1. Casey's Prescription for Health Care:
- Establish whether Americans have a "Right" to Health Care or not. End the legal ambiguity.
- Put an end to the Doctor -> Patient -> Insurance Company triangle. Meaning: Currently, the patient looks to the Insurance Company to pay the bill; the Insurance Company looks to the Doctor to reduce costs or avoid "experimental" treatments or to make a paperwork mistake that might justify a denial-of-coverage; and the Doctor looks to the Patient as the person who is ultimately legally responsible for the bill.
- Insurance Companies become legally responsible for the bill. Doctors are subjected to a national index which evaluates their results. Patients can buy insurance to be covered by particular doctors or systems, and the price for than insurance reflects the quality of the care. This way doctor's prices (echoed in insurance prices) reflect something in the marketplace.
- Health Insurance companies are limited to a profit percentage by law. They cannot turn down anyone for basic coverage (meaning most everything, like birth or genetic conditions, checkups, blood-work, chronic conditions like diabetes and AIDS, catastrophe, and long-term care for the aging, plus coverage for most kinds of cancer treatment). Because of the extremely expensive nature of them, some rare diseases whose treatment runs in the millions would not be covered by Basic. These folks would have to buy some kind of Extraordinary Insurance.
- There remain inequities in health care (quality of doctor), but basically the cost of Basic falls low enough that anyone can be covered (Casey didn't mention his take on the Hillary-Barack debate over whether very inexpensive insurance coverage could be made "mandatory.") Because of an insurance system in which price reflects quality (and paycheck), doctors -- even at the lowest level -- would at least be motivated to be be better, since the salary level of the worst ones would (checked by the market) fall so low as to make it hardly possible for them to pay back med school loans.
I thought it was interesting that Casey way thinking in terms of real solutions for the short-term. (Assuming "universal" non-private health care is available in some long-term future. He is very disillusioned with politics, because he feels our politicians don't ever offer us solutions outside the terms-of-debate of the moment. For example: Politicians this season will debate whether to make the Bush tax cuts permanent, or whether to raise or lower a particular kind of tax. But an open discussion that explores the question, What is an appropriate tax burden, in the absolute sense? is not possible. Also he thinks that politicians rarely have creative ideas or tap creative ideas. Which ... when you think about how much independent research and proposals are available to them ... is shocking. They say they'd like to "incentivize" (read: tax credit or subsidized loan) Activity A or Activity B, usually without proposing any attending creative mechanisms to offer non-monetary encouragement.
2. The Strengths and Weaknesses of the LSAT. Won't get into this one.
3. Debating my proposal to write a short philosophy around the "3 Pleasures," defined briefly as:
- Pleasure 1: Independent, autonomous, autochthonous thought. Having a strong resource to, and comfort in, the strength of your own thoughts. Finding that what you think is rarely a regurgitating or reprocessing of outside opinion, but a uniquely personal take on it. This is not the same as "liking yourself," which implies standing outside yourself and judging yourself. It's being yourself more. Being yourself better. I especially like the word autochthonous, in the geological sense, as a rock which is found in its place of origin. This idea, applied to humans, is NOT a paean to nativism in geographical terms, nor to "homespun" thought (necessarily). Rather, the idea is that if you want to know more about something Theresa thinks -- or wish to understand it better -- your best source of information or clarification, or depth-ification is Theresa. Theresa may belong to a movement, or a church, or an ideological tendency, but Theresa will feel mental ownership over her beliefs. Theresa will never be "at a loss," to explain herself, in need of deferring to someone else to explain her. (Of course, someone might help to clarify what Theresa is saying in the case of a misunderstanding or language difficulties or terminology incongruencies, but it won't be because Theresa's understanding of her own "take" on things is limited. Its origin may be outside her -- For it is good to learn from others -- but it's home and place of development is within her.)
This, of course, is only an ideal, a "pleasure" that no one can live up to completely. But the more it is cultivated, the more resourced and resourceful a person may be under any circumstance.
[Video = Cornell's Christian Charity Take.]
- Pleasure 2: The body. This one needs the least explanation, other than to say that our sense of it should be ever less prescriptive. Sexual experience may be very important, or very un-important, as per the individual. In general, human history has a lot more variety in models of bodily health than contemporary society allows for. Some people grow stronger in the Sweat Lodge, others will get very sick the next morning no matter how much they train for it. Knowing one's own body ... again, as an "autochthonous" source for health information ... is a pleasure.
[Video= Pure Pleasure, Zaireans hearing the Fania All-Stars in the 70s.]
- Pleasure 3: (This pleasure is hard to name in non-negative terms). Self-abnegation, not as a masochistic pleasure (although masochistic pleasures can be good and may be affirmed if they work for the individual, sub-categorized under "Pleasure 2") but as the ability to forego. Two individuals are equally cold (let's say for argument's sake that they enjoy an equal level of cold tolerance), but if only one blanket is available one person is more equipped than the other to cede it. Casey wondered whether this wasn't simply discipline, but I disagree. Or at least, if pain is endured, that's not what is being referred to. What is referred to is the pleasure of needing little.
Both Ellen and Casey thought that this formulation was a little ignorant of the role of other people, and it does sound that way, but I would say rather that being fully engaged with other people is implied in each pleasure. (Perhaps, for some, it would be least so in the case of the body if their preference is for lonely bodily pursuits.) The other main problem -- as Casey notes -- is the world "pleasure." When in fact, as he says, any pleasure can cut, or can become a vice-in-waiting. Other possible words to substitute here might be "Resource" or "Safe Spot of Self Strength," but I don't really like anything other than "Pleasure" understood in the widest sense. That which lubricates life and its tasks, done "with pleasure" even if not easily or without pain.
Casey's other critique is that my pleasures might be geared to the young, and do not take into account the loss that comes with age. (Bodily in the cases of 2 and 3; perhaps mentally in the case of 1). All I can say about that is that I think a measure of these pleasures -- or new avenues to them -- can be enjoyed by all except the very old or the very infirm, who -- I'll admit -- are somewhat excluded. Of course, very small children would be too (depending on their level of precociousness). And all who ultimately live primarily as "dependents" at all times, rather than "providers" or "independents." For, if 100% of your material security and capacity depend on another person, it becomes intensely challenging to be really autonomous in the enjoyment of these pleasures. Because you simply cannot ever take a wholly objective view of your caretaker. Even very dedicated spouses have more independence of thought that is possible in this type of relationship. However, if your caretaker is very liberal with you and actively supports your freedoms, you may enjoy at least the simulacrum of the pleasure of independent living through the autochthonous knowledge of the dimensions of (1) your mind-worldview, (2) your body, and (3) your ability to forego. But likely you are not free -- even with this liberal person -- to implement the most radical truths you learn for yourself.
Another concession I made to Casey (which he didn't care for) is that it's possible that a 4th pleasure could be considered to be "the opportunity afforded by suicide." Not suicide itself, which is in no way a pleasure. But rather the notion, if only subconscious, that under the worst possible circumstances you hold the key to unlock the Exit door on your mortal. existence. I am not overly convince of this "Pleasure" myself, so it's not included in the Top 3.
3. How, as Mark Twain said, too much schooling gets in the way of your education.
4. The declining relevance of the theory of unipolar global geopolitics and the fate of Fukuyama's End of History.
5. Whether Casey should continue living in Madrid when he takes a new job in the suburb of Fuenlabrada en September.
6. What we understand to be Rights (returning to the proposed "Right to Health Care"): Whether they [rights] are dependent on cultural antecedents, or presence in language in a Derridian sense, or whether they just simply indicate the goodness of people period. (Such that, a people that doesn't naturally believe in a Right to Universal Health Care is simply a scandalous people, and is in need of no further explanation than that they are in need of change.)
7. Bunch of other Random stuff.
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