Sunday, August 30, 2009

Long Term Care and Medicaid

An article in today's New York Times tells the story of a woman who was prompted to divorce her ailing husband in order to keep from being bankrupted by his anticipated medical and long term care costs. 

Op-Ed Columnist

Until Medical Bills Do Us Part


Published: August 30, 2009

Click HERE for story


Most people understand that long term care is incredibly expensive, but I don't think they realize just how expensive.  Think in terms of a general range of $60,000 - $100,000 per year, depending on location and services.  In 2008, the average cost for a private room in a nursing home was $76,285, and I use that number because the semi-private rate is not much less.  That's in today's dollars, not adjusted for inflation which will have occurred by the time you need the services. 

People also need to understand that Medicare does NOT pay the cost of long term care.  Let me repeat that: Medicare does not cover the cost of nursing home care.   In 2005, Americans paid $206 Billion for long term care, and amount that does not include any services provided by people who were unpaid such as family members.  

At the present time, Medicare (remember Medicare is not the same as Medicaid) will pay for a lifetime maximum of 100 days of rehabilitative stay in a long term care facility, with three key restrictions.  First, there's a copay of $133.50 per day.  Second, the placement must come after a hospital stay.  Not coming out of a hospital?  Then forget any reimbursement whatsoever from Medicare for in-patient therapy.  Third, the care must be rehabilitative in nature rather than merely care taking.  Not really a candidate for rehab?  Then too bad, so sad.  And after 100 days?  That's the end.  Medicare ain't gonna help you with any other long term care costs. 

Overall, 75% of Americans will need long term care in the future.  There are four ways to pay for costs of that care.  They are (1) out of pocket, (2) long term care insurance, (3) reverse mortgages, and (4) Medicaid. 

Over and over, I hear people using the term "Medicare" when what they really mean is "Medicaid".  Medicaid will pay a limited amount for long term care.  But indivuals are usually sadly misinformed about Medicaid, as well.  They generally have no idea what the real benefits and restrictions are for Medicaid, or what you have to do to qualify for Medicaid. 

To qualify for Medicaid, a person must spend down his or her own assets to poverty level.   And, fundamentally (this is only a broad brush summary), current Medicaid regulations do not allow the surviving spouse to keep enough assets to take care of themselves in their own old age.  This NY Times story tells of a woman who divorced her husband for the purpose of shielding enough assets to care for herself during her own lifetime. 

It is good that the story also mentions the (very important) Five-Year Lookback Rule.  Knowing that people will go to extreme measures to deliberately impoverish themselves in order to qualify for Medicaid, state Medicaid programs will examine all transactions you have undertaken in the last five years prior to your Medicaid application.  If the Medicaid auditors determine that a transaction was done for the purpose of qualifying for Medicaid, they will go after the asset so that it can be sold and proceeds used to reimburse the government for the cost of benefits it paid on your behalf. 

There are special trusts and things that can be done by legal specialists, but the bottom line is that if someone is trying to plan ahead to make themselves eligible for Medicaid, then it is extremely important that they  not wait until there is a need, and especially not until there is a crisis.  Better to do it now, before there is a need even on the horizon. 

You heard me right.  Exactly!  The time to think about this is NOW, when you are healthy and do not have any current need at all.  No matter what your age or health status -- even if you are 20 years old and in perfect health -- make an appointment today with your lawyer to discuss what documents you need to have in place so that your family will not be left destitute in case of a "worst case scenario".


I must add the disclaimer that this blog is for information only, is not intended to give legal advice or create an attorney client relationship, and it should not be relied on for legal or estate planning.  Consult the lawyer of your choice to learn current laws and to discuss your individual needs. 

Friday, August 28, 2009


This has nothing to do with peace or peacemaking, it's just cool new creativity.  The film is old.  Wow, are these guys the original break dancers?!  The music is new, by Crystal Castles, I understand the lyrics are from Ulysses by James Joyce.  What's your reaction?   (post below) ...



I Have A Dream

28 August 2009

Today marks the 46th anniversary of Dr. Martin Luther King's "I Have A Dream" speech, delivered at the end of the March on Washington on 28 August, 1963.  (For text click HERE.)

martin-luther-king on capital mall

This image is from

Dr. King is of course remembered for his role in fighting segregation in the Deep South of the United States.  In that battle against institutionalized injustice, he was one of many voices.  Some of those voices advocated hatred and violence.  A student of Jesus and of Gandhi, King instead chose to lead his people in the way of peace. 

In his Letter from a Birmingham Jail, he wrote: 

In any nonviolent campaign there are four basic steps: collection of the facts to determine whether injustices exist; negotiation; self-purification; and direct action. We have gone through an these steps ... .

The March on Washington was a manifestation of his Direct Action campaign.    

[W]e who engage in nonviolent direct action are not the creators of tension. We merely bring to the surface the hidden tension that is already alive. We bring it out in the open, where it can be seen and dealt with. Like a boil that can never be cured so long as it is covered up but must be opened with an its ugliness to the natural medicines of air and light, injustice must be exposed, with all the tension its exposure creates, to the light of human conscience and the air of national opinion before it can be cured.

MLK hand 494px-Martin_Luther_King_Jr_NYWTS


These two images courtesy of
Wikimedia Commons

Here is a video of the speech: 

(中国人 If YouTube video is blocked, you can see the speech on Tudou HERE, though I guess it doesn't really matter since Blogspot is also blocked in China.)

Thursday, August 27, 2009

Mediation for Elders and Their Families

28 August 2009

I like this blog post on Southern Cross, Inc: What is an Elder Care Mediator . It neatly distills a lot of the issues and challenges facing Elders as they confront the inevitable realities of aging. Elder care management is a complex, confusing maze of big, life changing decisions, and most people only navigate the waters a handful of times in a lifetime (e.g. mom, dad, self). An expert in elder care is familiar with the issues and can suggest positive ways to address them. Though I think I view the role of mediator as separate and distinct from that of care manager, I also completely concur with the value of a mediator to help families navigate these waters. Roles shift, many interests must be balanced, decisions are big and life changing. Previously unnoticed family dynamics may suddenly cause disharmony. Mediation offers the possibility of working through all the issues in a positive, safe environment. It may even strengthen family relationships through the process of building teamwork and positive ways of responding to challenges as elders navigate these deep and sometimes turbulent waters.

Tuesday, August 25, 2009

Using Social Media to Build Local Community, Part II

24 August 2009

"We are caught in an inescapable network of mutuality, tied in a single garment of destiny." Rev. Martin L King, in Letter from a Birmingham City Jail


In my blog entry two days ago (for link click HERE), I used the story of Mary and Martha to urge that social media is not evil and and of itself, but rather that it is a tool which can benefit the larger goal of building community.  I urge that social media, and the activities it fosters, connects people in a way that is unbounded by geographic restraint, thus opening up a vast new range of possibilities in connectedness.  I view people who are focused on "ideas" (and using social media extensively) as being more like Mary, while I view people focused on "necessary chores" (like caring for local church groups, not caring about social media) as being more like Martha.   Rather than resist social media, I urge, leaders in community organizations should consider viewing social media as just another tool in the toolbox for building community both within and beyond our geographic boundaries. 

mary and martha by Jan Vermeer van Delft

Christ in the House of Mary and Martha by Jan Vermeer Van Delft, 1654
located at


Now to my main point:  I hope that individuals and community organizations -- both the Mary's and the Martha's among us -- will take time to learn about the new social media as this continuing drama evolves, and that community leaders will incorporate it for uses that benefit the local and broader community.  I hope that each person reading this -- whether by nature a Mary or a Martha -- will choose some of the "good part" for themselves.  I hope each has some passion that goes beyond whether today's dishes have been washed.  Yet I hope that the Mary's among us will not neglect the dishes.  Social media can be used for both purposes: to nurture and strengthen local community organizations and ties as well as to enter the swirling universe of conversation in ideas. 

Social media enables us to forge deeper relationships with people in our local communities.  By interacting on Facebook, for example, with people in my local community that I may only see casually, I might learn more about them and in that way become more closely connected than perhaps possible through superficial, face to face encounters.  If I want to host an event such as a meeting of a community service organization, I can create an event on Facebook and notify my friends with just a few clicks of a mouse.  This takes a fraction of the time that previously would have been devoted to telephone notifications, which in itself took much less time than mailed invitations.  As the event progressed, I could twitter about it or follow it on twitter.  I could also post videos of the event on a web site such as YouTube and photos of the event on a photo sharing web site such as Facebook or Flickr.  Pastor Boyd of New Life Church (referred to in Part I of this series) says that he is particularly fond of Podcasts.  (For a video showing how to create your own Podcast, click HERE.)  Why don't more community organizations use YouTube and Podcasts?   These tools have "flattened" the earth by making the benefits of media available to amateurs without the need for hiring recording and distributing companies! 

Truly, social media do not replace human relationships.  Of course there are some who use information on the Internet to avoid social interaction.  A person can now live in their home, buy everything online and never go outside, and do all of their corresponding online.  But I hope those are a small minority of people using social media.  For the most part, social media are nothing more than tools in a toolbox for building relationships stronger and deeper.  It's just that nowadays people chat via computer rather than chatting over beer at the bowling alley. 

In my own life, social media has actually enabled me to retain flesh and blood friendships that otherwise would have been lost in this era of transient jobs and a mobile workforce.  My grandparents lived and worked their entire lives in the same community, giving them great stability in their friendships.  Not so for my generation.  Our parents moved us around the country and, after my generation were adults, we moved as well, accumulating and then losing friends as a result of those moves.  Social media enables us to maintain social ties with those from whom we are separated by geographic distance.  I was especially grateful for that when I lived in China, which is the time when I began my China blog as a means of sharing my life with my friends "back home".  

A more recent tool in the social media toolbox is the development of Twitter.  Twitter is being touted as the next generation beyond traditional search engines.  The concept behind Twitter is deceptively simple.  A person can send short messages to people who choose to subscribe to those messages.  But people are doing more with twitter than merely sending messages that say "I'm hungry". 

By using a hash tag (#) in front of a word, people can assign topics to their twitter conversations, and then those hash tags can be searched.  This means that if I am interested in some particular, specialized topic, I can search for it and thereby find someone else who may be "twittering" about that topic.  In this way, twitter enables me to be in contact with people all over the world who are experts in or passionate about the same things I am passionate about. 

I, for instance, twitter on the subject of "peacemaking". Other peacemakers find me by searching for that topic.  If I want to communicate in more depth than 140 characters, I create a blog entry (such as this one) and then post a link on my twitter account to that blog entry.  Any time I don't like someone's posts on twitter, I simply remove that person from my "feed" and I don't receive their posts anymore.  I also block anyone whom I don't want reading or following my posts. 

Now, let's put that all together:  Here on my blog, I have embedded a YouTube explanation by @pistachio about why you should be interested in Twitter.  And for what it's worth, I twitter under the name @xanskinner .  Now I will go on twitter and post a tweet with a link to this page, as well. 

Is this something Jesus would approve of?  In Part III of this series, I discuss the relationship between the local and the online communities. 

Enjoy the video, and think about whether you have something worthwhile that you might like to add to the global conversation. 

Saturday, August 22, 2009

Cash for Codgers Program Announced

Faced with expiration of the "Cash for Clunkers" program, Obama shifts to a program expected to be equally popular "Cash for Codgers" ...

For more information, see Shuck and Jive: The Latest in Health News

Using Social Media to Build Community, Part I

22 August 2009

The Moderator of my Presbyterian denomination recently posted a blog entry called "Top Ten Reasons Church and Pastors Resist Social Media".  His thoughts, and comments left by others on his blog page, are thought provoking.  There is an image of "social media" as being a world where disconnected, alienated, lonely people fail to participate in their local communities.  Instead, this view holds, they do nothing but stare at a computer screen all day and do not interact with other humans.  Is this a valid stereotype?  

What is social media, and is it a good or bad thing?  A pastor of one mega-church,  Brady Boyd of New Life Church in Colorado Springs, Colorado, thinks organizations that fail to utilize social media are making a big mistake.  He says: "Churches have to stay current. We're in the communications business. ... We have to stay informed and we have to realize that most of the world is rapidly advancing in their ability to communicate."  According to the article from which this quote was taken, Boyd thinks that keeping up with new technology in communication is so important that he arranges monthly briefings on it. 

This photo was taken inside the media room of a church I attended in China

I grew up in the days when social media consisted of neighborhood children participating in a TV show produced locally in a studio on Saturday mornings. The latest technology consisted of carbon paper, mimeograph machines, and telephone party lines.   Things shifted a bit over time.  As a young lawyer, when I requested a computer on my desk, other young lawyers in my office warned me that was a bad idea.  They thought that if I typed my own material, I risked being viewed as secretary and not taken seriously in my career.  These concerns were not unfounded.  In the old world order, women were secretaries and only secretaries typed anything.  The secretaries were not happy with me, either, because they saw me as infringing on their turf.  But the earth was moving; an even more drastic change was on the way. 

The "Age of Information" dawned, and with it a whole new level of access to information previously available only in a few places.  Gone were the days of having to go the library and looking through encyclopedias for information.  I remember being astounded to purchase an entire set of encyclopedias on a CD ROM, and then there came the Internet, where I could do a search for anything -- ANYTHING! 

I also well remember how my first LISTSERV subscription opened up a new world of friendships.  I had always been a bit of an eccentric among my local peers.  Internet focus groups enabled me to discover others with similar interests in places as far flung as Washington State, Australia, and Japan.  With these people, I was able to learn, share insights, stories and thoughts, or receive advice about, things my local friends may have thought I was crazy for asking about. 

The availability of information on the Internet did not cause me to abandon my local friends, however!  We are, after all, em-bodied beings.  Internet friendships will never replace our local connections.  We live here and now; we eat and sleep and laugh and cry and hug, and we need connections with people in our home communities.  I treasure my family and local connections.  Those threads and fibers -- my connections to my friends and family -- weave me into the fabric of humanity.  If you are reading this and you feel you have no friends or family in your local community, then that is a wake up call that you need to get out and meet real people and make those connections!  Find activities or causes in your local community that you are passionate about, and pursue those.  You will find others in your local environment that you will build community with. 

I personally think this tension between living in the physical here and now, versus being concerned with ideas and concepts, goes a long way back.  I also think it underlies a lot of the concern people have about social media displacing more valuable and real face to face relationships. 

The Bible tells a story about the tension between the practical and the ideal.  Mary and Martha, two sisters, were friends of Jesus.  When Jesus came to visit them, many guests came to their home to hear him speak.  Mary was so passionate about listening to Jesus that she ignored the physical reality that she had guests who needed care in her home.  Martha, left to do all the cooking and cleaning, was resentful.  Martha asked Jesus to instruct Mary to help her. 


mary and martha by Green

Mary and Martha, painting by

Nathan Green, found at

I wonder if people concerned about social media are, in a sense, like Martha.  I suspect they are concerned that cultivation of relationships based primarily around "ideas" will come at the expense of tending to "things".  Important things, like caring for people who physically exist in close proximity to us and with whom we need to be in community.  These community connections really do matter in the real world -- We need to care for and build up those in our physical and geographically proximate community.  Even if they are different from us, even if they don't share our identical values, and even if we meet those people somewhat by accident. 

The Martha's of the world, perhaps, fear that if we all disappear into our virtual reality worlds of social media, there will be nothing left of the geographically local community.  And maybe with good reason.  In the book Bowling Alone: The Collapse and Revival of American Community, author Robert Putnam documents a shocking decline in participation by Americans in community activities.  Participation in almost every community indicator is down, whether it's voting, public meetings, family picnics, or bowling leagues (which inspired the name for the book).  Church attendance mirrors this larger trend; it is down by 25% - 50% from the 1950's. 

I appreciate the Marthas of the world.  Without them, we would all be hungry.  We'd never have clean clothes.  It really can happen!  Families in the USA have shifted even their eating habits, using kits and prefab ingredients rather than food prepared from scratch.  This summer, I was shocked at how few adult volunteers there were to run our church's vacation Bible school.  The Martha's of the world are frightened that we might leave them to toil alone.  They're afraid our society, already a paper shell like a Chinese takeout box, may collapse from its own weight when everyone is doing takeout and no one is cooking anymore. 

Nevertheless, in spite of these types of concerns, Jesus told Martha, "Martha, Martha, thou art careful,  [anxious] and troubled about many things.  But one thing is needful: and Mary hath chosen that good part, which shall not be taken away from her."  

There will always be challenges involving new technologies.  The question is not whether the technology itself is bad, but rather how will it be used.  The atomic bomb made it possible to kill and destroy on a scale theretofore unimaginable.  But that doesn't mean the atomic bomb necessarily would be used that way.  Tools of technology are still within our control, and it is our responsibility to sort out how to use them wisely.  Today nuclear power accounts for about 20% of the electricity used in the USA.  The potential uses of nuclear power are for good or for evil, and it is up to us to use it wisely.  The same can be said about social media. 

This post CONTINUES.  For discussion of how to use social media, click here: Peaceworks: Using Social Media to Build Local Community, Part II

mary at jesus feet

This painting is by Henryk Siemiradzki (1886) and is found at

Thursday, August 20, 2009

Death Panels: A Surrealist, Paranoid Fantasy of the Christian Right

20 August 2009

art grim reaper

Are Claims Really True That Your Request for Medical Services Under Health Care Reform May Be Reviewed (and denied) by a "Death Panel"? 


A woman named Mary recently called into an AARP-sponsored health care "tele-town hall" with a question for President Obama.  "I have been told," Mary said, in a call recorded on NPR, that under a new health care plan, "Medicare recipients would be visited and told to decide how they wish to die." 

The foundation for Mary's fear is the fact that the health care bill contains a provision providing for doctors to discuss end of life decisions with their patients.  Right Wing Christian Fundamentalists, and the likes if Rush Limbaugh, are using this to fan flames of fear that if you slide down the slippery slope, these could possibly become death panels. I decided to investigate this claim for myself by reading the materials and the Health Care Act. 

I conclude that the claim is so outlandish that it can not be said to have any basis in reality.*  An online source defines "surrealism" as being "an anti-rational [social] movement of imaginative liberation".  The characterization of provisions of the Health Care Bill as leading to euthanasia is so irrational, imaginative, and so far liberated from any basis in fact, that it is fair to characterize it as surreal. 

As a lawyer, and as a person who takes great interest in medical ethics, I think our society needs to do a better job of discussing end-of-life decisions in advance, before it becomes a crisis.  I am offended at the suggestion that asking doctors to discuss end of life decisions with their patients, in advance of need, is the equivalent of advocating euthanasia.  To the contrary, ascertaining a person's feelings about feeding tubes, respirators, and who they would trust to make decisions on their behalf (only in they were unable to make decisions themselves) gives that person more autonomy, more opportunity to direct his or her care.  If anything, it gives more freedom and autonomy to the individual, not less. 

When a person arrives at a hospital unconscious or unable to participate in the decision process, they are placing crucial decisions in the hands of people whom they may or may not know, and whose values they may or may not share.  These circumstances can also place complete strangers in the awkward position of having to make the most personal of decisions for the patient. 

We are not talking about an ordinary emergency room admission.  In an ordinary case, the directive is clear: treat the person so they can recover and live a normal life.  But modern medicine has the capacity to go far beyond this.  Modern medicine can keep a heart pumping when the brain is dead.  Modern medicine can keep a brain alive even when the ability to breathe independently has been snuffed away by injury. Modern medicine literally has at times to ask itself the question, "am I prolonging the process of living, or am I prolonging the process of dying?"  The inquiry is laden with values and how we view ourselves. 

One of my friends declined a brain surgery that would have erased his memory, because he felt that his memory was an inseparable part of what made him the person he was.  Yet another person could, just as legitimately, choose to have the surgery even if they knew it would erase their memories and drastically change their personality. 

Yes, the patient surely ought to be a part of the decision when it comes to medical treatment.  What an advance directive does is to enlighten caregivers and providers about the patient's preferences in advance, to be used at a later time if (and only if) the patient lacks capacity to voice an opinion due to incapacity. 

Sarah Palin is just, plain WRONG:  A Health Care Power of Attorney is NOT the equivalent of euthanasia!  A doctor or lawyer who wants to discuss this with you is NOT the equivalent of a Death Panel.

Indeed, having that conversation -- with your lawyer, your doctor, your spouse -- enables you to enunciate whatever you like about your care.  Your wish may be that you want everything possible done to keep you alive, no matter how invasive, no matter what the prognosis, or no matter what the cost.  That is your personal decision.  If you have a health care proxy, you voice those wishes and your medical providers will respect it. 

Hear me on this:  EVERY PERSON READING THIS NEEDS AN ADVANCE CARE DIRECTIVE!  (If you would like to talk about your planning needs, feel free to look at my legal web site, HERE.)  

Why doesn't everyone have an advance care directive?  Beats me!  Maybe they are as irrational and ignorant on the subject as Sarah Palin seems to be.  I can understand, on one level.  Nobody likes to think of themselves as comatose or critically injured and unconscious.  Nobody finds it pleasant to think of the worst case scenarios, do we?  But in real life, all it takes is one driver talking on a cell phone to swerve into our lane, and the worst case scenario happens.

Terri Sciavo was in her 20's, healthy, and gainfully employed when she collapsed on the floor of her home with respiratory and cardiac arrest.  Fifty years ago, she would have died on the spot, but thanks to modern medical intervention her life was saved.  However, she was left in persistent vegetative state.  Her husband wanted her taken off life support so that she could be allowed to die naturally.  Her parents thought that she was conscious and aware, and they wanted everything done to prolong her life.  Her family was torn apart.  The two "sides" litigated her case in federal and state courts, and in the legislatures and the press for seven agonizing years.  If only this young healthy woman had executed an advance directive when she were able!

In my experience as a lawyer, it is very difficult to get people to face these questions head on.  Even in my own family, there are those who equate creating a will or discussing end of life issues with death itself.  Even in my own family, there are those who have procrastinated for no good reason.  It makes me want to shake them!  Do such people think that if they make no preparation for a storm that it will somehow turn the other way? 

Yes, it's hard enough to prod people to THINK about the worst case scenario types of circumstances that lead to a need for activation of a Health Care Powers of Attorney, or that would lead to probate of their Will.  Unfortunately, death is inevitable and disability is almost a near certainty, especially right at the end.  Procrastination only invites tragedy, because when a crisis actually hits, the opportunity for advance planning has slipped away.  That's when you leave your next of kin saddled with questions and doubts about whether their decisions match what you would have wanted for yourself.  Or worse, when someone you would not have chosen -- perhaps even a complete stranger -- is appointed as your guardian to make the decisions for you. 

As now, as if there weren't already enough mental barriers, the Rabid Right Wing Religious Radicals act like Chicken Little running around exclaiming that "the sky is falling," using this as an excuse to insinuate that mere discussion of these decisions is equivalent to advocating euthanasia!!!   The Chicken Littles of the world -- the extremists who view advance directives as standing on the brink of the slippery slope that leads to mass euthanasia -- argue that if government is interested in cutting costs then by definition a government-paid person will push people to sign on for voluntary euthanasia. 

This is preposterous.  What leads them to think your family doctor is signing on as a secret agent for an evil, vile government?  What kinds of villains do they think actually work in government, anyway?  Surely not people who live next door to you, who shop in your grocery store and attend your place of worship?  Surely not people whom you elected to office?  Perhaps they are thinking, instead, of people who have the same lack of morality or regard for truth that they exhibit when they make these outrageous claims. 

As a Christian I can hardly express how deeply offended I am at the far right for this sort exaggeration and fear mongering.  Indeed, it makes me almost embarrassed to refer to myself as a Christian, out of fear that I might somehow be associated with such insane viewpoints. 

I hope that everyone reading this will understand that they have a need for a HCPOA and will take time to create one if they don't already have one.  While I must insist on the disclaimer that this blog does not give legal advice and certainly does NOT create an attorney client relationship, you may CLICK HERE for a free link to a Health Care Power of Attorney form designed for use in the State of South Carolina.  (To be valid, this form MUST be filled out, then executed in front of a notary and witnessed by two witnesses.)   For a similar form for your state, Google for the term "Health Care Power of Attorney" and list your state in the google search.  Even if you do not execute a document with formality so that it is legally binding, I also suggest that you print out a copy, think in advance and express your preferences about the decisions it asks you to make, designate a person who you trust to make decisions in the event of your incapacity.  Last but not least, discuss your preferences with that person, and tell others in your family who your health care proxy is (so they know who to call in the event of a crisis and so that the person who is your proxy will know what your preferences are). 

Finally, I am not alone in my outrage about these absurd factual assertions.  The claim that the Health Care Bill would result in euthanasia has been called a "pants on fire" lie by the site Politifact, a nonpartisan fact checking service run by the St. Petersburg Times newspaper, which ascertains the truthfulness of campaign and political statements.  Politifact states:  "[A]nother statement making the rounds . . . says that health care reform would mandate counseling for seniors on how to end their lives sooner. We rated this claim Pants on Fire! The truth is that the health bill allows Medicare, for the first time, to pay for doctors' appointments for patients to discuss living wills and other end-of-life issues with their physicians. These types of appointments are completely optional, and AARP supports the measure."  

The Religious Right should be ashamed for fear mongering which takes one splinter of fact (discussion about end of life decisions) and attempts to build that into a case that the government will force euthanization of Seniors by death panels.  I will write later about what an extreme lack of faith this deliberate fear mongering demonstrates:  lack of faith in the democratic process, lack of faith in fellow men, and lack of faith in God.  I truly feel sorry for anyone with such a paranoid and limited world view.  But I am angry that they would seek to impose that view on me, by undermining the democratic process by use of a deliberate campaign of misinformation.  Let's call it what it is:  LIES. 

Have faith.  The world is not coming to an end.  But think about your preferences for care in the event you are incapacitated.  Some day, hopefully not in the near future, each of us faces the possibility that we may not be able to speak for ourselves.  Do everyone a favor, especially yourself, and execute an Advance Directive document today. 


*This blog post is in reference to an article in Christianity Today as well as to articles appearing in the Washington Post.  To verify my facts I also read the pertinent provisions of the Health Care Act currently proposed before Congress. 


Tuesday, August 11, 2009

Saving the Small, Family Farm in America

10 August 2009

Most people in the USA, when they think of a farm, probably think of a farm much like my family's.  Although our farm has been planted in pasture for some time, prior to that the fields were terraced and plowed. 


Regardless of its size, whether 20 acres or 2,000 acres, the main thing (I think) is that most people in the USA think of a "farm" as a place where a family lives and makes a living from working the land.  Unfortunately, one can no longer assume that the food one eats comes from such a farm. 


The big picture is that in the USA, small family farms are becoming extinct.  What has taken their place are huge corporation-owned mega farms.  At some of these farms, for example, as many as 20,000 hogs are housed in one spot.

My personal belief is that if ordinary consumers knew what conditions are really like for animals on these farms, they would never purchase meat produced on them.  The animals are fed hormones and antibiotics that artificially cause them to gain weight faster; but that's not the worst of it.  Rendered parts of dead animals are mixed back into the animal feed, forcing the animals to eat things that God (and their vegetarian digestive systems) never intended. 

Think about it this way:  if the difference in price between the "all natural" chicken and the "ordinary" one is 50%, ask yourself what led to that price difference.  The difference is a monetary quantification of difference in quality between those two animals' feed and living conditions.  That difference in quality also translates into what goes into, and becomes part of, your body.  Do you want antibiotics, growth hormone, and antibiotic resistant bacteria to become part of what goes into your own body? 

For commodity crops like corn and beans, fields on industrial, mega-farms are sprayed with herbicides that kill all plants.  The fields are then sown with seeds from crops that have been genetically modified so that only that the type of seed is resistant to the herbicide.  It is a realistic fear that one of these freak genes may make its way into a weed plant, resulting in a weed that is resistant to all efforts to control it.

These mega farms also utilize only certain varieties of seeds that are grown specifically to optimize production and ship-ability.  Tomatoes and peaches are two crops that immediately come to mind when discussing shipability.  Delicate or unusual varieties such as Georgia Belle or Cherokee, which don't ship well, will never be found in a megafarm.  This reduces genetic diversity of the seed stock, ultimately making the food supply more vulnerable to various blights and diseases. 

It is also argued that corporate megafarms have little regard for workers and communities.  They are highly mechanized and employ as few workers as possible.  Moreover, U.S. migrant worker policy allows corporations with the wherewithal to import alien workers, who are then exempt (to their own detriment) from laws which protect citizen workers.   Industrialized farms treat each worker as one cog in an assembly line, having that worker do the same work over and over again for a low wage.  As such, workers require little training and are more expendable.  These low wage workers also have few protections that were traditionally afforded to workers in other industries.   

Mega farms have the same effect on small time farms that Wal Mart has on its small time business, except that Wal Mart is subsidized by American consumers rather than the U.S.Department of Agriculture.  

U.S.Department of Agriculture subsidies flow disproportionately to megafarms, reducing the production cost of commodities like corn and milk.  As a result partly of U.S. farm subsidies, it's cheaper to buy a fully processed McDonald's hamburger than it is to purchase a wholesome all-vegetable meal grown on the more environmentally friendly, "green" family farm next door.   


That's a gross oversimplification of the situation, of course.  Additionally, it paints the picture with a very broad brush stroke.  Some family owned farms are quite large, and some use sustainable, environmentally friendly agricultural practices (though they are few and far between). 

My main goal here not to provide painstaking detail but rather to paint with a broad brush, get you thinking, and to provide a starting point for further research (if you are interested).  But here is the meat of this blog post, the



One web page (click HERE), states (with supporting footnotes) the following facts:

  • According to the EPA, 3,000 acres of productive U.S. farmland are lost to development every day.
  • Between 1974 and 2002, the number of corporate-owned U.S. farms increased by more than 46 percent.
  • 82% of Americans are somewhat or very concerned about the decreasing number of American farms.
  • 85% of Americans trust smaller scale family farms to produce safe, nutritious food.
  • In the US, the average principal farm operator is 55.3 years old.
  • Between 2005 and 2006, the US lost 8,900 farms (a little more than 1 farm per hour)

A study by U.S. Department of Agriculture which shows the big picture is titled “A Time to Act: A Report of the USDA National Commission on Small Farms,” January 1998 (click HERE).   It recommends specific policy goals as being:

  • Policy Goal 1: Recognize the importance and cultivate the strengths of small farms;
  • Policy Goal 2: Create a framework of support and responsibility for small farms;
  • Policy Goal 3: Promote, develop, and enforce fair, competitive, and open markets for small farms;
  • Policy Goal 4: Conduct appropriate outreach through partnerships to serve small farm and ranch operators;
  • Policy Goal 5: Establish future generations of farmers;
  • Policy Goal 6: Emphasize sustainable agriculture as a profitable, ecological, and socially sound strategy for small farms;
  • Policy Goal 7: Dedicate budget resources to strengthen the competitive position of small farms in American agriculture;
  • Policy Goal 8: Provide just and humane working conditions for all people engaged in production agriculture

Here are some interesting facts from this report:

  • Even though only about one-third of U.S. farmers have participated in Federal farm programs, these programs have historically been structurally biased toward benefiting the largest farms. Farm payments have been calculated on the basis of volume of production, thus giving a greater share of payments to large farms, enabling them to further capitalize and expand their operations. Attempts to place caps on the amount of payments per farm have not resulted in their intended effects.
  • The present system of “transition” payments perpetuates the large-farm bias because the amount of payment is based on historical payment levels. A new risk management tool, “revenue insurance,” also perpetuates a large-farm bias through its provisions of coverage for the few major program commodities with no limit on the amount of coverage provided. Additionally, recent changes in Federal tax policy provide disproportionate benefits to large farms through tax incentives for capital purchases to expand operations. Large-scale farms that depend on hired farm workers for labor receive exemptions from Federal labor law afforded workers in every other industry, allowing them the advantage of low-wage labor costs.
  • Another popular statistic used to describe the structure of agriculture is the contribution of value of production per sales class. Farms with gross sales under $250,000 make up 94 percent of all farms. However, these farms receive only 41 percent of all farm receipts. In other words, out of 2 million farms, only 122,810 of the super-large farms receive the majority of farm receipts.


I have mentioned that industrial agribusiness is very different from small family farming.  A web link which compares and contrasts sustainable versus industrial farming is HERE

And now for what I hope will be the most helpful:



If you're a consumer, purchase in-season vegetables that are produced locally by a small scale producer.  Organic is best.  Ask your grocery store to support local agriculture by selling locally grown goods.  When a sign in your local supermarket says "grown locally," ask them "WHERE?"  (Also, ask your local grocery store to use environmentally friendly packaging materials.) 

It will cost more.  If you think about it, this is one area where you really want to pay for quality.  Would you rather eat food that has been grown on a large, mechanized industrial complex using lots of chemicals at great damage to the environment and to local people or would you rather support your local community in sustainable way of living?   

This leads to another issue.  Good food is expensive.  Ask your local farmer's market to arrange to accept food stamps.  Otherwise, eating healthy will only be an exercise for the wealthy. 


If you are a small farmer struggling to make it, and trying to find ways to stay on the farm, my sympathies are with you.  My personal belief is that the way forward must include educating consumers about the benefits of buying locally produced goods from small family enterprises. 

One successful co-op is Organic Valley Farmer's Cooperative.  Their web site (HERE, and specifically ) gives information about the products they produce and what it takes to join. 


Another excellent web site is posted by the Koinonia community (click HERE ).  This site even has links to videos which may give you ideas about what to farm, practical tips on running a farm, and even videos devoted to how to market your farm products.   


A video worth watching

Last but not least, here is a trailer for a new video about industrial farming, called Food, Inc.   The web site for this video belongs to a group called Hungry For Change.  This is a documentary devoted to showing how "our nation's food supply is now controlled by a handful of corporations that often put profit ahead of consumer health, the livelihood of the American farmer, the safety of workers and our own environment."  I just watched the film, and it is quite enlightening.  If, after seeing the trailer, you would like to see the movie, click  HERE for show times.  

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Monday, August 3, 2009

RIP Corazon Aquino (25 January 1933 - 1 August 2009)

4 August 2009

Today I write to honor the life of Corazon Aquino.  Who was this remarkable woman, that she inspired throngs of mourners to pay respects at her funeral? 


This photo is from today's LA Times online,


In some ways, Corazon Aquino started off life as an "ordinary housewife," though she was never ordinary.  She was born into wealth, educated in the USA, and then married a young and upcoming politician, Benigno Servillano "Ninoy" Aquino, Jr..  In his role as Senator, her husband first became a leading critic and then, eventually, a leader of the opposition to the government of Ferdinand Marcos.  After Marcos instituted martial law in 1972, he imprisoned Benigno for three years, charging and convicting him on trumped up murder charges.  In 1975, Benigno went on hunger strike in protest of the sham trial, but he was convicted and sentenced to death.  Marcos knew, however, that to execute Benigno would elevate him to status of a martyr.  In an arrangement brokered by Jimmy Carter, Marcos allowed the Aquinos to exile in the USA.  In 1983, Benigno, decided to return from exile.  He was assassinated as he exited his plane.  His final statement, which he was unable to deliver, was, ""I have returned to join the ranks of those struggling to restore our rights and freedom through nonviolence. I seek no confrontation."

His wife was allowed to return to the Philippines to manage the funeral of her husband.  She became a tireless campaigner and ran for President in 1986.  Amid widespread allegations of fraud, Marcos declared himself the winner of the election.  What happened next changed not just the history of the Philippines, but the history of the world. 

Nonviolent Revolutionary

It was the nonviolent People Power Revolution.  Two million people took to the streets of Manilla in nonviolent, prayerful protests led largely by the Catholic church.  The army refused to fire on so many unarmed civilians.  Units began defecting.  A reporter who was present at the time, Al Pessin, stated in an interview,

What he [Marcos] didn't count on was, I think, the bravery of the Filipino people, coming out in the streets and blocking the tanks and blocking the military units and also a few key officers, his defense minister and the vice-chief of the army who went over to the revolutionary side. . . . 

Eventually, Marcos conceded defeat and fled to exile in the USA.  Corazon Aquino represents profound victory for the forces of nonviolent change.  The People Power Revolution demonstrates that nonviolence can work.  At the time of the People Power Revolution, Bob Simon, an anchorman at CBS said, "We Americans like to think we taught the Filipinos democracy. Well, tonight they are teaching the world."[20]

This image is from

After being elected, Aquino still faced many challenges.  Saturday's Washington Post writes,

In her six . . . years in office in the fractious, strife-torn, disaster-prone archipelago, Aquino resisted seven coup attempts or military revolts, battled a persistent communist insurgency and grappled with the effects of typhoons, floods, droughts, a major earthquake and a devastating volcanic eruption. . . .  As she dealt with those challenges, she took pride in restoring democratic institutions that had been gutted under Marcos's 20-year rule. And she presided over a series of relatively free elections, the dismantling of monopolies and an initial spurt of economic growth.

In 1992, Corazon Aquino voluntarily relinquished power after another democratic election.  This, too, was hailed as a victory for forces of nonviolence, setting a precedent for peaceful transition in a country with a history of military dictatorship. 

As Pessin notes in his interview:

But if you look back you could see that the Philippine revolution was one of the first during that period and then it was followed either by revolutions, or democracy movements in other parts of Asia, in Thailand, in Indonesia, as well as in eastern and central Europe as we saw in 1989.  . . .  So, it really was an early model for all of that sort of people power that we saw in the subsequent years.


1991 image of Yeltsin on Russian army tank is from

The People Power Revolution is credited with setting the stage for other People Power movements throughout the world.

The symbols of Corazon's campaign were the color yellow, the power sign of hand held up with fingers upright and thumb extended, and the song Banyan Ko, a song which celebrates the beauty of the Philippine islands and freedom from oppression. 

Here is a version of Banyan Ko from YouTube that includes English captions:

Sunday, August 2, 2009

What is Mediation?

2 August 2009

Mediation is a non-adversarial process in which a third-party neutral assists parties in reaching a negotiated resolution to a conflict.  The mediator does not impose any solution; the parties come up with their own solution.  This leads to greater satisfaction as well as greater compliance with the terms of the mediated agreement. 

The goal of the mediator is to facilitate communication between the parties, maintain order and civility, focus the parties on the real issues, and to inspire the parties to generate and agree on options that meet all interests.  To achieve this goal, the mediator must be a skilled communicator, trusted by the parties, assure the parties of confidentiality, and remain completely neutral.  

One article describing mediation states, "the mediator is primarily a "process person," helping the parties define the agenda, identify and reframe the issues, communicate more effectively, find areas of common ground, negotiate fairly, and hopefully, reach an agreement. . . . The key [to successful mediation] is the ability of the mediator to create a more productive discussion than the parties could have had by themselves."

When parties submit to having a solution imposed by an outside arbiter, such as a judge or arbitrator, one often ends up as a "winner" and the other as the "loser".  Mediation allows a greater and more creative range of solutions than is available to a court.  Parties who craft their own, negotiated solutions, are empowered to focus on their real interests and thereby to find creative ways to meet the needs of both sides.  As a result, the parties are generally happier in the long term. 

Indeed, one benefit of mediation is that it makes it possible for parties to preserve and even strengthen relationships by fostering communication and helping them learn strategies for working through difficult issues.  Thus, mediation is particularly beneficial when the parties must interact on an ongoing basis, whether that interaction is the result of a child custody and visitation arrangement or the result of two tribes linked geographically who must share natural resources.  

Mediation that is primarily focused on working through a particular issue, without any particular concern for preserving an ongoing relationship between the parties, is termed problem-solving mediation.  This is the type of mediation in which two parties to a particular dispute use a mediator to facilitate a settlement of one, particular dispute.   

Transformative mediation, in contrast, is mediation that is primarily focused on enabling parties to build and strengthen a continuing relationship.  Focusing on the building of relationship, transformative mediation helps parties establish ground rules for engagement, teaches positive techniques for communication, and enables parties to communicate and thus better understand all aspects of the conflict they are experiencing.  Even when a solution both parties agree on is impossible, transformative mediation can further peace among the parties by giving them clearer and deeper understanding of the conflict and of each other.