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Welcome to Red State/Blue State, a feature presented by The Anniston Star of Anniston, Ala., and The Philadelphia Inquirer.

In the December 2001 edition of the Atlantic, David Brooks wrote an essay titled "One Nation, Slightly Divisible," in which he suggested that America is divided largely into two political cultures, one "red" and one "blue." His idea is based on those electoral maps in 2000 that colored majority-Republican states in red and majority-Democratic states in blue. Brooks' witty essay pictures the red-state voter as trending rural, a salt-of-the-earth type, concerned with individual liberty and family values, whereas the "blue" voter trends urban, more of a book-reader, a Beltway-savvy intellectual, the environmentally conscious soccer mom or dad.

Cliches? Maybe. But Brooks does have his finger on two very strong currents in the American votership. It's not that Pennsylvania is a "blue state" or Alabama is a "red state." It's that our two political cultures don't talk to each other much, or even know much about each other. To bridge that gap, we've brought together two "red" voters - John Franklin and Cynthia Sneed - and two "blue" voters, Terri Falbo and Timothy Horner. Each week, they'll ponder and debate the issues arising in the election campaign. The hope is that they'll model an intelligent discussion, a great big conference room where red and blue sit down together.

Monday, September 20, 2004

Joe Franklin, Red Stater 

Question Number Eight: President Bush and Sen. Kerry unveiled their health-care plans. How would you structure a health-care plan? Would it be universal, or only for indigents? Would you feature privatized health-related savings accounts? What would you do about malpractice lawsuits?

We have Medicaid for indigents and Medicare for the elderly. We need a universal plan to cover those remaining. The government needs to set the guidelines for coverages and premiums. Then the system needs to be managed by private insurance companies. A privatized health-related savings account funded by payroll deduction could then be used to pay a higher deductible, thus making the premium more affordable. Malpractice lawsuits must be curbed, capped or abolished. This would reduce the cost of medical care in this country.

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Cynthia Sneed, Red Stater 

Question Number Eight: President Bush and Sen. Kerry have unveiled their health-care plans. How would you structure a health-care plan? Would it be universal, or only for indigents? Would you feature privatized health-related savings accounts? What would you do about malpractice lawsuits?

These are very serious issues and Americans deserve a thoughtful, nonpartisan solution that will be fair to the majority of people. America has to decide what we mean by "health care" - i.e., is it 10 or 12 heart catheterizations for an undocumented worker? Is it prenatal care/delivery/PICU care for a premature undocumented baby whose mother comes the United States only to deliver? What about those who come here for health care and return home?

Is "health care" mandatory coverage for every single worker, whether they want coverage or not? Is it mandatory coverage for every single American? The homeless who choose not to work? Is it mandatory coverage for those who have enough money stashed away (there are more than you think) who do not want to pay for health insurance under the notion that "I'm not sick now, why pay?"

America has difficulty identifying the number or distribution of uninsured Americans. Demographic data available include:

* In the first half of 2001, 16.7 percent of the noninstitutionalized civilian population of the United States were uninsured meaning that nearly 80 percent of the entire population did have insurance.

* Among the U.S. civilian noninstitutionalized population under 65, more than a third of Hispanics (37.7 percent) and 20.2 percent of black non-Hispanics were uninsured during the first half of 2001, compared with 14.9 percent of white non-Hispanics.

* Among people under 65, Hispanics accounted for one-fourth (26.3 percent) of the uninsured civilian noninstitutionalized population - even though they represented only 13.1 percent of the overall population this age. (

What we know is that the largest numbers of uninsured are Hispanic, and this raises the question of how many of those are undocumented workers. Nobody seems to know.

Canada and England have socialized medicine, and I do not know whether, if I entered either country illegally, they would provide me with medical treatment.

I do know that a large part of our health-care crisis is related to medical care for undocumented workers and that Hispanics are now the majority minority population in America. Many members of this group do not speak English so that providing health care becomes even more costly with translators and such.

The Federation for American Immigration Reform's estimate of the national cost incurred by undocumented workers for Medicare and Medicaid is $3.7 billion. The federation cites cases in which individuals come here just for the health care, and then return home. Again, no one knows how many people do this, but undoubtedly whenever it happens, the rest of us incur the cost.

I have yet to see either candidate, or wither major party, address the problem of an estimated 3 million (and that may be low) undocumented workers crossing our porous borders every year. I personally believe this to be the most important domestic issue this election - but you'd never know it by the content of the political speeches from both sides. Maybe we can ask Dan Rather to investigate.

As long as either party politicizes the health-care crisis, nothing will be done to solve the problem. We need a task force, madeup of experts in medicine and the health-care industry who have not now nor ever will be elected to office, to examine this issue seriously. Outside of Washington, behind closed doors, with no media, much the way the Founding Fathers developed the structure of our government. There is nothing worse than preening, egocentric politicians "solving" a problem.

I hear Republicans and Democrats alike whining about people choosing between food and medicine and I know there are some people who must make those difficult decisions. But I know more who are choosing between health insurance and cigarettes, beers, widescreen TVs, DVD players, and other non-necessities. They do not want to pay $300 a month for health insurance but think nothing of smoking two packs a day at nearly $200 a month, paying $100 a month for digital cable or satellite, and trading in their cars every three years.

If, as we say, health care is a "right," then health insurance is a responsibility of the individual. Our problem - or the issue, depending on how one looks at it - is that many Americans want free health care. The 50 percent of American "taxpayers" who do not actually pay taxes are more than willing for those who do pick up the tax tab to pay more for everyone to have health care.

I know that the high costs of lawsuits is a real problem, and the malpractice premiums are very high, but I also see medical doctors with million-dollar homes, six-figure cars and beach homes/vacation condos on the beach. Practicing medicine today in America is a license to print money. I do not begrudge a physician his or her income except that now we may have to take my health care choices away to pay for all to have health care to maintain the physicians' lifestyle. I know a lot of doctors who would like some type of socialized medical coverage but not if it impacts their lifestyles.

My grandfather was a physician. I can clearly remember the day he purchased a Buick - a big day for them. Not a Caddy, not a Benz - a Buick. My grandmother told me he would take chickens and vegetables from folks' gardens for payments. I know physicians today who practice "boutique" medicine so that people can pay a yearly fee and pay their doctor cash - no sitting in the waiting room (Dante's 7th Circle of medical hell) with the unwashed masses of folks on Medicare/Medicaid and (gasp!) Blue Cross/Blue Shield.

We cannot craft a health care policy until we decide what we believe our responsibilities are, as Americans, for our own health care and the health care of others. We cannot propose sweeping changes in the health-care system without making sweeping changes to programs such as Medicare/Medicaid, and we have to address the undocumented worker issues. We cannot make sweeping changes to health care unless we address the compensation to physicians.

Socialized or universal medical coverage would affect all of us, not just those paying the taxes, and not just the patients. It woulld affect physicians and their income, nurses, drug companies - everybody. A governmental board will decide if you really need a pain clinic, or if you should just cowboy up because everybody hurts sometimes.

I think everybody who wants socialized universal healthcare ought to call his or her local Social Security and IRS offices. After all, socialized medicine can't be worse than that, can it?

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Sunday, September 19, 2004

Tim Horner, Blue Stater 

Question Number Eight: President Bush and Sen. Kerry have unveiled their health-care plans. How would you structure a health-care plan? Would it be universal, or only for indigents? Would you feature privatized health-related savings accounts? What would you do about malpractice lawsuits?

I and my family lived in England for seven years. We arrived with three young children (4 and 2 years, and one of 4 months) and left with four (11, 9, 7 and 4). We were able to see and experience national health care, in the form of the British National Health Service (NHS) up close and personal. And through all of this I can say that never once did I think, "Get me back to America!"

That does not mean that the NHS is just like American health care; it is not. We had to be weaned off of our U.S.-born addiction to the expensive antibiotics we got every time our babies had a runny nose and fever. We were told by our British physicians: "Wait it out, give it a day or two, let their bodies take care of it, antibiotics are not always a good idea in the long run." It was hard at first because we desperately wanted to medicate. It made us more comfortable because we were using science to battle the evil bacteria!

Well, after a year of this, we realized that we did not really need all those antibiotics. And our kids did recover - not as quickly, but in England it was just not a big deal for a kid to have a runny nose. It was what made them kids. I believe our kids are stronger because of it.

But when things were more serious, we saw a different side. At one point, my wife came down with severe pneumonia, and we nearly lost her. That was scary. She was rushed to the hospital after a doctor came to our flat to check up on her. That house call may have saved her life because she was fading fast and I had no clue what was happening. She did not wait in ER at all. And she was given the finest care I could imagine. They had a cocktail of high-powered antibiotics in her so fast it made her head spin, but it also pulled her out of a possibly fatal nosedive. The same was true for the birth of our fourth child, who flipped shortly before labor and mooned the world as he came out folded in breech position. The doctors and staff and followup were fantastic, although they could not hold a candle to my wife! Hats off to her. Every single health professional we ever met in England was dedicated and passionate about what he or she did. They did not make as much money as American doctors, but they were just as good. I have waited longer in emergency rooms in America than I did in Britain. And I never waited for more than 5 minutes on the high table! Perhaps the doctors were even better in some ways because they were all part of one team: The NHS.

We had several friends who were doctors, and they said they felt attached not to a practice as much as the whole of the British people. No insurance companies only trying to make money. There was only the government, which was trying to stay within a budget. Drug companies were not autonomous money-making machines. They were held in check by the government. Not every exotic drug is available, and doctors have to justify prescriptions of expensive drugs, but in the long run I believe that the common good is served better by universal health care.

The NHS is not perfect, but the philosophy behind it is. And that is what the issue of health care rests on: How much we see it as part of the common good. I think this crucial aspect is slipping away. When you listen to conservatives talking about health care, they do not talk about the common good as much as they talk about your personal welfare: Your prescription prices, how much your health insurance costs you every month. As a nation, we need to think not of ourselves but those who do not have access to health care. We are the richest, most powerful industrialized nation in the world, it is appalling to me that there are 44 million Americans without health care. We can do better than that. The most essential duty of government is to provide safety to its citizens. A government that cannot provide this is no government at all. An effective health-care system entails keeping Americans safe and sound. Government should have control of health care because then health-care decisions will be made not by corporations, whose only goal is to make a profit, but by public servants, whose mandate is to serve the people, not their own pocketbooks. Corporations do not answer to the people; government does.

This administration is taking health care away from the control of the people and handing it over, piece by piece, to corporations. Health care should be a political issue, not a corporate one. At least you can vote against an administration that is not heading the way you want. Bush's proposal gives the illusion of choice, but there are only a few big players at work here, and they will do only what is profitable. Period. This is the dark side of privatized medicine.

Health care is too important to be let loose into the conscience-free market. Bush says that every American should have the "opportunity" to get affordable health care. But why not go all the way and say that every American should have at least basic health care? Because the word opportunity is the back door that will allow this administration to avoid this issue and shirk its responsibility to the American people. If 44 million people don't have health care, then they simply didn't take the opportunity. The minimum-wage single mother with an 18-month-old baby with asthma didn't take the opportunity to buy health care, so her doctor is on call in the emergency room. But who pays for those expensive, "free" visits? The hospital? The insurance company? No. You pay for it with higher premiums. Does that make sense?

This administration as no intention of making sure that our most vulnerable citizens have health care. America can do much better than that. It comes down to a basic difference I see between progressives and conservatives. Conservatives appeal to our concern for ourselves, our personal income, our personal tax rate, our personal safety, our personal standard of living, our insurance premiums. (This concern for our personal lives also extends to our most intimate life-style choices and personal morality. How touching.) Progressives have a tougher sell because we have to appeal to the selfless side - the side that wants to give to others, make sacrifices so that less fortunate people can have what we have, and make sure that every American has access to quality health care even if it means that we have to support it with our tax dollars.

In times of stress, fear, and unrest, people tend to fall back and "take care of their own." Bush is counting on that, because it is the core of his platform, health care notwithstanding. I believe, however, that there are more Americans who are fundamentally selfless and want to do good for others. I am counting on the fact that there are people who are willing to make sacrifices for the good health and well being of every citizen. I think this is America at our best.

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Bloggers from
Blue State (Pa.)

Terri Falbo

Born and raised in Southwestern Pennsylvania, Terri Falbo is a union organizer who has lived in Philadelphia for almost 30 years. She graduated from Temple University and previously worked as a construction worker for 17 years.

Tim Horner

Tim Horner grew up in Iowa, but has lived out significant chunks of his adult life in Chicago, IL and Oxford, England. He is married and has four children (14, 12, 10 and 7). Having grown up as an Evangelical in the Midwest and still a practicing Christian, he is concerned with how religion and politics mix. Because of a combination of circumstance and apathy, he has never voted in a presidential election. He currently teaches Humanities at Villanova University.
Bloggers from
Red State (Ala.)

Joe Franklin

Alabama native Joe Franklin, 58, was born in Pike County and grew up on a farm in Crenshaw County. He graduated from Troy State University in 1967. After working for 28 years with the Alabama Board of Pardons and Paroles as a parole and probation officer, retired to Crenshaw County, which is just south of Montgomery, where he spends his days working on the farm.

Cynthia Sneed

Gadsden resident and local college professor Cynthia Smith Sneed has a doctorate in Accounting from the University of Alabama. Her fields of academic research are in state pension and employee benefit issues. She has been published in numerous academic accounting journals and has done research for the Alabama Policy Institute. She is a member of the American Accounting Association, Governmental Finance Officers Association as well as being active in the Republican Party.

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