One of the first things that people started wailing about when it became clear that Obama would get the nomination was his health plan. “It’s no good,” people said. “People will be left without insurance.” “It doesn’t go far enough.” So, I decided to read said health plan to get an idea of what was actually going on, so that I could comment on it. You can read it too, if you want, it’s hosted on his website and it is pretty short.

After reading the health plan, I was forced to both agree and disagree with people who criticized it. I’ll start with the disagreeing, because I can get that over with very quickly:

The fact that any sort of health plan is being proposed for Americans is a good thing, because it shows that politicians are responding to growing upset among Americans about the state of their healthcare. However, and here comes the agreement part, Obama’s plan is going to fail, and that sucks both for Americans now, and for Americans in the future, because it means that the next time a health care plan is proposed, people are going to point to the failure of Obama’s plan as a reason to not enact it.

Why is it going to fail? Because it’s not universal. The only way to make a national health plan functional is to make it universal and mandatory. I have really been torn on the issue of mandates, but I was recently converted. Simply put, it’s better for us to have one central insurance provider (such as the plan available to federal employees) and for every single American to be covered. Because people who are uninsured cost all of us money, and the system will be cheaper and better if everyone’s on board.

That said, I still strongly feel that health care should be free. Not just to the poor, but to everyone. People like me would really suffer under health care mandates, because I can’t afford insurance, but I’m not poor enough to qualify for help from the state. On paper, my income is quite reasonable, and I should certainly be able to afford insurance, but unless it was offered at a drastically reduced rate, I couldn’t. Because the cost of living here is too high, and because I am in debt. And a lot of Americans are in the exact same position; on paper, we look like we’re in clover, but the reality is a little different. The poverty line is one very useful marker for determining eligibility for free/discounted services (and if you live below the poverty line, everything should be free), but it can’t be the only yardstick; we need to accept that America is an expensive place to live in, especially for college graduates struggling with debt.

Mr. Obama’s proposal doesn’t mention anything about how much the premiums would be, which is a pretty crucial piece of missing information. Perhaps the proposed premiums would actually be quite reasonable, and totally attainable for people like me. And maybe not. Either way, I can’t get behind the plan, because it’s not mandatory.

So I wrote Mr. Obama a letter, explaining my trepidations about his plan. Obviously he won’t be reading it personally, but I hope that more letters like mine trickle into his offices; enough so that his aides sit down with him to have a serious talk about reforming his plan, because I think that he genuinely does want to set up a plan which will work, and I would like to see him succeed at that.

Incidentally, here is a very short, clear, neat little video on what single-payer is, and why it’s a darn good idea.

“Do you want STDs?” The friendly nurse is quite perky when she says this, looking at me with genuine interest.

“Uhhhh…no,” I say, hearing my doctor snort as we pass her in the hallway. “I try to avoid them, as a general rule.”

The nurse stares blankly back at me, the hilarity of the moment apparently lost on her, and I finally close the silence with: “oh, you mean STD testing? No, I was tested recently, I think I’m all good.”

I learned several things yesterday:

• When you go to the clinic for a visit to ladytown*, you now go to a separate building which is all shiny and new.
• But the receptionist is kinda mean.
• At least when you are late.
• Which wasn’t my fault.
• Also, when you are late for a medical appointment, you don’t sit around in the waiting room for half an hour, and you skip a lot of gruesome paperwork, and the nurse doesn’t have time to yell at you for being fat. And you don’t have to go through the gauntlet of the infamous clean catch. I get why people show up late now, I really do. I mean, I never could, because it’s basically against my religion, but I get it.
• Did you know that the California Dairy Board papers doctor’s offices with helpful notices about how milk is the best (read: only) source of calcium? Yeah, I thought that was funny.

Anyway, for readers just tuning in to this ain’t livin’, it’s kind of traditional for me to write about my annual exams, because I think it’s funny, and because it causes some readers to get all squirmy, and I like doing that. And for the medical professionals reading along, I plead guilty: I was due six months ago, and I wussed out, because I loathe my annual exam with a fiery passion. I am a bad person. And I actually had two medical appointments yesterday, not just one, but I’m only writing about the one, because, well, frankly the other was much less interesting for y’all and much more scary and unpleasant for me, so it’s hard to write about it in the acerbic, witty way to which you are accustomed.

At any rate, things went pretty much as expected on the annual annual adventure. I like my provider, she likes me, and she makes things relatively quick and not too awful, which I greatly appreciate. We talked briefly about the HPV vaccine, and bemoaned the fact that it is expensive (they don’t even offer it, because it is too expensive to stock), and we talked about how universal health care should happen, and about packing up your parents’ houses after they die. (Don’t ask.) Also, we talked about my family’s predilection for cancer, and the nice note UCSF sent me that says if I’m ever diagnosed with cancer, they would like to study me, please. (I replied that if I’m ever diagnosed with cancer, they’ll have to move fast to study me, so I can’t afford treatment, and therefore presumably will be dead in a relatively rapid amount of time. I didn’t hear back, for some reason.)

I like the new ladytown clinic. Well I mean it’s not just for that, they do other stuff too, but it’s kind of a nice little branch of the main clinic of doom, and it still has that shiny and new feel, instead of the public health vibe. I mean the regular clinic is nice too, way nicer than the old location, this is just so new and different, it’s kind of exciting. Although the art in my exam room was a little, uh, grim, since it showed cats cavorting on the Rainbow Bridge while their owner looked wistfully on. I’m not sure quite what kind of message was being sent there, although I did find it amusing that the need to surround me with weird creepy cat stuff apparently extends to medical providers as well as misguided friends. (Note to people buying me presents: just because I have cats doesn’t mean that I would like weird creepy/tacky/dumb cat stuff.) Not quite the glory days of the clinic I used to go to in Berkeley with the insanely hot phlebotomist, but close.

I also discovered that our bus system is, uhm, not very good. Honestly, calling it a “bus system” is a bit extravagant; there’s one bus, it goes by once an hour starting at eight, and the last run is at six. Which is pretty much the most inconvenient thing you can imagine. And, like all public transit, it smells bad, but there’s an especially high concentration of loonies who all gabble to each other. At least in San Francisco, we sat in stony silence staring blankly off into space, and there was a broad cross-section of people, from executives in suits to crazy people. And given that I am both reasonably sane and non-smelly, I stuck out on that bus like a sore thumb.

It sucks, because I wish we had a good public transit system, and I know that the way to improve it is to ride it, to show that there is a market for it, but I can’t really bring myself to do it. I only bussed under duress, and it’s not an experience I intend to repeat any time soon.

Also, bonus points for giving me a cloth gown instead of one of those imbecilic paper ones. Honestly I should just bring a kimono next time, though. It would be way more comfortable, and I feel like I would earn major style points.

*A trip to the pee-pee poker, if you will. A stroll down vagina avenue, even. Still confused? Read: gyn exam.

The other day, Kremlin drew my attention to an article in the New York Times about rising insurance premiums (and denial of coverage) after C-sections. Then, not a day later, I found this article in the Los Angeles Times, discussing the rise of pre-term births, many of which are apparently occurring as a result of the rising C-section rate in the United States. I thought it was a funny bit of happenstance that these articles should dovetail so neatly, given that I find the whole process of pregnancy and birth really fascinating.

Home birth especially has always been a long interest of mine, as is natural birth in general. I am a firm believe in birth with a minimum of interference, as humans have, after all, been doing it for rather a long time. Yes, birth can be dangerous, and women in high-risk pregnancies should pursue every possible precaution, but it seems like we’re seeing a trend these days towards child-rearing and now apparently childbirth by convenience.

Look, I’m not a parent. But I do know that child rearing is not “convenient,” no matter when and how it happens. It’s hard work, and it’s work that deserves a lot more credit and respect than it gets. Raising kids that aren’t totally messed up is pretty darn hard to do.

We live in a society where people delay having children until later because it’s not convenient to have kids in youth, which seems kind of weird to me, and we also live in a society where people schedule their births, which just seems insane to me. But, apparently, it’s a very common practice to pick a date and schedule a C-section, rather than waiting to see if the baby makes its way out without assistance.

Are there cases in which a C-section is necessary? Absolutely, and I’m glad that safer C-sections are accessible to women today as an option for dealing with situations when complications emerge. But it seems a bit crazy to me to elect to undergo a surgical procedure on the scale of a C-section for convenience. And, quite frankly, I’m surprised that obstetricians are permitting it, because it seems like babies should be allowed to develop as long as they need to, and to come out when they are ready, not necessarily when it’s convenient for their parents.

After all, as the Los Angeles Times pointed out, even “late preterm” babies come with some serious risks of health problems associated, and these risks could be mitigated by, you know, letting them pop out on their own. And fetal development isn’t an exact science; it’s hard to predict when, precisely, a baby is due, although you can get pretty darn close. So why not, you know, let the bread bake all the way so you don’t end up with a loaf that’s raw in the middle? You can’t stick it back in the oven, and it just doesn’t taste the same when you toast it. I’m just sayin’.

I think that a lot of OBs are under serious pressure right now, thanks to the fact that this is a lawsuit happy culture, so many are choosing the C-section route because it’s perceived as less dangerous, and thereby it creates less potential for a lawsuit. They’re also opting to do C-sections for relatively minor or potentially controllable complications, out of a concern that those complications could turn more serious, and thereby bring on a lawsuit. In fact, a lot of young doctors are choosing not to go into obstetrics because it’s such a high risk profession, and that’s a real pity. By being so eager to sue for the slightest pregnancy-related complication, we are ironically making it harder to provide good care in the field by limiting the number of practicing OBs and severely restricting their practices. Go us.

Pregnancy is risky. Maybe not all the time, and maybe not as risky as some rabidly anti-home birth advocates would have us believe, but there are some inherent risks involved, especially for older women, a growing demographic in the pregnant community. Refusing to accept those risks, and steamrollering over thousands of years of evolution, just seems silly to me. Taking steps to reduce those risks is a sensible tack, but manic fear seems a bit counterproductive, yeah?

30% of births in the United States are via C-section, which just seems crazy to me. It would appear that our American mania for convenience and our intense fear of lawsuits has spilled over into some surprising arenas, and I wonder what it’s going to take to see some major reforms in the American birth industry.

One perhaps predictable result of the Iraq War is a skyrocketing PTSD rate among American soldiers and allied forces returning home. I think in part that this is due to an increased recognition of PTSD, paired with more aggressive screening and a willingness to diagnose it, in the hopes of getting help for service members, but I can’t help but wonder if it’s also due to the style of war which is being fought in Iraq. Being constantly under threat from IEDs and insurgents has to be more stressful than I can even begin to imagine, and it’s a different kind of stress than has been endured in previous wars.

While all wars are fundamentally the same, in some sense, they are markedly different, also.

At any rate, I saw not one but two articles about the treatment of PTSD this morning, which seems to indicate that some steps are being taken to address the rising PTSD rate, including considerations of alternative and more unusual treatments.

The Washington Post had a great article on the use of meditation and yoga in the treatment of PTSD. Both of these treatments have actually long been used to treat civilians with PTSD, and I’m glad to see them being used by the military, because they really do work. And I think that promotion of yoga among service members is just a good thing in general, because I like yoga. And I think it’s good for your soul. Observers at Walter Reed have also pointed out that the yoga plan seems to be working to reduce stress and anger, which is pretty groovy.

Speaking of groovy, there’s apparently a hot new drug for treating PTSD, according to the Times of London. Maybe you’ve heard of it? It’s called methylenedioxymethamphetamine, but you might know it better as MDMA, or Ecstasy. In a funny turnabout, it turns out that Ecstasy might be beneficial for the treatment of PTSD, which brings back memories, for me at least, of the use of other now restricted drugs in medical treatment. LSD in psychiatric therapy, for example, or heroin as a painkiller. But if it works and research can be taken seriously, I think that would be pretty excellent.

It’s good to see PTSD being taken more seriously, because I think it’s a problem that’s not going to go away. PTSD isn’t just an isolated problem: it becomes a social issue when people with PTSD engage in acts of violence, find themselves unable to hold down jobs, or end up homeless. I also believe that the least we can do, as a nation, is provide adequate care for veterans, whether or not we agree with the wars they fought, who they are, or the reasons they joined the military. Military service comes with a contract, in which the government claims to care for veterans, and lately I’ve been noting a lot of breaches of that contract.

I was talking with a friend recently, and somehow the topic of fantasies came up. This person expressed a sense of deep personal discomfort with certain fantasies, and I got a sense of shame and misery from this individual about having those fantasies, and we had an exchange that went something like this:

Me: Ok, I get that you feel like such and such a fantasy is “wrong,” because the behaviour involved is morally questionable, but I don’t think you should beat yourself up over it.

Person: But, its wrong, I shouldn’t feel that way, and it makes me feel like a bad person.

Me: Right, but here’s the thing. Unlike an actual bad person, you would never do the thing that you are fantasizing about. Because you recognize that it is a bad thing, and you understand the difference between fantasy and reality.

Our whole exchange was very interesting, and obviously I’m not going to delve into it, but it got me thinking about one of the reasons I really love Savage Love, Dan Savage’s advice column. (Dan Savage himself, alas, is extremely fat-phobic, but I can separate one dislikable aspect of a person from their more redeeming traits.) Savage explicitly and frequently expounds on the difference between fantasy and reality, and I think it’s a good difference to underline.

There’s a huge difference between doing something and thinking about doing something. For example, I occasionally fantasize about ruthlessly slaughtering my neighbors, but obviously that’s not something I would ever do, because I recognize that it is, you know, not very nice. But I don’t think that imagining the act is necessarily a bad thing. In fact, I would argue that working out elaborate schemes in my mind while I seethe in bed trying to sleep allows me to express my irritation and anger, thereby defusing it.

America is all about repression, and the mind is a dangerous thing to repress. People in this country wig out about fantasies like the citizens of 1984 fret about thoughtcrime. I just don’t think that the world of the imagination is or should be subject to the same rules which govern actual, physical behavior. Imagination is a wonderful thing, after all.

And, in some cases, I think that there are ways to realize certain fantasies with consenting people in a healthy, safe, and sane way. There are whole communities of people out there who love to do just that, and many of the people in those communities are gentle, loving, caring people who simply have a few unusual extracurricular pursuits.

It makes me sad that we live in a society where people are taught to feel ashamed of themselves when they think in ways which are nonconventional. Obviously, I am not condoning actual atrocities, but I don’t think that trying to repress fantasies is very productive, or healthy. I also certainly wouldn’t condone any acts which were nonconsensual, but I am not opposed to the illusion of nonconsensuality in a carefully negotiated and controlled scene with mentally capable adults.

The boundaries of what we consider to be sexual deviance seem to be constantly changing, but there’s a common thread of treating people who are perceived as deviants like animals. I find this attitude extremely counterproductive, because it suggests that there is no sane, healthy, safe way to express desires and fantasies.

In a world where people were more open about their fantasies, maybe they would understand the difference between fantasy and reality more clearly. If you’ve ever looked at Japanese comic books within the larger context of Japanese society, you can see that people are perfectly capable of expressing some pretty astounding fantasies without actually acting on them. And for those who do want, in some small way, to act out such fantasies, there are healthy outlets for doing so, because it’s a culture where the concept of fantasy is accepted, allowing people to negotiate their own boundaries and to seek out like-minded individuals.

Personally, I’d rather see that than the inevitably explosive results of repression.

You do know that photographs in fashion mags are heavily altered before publication, right? I always assume that this is common knowledge, but I wasn’t aware of how heavily modified some images are until I checked out some before and after comparisons (click on ‘portfolio’). Looking at those images was quite eye opening, as I suddenly realized that all of the porcelain dolls I see on magazine covers have skin that’s actually a lot like mine, with small blemishes and natural imperfections. And that even “perfect” actresses and models are altered before being placed in the public eye.

I find that pretty depressing, myself. We constantly rail on about the unrealistic beauty standard promoted by the fashion industry, but it’s kind of a shock to be actually confronted with it. Of course, I knew that image manipulation happens, but I don’t think I realized the extent of such manipulation. It certainly didn’t occur to me that even for the perfect, there is no perfection, thanks to this crazy society we live in.

Yesterday, this article was published in the Telegraph, and the fatosphere started responding, along with feminist bloggers. For those of you who don’t feel inclined to read the article, the short version is that many fashion magazines are starting to alter images of models and actresses to make them seem less thin. And I stress “less thin,” although the Telegraph opted for “fatter,” because these women aren’t fat, they are still thin. Very, very thin.

My response to the article was mixed. On the one hand, I thought it was interesting that magazines are actually altering images to make their subjects look larger, although still nowhere close to real women. On the other hand, it depressed me to think that these magazines have chosen to cover up the real consequences of dangerous thinness, probably in response to rising public outcry about the issue, and to make them seem more attractive.

As Ann says in the post at Feministing, if you want pictures of healthy models, hire healthy models, rather than modifying photographs of unhealthy models to make them look healthier. This seems pretty straightforward to me. She also made a very good point when she discussed the fact that extremely thin women don’t actually look that attractive, what with tiny breasts and bottoms, and jutting bones, so altering their images encourages people to pursue a thin look without revealing the physical cost.

Image manipulation of this type is simply a clear, blatant, lie. It conceals an important reality: the fact that anoretics have sallow, nasty skin, ashy hair, jutting bones, and a variety of other grotesque symptoms. The reality is that if you want to be as thin as the people in magazines, you’re going to look awful, but you might not realize that, since the truth is concealed from you.

The fashion industry is brutal for people on the inside, and pretty awful for those of us on the outside who are still influenced by it. I’m not sure what kind of message photoshopping to add flesh might be sending, but I don’t think it’s good, and I would love to see even one fashion magazine use honest, unaltered images straight from the camera. Just for once, it would be nice to see the truth, rather than an elaborately constructed fiction.

There seems to be growing awareness that maybe being extremely thin is dangerous, and some action is even being taken, like banning anorexic fashion models from fashion shows. Yet, at the same time, I see casual references to the “obesity epidemic” everywhere I look. I wonder if anyone’s left in the middle anymore, when a size eight is fat, all the models are all under size zero, and even they aren’t perfect enough for the exacting standards of the fashion industry.

One Saturday in the fall at my first college, I was feeling a bit down in the dumps, and a friend of mine turned to me and said “let’s go to Brattleboro and get some crispy tofu,” and we did, three of us in her big purple Subaru. It turns out that Brattleboro happened to have a very good Vietnamese restaurant at the time (and maybe they still do), and the tradition of going out for crispy tofu when feeling blue had begun several semesters before.

So we ate our crispy tofu and spring rolls, and then we wondered around Brattleboro in the warmth of early fall, going to bookstores and the Brattleboro Food Co-op, and then one friend remembered that she actually needed something from the outdoor store, so we went there, and while we were there, I purchased a Nalgene bottle.

This may not seem like a big event in a person’s life, I mean lots of people have water bottles and a fair number of those water bottles are Nalgene bottles, but Nalgene had just come out with the line of brightly colored ones, as I recall, and it was a topic of much debate, which color I should get, and then someone else got one too. I also got a tin of Burt’s Bees Chapstick, as I recall, and even now, the smell of Burt’s Bees transports me back to Vermont in the winter, with snow and cracking lips and long silences.

I’ve been using that bottle ever since.

I missed the bottled water craze because of my Nalgene. Why buy bottled water when I already had a bottle of perfectly palatable water, ready to hand? I never got the point of bottled water, and was kind of surprised when it became hip and trendy.

The printed volume measurements on the side wore off long ago, and at one point the cap became so damaged that it couldn’t close anymore, so I was forced to replace it. On the side of the water bottle, I typed a helpful typewritten reminder: If love is free, why so sad? The tape has endured through years of use and multiple dishwashings, as has the paper itself. I’m kind of surprised it hasn’t disintegrated, thanks to the humidity.

I’ve taken my Nalgene camping in all sorts of strange places. I’ve accidentally left it clipped to my pack and watched my bag skid across 150 feet of tarmac at an airport after being misthrown, leaving one small scratch on the bottle. It’s been carried on hikes, refilled from mountain streams, frozen, and run through a garbage disposal by accident (there’s a small scratch on the bottom).

When I had real jobs where I went to work somewhere, my Nalgene always came with me, and people could tell when I was working because they would see it perched on the counter, or near my workstation. I drank from it in nervous, sudden gulps when I was stressed out or upset, I used it as a handy gauge to see how much water I drank a day, I threw it at someone in a fit of rage one when I was breaking up with him and split his eyebrow on it.

My Nalgene and I have been through the wringer. That water bottle has more frequent flier miles than most people I know, and it’s been present through thick and thin. It might seem silly to think of having such an intense and personal relationship with an object, but there it is. That bottle has been a part of my life for so long that I’ve forgotten what it would be like to live without it.

Looking at my Nalgene reminds me of so many events, places, people, and relationships. There’s a lot of memory packed into that humble water bottle, and sometimes it’s almost too much to bear. I’m sometimes reminded of the scene in Stranger in a Strange Land where Michael looks down at a city and sees it as “so choked with living experience.” I have always suspected that places and some objects can become almost overloaded with memories and experiences, personally.

I think it’s safe to say that my Nalgene is one of my oldest friends, and that’s why I was sad to learn that the plastic it is made from is apparently toxic. People have had their suspicions about BPA for years, but I guess it’s official now. The Canadian government even says ixnay on the pabnay. Nalgene has stopped making bottles with BPA, mainly in response to consumer concerns, I suspect, and some stores have pulled products which contain it.

I suppose I should retire my Nalgene, given this information, but I can’t bring myself to do it. After all, I live a block away from a hazardous waste dump, and I lived on a hazardous materials site for almost a year. Lots of things around me are probably cancerous, including a number of former friendships. So I’m just not ready to drain my Nalgene and recycle it. It seems so cold and callous to dump my old friend like that, just because of the latest health scare, the latest political trend in the health conscious community. Maybe I will be ready, someday, but for now I know that it will always be there in the fridge waiting for me, filled with cold water, and I like something fixed and dependable in my life.

Sometimes, my posts about irritation with modern society just write themselves, and this was definitely the case when I encountered this Newsweek article about a children’s book explaining plastic surgery. It’s called “My Beautiful Mommy,” and it kind of makes me want to vomit.

Ostensibly, the book is designed to be marketed to mothers who are considering plastic surgery and want to be able to explain what’s happening to their young children. I get that. I can imagine it would be weird when your parents undergo medical procedures and don’t explain it, and it can be scary, so being able to talk about it would probably be really beneficial for young children, taking the fear of the unknown out of the equation.

But has plastic surgery for mothers become so commonplace that we need a children’s book to explain it? The outrageometer says yes, because obviously mothers have gross, disgusting, nasty sagging tummies and breasts, and no one will ever love them unless they resort to dangerous invasive surgical procedures to make them smooth, firm, and tight again.

I’ve noticed that mothers seem to be in for it more and more these days. First, they’re expected to lose their baby weight post haste, because baby weight makes you FAT and no one wants to look at fat people, even if they did just grow a human being. And now, apparently, mothers are supposed to surgically correct the somewhat inevitable results of pregnancy, thereby even further disguising the evidence that they gave birth to children.

Now, I don’t have children, so maybe I’m missing something here, but I feel like parenthood is a source of pride and personal identity for many people. So why would you want to conceal the fact that you are a parent? And why would you want a partner who erases all evidence of having born children, despite the fact that the children are (presumably) still in your lives?

A friend of mine once told me that he always thinks that women who haven’t had children look incomplete or unfinished somehow. He didn’t mean it in an insulting way (really), and he made a valid point; hormonal changes during pregnancy do change your body in certain ways, and some of those changes endure. From an evolutionary standpoint, it would make sense to be attracted to women who exhibit characteristics associated with pregnancy, because it means that they are fertile, which makes it kind of doubly sad that mothers now apparently feel like they need to cover up the evidence when they have children.

I’m opposed to plastic surgery in general, except in the case of reconstructive surgery after serious injuries or accidents, or in the case of surgery to correct congenital birth defects which cause pain or extreme embarrassment, or hinder someone’s ability to live. By all means, fix cleft palates and give burn victims new skin, but why hack the bodies of healthy people to satisfy some insane beauty standard?

Not having been pregnant, I don’t know what it’s like to experience the physical and hormonal changes associated with pregnancy and its aftermath. And I can definitely understand a sense of frustration or unhappiness with one’s body after pregnancy, because it has undergone some major changes. But I feel like it’s something that people should ride out, rather than correcting surgically. I know lots of mothers with washboard abs and firm, high breasts who came by them naturally, illustrating that it is, in fact, possible to tone your body back into shape after pregnancy, if that’s what you want to do.

It makes me incredibly sad that our solution to the complex emotions which women experience after surgery is to sweep them under the rug, to hack their bodies apart so they look “normal again.” What kind of society do we live in?

There’s an article up on the BBC which actually made me feel lightly ill.

It’s about winning the lottery in Oregon.

The healthcare lottery, that is. Apparently Oregon has decided to address the issue of healthcare for low income individuals by creating a lottery system, with lucky winners who receive healthcare. The losers, apparently, buy tickets…er…apply…again next month. The timing of this article is especially interesting to me because I’ve just been thinking (again) about the need for universal single-payer healthcare.

The thought that people should get healthcare coverage through a lottery system is just obscene, and I’m sure that European readers must find the article a bit perplexing. There are a lot of misconceptions about the American healthcare system in Europe, and articles like this only cement those misconceptions, while also pointing out the serious problems with America’s approach to healthcare.

The thing about universal single-payer healthcare is that it’s just straight up cheaper to run than this asinine system we have going now. By covering everyone, the government would encourage a culture of preventative care, and it could negotiate better costs with drug companies and healthcare providers. In many parts of Europe, doctors make quite respectable salaries, and they get bonuses for keeping their patients healthier, in a system which encourages a strong relationship between patients and doctors while promoting a generally higher standard of health. Meanwhile, Europeans in general appear healthier than Americans, accounting for less missed days of work and creating a more vibrant, productive society. The EU, my friends, is kicking our butts.

I’ve read several critiques by American doctors who find the thought of universal single-payer repugnant, arguing that it is nothing more than rank socialism. And it is, but that’s the beauty of it. Socialized medicine is vastly better than entering a lottery in the hopes that you can get healthcare coverage. It’s better than a system where people overload emergency rooms with petty complaints because they don’t have regular doctors. It’s better than a system where scads of independent contractors (like me) gamble that they won’t have major health problems, because they can’t afford health insurance. I hear Clinton wants to cap health insurance costs at 10% of people’s incomes. That would be great, if I could spare 10% of my income for health costs. But I can’t, and neither can most middle and lower class Americans.

A lot of Americans don’t seem to understand that the healthcare system is broken, yet fixable, with some effort. I can’t help but think that people are kept in deliberate ignorance in the hopes that insurance companies can continue to profit, because anyone with half a brain ought to be able to see that this system is not working. People should not be afraid to go to the doctor because they can’t afford it. They shouldn’t be afraid to embark on a course of medical treatment which might change their lives because they can’t afford it. People in this country should not be dying from lack of healthcare. It’s just not…well, honestly, it’s just not American, darnit. This is the country where people are supposed to be neighborly, looking out for each other and lending a hand where it’s needed, not a country where people let their teeth rot in their heads because they can’t afford a dentist. It shouldn’t be a country where people rely on games of chance for medical treatment.

Europeans get cradle to grave care, so clearly it’s not impossible…so why are we having such a hard time figuring our scene out?

One of the things they did during the “downtown revitalization” which involved ripping out half of Franklin Street was install crosswalks and sidewalks which are supposed to be more wheelchair friendly, along with textured material at street corners and driveways to alert the blind to changes in elevation (and the fact that they are about to walk out into the street). I happen to think that these modifications are awesome, because I am all for making spaces more friendly to the disabled.

However, it is sort of funny that while people in wheelchairs can now navigate Franklin Street, they still can’t enter a surprising number of the businesses on the street. In the rare cases of businesses which a wheelchair can get into, the stores themselves are usually not very wheelchair accessible (one notable exception to this is Racines, which has a very clear, open floorplan which makes it pretty easy to navigate in a wheelchair, although some of the corners of the store are a bit tight).A friend on mine in a wheelchair has often pointed this problem out.

“It’s one thing to be able to get into the store,” she says, “but usually I get inside and then can’t move, because the aisles are insanely narrow and cluttered with crap. So either I can’t fit down the aisle, or I can just squeeze in, but I am terrified of knocking stuff down, and most of the stuff is displayed out of reach, so I have to call a rude, surly employee over and beg them to get things for me. That’s why I shop online.”

When I was at the Botanical Gardens on Saturday, I found myself thinking about this issue, because I noted that wheelchair users really wouldn’t be able to see most of the gardens. And it really made me wonder how it is that almost 20 years after the passage of the Americans With Disabilities Act, many businesses are still not friendly to the disabled.

Look, this isn’t a politically correct thing. This is a cold, hard business concern. Back in my days as a retail whore, I made a conscious effort to recommend businesses which are handicapped accessible, not only to parties with obviously disabled members, but to everyone, because I think that these businesses demonstrate a genuine desire to reach out to customers. I also find that the staff at places like that tend to be more friendly, patient, understanding, and helpful, and those are all traits which I feel are worthy of promotion.

Especially since everyone here is all like “rah rah tourism!” It amuses me that business owners apparently think it is perfectly acceptable to write off the elderly and disabled as potential revenue sources. Especially since we have a growing population of elderly in this country, and we’ve got a fair number of disabled veterans returning from Iraq. Thanks for serving, hope you didn’t want to be able to buy underwear!

By excluding the handicapped from their businesses, people miss out on a lot of potential sales, and they frustrate a huge segment of potential customers. If you have stairs at your doorway instead of a ramp, right there you’re cutting customers off. And disabled people are just as capable as complaining about bad service to their friends as the “abled” are. When a friend of mine who was walking on crutches for a few weeks got rude service at a coffeehouse in San Francisco, I stopped going there. When a blind friend mentioned the generous, helpful service she got at another coffeehouse, I made a point of going there, just like I would when anyone gave me a good recommendation for an establishment.

I think that disabled activists are sometimes less vocal than activists for other groups who find themselves marginalized. You don’t see businesses with “no colored” signs on their doors anymore, and if you did, you would probably make a furious complaint to the business owner, town hall, and anyone else who would listen. Yet, you think nothing of walking up a flight of stairs which would be insurmountable to someone in a wheelchair or someone on crutches.

A lot of strides have been made for disabled rights in this country, and there is a growing idea that making accommodations isn’t just legally obligated, it’s also good business, and it’s just plain polite. Apparently that idea hasn’t reached Fort Bragg yet, which is a great pity.