In my last post “An Old Turk” I talked about mt involvement in the politics of the 1960’s and early 70’s. I also spoke about my school’s struggle with a children’s liberation group CAFETY. In this post, I want to examine the rhetoric and ideas behind “child rights”. This rhetoric seems a natural extension of the rhetoric of the civil rights movement and later of the women’s movement. This way of talking has become so pervasive and so natural that we are led to accept premises that we should stop and examine.
Racism and sexism depend on establishing a group based on some external characteristic–gender, skin color, or nose shape, etc. This group is then either demonized or infantilized. The fact that the group is composed of fully functioning human beings is disguised and many laws and social strictures are created “for their own good.” Since the 19th century pseudo-science has been created to justify racism and sexism. The work of the French scientist Arthur de Gobineau is the beginning of a long European and American pseudo-science of race. It is important to note that the rhetoric of racial or gender difference applied equally to adults and children.
The movements of the last half of the 20th Century deconstructed this rhetoric, Both the demonizing and infantilizing of the groups was labeled and deplored. Race and to a lessor extent gender (as opposed to sex) is a social construction and therefore can be changed. Throughout all of this struggle the new sciences of genetics and brain research showed the lack of natural basis for these social divisions.
I first heard of the children’s rights movement in the 1980’s. A colleague at St Cloud State University was active in this area and presented these ideas as a natural extension of the line of thought I presented above–Children are an arbitrarily created social class, we have “infantilized” them and therefore they should have “rights.” He would have given the vote to eight year-olds. I suspect this was just rhetorical exaggeration. It seemed to me at the time that this argument flew in the face of all we knew about human development.
Thirty years later, this objection seems stronger because of the last ten years of brain research. We know that the frontal cortex does not fully develop until a persons early twenties. To argue, as CAFETY does, that 13 year-olds have the right to decide not to live at home, to refuse treatment parents believe necessary, or to refuse to attend private schools the parents choose flies in the face of our best and most humane science. These arguments also strike at the roots of parental responsibility and the state’s obligation to support parents and children
Anyone who has had teen aged children knows the struggle to set limits and boundaries that are appropriate and allow the teen to move toward independence is difficult and personal. Teens can reason well, but cannot fully see consequences, resist peer presasure, or control impulsivity. The state’s interest should be to keep the child safe. None of this is to say that children don’t have rights. That will be the topic of a later post.
For most of my student and professional life I considered myself a young turk–someone who thought of himself as trying to improve and modernize the structure and function of the university. As an undergraduate I had been a member of SDS, although at Washington and Lee University our politics more nearly resembled the left wing of the Young Democrats than those of Tom Hayden. As a young faculty member I was a member of the New University Conference, a group dubbed the SDS’s faculty auxiliary. It was the 60’s and the issues were civil rights and the Vietnam war. The 70’s added gender politics to the list.
As I reached middle age and tenure, I found myself both part of the establishment and a critic of it. Many in my generation of academics found themselves in this predicament. There were several standard responses. One was to pretend one was still young and cultivate a following of politically active students. The conservatism of the 80″s and 90’s made this difficult, but not impossible. A second option was increased careerism–publish and ignore. The third, which is the one I followed, was to involve oneself in university governance and work to make changes from the inside. This choice makes enemies in each of the other two camps.
During this time I was comfortable calling myself a radical, which I defined as one who went to the root of the issue. During my youth, I was proud of the title “radical;” more recently I have been aware of the irony inherent in such a title. However, one consistency I see in my life is a desire to actively influence both individuals and the larger social structure. That desire is one of the reasons I left the university for my current position at the Family Foundation School.
Those readers who have followed the school blogs know that we are in struggle with a group called The Community Alliance for the Ethical Treatment of Youth (CAFETY). I described the group as radical or rather that their agenda represented “a radical take on children’s rights.” Many of my colleagues both co-workers and others in the wider profession have objected to the characterization as radical as being too insulting.
I suppose I should acknowledge that I live in an age where radical gets most often paired with jihadist and not be surprised at this reaction. But I see CAFETY’s agenda striking at the root of the relationship of the family to the state and in that sense it is radical. The irony has not escaped me. I am now the target of the kind of group I would have considered joining when I was twenty-five. My twenty-five year old self would say, “well, you are old and have an ecnomic stake in the outcome. Just what did you expect?” In my next post I will discuss their agenda and my response directly. I wrote this post first so my readers can see where I am coming from and how personally I take these issues.
Last week I spend two days traveling the halls of the Senate Office Buildings. The senate will consider legislation regulating therapuetic boarding schools and other sorts of residential care for troubled teens. The visits were arranged by the National Association of Therapeutic Schools and Programs (NATSAP). I brought with me two alumni and the mother of one of them.
I wish I could regale you with tales of expensive dinners, taking senators out on yachts, or any of the other excesses we think of when we hear the term “lobbying.” In fact, we sat down with legislative aides and explained our industry to them. They generously gave us between thirty and forty-five minutes to tell our stories and explain what we liked and what we didn’t in the proposed legislation. For the most part they listened carefully and asked intelligent questions. Whatever our opinion of Congress may be, Congressional aides are, for the most part, as polite and intelligent group of people as you’d ever want to meet. As the mother of my alumnus said, “It feels like our government.”
Regardless of our effect on the legislation, I had a successful trip. The angry, troubled teen girl I had known was now a poised, confident young woman. The drug abusing teen who was two years behind in school when I first met him was now a focused college student. The young woman said in several offices, ” the school is where I grew up.” No greater argument for our effectiveness could have been made than the one made by the presence of these three people. The young people are well on their way to becoming purposeful adults. Both mother and son testified to the improvement in their relationship.
As it turns out I had worked closely with both these people when they were at the school. I am not sure I am entitled to any credit for this success, but I take enormous satisfaction in it.
In the June 1st issue of The New Yorker, Atul Gawande writes about the practice of medicine in McAllen Texas. Why McAllen? It is one of the most expensive health care markets in the country; only Miami is costlier. McAllen is a much poorer community. His measure, and it is a standard one, is medicare dollars per enrollee. In this post I will repeat several of Gawande’s points, but I urge my readers to read the whole article.
One reason the people of McAllen suggest for this anomaly is that theirs is an unhealthy community. Despite its high obesity rate, its high rate of heavy drinking, and its poverty, it has lower than average cardiovascular disease rates, and low incidents of asthma, H.I.V., infant mortality, cancer, and injury. In short if one judges by the statistics McAllen is a realitively heathy place.
Gawande develops his argument carefully through a series of interviews, references to statistics and and his own experience as a doctor. In a short post I need to skip to his conclusions. He finds that in McAllen and other high cost areas order more tests, operate more frequently, refer to other specialist more often. He also finds that doctors there are entrepreneurs; they own imaging centers, ultrasound machines, or serve as medical directors at nursing homes.
Gawande contrasts these practices to low cost areas. One of them Rochester Minnesota is dominated by the Mayo clinic which pays it’s doctors a good salary, but does not allow them to participate in the ownership of the auxillary services. As a result fewer tests and scans are ordered and the patients needs predominate. Several other cities are discussed with similar conclusions.
Respect for the common health means that we must pay doctors well, but prevent them from developing multiple streams of medical income. In fairness, we will also have to do something about the cost of medical education. A new doctor may begin practice so far in debt that he cannot afford not to be an entrepreneur. As Bernard Shaw says, ” That any sane nation having observed that you could provide for the supply of bread by giving bakers a pecuniary interest in baking for you, should go to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity.”
In my earlier post Doctor’s Dilemma, I offered up the idea of the common health, a parallel, I suppose, to the common wealth. We have a measures of common wealth, but no corresponding number for the common health. It is my idea to offer a series of posts on the health care debate. In this first one I want to set some premises and home truths.
It is my belief if we consider only health care and funding insurance, we will fail. A public program must seek to create public health and private health. We must understand that we have a vested interest in our neighbors’ health as well as our own. The recent swine flu scare brought this idea home to many of us.
Some facts we need to acknowledge:
Life is 100% fatal. Health means we can live a happier, more active life.
The rich have always had better access to doctors than the rest of us. It’s not until the 20th century that this becomes a major advantage. Diet, cleanliness, and not doing dangerous work account for most of the upper classes health advantages throughout history. Nothing we do will change this.
Our public health system is currently strained and any serious threat might break it. If swine flu returns as a pandemic this fall and hits the uninsured, our emergency rooms and public clinics will be overwhelmed.
Medical science is not as advanced as we like to think.
Private persons are responsible for their own health. No system we put in place can alter that. A concern for your health means a concern for the health of others.
Medicine is most expensive at the margins of life.
Whatever our feelings about statistics, health care must use them. If we know that for a set of symptoms a particular test is useless 97% of the time, no insurance should pay for it. If we are in the 3% whose cancer would have been detected early, we want to sue. No system can give millionaire’s coverage to everybody.
There are probably many more facts I could list here, but I’ll start with these. We will need to be willing to examine both market and non-market solutions. In no other area of our lives is the “role of government” more contentious than this one. We need to think deeply and originally about these problems.
I combined business and a short vacation two weeks ago and spent some time in Salt Lake City. My last post reflected my visit to the ballet there; in this one I’d like to offer some reflections on my visit to the city and to Utah. For someone from the East, one is struck by the newness of many of the buildings, the width of the streets and the whiteness of the population. There appears to be a small hispanic community and a small Asian community and excellent restaurants sponsored by both. However, people from other parts of America will note the relative absence of African Americans.
The week end I was there coincided with the annual meeting of the LDS church, and since a new apostle had to be selected, it was a very important meeting. There was coverage in the newspaper and on the local TV channels, but given the reputation of Utah and the church. I found the coverage newsworthy and moderate. The meeting was important to many in Utah and was covered positively, but well. My hotel was only a few blocks from temple square and next to the Salt Palace, but had I not read the news, I might not have been aware of the meeting.
When I visit a city, I often try to imagine what my life would be like if I lived there. Salt Lake City offers me a good life, excellent performing arts and museums, a wide variety of good restaurants, and good books stores. The recession seems not to have hit Utah too hard and the church is rebuilding a lot of down town. But I am not a Mormon and as the young ladies who showed me around the Beehive House quickly discerned not likely to convert. (The house is so historically interesting that one should risk the religion to see it.) I suspect that if I lived a long time in Utah, I would feel like an outsider. The picture here is not the best one of my trip, but the one that symbolizes the church-state axis.
Salt Lake City seems to me to represent one view of American life. Set in a beautiful spot, the city represents a homogeneity of values and of population. If one belongs here, one has a real sense of community. The city represents values I share–common culture, service, and civic order and pride. Utah clearly believes in building maintenance in a way New York does not. Now the natives were all hospitable, I saw no overt racism, and I saw little criticism of alternative lifestyles. On the surface Salt Lake seems pluralistic, but I missed the grit that eastern cities have. They cacophony of very different lives interacting, and the excitement that interaction creates.
The challenge Salt Lake City lays down to us is this–Can we create as livable and peaceful a city and maintain the grit diversity brings? I don’t know the answer, but I think we need to strive to say yes.
Those of us with literary educations tend to draw our political opinions from literary sources before we turn to political theorists. Thus reading Ayn Rand may have created Republicans and Libertarians, and I am happy to acknowledge that an early reading of Bernard Shaw helped turn me leftward. Thinking about the upcoming debate over health care, I got down my copy of The Doctor’s Dilemma and its long and wonderful preface. The play is sort of standard witty Shaw melodrama in which a doctor falls in love with a patient’s wife and realizes that he can let the patient die and make the wife an available widow. The doctor is no such cad and withdraws from the case allowing a less competent colleague to do the patient in. This plot could show up on House or ER with only minor updating. Although one can’t imagine the wise old doctor character in any medical TV show saying, “Come, come! When you both have killed as many people as I have in my time youll feel humble enough about it.” Writing in 1911, it’s easier for Shaw to point out the absurdity and indignity of medicine than it is now, but anyone who has dealt with modern American medicine certainly knows indignity and absurdity.
Shaw is one of the few playwrights to make money from the published editions of his plays and he has provided most of them with prefaces that discuss his moral and social themes.. He is a great polemicist and his essays abound with insight and irony. Take the opening of this preface, ” That any sane nation having observed that you could provide for the supply of bread by giving bakers a pecuniary interest in baking for you, should go to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity.” The preface goes on to lay out many of the ideas that went into Britain’s national health system. It also discusses some issues that were alive in 1911 and are not so today.
Nonetheless much of the essay does speak to the issues we will face in our national health care debate and I recommend it to you. He ends the essay with a list of 14 items. The last three seem particular relevant:
Do not try to live forever. You won’t succeed.
Use you health, even to the point of wearing it out. That is what it is for. Spend all you have before you die; and do not outlive yourself.
Take utmost care to be well born and well brought up. … Otherwise you will be what most people are at present: an un sound citizen of an unsound nation, without sense enough to be ashamed or unhappy about it.
Good advice from a man who died at 90 from complications of falling out of a tree he was pruning.
In a recent post, the blog Cogni-Scent offers a list of rules for Solution-Focused Therapy. One really seems to apply to many situations other than the therapeutic. It is, “The language requirements for solution development are different than those needed to describe the problem.”
This seems to me to be particularly true of political discourse. Both sides desparately fight to frame the problem in ways that implyan ideological solution. Are social security and medicare “entitlement programs” or “a social safety net.” Both are the language of problem description. The government costs too much because of entitlement programs. Or without help I will have to watch old people and poor people live on the streets, I might end up there myself.
If we fight over the definition of the problem, how do we move to a language that describes the solution? Frames by definition distinguish the picture from the rest of experience. Un-framing a question means looking at what areas the frame has separated it from.
Removing the frame around the question I posed above, we find an age-old American tension. On the one hand we see our belief in individualism; we should take care of ourselves. On the other, we see the laudable virtue of helping those in need. So lets not talk about “Health Care.” Lets talk about “the Common Health.”
The language of solution will form an idea of the Common Health and extend it to physical exercise. “Bike lanes are good for the Common Health.” Extend it to Social Relations, “Senior Centers and Boys and Girls Clubs are good for the Common Health.” And as we talk about a Common Health, we might find ways to talk about what health care contributes to the Common Health and what is individual and must be paid for by the individual.
We need a new vision and a new language that responds to both the altruistic and the individual side of most Americans.
The cover of the February 16 issue of Newsweekproclaims, “WE ARE ALL SOCIALISTS NOW.” I shuddered when I saw the cover. Newsweek, the least conservative of the three big news weeklies, seemed to be putting Obama in a box. This is Socialism; it’s bad; therefore, we don’t have to think about it.
The article itself is fairer. It correctly points out that the Bush administration’s Medicare drug plans expanded the state as did the TARP bailouts. It compares us to European economies and points out that we have grown more like them and that all parties want government involvement in the economy, even if they disagree as to what it is they want.
What strikes me is our inability to find a language in which to rationally discuss our current situation. The Newsweek article tries to be balanced but still uses “socialism,” “big government,” and compares us to the French. Language that I believe will prejudice the average American reader.
Where might we find a new language, a new frame, for an analysis of our problems? We might do somethings that are un-American, such as have a philosophic discussion about the role and purpose of government. Do all believe that the business of government is business. Pragmatist will cry, “you want philosophy when the economy is burning?” Without an answer to this question, we will be unable to proceed without finding ourselves in another predicament.
We might look north to Canada. Their banking system is relatively sound. The Newsweek points in that direction when it discusses the housing crisis. We never much like looking at others’ solutions, but the Canadians have a good sense of the purpose of government and we would profit from looking there.
V.I. Lenin says the first question to be asked of any new policy is “whom does it benefit?” That is not a communist question or a capitalist one. But one that if we asked and answered it truthfully might change how we do things. It would certainly change how we talk about them.
I began this series of posts asking how I could bring the importance of Obama’s election to the students at The Family Foundation School. The answer I seem to be providing is to share our experiences with them, to show that history is series of lives lived and examined, not dusty reports of events. I want to skip now to this past year and the elction itself.
I started the year a Clinton supporter. I well remember Jimmy Carter and Obama seemed an honest, well meaning, but inexperienced candidate. As the campaign went on, I became more and more impressed with his vision and his self control. The Jeremiah Wright controversy and Obama’s speech about Race in America made me a supporter.
Anyone who has spent time around African-American churches would not have been surprised at Wright’s rhetoric and anyone who had read Henry Louis Gates’s The Signifying Monkey would have had a context in which to place it. To a certain extent the Wright controversy brought up some of the cultural contradictions in the country. It also challenged the role of the church in politics. People who were happy that their church spoke out became increasing uncomfortable after the YouTube video of Wright’s sermon.
Obama faced this issue head-on which is the first thing that attracted me to him, but more importantly he made it personal. He talked about his experience and about his white grandmother, who he reported had said things about Blacks that hurt him personally. He also acknowledged this woman’s love for him, her support of him, and the good she had taught him. Suddenly there was a model and permission for all of us to move forward without forfeiting our love of our personal past, a way to move apart from our family’s racism without denying our love for them. They were of their time. We are now and we live in a country where those ideas and feelings are no longer viable.
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I combined business and a short vacation two weeks ago and spent some time in 
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