Posts Tagged ‘Obama’

20 March, 2010

Healthcare in America as it is in Sri Lanka

starry-nightI was born in a country usually described by those subscribing to the dominant paradigm of development as being poor and developing. Year after year, beginning from first grade, in our classrooms both public and private (we have a national curriculum), we learned mathematics, reading and writing, but also world history. We studied world civilizations, cultures, economic foundations, imports, exports and religions. We learned of most things as facts, only questioning choices – within political systems, for instance – when we reached the senior classes. There was, however, one thing that it would never have occurred to a Sri Lankan student to ask: Do American have the same access to health care that we do here?

In order to ask such a question, Sri Lankans would have to be suffering the same deprivations that Americans suffer today. They would also have to take it as a given that health care is something that is not commonly provided to all but, rather, reserved for a few. In the absence of those realities, no Sri Lankan child could conceive of a society where people are routinely denied medical care, where children remain un-vaccinated, and where the elderly perish because they cannot afford to visit a doctor. They would have to imagine a milieu where parents must decide between food and medicines, between dead-end employment with health care v. fulfilling work without health insurance, and between taking care of a sick parent and going into debt, or setting those parents adrift and saving for their children’s future. Indeed, they would have to conjure up a way of living that was routinely, relentlessly, psychotically preoccupied with the dread scepter of sickness rather than the much more joyful activity of the conduct of life.

Sri Lankans cannot do that. While I have joined this American life where all of the above have become my reality, every single one of my countrymen in Sri Lanka continues to enjoy first-class medical treatment in hospitals which provide it to them entirely free. Should a Sri Lankan not wish to avail themselves of free medical care, they have the option to visit a multitude of private hospitals. The same caliber of physicians serves at both. After a free education, Sri Lankan doctors are required to serve in public hospitals. They are also free to engage in private practice so long as that fundamental requirement – giving back to the country what it has given to you – is met. The decision of a patient to go to one or the other depends upon the patient’s idiosyncrasies; I have wealthy friends who have preferred to give birth in a shared dorm in a public hospital rather than in a private room at a fee-charging medical facility, my father vacillates between one or the other.

Yes, it is not perfect. Last time I checked, they do not have the capacity in Sri Lanka to separate twins sharing hearts or lungs. They do not have the Childrens’ Hospital of Philadelphia (CHOP), they do not have Memorial Sloan-Kettering. What they do have are the kinds of services, including advanced care services, which are pertinent and ought to be accessible to 99.9% of human beings. And what they do have is a society where should a particularly specialized form of medical care unavailable in the country be required by one of its members, citizens will routinely donate the funds necessary to send that patient overseas. It’s a lot cheaper to chip in the equivalent of about $5 to help a fellow-citizen about once a year than to live as we live (and die), now, here in America.

We are here today on the brink of a vote on making health care substantially more compassionate than it is currently is in America. It is a day that dawns with one of the last independent hold-outs from the left, Dennis Kucinich, deciding to make possible what is possible rather than wait for what will forever be denied. It is a day that alters the fate of three close neighbors, all of whom are professionals with doctorates and halves of two-income families in one of the wealthiest suburbs in America, who are trying to make ends meet without health insurance. They aren’t poor people, they have jobs; nonetheless, they cannot afford health care in this country. What then of the millions of others struggling with neither wealth nor employment? Which reminds me of a few words spoken on January 20th, 2009, in Washington DC by a new President:

“For as much as government can do and must do, it is ultimately the faith and determination of the American people upon which this nation relies. It is the kindness to take in a stranger when the levees break; the selflessness of workers who would rather cut their hours than see a friend lose their job which sees us through our darkest hours.”

This will, hopefully, be the end of that darkest hour for Americans. It is an hour that has lasted for more than five decades. Surely it is time for the leaders of this country to recognize their obligation to their fellow citizens. Surely one of the wealthiest nations in the world can finally do for its people what one of its poorest has done throughout its history.

26 April, 2009

Obama’s DC

I should have written this while I was still sneezing among the dogwood, tulips and cherry blossoms, but DC has a way of taking up all available space, time and mind and I have a way of dancing to the music…

I was in the area for a multitude of reasons: community building, political advocacy, book promotion, policy wonkishness (I am, quite possibly one of the few individuals who actually listened to the Clinton impeachment hearings in real time), much of which coincided with the amazing South Asian Americans Leading Together (SAALT) 2009 Summit.

During the course of the last three days I met with a variety of senior staffers from the new administration including those from the Department of Homeland Security, Speaker Nancy Pelosi’s office, the white House offices of Public Engagement, Intergovernmental Affairs, and Management & Budget. Having lived in DC in the past, and worked in the American national and international non-profit sector as well as the Federal government, what was most illuminating to me was the transformation of the way in which the business of governance is being conducted. To a person, the officials with whom I met, described a process where listening was giving precedence over talking, where partnership with community leaders was valued above the dictating of regulations, and where the underlying precept is that policy ought to be informed by the expertise of the people who are working in the field rather than implemented in an environment devoid of consultation. Even more staggering was the revelation that the new administration was committed to “preemptive strikes” whereby the problems that crop up in the field can be brought to lawmakers and solutions negotiated before they became poisonous enough to require lawsuits.

And all this transmitted to us by a sea of faces that in color and gender and sexual orientation reflects the awesome diversity of the nation itself. It is true, I suppose, that a country gets the leadership it deserves, and that such leadership is deserved only by a populace willing to do the work of bringing it to being.

Describing the best part of their jobs, the various White House personnel gave us a snapshot of a president as accessible as he is inspiring, but the words of Christina Tchen, Director of the White House Office of Public Engagement, were particularly evocative:

“Everything you saw in him on the campaign trail is true. His is the amazing marriage of a brilliant mind and the power of the office. He is always the most intelligent and the most thoughtful person in the room. He listens, and when he disagrees, it is with the utmost respect of the person with whom he is disagreeing.”

I will have to write more about the conference itself in another post, but for now I will have to simply say that my delight – in discovering, in person, that the change I worked to make possible in my corner of the country, is coming to fruition – was tempered by the fact that the State Department lead by Hillary Clinton, the Senate Foreign Relations Committee chaired by Senator Kerry and the Sub-Committee which deals with Sri Lanka, as chaired by Senator Casey, is yet to make a statement that is cognizant of the reality on the ground in Sri Lanka. It seems particularly jarring to me that a president who is known for his desire to know all the facts before he speaks is letting these bodies do the exact opposite. To have people who have never visited the conflict zone in Sri Lanka, or spent any reasonable length of time traveling within the country, put out press releases that run counter to the facts, unpleasant though they may be to take, is a deplorable repetition of the arrogance of the administration they replaced. I would have thought that in light of a new push into Afghanistan, the Obama administration would be more circumspect than that, and that the NYT or the the Washington Post would have had the guts to say what the Washington Times did, just this morning.

Lord knows that I did my best to get the offices of both Casey and Nancy Pelosi to agree to facilitate a multi-ethnic discussion within the Sri Lankan diaspora here. So far, campaign finance contributions appear to have ruled harder than civic engagement, commitment to America’s progress and place in the world and ideological support. Then again, the night is still young. There is such a thing as a learning curve. Perhaps this, too, will pass. I’ll keep y’all posted.

The Books:

The Books:

On Sal Mal Lane

In the tradition of In the Time of the Butterflies and The Kite Runner, a tender, evocative novel about the years leading up to the Sri Lankan civil war.

A Disobedient Girl

A Disobedient Girl is a compelling map of womanhood, its desires and loyalties, set against the backdrop of beautiful, politically turbulent, Sri Lanka.


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