I think, this morning, of the one time I did a major construction project.

Back in the very early 1970s, we bought a package including a concrete slab and the framework and materials for a two-car garage, and I spent the better part of a summer doing the vast majority of the work to complete the structure. I’m not a carpenter, and it was a great deal of work, but each time I’ve been by that house in subsequent years, that garage is still standing, a testimony to a very good job.

The Health Care Reform Bill passed last night and now nearly ready to begin life is a similar piece of construction: it’s new, it’s not perfect, and it’s not done. But it’s a start.

The big difference between the Reform bill and that garage of mine, is that there’s a gang down the street whose cause in life, now, will be to tear down that frame, and if it can’t be torn down, to make it look like a rotten piece of construction. “Who could possibly make such a stupid decision? Call us in and let us start over, and make a good building.” Of course, these are the same folks fought against the building in the first place, but no matter. “Let us start over and do it right.”

The narrative for the opposition is very simple. I haven’t seen their script, but it is obvious in the rhetoric: suddenly it will be suggested that the evil ones, called “socialism”, have taken over. The research on opposing has been well done. The icky words which resonate with the people who have been taught to fear Health Care Reform will be dragged out constantly. That is how the game is played.

I’ve been through the training, years ago: stay on message; make sure that message is never more than three parts. Don’t allow anyone to divert you from your message.

There is an antidote to the nay-sayers, and that is to go, and stay, on the offense.

It is not enough for us to be spectators in a TV drama. We need to learn about what is going on, and participate.

We can start by keeping in mind that every single Republican – every single one – voted against the Reform initiative, this over a year from the inception of the debate. We are not a country that is that polarized. The Democrats who voted against the initiative for their own reasons probably better reflect the diverse views of the country than the Republicans who simply represent a monolith of NO.

Health Care Reform is not an ideological hate phrase. Rather it is an absolutely essential (and long overdue) move in a better direction. It won’t be perfect, and its every imperfection will be pointed out ad nauseum.

In my opinion, there are two constituencies who will be most courted to be against Health Care Reform, and they are a very odd couple:

1) They will be the senior citizens, like me, who will be made to feel that their Social Security and Medicare is at risk (it is not.)

2) And they will be the young, healthier people who cannot conceive of ever needing insurance, and don’t want to pay insurance premiums. In a sad sense, I was once in their shoes. “Been there, done that” 1963-65 (note Story #1).

Both groups will be courted on the premise of individual rights as opposed to responsibility to the greater good – to the society of which they are a part. Little things will be left out of the story: like the absolute requirement for people who own cars to have insurance; or the massive positive benefit of Medicare to senior citizens in this country – a benefit which should be shared with everyone.

There will be other segments as well, but these are the two I’d watch.

Teaching Nuns at Sykeston ND ca 1960

In the weeks just past the Catholic Hospital Association and a coalition of Catholic Nuns, leaders of their orders, basically changed the conversation on the Health Care Reform legislation by coming out in support of the Health Care Reform proposal which passed tonight.

On the other hand, the Catholic Bishops and Rome didn’t have a particularly good week last week.

I’m a lifelong Catholic, and an active one. Personal circumstances years ago have made me a pro-choice Catholic. I spent my first six school years in Catholic grade schools, and in the years since I’ve had some great friends who are, and who were, Sisters. I offer my own thoughts, from my own experience.

Statistics indicate that perhaps one-fourth of the population of the United States might be Catholic. I’m always intrigued by this statistic: I wonder how they arrive at these numbers.

But, assuming that it’s true, three-fourths of the population has no reason to care or understand how the Catholic Church works. Most Catholics don’t either. I’ve had an interest in the topic for years, and even after years of seeking, I have only an imperfect understanding of the topic of “the Church”.

Nuns – also called Sisters, and Religious – were a huge influence during my growing up years. They were our parents during the school day, if we were attending Catholic Schools. We lived with them, in small towns and large. They are the stuff of legend.

I never had a bad experience with Nuns (nor with Priests, but that’s a different story). Nuns were our every day teachers, counselors, disciplinarians. They were powerful people, in our eyes. So we remember them. They never had easy conditions. They had large classes, often more than one grade, and I don’t recall one of them being sick – at least no calling in sick!

Priests were not nearly as visible or as truly influential (they don’t appear in my title for a reason). Altar Boys (one of which I was in my youth) had a closer connection. The mysterious Bishop was the real “father”, who came by once a year for confirmation, and one time in one’s adolescence a kid might have a personal moment with the Bishop, when the Bishop asked some softball question about the Catholic Catechism. The Pope and Rome were a picture on the wall: in my day, it was Pope Pius XII.

In Catholic Hospitals, it was the Nuns who were the “boots on the ground” folks. In most cases they established and staffed the hospitals, and helped them grow into pillars of thousands of communities in this country and others. Hospitals and Catholic Nuns are virtually synonymous everywhere.

Without Catholic Nuns, there would not have been Catholic Hospitals; nor would there have been Catholic Schools. Nuns are largely elderly now, and they’re not being replaced. There are good reasons for this; when they are no longer around, they will be missed. Four of my great Nun friends have died in recent years; a fifth, near 90 now, no longer knows who I am. It is sad.

I’ve had extended conversations with Nuns from time to time over the years, and what is apparent is that the assorted orders of Nuns, while generally obedient to the Bishop and thus to Rome, are not necessarily subservient to the dictates of their local Bishop.

In the case at issue, health care reform, I think the tipping point for the Nuns was finally reached where the leaders of numerous orders of Catholic Nuns, as well as Catholic Hospitals, could no longer stay below the radar, and felt a need to speak out in favor of what was plainly needed by our society.

The Bishops took a strident and rigid position on a single aspect of the reform question, and allied themselves with others taking a strident position.

This led to a significant parting of the ways. For most of history, the orders of Nuns have stayed in the background, silent, doing their jobs. There could be an illusion that they were completely obedient.

(At times during the civil rights movement, they also violated the rules by participating in civil rights marches in the south, while the local Bishop specifically prohibited their participation. But this is one of the few times they’ve taken an overt stand.)

No one questions the respect for life these Nuns have.

For that matter, those of us who are pro-choice equally respect life.

I write and will publish this post before I know what Rep. Dennis Kucinich says this morning. Except for correcting the usual punctuation and grammar maladies that affect an amateur writer, the content will remain identical. Any new content will be in a specific update.

Barring unforeseen calamity’s, Mr. Kucinich will have the spotlight on himself. It is a most desirable position for a politician.

Depending on what he says, and depending on the point of view of the person or constituency which wants to know his position, he will be a hero, an unsung hero, a goat, or irrelevant. (The unsung hero status will be reserved to his enemies, who hope he says heroic things advancing his own ideology, which can be useful to kill his objective on health care reform.)

Propaganda under any of its names (“spin” is a very common one) is always fascinating. I have been an amateur student of propaganda for many years, dating back to teaching junior high kids about advertising tactics in the late 1960s, to being an intended victim of propaganda in the early 1970s, to being formally taught about it in later years. I know how propaganda works, and how it feels.

Of course, speculation is rampant about what Kucinich will say. Whatever he says, doubtless partisans on all sides have primary and alternative messages already prepared, and roll them out, instantly.

As to the actual vote, whenever it happens, and whatever it is called, and however it happens, nobody knows absolutely for sure how it will go, since a number of Democrats are playing coy with their position. Last night Ezra Klein of the Washington Post observed that this is the normal lying that happens in advance of an important vote. This is the time, members reason, to attempt to extract this concession or that as the price of their vote. It is something of a dangerous game but it is just another proof that just because some legislator carries a label of this party or that, he or she is a free agent, hopefully voting correctly for a majority of his/her constituents as measured in the next election.

Rep. Kucinich is just one of 535, only with a little more spotlight at the moment, and a little more risk.

My personal prediction: Kucinich will say he’ll vote yes, but with a probably long list of expectations and demands. Health Care Reform Round One will ultimately pass House and Senate, and will be shown to be a major (if inadequate) improvement over what is, and will be a platform for future modifications.

Round Two is the November election, and we the people will be asked to decide our future course. My bet is that enough of us will respect the results of Round One, and the risks taken to pass it, that we will not choose to go back to the good old days.

Now I’ll see if I can find out what Kucinich said this morning…I publish at 10:06 a.m. CDT. Update will include a comment about the recent Michele Bachmann anti-Reform rallies in St. Paul and Washington.

Part I, yesterday’s post, turned out to be a very positive experience. The exam revealed nothing worthy of note – the next appointment in five years. Everything was very efficient and the five medical staff who worked with me were very friendly, from the person who checked me in, to the doctor who did the procedure. The bill, when it comes, will be paid by someone else. All I’ll see is the basic paperwork.

I was apparently the doctor’s last appointment of the day. We rode down in the elevator together and chatted. He’s been a specialist for over 25 years. Not always do procedures go so well. Part of his reality, he said, is the need to deliver sometimes very bad news to patients….

Yesterday’s appointment was at a hospital on the bank of the Mississippi River in Minneapolis. Over 44 years ago, July 24, 1965, at another hospital on the other side of the river, less than a mile from where we were visiting in the elevator, I personally encountered the bad news side of medicine when my then-wife died late at night of kidney disease. She was only 22. We were uninsured. Hers/Ours was the second story I wrote in what has turned out to be a long series on Health Care Reform.

That night I left the hospital – I was there by myself – and went to the local Western Union office in deserted downtown Minneapolis, and sent telegrams to relatives in California, telling them of her death.

My wife had received outstanding care in 1965, but it was to no avail. And we had no insurance.

The very last thing on my mind that night in 1965 was how I’d pay the medical bills. I had a year and a half year old son; three days earlier I’d signed a teaching contract for the fall, so I had a job upcoming, in a town and metropolitan area I’d never lived in or near before. But all those details wouldn’t hit me until a few months later.

First, my car broke down early in the fall. When you have money, no problem. I didn’t. Problem. I needed a functioning car to get to work – both jobs.

In October, 1965, it finally hit me that I would have to file bankruptcy, and I prepared the balance sheet for an attorney (a copy of which I still possess). Succinctly, almost all of my debts were medical bills from one place or another; those debts were almost four times my then-teacher salary.

Not long after that, I got very lucky. North Dakota Public Welfare agreed to pay the largest portion of the bill, which amounted to two-thirds of the total that I owed; and our last local hospital – a community hospital -forgave our bill there. Suddenly the remaining bills became at least manageable. I was lucky because I couldn’t even establish with certainty that we were legal residents of North Dakota. Somebody had to bend some rules.

Life went on, and now I’m at today.

I’ve lived, literally, in both worlds of American Medical Care – the present one where, at least in my case, care is assured and largely paid for; and the one where care is accessed only at some unseen person or committees whim.

In both worlds, the care was and is excellent: I have huge respect for medical professionals. But there was a world of difference.

There is absolutely no excuse for today’s situation where medical care is a privilege and not a right for all; where we engage in endless debate about who qualifies for health care. We have our policy priorities mixed up.

I think that a very substantial part of today’s American medical system – probably a substantial majority – agrees with me on that.