The following is an article I posted originally on my blog at http://fringemusings.blogspot.com . It details how my personal experience with our health care industry informs my perspective that we need, at a MINIMUM, a strong public option. As the author of this article, I authorize it to be published here in its entirety.

Personal perspective on problems with our privatized health care system
by IrateCitizen

Many of the debates surrounding health care seem to dwell in the realm of ideology and polemics, and fail to address the way in which this issue meaningfully intersects with people's lives. I have had numerous exchanges with a good friend of mine on this issue, and we find ourselves in disagreement over it. However, this is an issue that did directly affect me over the past year, and I think it's important to discuss that in order to change the tone of debate.

About 15 months ago, I was dismissed from my position as a teacher in a public high school. I'm not going to go into details regarding that dismissal, other than to say that it was likely due to personality conflicts more than my performance as an aggregate over the entire year, from start to finish. I had invested a good portion of myself in that job, regularly putting in an additional 25-30 hours per week outside what I spent in the classroom, so when the district administration essentially let me know that my efforts were not valued nor appreciated, it affected me quite significantly. I had to eventually seek counseling in order to maintain my state of mind while working in a less-than-hospitable environment.

When the fall came and I was still unemployed, and my family was facing great financial difficulty as a result, I slipped into the depths of a depression that I just could not get out of. By depression I am not talking about just feeling a "little down," I am talking of being consumed with thoughts for significant lengths of time on how to hang myself down in my basement, or to simply speed up my car and swerve into a bridge abutment, and so forth. I'm not kidding in the least -- it got that bad. I probably was not that far from actually acting on these impulses, a thought that sends chills down my spine today when I think about how it would have affected my wife and young daughter.

When my wife finally confronted me on this and basically told me that I had to get some kind of help, I figured that the best place to turn would be the counselor I saw at the end of the previous school year since we already had an established relationship. I needed help immediately, so I scheduled an appointment and resumed counseling.

Since I had lost my job, we also lost the health insurance policy we had used the previous year and had to switch to my wife's plan. Not to worry my counselor told me, he was a participant in my new plan, so all I had to do was to make the co-pays. Except after a few sessions, I started receiving statements from my wife's insurance demonstrating that my counselor was NOT a participating provider, so the services were not covered, and instead of paying a $30 co-pay for the appointments I would have to cover $120 per visit!

As it turned out, the provider we had (and still have) has a myriad of different plans. While my counselor was a participating provider on most or all of the other plans, he was not a participating provider on the specific plan that we had. Fortunately for me, he was willing to drop the fee from $120 to $60 per visit, and I was able to keep seeing him. Eventually, after going on medication for a period of time, I was able to gain the perspective on my illness and overcome it. However, this experience certainly gave me a personal perspective on our health care system as it currently is, and how it needs fixed.

First of all, one of the common refrains heard in opposition to any kind of government-run system is that "decisions should be left between a doctor and patient, not put in the hands of some government bureaucrat." Funny thing is, under our for-profit system, decisions were NOT in the hands of my provider and myself. They were subject to corporate decisions.

Secondly, losing one's job and the inability to get another one is one of the most traumatic experiences that a person can go through -- especially a man in our society. When I was not able to work, I felt that I could not make any contributions to my family -- primarily because the way our society measures a person's worth to their family is the financial income they contribute. I was lucky in that my wife has a successful career that provides us health insurance. Given the current state of our economy, what about the millions of others who may be in similar situations but are not fortunate enough to have a "Plan B" like we had? Where do they turn in our for-profit system that ties health insurance to employment status? Answer: there is NOWHERE for them to turn.

Thirdly, when I lost my job an additional $30 (or $60) per week in counseling expenses was one that we really could not afford on our already-strained budget. When you don't have income, a medical co-pay can be something that strains your home finances past the breaking point. However, given my state of mind at the time, forgoing professional help was not really an option. Lucky for us, my parents stepped in and paid for the services. But regardless of our good fortune in this regard, what are those who are not lucky enough to have outside support like us supposed to do? Where are they to turn under our current for-profit system? Answer: there is NOWHERE for them to turn. It is undoubtedly situations like mine (and more dire than mine) that are the reason that medical costs are the #1 reason for bankruptcy filings in our nation over the past several years.

Now, the self-interested way of looking at this scenario might be for me to simply say that I was able to get through it and make it work, therefore other people should do the same. However, I cannot do that when I think of others who could be going through similar (or worse) circumstances and do not have the outside support to get the help they need. This is why I support, at a minimum, a public option in our health care system. I would rather see a single-payer system, because I believe it would completely circumvent many of the problems that I encountered. However, a public option would ensure that those who find themselves unemployed, underemployed, or in other difficult circumstances would not be simply left out in the cold.

At the heart of the matter, our health care is a MORAL ISSUE. It speaks to who we are as a society. It is way past due to listen to the better angels of our nature, and show ourselves to be a society that promotes the common welfare rather than self-interest. It is past time to institute a viable public option that will allow the government to use its volume to negotiate for lower prescription drug and service costs. It is past time to ensure that people have access to services WHEN THEY NEED THEM, and not tie that access to present employment status in an economic downturn.

I support a government takeover of our healthcare system because, based on my own experience and the mountains of evidence available, our current for-profit system has failed too many of those who needed health care. It is well past time for them to step aside. The kind of thinking and approach that got us into our current predicament is not going to get us out of it.

I run hot and cold on Kunstler -- hot because he recognizes the way in which our basic economic arrangements themselves are not only unsustainable in the long run, but because they quite often undermine the better angels of our nature; cold because too many of his columns are essentially excuses for him to engage in the same repetitive rant. However, I think in his latest piece, he really hits one something deep and meaningful in this paragraph:

This monster we call the economy is not just an endless series of charts and graphs -- it's how we live, and that has to change, whether we like it or not. Now, it is obviously a huge problem that a majority of Americans don't like the idea. If they were true patriots, instead of overfed cowards and sado-masochists, they'd be inspired by the prospect. But something terrible has happened to our national character since the triumphal glow of World War Two wore off. I just hope that the Palinites and the myrmidons of Glen Beck don't destroy what's left of this country in a WWF-style "revolution." In the best societies, such idiots are marginalized by a kinder and sturdier consensus about justice. In America today, the center is not holding because there is no center.

From my perspective, this paragraph resonates because it can also be found in Arnold Toynbee's A Study of History. Basically, Toynbee says that in all major civilizations throughout history, a small group of "cultural creatives" become the elites by offering new and fresh ways of doing things, and much of the masses are inspired by these elites and seek to emulate their behaviors. However, over time, these elites cease to be inspiring and then must increasingly resort to coercion to maintain their hold on power. One of the ways that a good many people respond to this phenomenon is to much less seek to identify themselves with those cultural creatives, and instead embrace the culture and social norms of the repressed sections of the proletariat (I mean proletariat in a persecuted minority sense, for example the early Christians of the Roman Empire, not a Marxist sense).

Our "center" can no longer inspire people because it has become ossified, decadent, and corrupt. Therefore, people seek their inspiration from other areas. On the one hand, there is the opportunity for new "cultural creatives" to emerge, proposing a new way of living that can appeal to increasing numbers of people as the existing order continues its inevitable decline. That is the positive option. The negative option is a desire to return to a golden age that is largely a work of myth and fiction, resorting to demagoguery and violent coercion to do so. This was the path taken by the Germans under Hitler, after their last real attempt at empire had failed. And it's the path being taken by those who subscribe to the rantings of Glenn Beck and Sarah Palin.

Note, I'm not saying that Beck and Palin are equivalent to Hitler -- that would be patently absurd and a descent into hyperbole. Rather, I am saying that there are broad historical and sociological trends at work here, and the people mentioned are simply players in those trends repeating themselves.

Anyway, enough commentary. Here's the link to the article: http://kunstler.com/blog/2009/09/reality-r...

As part of my studies toward my Masters' degree in history, I had to read excerpts from The Civilizing Process by Norbert Elias. This reading is part of a seminar on historiographical methods and analysis, focusing on different social theories and the way they affect the work of historians in trying to explain the past.

I found Elias's work to be quite fascinating. Basically, it theorizes that the process of "civilization" is largely the result of people subordinating their impulsive drives -- the repression of the id by the ego and superego, in Freud's terminology -- as their social organization changes over time. Elias says that this process is mutually reinforcing and not entirely rational. People demonstrate greater self-restraint as their social organization becomes more complex and interdependent. Likewise, increased levels of self-restraint propel a greater level of complexity and interdependence. Central to Elias's notion of "progress" along the scale of impulsiveness to self-restraint is the level of security under which people live. In societies that do not provide a high level of physical or material security, the impulsiveness of the id reigns. For those that achieve a high level of security, the restraint of the ego and superego keep the id in check.

To support this idea, Elias cites the changes in human behavior as Western Europe changed from a feudal society of warrior-nobles and knights into the court society of absolutist kings and aristocratic nobles. In the former, the use of violence was highly decentralized. Most people did not have adequate levels of security -- especially physical security. To venture on the roads outside of town was to invite the certain predations of highwaymen or rival soldiers. Disputes between individuals (particularly nobles) were settled by violent confrontation. By contrast, in the society of absolutist kings, the use of violence was monopolized by the monarch. Nobles could no longer settle their disputes through violence, so the court society (with its emphasis on manners, fashion, elaborate titles and intrigue) evolved instead as a forum for noble competition and a means of differentiating the aristocracy from the commoners. The latter was also a much more complex and interdependent society than the former. Finally, the former had a general world view largely characterized by fear and emotion (superstition and religion), while the move toward "civilization" appealed increasingly to empirical rationalism (observation and science).

As far as historical reference goes, Elias provides a decidedly Marxist superstructure for his theories. Basically, his history begins in medieval Europe and proposes a rather linear view of civilization's development, as well as describing Western Europe as the vanguard of civilization's progress. I was left wondering about how Elias would describe the notion of a society moving away from "civilization" -- from a highly complex, centralized, interdependent society to one that is decidedly less so.

Central to any analysis of collapse through Elias's lens is the loss of material or physical security. Also, the relationship between changing social organization and the loss of security must be viewed as a mutually reinforcing process. I believe that if Elias had gone back a little further, he could have found an excellent model for this process: the Roman Empire.

The collapse of the Roman Empire was certainly predicated by internal problems -- declining harvests, political intrigue, etc. However, these internal problems greatly contributed to the rolling back of the frontier by Germanic barbarians. When the highly complex society of Rome lost steam, it lost its cohesive force among its populace. Where the citizens of Rome once were willing to sacrifice for her, now they concerned themselves with the circuses of the Colosseum even as the empire crumbled around them. A substantial internal proletariat -- people who lived within Roman borders but felt no affinity or allegiance to Roman ideals -- swelled in number. A fine example of this proletariat is offered by the rapid spread of Christianity through Rome, in spite of its initial criminalization by the Roman authorities. (Arnold Toynbee, A Study of History)

So, the short version is that eventually complexity imploded, the "barbarian" conquered the "civilized," and Europe plunged into the Dark Ages. However, traces of the "civilized" still remained after 476 A.D. -- namely the Catholic Church. It is strange that what initially was a proletarian movement within Rome (Christianity) became its vehicle for the preservation of classical culture as society became less complex, less secure, less rational and more violent. What this demonstrates, however, is that the move either forward or backward on the scale of "civilization" is often a process of negotiation between the old and the new, the more and less "civilized." Even as Rome fell, it planted the seeds of what would eventually bloom after the Dark Ages had passed. Many ideas of the Renaissance, scientific revolution and Enlightenment found their genesis in the work of classical Greek and Roman scholars.

Fast-forward now to the present. Currently, we face a wide range of predicaments -- climate change, peak "everything," overpopulation, unsustainable debt, etc. The unprecedented complexity and interdependence of our social organization is largely the result (and cause) of increased material and physical security. What happens if these predicaments cause this security to deteriorate? Will we become stuck in a downward spiral like Western Europe after the fall of Rome, unable to regroup until after they hit rock bottom? Or will we be able to adjust our organization to meet new realities? Will the negotiation between complex and decentralized take place in a more rational manner this time around, or is a lack of rational forethought a fait accompli of this process?

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As the author, I give permission for publication of this article in full.