Healthcare: The U.S. versus the Rest of the World

A great video.  This is a U.S. Senate hearing about healthcare in the United States and Canada. The two senators asking questions are:  Bernie Sanders of Vermont (Independent) and Richard Burr from North Carolina (Republican).  The ladies being questioned are:  Dr. Danielle Martin of Toronto, Canada and Sally Pipes of the Pacific Research Institute in San Francisco, U.S.

The background to this debate is important.  The Affordable Care Act was passed in 2010 and I was amazed that it ever saw the light of day.  For years there has been sharp debate about reforming the American healthcare system.  That debate turned downright hostile and ugly right up until President Obama signed it into law.  Ever since, there have been efforts to repeal it and it didn't help matters that the rollout went very badly.  There is something in the ACA legislation for everyone to hate.  What I heard when I was in Seattle last summer is that the Left in the U.S. says it doesn't go far enough and is basically designed to make private insurance companies rich and the Right says it's just another big intrusive government program that will bankrupt the country sooner or later.

As for the American diaspora there was real concern last year that the mandate to have healthcare would apply to them which is silly because many already have access to healthcare programs or very reasonably priced healthcare in the countries they live in.  The idea of paying twice made some of us rather testy but the good news is here.   Or is it good news?  The rule is that US citizens abroad can avoid the ACA healthcare mandate provided that they stay out of the US for at least 330 day in a year.   So, if you are an American abroad, long stays in the U.S. are out. Another incentive not to come "home" for a visit?

What struck me the most about the debate was the insistence on the part of the Republican senator on the awfullness of non-U.S. healthcare.  Now I'm a pretty conservative lady but I spent over 20 years of my life under the U.S. healthcare system and then 20 or so under Japanese and French healthcare.  Hands down, the healthcare was better, more accessible and affordable outside the United States.  And it's not just my subjective experience that says so, it's any number of organizations that don't have any reason, frankly, to say good or bad things about U.S. healthcare like the World Health Organization. (For those who say that the WHO does have a reason because "everybody hates us" - Oh, get over yourselves.)

The fact (and it is one) that U.S. healthcare is not the "best in the world" does not mean that the Affordable Care Act is the only answer.  What one Seattle Democrat said to me was:  "Well, it was the best we could do."  Wow, what an endorsement.

So I'm going to reserve judgment and see what happens.  But when I see American lawmakers dissing other systems and trying to shore up an untenable position, well, I have something to say about that.  The argument should not be about who has the "best" (though as a cancer patient I'm happy to be living in what most argue is the best healthcare system in the world), it's about coming up with the best system for the United States - one that gives good care to every homeland citizen at a price that is reasonable and sustainable.  I may swing conservative in many ways but I am adamantly against any human being suffering and dying because they can't afford care.  That's just not right.



And just for fun, a Flophouse reader pointed out this study by the AARP, Association of American Retired Persons (not a radical Socialist organization as far as I know)  called 5 Myths about Canadian Healthcare.  It certainly answers one of the most common assumptions of some Americans which is Canadians are just flocking to the US to escape their dreadful system.  AARP says, no, over 99% of Canadians don't head south for healthcare....

Industrial Paternalism and Low-Cost Housing

In yesterday's post about my house in Porchefontaine I alluded to something called paternalisme industriel.

This term describes attitudes and policies that French companies in the19th and early 20th century France had to ameliorate the living conditions of their  workers.  It was a combination of private sector altruism, self-interest and social control.  In an era before national health and retirement programs (and the infamous HLMs) companies had various schemes to improve the lives of their personnel and to change their habits: better hygiene, reduction of alcohol consumption, and help for mothers and children.  Part of the goal was to improve production (epidemics were not good for owners or workers) but they also wanted to discourage strikes and atempts by the working class to get laws voted in their favor that were not in the interests of industry.  Laws like the one that was passed in 1919 that limited the working day to 8 hours.

Affordable housing was part of that and it took many forms: apartment complexes, barracks, dorms, and houses (single-family or duplexes). Around factories and mines entire complexes were constructed called cités-ouvrières. Here is a short video about one called la Cité Lafarge which was built in two phases - the first in the 1880's and the second in 1913.

I also recommend this article about worker housing in a region of the Maine-et-Loire Department.  Same era as above but the housing was constructed around the extractive industries (like mines).   One page 3 they talk about single-family housing developments that were built after the First World War.  These were clusters of little houses with gardens.  This population density (300 houses in one area) made it possible to have the kind of amenities that turns a planned housing development into a community:   post office, police station, sports, music, and churches.  The companies themselves often organized events for the workers.  The article also points out that these communities and companies had an important role in the integration of immigrants:  Poles, Czechs, Italians, Spaniards and Moroccans.

As I was reading all of this I had to wonder if I had seen vestiges of this mentality in one of the companies I worked for here in France long ago.   It was an old company founded in 1912 and still had a very strong identity when I worked there.  My colleagues and the management proudly described it with smiles all around as both paternalistic and franco-française.  Looking back, the culture shock was profound (I'd never experienced, or even imagined, anything like it) and yet I think it was very effective in integrating me not only into the company, but also into the larger society.

One of the rules was about speaking French at work which was perfectly normal but at times it was even extended to situations where I was dealing with fellow English speakers.  If they spoke any French at all, I was supposed to use French.  If they didn't, management used me on several occasions to shame the non-Francophones.  "If an American can learn to speak French, then you, ladies and gentlemen, have no excuse."  They had high expectations for integration but this was balanced with my sense that they genuinely cared and were willing to help in the process.  If integration is sometimes a bitter pill to swallow, they made sure that it went down with a spoonful of sugar.

If you have some time to kill (about one hour) this video is very interesting and is the most complete tour of the subject I've found.  This is Antoine le Bas speaking about  Le logement ouvrier : de l'utopie à la réalité and is available on the Net through the Cité de l’architecture & du patrimoine.  Some great pictures and comments about worker housing in places all around France. Enjoy!


16.Le logement ouvrier : de l'utopie à la réalité par Cite-architecture

Dual Citizens in a Secular Society

"Accordingly, two cities have been formed by two loves: the earthly by the love of self, even to the contempt of God; the heavenly by the love of God, even to the contempt of self. The former, in a word, glories in itself, the latter in the Lord..."

St. Augustine
The City of God

Every Christian is a dual citizen:  he belongs to a "City of Man" and a "City of God."  In both Canada and Europe today there are arguments about the extent to which religious people of all faiths are permitted to openly signal their membership in God's city.

 The example before us today is the Parti Québécois’s Charter of Quebec Values.  This measure would forbid public servants (government workers) from wearing "ostentatious" religious symbols while carrying out their functions.  The argument of the Charter's supporters is that this is necessary to reinforce the state's neutrality with regard to religion:

"cette charte de la laïcité visera notamment à interdire les signes religieux ostentatoires dans la fonction publique, c’est-à-dire que les institutions publiques et les agents travaillant dans ces institutions doivent refléter la neutralité de l’État."

This has provoked a bitter public debate.  My purpose here is not to add to the very good commentary about this charter one can find in any number of on and off-line articles.  (For a good round-up  of what has been said so far about the charter, see Andrew Griffith's fine blog Multicultural Meanderings.)  Instead I would like to broaden the discussion and talk about general efforts in some parts of the world to create (or reinforce) what is referred to as a "secular" society - an ideal world (some say) where religious beliefs no longer have a place in the public sphere and where, as Peter Berger puts it, "signals of transcendence" become rumors, "and not very reputable rumors at that."  

To many Europeans and Canadians (and even some Americans) this is a worthy goal and, in Europe at least, it has been moderately successful.  The recent battles over marriage in France notwithstanding, religious beliefs have much less voice in the public sphere than they had in times past.  It is worth pointing out, however, that when one looks around the world, there is a sort of European exceptionalism at work here.  In many parts of the world  (and especially in the Global South) religious beliefs are part and parcel of the public conversation on all issues and religious affiliation is growing, not shrinking.  Efforts by the Global North to convince such places that they must become less religious in order to become more modern are generally met with skepticism, if not outright contempt. 

Even more interesting is that there is another on-going debate within the world community of Christians (and this one began centuries ago) over the extent to which Christians should be involved in the earthly city and use their faith-based beliefs to weigh in on the pressing social issues of our time. A passion for politics is a passion for things of this world which Christians are asked to think of as transient and inferior to the city of God. Some argue for disengagement - leave Caesar to Caesar. As for signaling one's citizenship in the Heavenly City there is a line of thought that believes that this is a futile exercise. Religious beliefs are best spread by example (or as AA puts it) they prefer attraction to promotion.  A few even believe that complete separation is necessary in order for believers to avoid the taint of their secular neighbors and compatriots.  The last implies a certain common ground between the most rabid of the secularists and their fundamentalist Christian counterparts.

Most people of faith (whatever their affiliation) are not separatists.  Christians, Jews, Moslems, Buddhists, Hindus, and all other people of faith who end up in countries where the secular society is taking on the aura of a national project, have to struggle with this daily.  How open can one be about the sources of one's opinions if they are faith-based?  What kinds of religious signals are allowed - not only by law - but within a particular cultural context?    These questions are particularly challenging to those who belong to a minority religion practiced by immigrants or their children.  It is, however, not confined to them.  I am a Roman Catholic in a country that has traditionally been a "daughter of the Church" and even I thought twice before placing a small discreet statue of Mary in the niche on my front porch where it is visible from the street.

This is the "freedom of conscience" touted by democracies like France and Canada?   

This is not about separation of church and state - something that most established churches have discovered works quite well in their favor.  This is a purging of religious discourse and signs from the marketplace of ideas.  What is even more disturbing to me is that in the Global North we live in a context of religious pluralism.  The days when one church or one religion spoke with one institutional voice, controlled the message from the faithful, and were synonymous with the local culture and government are long behind us.  Instead what we see is that these "twin tolerations" (Alfred Stepan) have led to the empowerment of the faithful to speak as individuals and to participate as they see fit in the "City of Man" - the political community in which they reside or in the world.

I believe that the ideal secular society as proposed by some would be an impoverished one.  Even worse, I see a sort of separatism being forced on people of faith who for want of public spaces to express themselves, retreat to their communities, churches/mosques/temples, schools and homes, and let the earthly realm (one that does not seem to value their opinion and strongly condemns the source of them) sort itself out without them.

Furthermore, the attempt to generously allow some religious signs and activities to proceed under the umbrella of "tradition" is one that I am hardly thankful for (even where it graciously permits discreet expression of my religious tradition).  It is a hollowing out, a capture of religion and its symbols, in the name of a national culture, ideology or state.   A cathedral in Montreal is not just another pretty example of local architecture, and a baptism in France is not just a quaint little French custom and an excuse for a family party.  These things are part and parcel of a world religion (among others) which transcends borders and culture.  There is nothing particularly French or Quebecois about Catholicism just as there is nothing strictly American or British about Protestantism, or Indonesian or Saudi Arabian about Islam.

Sending people of faith into internal exile or placing them outside of the plausible public discourses is not a solution to what ails Europe or Canada.  On the contrary there is something very ugly and repressive (dare I say "predatory"?) in making  European or Canadian secular identities the only acceptable basis for conversation (speech and signs) in the public sphere in democratic societies.

Some of us feel called to be dual citizens of the "City of God" and the "City of Man."  Our membership in one should never make us inferior citizens in the other.
  

Tales from the Homeland: Mt. Angel

“On July 16, 1882, His Holiness Pope Leo XII had granted permission to ‘found a house of the regulars of the Order of St. Benedict of the Monastery of Engelberg in Switzerland, at the mission named Sts. Gervase and Protase, as well as permission to found in the same place a house of nuns of the same Order, who are free for the education of girls.’”

Alberta Dieker, OSB

A Tree Rooted in Faith

Just a few miles down the road from the family farm here in Oregon’s Willamette Valley is a small Swiss-American community of around 3,000 souls called Mt. Angel.

Founded in the 19th century by Swiss-Germans, Mt. Angel in 2013 is a small but healthy community.  A quick walk around the town reveals that it has retained much of the national characteristics of the original settlers, not the least of which is the German language.  Many shop signs, for example, are still in English and German.

We’ve visited Mt. Angel three times since our arrival.  The first visit was a family tradition - dinner at a local restaurant called the Glockenspiel;  an eatery with great food, a casual dress code and a family-friendly atmosphere (never a problem seating 10 people for dinner).   Until I ate there for the first time many years ago I had never realized how good German food was;  it was here I learned to love spätzle.

Our second trip into town was to visit the Queen of Angels Monastery.  This Benedictine community was founded in the late 19th century by sisters from the Maria-Rickenbach Benedictine convent in Switzerland.  The story of how these European sisters came to the United States (the far far West) and built convents, schools and churches is brilliantly told in the book A Tree Rooted in Faith written by Alberta Dieker.  More than just a dry recital of the facts, Dieker explores the historical context and the motivations of these unlikely pioneers.

“The sisters who came from Switzerland to Oregon by way of Missouri were part of what historians today consider a mass migration of peoples from Europe to the Americas.  The Land of Opportunity beckoned all kinds of Europeans for many reasons.  The reasons that inspired a particular group of sisters to emigrate to the United States and to make a permanent settlement in Oregon are important to our story.”

It was certainly not about “making it rich.”  The first years of settlement were hard - some sisters even died of disease caused by overwork and exhaustion.  The convent was often in debt and had to ask for funds and personnel from the mother house.  During World War I, the German sisters who were not U.S. citizens were required to register and many worried about anti-German sentiment (and a fair amount of anti-Catholicism as well). 

For those of us who are following the culture wars over the veil in France, it is interesting to note that the state of Oregon had similar ideas 90 years ago but directed primarily against Catholics, not Muslims.  

In 1923 the state legislature (regional parliament) passed The Garb Bill which forbid public school teachers from wearing any clothing thought to be religious. "This bill was aimed squarely at five or six small local school districts in communities with a predominantly Catholic population."

Since many nuns taught in the Oregon public schools as salaried employees, they had a choice to make:  cast off their habits or leave the public school system.  Since the communities they taught in were Catholic, the locals urged the nuns to comply; but they refused and instead chose to focus their efforts and use their teaching skills in private Catholic institutions.  Another law passed in the 1920’s would have made it a requirement that all children in Oregon attend public schools.  This, of course, would have shut down all the Catholic and other private schools in that state.  However, the law was fiercely contested and declared unconstitutional by the U.S. Supreme court in 1922.

A modest suggestion for those who support restrictions on religious apparel in public spaces (which for some reason seems to be mostly about what women are wearing - are we not old enough to dress ourselves?) or the rabid insistence on the exclusive use of the national language.  Things look very different when it is your culture or religion that is considered "foreign" and when your migrants and their descendants are being accused of a "refusal to assimilate."  I personally am delighted to see that German survives here and that the nuns can continue to wear their habits in public and that the Mennonites can wear their long skirts and cover their hair.  It makes for an interesting community.  And, believe me, it is no less a community as a result of these things.

Habit by Dior
http://monkallover.blogspot.com/2006_05_21_archive.html

For our third trip and last trip into town my mother and I got up at the crack of dawn this morning to go to Mass at the Mt. Angel parish church, St. Mary’s.  From the outside it is a rather sober structure made of brick.  The inside is another story.  The nave is airy and light and there are many statues - some to Mary and others of Benedictine nuns and monks.  As we reached the high point of the Mass (liturgy of the Eucharist) the sun began to shine through the stained glass windows on both sides of the altar.  Magnificent.

For an early early Sunday morning Mass the church was surprisingly full.  Many farm families with well-behaved children. The church parking lot was filled with huge trucks and many wore jeans and looked ready to get right back to work once services were over.  Perhaps it is my imagination but I had the thought that these parishioners would not have looked a bit out of place in a parish in Germany or Switzerland.  

As for us we came back to the farm and no sooner had we made coffee then it began to rain which put a halt to our various projects.  A good day to stay inside, make pies, read books and just be with family.

Bon dimanche, everyone.

French Feminism: Seduction and The Cultural Exception

There is a fascinating exchange going on right between the American historian Joan Scott and some (not all) French feminists.

In the June 9th on-line edition of the French paper, Liberation, Joan Scott very thoughtfully writes, not about the DSK affair itself, but the reactions to the affair and the internal debate going on in France right now about what it means.    She questions the assertion that there is a «féminisme à la française» - that, for cultural reasons, feminism in France is not, can never be, and no one wants it to be, like feminism in other countries.   She quotes Irène Théry who defends the uniqueness of the French approach to sexual equality by saying:

«Il (ce féminisme) est fait d’une certaine façon de vivre et pas seulement de penser, qui refuse les impasses du politiquement correct, veut les droits égaux des sexes et les plaisirs asymétriques de la séduction, le respect absolu du consentement et la surprise délicieuse des baisers volés.»
(This (French) feminism is made of a certain way of life and not simply a way of thinking, which refuses politically correct dead-ends, wants legal equality between the sexes and the asymmetrical pleasures of seduction, has total respect for consent and the delicious surprise of stolen kisses.)

Scott attacks this on several grounds.  She certainly does not believe, for example, that the French "Game of Seduction" is based on any kind of equality between the sexes.  You can read Scott's entire article here.  There is a reply by Claude Habib, Mona Ozouf, Philippe Raynaud and Irene Thery Ehess here.

After reading the entire debate, I personally have the following objections to the arguments proposed by the defenders of the French Feminist Exception:

Forsakes Any Claim to Universalism - if French feminism really is particular to France then it could follow that French feminists have little or no relevance in matters pertaining to sexual equality at the international level and have absolutely nothing to offer the rest of the world in this matter.  If feminist ideas born here can only be understood and applied in a French context then you might as well stamp the work of many brilliant French feminists "Not for Export" which I think is absurd.  

Dons the Dangerous Cloak of Cultural Exception - I have found that people really don't understand how cultural exceptions are a double-edged sword.  Once you claim it for yourself and your culture, you can't really complain when someone from another culture uses it as a reason for a cultural practice in their part of the world.  I once stopped an argument cold over the death penalty in the U.S. by simply saying that it was part of American culture (part of our history, mentality and so forth).  If you can have your cultural exceptions, I said, so can we which means that this debate is now over.  Match nul.

Treats Culture as a Fossil - And not as a river that flows and ebbs and changes course over time.  100 years ago French people (and all other people on this planet) had ideas and rules and laws and morals that are vastly different from what we see today.  It is a fact that things changed - sometimes in very radical ways but more often slowly over generations.  As I sit here typing this I am almost certain that 100 years from now what French and American culture becomes will be quite foreign to us and that our descendants will find many of our ways to be, at best, rather quaint.  To say that something is a "part of our culture" is misleading.  More correctly we should say that such things are a "part of our culture today" and may or may not be there tomorrow.  "Culture" and "Eternal' together is an oxymoron.

I do not pretend to know which way the winds will blow French feminism or French culture for that matter.  For the time being, I am very happy to sit back and watch the debate unfold.  Hold onto your hats, this is going to be interesting.