Tuesday, July 19, 2011

Liberty, death panels, and school funding

The following may seem a bit disjointed, but I have been thinking a lot lately about social obligations and how we can function best as inherently social creatures. Increasingly, I find myself seeing and wondering about a certain selfishness that has infected our society. I find the libertarian focus on personal liberty above all other values to be, at its core, selfish. I see the narcissistic inability to empathize or to appreciate other points of view as a pathological self-centeredness.

Don’t get me wrong: I’m an American, and I know from living abroad just how unusually individualistic our culture is. I was raised to kowtow to no man, to feel free to express opinions that might be unpopular or even considered treasonous in a less open society. As a typical American, I find it difficult and constraining to cater too much to the sensitivities of others—as, for example, the Japanese routinely do, to a point that seems ridiculous and dysfunctional to people not raised in that culture. They are so careful and indirect and overly polite that it can be impossible for a non-Japanese person to figure out what they are trying to say.

I am much more forthright, and I treasure the personal freedom my culture provides. But I also think our society is going downhill as more and more of us refuse to acknowledge that we are a society—that we have social bonds and obligations that do and should trump personal prerogatives. It feels as if the line between freedom and responsibility has moved too far, as if we no longer owe anything to others.

Oddly, these musings were prompted by a lot of reading about out-of-control medical costs, about our pursuit of longer lives—if not immortality—at nearly any cost. I am well-acquainted with the costs, since my late husband fought a very expensive fight with Stage IV cancer for nearly three years. I still feel uncomfortable with the magnitude of those expenses, even though their cost to society for a man in his fifties is likely outweighed by all the years of retirement and Medicare expenses that will no longer be required for him. In the midst of the fight, I made the decision to pay for expensive magnetic resonance spectroscopy scans that were not covered by the insurance we were fortunate to have. These were just (four-figure) scans, mind you, not treatment. I was so desperate to know whether the regular scans were showing tumor progression or radiation necrosis in his brain that I was ready to mortgage the house (and my own future) to find out.

So, I have an idea of how hard it is to make rational decisions about how much medical treatment is too much. And, take my word, we definitely crossed that threshold at some point. No one should have to die the way he eventually did, and death is not actually the worst thing that can befall a person. What this means is that I am more receptive than most to the notion of controlling access in some objective way to the most expensive medical interventions. Not all deaths are premature. Not all are preventable. Some delays are not ultimately worth the cost even to the one whose life is prolonged.

Yet we cannot even talk about this in a rational way. Some call this notion, of limits to care, “rationed care” or “death panels.” I think of it more as a way to talk people down from our irrational fear of death. No matter how many resources we pour into the problem, the mortality rate for humans will always remain 100%.

And we aren’t simply afraid of death. Perhaps even more, we fear incapacity, pain, and indignity. Many say their ideal would be to live life at full bore and then die suddenly and painlessly. But, if we did not have to face the slippery slope of diminishing capacity, would we ever accept death at all?

I am past 60 now, and I know how limited horizons wonderfully concentrate the mind. I am conscious of having finite time to make a difference in the world, to leave a legacy of some kind, to perpetuate myself somehow through good works. Would I feel the same urgency if the signs of my own mortality were not creeping up on me?

Now, finally, let me bring this back to matters of education. One sure path to perpetuation—of values, beliefs, traditions, collected wisdom, even hopes—is to have children. And spawning them is not enough. We must nurture and educate them, pass on our best habits and values, and point them toward the possibility of transcending our own accomplishments. That is our true immortality.

And to live on in that way, we must sometimes put our children before ourselves. This applies both to our personal families and to our collective children, since they pick up the baton from us as a community and carry on after we’re gone.

Even before we’re gone, we will depend upon them to police our streets, provide our medical and personal care, run our organizations—and maybe even support the charities that support us in old age and infirmity. Even the childless among us must count on younger generations to keep society running smoothly for our benefit.

The stunning rise of child poverty, both nationwide and in our own community, indicates that we are not nurturing this generation as we should. Statewide, the proportion of children under 18 living in households with incomes below the federal poverty level rose 36% from 2000 to 2008. Some 31% of Michigan children’s parents lacked full-time work, which certainly explains the poverty. Our state is now lumped in the “most poor” quartile along with the traditionally impoverished Deep South and Appalachian states. And it seems safe to assume that the proportion of poor children has increased further since 2008.

Census figures from the 2005–2009 American Community Survey estimate that 12–20% of children in the western part and 20–30% in the southern part of the Van Buren Public School district live in poverty. Poor children have more needs to be met when they arrive in school, but we must do that with fewer resources every year. Per-pupil funding has increased by the grand total of $100 over the past eight years—an average of 0.17% per year.

So, I ask you: are we fulfilling our obligations to future generations? Are we preparing them properly to replace us? Are we leaving a legacy to be proud of as we bow off the stage?