refuse to support our nonviolent efforts, millions of Negroes, out of frustration and despair, will seek solace and security in black nationalist ideologies, a development that will lead inevitably to a frightening racial nightmare.

There is no humor in thinking that this could just as well apply today as 50+ years ago.  What really seems to be the problem is that we as a society do not look at things from the other persons point of view and ask a very simple question, "If I were in their shoes, how would I feel?"  If we as members of the majority lose our ability to care about anyone in any minority groups, then we are in real trouble, because we have lost one of the pillars of our democratic republic, that being the majority must never impinge on the rights of the minority.  We should work to insure their rights and in so doing protect all of our rights.

It is also of note to me that the first white athlete to take up the National Anthem protest happen to be a woman who is openly gay,  This makes some sense to me because outside of race there are few groups more dismissed or demonized  than these two subgroups of our society.  Things have changed over the years for both of these groups, but not without protest and great pain.  It was not because the majority woke up one morning and said this is wrong we need to change.  It was the constant pressure on the majority by groups willing to protest which open our eyes to the fact that these were real people living and working around all of us, and they deserved to be treated as such with all of the rights the rest of us take for granted.

A final note, I did not come willingly or happily to supporting the National Anthem protest. My father served this country's armed forces for 22 1/2 years and was buried under its flag way too young. I would have proudly served if I had not been disqualified at birth. But, I have come to realize that for any protest to be effective, it has to disrupt our normal lives and cause us to pause, to think about what is being protested.  It is then up to us to become knowledgeable about the issue, and turn that knowledge into thoughts and deeds for a positive change to occur.  This, I hope my father would understand and appreciate, that I am taking a thoughtful and reasoned stand against injustice and inequality, especially because the protest made me uncomfortable and caused me to think about it,

When we get to the point where when I look at you, I see me and you look at me and see yourself, we can truly be one nation indivisible with liberty and justice for all.

Silent no more!                 

Saturday, April 11, 2015

Ryan White: the face for thousands!

This past week was the 25 anniversary of the death of Ryan White at age 18.

This has caused me to reflect on what this young man, whom I never met, meant to me.  Early in the 1980's, I was working at Texas Instruments when the first cases of a new disorder was hitting the hemophilia community.  Until this point in time, I had always disclosed my hemophilia to close co-workers, not making a big deal about it.  Feeling that this gave me some protection in case of an accident where I could not speaking for myself, that others would know what to do and to share the information.  This had been a long pattern in my life, having never lived around extended family and moving every four years because of my father's military service. My early family life was dependent on friends and neighbors to fill in the role of an extended family. So it was natural that I would continue this practice in my early adulthood when my wife and I moved to Houston for a job, our neighbors, co-worker and friends would fill the role of extended family.

But then something curious happened, there were news articles and television programming, reporting the first six cases of a new mysterious illness affecting hemophiliacs.   It was affecting others as well  and the early groups were dubbed the 4H club by some.  These were homosexuals, hookers, Haitians and hemophiliacs.  The reports spread more fear that illumination about the new disorder, because they alway said that this new mysterious disease was always fatal and that no one knew how it was spread.  I took one look at this list and took steps to protect my wife because at least two member constituents of the 4H club were there because of sex.  I did not understand why Haitians were in the list but I did understand that I was in the other constituent group hemophiliac and that there was a risk to me.  In early 1983 we moved into our first new home and because of the news reports I was no longer sharing my medical information with my new neighbors because of how the general public and in some places state government agencies were responding to this new disease.  Ryan White a child with hemophilia was prevented from going to school and his neighbors ran the family out of Kokomo Indiana.  The Ray family had their home burned down after the three boys with hemophilia disclosed to their church minister that they had the newly identified disease.  These events had a chilling effect and drove my medical information, particular my hemophilia underground.  There was nothing I could do about the co-workers I had previously told but to respond to their questions by saying that I was being tested every six months, which by late 1985 was true.  By then I was positive for the newly named virus HIV.  Years later I would find out that stored samples of my blood showed that I became positive for the virus during a six week period in the summer of 1983 shortly after the birth of my son.

Because I was a young father and husband, I took the steps I felt were necessary to protect my family and my career by not disclosing my hemophilia to anyone other than medical professionals, and even they did not always respond positively to the information.  At the same time my hemophilia was being driven underground, Ryan White was fighting to get back into a classroom and I was cheering him on privately.  But the experience of the fear I felt from having to worry about how others would respond to my having hemophilia and HIV has changed me forever.  I am less open, I let far fewer people into my inner circle of friends and I am more guarded with people who do not understand hemophilia and HIV well.  It was not until I lost my chosen career and my son was of an age that I could explain things to him, so that he could protect himself against ignorance, that I finally got my voice back regarding my lifelong advocacy for hemophilia and the newly acquired HIV and how much I was thankful to Ryan White for filling the gap with his courage.  From my point of view at a time when thousands of us with hemophilia and HIV were unable or unwilling to stand up and speak for ourselves, Ryan White filled this role, maybe reluctantly but always bravely.  Twenty five years after his death, some of us are still here and we remember the venerable role he played on our behalf.

Wednesday, March 18, 2015

Some Myths Die Hard!

After spending what seem a lifetime educating people about bleeding disorders and hemophilia specifically, it was disheartening to waken on Monday March 16, 2014 to find my social network full of statements denouncing ABC Television's "Secrets and Lies" (S1, E4) for one of the characters referring to hemophilia as "a nasty byproduct of incest". This is a myth born out of hemophilia being in the Royal family's of Europe and Russia. Before genetics and mutations were even thought of or well understood medical practitioners attempted to explain the occurrence of hemophilia in a family as one of those disorders that might happens within a small pools of genetic material, intra-family marriages. In other words incest was a possible culprit for the occurrence of hemophilia in a family, this is the myth that will not die.  This false explanation so long ago does not stand up to the medical and scientific knowledge and understandings of genetics and mutations of genes that we have garnered from years of research and study in hemophilia.

When I say that I have spent a lifetime educating people about hemophilia, I am including medical professionals as a large component of that group.  As a child growing up in a military family we moved every four years of my life until age fifteen.  So there were always new doctors, nurses and of course because of their military service they were always coming and going where and when the service sent them, so I never really and any one doctor for more than four years if we were lucky.  Since hemophilia is a small subcategory of a specialist in Hematology/Oncology and the disorder rare only 1 in 10,000 births, most hematologist may never have treated a person with hemophilia before meeting their first patient with the disorder.  So mine and my parents knowledge was important to my care.   Since the age of twenty four I have been under the care of one of the federally funded Hemophilia Treatment Center.  Like most of these centers mine is connected to a medical school, so we get to see medical students and newly minted young doctors from time to time and I take every opportunity to pass on as much information as I can in the time I have with them.  I have even given several talks to Intro- to- BioTech classes at my alma mater and presentations to insurance executives on hemophilia.  So it is hard to understand why this particular myth continues to persist.

The reason I have an understanding of this myth is that it is one that my own Grandmother held until she was in her nineties.  Late in her life I attempted to connect myself to the two other known hemophiliacs in my family tree, her brothers.  Both of whom die from internal bleeding early in their lives, one at age four and another at age sixteen.  During one of our long conversations about them, she expressed regret she had not been a spinster school teacher there by stopping the passing on of these genes.  Wanting to understand the source of this regret because it would have meant she would never have had her five children and their children and their children was and is unfathomable to me.  All to prevent me from having hemophilia was a most disturbing thought, because for the most part I have truly enjoyed my life with all of the challenges I have faced.  As I explored this statement by her in more detail the real source of this regret, guilt and shame was this myth that she had learned as a small child, that her parents were told by a doctor that the most probable cause for her brothers having hemophilia was incest in the family tree.  We have to remember that this was a time before blood typing and human to human blood transfusions were commonplace so this type of leap in logic might be understandable in that historical context but not today.   I spent some time talking with her about my understanding of hemophilia today and almost all of the information was beyond her understanding of hemophilia.  She was amazed to hear about spontaneous mutation and that women can have hemophilia.  Another myth that doctor religiously repeat even today is that women cannot have hemophilia, to a women with hemophilia.  It might be genetically hard but it is not impossible or improbable.  

My Grandmother passed away five years ago at the age of 98, since then I have learned through DNA testing that my hemophilia is a single point mutation.  This is exactly what nature does though the natural selection process, it changes a gene to see what happens in the environment, either the organism will success or fail.  Today with a little bit of high cost medication people with hemophilia can succeed in their environment just fine.  Tomorrow the future looks even better.  In my last conversation with her I told her that I firmly believe that there will be a cure for hemophilia in my lifetime, I still believe that statement to be true. 

Finally, I have spent the last couple of days thinking about what I would like to see ABC Television do about this false and offensive statement by a character in the show  "Secrets and Lies".  As an educator on the subject I thought that this might be our best chance to kill this myth once and for all.  So I would hope that ABC Television offers the national organizations representing people with hemophilia the opportunity to create a PSA (Public Service Announcement) to be aired on the anniversary of this episode in the middle of National Hemophilia Awareness Month to dispel this myth once and for all.  This would be the best possible outcome. 

Monday, June 25, 2012

Religious Freedom or Employer Oppression?

Over the course of the weekend, I was immersed into the current argument being fostered by the Catholic Church and its Bishops.  This argument goes something like this, because the Affordable Care Act includes provisions that allow for women to access a wide range of birth control and church teachings are against birth control of any form, the Church as an employer of people of many faiths at their universities and hospitals should not be required to provide insurance that covers birth control in any form to these employees regardless of who has to pay for these treatments.

President Obama's administration had hope to side step this issue in the rule writing process by HHS saying that the institution of the Church would not be required to pay for these benefits, that these treatment would be paid for by the insurance provider and not the Church, of course this became problematic in the cases of self insuring institutions.  The administration has said that it would work with these entities to resolve this matter.  But the Bishops and the Church are currently expressing that they believe the administration may not necessarily be trustworthy on these points in the rules, not withstanding the fact that the administration is trying to resolve these problems working with the Church.  The Church is advancing the argument that this provision in the law impinges on the religious freedom of the Church and it's members to live their faith.  By this standard every Catholic in a position of power in any company should be working to prevent these legal medical treatments from being provided to any women irrespective of the woman's faith.

In the case where the Church is the employer in venues that are not religious by nature, such as universities and hospitals, the Bishops have failed to understand that religious freedom is an individual's right. The relationship between employer and employee is an inherently unequal one and to have the employer determine benefit based solely on the employer faith is oppressive to those employees that live by a different faith or no faith at all.  It is the nature of this relationship that should be used as the determining factor here and not in the favor of the employer.  There is a doctrine of fairness when entering into a contract in our legal system, that being the person writing the contract cannot be the sole beneficiary of items that maybe vague in the contract.  In this case the point that every employee of an organization under a religious umbrella regardless of the nature of the business will have to live by the religious precepts of the employer was never spelled out to prospective employee.  No one who is not a Catholic would knowing enter into a contract where the result is to live as a Catholic but this point was never articulated to the employee at the time they were hired by the Church.  But, this is exactly the point that the Bishops are arguing, their faith as employer trumps that of the employee.  

If we are to take the Catholic Church and the Bishops at face value with this argument, then what happens to those institutions that do not believe in medical care of any kind (and there are some), will they be allowed to tell their employees to pray for good health as their medical benefits?  Of course this might negatively impact the bottom line at those hospitals run by the Church which may claim not-for-profit status but are run as for-profit entities.  The advancement of this argument by the Catholic Church and the Bishops seem completely alien to a person raised and weened on the doctrine of social justice that has been espoused for decades by the Church.  If the Church really wanted to live by its doctrine then they would pay a living wage that includes the necessary salary for the employee to buy their own health insurance coverage regardless of health status. The only reason that heath insurance is part of employment benefit in the United States stems from an effort to minimize inflation after WWII.  If we are to take the  Church seriously about social justice then they would have called for a single payer system just as loudly as they are calling for religious freedom today.  Alas, all we heard was silence from the Church as 50 million Americans went without health insurance coverage because employer did not offer coverage or they were denied coverage because of preexisting conditions.  The Church should have been leading the demonstration against insurance companies and employer executing these practices and policy for us to take them seriously now regarding healthcare reform and living their faith.

Thursday, February 3, 2011

MissingFactorIX: Solving the Constitutionality of Healthcare Reform...

MissingFactorIX: Solving the Constitutionality of Healthcare Reform...: "Watching the Senate debate on repeal of healthcare reform yesterday on C-SPAN, I had the overwhelming urge to throw the TV remote ..."

Solving the Constitutionality of Healthcare Reform

Watching the Senate debate on repeal of healthcare reform yesterday on C-SPAN, I had the overwhelming urge to throw the TV remote control through the front of the wide screen unit every time a Republican Senator spoke about the mandate requirement for car insurance is not comparable to the mandate in the Affordable Care Law.  After thinking about it for a while, I now think that there is less of a case for the car insurance mandate then before the debate.  

But let's think this through together.  Our city, county, state and federal tax dollars has in some partial way paid for the construction of the different localities road system typically by a for-profit construction company, so you might suppose that you would have the right to use these roads since you partially paid for them.  But according to the GOP Senators it is a privilege to do so and that using the road system by driving your own vehicle is not a right, even-though you were taxed to pay for the construction and maintenance of this infrastructure.  The purchase of your vehicle for which taxes were excised on this transaction and every gasoline purchase thereafter has been borne sole by you and your family.  The state requires that you maintain the vehicle in good working order and to demonstrate that you can operate the vehicle safely for which you pay a fee for a state license to operate the vehicle and annual renewal of license plates.  And yet the GOP Senators stood on the floor of the Senate and said that driving a car is a privilege and not a right, a privilege that the various local, state and federal government have taxed you for over and over again.  This seems a rather odd conclusion that you would have no right to drive on a road that your taxes partially paid for, in a vehicle that you did pay for yourself for which the different levels of government have collected taxes, that these Senators would believe that this is a privilege and that the state mandates that you buy a product from a for-profit entity, car insurance is constitutional. 

On the other hand if you follow the GOP Senator's logic, one could present themselves to the local hospital emergency room, for which you have paid nothing in the cost of construction or maintenance of these facilities or the training of the staff and you could fully expect to receive quality healthcare regardless of your ability to pay for it and that this is a right.  At least so these Republican Senators argued and that we should not be mandated by the government to buy health insurance from a for-profit entity because this is unconstitutional in their opinion and the opinion of two republican appointed judges.  So taking this view to the next logical conclusion, to solve the crisis in healthcare; the government should build and maintain all of the hospitals and doctor offices and tax us for this infrastructure, then going to the emergency room for quality healthcare would be a privilege, not a right and then the mandate for buying health insurance from a for-profit entity would be constitutional.  Problem solved, with this type of logic it is a wonder that the government functions at all, are these really the best and brightest or has politic slide so far that this is the best we can get to do the job, a handsome face to read other peoples talking points as if they are their own thoughts.

No worries about my television set, it is still in tact and the remote control is safe.  I cannot say the same about the state of rational thought and our healthcare system. 

Monday, January 24, 2011

Cognitive Dissociation

While driving on a major road in the city where I live, I was struck by what the vehicle in front of me was telling me.  The view was a flex fuel pickup truck with disabled veteran license plates and a bumper sticker attached to the rear window that has the Texas State flag with the word SECEDE boldly written across the face of the flag.  As I sat behind this vehicle at a stoplight, I began to wonder if the owner of the pickup really held the belief that Texas should secede from the United States of America. The owner must have at one time taken the oath to serve and protect the United States of America against all enemies foreign or domestic, served in the military for a period of time, was honorably discharged from service and injured severely enough during that service to qualify for the disabled vet license plate, so I had no doubts about how he felt about the US or at least I thought I did.  And yet, he or she also holds the belief that it is a good idea for Texas to leave the republic of the United States.  How is it possible for a person to hold the idea that secession would be good for Texas, having also taken the oath to the United States and served honorable in US military?  I am at a loss to explain this cognitive dissociation, the ability to hold two or more thoughts and the inability to see how these ideas or beliefs affect each other.
As I sat there at the stoplight I started to wonder if this person had really thought through the ramification of secession would have on them personally.  At the very least would they still qualify for that disabled vet license plate since they had served in the United States military and not the Texas military.  Where would they get VA healthcare if they need it, since it certainly would not be offered in a separate country if secession succeeded.  I also wondered if they had really thought through the economic impact this action would have if all of the US military bases in Texas closed and all of the jobs both public and private that support the communities around these bases would suddenly not exist or were moved elsewhere.  Having lived just outside of Houston for the past thirty years I wondered what would happen to NASA's Johnson space center and all of the high tech jobs and businesses associated with it, they surely would not stay.  I really could not determine how much thought if any, this person put into the message that the back of his or her pickup was sending or was the addition of the bumper sticker just a whim, without any real consideration of the impact of such a treasonous act they were advocating.

I know where the idea for the bumper sticker came from Governor Rick Perry saying that secession was an option for Texas if Washington DC was not reigned in.  This was done to appease a vocal political group and without any real conviction that it was the right course of action.  Although the governor did say this and maybe I am being naive to say that I do not believe that he has any real intentions of moving forward with the idea regardless of his words because of the various problems outlined previously.  But what struck me the most was the true failure of leadership the Governor demonstrated.  Rather than saying that although secession was technically possible, he should has said that it was absurd on the merits.  The State of Texas does as little as possible as a government now, it is ill prepared to be a nation.  It causes one to wonder what the Texas budget shortfall would be without all of the federal jobs and funding that flows to the state.  

So by now you might be wondering why a healthcare advocate is blogging on this particular topic.  The answer is that the vision represented by the back of this pickup truck clearly illustrates what went on in the US House of Representatives this past week and the actions of the Republicans voting to repeal healthcare reform.  First let start with the fact that this particular piece of legislation was brought to the floor of the House without any committee hearings, without any real ability for the minority to offer amendments and only several hours of floor debate.  These are things that the minority in the 111th Congress complained about bitterly during the healthcare debate last year and frequently using the phrase "the bill was rammed though by the majority" eerily in lockstep fashion.  The majority of the 112th Congress came in saying that there would be more transparency in the process and immediately chose not to be transparent at all on this bill, this only proves that their actions speak louder that their words.  Secondly, almost on mass the Republicans said that they still want to cover people with preexisting conditions and eliminate annual and lifetime caps but without the personal mandates for insurance coverage.  The reality is that without the mandates there clearly is not the economic case for covering people with preexisting conditions and the elimination of caps, you need the additional healthy people as part of the pool for this to make any sense.  Former Senate Majority Leader Bill Frist made a very compelling case for the GOP to drop their efforts for repeal and rather work to strengthen or correct deficits in the law. (see: )  The GOP in the house and the minority leadership in the Senate are like the vision presented by the back of the pickup truck.  They hold two ideas in their heads without the cognitive ability or effort to see how these two ideas impact one another.

The reality is that the GOP want to repeal healthcare reform without ever having a viable option to replace it with, at least not for those of us with preexisting conditions.  The Republicans will say that their idea of buying insurance across state line is a good idea.  At face value this sounds agreeable until you think about what happen with credit cards.  The credit card companies found states to set up shop in that were willing to regulate them as little as possible if at all, that would allow the companies to charge up to 30% interest on money that they were borrowing at less then 5% and to use every trick and trap thinkable to trip up and then trap their customers on late fee and other penalties.  So given this history by credit card corporations would it not make sense that insurance companies would follow suit and find states with poor or non existent regulation on health insurance to create policies that maybe cheap but when you needed it, failed to provide the necessary coverage or payment for services.  Buying health insurance across state lines is a dive to the bottom and is not a serious solution to healthcare reform, no matter how much the GOP states otherwise.  Holding the view that you can cover people with expensive chronic health condition and eliminate caps without adding the young and healthy to the system is true cognitive dissociation on the part of the GOP.