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How Americans Now View Health Care Cannot Be Repealed or Replaced

More than half of the world’s countries have a specific right to health care written into their constitutions. The United States is not one of them. Although the constitution of the United States does not guarantee any kind of health protection to its citizens, Americans increasingly consider health care to be a right. Seven years of Obamacare have established a belief among Americans that the government has a responsibility to provide access to health care coverage. Even as Republicans attempt to limit Americans’ access to health care, they cannot change the growing conceptualization and expectation of health care as a right in the minds of Americans.

Barack Obama signed the Affordable Care Act in 2010, and the Supreme Court upheld its legality in 2012. Jeff Jeans, a lifelong Republican and small-businessman from Arizona, had passionately opposed the Affordable Care Act before being diagnosed with cancer and told that he would have just six weeks to live if left untreated. Jeans is alive today because of an early Affordable Care Act program that offered coverage to people with pre-existing medical problems. At a town hall meeting earlier this year, Jeans confronted House Speaker Paul Ryan with his story. “Being both a small-business person and someone with pre-existing conditions, I rely on the Affordable Care Act to be able to purchase my own insurance,” Jeans told Ryan. Jeans created a Facebook page called “Obamacare Saved My Life,” where those who have been positively impacted by Obamacare can share their experiences. As Jeans’ story shows, the individual mandate matters, as it allows premiums to be low enough so that the health care system is accessible to people with pre-existing illnesses. The individual mandate is the Affordable Care Act’s requirement that most people buy health insurance or pay a penalty. Without the mandate, premiums are expected to rise by 10% for most years in the next decade.

Republicans have vowed to repeal and replace Obamacare, efforts that failed this summer, but took on another life in their overhaul of the tax code. Senate republicans want to eliminate the Affordable Care Act’s individual mandate, and have attached a provision to the $1.5 trillion tax cut to do so. Republicans hope that removing the individual mandate would allow lawmakers to save hundreds of billions of dollars to help pay for broad tax cuts to corporations and individuals. They are assuming that without the mandate, many people would no longer buy insurance, allowing the government to avoid spending billions on subsidies that the ACA provides to those under a certain income level to pay their insurance premiums. They hope that without the individual mandate, most people with lower health costs would choose not to buy insurance coverage. The Congressional Budget Office estimated that removing the mandate would result in $338 billion in savings and 13 million uninsured people by 2027.

But there are no guarantees that this is what would happen. According to the New York Times, “polling data, analysis from a private forecasting agency and interviews with people who buy coverage through the Affordable Care Act marketplaces suggest the savings could be far less, largely because many people who qualify for the subsidies will still take advantage of them.” Even if the mandate were no longer enforced, it seems likely that those who qualify for subsidies will continue to buy insurance. A survey by the nonpartisan Kaiser Family Foundation this past October found that only 7% of people who buy insurance on the individual market said they would choose to no longer buy coverage if the mandate were removed. Most said that the mandate was not why they chose to buy insurance. At the same time, consumers are confused about the current state of affairs: whether or not the marketplaces to buy insurance through Obamacare still exist, and whether or not they have an obligation to buy coverage. The marketplaces are still here, even as the government attempts to restrict affordable health care.

In a Slate article from May 2017, Mark Joseph Stern and Perry Grossman outline how Americans came to view health care as a right by drawing an analogy to marriage equality. Marriage was long viewed as a biblical sacrament and privilege that states honored through legal recognition, but states selectively granted marital privileges, discriminating based on race and sexuality. In the 20th century, civil rights attorneys challenged the idea of marriage as a religious benefit that states could discriminately revoke. Loving v. Virginia was a landmark civil rights decision made by the Supreme Court in 1967 that invalidated laws prohibiting interracial marriage. Marriage is now considered a right for all, not an exclusive privilege for those who qualify. Marriage equality was fought for on the same lines in the 21st century, culminating with Obergefell v. Hodges in 2015, when the Supreme Court ruled that the fundamental right to marry is guaranteed to same-sex couples. Marriage rights in the United States are now for everyone, regardless of sex or race. Stern and Grossman illustrate that a similar evolution has taken place in discussions on health care. Since the New Deal, democrats have vouched for universal health care. In 1978, Senator Ted Kennedy declared that health care “is a basic right for all, not just an expensive privilege for the few.” Obamacare’s expansion of health insurance coverage has given these ideals more weight. A poll by the Pew Research Center found that “60% of Americans say that the government should be responsible for ensuring health care coverage for all.” The rise in the belief that the government has a responsibility to provide health coverage is significant even among Republicans. Among middle-income Republicans, there was a 20-percentage-point increase (14% to 34%) from last year to now. Now more than ever, Americans consider health care to be a right.

Taking insurance away from millions of Americans and allowing Obamacare to crumble would be a failure of the government’s duty to protect its citizens’ lives. Even as Republicans’ last effort to dismantle Obamacare unfolds, they cannot dismantle how Americans think about health care in their lives. Americans have a right to affordable health care and they know it, and no selfishness or cruelty on behalf of the current government can change that.

 

Bringing Women’s Voices Back into the Abortion Debate

In 2014, the Missouri legislature passed a law requiring women to wait 72 hours before terminating a pregnancy. After this happened, a team of filmmakers began collecting the stories of women who, over several months, had crossed the Mississippi river to go to clinics in Illinois where the laws governing access to abortion were slightly more relaxed. “At the time we were really, really poor…and my husband was very verbally and physically abusive,” said one patient, whose name is Monique. “It was very, very lonely. Because I had nobody to tell.” The voices of women like Monique, and thousands – if not millions – of other women are having their voices sidelined and ignored in the debate around abortion access and rights.
Planned Parenthood Rally, NYC, 2011. Credit: Charlotte Cooper
But there’s more. As Michelle Oberman, a law professor at Santa Clara University, discovered, the high cost of motherhood might encourage abortion for women who might have otherwise kept their pregnancies – but we’re not really talking about that. In fact, as Oberman finds, the reality is, it is always going to be cheaper for a woman to have an abortion than it will be for her to raise a child. The woman that Oberman taught her “how little choice is involved in the abortion decisions made by some of the poorest Americans.”Many might be wondering – where do we go from here? To begin, the general underrepresentation of women in politics hinders the policies that could be put forward by female or female-identifying politicians which could impact women’s lives for the better. Additionally, incorporating the voices of the most marginalized women in the conversations and debates around abortions could result in more targeted and immediate action that directly impacts women’s lives. At the end of the day – this isn’t just a political issue – it’s an issue that can either help or hurt women’s lives and they deserve to be at the core of that conversation.
Renee Bracey Sherman of Chicago celebrates at the Supreme Court in Washington, Monday, June 27, 2016, after the court struck down Texas’ widely replicated regulation of abortion clinics. The justices voted 5-3 in favor of Texas clinics that had argued the regulations were a thinly veiled attempt to make it harder for women to get an abortion in the nation’s second-most populous state. (AP Photo/Evan Vucci)
In 1973, a US Supreme Court decision, Roe v. Wade, granted all American women the right to have an abortion. Between 2011 and 2015, states enacted 231 restrictions. The issue around the legality of abortion remains one of the most divisive debates in the United States. Often, when discussing whether or not abortion should remain a protected constitutional right that all women in the United States can equally access, we get bogged down in debates about laws and policies, fighting against the campaigners done by anti-choice advocates and dealing with government backlash that we forget the women who are affected by it all.The documentary Abortion: Stories Women Tell seeks to follow the staff servicing women having abortions at the Hope Clinic for Women in Granite City. Tracy Droz Tragos, the film’s director, said, “The thing that really came home for me in the making of this film is how personal this is, and how impossible it is to legislate for every circumstance a woman is going to face, and how it’s also impossible to judge.” She continued, “It’s a damned position where people have a lot of opinions about what you should do with your life,” Tragos said. “Women do not get pregnant on their own, yet it is really women who are left with a pregnancy and the decision about how it’s going to affect their lives and their families and their futures.” Tragos brings to our attention to isolating nature of abortion – but also how our discourse can fail to recognize just how personal this is for each individual women, reminding us yet again why their voices are so crucial.When we don’t listen to stories when it comes to abortion, we don’t understand how multifaceted each of the woman’s stories and experiences are – and it makes it that much harder to fight for the laws and policies that will best support them. At Hope Clinic for Women in Granite City, many women shared that they were too young and wanted to graduate high school, or they had other children at home and couldn’t afford to support another child. One couple wanted a baby, but then they found out early in the pregnancy that the fetus’ skull did not form – which is a fatal condition. One woman choose to place her child for adoption. The variance here dispels the myth that the women having abortions are women that are socially irresponsible teenagers who don’t want to take responsibility for their actions. Instead, the plurality of their stories reminds us that abortion affects so many of us.

Let’s simplify this problem

Problems are not “puzzles” to be solved. That metaphor assumes that all the necessary pieces are already on the table, they just need to be rearranged and reprogrammed. It’s not true.

                                                                                                                  – Benjamin H Bratton

Benjamin H Bratton, a Professor of Visual Arts and Director of the Center for Design and Geopolitics at the University of California, San Diego delivered a TED talk entitled “What’s Wrong with TED Talks?” He did not like the fact that TED talks oversimplify complicated problems. He states that “a TED talk is a combination of epiphany and personal testimony. The speaker shares some personal story of insight and revelation, its trials and tribulations. What does the TED audience hope to get from this? A vicarious insight? A fleeting moment of wonder? A sense that maybe it’s all going to work out after all? A spiritual buzz?”  The audience is shown the journey of the speaker from the light bulb moment to the solution of the problem.

This intense oversimplification mirrors my experience with the Global Health department at Duke. It feels like I sit in a classroom and I am told over and over again that problems in Sub Saharan Africa can be solved by simply educating and empowering the local people. There is talk that it is important to consider the context, but there is a huge assumption that understanding the culture, the politics, and issues is also a simple endeavor, and this is frustrating for students who actually come from Sub Saharan Africa and cannot claim to understand their complicated countries. This is not because we do not care, but because one has to understand colonialism, exploitation, history, cultural norms, and many other things. Bratton asserts that “transformation” can only occur if we go through the hard stuff such as “economics, ambiguities and contradictions.” It is also important to understand the strengths of these societies and figure out how they can be used.

This is not about demonizing TED talks; I learned about feminism from TED talks by the writer Chimamanda Ngozi Adichie, and these talks taught me more about my identity than I have ever heard in my life. However, by reading Angela Davis, Claudia Jones and many other feminists, I have better understood the birth of patriarchy and the role capitalism played at the end of feudalism. By taking the time to explore the topic, I have also learned that mainstream feminism sometimes ignores the other types of oppression black and brown women face that has to be acknowledged and understood in order to make the movement help every woman.

We need to realize that everything is complicated and that we need to respectfully try to go deep and understand the complexities. It is time to acknowledge that in our pursuit for answers that will change the world, every problem has become a set of puzzle pieces.

 

Reading between the lines

I have a friend who is a history major. Every couple of weeks, we meet up in Café, eat crepes, and she tells me about the writers and artists who populate her classes.

Spoiler alert: they’re all awful people.

Past misdeeds include: cultural appropriation to the extreme, shooting one’s wife in the head, claiming that a man was a gay stalker and murdering him in a duel, helping a friend bury the body of the alleged stalker, sleeping with child prostitutes, marrying a woman to avoid jail time for burying a body, and advocating to remove stigma associated with pedophilia. Among others – the list goes on, but I really don’t want to.

And the thing is – this isn’t a study on literature produced by prison inmates. This is the beat generation – a generation known for its high ideals and devotion to defying convention and changing the way we saw the world. This is from the era of rebels, an era that deep down inside of us, we aspire to be. This was the era of nonconformity and social revolution. These were my heroes, man.

And they were utter rubbish. All of them.

It has been several weeks since I first was introduced to these deceased dregs of humanity, and I have yet to find one that was redeemable. I thought I had, but then the whole pedophilia thing came up and there went that idea. Of this entire movement, of this group that dominated thought and culture in San Francisco for several years, there was not one artist who had passed the not-too-high standard of decency that comes from not doing anything worse than trafficking illegal goods.

The point of this is not to say that beatniks are the worst and that sometimes there’s a good reason to conform and follow social norms, although that’s also an interesting conversation. The point is that these people are the greatest artists of a generation. And while they’re objectively horrible human beings, they’re also well-known for a reason – they were freaking good poets.

Now, since I haven’t taken a humanities class in way too long, I haven’t actually read their work. But my friend tells me that a lot of it is good stuff – witty, and self-deprecating, and insightful, and a powerful look inside the human condition. These men were awful, but they were great at what they did. And the nonconformist in me kind of wants to read it, see what all the fuss is about. But then I remember the multiple murders and assorted crimes they committed, and I figure it’s best not to.

So the problem becomes – how do we separate these people from the beautiful works they produced? Can we appreciate their work, laud them for their genius, while simultaneously acknowledging that they manipulated, betrayed, and destroyed people multiple times? Can we respect them and honor them while wondering how the heck they avoided prison? And part of me says no. This is the same part that refuses to listen to Bill Cosby, no matter how funny I used to think him. This is the part of me that has acknowledged that, classic or not, there are some movies I will never see because I don’t want to honor the people who produced them. This is the part of me that says that the artist can never really be separated from their art.

But at the same time, the beat generation was a thing. They shaped hearts and minds, and changed the way a lot of people saw the world. They were a movement that had long-lasting effects on the ideals of San Francisco, and effects I’d probably understand if I actually took the class. We can’t just say that history doesn’t exist just because we don’t like some of the characters, and we can’t just close the book on that chapter because we don’t like the way it ends. If we just stopped studying the beat generation, stopped giving them and their estates the posthumous honor of our royalties, attentions, and critical thinking and essay writing, if we failed to favor them with our analysis, we’d lose a lot of valuable information of what makes us who we are, now.

I guess it can be argued that there’s a distinction between reading for pleasure and reading to understand (a distinction I feel all too clearly with my Semiconductors textbook, which somehow fails to provide either). In studying their work, we’re analyzing it not for a poem as a work of literature, but as evidence of a time different from their own. Reprehensible or not, it’s a manifestation of the way they thought and lived their lives and led a generation. And without understanding this particular incarnation of rebels without a cause, can we really understand the counterculture movements of today?

And at the end of the day, people will still read the work of Kerouac, and Burroughs, and Ginsburg, and Snyder, and they will be awed by their brilliance – because, let’s face it, there was a reason people followed these guys. The world has been changed by the mark they left upon it. But when we read their work, see the world through their sketchy eyes, it’s important that we ask ourselves how this world is different from our own, and what steps we need to take to keep it that way.

It’s only when we see them as all of what they are – as liars and scoundrels and philosophers and cretins and dreamers and lovers and philanderers and artists – that we can truly do them, and their work, justice. They are more than what they have created, and yet a product of the time they lived in, and while that does not excuse or condone what they have done, it provides a backdrop for their work. We do not have to like them. We do not have to hate them. But we do need to try to understand what they were and who they stood for. All of us, rebel or patriot, poet or criminal, deserve that much.

 

Son of Guns

When I was ten years old my grandfather took me to the range for the first time. He told me I’d pick it up quick, but after six rounds of skeet shooting I must’ve only hit a single disc and, even though he cut the stock about six inches below the factory recommended minimum length to accommodate for how scrimpy his grandson was, my shoulder was blue and black for a week. Nonetheless, it was intoxicating and I’ve loved going to shooting ranges ever since.

This was long before I knew anything about the political divide in our country, or that the issues surrounding guns widen that gap every day. Long before the year of 24/7 Fox News leading up to the 2016 election or the countless, tense dinnertime discussions with my mom about our radically different political views. But, I digress. The election ended, I am off in college now, and what little time I spend with my mom I very intentionally avoid any conversations that could spoil the moment. Seems simple enough, right?

It really was simple, at first. My mom’s house is a twenty minute drive from campus and I see her once or so a month for dinner and generally there is so much to talk about that we don’t have time to argue about the latest Trump tweets. But then, starting at thanksgiving, a new gun would appear on the dinner table every time I visited. It started with two pistols. An AR. A shotgun. Another AR. Another pistol. Yet another AR. At this point you probably have a pretty good idea of what issue this post is trying to tackle: “how do you deal with the people you love sharing none of your views???”. Well, no, not exactly. The problem is how much I like the guns.

When I go to the range I get the same giddy feelings that I had when I was ten: I still love shooting. Now, I am by no means a “gun nut”, nor do I think that owning guns is necessary, but it’s significantly harder to tell my mom that I think it’s unnecessary when she knows how much I like them. This is complicated even further by the fact that every person I meet at the range is respectful, kind, and, above all, concerned about safety. No backwoods hillbillies who have guns to “protect themselves” and to piss off liberals, just normal people who enjoy a different kind of sport.

Now, one school shooting was enough for me to say “Okay, there needs to be greater regulations on the purchasing of firearms”. It’s unfathomable that, nine weeks into 2018, we are already at twelve school shootings and that thought hasn’t occurred to every single person in this country. I, like most, don’t know how to move forward. But I have an idea of how we can avoid moving backwards. I’m sure you’ve heard it before, but we need it now more than ever. It’s simple, and applies to nearly every polarizing, politicized issue in this country: stop demonizing the people on the other side. At the end of the day, they are just that: people. No one should be screaming at the people clinging onto their guns for dear life, or berating the people trying to take away your precious firearms: as sappy as it sounds, we need to meet somewhere in the middle and analyze not how this is affecting Democrats and Republicans, but how this is affecting the people and children of the United States.

 

An ode to The Office

Way before I actually watched it, my news feed was saturated with The Office gifs. Short moving slices that captured the show’s most iconic lines: “I’m not superstitious, but… I’m a little stitious.” I was late to The Office train, but once on it, I rode it all the way through a whole semester, even slowing down when I reached the later seasons because I wanted to savor the ending of the show.

Even in the show’s worst seasons (5 and 7, indisputably), it felt like it captured so much of what frustrated me at Duke. I found myself thinking of Michael Scott’s incompetence and ignorance everytime a Duke student asked me, “Why is your English so good if you’re from India?” Even The Office’s gentle stereotyping of Kelly Kapoor and Oscar felt lovable, though I doubt the show would have been produced now.

But my favorite thing about The Office isn’t its iconic characters and quotes (though there’s several of them). My favorite thing about The Office is the several lessons to be learnt from the show. My favorite storyline is Jim’s. At the beginning, he’s the office prankster; his adorable romance with Pam and his jokes on Dwight are the backbone of each episode. In the end though, when he starts a new company, the show’s storyline doesn’t take the easy way out. His business doesn’t take off easily; he has marital issues; and he misses Cece’s ballet recital. The Office’s larger lesson is that even in that situation, there’s always something to laugh at.

The TV shows I’ve watched have always said a lot about who I am and where I’ve been in my life. The summer between 8th and 9th grade, I was obsessed with Desperate Housewives; I was fascinated by what it meant to be a woman and how the choices women made narrowed their horizons. My freshman year at Duke, I learned from The Unbreakable Kimmy Schmidt that it didn’t really matter what people thought of who I was – as long as I was being true to myself. The Office is about a desire to laugh but also to connect with contemporary issues. At Duke, it can sometimes feel like there’s not a lot to laugh about when you have three deadlines and a test on a Tuesday. Those are the days I pull up The Office to be reminded by Dwight that hard work is important, to learn from Oscar that being condescending about knowledge is obnoxious, and to understand from Pam that humility is a virtue. Now, when I pass a laptop at Perkins with The Office pulled up to it, I resist the urge to smile, pull up a chair and discuss whether Creed’s backstory was every fully flushed out or not.

In the words of Michael Scott, “Would I rather be feared or loved? Easy, I want people to be afraid of how much they love me.”