Recall from Part One the World Health Organization ranking of health care systems chart. The United States clocked in at #38. On a recent cruise around the Baltic, my wife and I had the opportunity to take shore excursions in and around the cities of Amsterdam, Sassnitz-Rugen, Riga, Tallinn, St. Petersberg, Helsinki, Stockholm and Copenhagen. Here’s another article/chart you might find interesting.
What an incredible trip! Because I was interested, I talked to locals in different Baltic cities about their health care systems. It was in the late afternoon in the library of the cruise ship during a group discussion among about twenty international seniors of Andersen’s The Ugly Duckling, that the ugly duckling was mentioned as a metaphor for Obamacare in the United States.
In the morning, when the wild ducks rose in the air, they stared at their new comrade. What sort of duck are you? They all said, coming round him.
He bowed to them, and was as polite as he could be, but he did not reply to their question. “You are exceedingly ugly,” said the wild ducks, “that will not matter if you do not want to marry one of our family.”
Poor thing! He had no thoughts of marriage, all he wanted was permission to live among the rushes, and drank some water on the moor. After he had been on the moor two days, there came two wild geese, or rather goslings, for they had not been out of the egg long, and were very saucy. “Listen, friend, said one of them to the duckling, you are so ugly that we like you very well. Will you go with us, and become a bird of passage? Not far from here is another, in which there are some pretty wild geese, all unmarried. It is a chance for you to get a wife; you may be lucky, ugly as you are.”
“If Obamacare costs more money and provides worse health care, well isn’t that just exceedingly silly?” an English lady said in a British accent at the book club meeting. “The NHS in Britain has three core principals. One, that it meet the needs of everyone,” she spoke slowly and clearly. “Two, that it be free at the point of delivery.” She tilted her head sideways just a little. “And three, that it be based on proper clinical need, not ability to pay.” She raised one eyebrow slightly.
“And do zey tek care of zee oogly persons, zee deformed ones, zee old ones?” a seventy-something French woman quipped and made a funny face. Several people chuckled. “Well, we are talking about zee ergly dockling, no?” She asked, smiling.
“Ja, ve sent all de oglee Yermans to Amerika,” the big German said. “Har, har! Obama ees an oklee donkey.”
“Pop, Pop,” sounded in the air, and the two wild geese fell dead among the rushes, and the water was tinged with blood. “Pop, pop,” echoed far and wide in the distance, and whole flocks of geese rose up from the rushes. The sound continued from every direction, for the sportsman surrounded the moor. The blue smoke from the guns rose like clouds over the dark trees, and, as it floated away across the water, a number of sporting dogs bounded in among the rushes, which bent beneath them wherever they went. How they terrified the poor duckling! He turned away his head to hide it under his wing, and at the same moment a large terrible dog passed quite near him. His jaws were open, his tongue hung from his mouth, and his eyes glared fearfully. He thrust his nose close to the duckling, showing his sharp teeth, and then, “splash,” he went into the water without touching him. “Oh,” sighed the duckling, how thankful I am being so ugly; even a dog will not bite me. And so he lay quite still, while the shot rattled through the rushes and gun after gun was fired over him. It was late in the day and all became quiet, but even then young thing did not dare to move. He waited quietly for several hours, and then, after looking carefully around him, hastened away from the moor as fast as he could. He ran over field and meadow until the storm arose, and he could hardly struggle against it. Towards evening, he reached a poor little cottage that seemed ready to fall, and only remained standing because it could not decide which side to fall first. The storm continued so violent, that the duckling could go no further, he sat down by the cottage, and then he noticed that the door was not wide in consequence of one of the hinges having given way. There was therefore a narrow opening near the bottom large enough for him to slip through, which he did very quietly, and got a shelter for the night. A woman, a tomcat, and a hen live in this cottage. The tomcat, which the mistress called, my little son, was a great favorite; he did raise his back in her and could even throw out sparks from his firm if it were stroked the wrong way. The hen had very short legs, so she was called Chickie short legs. She laid good eggs, and her mistress loved her as if she had been her own child. In the morning, the strange visitor was discovered, and the tomcat began to purr, and the hen to cluck.
“I just don’t think that’s very funny,” said an older American lady who had introduced herself as a former librarian. “We should not make fun of people, especially the handicapped, the deformed or the ‘oogly’ as you call them.” She was staring at the French lady. “Obamacare certainly IS an ugly duckling.” Her old neck flapped a little as she spoke with conviction. “But we intend to kill it before it ever has a chance to become a swan.” She had a mean look on her wrinkled face. “The lesson of Ugly Duckling is that our perceptions of a person can change over time.” Long pause. “No one is perfect except Jesus Christ.” She was very serious. “He was reborn. That is the message.” The group got very quiet. “I’m very serious,” she said. The mood suddenly became tense in the room.
“Bloody aborigines are ugly, and they get all sorts of handouts, yeh,” said an old Aussie. I couldn’t restrain myself and chuckled out loud.
“Ha ha.”
“Buggers have noses splayed across their faces.” He put his hand in front of his face and opened his fingers away from his thumb. Several of the assembled seniors laughed.
“They get government money because their ugly?” I asked, laughing.
“That is racist,” the old librarian shouted.
“I’m just sayin’, mate’” he said in Australian-accented English, looking at me and then his wife who looked back at him scornfully. Several people chuckled.
“Abort the ugly ones, eh” the ancient Canuck said.
“Excuse me, abortion is murder,” the old American librarian said, attempting to eschew her emotions. “Life begins at conception.” She opened her purse and dug for a tissue. There was a box on a table. I got up, retrieved the box and offered her one. She withdrew a tissue.
“If you please,” the English lady said. I held out the box to her. She also withdrew a tissue. I set the box on a table, then sat back down.
“Thank you,” she sobbed.” Her husband, sitting beside her, glowered then spoke slowly and deliberately. “Abortion is murder. Life DOES begin at conception,” he said solidly. “Who are we to play GOD?” he paused. “Obama is a socialist. Socialism is evil” I could tell he had offered this opinion many times in many previous venues.
Careful vaht yew say olt man,” the big German said. “Yew not een Amerika now.” His wife, the old librarian, sniffed, then dobbed her nose with the fresh klenex.
“God said thou shall not kill,” the American man said directly to the big German.
The old French woman looked at the elegant Finnish woman, demurely.
“What is that noise about?” said the old woman, looking round the room, but her site was not very good; therefore, when she saw the ugly duckling she thought it must be a fat duck, that had strayed from home. “Oh what a prize!” she exclaimed, “I hope it is not a drake, for then I shall have some duck’s eggs. I must wait and see.” So the duckling was allowed to remain on trial for three weeks, but there were no eggs. Now the tom cat was the master of the house, and the hen was mistress, and they always said, “We and the world,” for they believed themselves to be half the world, and the better half too. The duckling thought that others might hold a different opinion on the subject, but the hen would not listen to such doubts. “Can you lay eggs?” she asked. “No.” “Then have the goodness to hold your tongue.” “Can you raise your back, or purr, or throw out sparks?” said the tomcat. “No.” “Then you have no right to express an opinion when sensible people are speaking.” So the duckling sat in a corner, feeling very low spirited, till the sunshine and the fresh air came into the room through the open door, and then he began to feel such a great longing for a swim on the water, that he could not help telling the hen.
“What an absurd idea,” said the hen. “You have nothing else to do, therefore you have foolish fancies. If you could purr or lay eggs, they would pass away.”
“But it is so delightful to swim about on the water,” said the duckling, “and so refreshing to feel it close over your head, while you dive down to the bottom.”
“Delightful, indeed!” said the hen, “why you must be crazy! Ask the cat, he is the cleverest animal I know. Ask him how he would like to swim about on the water, or to dive under it, for I will not speak of my own opinion; ask our mistress, the old woman – there is no one in the world more clever than she is. Do you think she would like to swim, or to let the water close over her head?”
“Dat ees shtoopid,” the big German said. “Yesus iss fairy tale, like dat Hans Anderson story about the oklee doklink. Der Bible say Yesus born from vir hen. Hah,” he shouted. “Maria wasn’t vir hen, she was married tew Yuseph. Yew tink Yuseph not bumpsen mit hees Frau?”I chuckled.
“Dat ees shtoopid,” he said loudly. The big man was turning red. “Yew tink Yesus came back from dead? I tell you this; no persons come back from dead.” “Ja, yew woot know aboot dat, sure,” the old elegant blue-eyed Dutch lady said to the large German. Several tense moments passed.
“Anyway,” I said, breaking the moment. “The little ducklings are like the different forms of healthcare in different Baltic countries.”
“Oh mein Gott,” the big German said.
“You don’t understand me,” said the ugly duckling.
“We don’t understand you? Who can understand you, I wonder? Do you consider yourself cleverer than the cat, or the old woman? I will say nothing of myself. Don’t imagine such nonsense, child, and thank your good fortune that you have been received here. Are you not in a warm room, and in society from which you may learn something? But you are a chatterer, and your company is not very agreeable. Believe me; I speak only for your own good. I may tell you unpleasant truths, but that is a proof of my friendship. I advise you, therefore, to lay eggs, and learn to purr as quickly as possible.”
“I believe I must go out into the world again,” said the duckling.
“Yes, do,” said the hen. So the duckling left the cottage, and soon found water on which it could swim and dive, but was avoided by all other animals, because of his ugly appearance. Autumn came, and the leaves in the forest turned to orange and gold. Then, as winter approached, the wind caught them as they fell and whirled them in the cold air. The clouds, heavy with hail and snow-flakes, hung low in the sky, and the raven stood on the ferns crying, “Croak, croak.” It made one shiver with cold to look at him. All this was very sad for the poor little duckling. One evening, just as the sun set amid radiant clouds, there came a large flock of beautiful birds out of the bushes. The duckling had never seen any like them before. They were swans, and they curved their graceful necks, while their soft plumage shown with dazzling whiteness. They uttered a singular cry, as they spread their glorious wings and flew away from those cold regions to warmer countries across the sea. As they mounted higher and higher in the air, the ugly little duckling felt quite a strange sensation as he watched them. He whirled himself in the water like a wheel, stretched out his neck towards them, and uttered a cry so strange that it frightened himself. Could he ever forget those beautiful, happy birds; and when at last they were out of his sight, he dived under the water, and rose again almost beside himself with excitement. He knew not the names of these birds, nor where they had flown, but he felt towards them as he had never felt for any other bird in the world. He was not envious of these beautiful creatures, but wished to be as lovely as they. Poor ugly creature, how gladly he would have lived even with the ducks had they only given him encouragement. The winter grew colder and colder; he was obliged to swim about on the water to keep it from freezing, but every night the space on which he swam became smaller and smaller. At length it froze so hard that the ice in the water crackled as he moved, and the duckling had to paddle with his legs as well as he could, to keep the space from closing up. He became exhausted at last, and lay still and helpless, frozen fast in the ice.
“What about old age. What happens to old people that have no money? Does the government pay for their health care?” I asked the group.
“Zees also ees free, Ja sure” the elegant Finnish lady said. “Vee tek ker uf old ones; even eef dey haf no munees. Whut abowt in US? How err de old ones cared fur eef dey haf no munee?”
“Well, family is important in the United States,” the old librarian spoke up. “Families take care of their own. And we have churches,” “We also have Medicare and social security, although in Texas, our Governor is bucking Medicare, thank God. Social security is a form of socialism.”
“Yew mean he is bucking bronco?” the big German said. “He not bucking bronco, he oklee donkey. Har, har!” The big German was amused. “He ees goot Texas cowboy. Har, har”
“Crikey, that’s a good one” said the old Aussie, laughing. “We’ve got our homeless in ‘Stralia, too, we call ‘em swagmen, like in the song.”
“Zee song?” The French lady asked, smiling.
“Yeh, Waltzing Matilda,” he quipped. Then the old Aussie, his wife, and another old Aussie couple started singing:
Once a jolly swagman camped by a billabong
Under the shade of a coolibah tree
And he sang as he sat and he waited till his billy boiled
You’ll come a waltzing Matilda with me.
Everybody joined in on the chorus, except the old librarian and her husband who looked perturbed.
Waltzing Matilda, waltzing Matilda
You’ll come a waltzing Matilda with me.
And he sang as he sat and he waited by the billabong
You’ll come a waltzing Matilda with me.
After the singing ended, everyone clapped. No one spoke for a few seconds.
Remembering the story of Waltzing Matilda, I asked the group,“Should sick old people be allowed to end their lives?”
Nobody said anything. They just looked at me for a long few seconds. Finally the elegant old Finnish lady spoke: “I tink de goobermen chood allow pipl tyew end der lifes eef dey want tyew, Ja sure.” She looked at me with captivating blue eyes.
All the international seniors except for the librarian and her husband, nodded their heads in agreement and said, “Ja, ja, yeah, sure, I agree.”
Early in the morning, a peasant, who was passing by, saw what had happened. He broke the ice in pieces with his wooden shoe and carried the duckling home to his wife. The warmth revived the poor little creature; but when the children wanted to play with him, the duckling thought they would do him some harm; so he started up in terror, fluttered into the milk-pan and splashed the milk about the room. Then the woman clapped her hands, which frightened him still more. He flew first into the butter-cask, then into the meal-tub, and out again. What a condition he was in! The woman screamed, and struck at him with the tongs; the children laughed and screamed, and tumbled over each other, in their efforts to catch him; but luckily he escaped. The door stood open; the poor creature could just manage to slip out among the bushes, and lied down quite exhausted in the newly fallen snow.
It would be very sad, were I to relate all the misery and privations which the poor little duckling endured during the hard winter; but when it had passed, he found himself lying morning in a moor, amongst the rushes. He felt the warm sun shining, and heard the lark singing, and saw that all around was beautiful spring. Then the young bird felt that his wings were strong, as he flapped them against his sides, and rose high into the air. They bore him onwards, until he found himself in a large garden, before he well knew how it had happened. The apple-trees were in full blossom, and the fragrant elders bent their long green branches down to the stream which wound round a smooth lawn. Everything looked beautiful, and the freshness of early spring. From a thicket close by came three beautiful white swans, rustling their feathers, and swimming lightly over the smooth water. The duckling remembered the lovely birds, and felt more strangely unhappy than ever.
“I will fly to those royal birds,” he exclaimed, “and they will kill me, because I am so ugly, and dare to approach them; but it does not matter: better be killed by them then pecked by the ducks, beaten by the hens, pushed about by the maiden who feeds the poultry, or starved with hunger in the winter.”
Then he flew to the water, and swam towards the beautiful swans. The moment they espied the stranger, they rushed to meet him with outstretched wings.
“Kill me,” said the poor bird; and he bent his head down to the surface of the water, and awaited death.
“The story of The Ugly Duckling is NOT good for kids,” the old librarian said. Everyone looked at her. “It teaches that beauty is a thing to be rewarded. The ugly duckling became beautiful because he was a swan. He was regarded as handsome by the other creatures. That is like saying that if you are born handsome or pretty, that you will have more opportunities in life; that you will get a better job, get promotions, have more friends,” she paused, “go to more parties.” Her words trailed off. She began to well up again. “I just think that sends the wrong message. Just because you are born pretty, doesn’t mean you are better.” sniff “All men are created equal in the eyes of the Lord.”
“Obamacare attempts to make all Americans more equal,” I said. “And even though it is not the same as universal health care, like northern European countries have, it is a step in that direction. Right now, the emergency rooms are flooded with ‘oogly’ people; people who don’t have insurance; dark skinned people, people from Mexico, black people. Someone is paying for that. Indeed, WE are paying for that. What about basic health care for everyone?” I could feel my heart rate quicken. I looked directly at the librarian’s husband.” If Hillary becomes President, there WILL BE universal health care. That’s what you guys are afraid of.” The international seniors stared at me.
“Obamacare should be DEfunded,” the librarian’s husband retorted, then stood up. “And if we have to shut down the ‘gooberman’ to do it,” he said, mocking the elegant Finnish woman, “then SHUT IT DOWN.” He was visibly shaking with anger. His wife grabbed a tissue in a flash of pique as they marched out the library door. Nobody spoke for a few seconds.
“Oh spare us, eh,” the Canadian said. “I need a beer.”
“Ja, un beer sounts goot,” the big German said. They strode away together.
“I need to change me clobber for dinner, you coming with me girlie?” the Australian said to his wife as he stood up.
“Cheerio,” the English woman stood up.
“Au revoir,” the French lady said. Everyone stood up and left the library except me, and the Finnish woman.
“Iss there more yew want tyew say?” she asked with serene eyes and a tiny smile.
“No, I think I’m…..Finnish,” I said. She chuckled and gracefully walked away.
But what did he see in the clear stream below; His own image; no longer a dark, gray bird, ugly and disagreeable to look at, but a graceful and beautiful swan. To be born in a duck’s nest, in a farmyard, is of no consequence to a bird, if it is hatched from a swan’s egg. He now felt glad at having suffered sorrow and trouble, because it enabled him to enjoy so much better all the pleasure and happiness around him; for the great swans swam round the new-comer, and stroked his neck with their beaks, as a welcome.
Into the garden presently came some little children, and threw bread and cake into the water.
“See,” cried the youngest, “there is a new one;” and the rest were delighted, and ran to their father and mother, dancing and clapping their hands, and shouting joyously, “There is another swan come; a new one has arrived.”
Then they threw more bread and cake into the water, and said, “The new one is the most beautiful of all; he is so young and pretty.” And the old swans bowed their heads before him.
Then he felt quite ashamed, and hid his head under his wing; for he did not know what to do, he was so happy, and yet not at all proud. He had been persecuted and despised for his ugliness, and now he heard them say he was the most beautiful of all the birds. Even the elder-tree bent down its bows into the water before him, and the sun shone warm and bright. Then he rustled his feathers, curved his slender neck, and cried joyfully, from the depths of his heart, “I never dreamed of such happiness as this, while I was an ugly duckling.”
Sally Belladonna Baggins Stricklett says
I don't know how to take any of this story. I already knew the ugly duckling… and we learned it in school.. probably banned now. I'm not sure if I';m suposed to be persuaded that some government control of health care is good, and that the Americans on the cruise are idiots, or what. I think it's important to stand firm in one's convictions. But that seems to be something not good. Is abortion ok part of the time? Here's what I think. Any time a human is making decisions for someone else, death can happen.
Izzy says
Sally,
Traveling to foreign countries enriches one in so many ways. As an oilfield worker in a previous life, I, like many Houstonians, had the opportunity to live as well as work overseas. Lately, my wife and I are fortunate to travel to wonderful places we only read about or saw on TV.
While traveling to the Baltic in August, I had the opportunity to visit several cities that are often held out as ‘socialist’ or ‘European’ as if that is a bad thing. Let me tell you, if you ever get the chance to visit Amsterdam, Tallinn, Helsinki, Stockholm or Copenhagen, do yourself a favor and go. The people are friendly (and very tall), the weather was great and the history is ever so interesting. I decided to talk to some locals about their health care systems because I am interested. Our health care system in the United States is in transition and this surely turned out to be a conversation starter, not only with the locals, but also on the ship. Somewhere between the Kiel Canal and St. Petersburg I got the crazy idea that Obamacare might just change from something to be mocked and derided to something respected. At about the same time, I participated in a study of The Ugly Duckling in the library on board the cruise ship. Bingo!
As to your point about the Americans on the cruise ship being idiots. Yes, some Americans on cruise ships do act like idiots. However, trust me, there are idiots in every country. There are also thinking people who are willing to listen to other points of view in every country, including ours. Standing firm on ones point of view for the sake of standing firm is a fools errand. Similarly, changing ones view because everyone else does is like building a house on sand….you know the story. Just one more thing; abortion is ok part of the time. The Republicans in the Texas Legislature got that mostly right.
Thanks for commenting.
Izzy
Izzy says
From Ugly Duckling
The transformative potential of Obamacare is not a conservative hallucination. It is the resolution of a confounding dilemma decades in the making. The American health-care system is not merely the only one in the advanced world that’s closed off to a large share of the population; it’s also the most expensive by far. The normal structure of a public problem is that the worse the problem, the easier it is to solve—as traffic gets worse, more people support mass transit; the more soldiers die, the more pressure to end the war. American health care has long defied that dynamic. The worse the problem grows, the harder it has gotten to solve. The more waste and inefficiency that sprout through the medical system, the more of an interest doctors, hospitals, and pharmaceutical companies have in maintaining the status quo. The uninsured are diffuse and disorganized, unable to marshal any substantial political support, and the effect of their plight has largely been to make people with insurance fearful of any change lest they join them.The Affordable Care Act broke through the policy trap by combining solutions to the cost-inflation problem with solutions to the access problem. The medical industry would undergo painful reforms, but in return Washington would supply it with some 25 million new customers.
At the time of its passage, the received wisdom in Washington (and not just among partisan Republicans) deemed Obamacare’s cost reforms pitifully inadequate. “This legislation was supposed to end that asphyxiating growth, which will crowd out investments in innovation, education, and everything else. It will not,” concluded David Brooks. “This bill is full of gimmicks designed to get a good score from the Congressional Budget Office.” The final, negative pronouncement from the professedly sympathetic pundit emblematized the widespread conclusion that Obamacare amounted to well-intentioned but softhearted big-government liberalism.
In the three years since, a steady accumulation of evidence has amassed to the contrary. Through a thousand tiny nudges, the law has transformed the entire medical field from one that encouraged more, and more expensive, care with no regard for outcome into one geared toward paying for quality. Some of the changes have been blunt and simple. The old pay-for-quantity system rewarded hospitals for doing a bad job, since patients who contracted an infection or received poor treatment would come back for more treatment, bringing in a second Medicare reimbursement. Obamacare created penalties for hospitals with high rates of infection or patient readmission. Lo and behold, this year, Medicare announced that its patient-readmission rates fell—“a feat that long seemed beyond reach,” the Washington Post reported.
To Beautiful Swan
these reforms have added up to a revolution in modern medical economics. Health-care inflation since 2011 has fallen to its lowest level in half a century. The Congressional Budget Office estimates of Obamacare’s costs, widely derided at the time of its passage as too optimistic, have thus far proven too pessimistic. The agency has already cut $600 billion off the expected ten-year spending total for Medicare and Medicaid. If the reforms continue to bear fruit, costs will come in even lower.
And health experts increasingly expect the reforms will bear fruit. “The ongoing slowdown in the health-care growth rate defies historical post-recession patterns and is likely to be sustained,” concluded PricewaterhouseCoopers in June. “It appears that the reforms will stick and health-care exchanges and other policies will bring competitive pressure to markets,” says Randall Ellis, a professor of health-care economics. “Although the proof for this point of view is not yet definitive,” reports the Health Affairs blog, “the depth and breadth of change suggest that significant transformation in the nation’s delivery system is under way.” Among health-care wonks, this is no longer a controversial assertion: The evidence thus far suggests Obamacare’s cost reforms are a staggering success.
http://nymag.com/news/features/gop-obamacare-plot-2013-9/index1.html