How Many Other Things Do We Not Know?

Last Friday marked the 50th anniversary of the assassination of John F. Kennedy. I was too young to really remember much about it. I was in first grade. I remember getting a day off from school and watching a parade and not understanding why it was making my mom cry. I don't recall much else about it.

It was 1968 before I got how crazy the world had become in the 1960s. The assassinations of Martin Luther King, Jr. and Robert Kennedy, the riots throughout our major cities, the Chicago assault on protesters at the Democratic Convention. I remember believing the world might come to an end at any time. All that coupled with growing up under the shadow of the nuclear bomb (my Junior High School, built in Florida in 1962 was lead lined in the wake of the Cuban missile crisis and I remember duck and cover exercises from elementary school in Indiana), made for a rather paranoid feeling growing up. It is probably the root of my cynicism.

When I teach about governance in my sociology classes, we discuss charismatic leadership. JFK stands out as one of the few charismatic leaders who actually held a position in government. Most are leaders of movements to change the system, not part of the establishment. Almost all charismatic leaders will either be killed or be discredited. Sometimes, such as the case of JFK, maybe both. The sociological reason for this is simple. The group that forms around charismatic leaders is highly unstable. "Group Stability" is a sociological term referring to the ability of a group identity to outlive its members or the decisions of it members. Since the leadership of this group is through the inspiration of a central figure, getting rid of the central figure either directly via assassination or indirectly via smear campaigns, essentially breaks up the group. The movement cannot survive the loss.

I do have a conspiracy theory regarding JFK. Not so much a "who" theory as to a "why" theory, though "why" points to some specific "who"s.

I believe this speech sealed the deal for JFK's inevitable fate:

(text for this speech can be found here)

Following up on a speech he gave two years earlier on September 25, 1963, Kennedy was advocating peace over war. He was threatening the military-industrial complex, which by this time had rose to considerable power in the United States. I have no doubt that this threat was the motivation behind his assassination.

Kennedy was not perfect and his being put on a pedestal was problematic, as it is when anyone is put there. But I believe the world would have been a different place if he had lived and continued to lead.

My husband and I often have debates about when United States started going downhill. I usually argue that we were never as good as our rhetoric and that the democratic facade has always been with us, since we were built upon lies about equality and theft of land and labor. But if I had to choose a moment in time that changed any possibility of the United States living up to her declared values, it was the assassination of John Kennedy.

I don't know who actually pulled the trigger and I doubt the answer will ever be definitive. But I do know who benefitted from that trigger being pulled. In fact, the lack of knowledge about the assassination is indicative of how the world changed that day. I have no doubt that it was a conspiracy. Some people killed a president and some other people bought the story that it was a lone gunman and it is 50 years later and no one knows the truth.

As I contemplate this anniversary, I cannot help but ask: How many other things do we not know? 

I don't have answers. I don't know where things might head from here. But I remain cynical and that cynicism was born of the 60s and 70s when I learned not to trust power. I do believe this. The world changed that day and not for the better. I also believe that our hope must rely upon something other than a charismatic leader emerging. If we want change, we must find another way than business as usual.

My cynicism should not be mistaken for pessimism. I do have some hope. I have come to believe that a sociological imagination is the key to addressing these changes and that is why sociology remains suppressed through economic means.

Never before has there been a greater need for public sociology and never before has there been a greater call for the sociologist. I am discouraged with our discipline, but I remain hopeful that we have something to offer and that many more are starting to get their voices heard.


As the quote at the top of this blog states, the "sociological imagination [is] our most needed quality of mind." We must do what we can to develop that quality and we must not be silent.

Some Thoughts on Labor, Work and a Job

Two weeks ago, on August 19, I started the first full-time job I've had in 19 years. So the post I am about to make here is a little ironic. But there is a difference between what could/should be and what is. Today, Labor Day, I want to talk about what needs to change.

First, I'm going to cheat and offer you a crash course in US economic history in the form of two episodes of Crashcourse, American History (I know, it is a bit like homework, but I really think these two videos set the stage better than I can):

And...

=================
 What strikes me most about this history is that it did cost us a lot of freedom.

I have mixed feelings about this. On one hand, I am a consumer of goods and services that are made possible by this history. I would never have made a good farmer as I killed every plant in my possession. I would never have made a rugged individual on the frontier as I don't know how to cook or sew and every serious attempt I've made has resulted in failure. I am, in a word, a city girl (okay, three words). As an urban dweller, I am inextricably dependent upon these goods and services and while I don't sport the largest footprint on the planet and never would (I hate shopping as well), I don't see myself heading for the mountains and living off the land in some Jeffersonian ideal any time soon.

 On the other hand, it seems patently obvious to me that the time for "jobs" has passed. Politicians keep promising "more jobs" but a job has become one of the most insecure thing in the world for most people, especially low-skilled people. The old narratives of "job-makers" and "job-killers" and "unionized labor" are falling short and they are falling short for a reason that no one on either side of the political aisle seems to want to discuss. A "job" is an industrialization concept and we no longer live in an industrial economy.

 What is the evidence for post-industrialization?

1. Most manufactured goods created in the United States from highly mechanized and robotic factories that employ mostly high tech workers who oversee these electronic gadgets. Even companies that employ factory workers have them working side-by-side with robots. The heyday of the factory job is over, even if some factories provide some jobs for a few skilled workers, we will not see 40% of the labor force employed by factories again. It just isn't necessary and it is too expensive.
   
   
2. The rise of e-commuting and the "on-call" nature of many jobs has blurred the lines of the "where" and "when" of a job. Factories were based on time and place. Workers arrived at specific times and they gathered in specific places to accomplish their work. This is less and less true. The "time" is always and the "place" is everywhere.
   
   
3. The original factory workers, as John Green notes in the first video, were mostly women and mostly temporary workers who expected to leave that employment within a few years. This was a good thing because if you worked too long you would probably die or become disabled as conditions were dismal. But with the rise of unions came job security and for a couple of generations, mostly men, who worked for a large corporation, expected to be there for life and to have a small, but secure, pension available in old age. The day of The Organization Man has long since passed. So called "job-hopping" is on the rise, with some estimates that so-called "Gen-Yers" will have 15 to 20 jobs in their lifetime. The concept of loyalty on both sides of the employment equation is gone.
   
   
4. The rich are getting richer and the poor are getting poorer and the middle-classes are disappearing or surviving only via debt. This trend is worldwide, but it is of particular concern in the United States. Such inequalities in the distribution of wealth resembles feudalism more than it does democracy or free markets. In fact, more than a few analysts are talking about our current political economy as "neofeudalism." 

"Our passivity has resulted... in much more than imperial adventurism and a permanent underclass. A slow-motion coup by a corporate state has cemented into place a neofeudalism in which there are only masters and serfs. And the process is one that cannot be reversed through the traditional mechanisms of electoral politics."--Chris Hedges, Journalist, quoted by John W. Whitehead in The Age of Neo-feudalism: A Government of the Rich, by theRich and for the Corporations. 

I've been doing a lot of thinking in the past few years, especially living in the margins of the current economy, holding multiple part-time jobs and/or contracting for services and running a small micro-enterprise. I am coming to the belief that the sociological imagination could be applied to this history and its seemingly inevitable outcomes (note that the current situation is not the first time such inequalities in wealth distribution have occurred in our short history of both democracy and capitalism.) What is emerging in my thinking is a long project (either a book or a documentary, or both) that will sociologically examine several things at once and how they interplay with each other to create our current situation:

• the influence of the tax code on culture and culture on the tax code;
• our understandings of "work" including Weber's Protestant Work Ethic and how it continues to play into the wealth inequalities that exist and are growing;
• the long history of central banks as the new feudal lords under which we labor;
• and how organizational theory, group dynamics and specifically, a better understanding of the nature of group stability would be key to changing things for the better without resorting to outdated dichotomies like "socialism v. capitalism" or "democracy v. totalitarianism." 

In short, I think the time has come to think outside the box and I hope to find a way to do that. 

I leave you with a quote from Muhammad Yunis, winner of the Nobel Peace Prize in 2006 for his work on microlending, asset development and the Grameen Bank in Bangladesh. This radical approach to addressing poverty through wealth development rather than "jobs" is an excellent place to start:

My greatest challenge has been to change the mindset of people. Mindsets play strange tricks on us. We see things the way our minds have instructed our eyes to see

His big idea: "Poverty is unnecessary." 

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Top 7 Things Sociology Offers the World: Introduction

I've been thinking a lot lately about why I love Sociology so much and why the rest of the world does not.

An article in the Huffington Post by Scott Atran called The Folly of Defunding Social Sciences raised some important points. The last sentence caught my eye:

There is more to being a citizen than voting!

The Founding Fathers envisioned a Republic with an enlightened citizenry educated in "all philosophical Experiments that Light into the Nature of Things ... and multiply the Conveniences or Pleasures of Life" -- not just technical training for jobs that pay well.

I have come to believe that it is an "enlightened  citizenry" that our government fears the most. And I've come to believe (or rather, have strong evidence suggesting) that Sociology is a key to enlightenment.

So over the next week I will be posting daily my Top 7 Things Sociology Offers the World.

Stay tuned!

Next: Sociology offers a fuller picture of our condition as human beings. (Published March 25, 2013, 6am PDT)

Something for Which I Am Thankful

I teach a course called "Race and Ethnic Groups in Contemporary Society" and have been asked on several occasions, "what can we do to end racism?" Here is my answer, though simplified:

1. Own up to our racist history--we need to start talking openly and honestly about how America became one of the richest countries in the world through colonization, exploitation and oppressive domination.

2. Have a national discussion regarding restitution and healing of the wrongs that have been committed. I don't know the answer, but I do know we will never find one until we start looking for one.

3. Be grateful. Any wealth we Americans have, any material goods for which we can be grateful on a day such as today, was built on the backs of slaves and stolen from the indigenous peoples who were the first "occupiers." It does not matter if you came here after these deeds were done. You live here, you benefit. So those of us who were the children of the colonizers and slave owners, and those of us who were not, should never forget that the cities we live in, the food we eat, the houses over our heads, and the bounties we share were made possible by the sacrifices made by these peoples.

It is my belief that from these three steps healing could begin. We should be open to where it leads us.

I just saw this article about The Thick Dark Fog. I think it looks like a good start for a national conversation:



The film is still in production and needs contributions to help it get finished. You can contribute on the Human Arts Association website (be sure to select The Thick Dark Fog as the project, though it looks like they have a number of worthy projects to help with this national conversation.

Finally, consider Truth Out's call for United States Truth and Reconciliation Commission to begin to provide for the damage that has been done and also to provide a way for the stories of indigenous people to be heard.

So I hope, on the national day of thanksgiving, you will join me in the gratitude I feel to these sacrifices and the other ongoing sacrifices that exploited people make, sometimes willingly, sometimes under force, to others. We take so much for granted. Today, let us stop and take note of the truth. The truth will set us free.

What a Day--Stigma is alive and well

I wrote a little blog entry on Psychology Today yesterday and today all hell broke lose and I spent the day being attacked on a number of personal levels, including threats to my job at CSN.

As a description of the blog I wrote:

Judging character, work ethic, health or worth on the basis of how somone looks is ALWAYS prejudice. No one should be treated as "less than human" because of their body size.FATISM is a matter of cultural stigma. This blog is about cultural and social issues, not a health debate.

Talk about a prophecy. First controversy and the judgements about my character, my work ethic, my health and my worth were all over the place.

I think the thing that interests me most as a sociologist is that I was considered "obsessed" because I have written about this. These persons were defending themselves on the basis of credentials and a body of work, but as a stigmatized person I was considered "biased," "obsessed" and "deaf to other points of view" because I, too, had a body of work.

I have never seen a more beautiful example of what Goffman meant by spoiled identity. If I wrote and researched the topic, I am obsessed. If I am uniformed and unwilling to change, I am ignorant and need help. My body was code for "stupid," "unhealthy," "lazy," and "incompetent." It makes me wonder what they would have used if I had been thin.

I have written in other places about my reluctance to be a "professional fat person." Today was a reminder of both why I became one and why I hate it.

It remains my hope, however, that having become one, I can use the example of fat stigma to end all stigma. Stigma is a horrible cultural practice and one that hurts both individuals and society.

I Take Up Space: New Blog on Psychology Today

I'm excited about kicking off a new blog at the Psychology Today website. The blog is called "I Take Up Space" and is about the consequences of fatism. The site has millions of visitors each month, so I'm hopeful that it will become an outlet for discussing Fat Studies as an emerging field and promoting sociological perspectives on these issues as well.

I write about the failure of New Year's Resolutions and the Moral Panic of the War on Obesity in my first effort.

(Please forgive my cross-posting if you read me in more than one place.)

My Critique of the New York Times Article on US as Banana Republic

My facebook friend and fellow Sociologist, Lesliegh Owens wrote on Facebook comments to my New York Times Blog entry:

"Pattie, I'm intrigued by your comments about cultural production and social infrastructure. Would you please expand a bit? Huge thanks!"

I could write a whole lot on this, but suffice it to say that ownership of production includes ownership of cultural production such as media, education and the arts. This means that, as Gramsci noted, the interests of a very few are being served up hegemonically as being "American" interests. Thus, what feels natural or normal by the vast majority of Americans is actually only good for a very small percentage of Americans.

As far as infrastructure goes, we saw in this last election a group on the right who looked like a grassroots movement, but were highly funded by billionaire brothers David and Charles Koch along with puppetmaster, Karl Rove, and a group on the left who looked like a grassroots movement, but were highly funded by billionaire George Soros.

With the ridiculous Supreme Court ruling that corporations have freedom of speech, we now have a select few who are funding and influencing a chess game of politics using "common" folk as pawns. Everyone wonders why this midterm election seemed so visible when most midterm elections are usually dull with little turnout. Well what we are seeing is an election battle between two billionaire camps, that top 1%. It is interesting to consider the election in light of the NY Times article.

If you saw, Capitalism: A Love Story, you know about the Citigroup plutonomy memo which lamented the fact that we have voting rights. Well, I think we just witnessed in the past two years exactly how the rich are going to handle the voters -- fund them and get them riled up through media.

By concentrating so much on the personal aspects of these inequalities, I think Kristof missed some real structural and cultural changes that this inequality is creating and the very real ways it is changing our so-called democracy into something very undemocratic.

Is an Empathic Civilization Possible?

This is an interesting take on the ways in which socialization and biology intertwine to create society. It is also an interesting take on how we might change social systems in the future.

In my classes we discuss that three elements contribute to human interaction: nature, nurture and choice. We also discuss how sociological imagination is the connection of our own biographies with the collective history of human beings at group levels. Global empathy would surely change the world.

I may use this video in future 101 classes. Not sure I agree with everything in it, but it is thought-provoking. (Thanks to Evan Ravitz for posting this on FaceBook.)

7 Ways Health Care Could Be Improved in the US

So after a year of debate that was full of backroom deals, posturing and ultimately the demise of anything resembling bipartisanship, we have a radical but weakly constructed Health Care Insurance reform law aptly and anemically named: The Affordable Care Act.

Okay, before I discuss what I hate about this bill, let me make some concessions to my liberal friends:

• Yes, this goes way further than anyone has gone before;
  
  
• Yes, it is good to do away with the discriminatory practices of the predatory health insurance industry such a pre-existing conditions and dropping insurance when one is sick;
  
  
• Yes, there are some immediate benefits that are helping some people; and
  
  
• Yes, this will most likely result in some improvements both in the cost and delivery of health care.

But this is a drop in the proverbial bucket and Michelle Obama's anti-childhood obesity campaign tells me all I need to know about how much this administration knows they have failed to produce real change. Just like the Clintons in 1994, blaming fat people is a great way to blow smoke and use mirrors to make the failure disappear.

So why am I profoundly disappointed in this bill?

• First, no public option other than some lame expansions of Medicaid and some temporary fixes like High Risk pools which will go away when the full non-existing condition prohibition goes in effect in 2014.
  
  
• Leaving these lame expansions in the hands of states and demanding that states provide matching funds. Nevada's a-hole of a governor (and my boss--I'm technically a state employee) Jim Gibbons had decided that it is better to sue the federal government than provide the extra medicaid and high risk pools. Thus, a beggar-thy-neighbor affect has already begun. And yes, he's acquiescing but it is really too little too late.
  
  
• No effort has been made to even begin to address social inequities inherent in medical relationships or to ask the hard questions about the money and power held by hospitals, pharmaceuticals, physicians, insurance companies and other big-time players in the system. (Like, I don't know, maybe a regulatory system that allows patient's complaints to be heard.)
  
  
• Health care coverage is still tied to work. This is a ridiculous idea and it belies the latent function of health care in America: keeping the working class compliant. This is not a natural fit at all and all the celebration of tax credits is a perfect example of politicians pretending they are doings something when they are not.
  
  
• In fact, the health care tax credits for personal income tax is essentially making school loan debt, tax debt and non-payment or being behind in child support payments a death sentence. If you don't have enough money to pay these things, you probably are not going to have enough money to buy insurance. If you get the tax credit to supposedly help pay for insurance, it goes to pay these other debts, which means you have no money to pay for the insurance the government requires. This in turn means you will owe more taxes because of the penalty and therefore you will be further in debt and the cycle continues.
  
  
• But the biggest reason I find this law to be distasteful is that millions of Americans who have been bullied and mistreated by the nation's health insurance industry are now going to be forced to buy insurance from that same group of people. You see the dirty little secret is that the insurance industry knew they were in a win-win situation.
  
  OOH, if reform failed, their unbridled profiteering at the expense of our health and well-being would continue unimpeded. OTOH, if reform passed without a public option, then a whole new group of people would be forced to buy insurance. Not that wonderful group they hate -- the sick, but that wonderful group they love -- the young folk who rarely get sick.
  
  Now let me make this clear -- for a universal system to work, mandatory insurance has to be a part of it. The whole concept is that everyone buys in whether they are sick or not, then the cost for all is lowered and the protection for all is in place. But that is only valid IF everyone receives the same protection. This bill leaves in place all sorts of stratification, meaning that young people and their parents (till they are 26) are going to get the short end of the stick, or in other words, the stick is going to be stuck someplace where the sun don't shine.

If I believed that people in Washington really saw this as a first step towards true reform, I'd be more excited. But as near as I can tell they are all celebrating the victory or mouthing off about repeal and no one is discussing the next move.

The fact is no one has really faced some fundamental truths about for-profit health care systems, and as long as lobbying and corporate money flows unimpeded, they are probably not going to face those facts. As Upton Sinclair once said, "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!"

So not ever wanting to be simply "anti" anything, I offer some specific Ways to Improve Health Care in the United States. Some of these are shifts in perspectives, while others are downright practical:

1. True reform must begin with understanding the collective nature of health care. Germs do not care which bodies they infect. The water, soil, air and environment surround us all. Our well-being is collective and pretending this is an individual's business only is costing us. All health care is public health care. This basic fact is radical because it is the crux of the whole debate. When other countries debated how to achieve universal health care they took this as a given and then discussed reform. Americans are still pretending that they are in total control of their lives and it is costing them their health, their well-being and their livelihoods. This paradigm shift has to happen or we will never achieve good health care that is sustainable.
   
   
2. We must eliminate the primacy and monopoly that allopathic medicine and the physicians who practice it have on our health. What little regulation through licensing and academic accreditation that we have gives a virtual monopoly on this form of medicine and it is to our peril. The reason chronic illnesses are on the rise in the United States is that practitioners who have methods to address these conditions are systematically pushed aside in favor of the "magic pill" form of medicine. I love what surgery and pharmaceuticals can do. I'm alive because of advances in these areas, but I am, along with millions of others, in daily pain and disabled because these are the only advances that have been encouraged. Any reform that does not get rid of the monopoly of the allopathic doctor and overblown reward that monopoly affords him or her is going to fail. We need multiple modalities and we need to be rewarding these modalities and allowing them flourish.
   
   
3. We need to allow more locally based systems in the practice of medicine while finding ways to use economies of scale in the acquisition of resources. In other words, local communities should have more control over their clinics and practitioners but acquisition and distribution of equipment and medicines should be organized in such a way that lowers costs. Such organizational schemes are not without precedent but they are often defeated by monied interests. There should be no reason we cannot have medical boards in a community that oversee the practices of health care providers locally and still have vaccinations, medical supplies and equipment bought on a national scale and distributed according to local needs.
   
   
4. We need to divorce health care from wage slavery. This is not a natural marriage. It has a specific and sordid history and if we really want to have health care for all, this marriage must die. As long as health care is connected to employment we are enslaved by both systems. It's just that simple.
   
   
5. We need to recognize that it IS NOT and it NEVER CAN BE a level playing field between health care provider and sick person. This means it should never be "for-profit." The provider is always going to have far more information than the sick person. The sick person is in desperate straights when ill and therefore does not have time or ability to seek out good information and shop for the best price, best service and so forth. Thus, the opportunity for price gouging and fraud is always present. It cannot help but be corrupted and therefore it can never be a free market. Pretending that the patient is a "client" is ridiculous. In our current system, we cannot trust our providers. How do we know they have our best interest at heart? We cannot truly know if a doctor is prescribing a drug because we need it or because he owns stock in the company that produces it. We cannot know if the procedure the doctor suggests is because it is the best thing for us or if he just needs to pay for his daughter's tuition this month. We think we trust our doctors, but how can we know the purity of their motives when they make more money when we are sick than when we are well?
   
   
6. We need to recognize that social ills create much of our personal ills. If we really wanted to lower our health care costs we would be working towards the end of poverty, we would be working towards a better ecological balance and we would be working towards the end of war and violence. Corruption, pollution, violence and lack of access to care are the leading causes of ill health. We will not be serious about improving our health and well-being until we are seriously trying to change these things.
   
   
7. Finally, related to #6, but not quite the same thing, is we need to end stigma and the medicalization of prejudices. Far from improving our collective well-being, the unintended consequences of many public health programs is to reinforce stereotypes, prop up bullying and paternalistic behaviors of bigots and mark people as less than human because of who they are or who they associate with. There is beginning to be ample evidence to support the notion that stigma leads to ill-health. Creating programs that continue to stigmatize, even if it is "unintended" will make true health care reform impossible.

Yeah, I know, if you made it this far, you are probably saying, "Yeah, but..." Well, reform is supposed to be change. Reform is supposed to be something radical. The so-called reform we have to date is just same ole, ahem, well you know. If we really want change, if we really want reform, we are going to change our core values. Right now we care more about profit than people, we care more about ideology than truth and we care more about getting our way and not having to make any sacrifices than we do about life and the future. There is a price to be paid for everything we believe that is not true. The price this time might be our lives, our children's lives, our civilization, and our planet. We cannot afford anything but reform.

Talking about Sociology on the Radio this morning

I rarely cross-post from my other blogs, but I wanted to tell as many people as possible about a great show I did this morning with Verria Kelly, the Good Health Coach.

This was a rare chance to discuss how understanding Social Roles can improve your life, specifically your health.

Check out the details on Ample Ramblings.

7 Reasons Why UNIVERSAL Health Care does NOT EQUAL SUPPLEMENTING THE SICK

My outspoken stances on universal health care coupled with the size of my body, the disabilities I live with, and my unapologetic attitude have led to some flaming of me personally on the net. I'm not too worried about it and while the hatred saddens me somewhat, I generally ignore it and almost never respond to direct flames. I've been around the net long enough to know that arguing with such people basically just fans those flames and doesn't accomplish anything but an ashy mess.

I received one such flame this weekend, however, that I do want to address, though not directly. Basically I was told in not-so-nice terms that I was for healthcare reform so I could sponge off my  healthier peers. The belief that universal health care is some plot for sick people to lay back, do nothing at the cost of the healthy is, I believe, at the heart of the health care debate. It is a belief that has been exploited by insurance companies for decades.

The irony is that the basis of insurance is exactly the same basis of universal coverage: insurance is based on the principle that if everyone pays a little when they do not need whatever the insurance is covering, then when something happens and they do need it, the fund will be there to help. If the group is big enough and has enough diversity, the bet is that it will be unlikely that the fund will be depleted because only a small percentage of those paying will need help at any given time. Of course, there is a certain understanding that each member of the group has to pay enough to cover that expected collective need for a given time, but for the most part the amount paid to the fund is supposed to be significantly less than any individual's need if it arises (making it more appealing to pay into the fund rather than just save for a rainy day). 

Of course, one of the reasons for last years collapse in the credit market is that large companies offered "insurance" against default on debts without adhering to the basic principles of size and contribution and the system collapsed.  But the idea behind insurance is an old and tested one and when done soundly it is not a bad idea. It is, in fact, one of the benefits of collectivity.

So why has the idea that the public option would be something new and different been so easy to sell to a good percentage of the American public? I believe it is because of the fear of collectivity and the cult of individualism that pervades our culture. It is this knee-jerk reaction to anything that smacks of collectivity that has made it possible for this current system of cutting off the access to good care for as many people as possible to exist.  Because Americans accept the cult of individualism we are willing:

• to blame individuals for their illnesses;
• to understand when doctors get richer because we are ill (after all each person is obviously responsible for their own illness);
  
• to buy into the lifestyle myths that eating and exercise means we can live forever (thus leading us to buy billions of dollars in diet and exercise products);
• to stand by when insurance companies and HMOs discriminate against sick people by refusing to sell coverage to people with pre-existing conditions, by denying coverage to sick people, even when they have paid premiums, and by canceling their coverage when they get sick;
• to support pharmaceutical companies even though they continue to make obscene profits by selling their medications to Americans at extreme prices to make up for the reasonable limits on their profits in other countries;
  
• to yell "socialism" when any remedy to this racket is suggested.

The reason that these companies can do what they do is because the majority of people in the United States are sold on this idea that they are in control of their health and anyone who gets sick is "obviously" at fault. So why would it be shocking when someone takes advantage of the sick? It is not "my problem." Even more basic, most Americans believe they can control risk and that a risk-free environment is fundamentally their birthright.

So I propose another way to look at all this.  I suggest that life is risky and that any one of us could get sick, disabled or incapacitated just by living a normal, every day existence, no matter how "good" we are or how much "care" we take. Life is risky, but we can face these risks and these troubles better together than apart.

So here are seven reasons to consider why one should not view universal health care as supplementing the sick, but rather as a basic right that each individual should have guaranteed under our law, as our founding documents suggest:

1.  All people can get ill no matter how "healthy" their behavior.

Yes it is true that eating enough nutrients and moving often seems to help create a healthier life. But this does NOT equate to A GUARANTEE that one will never be sick. Health and illness is complex with genetics, environment, behavior and just plain germs all calculating into the mix.  Many of the illnesses that people experience have no apparent cause and have little understanding by the medical community at this point. So deciding that one "is healthy" means that one will "stay healthy" is a costly naivety.

2.  The Healthy/Sick Dichotomy Does NOT Exist.

Health is not a binary function where it is obvious that one is either healthy or sick. Health is a continuum at least and probably more like a web structure. One can have a chronic illness but live a fairly fulfilled and active life. One can have something affects one's body but leaves one's mind sharp or vice versa. One can believe they are healthy for months or even years before a symptom of problem shows up. The belief that the healthy would be supplementing the sick is based upon a false dichotomy that cannot be worked out in the real world. All of us are dying from the moment we were born. So in a sense, we are all sick.

3. Many diseases are contagious and germs do NOT discriminate.

A really fundamental reason to work towards collective health is that the less people carrying germs around, the less chance other people will carry germs around and the benefit grows exponentially. We have a public health system in the United States right now. Universal coverage will enhance this system by ensuring that it is not a matter of money that people get immunized.

4. The question of "health care costs" is complex.

The concept of supplementation is based upon all these "cost" figures bouncing around. Costs are basically arbitrary and negotiable since most of what is involved in health care is service not raw materials. Because of economies of scale and because early intervention will help prevent more involved treatments, coupled with the power of the collective to negotiate prices and simplify administration, the overall cost of health care will get lower. This lowering of costs has been shown to occur in every country that has adopted universal health care and it has not been taken into account by those who are estimating the costs of various programs because it is hard to predict when and how much such reductions will occur. Thus, as with good insurance practices, the size of the pool and the sufficiency of the contribution will help reduce the costs for every individual and be there for each of us when we need it.


5. Public Health approaches can lead to cures and preventative measures that individual health care misses.

One of the big advantages other countries have over the United States is the ability to see big pictures when it comes to health because there is a collective understanding of data collection and analysis. Understanding epidemics, environmental factors and other kinds of risk factors comes from big picture analysis. Thus, universal coverage will make it possible to know what the health of the population is and to see patterns and gain information that will lift up the health of us all.


6. All people have the potential to make contributions that will enrich our lives and illness does not discriminate among the best and worst.

By keeping people in sickness, we may be wasting human resources that would make our lives better. Equality of access is something that has been recognized as important to the strength of our country by many of our founders and leaders. Discrimination on the basis of illness is one more wasted result of xenophobia.


7. Justice demands it.

You may consider this trite but universal health care is JUST in the most fundamental sense of the term.  Rawl's basic principle of justice calls on us to imagine a world that we would want to exist if we had no idea who we would be when we were born into it. If we didn't know whether we'd be dark or light skin, a just world would treat people the same no matter what color their skin.  If we didn't know whether we would be male or female, a just world would not discriminate on the basis of gender. If we didn't know whether we'd be rich or poor, a just world would not discriminate against the "have-nots."  So, if you imagine yourself to be one of the "healthy" and do not want to "supplement the sick," I ask you to consider how such an attitude is any different than racism, sexism or classism.

Universal Health Care is a basic human right that has been recognized by others around the world for hundreds of years. It is time Americans join the free world and put an end to discrimination against the sick.

Collectivity: Howard Roark's Sociological Imagination

In the film, The Fountainhead, based on Ayn Rand's book, two philosophies are counterposed and represented by two characters. Ellsworth Toohey, a mover and shaker who believes in the collective and is angered by those who would stray from the standards set forth by the collective. And Howard Roark, an individualist whose insistence that he is in control of his own destiny is so committed that he is willing to sacrifice all he has rather than conform. Rand's simple view of the world cannot contain the story she sets out to tell because film requires interaction and interaction demands collectivity. Thus, the very writing of the book and the very making of the film undermines the message of individuality.

Toohey exclaims, "Artistic value is achieved collectively by each man subordinating himself to the standards of the majority."

Roark defends his position, "No creator was prompted by a desire to please his brothers. His brothers hated the gift he offered. His truth was his only motive. His work was his only goal. His work, not those who used it, his creation, not the benefits others derived from it. The creation which gave form to his truth. He held his truth above all things, and against all men. He went ahead whether others agreed with him or not. With his integrity as his only banner. He served nothing, and no one. He lived for himself. And only by living for himself was he able to achieve the things which are the glory of mankind. Such is the nature of achievement."

Both are wrong and both are right.

There is no doubt that creativity cannot be achieved via compliance. The nature of art and creation of art can only be distinguished from the factory by its breaking out of that container and pushing boundaries outward. Compliance produces duplication and mass appeal, but does little to enrich or please. To suggest that art must bow to the will of the masses is to doom us to a dull life of repetition leading to all sorts of consequences, not the least of which would be plain old boredom. One only needs to travel in the American Southwest or the Yukon to understand that beauty is about diversity and variety. If Toohey really meant what he said, his philosophy would lead us to the most unnatural of existences.

But Rand's insistence on a dichotomy doesn't work because Roark's viewpoint is lacking as well. His own life's story undermines his assertion that he alone controls his creation. Simply recognizing the existence of others in the equation means collectivity is influential. His own baser needs for food, clothing and shelter lead him to menial tasks to make a living. His willingness to do these tasks rather than compromise his art is admirable, but the tasks are still part of the collective and he is dependent upon others to pay him and to make food for him and to rent shelter to him and to sell clothes to him. He is even dependent upon others to allow him to create his art, design his buildings.

Probably the most telling quote in the film is Roark rejects his clients' rights to demand a particular kind of design from him and is told that his uncompromising attitude will cost him business and, possibly, his career:  "I don't build in order to have clients. I have clients in order to build!"

What seems to lost on Rand is that in either case, he needs clients. He needs someone to fund the project. He also needs someone to build the building once the design is complete.  This is collectivity.

Taking a step back from the book and the movie, the very act of creating both undermines the message as well. Rand needed a publisher and readers. After writing, she often spoke in public and thoroughly and obviously enjoyed the interaction with her audience, especially her followers.

The making of the film required collaboration and collective effort. The story could only become a film with a shared vision among those who funded, who directed, who operated the equipment, who acted, who created the sets and so forth. It also required an audience that continues to watch the film years after most of those involved have passed away.

Rand's own life undermines the message as well. Her disdain for the collective did not spring forth from her as a isolated revelation about the true nature of human beings. Her early years in communist Russia shaped her beliefs about the dangers of the collective and led her to glorify the superiority of individualism. Her own experiences with oppression and the strength of her determination to break free from that oppression were the birth pangs of her own artistic vision as an author and speaker.

I actually love The Fountainhead as a film about the complexities of collectivity. It is a wonderful meditation on the tensions between the individual and the collective, the creative and the mundane, achievement and oppression. I'm quite certain that my reading of the film and the story is quite different than what Rand (and probably director King Vidor) had in mind. But that is another joy of art. The unintended consequences that can only be discovered when art is shared.

What does emerge for me when contemplating the film is a basic question (or really set of questions) about collectivity.

Somehow there is a whole as well as parts. As each individual within a particular group acts, something is created that can be understood as the group acting as well. Sometimes the individuals involved are quite aware of the parts they are playing. Both Toohey and Roark have thought long about their positions and have articulated their reasons for their actions. But more often individuals just do things without much thought.

They do things out of habits long ago formed. They do things because it is "the way it is done." They do things because they want to shake things up. Whether mindlessly following traditions that feel natural or reactively rebelling against those traditions, the perceived whole shapes the action of the part and then, in turn, the action shapes the whole.

So, in a sense, the collective is always a sum of the past. It is our way of understanding what has already happened, has already been decided. The present and the future are shaped by this past, but are at the mercy of the actions of individuals. Toohey is just as much an independent actor as Roark. His decisions to promote the collective, to promote the compromise, to promote the mundane is just as proactive as Roark's decision to reject these things as a basis for his designs. Toohey's action shapes the collective as much as Roark's action is shaped by the collective even as each protests the other's positions.

One advantage to developing a sociological imagination is the ability to see these forces and respond to them intelligently. In the end, that is what Roak is doing. He is not acting independently as he asserts. He is reacting just as much as those around are doing mindlessly. But his mindfulness does give him an advantage. His mindfulness of the collective affords him the ability to see that he must stand his ground in order to keep his integrity. He has to see the world not only from his own point of view, but from the point of view of others. He has to understand how his actions and the actions of others are interconnected. He has to see how he fits in the big picture and how his actions can lead to unintended consequences if he does not pay attention to these larger visions. He must actively resist the pressure brought to bear on him and his creativity. In other words, he must see that he is part of a collective system in order to maintain his individuality. That is the essence of sociological imagination. To see one's part is to be empowered to act upon the collective as well as be connected to it.

False Dichotomies

Freedom is not merely the opportunity to do as one pleases; neither is it merely the opportunity to choose between set alternatives. Freedom is, first of all, the chance to formulate the available choices, to argue over them -- and then, the opportunity to choose.
--C. Wright Mills

false (adj): not in accordance with the fact or reality or actuality

dichotomy (n): being twofold; a classification into two opposed parts or subclasses

Probably the most basic concept that keeps my students from understanding their own connectivity is this strong tradition of believing that things are "either/or." Specifically, they fear that understanding themselves as part of a group means they will lose their individuality.

I begin every semester of any sociology course with the ultimate sociological trick question: "Who's in control of your life?"

It is the ultimate sociological question because studying societies is studying power. Power is about control. In fact, the only way we really know if someone's power is by observing what that someone has control over. Power is not really something we "are" or something we "possess," though our language would suggest this. We say "she's a powerful person" or "he has a powerful personality" or more simply "they have power." But the truth is power is always a social relationship because the only way we know power is by the extent to which the wishes of one person or set of people get carried out while the wishes of another person or set of people gets ignored or resisted. In other words, power is perceived through control and control requires cooperation coupled with consequences. Understand that if the consequences are severed enough the cooperation is not freely given but rather extorted, but nonetheless if the subordinate person decides to face the consequences instead of obey the wishes of the other, the other's power is diminished.

And that leads us to the trickiness of the question. Because the answer is inevitably given with a dichotomy in mind: I control my life versus someone or thing outside of me controls my life. But both are correct. To the extent to which I can express my wishes and they are done, I determine the agenda and to the extent to which I cooperate with the wishes of others they determine the agenda.

Not only is the dichotomy wrong because it sets up an "either/or" that is really a "both/and" but it is wrong because in truth their are myriads of possibilities and complexities to the answer that are hidden in dichotomous thinking.

For example, take a simple and mundane situation like driving a car. In one sense, I am in control of the machine when I'm driving it. I have a desired agenda (a destination) and I act upon the vehicle, it follows that agenda. So I'm in control. Except that the shortest distance between two points is a straight line and I usually can't get in my car and drive the shortest possible distance because I have to take roads and I have stay on the correct side of the road. I can't even get the fastest possible time because I have to obey speed limits and stop at lights and stop signs and signal and yield the right of way before turning. If I disobey these rules their are consequences. There are legal consequences because I can get a ticket and the guy in the blue suit who wants to give me that ticket, wears a gun and other weaponry, so I pull over when he flashes a light at me. There are physical consequences as well because two objects cannot occupy the same space at the same time, which means that if I drive into another person, vehicle or building, something has to move over. If it's me that has to move on impact, it could mean injury or death. But I could speed. I could crash. I could plow through a straight line at optimum speed and try to get to my destination as quickly as possible. There are also economic consequences because I want my car to be available for the next trip and someone designed the car with economics in mind so that it would experience wear and tear and only be able to achieve a specific speed or last a specific number of miles. There are biological consequences because I may have physical limitations in my ability to see and use muscles to interact with the car.

So who is in control of my driving? The answer is all of these factors and more are driving the car.

False dichotomies hide this complexity and give us the illusion of control and that makes them hard to give up.

False dichotomies hide the truth of our existence from us and this can cost us dearly in the long run because if we do not understand the available choices we have and the consequences of these choices, we will never be free.