Exploring Satire

The following was the result of a two part writing assignment. The first part was to produce a satiric proposal along the lines of Jonathan Swift’s “A Modest Proposal” http://art-bin.com/art/omodest.html or Benjamin Franklin’s “Essay on Daylight Saving” http://www.webexhibits.org/daylightsaving/franklin3.html . The second part was to write an analysis of the satire. I realize that this isn’t exciting reading for the masses, but if you like to play with words, you may find it a fun read.

Responsible Health Care Reform for All

Health care reform has been a topic of much debate in the past 18 months, and the passage of new legislation has not settled much. No one seems happy with the new law, believing that it either goes too far, or does not go far enough. I think the real problem is that we are traveling in the wrong direction.

Some of the critics of the new law have used the phrase “personal responsibility” in their arguments, but what they really mean is personal payments. However I would like to reclaim the phrase and make it meaningful. I do believe that a nation with our wealth, education and standing should make sure that health care is available to all of its citizens. I also think we need to take personal responsibility for our health to minimize the costs to our society.

The main argument against a nationalized health system is the prohibitive cost, but this is based on costs in a broken system. What we have is not free-market, laissez-fair economics or anything remotely tied to the regulating forces of supply and demand. For-profit insurance corporations need to recruit healthy people, who have very little health care “demand” to pay premiums which cover the medical costs of supplying their UN-healthy customers. Medical care providers, especially hospitals, need to charge exorbitant prices to the insurance companies to recoup the cost of uninsured patients who don’t pay their bills. People without insurance ignore minor health problems they can not afford to pay a doctor to treat, until the problem grows to something major, landing them in an emergency room where the hospital can not refuse to treat them, even if they cannot pay.

HMO s were developed with the idea that if people had inexpensive access to regular care, they would save money by avoiding costly major treatments caused by letting minor problems get out of control. Insurance companies, with their business experience and the ability to use economies of scale to make low-profit margin care, such as immunizations and check-ups profitable, combined with the wealth of information they held, which by its volume allowed them to do statistical analysis on patient care, populations and outcomes anticipated this as the business model that would revolutionized health care, making it affordable for people and profitable for companies to keep Americans healthy. It seemed like a reasonable argument, but it does not help those who don’t have an HMO and still strain the system, and it makes the insurance company, not the individual, or their physician, the arbiter of care.

We need to shift our focus away from care and toward health and that means personal choice and responsibility. I propose we have a nationalized health system, with initial eligibility determined by residency (much easier to handle than citizenship for those who need to check documentation at the desk). To minimize costs, we need to fall back on some personal responsibility.

I think we can all agree that someone who chooses a lifestyle of abusing illegal narcotics, is not taking responsibility for their health. I think most people would be, not only comfortable, but happy, if they knew their taxes were not paying for a heroin junkie’s AIDS medication, or root canal therapy for meth-heads. I do not propose allowing them to come to the emergency room for “free” care because of a lack of insurance, I suggest they become ineligible for national health care services. Oh, I’m sure that there will be some medical professionals who will hang out their shingles as private practitioners for the very wealthy, more along the lines of boutique medicine, and if the drug addicts haven’t gone through all of their own money, or they have wealthy and/or gullible family members to pay for private care, more power to them. I think all in all this policy will greatly reduce costs for care of drug addicts, neo-natal units filled with crack babies (who will now, not be born in hospitals and thus not burden the whole system with years of intervention and therapies) and will probably do more to win the “war on drugs” than DARE or “Just Say NO!”
Taking that idea of personal choice a bit further, I think it would be fair to exclude all smokers as ineligible. Considering the evidence that clearly shows the health risks of smoking, it is no more reasonable to have tax payers foot the bill for lung transplants, cancer treatments, emphysema care, or even asthma medication for someone who deliberately inhales toxins, than it is to pay for the heroin junkies.

Membership in gangs should exclude one from receiving treatment for violent trauma, gunshots, knife wounds and the like. To be fair, people who choose to indulge in risky behavior, like downhill skiing, racing, skateboarding and other sports which frequently cause injuries such as broken bones, should probably be excluded from receiving care for those clearly avoidable health care calamities.

Let’s face it, no one gets to be 400 pounds by accident. The behavior that causes obesity is a lifestyle choice. Obesity leads to stroke, type 2 diabetes, heart disease, kidney failure and various other health problems. I don’t know anyone who goes out to force strangers to eat Twinkies as Friday night entertainment. It should not be our problem if these people choose to treat a family size box of macaroni and cheese as a single serving. Second graders are taught about the food pyramid so anyone over the age of seven knows they should be eating more fruits and vegetables than anything else Really, how much spinach would you need to consume to require an airlift out of your house because you won’t fit in an ambulance? Cows can’t eat that much!

The policy for sexually transmitted diseases hardly needs to be mentioned. This is clearly an area where responsibility is of the most personal nature. Being responsible about sex isn’t limited to disease of course. Pregnancy and childbirth are a huge part of health care and deserve serious attention. With the drain on the natural resources of this planet, we really don’t need population growth. Everybody should get to make one replacement on the house. I’m sure some people will claim that violates their religious beliefs, if so, let the church foot the maternity bill, or train mid-wives and open a birthing center. Of course, if you have a child in some facility that isn’t part of the national health system, we tax-payers can’t be expected to pay for the health care costs if someone else screws up the birth.

Current technological advances make this an ideal time for people to make really responsible choices about having children, in a way we simply could not have done 25 years ago. We can use pre-natal testing and genetic testing to screen pregnancies and probably, in many cases, couples contemplating pregnancy to avoid children with Down Syndrome and many other congenital birth defects. Just think when we can wipe out cancer and heart disease because we don’t have parents giving birth to children who carry the genetic predisposition! And why should society have to pay for the extensive costs of a child who has a malformed heart or only one lung, when it can be terminated? Parents who choose to raise a child like that clearly need to be cut off.

Critics are going to point out, and it is true, that there are a lot of problems that are not diagnosed until after the child is born, sometimes not until age two or three, but I am confident that improved testing will enable us to catch these things early enough to do something about them and changing our focus to responsible health care will free up money for more research to improve our health screenings.

This, of course, is just a broad outline. Real experts would have to fine-tune the details for situations that are bound to come up. Guidelines need to be in place for those who are told that their cholesterol is high, or other health issues that are not apparent without medical tests. How long does a patient have to take responsible action to correct his behavior before he is ineligible? If he suffers from a heart attack two days after being told he is at risk, I think it fair to cover him, but six months later? That should have been sufficient time to make significant changes. At two or three months, we need the experts to handle those calls.

I may be an optimist, but I predict that within 30 years of implementing these policies, our nation will have virtually eliminated the majority of the problems facing our society today. It is easy to see that gang and drug related crime would essentially disappear, bringing overall crime down dramatically (bringing a huge additional savings in the penal system). Reduced population would mean our school systems wouldn’t be overburdened, producing a better educated citizenry, reduced population would also have to mean lower unemployment and healthier workers would also make for increased productivity, so that should eliminate poverty as we know it. Our nation, being healthier, would walk and bike more, making us less dependent upon fossil fuels and so, more secure. Of course, unless the rest of the world follows our example, we can only stave off the energy crisis, but that may give us the time we need to find a real solution.

As you can see, moving to real personal responsibility will make our nation stronger and healthier while actually lowering the costs of health care for all. There is no denying that this is the solution we have been looking for.

-Concerned Citizen for a Healthy Nation

If one considers the above as something found on an editorial page, there would be individuals wanting to use parts of it as ammunition to “prove” their point. A certain faction would see a new form of “death squad” to scare people away from a comprehensive, nationalized health care system, while their opponents wouldn’t want to claim the whole plan, they would like to tout single-payer systems as a panacea.
Of course, such an essay wouldn’t be likely to appear on an editorial page. This piece is pretty obviously a work of satire. Perhaps there is someone who really would believe in it, just as it is written, but I think that this author is likely to remain a fictional construct, like Franz Liebkind, in Mel Brooks’ “The Producers.” Because Brooks uses so many obvious gags in his movies, from sight gags, to bad puns, to slapstick-style, physical comedy it is easy to overlook subtleties. I do not say that to disparage those comedic vehicles; Charlie Chaplin and the Three Stooges made physical humor into a high art. It is a special kind of sophistication that makes a four year old and a forty-four year old laugh equally hard, at the exact same thing, for completely different reasons.

The obvious joke is Liebkind, not only is he, shall we say schmuck?, enough to have made his literary “magnum opus” a musical, love story about Adolf Hitler, but he is completely taken in when approached by the producers. He sees nothing odd and feels only vindication that his work is finally recognized. The producers, of course don’t believe a word of their hype to him, they have sought out the worst play they could, to guarantee a failure. We, the movie audience, laugh at the unexpected consequences (and financial obligations) of the producers’ when the musical becomes the top comedy on Broadway. Ho, ho, the scam goes awry, how will they get out of this fine mess? Simple, obvious and funny. Liebkind is upset that what he poured his heart into is taken as a joke, and again, we the movie audience laugh, because he’s clearly a fool to have thought his play, a musical homage to Hitler, could be taken seriously; could be accepted by rational, thinking, non-Nazis as other than offensive; could be accepted by hard-core Nazis as other than simpering, pathetic and offensive; could be a success; could be…a Broadway hit? And yet, they, audience in the movie, do all of that, as a comedy and not a love story, but still glorifying Hitler in the heart of a city with a huge Jewish population. Who has really made the foolish assumptions about the play?
So the obvious joke is the author of this essay, Concerned Citizen. This is the kind of thing the right-wing demagogues would write to lampoon the liberals’ and nationalized health care. This is the kind of thing the left-wing elitist, media would write to lampoon the conservatives’ scare tactics. Which begs the question, if Concerned Citizen is accessible to either side as a lampoon, who is really being targeted? As with, Brooks’ work, it is the audience. No matter where a reader stands on the issue of health care, this should feel uncomfortable to read.
Concerned Citizen opens up with the fact that months of arguing have garnered us with legislation that is an example of perfect compromise, everybody hates it. Although, the suggestion of it going in the wrong direction is likely to appeal a trifle more to conservatives, as they were more united in their opposition to the bill. The second and third paragraphs appeal to liberals on several levels, co-opting a conservative catch-phrase, promoting the idea of health care as an obligation of a successful nation to provide for its people, disregard the arguments about cost because they are not valid and it’s all big businesses’ fault anyway. But because our Concerned Citizen mainly makes statements, allowing the reader to make their own judgments and project them back, conservative readers should not be alienated. After all, the system is not working. There are people out there who are taking advantage of loopholes, getting hardworking Americans, (who manage to scrape together what they need to, to pay their premiums and co-pays even if it means their kids don’t get a new bike this year, or forgoing a family vacation) to pay for their emergency medical expenses either through higher fees at the doctor’s office or hospital, or through taxes. Besides, in paragraph four it is clear that Concerned Citizen understands that the insurance companies have been working hard to try to find solutions to these problems, even if it didn’t work out, business has done more than government.
So our Concerned Citizen has managed to bring all parties along, even if there are some reservations, to listen to the new plan. Introducing not, the plan, but a group of undesirables, gives everyone a target. “I think we can all agree that someone who chooses a lifestyle of abusing illegal narcotics, is not taking responsibility for their health.” Who is going to argue that? We aren’t discussing victims who were maliciously hooked on drugs by some nefarious character. We aren’t even including those who abuse totally legal prescription narcotics. And in a nod to ultimate, liberal tolerance, we are not making any judgments about their character or moral fiber. Whether you believe addiction is a disease, a personal failing or a symptom of a decadent society on the verge of collapse, you are not going to argue that habitual drug abuse is an expression of responsible health care, and so you are hooked.
Conservatives are a little squeamish about socialized medicine, but it becomes palatable if we can weed out the undeserving. Liberals can assuage any lingering guilt with the idea that anyone seeking treatment shouldn’t be classified as choosing to abuse, and you can’t really do anything to help an addict until they ask, besides there is still the “out” that they could receive privately funded care. Everyone can wince slightly over the “crack babies” reference, but it might be a misunderstanding, Concerned Citizen just said they wouldn’t be born in hospitals, not “leave them to die in some dumpster or whatever alley their junkie mother gave birth to them in,” and pass right on to “amen, the ‘war on drugs’ is finally going to be over” whether you believe it will be won or the farce will end.
We are currently pretty primed to vilify smokers and it is hard to refute the same argument you supported for junkies, although you may have some doubts, especially if you smoke, after all, cigarettes are legal. You may feel like you are being targeted by this policy and questions of fairness may start to enter your mind. Or it may bring to mind thoughts of people who abuse other legal substances, like prescription drugs or alcohol and how they might be viewed, but it’s still hard to work up a good argument for these folks that does not apply to the heroin junkies, and unless it’s personal for you, why bother?
Gang-bangers and violent criminal are much easier to think about. We aren’t excluding them entirely; if they don’t get into fights, they can have the same health care as anyone else. We can even feel good, because this provides an incentive for them to reform, win-win from either side of the argument. The slap in the face that excludes a fair number of Olympic athletes from medical care for injuries related to their livelihood is likely to catch you by surprise, and the shock that you can’t really justify your urge to give them preferential treatment over gang members using the criteria we’ve established, (if they don’t engage in things like traveling down a snowy slope at speeds in excess of 30 miles per hour, they can be treated for broken bones, like anyone else who may slip in a shower) might stun you enough that you won’t wonder about other high-risk professions, like construction worker, or fire-fighter.
Moving on to the obese will seem like a bit of a relief. Here we have a cut and dried case of choosing unhealthy behavior. A seven year old can tell you that spinach is healthy and a Twinkie is not. Most seven year olds will still choose the Twinkie, because it is a rare child indeed who thinks spinach is the tastier choice. Our culture has done it’s level best to make over-weight shameful, but we are rarely clear about who should feel ashamed of an over-weight child. Should the child feel ashamed? They usually do, though they are not the ones buying the groceries. They may ask, whine or beg for junk food, but I haven’t found any store clerks who will accept their checks. Of course it is the parents who have control, children of that age don’t get to choose whether to get immunizations, or what kind of education they will get, rarely do they have a choice in their sleeping schedule, some aren’t allowed to pick out their own clothes for the day, so, why on earth would we hold them responsible for making sound nutritional decisions? No one wants to talk about fat kids, not even the Concerned Citizen. Do we take care of them through childhood and cut them off on their eighteenth birthday, or write them off in elementary school and let their parents kill them with cookies? What happened to our easy target?
Concerned Citizen brings government into the bedroom, figuratively flips off a majority of religions and promotes eugenics. Franz Liebkind is goose-stepping in a field of flowers and dreaming of HJ rallies. Nobody wants to be at this party anymore. The problem is, no matter what your views were at the beginning, no matter where you fell on the liberal to conservative spectrum, if you were willing to justify excluding anyone, for any reason, to make some human being worth less than another, there is a thread that connects you to this ugliness.
The proposal to have experts fine-tune, and the bureaucratic process it would necessarily engender, topped by the hyperbole of the new world order that would follow this plan, highlight the absurd and make it easy to laugh off as a joke. We would like to forget that we bought a ticket, we sat down and watched it unfold. Does it matter if you walk out during intermission or stay until the end and talk up how ridiculous it is? Controversy and curiosity will spur as many ticket sales as laughter and pretty soon we have the biggest hit on Broadway.
Satire may draw us in with easy laughter, obvious targets of ridicule we can grasp like low hanging fruit, but for it to fulfill its corrective purpose, we must discover we have grabbed a prickly pear, not a Bartlett. Easy laughter should make us wary about what kind of target we are offering in our amusement. There is a reason we have so many cliche’s about people living in glass houses, eyes filled with motes and beams, and what the pot calls the kettle. It is easier to view others critically than it is ourselves. We must take advantage of the mirror satire holds up for us and look closely at what is there.
We can, in our communities, encourage people to make responsible decisions, about lifestyles, health or the world around us, that is the role of the social community. Providing for the needs of a society in terms of infrastructure, which includes adequate health care facilities such as hospitals and clinics, is the role of government. Making sure that all members of society have access to those facilities should be a matter of equal protection under the law. To forget that equality is, at its heart, placing an equal value on all of us, is to forget who you are, which will make looking into a satiric mirror shocking and unpleasant.
When going to a show, remember, no matter what the reviews say, “caveat emptor.”

 

 

 

All rights reserved.  This blog and all it’s contents is the original creation of Jennifer Maher, the author / publisher.  No part of the contents may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission of the author / publisher.

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~ by friendlycurmudgeon on January 9, 2012.

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