Showing posts with label healthcare reform. Show all posts
Showing posts with label healthcare reform. Show all posts

Tuesday, May 20, 2014

On LBJ

We meet again, old vague acquaintance.

I never did get the hang of you last time.

Your entry into the White House was sudden, unexpected, tragic. It was inevitable for you to end up in Jack's shadow. History didn't change that.

Your domestic experience gave you no credit among students of diplomatic history. Whatever foreign policy you led, we usually accounted to your predecessor's memory. Besides, your foreign policy = Vietnam.

You are little more than a footnote in books about U.S. policy in the Middle East, and he only thing really worth mentioning is your strong support for the State of Israel (but then this isn't exactly unique among American presidents).

You are said to be one of the main inspirations behind Kevin Spacey's character in "House of Cards" (along with King Richard III of England). Good for you.

Your name. Lyndon! It sounds like a character from a 1950s superhero comic (though no the hero. Not the villain either, I think. The jury is still out). The only U.S. politician sounding more like a superhero comic character is Spiro Agnew. You can't beat that.

You did leave a legacy in domestic politics. But I don't study domestic politics.

You're from Texas. Which called for another footnote in the books about U.S. policy in the Middle East, as you were already accustomed to deal with oil companies. So no need to mention that part of your foreign policy either.

Your wife is called Lady Bird. That is all.

You share initials with your wife (and your daughters, and your dog), though I think it would be much more entertaining if you also shared her middle name. Lyndon Bird Johnson makes you sound even more like a character from a superhero comic (though still not the hero).

We were never friends. I don't think that will change this time either. But perhaps I might get to know you a little better, at least?

I am not sure how I feel about that.

Friday, January 7, 2011

On bureaucracy and blessings


We are blessed with a great many things in Norway, one of them being excellent health service and a government issued health insurance that ensures that you can get affordable treatment regardless of your financial situation. This health insurance also extends to certain circumstances where treatment outside of Norway is necessary, for instance when the patient in question is working for a Norwegian government agency abroad (as I very soon will be).

That being said, we don’t necessarily ace in the bureaucratic process said insurance, especially the abroad version since this is not an automatic process like the regular, domestic health insurance is. You have to send an application – 8 weeks ahead of departure (or at least that is the time frame they provide for processing the application). This is not one but several forms, and they are, as forms tend to be, completely impossible to understand. I generally think of myself as a reasonably bright human being, but when it comes to filling out forms my stupid gene kicks in.

Once the forms are taken care of, you wait. And wait. And wait. And hope. In my case I had called ahead to confirm that my position indeed warranted a positive outcome of the application, so I was not too worried, but it certainly took a while to get the final confirmation.

Now, I’ve been through this process before. When I went to Japan in 2006 as a student, I also had to do the application dance. Back then I received not only the confirmation of the positive outcome of my application, but also a health insurance card of sorts. The kind that has words in English on it. You see, the confirmation letter I received this time is written in Norwegian. The problem is that if the chance arises for me to use my health insurance – say by exploring the inside of a Japanese hospital from a wheeled bed – the likelihood of anyone working at the hospital being able to read the confirmation letter in my native Norwegian is disturbingly slim.

Since I foresaw this complication I decided to give the Welfare State a call, to see if anyone there could tell me whether I’d need a insurance card, or if my assurances to the Japanese doctor that “the Norwegians will pay for it, really!” would do.

I phoned the assumed appropriate agency, and they put me in one of those endless phone queues. You know the kind:

“Thank you for calling Welfare State Health Insurance And Every Other Government Issued Benefit Agency (WSHIAEOGIBA). We are currently experiencing heavy traffic on our phone lines, but one of our operators will get to you as soon as possible. You may also contact us at 800-EXPENSIVEHOTLINE, or visit our web page, www.wshiaeogiba.no.”

Fine, I’ll hold. After about thirty seconds, you think the phone is being answered in the other line. But no…

“Thank you for calling WSHIAEOGIBA. We are currently experiencing heavy traffic on our phone lines, but one of our operators will get to you as soon as possible. You may also contact us at 800-EXPENSIVEHOTLINE, or visit our web page, www.wshiaeogiba.no.”

Yes. I heard you the first time. Thank you very much.

30 new seconds, and…

“Thank you for calling WSHIAEOGIBA. We don’t really care if you have heard this message before, so we will repeat it endlessly. One of our operators might get to you as soon as he is done checking his Facebook updates. You may also contact us at 800-EXPENSIVEHOTLINE, or visit our web page, www.wshiaeogiba.no.”

This cycle repeats itself quite a few times, until you swear the message you hear is something along these lines:

“Thank you for calling WSHIAEOGIBA. We are trying to make you go mad. This is the little voice in your head telling you that you probably should find another way to finance your costly health insurance abroad. If you are still with us after this lengthy wait, we might consider letting you into the exclusive club of people who survived waiting in this phone queue without smashing their phone into the wall, people who thus managed to get to the end of the phone queue to find out if they will get their required insurance. Have you smashed your phone yet? No? If not, press one. Just kidding. One of our operators will get to you soonish. After he is done checking his Facebook updates, of course. He might also check into Twitter while at it. You may also contact us at 800-EXPENSIVEHOTLINE, or visit our web page, www.wshiaeogiba.no.”

Once I finally reached an operator, she was friendly and efficient. I am completely satisfied with my operator-time, except for one small thing: She could not answer my question.

A small digression to explain: A few years ago, the various agencies handling unemployment benefits, pensions, and other social security systems in Norway were morphed into one big agency (the one which my WSHIAEOGIBA is modeled on). The idea was that one agency that covered all the departments would be easier for the users to access than the multitude of agencies of the past. The problem with this vision was that (it seems) no one thought of the fact that the separate agencies were specialized within the field they were handling. The morphed agency consisted of people having worked in the specialized departments, who were now required to know everything about not only their former department, but also about all the others.

Obviously, this was problematic, and the morphed agency (from now on it will again be known in this post as WSHIAEOGIBA) has been the target of many a jolly joke ever since.

Despite this, however, my discovery was that the generalized WSHIAEOGIBA handled the generalization by outsourcing specific issues to other, new, agencies… Thus, my operator informed me that I had to call the Never Heard About Health Something Economy Something (NHAHSES). She provided me with a phone number, and we hung up.

I called the NHAHSES, went through a similar phone line routine, and ended up with an operator telling me she could not answer my question. I had to call NHAHSES Abroad Section, naturally.

Naturally.

So I did. Imagine what happened. Phone line? Yup. Operator able to answer my question? Of course not.

At least this time I was told I was at the right place, but the person/people who could answer my question was in a meeting. Or checking his/her Facebook updates. At any rate, I was instructed to call back in half an hour. Which I did.

This time, I managed to get to an operator fairly quickly, but alas, it was one of the secretaries who only could try her best to transfer my call to the right person, but whose attempts did not lead anywhere. I don’t know if it was the phones (not mine) that failed, the secretary not doing it right or the person at the end of the line checking her Facebook updates, but either way it took three attempts – each time I had to go through the phone queue thing again, mind you – to finally reach the right person. Who managed to tell me that while I did have all the rights I thought I did, they did not have a health insurance card to prove I had such rights. She promised, however, to send a confirmation letter in English, so at least I will have that. And I imagine that working at the embassy will make it easier to contact the embassy in case of emergency.


The whole thing reminds me of the Norwegian folktale “Den syvende far i huset” – “The Seventh Father”, where a tired traveler has to ask each generation of a surprisingly large family for permission to spend the night. While I am all for preserving our folktale tradition, I am not convinced that the welfare system is the best place to do it…

Monday, October 19, 2009

On the President, the Peace Prize and precarious positions

For the most part I’ve tried to keep this blog nice and diplomatic. I tend to turn to humour instead of cannonballs (a technique I believe a number of world leaders, past and present, ought to adopt). However, there are times when I can’t help but ram the cannon, even if I know it’s a risky business. I have expressed my opinions on the Middle East conflict, for instance, although I limited this to show my concern for the fact that there is an ongoing conflict rather than expressing my sympathies (or lack thereof). I’ve also written a couple of pieces on the Nobel Peace Prize – one generic and one specifically concerning the most recent laureate.


When I do write something like this I don’t do it lightly. I have a bachelor’s degree in international studies. I am in the process of getting a master’s degree in history. I have specifically studied war and peace for years, and even if I hardly can claim to be an authority on the subject, I do believe that by now I have the right to say that at least I know when I know what I am talking about. Therefore it bothers me when people tell me I don’t.

Normally, I don’t like to target specific people or specific replies, because inside me somewhere there lives a little girl who simply wants everyone to like her and to get along with everybody. However, sometimes I am forced to tell this little girl that this is not how the real world works. Sometimes one needs to confront things to have a fruitful discussion, and there will always be someone disagreeing with you. This is okay – I don’t mind that others don’t share my opinions. What matters is the way it is done. Some of the replies to my previous post on President Obama’s peace prize I was fine with – the opinion that Obama did not (yet?) deserve the Nobel Peace Prize is a valid one, it’s even one I partly agree with. The opinion that the Nobel Prize has lost some of its credibility because of the committee’s recent decision might also be valid – at least as an opinion. Whether it is a historical fact remains to be seen. I am not inclined to think this is so, actually, since the history of the prize shows several equally (and more) controversial laureates. The case against this year’s decision is that it is political, and that Obama has not yet done anything to deserve it. Well, the prize has frequently been accused of being political, and its laureates have on several occasions been accused of deserving war prizes rather than peace ones. At least no one can say that about Obama (yet?). Accusations that he is an “evil communist” do not count in this respect, by the way, since a) he is not a communist (and I very much doubt he is evil); and b) even if he had been a communist, or even evil, that alone does not equate him being in favour of war rather than peace.

But back to the replies I received. My post spurred something of a debate on my Facebook-page of all things. Since I was away, I was not able to participate in the debate (that in true digressionary spirit derailed into a debate on U.S. healthcare reform and its funding). I don’t like jumping into a debate this late, but I do feel that some of the premises raised more than deserve my attention. Therefore I will step away from two of my principles – this post will be (already is, I believe) political, and in order to get my point across I will target specific replies (even though the little girl inside me is silently aching).


It is sad that people around the world think they know what is best for the U.S.
I don’t think I know what is best for the U.S. But I do think that when a country has rapidly increasing unemployment rates, when its economy is in deep crisis, and when there are growing numbers of people living in poverty, it is high time to try to solve the problems. So far, it appears that Obama is at least willing to try. I am not saying he will succeed, and I am not saying he won’t. But I do think it is a good thing that he is trying.

I say this leaning on my background from international relations and history (and international economy, I might add). If my own political convictions also come to play, this just means I am human. It does not mean I think I have the right to enforce my beliefs on the people of the United States. I respect the fact that there are people here who have different opinions than me. I also notice, however, that there are people who share my opinions – people who are tired of the fact that they have to work their backsides off and still only barely afford healthcare. This is actually more evident to me now, living in the U.S., than what it was before I came here. So to say that I, as a foreigner, has no idea what I am talking about is a grave underestimate of my education, my intelligence and my ability to observe my surroundings.

You and others around the world who think Obama is so great, didn't grow up in the kind of freedom we are used to
I’m not entirely sure whether this is supposed to offend me, or whether this too is an underestimate. I chose to believe the latter. See, I can’t quite understand what kind of freedom U.S. citizens supposedly have that Norwegians haven’t.

Let me clarify. Norway has been an independent country since 1905. Even while we were in union with Sweden, however, we had our own constitution (since 1814), which at the time was the most progressive one ever written (including the U.S. one). In the following century, Norwegians gradually gained more civil rights. By 1913, we had universal suffrage (Norway was the second country in the world to allow women the right to vote). Excluding the five years of Nazi occupation during World War Two, Norwegians has thus enjoyed incredible freedom for a long time. In fact, since our collective memory so vividly remembers what lack of freedom implies, many Norwegians are very aware of what kind of freedom we are fortunate enough to have today.

Further, citizens in Norway enjoy the freedom of speech, the right to assembly and other fundamental human rights now integrated in our constitution. I have never experienced that I could not express my own opinions (which is probably why it shocks me when I in this instance basically am told that I should not). I have always enjoyed great freedom – in fact, I am willing to claim greater freedom than what many Americans do, because unlike many of them, I have for instance been fortunate enough to be able to travel a lot. Seeing different parts of the world allows me to appreciate my own country, because I do see that there are disparity in terms of freedom and prosperity around the world. The United States is a great country, but let there be no doubt – it is not the only great country.

In terms of civil rights, as shown above we are right up there with the United States. When it comes to other types of freedom, I don’t see that we fall short there either. Norway has one of the highest per capita incomes in the world, and also one of the largest PPP (purchase power parity) per capita, both considerably higher than that of the U.S. – Norwegians enjoy far larger financial freedom than most people in the world. Norway this year ranks top at the United Nations’ Human Development Index, which measures level of education, life expectancy and GDP per capita. We have been number two for a couple of years now, but before that, we ranked top six years in a row. What this translates to is that the UN considers Norway “the best country to live in”. I’m not saying the UN list is exclusive – clearly there are other factors that determine how happy or free the citizens are, but it does appear that a high score on these three points constitute a good starting point.

Finally, I believe there is a common misunderstanding coming to play here – the assumed battle between “individual freedom” versus a “strong government”. In theory I have less individual freedom because I pay more taxes than an American, and because I cannot choose which health insurance I want, since I am automatically insuranced through the government rather than with a private company. I am willing to argue till my face turns blue the Norwegian welfare system actually gives me MORE individual freedom, because I still have the option of choosing a private clinic in Norway or abroad if I want to, an option that I actually might be able to afford because there are no insurance companies stealing my money (since I don’t have to pay for health insurance), and because I, despite the taxes I pay, am still left with more money at the end of the month due to all the other services my government also provides that I thus don’t have to pay for. I can, if I want to. But I don’t see the point – after all, the system is working. If anything, I pity those who didn’t grow up in the kind of freedom I am used to – a freedom that also allows you to trust your government.

American Freedom will never die and Socialism will not last.
Here it is again. The struggle between “American Freedom” (individual freedom) and “Socialism” (strong government). I believe that I under the previous point clarified why I don’t think this is a particularly fruitful debate. One further reason, however, is a matter of definition. You can find a number of definitions of socialism in various dictionaries, but let me provide one:

Socialism: Any of various theories or systems of social organization in which the means of producing and distributing goods is owned collectively or by a centralized government that often plans and controls the economy.
Under this definition, or most others, Obama’s policies don’t warrant the label socialism. Neither does, actually, the Norwegian system. Norway is currently governed by a social-democratic government. I emphasize democratic, because even though it is evident to me that there is a difference between socialism in its purest form and the variety of ideologies or systems that include socialist elements, I realize it might not be as clear to everyone else.

Transferring power to the government from the individual isn’t taking power from the people in a social-democratic system. This is where the democratic part comes to play. The government is elected by the people.

Social-democracy has been part of Norway’s backbone, alongside capitalism, since the end of World War Two. Yes, capitalism. Because we do have open markets (in some cases even more so than the U.S., because we are subject to EU rules even if we’re not a member). But this does not change the fact that we also have a strong government, deeply vested in the welfare state. Even when we have conservative or liberal governments, no one is trying to put an end to the welfare state, since this is the foundation for how our entire society is wired.

Likewise, Obama is not trying to change everything about the existing system in the United States. I don’t foresee a similar construction as the Norwegian welfare state forming in the U.S. I’m not even sure it is desirable, and it is probably not possible considering the mere size of the Unites States. What Obama is saying is that today there are a number of Americans that cannot afford proper healthcare, and this is not something a civilized society ought to tolerate. His proposal to get there is to have a government based alternative to ensure at least a minimum of security for everyone (and how do I know this? Because I have listened to what he says about the reform, I have read the reports and I pay attention to what is being said in the media. That is media in plural, yes).

Despite my welfare state upbringing, I happen to believe that the important part of Obama’s promise is “minimum for everyone”, not “government based”. If there can be other solutions more compatible with the current U.S. system – fine. Go for that. But rather than trying to find such solutions, the opposition largely seems to be doing their best to trash Obama’s proposal by labelling it “socialist” or “communist”, or even “evil”. Why they want to revoke fears that should have been buried with the Cold War axe instead of constructively cooperate, is beyond me, and this, more than political convictions, is why I am inclined to believe that Obama has a better case than the rest of them.

The healthcare plan will not make you poor. It will not make businesses go bankrupt. It will not turn the USA into a socialist as opposed to a capitalist country. If anything, Norway is an example that a middle way is indeed possible. I am not saying the Norwegian system is flawless, because it isn’t. Let me once again emphasize that I am also not saying that the U.S. should adopt Norway’s system. But I do think it is worth considering the proposed changes rather than dismissing them as “socialism”.

It [the fact that Obama won the Nobel Prize] just proves that the rest of the world wants us to be just like them.
Well, no. It doesn’t prove anything. First of all, the Nobel Peace Prize is not a “be like us or else” kind of prize. Secondly, it hardly reflects the opinion of the world. I think the six members of the Norwegian Nobel Committee would be rather flattered to hear such an accusation. Their decisions reflect their opinion, and nothing else. In this case the committee’s reasons for awarding Obama was “his extraordinary efforts to strengthen international diplomacy and cooperation between peoples”, his “vision of and work for a world without nuclear weapons” and for his initiatives in cooperation in such themes as human rights, democracy and climate challenges. Not once during the announcement was domestic, U.S. issues mentioned. If the members of the Nobel Committee also have an opinion on these matters, they do not mention it as a basis for their decisions. Since both the nominees and the records of the committee’s meetings are confidential and not to be released for at least 50 years, we will not know for a while yet whether the committee members had ulterior motifs. Therefore it is pointless to discuss it.

In the end, it does not matter whether we like or dislike the awarding of the Nobel Peace Prize to Obama. The decision has been made, and the Nobel committee never has, in its 108 year long history, changed its mind. The decision will stand. There has been disagreement within the committee (in 1973, when the prize was awarded to Henry Kissinger and Le Duc Tho, the North Vietnamese who is one of the few that has declined the prize, two of the committee’s dissenting members actually resigned), though this year’s decisions appears to have been unanimous. I’d like to quote Obama’s big sister, Auma Obama, who this weekend visited Norway in her capacity as working for CARE in Kenya. When asked what she thought about her brother’s reaction to the prize – that he felt he didn’t deserve it – she said that she did not think it was important whether he felt he deserved it. “It’s not up to you to decide whether you deserve something or not. When you get a prize you are given that prize. You are nominated. (…) We can’t define how those people feel about us.”

To conclude. If you think Obama didn’t deserve the prize, fine. It won’t change anything, but you’re entitled to that opinion. If you think Obama is an idiot who will ruin everything the United States was built upon, you’re entitled to that opinion. If you think Norway is a socialist state where the poor people have no idea how un-free they are, I suppose you are entitled to that opinion as well, although I do feel I have done an effort to enlighten you so that your opinion may be based on facts rather than assumptions. What I demand, though, is my right to express my opinions (especially considering this is MY blog). I don’t appreciate insinuations that I shouldn’t use this right, and I don’t appreciate insinuations that I don’t know what I talk about (for the record – no, I don’t believe everything I hear in the media. That includes Fox News, by the way).

I know I am putting my head on the chopping block with this post, but I feel it’s the right thing to do. And I apologize in advance if anyone feels offended by my doing so. Most of all I apologize that this got so long. If you managed to stay with me through the end – kudos to you for that!
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