Health Coverage for All in U.S.

Why does the United States, a world leader, not make sure that all its residents are covered by health insurance? Other countries can do this; why can't we?

The President of the American Public Health Association, Walter Tsou, wrote recently in The Nation's Health that we are very unlikely to reach the 2010 U.S. national health objective to ensure that all Americans are covered by health insurance. "Short of a political miracle," Dr. Tsou wrote, "it is unlikely we will reach this goal. The price that we pay for our national failure is a missed opportunity that is much larger than most of us realize."

Universal health coverage, to at least a basic level for all, is a moral obligation.

Moreover, Dr. Tsou points to many practical benefits. For example, it will help protect companies who will struggle during the coming decades with retiree health costs; it will offer a solution to the nation's medical malpractice crisis. It will resolve issues that arose with those in Hurricane Katrina's diaspora who lack health insurance - who covers their care, their original state or their new state? Rather than delaying care and focusing attention on paperwork and reimbursement regulations, in crises or normal situations, universal health coverage enables health care programs to focus on care.

Dr. Tsou notes that the United States is "the only nation in the developed world that continues to do a 'wallet biopsy' before an actual biopsy.

Should arts organizations qualify as "charities"?

Nonprofit arts organizations clearly can achieve charitable goals. However, simply because an arts or educational organization, or any organization for that matter, has nonprofit status - should we consider it a charity in the same sense as organizations that dedicate themselves exclusively to serving poor or disenfranchised people?

The comment on my previous blog brings this issue into the discussion.

Humanity needs the arts. Creative thought opens our eyes, provides new perspectives, and expands human potential. Without the arts, society will miss opportunities to nurture and sustain the values important for civilization. Moreover, the written word and spoken word have, for example, led us to understand and act on problems that confront society; theater has portrayed societal issues in ways that other media cannot.

However, should an arts organization - let's say a symphony orchestra or a dance company - be exempt from taxes? Should contributions to such an organization be allowed as deductions on individual tax returns? What if such an organization serves exclusively middle and high income audiences and does nothing to spread the arts to lower income groups?

These are not merely academic questions. Taxpayers and some public officials are increasingly raising them, sometimes in connection with challenges to the ability of organizations to achieve the privileges of nonprofit, tax exempt status. After all, nonprofit organizations place demands on the services of cities, states, and the federal government in just the same way as profit-making organizations do. The salaries paid to some leaders of nonprofit organizations put them well into the ranks of this country's highest paid professionals.

In the 1960s, a shop in Greenwich Village sold a variety of "protest buttons." Some were purposeful; some were satirical. One proclaimed "Tax the Churches". It seemed funny to me then; it seems serious now. Both sides of the debate have some valid points, and we need to pay attention to them.

What is charity?

The New York Times of November 14 had an excellent special section on Giving.

The lead article posed the question: What is charity? It asserted that, over the past 40 years, contributions to education and health organizations increased approximately 300-400% while contributions to human service organizations increased only 28%. Moreover, it stated that "the share of giving going to organizations most directly related to helping the poor hit a record low, accounting for less than 10 percent of the $248 billion donated by Americans and their philanthropic institutions."

The article quoted one expert who opined: "In general, philanthropy seems to have stopped talking about poverty and race."

Those of us concerned about social issues, social justice, nonprofit organizations, and "charity" need to consider carefully the issues this article raises. If nonprofit organizations are drifting away from service to the poor, needy, and vulnerable, then we probably have a significant problem. If they are not drifting away from an emphasis on the poor and vulnerable, but nonetheless the general public has begun to question the value of charity, or nonprofit organizations, or voluntary action to to bring assistance to those in need and to make communities better places to live - then we need to perk up and do something.

What better week to think about all this than the week of Thanksgiving, when we can all offer thanks, in our own ways, for the people who nurture us and for the resources that meet our basic needs and make our lives more comfortable.

Disparities - A Concern for All of Us

Disparities – social, economic – along with differences in access to resources, health care. Such conditions have existed throughout human history. Disparities produce frustration and unrest; riots in the suburbs of Paris provide some of the latest visible evidence of the consequences of this frustration. Violence is not justified; but in conditions of chronic disparity, it is understandable.

In today’s society, we need to be concerned about disparities among cultural, racial, religious and economic groups. These include differences in academic achievement, differences in access to health care, differences in access to employment and in opportunities to create wealth.

The less visible consequences of disparities may have more detrimental consequences than do riots or crime. In the U.S., younger generations must have the ability to take positions in business, government, and nonprofit organizations – maintaining a high quality of life for all of us. As our population diversifies, this means that younger people of all types must have the training, background, and motivation to move into adult roles in society – some of them into leadership roles.

At Wilder Research, for at least 15 years, we have been concerned about the educational achievement gap. Dan Mueller's paper, Tackling the Achievement Gap Head On, identifies issues and approaches for all of us to consider.

An interesting regional resource and initiative to watch is the Itasca Project’s initiative on disparities.

Election Day Welcome

Election Day, democracy in action, seems like an excellent time to start this blog. You need at least two things to blog: Technology and freedom of expression.

A year spent in Northern Ireland showed me firsthand what happens when people have been barred from participating in political decision-making. I also saw the frustrations that arise when the opportunity does arrive, but people aren’t really prepared to take advantage of it. They don't have the know-how.

Democracy has occupied a pretty small slice of human history. We need to appreciate it, nurture it, and improve it.

What I hope to do with this blog:

• Alert you to facts that seem important to notice.
• Let you know about new developments, and the latest research, on ways to improve the quality of life for individuals and communities.
• Tell you what I see in those facts and developments that is worth your attention.

My professional life is focused on research about social issues, with special attention to the vulnerable. So you can expect a slant in that direction.

Please share your thoughts. I want to understand how you feel about what I say and what you find useful. Please comment – and please point me to other information sources or suggest topics you’d like to put on the table here.