Medicine vs health care

I have a cold and my head is doing that underwater whomp-whomp pulsing thing and every sound feels like someone driving an icepick into my ears, like typing right now is excruciating and I really should just go downstairs and hide in the dark and the quiet with my book and my sticky tabs, but…

An interesting conversation started (on twitter, where else?) and then my one in particular picked up a different thread of it here at home and now it’s all swirling with this other post I’ve been meaning to write. So, here in my virus addled state, I’d like to dive in, because why not.

I want to talk about Western Medicine and how it is NOT health care, and how if we want health care we need to a. change the conversation and b. change the way we do pretty much everything that we consider “health care” now, but which is really medicine.

Disclaimer – This piece is going to read like I am doctor bashing – I want to make it clear that I think most doctors WANT to help their patients, they want to help them to have healthy lives. However, the medical system we have created in America doesn’t have room for doctors to practice health, only to practice medicine and the two are VERY different. So please, understand I am not attacking individual doctors, I am attacking a broken system that incentivizes and rewards the wrong things.

This does NOT mean "Intervene at all cost!"

This does NOT mean “Intervene at all cost!”

Okay, quick history lesson – WAY back in the day, in China, people used to pay their physicians every month – but ONLY if they were healthy. When you got sick, you stopped paying. This created a culture where doctors were invested in keeping people healthy, because that was how they made money. It also created a culture where once people were sick, doctors were incentivized to make them healthy again so they could go back to earning. Doctors did not profit from illness or hardship, they profited from wellness and health.

Here in America not only do doctors not profit from wellness, they also don’t profit from many of the things that promote wellness and long-term health. They are incentivized to look for, find, and treat illness – not to actually improve health.

The conversation that started this morning was about how this woman used to be morbidly obese, and how when she thinks about those days and remembers what she ate compared to now, it’s like night and day. Now she drinks a glass of water every morning before anything else goes inside her. Her house is filled with fresh fruits and veggies. She cooks her own meals from real ingredients most days.

She is no longer obese or even overweight. Her skin condition has cleared up, her hair is healthy – She is healthy.

Her doctors did not do this for her. They did not recommend this course of action. I mean, yeah, sort of, they told her to lose weight and exercise, but they didn’t say – drink water, eat fruit and vegetables, go outside. They did not prescribe a healthy lifestyle.

What the doctors did was perform weight loss surgery, which ultimately would have failed if this woman hadn’t been invested in making these lifestyle changes and committing to living a healthier life on her own. There was no “physical therapy” or “food therapy” or mental health consideration in her post-surgery plan. The doctors simply took her money (or her insurer’s), did the surgery and sat back. Their job was done. What she did next didn’t concern them because they were not paid to follow-up, to create a nutrition plan, to develop an exercise routine… They were not invested in creating health because that is not what pays their bills.

This woman was lucky that she was able to make those lifestyle changes – not everyone is able to afford to switch from a processed food diet to a real food diet. Real food is expensive in this country, and it takes time to cook meals at home. Time and money are both precious commodities these days as the middle class shrinks and slides ever closer to poverty and the minimum wage refuses to budge toward a living wage, forcing people to work multiple jobs for inadequate returns.

But “health” insurance doesn’t cover vegetables. It doesn’t cover fruit. Or gym memberships, or the purchase of a bicycle so you can ditch your car and exercise your way to work. “Health” insurance covers medicine, surgery, intervention. It covers the things that Chinese physicians used to have to do for free to return their patients to health, those last-ditch efforts – not the first line prevention. And this is because health insurance used to be “Oh-shit” insurance. Insurance is supposed to be for when things go wrong, which is supposed to be rare. But for that to work, we need health care that focuses on health, not medicine.

There are a lot of things health insurance doesn’t cover, but the most important thing it doesn’t cover is a conversation with your physician. As a result, more and more physicians are being told to reduce the time they spend with patients.

We see the results of this in everything from my friend whose young daughter was just diagnosed with diabetes and who had to go home and learn what that meant and how to care for her child beyond the daily insulin checks and shots – She had to learn on her own how to cook for her child, what snacks were okay and what snacks were dangerous… Because that is not the doctor’s job. His job was to deliver the diagnosis and write the prescription for insulin. Educating my friend on how to keep her daughter healthy is outside his purview.

We see it in the three trips I had to make to the doctor to diagnose a skin condition on one of my kids because the doctor didn’t actually look at her skin the first two times!

We see it in my other friend whose son was diagnosed as learning disabled when actually he just had an ear infection that made it hard for him to hear, and therefore hard to learn to speak – when all the doctor had to do was look in his freaking ears!

My one in particular picked up the failures of Western Medicine in a completely different place – the recent resurgence of heroin use in our country.

Apparently this resurgence has come about as a result of the over-prescribing of opiates combined with a distinct lack of a plan for how to ween patients off of them when they no longer need them, combined with the fact that many patients are being given what amounts to life-long prescriptions of these powerful “habit-forming” (read addictive as fuck) drugs, combined with the fact that street heroin is CHEAPER than prescription opiates!

So, what is the solution?

Well if the goal is to create improved health as opposed to simply treating pain, then I can think of a few – first, if someone has chronic pain that will last them the rest of their life and the goal is to manage the pain without reducing health, why not look into less addictive treatment options?

Lets start with massage which can greatly reduce all kinds of chronic pain. Acupressure & acupuncture have also been shown to be highly effective and less harmful treatments for chronic pain than prescription opiates, but these are not covered by most insurance plans and are not considered/prescribed by most doctors. (Thanks to Veronica below for reminding me to include these options! Stupid cold.)

If those low risk interventions fail to help the problem, Cannabis has been shown to be incredibly effective for many types of pain and is non-addictive in its natural form. (Don’t get me started on the shit-show that is synthetic cannabis.) But for doctors to be able to use that, we’d have to get the federal government to change its classification, we’d have to start allowing more research to be conducted into the medical benefits of this drug, and we’d have to go back and dig up all the previous research that got buried in the height of a racially charged fear campaign against this plant.

Second, for patients who are not using these drugs forever, doctors should be creating plans to help patients wean themselves off these potent and addictive drugs once they no longer need them. They should not be cutting them off cold-turkey. And this plan should be discussed in advance with the patient.

We talk about a patient’s right to know, but when it comes to these drugs, it’s up to us to read the warning label. NO – doctors need to sit down with their patients and tell them about the risks of these drugs and create a plan to mitigate those risks. It should not be up to the consumer. The doctor should not be off the hook as soon as his or her pen leaves the prescription pad. (And no, I’m not advocating for more malpractice lawsuits, I’m talking about returning to a time when doctors had a relationship with their patients.)

Last, prescription drug prices should be regulated and reduced. Before anyone screams “But capitalism!” at me – most of the funding for new drugs comes from government grants anyway, so once again we are socializing the cost and privatizing the rewards. Let’s stop that.

These are just two tiny examples of places where medicine trumps health in our culture. There are a bazillion more.

We could talk about the medicalization (not a word, I know, roll with me, I’m sick) of pregnancy and the resulting insanely high rates of cesarean sections in the USA compared to other countries and how in other countries healthy pregnant women who do not require intervention have midwives or nurse midwives as their primary attendants which reduces cost AND improves outcomes!

We could talk about how many kids are being given high potency ADD and ADHD drugs rather than a prescription for better nutrition and increased exercise. I’m not saying that some kids don’t benefit from those treatments, I just don’t think they should be the first option.

We could talk about the number of doctors prescribing antibiotics for viral infections, even though they know better – but their patients have gotten so accustomed to getting some sort of medicine that doctors no longer feel like they can say, “go home, drink herbal tea with honey, eat some chicken soup, watch bad TV, rest.” First, that takes too long and doctors aren’t paid to consult, and second prescribing health doesn’t pay, prescribing drugs does.

We could talk about diet pills and mood pills and the number of unnecessary and often invasive procedures done on patients who do not need them.

We could talk about the ways doctors are trained to look for ailments to treat rather than look for health to boost.

We could talk about the increase in allergies, both food allergies and other allergies and what that means and where that is coming from and how we are treating the symptoms rather than the causes…

We could talk for DAYS about end of life care that promotes quantity of breaths over quality of life.

Pick any area of “health” and you’ll soon see that it has become an area of medicine, often at the direct detriment of actual well-being.

Doctors get paid per action – per prescription, intervention, surgery, shot… They do not get paid to sit down and talk about what is happening in their patient’s life that might be causing poor health. They are not paid to talk about diet and nutrition and exercise and stress and work and all the other things that feed into who we are and how healthy, or unhealthy, we are. They are not paid to promote or create health – they are paid to treat illness, disease, pain and trauma.

And… Even if they were – out here in the real world, outside their offices, there is little to no support for people who try to make that shift on their own. It’s not like fruit and veggies cost less for people on food stamps. Whole grain bread isn’t cheaper than white bread. There’s no system in place to help someone who is already struggling just to eat make the leap to eating well. And I don’t know about the rest of you, but every time I take out my calendars and start color coding my days I find that I have way more things to do than time to them. Imagine if I was working two jobs while raising children without a partner – where in the world would I possibly find the time to exercise or cook from scratch? And how would I learn how to cook? There is no support for that. No one is stepping in or stepping up to help people balance their life better, because that costs money and we’re all broke.

So, we need to change the conversation. We need to acknowledge that when we’re talking about medicine, we aren’t talking about health. And health is where it starts – with reducing stress, with increasing nutrition, with making sure that EVERYONE has time to go outside and take a walk (and that they can do so relatively safely).

We need to make sure that doctors have follow-up plans with their patients after procedures and after prescribing drugs. I keep hearing that homeopathy and naturopathy don’t have the backing of science because in blind trials those treatments are no more effective than placebos – and yet in study after study in the real world, they actually do work. Why? Science says it’s because those practitioners SPEND TIME with their patients, they talk, they create wellness plans, they do the work to promote and create actual health rather than just treating ailments and allowing their patients to resume poor habits that create bad health again in an endless (but highly lucrative) cycle.

If we want better health outcomes, we need to smash this broken system all the way down to the ground and rebuild it from scratch, centering actual health and wellness (including helping all people access healthy food and active lifestyles) and pushing medicine back to the fringes of last resort where it belongs.



Filed under Uncategorized

What’s at Stake in the Midterm Elections? Or – VOTE DAMNIT.

I don’t want to tell you how to vote. (Well, that’s not really true, I desperately want to tell you how to vote – but I’m not going to. Because what’s best for me might not be what is best for you, and I respect that.) And I’m not going to tell you how I voted. Anyone who knows me can probably guess with at least 80% accuracy. (I say 80% because I surprised even myself on a couple of issues and people this year.)

What I want to do is remind you what is at stake, in your town, in your county, in your state, and in our country this mid-term election. Because, I keep hearing how close the polling is on a bunch of candidates and a bunch of issues this year.

The infamous They say it is because many people tune out during the mid-terms and don’t bother getting themselves to the polls, or in my state – filling out the ballot they send you in the mail using the information they send you weeks before hand to make sure you’re at least minimally informed and then sending the ballot back.

SERIOUSLY – it’s not hard.




If you are in one of these states – THERE ARE NO EXCUSES.

But hey, maybe you live in a state where you actually have to leave your house to vote, and where voting only takes place one day a year and there are HUGE lines and you have to miss work, which you can’t afford to do, and you have to have special ID that isn’t required in your regular life and costs money that you need for groceries or… Maybe you live in one of the states where they have made it so freaking hard to vote that it feels impossible to do, even if you wanted to, which you’re not sure you do because hey, your district has been so gerrymandered that your vote won’t count anyway…

I can *almost* sympathize with those folk. And I say almost because, if you don’t make that HUGE sacrifice to vote, it’s not going to get any better.

Vote for change

It’s up to us to be the change.

Or maybe none of the candidates really represents you, your wishes for your town/state/country. I get that. Sometimes, and I truly hate it when I have to do this, but sometimes I have to vote against someone rather than FOR someone. It happened this year and I’m super annoyed by it. I even wrote to the person and party that got my vote to let them know that it was NOT a vote for them, and why and what they needed to change/improve if they did want my vote for real. Personally I blame the two party system and the way that often forces us to vote for the lesser of two evils rather than the candidate we really want. This is something I hope we all get annoyed enough by that we work to change it.

Just remember, if you don’t vote – you are letting others vote for you.

Or maybe you’re one of those people who thinks that voting doesn’t matter – the game is rigged, all politicians are the same, government is owned by big business anyway, your vote doesn’t count, blah, blah, blah…

And look, I feel you. Sometimes it does feel like none of it matters.

The very first presidential election I got to vote in was Bush Jr. vs Gore. Remember that one? The one where I thought Gore won, and then I woke up to a Bush victory and then maybe it really was Gore and then we all waited, and waited, and waited and then the supreme court picked our president for us?

Yeah, after that it was a little harder to drag my ass to the ballot box. But even so, I voted. EVERY CHANCE I GOT.

Because if voting doesn’t matter, then why are some people trying to make it so hard to exercise that right?

If voting doesn’t matter what are they so scared of? Heck, let everyone vote if it doesn’t make a difference…

But voting DOES matter, it does make a difference, ESPECIALLY in the off years, the mid-terms, the non-presidential years.

Here in America we often make fun of the Brits for still having a royal family. And yet, every four years we all rush out to elect a president who doesn’t change our day to day life all that much, who is mostly a symbol, a person who has much less power than we all seem to think. And every other year we pass up the opportunity to vote on people and issues that REALLY matter, that really will affect our everyday lives.

So, this midterm, I’m asking, begging really, please – VOTE. And if you live in a state with a mail-in-ballot and you just don’t have the stamps, tell me. I’ll totally front you a couple. Seriously. I will send you stamps.

If you have to take time off work, and stand in line for 13 hours, and purchase a new ID – first, remember your boss CANNOT fire you for taking time off to vote. That is illegal. Second, bring snacks – and water. Last, I wish I could front everyone the money they need to get the proper ID and to pay for the time you have to take off work to get it since those offices are only open during regular working hours and… But I’m not that rich. If I ever win the lotto –  I pledge my winnings to the cause. In the meantime – maybe you can crowdfund it? Or ask on social media. You can certainly ask in the comments. Maybe we can all get together and help. But seriously – VOTE, because this shit isn’t going to get any better if you don’t.

So, now that YOU ARE GOING TO VOTE – let’s talk about some of the issues you’re likely going to be seeing on the ballot this year.

1. Voting Rights

I feel compelled to start here – if you want the right to vote – you better exercise that right. AND as you exercise it, you need to think about your candidate’s stand on this issue. Do they believe that all Americans should be able to access and exercise their right to vote, or do they believe that right should be curtailed for people who cannot jump through an increasingly complex, time-consuming and expensive series of hoops?

2. Women’s reproductive rights and health issues.

In light of recent Supreme Court rulings regarding buffer zones, birth control access and abortion access, lots of states have reproductive rights issues on the ballot. My state is voting yet again on a fetal-personhood bill and wishing that there was a three-strikes-and-you’re-out policy on introducing legislation to voters so we could finally put this issue to rest for good.

Regardless of your personal stance on abortion, fetal personhood goes too far. It usurps FEMALE personhood and comes with a whole host of secondary problems, like criminalizing miscarriages and poor pregnancy outcomes if the mother’s behavior during the pregnancy was less than perfect. This is already happening in multiple states.

Even if women’s reproductive rights are not directly on the ballot in your state, there is a good chance that your candidates have strong positions on this issue. This is one of the many issues where I would argue that not all politicians are the same – and it matters!

I’ve been told for years now that this is a red-herring/straw-man/make-believe issue. But all you have to do is look around the country to see heinous abortion restrictions being implemented over and over again. And yes, some of them are being blocked in the courts, but many are not. Reproductive justice is no longer universal, our nation is covered in a patchwork of laws and barriers and hoops that must be jumped through for a woman to make a decision about her own health care.

Pay attention to the politicians you are electing. Not only do they have the power to enact legislation that can harm or liberate women and families on this issue, they also have the power to appoint the judges who  may one day be called in to determine just how many barriers present an “unreasonable burden” to reproductive health care access.

3. Social Services including Social Security, Medicaid, Medicare, Mental Health funding, SNAP, Section 8 Housing, education, libraries, roads, emergency services etc.

Yes, I know someone who knows someone who told someone about a family who was getting rich on welfare. Damn those lazy bastards gaming the system. BUT, I also know a much larger number of actual people who are working their asses off to make ends meet and need a little help to get there. And even more people who already worked their asses off for a few decades and have earned the right to stop working their asses off and still expect to have a roof over their head, food on their table, clothes on their back and access to competent medical care. All of that is at risk in this midterm election.

These issues are on the ballots not just in the candidates we vote for, but also in more direct ways. My state has a law that makes it so people get to vote on any/every proposed tax increase or extension. The problem is, people hate taxes, no matter what they are for. I have a friend who totally shot herself in the foot by voting no across the board on all tax proposals and then she was upset when some of her benefits got cut. DUDE – WHERE DID YOU THINK THAT MONEY WAS COMING FROM!?!

Services cost money. If we want services to exist, we have to vote yes on taxes from time to time. If the taxes say they are going to something you wish was funded better, or funded at all, vote yes and try to get your people to vote yes with you.

4. Prison reform and the militarization of the police

This is another issue that probably isn’t directly on the ballot, but which you should be paying close attention to – where do your candidates stand on these issues. What are they saying about military style SWAT raids, about police killing unarmed youth in the streets, racially biased mandatory drug sentencing laws, prison overcrowding (is their solution to build more prisons, reduce sentences, or change laws?), a for-profit prison system that rewards high incarceration rates and penalizes rehabilitation programs… etc. Remember, beyond creating policy and law, the people you vote for also have the power to appoint justices who will ultimately decide about the legality of some of these actions.

5. Gun regulations and gun rights

This is one of those touchy issues. In this country the right to bear arms is seen as more basic and protected than the right to vote, the right to access medical care, and even the right to life. You want to talk about sacred fucking cows – talk to someone who thinks that all people everywhere should have access to all the guns and all the ammo all the time. (Unless they are black and living in Ferguson…)

Personally, I think there is some room for nuance. I promised I wouldn’t tell you how to vote, so instead I will just ask you to look at the candidates on your local ballots and look at their voting records if they have them, listen to what they themselves have said on the issue (as opposed to any attack ads their opponent has funded) and think about the world you want to live in and who will best represent your vision for that world.

6. Campaign Finance Reform

I’ve heard that this is a lost cause, that Citizens United is the law of the land and we will never put the genie back in the bottle. Call me a naive idealist, but isn’t the whole point of a democracy of the people and for the people that we can change anything we don’t like if enough of us get together and raise hell, ahem, VOTE.

7. The Environment

From climate change to smaller, more immediate environmental issues - local droughts being exacerbated by certain water hungry/water killing businesses, extended wildfire seasons, water contamination from unregulated chemical storage facilities, exploding train cars that weren’t voluntarily upgraded to be safe to carry their contents without exploding, dying bees and colony collapse disorder which will affect our food security far into the future, pollutants in rivers, streams, lakes and the ocean which is killing fish – again putting our food security at risk…

I keep hearing that I should shut up about the environment because, JOBS! whatever the fuck that means. I’m pretty sure without air to breathe, water to drink and food to eat I’m not going to need a fucking job… Sorry, that came awfully close to telling you how to vote. But seriously, why would anyone vote for a candidate who thinks we can afford to trash our home, or who doesn’t believe that trashing our planet carries real consequences?

8. Immigration reform

Those are some loaded words – depending on who you are they either mean – “Send them all back and build a giant wall to keep them out!” Because, ya know, that worked so well for China. Or, they mean, “Hey, let’s create a process to help people who have come to America become contributing members of our society beyond doing all the shit jobs we don’t want to do.”

So, whichever side of that line you fall on – again, look at who your legislators are and what their position is on this issue. It’s not an issue that is likely to go away any time soon, and it’s an issue that really matters to real people. I’ve seen so many families torn in half because of our broken immigration system, not to mention all the unaccompanied minors who are stranded in legal no-man’s land.

9. WAR!

The war drums are beating again and we haven’t even started paying for the two longest wars in American history. So, unless you want deeper reductions in service programs, or seriously high tax increases, or most likely both – see where your candidates stand on increasing our use of the military in our efforts to police the world and maintain a constant flow of cheap goods to our borders.

10. Minimum wage and worker’s rights

A few decades ago people literally fought and died so that the average American could have weekends, bathroom breaks, lunch breaks, an 8 hour work day… We still don’t have a guaranteed living wage, parental leave, sick pay, vacation days… Unions are being busted and not all workers even have the right to unionize. Minimum wage employees are being asked to sign non-compete clauses and getting paid with fee-riddled debit cards, wages are being stolen in ridiculous (or ingenious depending on your political leanings) ways. CEOs are now earning about 300 times more than their lowest paid employee. That means every day a CEO brings home what it takes their employees an entire year to earn.

Look at what your candidates think and say about this issue, what does their voting record say? Do they think that all workers deserve a living wage, or do they think that only the workers who were privileged enough to graduate college and land a coveted job deserve the right to live?

11. Health Care

Beyond just ObamaCare and whether it gets repealed, revisited, rewritten, or possibly improved… Health care access is at stake in many ways from reproductive health care, covered above, to insurance law, to various states toying with their own levels of opting into or out of ObamaCare and medicaid expansion. There are also issues on some ballots that will directly affect access to mental health care vs imprisonment of mentally ill people. If you’re tired of prisons being used to house people who need rehabilitative mental health care, pay attention this year, and listen to what your candidates are saying about this issue.

12. Gay rights, trans* rights, civil rights and other social justice issues

Equal rights for all people are absolutely on the ballot this year, from gay marriage to protections for trans* people to equality under the law regardless of skin tone or gender – think long and hard as you vote for your candidates and listen to their definition of liberty and justice – are they talking about liberty for businesses, or for actual people?

13. Judicial Appointments

I touched on this a little above, but please keep in mind as you vote for your candidates that some of them have the power to appoint justices to state supreme courts, appellate courts, etc. AND others have the power to confirm or block those appointments. Who we vote for in the midterms matters – it matters WAY more than who we vote for for president.

Now that you’re all fired up to VOTE because you see how important it is – make sure you’re registered to vote – If you aren’t registered, check your state’s laws and see if you still have time. Check and see what the voting laws, regulations and restrictions are and make sure you’re all set to vote when you show up at the polls.

Get yourself educated on the candidates and issues that are on your ballot. If you live in a state that sends you a non-partisan information book, take the time to read it. Read the for and against arguments on the issues, read the full text of the measures and the summaries of what they will mean for your state or town.

It’s easier than ever to do the research into candidates and issues, we have The Google and there are non-partisan organizations trying to get past all the noise filling the airwaves and deliver real information to voters. Use them.

Ignore the attack ads, even the ones that confirm your biases. Attack ads are crap.

AND – If I missed an important issue that is on the ballots this year – drop it in the comments.


Filed under Naive idealism, Of Course I'm a Feminist, Rant, Things that work

Remembering the cost of war

This post has been building for a while, but as we creep into our third middle-eastern war, I mean conflict, I mean police action, I mean… bombing the shit out of another nation or two… it seemed like a really good moment to stop and reflect.

It probably doesn’t hurt that I picked up yet another novel about World War II last night (This has been the year of WWII novels for me. There is a lot to be learned there…) and was reminded about The Way Things Were.

So, let’s take a minute and talk about war – and the cost of war – and the potential benefits of war – and the way we used to balance these things versus the way we appear to be balancing them now – and then, let’s see if we can’t all get together to riot in the streets a little bit…

As I was starting this new novel last night I suddenly realized that my country, our country, has been at war longer than I have been married! And that’s a really long time, like a third of my life long! My children have never lived in a nation that wasn’t at war.

Never, not for one single breath of their lives!

And yet… Most days for most people in the USA, it’s really hard to remember that.

As my friend noted this morning when she woke up to my late night twitter rant on this subject, if you’re not part of the 1% that is fighting these wars, there really isn’t anything being asked of you. There are no reminders. There is no sacrifice.

We still aren’t being shown images of caskets coming home. We aren’t having our goods rationed. Our taxes haven’t gone up to pay for these wars. Uncle Sam isn’t asking us to buy war bonds, or drafting soldiers or even asking anyone to enlist. He’s just stop-lossing the people already enlisted and recruiting people with “prison or war” deals.

America has been at war in two nations for over a decade and the majority of our citizens haven’t been asked to sacrifice a single thing.

Or… have we?

Because while there aren’t any fuel lines at the pumps, and no one is being asked to grow victory gardens, the money for these wars IS coming from somewhere.

In World War II, the conservative congress agreed that the war had to be paid for and they agreed that in order to pay for it, they would have to increase federal revenue – that meant taxes. LOTS of taxes! The top marginal tax rates were 81-94%. Yeah, you read that right. And yet, World War II is often credited with pulling us out of the Great Depression – because with all that money, the government created jobs. We manufactured airplanes and bombs and parachutes and uniforms and guns and everything else our soldiers needed for war.

Soldiers come first in war time.

Soldiers come first in war time.

Meanwhile, not only were tax rates increased, but the minimum income for having to pay them was lowered meaning that more people than ever before were required to pay federal income taxes. So everyone felt the squeeze.

But that wasn’t all.

Production of durable non-war goods like cars, vacuum cleaners, home appliances, etc. were all stopped until the war ended.

And then the rationing of goods – like tires, food, and gasoline. Families were given 3 gallons of gas per week. That’s it. That’s all. So… No driving ya’ll. And as for the food rationing – the soldiers got first dibs on food, so families were asked to grow “victory gardens” to supplement their rations. Neighborhood gardens popped up, not because it was trendy or because fresh veggies were for food-snobs, but because without them people wouldn’t eat. Of course, it wasn’t sold that way.

Are you doing your part to help the war effort?

Are you doing your part to help the war effort?

In World War II, everyone was required to pitch in to the war effort, it was considered unpatriotic to engage in certain frivolous activities and leisure spending. We were at war, and everyone was expected to participate in whatever capacity they could. As part of that, people were asked to save money, preferably by buying war bonds which fueled the government and then, when the war was over, provided a nice savings windfall that helped truly rebuild the American economy as everyone rushed out to buy new housing, new cars, new clothes and other consumer goods.

Yes, there was A LOT of propaganda fueling WWII, but there had to be, because they had to pay for the war, they had to convince the American people that war was worth sacrificing for, because EVERYONE was expected to sacrifice.

Fast forward to the Vietnam war. For people of my generation, we think of the war and we think of protests and hippies and counter-culture. Even my father-in-law who is a Vietnam veteran returned home from the war and joined the protests. My uncle served in the war at the same time his family helped deserters and draft dodgers escape to Canada, because while they respected my uncle’s “choice” to join the war effort my grandparents were both veterans themselves who knew that war is Hell and did not believe anyone should be forced into it.

My parents’ generation talks about the lines at the gas station that would stretch for miles and take hours to get through. They talk about bread lines and canned goods lines and grocery stores simply running out of food. During the Vietnam war, as in WWII, many factories that produced consumer goods were retooled to produce military goods to support the war. This created a drop in consumer spending which, combined with increased war spending not balanced by increased tax revenue created huge deficits and a national budget crisis and economic slump. Times got tougher for everyone.


One of the biggest war costs we hear about is the draft because the Vietnam War wasn’t seen as a “good” war by so many, or at the very least, it wasn’t our war. It wasn’t something that had anything to do with us or that we needed to fight and kill and die and sacrifice for. The draft was no longer seen as a patriotic duty to submit to, but a government intrusion to be railed against.

The draft was one of the biggest symbolic “costs” of the war. It was one of the big reasons people protested. And those protests are one of the big reasons America did away with the draft. It’s harder to rail against a war when the people fighting volunteered.

But… Have the people fighting our wars volunteered?

My uncle fought in Vietnam. He served for two deployments (which is less than many of our soldiers are serving now). He wasn’t drafted, but he didn’t exactly volunteer either. He was arrested for some misdemeanor drunk and disorderly type of offense and given a choice between jail time and a permanent record or one deployment overseas to fight in Vietnam. He chose a clean record, VA health care and the promise of a VA loan for a house and school when he came back.

He got the clean record, the rest of the promises never quite materialized, despite serving for an extra deployment beyond his plea deal.

Fast-forward to present-day.

We don’t have the draft anymore. Nothing to protest or get upset about there.

We want to think of our all volunteer military as the best and brightest and most patriotic – and certainly those soldiers exist. But many more enlistees join up out of desperation – they see the military as their ticket out of now-where-ville, or a way to escape a bad family, or a way to avoid jail time. We lure them in with promises of decent pay, free health care for life, housing loans, student loans, debt forgiveness, job training and placement… But after two wars stretching over a decade, that have gone largely unpaid for, the money isn’t really there to deliver on those promises.

We don’t have rationing, price fixing, wage fixing, tax hikes, or war bonds.


The gas prices at the pump might be a little high, but they are still lower than everywhere else in the world – and we are allowed to purchase as much as we want. There are no shortages, no lines, no riots. My grocery store is fully stocked day after day. This February, I’ll still be able to buy fresh strawberries if I want to. And guava. And avocados. And tomatoes. And… And that’s in the dead of winter after a decade of continuous war. I don’t have to stand in line to get a ration card to buy bread, or rice, or pasta, or canned goods. I can still buy clothes. New cars are still being made for consumer use. And new washing machines and vacuums and dishwashers and ATVs and leaf blowers and lawn mowers and… No one in my family has been drafted for the war efforts or recruited to work in factories or on farms to produce goods for the soldiers or the war effort in general.

Speed limits haven’t been dropped to increase fuel efficiency, we don’t have curfews on lighting to save energy – in fact any efforts to encourage or require people to conserve energy is met with shouts of “impeach the commie pinko socialist!” perhaps because the requests are being made in the name of global climate change science instead of patriotic war mongering? (Even though we are at least partially fighting over oil ie; energy… and conserving here would make war less necessary over there…)

My taxes haven’t gone up, Uncle Sam isn’t shouting at me to buy war bonds or support the war effort. In fact, Uncle Sam has been awfully quiet about these wars almost from the get-go, as if he’d rather we forgot we were in them at all…

I look around my house at all the waste – at the truly ridiculous and frivolous amount of stuff that fills every nook and cranny and then I think about a decade of war, I think about the nearly 14,000 American lives lost (roughly 7,000 soldiers and 7,000 contractors) and the 875,000 Americans disabled by their service in these wars, the 200,000 Iraqi, Afghan and Pakistani civilians killed, the 3,000,000 Iraqi refugees this war has created, the THREE TRILLION dollars already spent on these wars, and the trillion more that is obligated for veteran care – and I wonder… If it isn’t coming from me, from us, where is it coming from?

How are these wars being paid for?

And then I remember… The federal budget cuts for schools and cuts in the safety nets and cuts to entitlement programs and shrieking over deficit spending that can only be solved by eliminating every pathway of hope that poor people in America have for a better life outside of joining the military.

And I remember the cuts to the VA programs and the news that our soldiers are going off to war without proper boots or armor or equipment and that their pay is barely above a poverty wage and I realize that none of those trillions of dollars actually went to people, to our soldiers.

And I realize WE ARE PAYING for these wars, we’re just paying in ways that we don’t see. We don’t see the connection between cuts to federal service programs and an ever increasing pentagon budget. We don’t see the connection between the insistence that entitlement spending is out of control and the truth that WE HAVE BEEN AT WAR FOR OVER A DECADE WITHOUT RAISING TAXES. We don’t see the connection between a decade of war and our crumbling roads and bridges and the continued blocking of a federal jobs program that would put people back to work, including the veterans coming home from war desperate for a job that pays a living wage. Because government doesn’t create jobs, at least not without raising taxes, which we won’t do, even to pay for a four trillion dollar war.

So we pay in other ways.

We pay in services, we pay in security, we pay in lost opportunities for growth…

The only way to pay for a decade of war without raising taxes is to steal that money from somewhere else and convince the people that war is free, or better yet, that war will save us money – war will keep our goods cheap, our gas prices low, our refrigerators stocked… War isn’t the problem, programs that help people, they’re the problem. They’re what’s bankrupting the economy.

But history shows us that even in times of war – programs that help people – HELP PEOPLE and help the country grow. And history shows us that wars are expensive and have to be paid for. Look at the difference between WWII and the Vietnam war – one was paid for and pulled our country out of the Great Depression, the other was put on credit and plunged our economy into a deep recession. Granted, the Vietnam war was a hard sell based on lies and fear mongering, so maybe we shouldn’t have gone in to begin with. Sound familiar?

So… If you’d like to have schools and roads and bridges and job training and health care and safety nets (a large percentage of military families – both active duty and retired – rely on food stamps and other social wellfare programs.) and retirement… Start fighting to pay taxes, start fighting to figure out how to pay for these wars in honest ways – or end them.

We can’t have it all, we can’t use tax cuts to fund war, and we can’t balance a growing war budget without increasing revenue.

It’s easy to forget that we’re at war, they’ve removed the cost from our daily lives, sheltered us from the grim realities, convinced us that the real problem is all those service programs that help keep people out of poverty… But we’re about to start a third war. That money has to come from somewhere. The boots on the ground have to come from somewhere. If you’re not willing to pay, to contribute, to sacrifice some of your comforts to the war effort – then you better get your butt to the streets and start marching, because the war drums are beating.

I’ll be there with my food not bombs sign.

it will be a great day




Filed under Naive idealism, Rant, Uncategorized

What I mean when I say it isn’t the victim’s fault

The world is an inherently risky place.

There are all kinds of things out there that can, and will, hurt us if given the chance.

Some of these risks come in the form of natural disasters, toxins, disease, allergies, loose rocks, animal attacks – whatever. They are risks that stem from living on a volatile planet in the middle of space. We have little to no control over these “When nature attacks” kind of threats. I mean, yes, we can talk about global climate change, and human settlements encroaching into wildlife habitat, and how in our desire to over-sanitize the world we are simultaneously creating super-bugs and increasing the instances and severity of allergies… But that is a whole other blog post.

This one is about the risks of living in society – with other people. This is an important point to make because often when I try to have this conversation many of the arguments against putting blame on perpetrators of certain types of violence instead of their victims use these kinds of “false equivalence” comparisons to try to make their point. But taking steps to avoid the risk of falling off a cliff is different than taking steps to avoid “provoking,” “inviting,” “encouraging,” or “inspiring” violent behavior from another person.

Because the risks inherent in living in society stem from the reality that we cannot control each other’s behaviors or actions. We are only ever directly responsible for ourselves.

This is not to say that there are not things that we can do to reduce many of the risks of cohabitation – not eliminate them, but reduce them.

We can look both ways before we cross a street. We can lock our doors. We can avoid certain venues that have a reputation for being violent or dangerous.

As a society we can enact laws that say, “We as a group have decided that this action is not okay and there will be artificially imposed consequences for anyone who commits it.” We do this to deter actions such as theft, murder, drunk driving, consuming certain intoxicants and then getting behind the wheel of a car…

But taking those actions does not eliminate risk, taking those actions does not guarantee our safety.

And choosing not to take those actions is not the same as consenting to violence.

Most of the time we, as a society, remember this.

I drive a piece of shit car. I rarely, if ever, lock it. I don’t leave the keys in the ignition (usually) but if someone wanted to go in and dig through the mountains of garbage littering the floorboards to steal my old CDs, there’s really nothing stopping them. If they wanted to hotwire my car and take it for a joyride, they wouldn’t even have to smash the window first.

And yet, if someone did decide to take my unlocked car, society at large would still call that theft. If I called the police and reported it, they would still investigate and arrest the thief. Because me leaving my car unlocked (or even unlocked and running) is not the same as me giving someone permission to take it.

We understand that.

If someone comes into my house without my permission, even if I left the front door unlocked – I have the right to shoot them. Yeah, I can take away their “right to life” just because they stumbled into the wrong house. If I choose not to shoot them, I can still call the police and they will be arrested for trespassing. They might also be charged with attempted burglary, or attempted assault, or attempted whatever potentially criminal act we think they were trying to do when they opened a door that wasn’t theirs.

I don’t have to post “No trespassing” signs on my front door to invoke this right, or lock my door, or even close my front door. My home is my castle and you don’t get to come inside unless I invite you.

But… my body?

Not so much. At least not according to current legal rulings. Not according to people looking for a way to excuse certain types of violence directed at other people.

Too often when it comes to personal violence, especially sexual violence, we (as a society) try to use the victim’s actions against them to excuse the actions of the perpetrator.

This is called this “victim-blaming.” And no, it is not feminazi’s attempt to make it so that victims are not held accountable for their actions, or so that victims can do anything they want consequence free. We are simply saying that perpetrators of violence should be held accountable for their choice to commit violence regardless of how “easy” their target made it for them.

When a bunch of TV personalities support the thesis that the biggest threat to fraternities is drunk girls coming in and tempting all those upstanding young men – that is a case of victim blaming. It also erases the long and storied history of fraternities throwing parties for the express purpose of getting women too drunk to say no. (Because in a “no means no” model of consent, that isn’t rape. But in the up and coming “yes means yes” model, which so many people are freaking out about, that is rape.)

So, when I say that it does not matter if a victim is drunk, dressed in skimpy clothing, completely naked, flirty, passed out or otherwise making themselves an “easy target” for violence, what I mean is that the victim’s behavior should not alter the sentencing of the perpetrator of the violence, nor be used to excuse their behavior or actions.Did the victim make a choice to engage in certain actions? Yes. Does that mean they consented to violence? No.


I am not asking for victims of violence to be coddled, or saying that actions shouldn’t have consequences – I am saying that violence is not the price someone should have to pay for being in public or living in society. I am saying that violence is not the price that anyone should be expected to pay for enjoying the same social privileges as their peers such as enjoying a drink – or several, wearing revealing clothing, walking at night…

not asking for violence

Clearly asking for it.

I am saying that the victim’s actions and choices do not negate the responsibility of the perpetrator, nor invalidate THEIR actions and choices to commit a crime.

Let’s look at a couple of specific examples.

Late last year a Montana judge sentenced a teacher who repeatedly raped one of his students to only 30 days in jail. Why? Because, he claimed, the student was “older than her chronological age” and “as much in control of the situation as her teacher.”

Here’s the thing, there is a reason that there are rules prohibiting teachers from having sex with their students – there is an inherent power-imbalance at play there. This is also why there are statutory rape laws, because a 49-year-old man should know better than to have sex with a 14-year-old, but 14-year-old children more often than not don’t have the information, emotional maturity, or psychological understanding of long-term consequences, etc. to make that call. Again, there are power dynamics at play in that age differential, not to mention differences in knowledge about healthy relationships, sex and sexuality, etc. Those differences are easy for the older person to exploit to their own ends, severely damaging the youth in the process.

The victim in this case committed suicide while the case against her attacker was still pending.

This is a case where a judge seemed to be trying to do everything he could to create wiggle room for the perpetrator of a violent crime. In defending his sentencing of the teacher to only 30 days, the judge said, “This wasn’t forcible beat-up rape.” which is a way of saying that the victim wasn’t victimized hard enough to punish her attacker even to the MINIMUM requirements laid out by the state in which this judge presides.

We also have a case out of Texas from earlier this year in which a young man plead guilty to raping a 14-year-old girl. Both the victim and the accused testified that the girl said “no” and “stop” repeatedly. The man was facing 20 years in prison for this crime, the judge instead handed down a 45 day sentence because the victim “was not the victim she claimed to be” according to the judge, because the victim had had consensual sex with three other partners at some point in her life prior to the rape.

There are two problems with this argument – the first, if we take the judge’s statement about the victim as truth, is that it assumes that once a person has consensual sex once with someone, they are somehow consenting to all sex forever with everyone. This is a common argument in rape cases, as if people lose the right to sexual discretion once their “cherry” has been popped.

I don’t understand this argument at all. I don’t believe we lose the right of refusal once we’ve said yes once, or twice, or a thousand times. I don’t think that a person who has consensual sex becomes magically unrapeable.

The second problem is that the victim claims she was a virgin before the rape. While the judge says she has access to confidential medical records that show the girl had three previous sexual partners and gave birth to a child – both the victim and the victim’s parents deny this. That is worthy of an investigation right there. How did the judge get these medical records – and why? Shouldn’t it be the perpetrator being investigated, not the victim?

But all too often in rape cases, defense attorneys are encouraged to go for the “slut” defense – “The victim slept around, so this couldn’t have been rape.” and both judges and juries are willing to give those arguments weight.

We saw this in another big news rape case recently, Steubenville, OH. Where, despite video footage of the rape taking place, the defense still tried to go for the “she was a slut” and “she was asking for it” defense. I am not sure how someone who is passed out drunk can ask for anything… But then we are back at only “yes means yes” rather than, “See, the victim didn’t say no.”

Did this girl’s actions make it easier for someone to rape her? Yes. Does that in any way excuse the actions of her rapists, or the crowd of peers who watched, photographed, filmed and cheered on the rape? NOT ONE SINGLE BIT. Does she deserve rape as the natural consequence of getting drunk at a party? ABSOLUTELY NOT. Should she be allowed to report her rape and, with the support of a thorough police investigation, be able to prosecute her rapists? YOU BETCHA!

Just as the woman who left her car running to dash into the store made it easier for someone to steal her car, that did not excuse the actions of the person who took advantage of that opportunity. Her actions did not prevent police from investigating the crime, nor did they absolve the criminal of choosing to commit their crime.

When people say they are not victim blaming, they just want to help victims protect themselves from rape, I think that they are forgetting – we’ve already heard it. What we are asking for is that we talk to perpetrators and potential perpetrators as well, that we focus at least half our energy educating people on what rape is and how to avoid committing it. We are asking for police, medical personnel, judges, advocates and allies to step back from asking what “don’t get raped” rule the victim may have broken and instead focus on what the perpetrator chose to do wrong.

We live in a country where only 50% of rapes are even reported, and it is estimated that only 3% of rapists ever see the inside of a jail. Rape is a hard crime to report – the victim’s body becomes the evidence and collecting and cataloging that evidence for trial is invasive and unpleasant and often performed by people with little sympathy. While I fully support the “innocent until proven guilty” judicial standards in our country, when other violent crimes are committed we rarely try to deny the existence of the crime in order to set the perpetrator free, we instead acknowledge that there was a crime and simply quibble over who committed it.

When we focus on what the victim did wrong, or what the victim did to invite this crime, or how the victim wasn’t victimized enough to take seriously we are giving perpetrators of violence a pass and telling them that their actions are justifiable because they picked a an easy victim. So many rapes, the majority of them, are opportunistic rapes. Serial rapists know which victims to prey on – the kind who won’t be taken seriously, the ones who are a little too tipsy to be reliable witnesses, the ones who have a reputation for sleeping around, the ones who are too young or immature to fight back…

But if we treated rape and sexual assault the way we treat other crimes – by starting with the assumption that the crime being reported actually happened, and that the job now is to discover the perpetrator and bring them to justice, instead of questioning the integrity of the victim, this dynamic would shift in really important ways.

First, it would help victims come forward, knowing they would be respected, listened to, trusted. Knowing that they would be believed. Second, it would help encourage a culture where bystanders would want to intervene lest they be charged as accessories. Third, hopefully it would make perpetrators of this kind of violence think twice, if they knew that their victims would be heard.

Last, it would let people know that social freedoms, privileges and responsibilities are the same for everyone, shared by everyone and that violence is not an okay price to pay for exercising them.

In fact the first social responsibility we all share is the responsibility to treat others with decency and respect and not violence, and I’m pretty sure that we as a society have agreed that violating that responsibility should come with some judicially imposed consequences.

asking for justice

The only thing she’s asking for is justice.






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Filed under Naive idealism, Of Course I'm a Feminist, Rant

No Time to Die

A couple of years ago now I discussed and recommended a book called Living Proof by Kira Peikoff.  It was an intriguing book with a deep moral theme and a solid dystopian twist.

Kira has recently published her second book, this one called No Time to Die and true to form, she again engages us in a moral thriller.

beating death

What if Death and Taxes weren’t absolutes after all?

Someone is out for blood—Zoe Kincaid’s blood. She’s a 20-year-old trapped in the body of a 14-year-old girl and her DNA could hold the secret of immortality. Could it be the Columbia University researchers who see her as the key to fame and tenure? The shadowy figure, known only as Galileo, who is kidnapping the world’s best researchers? The Justice Department head who seems a little too intent on getting her alone? Or the maniac who just fed a leading scientist to his chimpanzees?

Zoe knows that unlocking the secrets of genome could save her beloved grandfather, a retired physician and former Olympian who grows frailer by the day. Can she trust the rogue physician whose secret lair hides discoveries that might just save her grandfather? Heart-pounding twists just keep coming in Kira Peikoff’s stunning biomedical thriller, NO TIME TO DIE (Kensington Publishing; August 26, 2014.)

Science has barely begun to unlock the secrets written in our DNA. Researchers are relentlessly hunting for the answers to chronic diseases, cancer, rare disorders and the biggest mystery of them all—aging—but at what cost? Bioethicist Peikoff asks the most troubling scientific question of our time in this taut thriller: when does medicine cross the line?

I love the question at the heart of this book – If science can stop the aging process, should it?

Humans have long sought a cure to aging, to cure death and disease really. We crave immortality. What if science had a breakthrough, one that could halt the aging process? Should scientists pursue that breakthrough and cure aging?

The secondary question this book asks is, who is our regulatory system really designed to protect? And how much medical science are Americans missing out on because of the burdens placed on scientists by the FDA and other regulatory agencies? Should consumers have more freedom to try experimental drugs and protocols?

This book challenged me in ways that Living Proof did not. It challenged me to think about issues of aging and death and medicine from an angle that I tend to ignore because of my personal beliefs around death.

Kira holds a somewhat different set of beliefs on this topic and she was kind enough to drop by and shed some light on them, and on what drew her to this story.

NO TIME TO DIE focuses on a 20 year-old woman who stopped aging at 14 years-old – where did you get this idea?

A few years back, I saw a documentary on Discovery Health about a young woman who had inexplicably stopped aging. She was almost 20 years old but had stayed frozen as a toddler her whole life, baffling doctors and scientists alike. The case caught my attention because I’ve always been interested in medical mysteries, and like many people, I’m also fixated on the promise of eternal youth. Yet staying young forever, as welcome as it might be, could also be a curse. I decided to explore it further in a novel, but I didn’t want my protagonist stuck as a toddler without much mental or emotional capacity.  So I decided to trap her in the worst possible page for maximum drama and frustration. What could be worse than 14?

What is Syndrome X?

Syndrome X is the name researchers have given to this phenomenon of total stunted development. To date, at least 6 people have been identified.

Why is our culture so interested in defying aging?

I think it probably derives from our collective fear of death. It’s very painful to face down our own mortality and to grasp how temporary our lives are. Religion may provide people with some measure of comfort, but there remains no scientific consensus on an afterlife. So we’re forced to accept that all we really have is the here and now. Defying aging would be the ultimate way to prolong our time and avoid oblivion.

Do you think scientists will find a cure for aging?

Some leading researchers believe the end of aging is within reach–perhaps in the next century. One respected scientist, Aubrey de Gray, thinks that the first person who will live to age 1,000 is already alive now.

What are some of the benefits of not aging?

On an individual level, endless time–time to spend with family and friends, time to pursue infinite knowledge, passions, careers, hobbies, etc. No longer having to worry about outliving your parents or grandparents. Knowing generations of your own descendants. Living in the prime of life without breaking down physically after 70 or so years.

On a societal level, much less spending on health care, since the diseases of aging (cancer, diabetes, Alzheimer’s) would be greatly reduced. A more robust economy, thanks to workers who retain full strength and energy long past retirement age.

What would be some of the negative results of not aging and becoming almost immortal?

Individually–people might suffer from a kind of idle purposelessness if they are living so long that there’s no point in “seizing the day” or making the most of life. They might start taking their time for granted and losing their ambition. But of course, you’d still have to support yourself with food, shelter, etc. And you could still get hit by a bus and die, or get sick. It’s very different from actual immortality.

Societally–we would have to deal with how to avoid overpopulation. People would have to have fewer children, or maybe skip generations before having children. We’d have to figure out how to make existing resources and infrastructure support the growing population. Social security would end. I don’t know if people would retire anymore.

You’re studying Bioethics at Columbia University, how did you choose bioethics?

I’ve long been interested in the intersection of cutting-edge biology, politics, and philosophy. Specifically, in the ways that exciting new advancements stand to improve human health, but are also raising unprecedented moral dilemmas. Our very definitions of life and death are being challenged by the latest innovations. It’s a thrilling field to study because it’s constantly evolving, and no one has all the answers yet.

Your book explores a secret network of scientists – why is it important to regulate what happens in science labs?

This is a controversial issue. On one side, you have people asserting that government regulation is necessary to protect vulnerable human subjects from exploitation by unethical researchers–which sadly happened a great deal in the early nineteenth and twentieth centuries, before notions of patient autonomy and informed consent were popularized. On the other side, you have researchers who now feel stifled by the layers of bureaucracy, like IRBs, ethics committees, and the FDA, that they need to bypass to carry out their studies. Many people, including me, are concerned that these protections have been taken too far and actually hurt more than they help, by holding back and even dis-incentivizing innovations that could save lives. In my book, the best and brightest researchers have become so frustrated with the slowness and inefficiency of the system that they form their own secret community to speed up progress. I think it’s possible for a group of researchers to self-regulate and still treat human subjects 100% ethically.

What do you hope readers will gain from reading NO TIME TO DIE?

First and foremost, that they will be transported on a thrilling and satisfying journey with characters they’ve become invested in. Then: that they’ll possibly think about their own positions on the controversial subjects the book raises, and finally that they will be shocked by the big twist ending.

KIRA PEIKOFF is a writer based in New York City. She graduated with high honors from New York University in 2007 with a degree in journalism, after four years of various reporting internships: covering street crime for The Daily News, writing about Capitol Hill for The Orange County Register in Washington, D.C., reporting on business and technology for Newsday, and researching feature stories for New York magazine. After completing her first book, Living Proof, Peikoff worked for several years in the editorial departments at two New York publishing houses, which gave her an invaluable inside look at the publishing process and the rapidly changing industry. Peikoff is working on her third thriller, freelancing for a variety of major media outlets, and attending Columbia University’s Master of Science program in Bioethics.

Me again – I think No Time to Die definitely raises some interesting ethical questions around personal responsibility and autonomy vs government oversight and regulation. I’d be interested to hear your thoughts in the comments.


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Filed under Books

Bring abortion services into the mainstream

Okay, before we get started on this one, I’m asking all of you to take @AndreaGrimes#TacoOrBeerChallengeIt’s super simple, eat a taco, or drink a beer, or do both, snap and share a picture or video of it, using the #TacoOrBeerChallenge tag and donate money directly to an abortion fund. If you don’t see one in your state or area (Utah, I’m looking at you.) try contacting your nearest abortion provider and donating directly to them!


Eat a taco, drink a beer, fund abortion.

I posed a question on twitter this morning -

“Why isn’t medical abortion available at EVERY sexual & reproductive health clinic and through every ob/gyn and family practitioner?”

But there’s a follow up question, one that really gets to the true heart of the matter – considering that 1 in 3 American women will access abortion services in her lifetime, some of them more than once, why is abortion segregated from standard, basic women’s reproductive health care at all?

I, and a lot of reproductive justice advocates, have long said that one of the biggest barriers to abortion access is the fact that it is segregated from other regular women’s health care. After all, I can get my annual exam, a pap smear and STD testing at any ob/gyn office or sexual/reproductive health clinic. Many family practitioners will also perform those services. Those same doctors and physician’s assistants will also prescribe birth control pills, fit me for a diaphragm, insert an IUD, give me a shot of depropravera, insert the Ring, etc.

They will, in essence, address all of my sexual and reproductive needs. Unless I fall into the category of being one of the 1 in 3 women who need an abortion. Then, suddenly, I have to go to a special clinic.

Granted, many, indeed most, of the clinics that offer abortion also offer the full range of other sexual and reproductive health services listed above. BUT… Why don’t all clinics and offices that offer sexual and reproductive health services offer abortion services as well. Either you care about the health of women and female bodied people, or…

Now, I know the history that plays into this “ghettoization” of abortion services, the history that led abortion to be singled out and separated from standard medical care.

I mean, first there’s the fact that it was illegal from 1880 (That’s right, abortion was a legal and fairly basic medical procedure when this nation began. It was performed primarily by midwives, until that profession came under attack along with other aspects of women’s empowerment.) until 1973. Combine that with the history of birth control being illegal, and then only being legal for married couples, and then finally becoming legal for women to access on their own without the consent of a husband (or father) and we see that reproductive care in this country has long been viewed as a separate entity, a medical outsider.

What I can’t understand is how, 40 years later, that care that so many people require and access has remained outside the umbrella of standard medical service.

There are very real consequences to this continued choice to view reproductive care as secondary care.

Recently a woman was arrested for accessing LEGAL abortion pills online and providing them to her daughter. This woman is not a doctor, and so though the medication is legal, she is not legally allowed to prescribe or administer it.

So, why did she?

Well, because this safe, legal medical service was not available in her area. The nearest place that her daughter could access it was 75 miles away. The laws in her state further required that her daughter consult with a doctor before hand, wait at least 24 hours and then return to get the pills.

This meant that the mother and daughter would have to take two days off from their life to access a safe, legal medical procedure. They would either have to make this drive twice, or get a hotel room and stay the night.

To many of us middle class and above folk, this might not seem like an insurmountable hardship – but as someone who has not always been middle class, I can assure you – it absolutely can be.

But… What if this type of abortion, a medical abortion, that does not require surgery, was simply available at every ob/gyn office, at every sexual and reproductive health office, and from any family practitioner who offered pap smears, STD testing and birth control services?

What if it was treated as the basic, common medical care that it actually is?

What if this girl had been able to access it the same way, and from the same medical office where she could access medicine for gonorrhea or HPV or herpes? From the same office she received birth control? From the same doctor who had administered her last pap smear, or who had helped her deal with menstrual problems, given her a breast exam or addressed her other sexual or reproductive concerns.

First, the cost of this drug and procedure would most likely go down, because it would be available in more places.

Second, insurance would most likely cover it because it would be seen and treated as standard, basic health care. (Though the girl in the above story did not have insurance, it probably wouldn’t have mattered if she had, many insurance plans both public and private do not cover abortion services for political reasons. See your local Hobby Lobby store manager or GOP representative for details!)

Last, and perhaps most important – this mother would not be in jail. Because she would not have been forced to make a bad choice in order to help her daughter access her legal right to safe, effective medical care.

The question of accessing medical abortion came up when I was researching abortion services in my state this morning. Accessing the list of providers and seeing what they provided, I suddenly became outraged that Planned Parenthood, which is touted as being the nation’s largest abortion factory by its opponents, doesn’t even offer medical abortion at all of its clinics.

I am outraged that medical abortion is unavailable in my town. I am further outraged that there is a HUGE chunk of my state with absolutely no abortion services at all.

We keep hearing about Texas and other “bad” states where women have to drive HOURS to access an abortion, but that already exists, right here in my state. Nothing has changed from my high school days. Abortion might be legal, but it still isn’t available to far too many people who might need that service. This seems ridiculous to me now that medical abortion exists and is safe up to 9 weeks into a pregnancy. We don’t even have to train new doctors to perform a medical procedure. They only have to know how to determine gestation to make sure that a patient is within the safe period for a medical abortion.

It has even been argued in front of both legislators and judges, this is something that doctors could do over the phone, or over skype to better serve rural patients. So why isn’t it at least available at every sexual and reproductive health clinic in the USA? Why doesn’t my town offer this type of abortion, despite having two such reproductive health clinics? Why doesn’t the town with the highest teen pregnancy rate in my state have this service? (Not that teens are the only people who need this service, but that seems like a pretty solid indicator of demand!)

And what about surgical abortions? Non-medical abortions are considered to be a surgery. A minor, outpatient surgery in the first and early second trimester, but a surgery none-the-less. That means that only certain types of doctors can perform them. Despite studies showing that trained nurses actually have improved safety records with first-trimester abortions, it remains a procedure that only doctors are legally allowed to administer. This limits access in additional ways, especially when you consider that ob/gyns are not required to learn how to perform an abortion as part of their required training!

Why aren’t more of us fighting to change this? I can understand not requiring family practitioners to learn this skill, after all they are not specializing in reproductive health. Yes, many of them will administer a basic pap smear or STD panel, but once a patient is pregnant, they recommend them to a specialist.

Part of caring for people of reproductive age and biological sexual maturity is helping them to manage the potential consequences. Whether that comes in the form of advising sexually active people to use barrier methods of STD and pregnancy prevention, prescribing other forms of birth control, administering STD tests, prescribing medicine to treat STDs, helping someone stay healthy through a pregnancy and deliver a healthy baby, or end an unplanned, unwanted or unsafe pregnancy.

Abortion care is part of sexual and reproductive care. It is not separate. It is not “other”. When 1 in 3 women require a service, that’s an indicator that that service is basic care and that the doctors who treat other issues related to that service, should be required to learn how to perform that service as part of their training and licensing.

And before anyone jumps into, “but FREEDOM!” ALL ob/gyns have to know how to do a pap smear, test for and treat STDs, give a manual breast exam, etc. etc. In order to call yourself a doctor, there is a list of things you must know how to do and when you specialize, additional items specific to your specialization are added. Abortion services are part of reproductive health services, thus doctors who choose (there’s your freedom, right there!) to go into reproductive health should be required to learn how to perform this incredibly common, safe, legal medical procedure, and medical offices which offer reproductive health care that include pregnancy services, should be required to offer and provide the entire range of pregnancy related care, which includes ending a pregnancy when keeping it is not in the best interest of the pregnant person. No ob/gyn gets to say, “But I object to looking inside vaginas” and keep their ob/gyn license. Likewise no doctor specializing in pregnancy care should be allowed to say they will not help a pregnant woman end an unhealthy pregnancy.

Back in the early days of this nation, abortion was legal. Midwives performed them as part of their standard arsenal of care. It was understood that not all pregnancies were viable. Not all pregnancies were safe. Not all pregnancies would end in the birth of a live child.

Abortion was understood to be a necessary service that kept women healthy, safe and alive – so that they could continue being mothers to any children they already had, or so that they might remain healthy and alive to bear children at another time in their life, or simply so that they could remain healthy and productive in some other capacity – because not all women want to or are able to bear children.

It’s time to get back to seeing abortion as standard medical care. It’s time to take it out of the shadows and bring it back into the mainstream. It’s time to treat reproductive health as essential health. We need to train our doctors, allow nurse practitioners and physician’s assistants to join the pool of people allowed to perform early abortions and administer medical abortions. We need to ensure that anywhere that reproductive services are offered, those services include the full range of reproductive health, including abortion.

Women should not be going to jail because they could not access legal medical services. Women should not be showing up in clinics or doctor’s offices requiring care for botched self-induced abortions. Those days should be behind us, but they won’t be as long as we keep treating abortion care as a fringe medical service, as something rare and dangerous and separate from other standard, basic reproductive health care.



Filed under Naive idealism, Of Course I'm a Feminist, Things that work

Do we really have the right to life?

My one in particular and I had an amazing date on Friday. We drove down to Denver to see a play called Grounded put on by the Boulder Ensemble Theater Company (BETC) – I plan to review it soon, but in the meantime, just buy tickets, it was amazing, thought-provoking, emotion inducing – everything good theater should be.

At dinner and during the drive down, my hubby and I had a great conversation about rights, privileges, social justice, supreme court rulings, equality, equity, freedom, American exceptionalism… You know, the usual romantic date night conversation.

As we were talking my husband put his hand on my knee and said, “I know I’m going into dangerous territory here, but… all of this assumes that we actually have a right to life, and I don’t think we do.”

“Exactly!” I shouted, loud enough to make the car swerve.

Because I’ve had this post, these thoughts swirling for weeks now.

The declaration of independence states that “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” It then goes on to say that the job of government is to secure these rights.

However, our founding fathers apparently found these rights to be so self-evident that as they crafted the constitution, they left them out entirely.

As I’ve been mulling this over – what would a true right to life look like – and my husband and I discussed it in the context of our larger conversation about individual rights and freedoms vs collective responsibility a few things stood out.

First, we clearly do not have a right to life. (And in case you’re new here – I am not using this phrase in any way that relates to unborn fetuses. I am talking about already living, full human beings.)

If we had a right to life then war would ALWAYS be a last resort. If we had a right to life then lethal force would always be a last resort. If we had a right to life then the justice system would not be able to take that right away no matter how terrible our previous behaviors. If we had a right to life, we would also have the right to end our own life on our own terms.

And… If we had a right to life, then the things that are required for life would also be ours by right.

What do I mean? What does a true right to life look like?

When I was a kid growing up my parents told me that humans require three things to live – Food, shelter and clothing.

I would add three more – water, education & health care.

So, if we truly have a right to life then all people would be guaranteed these things from birth until death. Without question.

Basic food, shelter, clothing, education and health care would all be provided and water would be something that people had access to for drinking, cleaning and agriculture long before any industry had bidding rights, or private company claimed bottling rights. And when drought hit, there would never be a question of who got the water, people or profit. People would ALWAYS win. In a recession, no city would be able to turn off its citizens’ water – because water is required for life, and their right to life would be protected by the government as is its job.

“Socialist! Commie! But who is going to pay for it?!?”

And this is the next place that the hubs and I went, because see, it turns out that capitalism and a right to life are inherently at odds with each other. If capitalism’s greatest good is dying with the most toys, then that pursuit of money trumps all else, including your fellow citizen’s rights to life.

trash town

Your trash, their town.

When we claim that a private company has more right to profit than duty to its employees or community (ie; they do not have to pay a living wage, nor do they have to pay taxes to feed the coffers that supplement the poverty wages that they do offer) and hail them as infallible god-like “job creators” instead of labeling them the “takers” and “moochers” that they actually are, we are in truth saying that not all people have a right to life. That some people have more of a right to life than others – which is to say life is a privilege reserved for those who can game the system.

Now, I believe that someone who innovates and takes a risk and starts a business should be rewarded for that – but I don’t think that reward should come at the expense of everyone else.

I do not believe that your right to pursue money should come at the expense of my right to live.

But… I don’t think America is protecting my right to live anymore.

Now, I have lived in a socialist democracy before. It wasn’t perfect. No system run by humans ever will be. But there were some interesting differences.

I remember at first, coming as I did from the USA and being a bit of a Randroid at the time, that I thought what many people here in the USA think, “What a lot of moochers. What motivation does anyone have to do anything, to work, to strive, to create…”

But then… I opened my eyes a little and it turned out that yes, some people took more than they gave (see capitalism above for how this happens everywhere in every system) but all they got was basic food, clothing, shelter, education and health care for it. Nothing extravagant. Nothing that threatened the life or livelihood of their fellow citizens. AND… When I watched a little longer what I saw was that many of those people, I would even dare to say most of them, used that time when it looked like they were just taking to study a craft, learn a skill, hone a talent, pursue a dream, cultivate a passion and then… They gave back. With interest.

It turned out that when they trusted that their life was valued, it freed them up to pursue their happiness – which paid dividends when they succeeded.

What I see happening in America right now is that the takers are taking, and taking, and taking and fighting every effort to require them to give a little back, to pay into the pot either in fair wages, or taxes that would support their workers and communities, or health insurance benefits that would allow their employees to breathe a little bit. I hear phrases like “income redistribution” and “theft” and “involuntary taxation” and worse. I hear a lot of people saying that if someone wants a house/apartment, or healthy food, or basic clothing, or health care, or an education for their children, or WATER, they “should have…” done something more than get one or two full time jobs.

And that tells me that life in America has become a privilege – not a right. Not a right at all.

I remember when I worked and lived in this socialist democracy across the pond, I worked a minimum wage job 4 days a week. Sometimes I put in extra hours at the bar, but only when I didn’t have something better planned for the weekend.

With my income I was able to rent a nice room in an apartment with 2 roommates. I was able to shop for quality food at the grocery store and cook nice meals. I was able to use my three-day weekends to travel more often than not. I was able to purchase both a bicycle and a bus pass to get me around town and the surrounding areas. I was able to go hit the town one night a week with my pals and drink until the bars closed. I was able to buy 2-3 new books every pay-day. And when I got sick, I was able to get care at the hospital free of charge.

Now, granted, I was only taking care of me at the time. I wasn’t trying to raise a family on this wage. BUT… If I had been, I could have skipped the travel and the drinking. I could have relied on the library instead of the bookstore. I could still have had shelter, food, clothing, water, education and health care. On minimum wage.

AND… If I had wanted more than that, I could have worked more, risen up the ranks at my job or looked for other work, or availed myself of the many free educational opportunities to learn a new skill or get the necessary qualifications to work in a different, better paying, field.

It wasn’t like living in a socialist democracy meant everyone had to wear the same brown sack clothes, live in the same brown tenement housing, eat the same brown mush meal after meal… It wasn’t as if no one could pursue their dreams (quite the opposite actually) or that there was no point getting up in the morning, or that hard work didn’t pay, or that you couldn’t pursue buckets of money and mountains of toys. It just meant, There is a social floor below which people can not fall.

It meant that if you were willing to work, you would have the basics covered – and parenting was recognized as work. If you were a parent, the nation would help you to be a parent without presenting you with the false choice of working to pay for daycare (and not much else) or staying home to starve with your children. If you were a parent, you could get help with your housing expenses, food expenses, clothing expenses – and again education and health care were covered for everyone so that you could be a full-time parent if that was your choice. Or you would get help with daycare costs so you could continue to pursue your career while being a parent.

I know there are people who think that America’s welfare system does this, that we have child care subsidies, that we have Medicaid, etc. but I can assure you – what we have is a joke by comparison. Entirely too many working people are falling through the cracks, being forced into bad choices to avoid even worse ones and then being punished for it.

We have broken the social contract, and we have broken our sacred trust to form a government that secures everyone’s right to life, liberty and the pursuit of happiness.

Because if we are all forced to chase our own tails just pursuing access to life – there is no time, no energy, no reserve left to pursue happiness or to exercise our liberty – those “rights” too become privileges reserved for a lucky few.

If we truly want to uphold the intent of our founding fathers, then we must uphold these fundamental rights – the rights we felt were being violated by the British, the rights we went to war for, the rights we founded a nation on.

If we truly want to say we are the greatest nation on earth, then every full time worker in this nation MUST earn a living wage – because YES, even uneducated burger flippers deserve water, food, clothing, shelter, education and health care. Even undocumented immigrants picking fruit in our fields and cleaning our houses and watching our children and doing all the jobs no one else wants to do have the right to the basic requirements of life.

If we truly want to be the greatest nation on earth, then everyone must pay taxes to pay for schools, roads, hospitals, emergency services, parks, social services, and to ensure that the basic needs of all our citizens are being met.

When did it stop being patriotic to pay taxes? When did it stop being patriotic to contribute to the well-being of fellow citizens? When did we forget that we all rely on public services too, public services that cost money? When did we decide that it was the job of private charities to take care of the downtrodden, instead of the job of all of us to look after our own? When did we decide it was more important to make a profit than to live simply so that others may simply live?

When did we decide that life was a privilege?


Filed under Rant